3rd Year Rotation: Rural or Academic Hospital

[ShadyMedicine]

Which one would you pick for more experience: a rural hospital or an academic hospital?

I figured they would let me do more at the rural place, but this might just be wishful thinking.

This is a "required" rotation and I was going to do more electives in the future.

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[DO4lifer]

i'd choose rural as a third year because it allows you to get time with a preceptor, who can show you the ropes and probably allow you to do more than at an academic institution where the resident is trying to get procedures under their belt.

learning i would say is hit or miss. since you are with a preceptor, it may turn out to be great if they can teach. at the academic hospital, you know you will be learning.

 

[Gimlet]

I'd have to go with academic. Agree with the above on it being hit or miss on the learning at a rural site, but I think you also run the risk of getting a preceptor who isn't used to having med students around and won't let you do anything. At an academic place, the attendings are going to know what to do with you, and be more comfortable with letting you take more of the reins. Also, if you can wrangle getting paired up with an upper-level resident, they're usually very cool about letting you do stuff.

Academic attendings are going to be more experienced at writing letters of rec, too, and will know what residency selection committees are looking for in those letters.

You could always try to do an elective rotation at the rural site early in your 4th year!

 

[DO4lifer]

gimlet brings up a good point about LORs. however, i think you can still pull a good LOR from the surgery rotation and find a rural hospital to do anesthesia. you can then follow up with another anesthesia using your elective month 3rd year.

i got 2 LORs from a single rotation...it was in the SICU. i got one from anesthesia and one from surgery.

 

[NUGasStud]

I would say do academic. Most anesthesiology residencies are academic. LORs are something to really consider. I did both a private practice type of rotation where I spent a solid week with an attending and an academic rotation where I did not spend more than a day with a single attending. I had LORs from both. The PP attending wrote a much more personal letter and the academic simply regurgitated my CV. I got more compliments during interviews about the letter from the academic attending than the PP attending.

Also agree with previous posts about the learning aspect. I always learned more on academic rotations because most academic attendings are used to teaching medical students.

 

[mamitch4]

As a student, I did a rotation at a small community hospital and an academic institution. Both experiences were really good for me. The community hospital was used to having students, and when I asked questions and acted interested I got good teaching. I also got a lot of hands-on time with masking, intubations, IV's, and even a couple of spinals. At the academic hospital, I got to interact with residents, attend formal didactics, and see more complex cases. Hands-on time/procedure count was much lower, but did include an IJ and art line. I'm glad I had the opportunity to do both. I think the fact that the smaller hospital was used to having students was pretty key, though.

 

[usnavdoc]

My take on this is that right now you should be exposed to as much pathology as possible. You will be a stronger intern if you stay at the academic facility choosing the harder rotations rather than a more cush rural one. True you may get to do a bit more in a rural facility but by the time you finish residency it wont matter at all that you did an extra few procedures as a med student. Also when you start as a ca1 they will assume you know nothing anyway and will teach you even the most basic stuff.

I also realize that med schools are very difrferent in how much students get to actually do. Emory students do very little in the way of CVL and art lines, but as a UT student I did numerous ones. Certainly it made internship easier for a few weeks but in the end it made little difference. If a choice has to be made then it is better to be exposed to the sickest patients possible right now.