3rd/4th year rotations time commitment

[swisschard]

Could anyone tell me what kind of time commitment is involved in the 3rd and 4th clinical years of medical school? I heard it depends on which rotation you're doing. Thanks,
-Wes

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[SurgeryChef]

Could anyone tell me what kind of time commitment is involved in the 3rd and 4th clinical years of medical school? I heard it depends on which rotation you're doing. Thanks,
-Wes

90+ hours/week on Surgery, 70-80 hours/week on IM (except outpatient which is more like 40), 80 hours/week on peds, 60-70 hours/week OB/Gyn, 40 hours/week on psych and 40 hours/week on family. You'll work your butt off - some months more than others. This is all for 3rd year - I haven't done 4th year yet. And those are hrs spent in the hosp or at clinic... put in as much studying time on top of that as you would like and you could literally devote your ENTIRE existance to medical school. But you have to prioritize -you can't know everything, so take breaks when you can and you'll learn more when you're on the job.

 

[quideam]

80 HOURS per week for PEDS?!?!?! Wow, I don't know where you did your rotation, but at my school, it's about 8 hours per day plus 24 hour call every 4 days... so around 60 hours per week max..... !!

 

[Magnus67]

90+ hours/week on Surgery, 70-80 hours/week on IM (except outpatient which is more like 40), 80 hours/week on peds, 60-70 hours/week OB/Gyn, 40 hours/week on psych and 40 hours/week on family. You'll work your butt off - some months more than others. This is all for 3rd year - I haven't done 4th year yet. And those are hrs spent in the hosp or at clinic... put in as much studying time on top of that as you would like and you could literally devote your ENTIRE existance to medical school. But you have to prioritize -you can't know everything, so take breaks when you can and you'll learn more when you're on the job.

Wow, Surgery Chef must go to school in a little known place called HELL. Not all schools are this bad, and honestly I don't know why you need to be at the hospital/clinic more than 40 hr per week as a med student, 3rd year you need to read almost a much as you need clinical experience. JMO.

 

[SurgeryChef]

No joke, those are the hours... they work us hard, and much of our grade comes from clinical evals. It's not hell, certainly better than studying all the time. Don't know where y'all go to school and no disrespect, but I thought everyone had to work as much as us... We pretty much work the same hours as the interns on many rotations (with a few less calls). I can see one difference immediately. We take 30 hour call - I've rarely gotten out post-call before 2pm - sure it's q4, but multiply ~2 calls per week and you're at 60 hours right there. And you're saying you work "9 to 5" other days - not where I come from. You get to the hosp at 6:30am on peds and leave around 5pm (if you're lucky).

 

[Duckie24]

Sounds like it is very school dependent. Our more time intensive rotations are IM, Surgery, and OB/GYN, with the last being the worst at my school. Family Med, Psych, and Peds are less hours here, but our Peds call makes the weeks long since it is the only rotation that requires midweek 30 hour call days. Every other service has night float so even when we are on call, we are done by 9PM.

I was surprised this year at how hard it has been to study outside of the hospital. The days are pretty long and it is hard to motivate to do the reading after getting out of the hospital. Finding the time to read is key, however. Learning from patients is great, but I've found that more time reading correlates to better shelf exam scores....for me anyway.

 

[Hurricane]

Our peds is like that. At least 80 hours. If you count class time, more like 90. Our children's hospital is one of the largest in the US, and so the general service is very busy and the residents have no qualms about scutting you out. Not to mention they're into this "patient oriented" business, so every day on rounds we have to go to every patient's room (usually 25-35 kids) as a group and discuss the labs and treatment plan in detail with the parents. Took for-freakin-ever. The 4th year electives in the peds subspecialties are great, but the general service sucked the life out of me.

Outpatient peds was awesome though. I got paired with a preceptor who took Wednesdays off, so I did too.

But like someone else said, it's school and location dependant. For example OB/GYN is awful at our university hospital and the large catholic hospital. But I was out at a community program, where I learned a lot, but was working something closer to a 40 hour week.

 

[Mman]

Wow, Surgery Chef must go to school in a little known place called HELL. Not all schools are this bad, and honestly I don't know why you need to be at the hospital/clinic more than 40 hr per week as a med student, 3rd year you need to read almost a much as you need clinical experience. JMO.

You don't know why you need to be in the hospital more than 40 hrs per week as a student? Maybe so you aren't scared quite so much as an intern when you start pulling 30 hr shifts, q3-4 call, and 70-100 hr work weeks. Let's just say that as an intern, I'm very glad that I had some tough rotations as a student to learn from. Got to watch how the interns/residents handled difficult situations and how they operated as efficiently as possible. It's stressful being a student when you are always trying to study and get recommendations and what not, but it's at least not stressful in that you don't have to make the tough decisions at 3 AM with patients crashing all over the place.

 

[Magnus67]

You don't know why you need to be in the hospital more than 40 hrs per week as a student? Maybe so you aren't scared quite so much as an intern when you start pulling 30 hr shifts, q3-4 call, and 70-100 hr work weeks. Let's just say that as an intern, I'm very glad that I had some tough rotations as a student to learn from. Got to watch how the interns/residents handled difficult situations and how they operated as efficiently as possible. It's stressful being a student when you are always trying to study and get recommendations and what not, but it's at least not stressful in that you don't have to make the tough decisions at 3 AM with patients crashing all over the place.

I guess everyone's perspective and situation is different. At my school there are no residents/fellows etc. It goes from the attending to Med Student, so there is very little true scutwork, so will you are there you are acting basically as a resident. A lot of days in IM I would do an admission H&P, order labs and imaging, come up with a therapeutic plan and then have the attending sign it. Not every situation is like this of course.

The reason I say that reading is just as important as clinical experience is how are works. For example a patient dumped gas over his head a lit it. I come to the ER and my surgery attending asks me what we should do, because I read a lot of surgery trauma a couple weeks before, I could walk myself through pertinent abcde's and recite the Parkland equation for burn fluids. That is entirely do to my attendings philospophy that "after your 7-8th lap chole, go read instead. You'll get more out of it." Instead of doing paper work or holding the camera for lap chole number 57, I learned some really important info for an unforgetable case.

It is really interesting to hear how things are different at schools around the country. I put in a 95 hour week during surgery and got zero reading done. just ate dinner and went to bed. Hats off to you people that can pick up a book after a busy 12 hour day.

 

[angel80]

In my school, Surgery, IM, inpatient Peds, and Ob/Gyn were the most time-intensive. Surgery, IM, and Peds had Q4-5 overnight call (and in surgery, they pointed out that none of the ACGME rules applied to students, so instead of 30 hour call, it was more like 34-36 hours). Ob/gyn had no overnight call, but we had 12 hour days during the week, and would have to come in on one of the weekend days to round. We also had one week of nightfloat on that rotation. Basically, in 3rd year, I had to work as much as the interns worked. In FP, outpatient Peds and Psych, it was more like 40 hours a week without any call or weekends. Outside of the time spent in the hospital, we also had to read up on our patients and study for the Shelf exam (which is pretty much impossible to do during surgery).

4th year, on the other hand, is a breeze. My school only requires 3 rotations-sub-I, EM, and an Ambulatory month. I did my sub-I in IM. I was doing Q5 overnight call, working about 75-80 hours a week. EM was easier-because it is essentially shift work, I worked about 40 hours a week (although the rotating shifts messes up the sleep cycle, and in essence, gives you less free time than you thought you would have). Ambulatory medicine is a breeze; my preceptor only made me come two days a week. The rest of 4th year is at your discretion. You can make it as easy or difficult as you want. During 4th year, the only exam we had was for EM, so you don't have to study nearly as much as you do during 3rd year. You spend a good amount of your time preparing your ERAS application, interviewing, etc.

 

[PhillyGuy]

You don't know why you need to be in the hospital more than 40 hrs per week as a student? Maybe so you aren't scared quite so much as an intern when you start pulling 30 hr shifts, q3-4 call, and 70-100 hr work weeks. Let's just say that as an intern, I'm very glad that I had some tough rotations as a student to learn from. Got to watch how the interns/residents handled difficult situations and how they operated as efficiently as possible. It's stressful being a student when you are always trying to study and get recommendations and what not, but it's at least not stressful in that you don't have to make the tough decisions at 3 AM with patients crashing all over the place.

But you are a student. You shouldn't have to do more scut work than necessary. I guess my hours are much better than most of the people here. Peds was probably the lightest one for me. I get in at 7 and I'm usually out by 3. We take call with our intern every 4 days, but we only have to pick up one to two patients so we can present to the attending the next day. So I would get out around 5-6 when I'm "on call." Even Medicine wasn't so bad. It's q4, but like peds we only stay to pick up a patient, then we are done. I'm pretty slow, so I would normally stay until 10'ish (which is when we are supposed to be out of the hospital), but one the other days, we would get out anywhere from 1 to 5. We don't have any call rooms for students, so we are not allowed to take overnight calls for any rotation.

 

[kaos]

90+ hours/week on Surgery, 70-80 hours/week on IM (except outpatient which is more like 40), 80 hours/week on peds, 60-70 hours/week OB/Gyn, 40 hours/week on psych and 40 hours/week on family. You'll work your butt off - some months more than others. This is all for 3rd year - I haven't done 4th year yet. And those are hrs spent in the hosp or at clinic... put in as much studying time on top of that as you would like and you could literally devote your ENTIRE existance to medical school. But you have to prioritize -you can't know everything, so take breaks when you can and you'll learn more when you're on the job.

Yep, that sounds about right.

 

[angel80]

I don't consider overnight call "scut work." Sure, it's no fun having to do it, but if you have a good intern, he or she can teach you so much while you are on call. When it came time to do my IM sub-I, I already had a good idea of what to expect as far as getting paged from the nurses and how to handle them, and I was able to handle all of the nurses and crosscover pages. There are usually more "code blues" during the night as well. Also, when I did surgery, we had a lot of trauma come in during the middle of the night (inner city Detroit), which was always interesting to see, and you could end up spending the whole night in the OR trying to fix those patients up. In ob/gyn, it seemed as if more babies were born during the night than during the day. I also had to go to the OR a couple of times in that rotation (once for a ruptured ectopic, and once for a ruptured TOA. As much as I detested overnight call, I think that it was definately worthwhile for a student to stay the whole night. When I start my internship in July, it will be much easier for me to deal with overnight call. Also, I've found that on rotations where you have to take call as a whole team, it builds comraderie.

 

[swisschard]

I am really tempted to ask which schools you guys attend! I'm thinking about the UC system... can anyone give me answers on schools over here in California? Thanks again,
-Wes