3rd Year Rotations

[Future_HeartMD]

Current 3rd year about to finish my first rotation (OBGYN). It's been decent so far but my rotation site is with a private practice group so I mainly rotate with different attendings. I'm wondering if anyone else has had a rotation like this and felt like it's glorified shadowing? The attendings do like to teach but it's almost as if they'd rather take the time to talk about conditions as a teaching method rather than have me see patients and teach that way but potentially slow down clinic. I've assisted with c-sections but when I'm on L&D I'm not given the chance to see a patient myself and report back despite offering to do so. I just feel like I should be given at least 1 or 2 patients to "manage" but that hasn't been the case at all. I'm also a male so that might be a factor. I've got one week left so its not like I can do much now but I just want to know if this is normal for 3rd year or if I should be a lot more proactive in future rotations. For what its worth, my mid clerkship eval was all 5s except for like medical management section. Hope that makes sense.

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[Redpancreas]

Current 3rd year about to finish my first rotation (OBGYN). It's been decent so far but my rotation site is with a private practice group so I mainly rotate with different attendings. I'm wondering if anyone else has had a rotation like this and felt like it's glorified shadowing? The attendings do like to teach but it's almost as if they'd rather take the time to talk about conditions as a teaching method rather than have me see patients and teach that way but potentially slow down clinic. I've assisted with c-sections but when I'm on L&D I'm not given the chance to see a patient myself and report back despite offering to do so. I just feel like I should be given at least 1 or 2 patients to "manage" but that hasn't been the case at all. I'm also a male so that might be a factor. I've got one week left so its not like I can do much now but I just want to know if this is normal for 3rd year or if I should be a lot more proactive in future rotations. For what its worth, my mid clerkship eval was all 5s except for like medical management section. Hope that makes sense.

This is not atypical. Each rotation is different.

 

[Lem0nz]

Unfortunate but normal.

 

[calivianya]

It might just be because you’re a male.

Most of my rotations have been preceptor based like this, but most of them have let me see patients on my own and report back. It’s only helpful if you have an attending who wants to teach, though. Otherwise, since nobody wants you to hold up the clinic, you can’t look anything up because they want you to give report immediately upon leaving the room, and they want you to go straight in with no preparation. So if you haven’t already studied a lot, you just end up sounding dumb and getting told you’re wrong. A lot. It can be pretty demoralizing and ruin a whole specialty for you.

This is extra fun when the people you’re with tell you at the beginning of the rotation, “I don’t really like to teach,” and so they just sort of expect you just to pick up everything by osmosis and almost never explain what they’re thinking. I guess they think you should pick it up just fine while they’re explaining their plan to the patient, but rarely do they fully explain their thoughts to the patient, so you end up learning their preferred interventions without ever hearing a “why.”

I‘d rather take an online rotation where I never had to see patients at all if I don’t have the chance to look anything up ever and I just felt stupid all day tbh. I’d get more utility out of spending the whole day doing practice questions.

 

[mmchick]

Such an unfortunate reality of some preceptors. I've already had a couple preceptors also do this to me in our early "feet-wetting" experiences where they've told me upfront they "understand this is an educational experience for me, but can't afford for clinic to get behind". In my mind, why offer to be a preceptor ($$) if you're worried about a student slowing down clinic nor are interested in allowing someone to make the most of their time there (i.e. see patients alone, carry solo interviews, have adequate resources to prepare a presentation etc.)? Pretty annoying. I guess that's why not all preceptors are created equal and you should just try and make the best out of every rotation where possible.

I haven't even started rotations yet, but again, with the few experiences I've had thus far, I can already see how any whiff glorified shadowing can be completely demoralizing. Unless you've never seen a patient before in your life, I can't possibly see how preceptors believe shadowing is a useful educational tool in a student's need to build clinical skills. The only way to learn is to outright do the thing. Watching someone speak to a patient with no acknowledgement to you wastes everyone's time.

 

[calivianya]

Such an unfortunate reality of some preceptors. I've already had a couple preceptors also do this to me in our early "feet-wetting" experiences where they've told me upfront they "understand this is an educational experience for me, but can't afford for clinic to get behind". In my mind, why offer to be a preceptor ($$) if you're worried about a student slowing down clinic nor are interested in allowing someone to make the most of their time there (i.e. see patients alone, carry solo interviews, have adequate resources to prepare a presentation etc.)? Pretty annoying. I guess that's why not all preceptors are created equal and you should just try and make the best out of every rotation where possible.

I haven't even started rotations yet, but again, with the few experiences I've had thus far, I can already see how any whiff glorified shadowing can be completely demoralizing. Unless you've never seen a patient before in your life, I can't possibly see how preceptors believe shadowing is a useful educational tool in a student's need to build clinical skills. The only way to learn is to outright do the thing. Watching someone speak to a patient with no acknowledgement to you wastes everyone's time.

This is assuming they offered.

My third year rotation site is small and there’s not a lot of physicians per specialty. We’re down to two full time OB/Gyns after one died and one left, and with 20+ third year students, it pretty much means both OBs have to have a student nearly every month whether they want to or not. We also only have three main general surgeons and one has completely refused to take students, so the other two have to take students every single month as well.

And to be clear, the only way the one general surgeon got out of having students is he started being so nasty and awful to them on purpose that they’d go crying to the HR person who coordinates the rotations, so HR finally listened and stopped putting students with him.

 

[Lem0nz]

Preceptors also don’t always get paid. Just throwing that out there. That matters.

 

[Osteosaur]

Current 3rd year about to finish my first rotation (OBGYN). It's been decent so far but my rotation site is with a private practice group so I mainly rotate with different attendings. I'm wondering if anyone else has had a rotation like this and felt like it's glorified shadowing? The attendings do like to teach but it's almost as if they'd rather take the time to talk about conditions as a teaching method rather than have me see patients and teach that way but potentially slow down clinic. I've assisted with c-sections but when I'm on L&D I'm not given the chance to see a patient myself and report back despite offering to do so. I just feel like I should be given at least 1 or 2 patients to "manage" but that hasn't been the case at all. I'm also a male so that might be a factor. I've got one week left so its not like I can do much now but I just want to know if this is normal for 3rd year or if I should be a lot more proactive in future rotations. For what its worth, my mid clerkship eval was all 5s except for like medical management section. Hope that makes sense.

Finishing up third year and I am on OBGYN now. From myunderstanding this is just the nature of OBGYN. Its high acuity and very chaotic. And a lot of women on the verge of giving birth want "their doctor" to be checking the cervix, not some random kid every 6 hours.

When you're on IM, FM, and Peds you'll be sent in and get to do HPI all the way to assessment and plan. Those are the best rotations and the ones where you get to feel like a real doctor.

 

[mmchick]

This is assuming they offered.

My third year rotation site is small and there’s not a lot of physicians per specialty. We’re down to two full time OB/Gyns after one died and one left, and with 20+ third year students, it pretty much means both OBs have to have a student nearly every month whether they want to or not. We also only have three main general surgeons and one has completely refused to take students, so the other two have to take students every single month as well.

And to be clear, the only way the one general surgeon got out of having students is he started being so nasty and awful to them on purpose that they’d go crying to the HR person who coordinates the rotations, so HR finally listened and stopped putting students with him.

Then IMO you shouldn't accept an offer at a small site that is linked to a medical school - I'm also sure they would have to tell prospective hires that there's a chance their site/practice could be used for educating the medical students at said linked program.. can't imagine that there would be a job offer contract signed without this required role/responsibility.. otherwise you're not obligated to perform such activity. I totally get this is how things shake out sometimes and not everything can run smoothly with only having attendings work for an institute that are good/willing educators... that being said, all doctors were trained for many years by many people.. every seasoned physician should be well aware and appreciative of the fact that it took good mentors to get them to where they are today. It just pisses me off when there is this entitled mentality of "I'll take a great education, but won't do my part to pay it forward" when medical students and residents need to get their training from somewhere/someone.

 

[Fatalis]

Current 3rd year about to finish my first rotation (OBGYN). It's been decent so far but my rotation site is with a private practice group so I mainly rotate with different attendings. I'm wondering if anyone else has had a rotation like this and felt like it's glorified shadowing? The attendings do like to teach but it's almost as if they'd rather take the time to talk about conditions as a teaching method rather than have me see patients and teach that way but potentially slow down clinic. I've assisted with c-sections but when I'm on L&D I'm not given the chance to see a patient myself and report back despite offering to do so. I just feel like I should be given at least 1 or 2 patients to "manage" but that hasn't been the case at all. I'm also a male so that might be a factor. I've got one week left so its not like I can do much now but I just want to know if this is normal for 3rd year or if I should be a lot more proactive in future rotations. For what its worth, my mid clerkship eval was all 5s except for like medical management section. Hope that makes sense.

Take it as a gift! OB rotations can be malignant/ suck. Working one on one with an attending will help build your knowledge base.

 

[7331poas]

Feel like most rotations are like this. Id say out of the entire year maybe 20 days consisted of actually talking to patients independently and formulating plans.

 

[zealously]

Outside of FM, most of my clinic-based rotations were like this. To be honest, there isn't too much learning in having a medical student see follow-ups as it can take a significant time to get acquainted with the patient (whereas the doctor has known the patient forever). If there are any new patients presenting to clinic, I would ask if you could see those. When I was on an outpatient rotation, there would usually be 1-2 new patients every day that I could go see, present, and suggest an A&P for. It didn't slow down clinic that much since the attending was able to see other follow-ups while I saw the new patient.

 

[sloop]

While I’m sure this is normal at some schools, I never had this experience and I can see why it would suck. My school had a primary care practicum between first and second year where I was placed at an internist’s private practice. Even that wasn’t like this and I was seeing at least some patients on my own before the attending. I don’t think I ever had a rotation where I was truly just shadowing like this.

I’ve had rotations that sucked in other ways. In some, the residents weren’t really interested in teaching. Occasionally I felt like I was mostly used for scutwork. I’ve also had rotations where nobody seemed interested in reading my notes even just to give feedback. Still, I was never told that I’m not allowed to see patients on my own and I personally think that falls below the standard for being a meaningful clerkship experience.

I suppose this could be related to being a male on OB/GYN but I don’t think this is a great excuse. I am also male and was seeing patients even in clinic based OB/GYN practices as a med student. The attending would just ask patients if I could talk to them and/or do the exam. If they said no, I would sit that one out but, way more often than I expected, patients were fine with it. Hell, I remember the OB residents routinely sending us in to see the patients in triage and report to them.

So I guess I’ll say that this might be normal at some schools but it really shouldn’t be this way. I think that after the rotation (perhaps after you’ve already gotten your grade), you should bring this up to your school and let them know that your involvement in patient care was rather superficial. It might not change things for you but, if your school doesn’t suck, they would want to hear about this and might make changes to the clinical sites they choose to utilize going forward.

 

[Matthew9Thirtyfive]

Feel like most rotations are like this. Id say out of the entire year maybe 20 days consisted of actually talking to patients independently and formulating plans.

At an MD school?

 

[mrbreakfast]

As others have said:

1) You're a guy on OBGYN. Be glad you're even seeing patients.
2) Your OBGYN rotation could be way worse; you're not getting the traditional OBGYN clerkship of working with nightmarish residents. My med school had to have multiple interventions with their OBGYN residents and actually fired a resident due to how they were treating med students.
3) All clerkships vary. Some rock, some suck. It depends on your program and whether your preceptor likes to teach or was just forced into it. Unfortunately, you'll view medical specialties through the lens you were offered. Just try to learn as much as you can and try not to let a disappointing experience color your specialty choice.