3rd year: One facility vs. several

[Red Beard]

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We are ranking our 3rd year tracks this week, and I am trying to choose between going to one city where almost all the rotations are in the same 3 hospital system or going to another city where the locations are at 3 unrelated hospitals plus several other private offices. Students in the latter track complain of having to go through a bunch of orientation and paperwork at the start of each new rotation and a few days of not knowing where anything is. On the other hand, they get exposure to more than one system and may be more adaptable come 4th year when doing away rotations (?)

Location-wise, I'd prefer to be in the city in which rotations are spread out...

Which is better in your opinion?

 

[Mayhem]

Bias alert: I don't really fancy our university hospital, and regret not having more chocies

That said, i'm sure you're not shocked that I'd choose the option with 3 unrelated hospitals. The exposure is a plus but also it's good to know that if you don't like one hospital it's only temporary torture. Besides, looking at the negatives you provided there's not that big of a difference between the choices -- I suppose the orientations and paperwork could be a chore but even if you are at the same hospital whenever you change wards there's going be a few days of not knowing where anything is anyway. My only issue would be transportation, sometimes it can be tricky going between locations.

 

[Law2Doc]

Bias alert: I don't really fancy our university hospital, and regret not having more chocies

I think this is the key. It matters less about the exposure opportunity and more about whether it is a good place to work. If one hospital is not a desirable rotation location for whatever reason, you might be better off with more options.

 

[QofQuimica]

I don't really have much to add to this discussion, except to say that today a doc gave me what had to be the funniest rationale I have ever heard for why I should pick his particular hospital for my rotation in his specialty: he said the faculty write better evals for the students there. Not better as in more positive--better as in, longer and more detailed. I'm still trying to figure out how he thought that would strike me as being an advantage. I probably am going to do that rotation in his hospital for my own reasons, but they definitely do not include the potential of getting a longer, more thorough commentary on my weaknesses. 😛

 

[smq123]

I don't really have much to add to this discussion, except to say that today a doc gave me what had to be the funniest rationale I have ever heard for why I should pick his particular hospital for my rotation in his specialty: he said the faculty write better evals for the students there. Not better as in more positive--better as in, longer and more detailed. I'm still trying to figure out how he thought that would strike me as being an advantage. I probably am going to do that rotation in his hospital for my own reasons, but they definitely do not include the potential of getting a longer, more thorough commentary on my weaknesses. 😛

I know it sounds counter-intuitive, but that doctor was absolutely right.

What every third year student dreads is the "contradictory" eval. There's two varieties:

1) Your attending says that you were a "5/5" but his only comment is that "QofQuimica was a decent student."

2) Your attending says that you were a "2/5" but his only comment is that "QofQuimica was a good student with a good knowledge base."

Both leave you totally mystified. 😡 A more detailed eval would help you understand the rationale behind the attending's choice...or at least give you some ammo when you contest the grade.

The point is, you NEED detailed and thorough evals in order to help you in later rotations. If the attending only comments that you were "fine," or his only critique is that "QofQuimica needs to read more," then you have learned NOTHING that will help you on your next rotation. Which (needless to say) absolutely S-U-C-K-S.

 

[PeepshowJohnny]

Rotating through multiple hospital systems, I don't feel learning the different ways this hospital wants student notes run vs. how that hospital posts vitals vs. how consultants work in that hospital helps me all that much. All it does is take away time you can learn about pathophysiology of disease.

I mean, does it help you that much to learn "Oh, HERE the doctor phones the consultant's office and THEY fill out the consult request" vs. "Here, the doctor fills out the request form and the unit secretary sends it to the office" This may seem like a minor point, but unit secretaries, nurses, etc. love to rake students over the coals for minor breeches of how things are done and sometimes it's just not worth the hassle trying to remember these things.

 

[lilzelda2]

Is it wise to spend a whole year in a hospital you don't plan on applying for residencies in? Also does the reputation of the hospital matter or is it more important to go to a hospital that would allow u do more even if its not that well regarded?

 

[smq123]

Is it wise to spend a whole year in a hospital you don't plan on applying for residencies in? Also does the reputation of the hospital matter or is it more important to go to a hospital that would allow u do more even if its not that well regarded?

You people are over thinking this. Don't stress so much about where you're doing your third year rotations - go where there is enough space, the residents are reasonably nice, and where students generally don't want to kill themselves halfway through the rotation.

 

[Ashers]

I know it sounds counter-intuitive, but that doctor was absolutely right.

What every third year student dreads is the "contradictory" eval. There's two varieties:

1) Your attending says that you were a "5/5" but his only comment is that "QofQuimica was a decent student."

2) Your attending says that you were a "2/5" but his only comment is that "QofQuimica was a good student with a good knowledge base."

Both leave you totally mystified. 😡 A more detailed eval would help you understand the rationale behind the attending's choice...or at least give you some ammo when you contest the grade.

The point is, you NEED detailed and thorough evals in order to help you in later rotations. If the attending only comments that you were "fine," or his only critique is that "QofQuimica needs to read more," then you have learned NOTHING that will help you on your next rotation. Which (needless to say) absolutely S-U-C-K-S.

totally agree with this. I was slightly disappointed with my eval I got after my elective. It basically just said "Excellent student. Anticipated the needs of the team." It gave some specifics, but I worked harder for that rotation than any up to that point that far since it's in the specialty that I plan on going into, on the program director's service, and I was the first M3 ever allowed on that service.

My family practice eval gave specific examples of what I did that was good: patient communication, technical skills -- giving examples with specific patients.

My psych grade was just off the wall saying I didn't look up articles, which I did, but my attending never wanted to hear about them. Oh well.

Back to the original subject... I've been at my school's main hospital since November. I really really really want a break from it. I'm getting a break next month to do peds. I enjoy seeing how different hospitals are run, but I think it's also rotation dependent. There's no way I'd want to do ortho at another hospital, but there's also no way I'd want to do OB/gyn or psych at the school's hospital. For family med, I drove 80mi round trip every day to go to a residency clinic that was a fun clinic.

Maybe at some point, when it's not children related, I'll leave the school's hospital.

 

[diosa428]

We have rotations at our main hospital and 2 other hospitals affiliated with our institution, plus some other clinics/private practices, and I'd have to say it's kind of a pain to figure out how everything works all over again. I don't know how often you'll be switching sites, but on some of our services we can switch sites as frequently as every 2 weeks, and when you spend the first week just trying to figure out what's going on, it's really annoying. It is nice to have the 3 hospitals, because the two affiliated with our hospital tend to be more relaxed than our university hospital, which is nice for rotations that you aren't really interested in. It's also nice that the majority of attendings are affiliated with our university, because if I want them to write me a letter, I feel like they still have a "big name" associated with them (which may or may not matter, but it makes me feel better).

 

[Mayhem]

You people are over thinking this. Don't stress so much about where you're doing your third year rotations - go where there is enough space, the residents are reasonably nice, and where students generally don't want to kill themselves halfway through the rotation.

I agree completely. In my case, this is not our university hospital hence I take every chance I can to leave. Now, if your home hospital is not a backward, stuffy pit of oppression then by all means stay there. BTW, it always helps to talk to upper years, because invariable some rotations are better at specific hospitals. For us, Psych at home is awesome but thankfully I was steered towards the away O&G rotation which had nice nurses and lots of deliveries, whereas the guys who stayed at home got chewed out by the vultures on the labour ward and got only 1 delivery each while having marathon 4 hour ward rounds.

 

[SoCuteMD]

I'm more than halfway through third year and I've been at 4 different facilities. It doesn't take that long to figure out how things are done and where the tegaderm is, etc. I don't think there's any huge advantage to switching hospitals, but I've managed to be at one of the strongest sites for each rotation by switching around like I have.

 

[lord_jeebus]

Although I did not have to, I chose to do my 3rd year at a variety of hospitals - 5 total including a military hospital and a VA. All were within 15 minutes' drive, and two were walking distance from my house.

I found the changes of scenery refreshing and learning the new systems wasn't that bad (although I don't understand why the VA system is so good, yet the military system is so horrible). I was also able to go to hospitals that were known to be particularly good for certain rotations. If I wanted, I could have done almost everything in one place, but that would have denied me the opportunity to seek out particularly attractive rotations elsewhere.