What can we do as a student in 4th year rotations and residency?

[cool_vkb]

I saw this serial yesterday where there will be a 4th year medical student who will be diagnosing patients and other stuff and basically acting like an independent doctor. Does this happen in real life?

What is the scope of a student during his 4th year rotations and in residency. I mean in rotation what exactly do we do and in residency what exactly do we do. Iam not asking about the length of training but just what procedures a 4th year student can do and as a resident one can do.

Ofcourse when we begin residency we are already physicians.What is a typical day during 4th year rotations and then is residency like a continuation of 4th year rotations with more indepence and more responsibility or its totally different game. And what about surgery. Do we get do major surgeries (like on real patients) during our rotations or we get our first hands on experience during residency.

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[dpmgrad]

I saw this serial yesterday where there will be a 4th year medical student who will be diagnosing patients and other stuff and basically acting like an independent doctor. Does this happen in real life?

What is the scope of a student during his 4th year rotations and in residency. I mean in rotation what exactly do we do and in residency what exactly do we do. Iam not asking about the length of training but just what procedures a 4th year student can do and as a resident one can do.

Ofcourse when we begin residency we are already physicians.What is a typical day during 4th year rotations and then is residency like a continuation of 4th year rotations with more indepence and more responsibility or its totally different game. And what about surgery. Do we get do major surgeries (like on real patients) during our rotations or we get our first hands on experience during residency.

During your fourth year, you will have the opportunity to enhance your didactic knowledge and clinical skills as you rotate through various hospitals for your externship and your clinical rotations at school / core rotation site. As a fourth year student, you will be given the opportunity to work up the patients and present your findings and assessments to residents or attendings. At all time, you will be treating patients under the direction of the resident and/or attending physicians. You will be seeing patients in clinics, on the hospital floors, etc... You will also have the opportunity to observe or scrub into cases during your externships. The amount of stuff that they allow students to do will depend on how comfortable the attendings / residents are with you. Majority of the students will either observe or just retract during surgical cases or some skin suturing. Sometimes, students may get to do some of the smaller procedures skin to skin. Of course, the attendings and residents will have expected you to read up on the surgical case and be prepared for questions.

During your residency training, you will be responsible for evaluating and treating patients under the supervision of an attending physician. You will be responsible for evaluating and developing an assessment and treatment plan for the patients and running it by an attending physician (however, this is not always the case). In surgery, you will be able to scrub in on the case. Depending on how comfortable the attending physician is with you and how experience you are, you may either just retract and suture skin or get to part of the case or get to do the entire case. Remember, scrubbing into surgery cases as a resident and doing stuff in surgery is a PRIVILEGE. The attending physician is ultimately responsible for the patient. If the attending physician is not comfortable with your skills or knowledge, do not get offended if the attending physician does not let you do much during a surgical case.

 

[cool_vkb]

Remember, scrubbing into surgery cases as a resident and doing stuff in surgery is a PRIVILEGE. The attending physician is ultimately responsible for the patient. If the attending physician is not comfortable with your skills or knowledge, do not get offended if the attending physician does not let you do much during a surgical case.

So like when do we exactly do an own independent surgery. I mean if we havent done entire surgery independently during residency then will the new graduate be confident to do his first ever surgery directly on his own patient with no other podiatric physician to guide him if something goes wrong. If he does some independent surgeries during his residency then he would be like confident to do surgery later on his own patients after he graduates. I thought its like car driving. First few classes the driving instructor guides us and then later we drive on own independently with the driving instructor sitting on side just watching us. before getting the license.

 

[dpmgrad]

So like when do we exactly do an own independent surgery. I mean if we havent done entire surgery independently during residency then will the new graduate be confident to do his first ever surgery directly on his own patient with no other podiatric physician to guide him if something goes wrong. If he does some independent surgeries during his residency then he would be like confident to do surgery later on his own patients after he graduates. I thought its like car driving. First few classes the driving instructor guides us and then later we drive on own independently with the driving instructor sitting on side just watching us. before getting the license.

You will never do your own independent surgery during residency. At all times, you will be working under the guidance of an attending physician. An attending physician may let the resident do the entire case but the attending physician is usually around to make sure that nothing goes wrong. Remember, these attendings are responsible for the patients. The only patients that some residents may claim to be their own are usually patients from free clinics. Even then, they are still treating patients under the guidance of some attending. If you do enough of certain procedures, you will be confident in doing those procedures.

 

[NatCh]

So like when do we exactly do an own independent surgery.

That happens when you are in practice. Even then, when you are new to a hospital chances are you will be proctored. That is, since you are new on staff and the hospital doesn't know you, they will require that an established doctor observe you doing a few cases before you are permitted to work without observation.

Often the Proctor will show up some time after you have prepped the case and have already started the procedure. It was a freaky realization for me during my first case out of Residency that all eyes in the O.R. were upon me, and that there would be no Attending to bail me out if necessary. When I walked into the O.R. it was time to start, on my call. Every decision was mine to make. There was no to whom I could turn and ask, "Is this what we want?" I had become the Attending.

Nat

 

[jonwill]

I saw this serial yesterday where there will be a 4th year medical student who will be diagnosing patients and other stuff and basically acting like an independent doctor. Does this happen in real life?

What is the scope of a student during his 4th year rotations and in residency. I mean in rotation what exactly do we do and in residency what exactly do we do. Iam not asking about the length of training but just what procedures a 4th year student can do and as a resident one can do.

Ofcourse when we begin residency we are already physicians.What is a typical day during 4th year rotations and then is residency like a continuation of 4th year rotations with more indepence and more responsibility or its totally different game. And what about surgery. Do we get do major surgeries (like on real patients) during our rotations or we get our first hands on experience during residency.

At many programs that I visited my 4th year, I was instructed to treat my patients independently. If I needed help or didn't know what to do, I was to ask. Surgically, I scrubbed a ton of cases and got to do parts of the case and close quite a bit. I did do some cases skin to skin which was cool.

You'll get to do a lot your 4th year depending on where you go. Some programs turn you loose and some do little more than let you hold the wall up!

 

[NatCh]

some do little more than let you hold the wall up!

When we got to do nothing more than retract (picture holding two Senns), we would call it, "Riding the motorcycle."

Nat

 

[gustydoc]

I just finished my first clerkship as a fourth year student and I got to do two case skin to skin so it was pretty exciting. Sure it was just an MBA and some hammer toes, but it was a lot of fun. Be sure to practice you knot ties and suturing, cause it seems to me that programs use how well you close during your first week as an indicator of whether or not you are ready to do more.

 

[densmore22]

Skin to skin? Not familiar with that one yet.

I got to scrub in w/ the podiatrist that I shadowed this summer. It was fun. Thank God to all the scrub techs and nurses out there that have patience for students learning because I never knew that scrubbing was that complicated.

 

[gustydoc]

skin to skin just means that you did the procedure from incision to closing. Sorry didn't mean to confuse with the jargon. Don't worry, after awhile srubbing just beocomes second nature. The hospital I am at right has the avagard scrub which is really nice and far less time consuming.

 

[Dr_Feelgood]

I cut this guys distal hallux off in office. He had some serious gangrene and under the supervision of residents and attendings, I cut off all of the necrotic tissue I could including bone. Then I admitted him, but could follow it any further due to the fact it was the last day. But you get to do some cool stuff.

 

[PODonny]

Skin to skin? Not familiar with that one yet.

I got to scrub in w/ the podiatrist that I shadowed this summer. It was fun. Thank God to all the scrub techs and nurses out there that have patience for students learning because I never knew that scrubbing was that complicated.

Was it a cool case Densmore?

Also, does scrubbing in constitute participation? I've heard students this summer say they've scrubbed in on some cases and was just wondering if that means they got to really get their hands in there.