I liked all of my 4th year rotations: DeKalb, StJohn North Shores (now StJohn Hosp and Med Cntr), DMC, West Penn, and Penn Presby. I also visited Oakwood and had great experience there also.
As you hinted at, it depends on what you're looking for: hands on, academics, etc. They all prep you - but in different ways.
For example, at West Penn, students don't even scrub in (most cases are double, triple, etc scrubbed with residents already), so it's not very hands on. On the flip side, they have academic lecture/labs/etc nearly every day, have required research, their core attendings see a very high volume of pts and do very complex cases, and their residents are very bright... so you do see and learn a lot.
DMC was kinda the opposite during my month. They are very busy with so many cases they barely ever double scrub with other residents (only on rare procedures or rearfoot cases). Students get to participate quite a bit (suture, put in screws, see consults, etc). On the other hand, their academics were fairly sparse compared to most other "top programs" and mostly resident-run academics since the program is just so busy with patient rounds and surgery, but the program usually gets great residents who are mostly all motivated to read/learn on their own without being spurred.
Presby, StJohn, and Oakwood seemed more balanced to me. They all do regular academics but also let students participate in a fair amount of patient care as well. Ideally, you want a mix of clerkship types, but you will get that - esp if you clerk in different regions where procedure selections and standards of care will show a bit of variety (New England vs Michigan vs Texas, etc).
I'd say DeKalb is probably the best overall for student learning. Even students who don't like the intensity or culture there will still say they took a lot away from the rotation. They pretty much have it all: very good surg volume, many dedicated attendings, also a ton of academic resources with the
PI (slide library, cadaver lab, libraries, frequent seminars, etc). You have to be ready to eat, sleep, and breathe podiatry surgery for that clerkship month, though (or 3yrs if you match there). It will probably make most other programs, even other good programs, seem at least a bit easier by comparison. Unless you feel very well read for interviews already, DeKalb's probably not a good one to pick right before interviews (in Nov or Dec) since you will have barely any time to read and possibly re-visit or correspond with past clerkships compared to most of other months.
The programs on this list - and many others I'm sure - are all ones you would probably have a good clerk experience at:
http://forums.studentdoctor.net/showthread.php?p=6091105#post6091105
The "top programs" are considered that because they have more surgery (esp rearfoot/trauma), longer hours, and probably more motivated residents/attendings than the avg programs, so putting yourself in those environments will definitely help you to rise to their challenge. However,
you have to be realistic at the same time. Remember that most top programs see anywhere from 10 to 20 to maybe even 40+ clerk students per match cycle but probably only have 2-5 spots for new residents. Sure, some of those top students visit 4-6 top programs and can only match one of them, it's still not too smart to clerk at ALL top notch competitive programs if you are a pretty average paper applicant who will be gpa/ranked below and may also interview below or clerk a bit below most of the residency programs' other clerks. It's still great for any student to do a high level and challenging hospital or two if they can get accepted to the rotation, but you also have to focus your limited number of clerkships where you think you will be likely to end up based on realistic self analysis and self/family needs/wants. That is a recipe for scrambled eggs, and nobody wants that in the wake of a residency shortage. Make sure you do clerkships - or at least a few visits - at "
safety net" types of programs where you know you will be near or at the top of their applicant pool in terms of paper app strength and likely interview performance. Obviously, the key making the most of any rotation is just being punctual, being interested, and reading about cases/pathology/surgery you saw or know is scheduled in the days ahead. GL and good job planning ahead.
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