4th year rotation suggestions needed

[DrSwede]

I'm looking at setting up my 4th year to prepare for applying to FM residency.

Anyone have any suggestions?




On a side note, any good books or software that are helpful in evaluating labs, interpreting x-rays, etc...?

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[tootsweet]

Hi, Good luck setting up rotations.

I like "laboratory testing in clinical medicine" by Goljan, MD, Sloka DO. but it's not pocket sized. It's a good review book with questions at the end of each chapter.

 

[drwatson]

This comes up a lot actually and perhaps this question: "I'm going into FM what electives should I take as a 4th year?" should be a sticky.

You can look at this in two ways. 1-Using elective time to prepare for residency/career or 2-Using elective time to do something fun/different.

The thing to keep in mind is that if you do a derm rotation now and again in residency, it will be a totally different experience because you (and your clinical experience) will be totally different. Same with an ICU rotation, etc. However, ff you know what program you want to match into, you could look at the resident curriculum and see what is lacking and then choose electives based on that. For instance, maybe you want to do Urgent Care or use Ultrasound more and you could start learning that as a med student.

The flip side is you could do something like "Forensic Pathology" if, for no other reason, it will be your last chance to do a rotation like this. Other good ones you will most likely not do as a Family Doctor would be surgical sub-specialties, Pediatric sub-specialties, an "away" rotation, and so forth. You would be surprised at what you will take away from the elective experience anyway. I took a Clinical Pathology elective and it was wonderful. I now have a better understanding about basic lab science. And I feel this has made me a better physician.

I advocate for the latter, ie. do something fun you won't get the chance to do again. Mainly because I feel I'm a different learner now that I was as a medical student. I think that if I took a rotation to "prepare" for residency would have been wasting a month of my education. Plus have fun some fun in medical school; residency is hard enough.

Just my 2 cents.

 

[cabinbuilder]

Some things I took: Interventional radiology, podiatry, forensic pathology (city morgue), orthopedics, hospital pathology, blood bank and lab, oncology, derm, general surgery sub I, rural medicine Indian Health clinic in alaska, radiology in las vegas, free clinic family medicine, infectious disease, ICU,

 

[DrSwede]

I took a Clinical Pathology elective and it was wonderful. I now have a better understanding about basic lab science. And I feel this has made me a better physician.

Thanks for responding!

Do you mind elaborating on what kind of stuff you did during that elective?

 

[hippiedoc13]

I'm looking at setting up my 4th year to prepare for applying to FM residency.

Anyone have any suggestions?

I did 2 away rotations early in the year to check out the 2 programs I was most interested in. Then did a bunch of rotations that I was just interested in, either because I thought they'd be good preparation for residency or a "must have" experience before leaving medical school, or just because they sounded like fun.

I remember doing dermatology, emergency med, adolescent medicine, radiology, cardiology/CCU, and a medical humanities seminar.

The 4th year was so much fun, because I didn't care about grades or making a perfect impression anymore--it was all about my learning, and I was there because I was interested. I actually wish I could have done more rotations.

If I'd had more time, I probably would also have done anesthesiology (to get more experience & confidence w/ intubations and lines), outpatient ortho/sports med, ophthalmology, forensic pathology (just because it's off the wall and kinda fascinating), and some international rotations.

Have fun and make the most of it.

 

[FutureCTDoc]

Ophtho, Derm, Endocrine and Psych. Ophtho because so many systemic diseases present in the eye, you need to know what glaucoma looks like, retinal detatchments, how to deal with common complaints i.e. sties, allergies, lashes abrading the cornea etc. Derm as people will come in with acne, psoriasis, actinic keratosis, rashes, contact dermatitis and you may want to do botox in private practice. Endocrine because 1 in 20 Americans has diabetes and this may help you better manage this. Psych as FPs are the biggest prescribers of SSRIs in the country, it helps to be cognizant of the many psychiatric issues that will present on an outpatient basis and this is worthwhile to do, especially on an outpatient basis.

 

[lowbudget]

Agree with ER, derm, ICU, ortho, and rads. These are things that are hard to learn on your own. You'll get plenty of Psych and Endo, so I would bump that further down.

One not mentioned is OB, which I would highly recommend. Being comfortable and confident on L&D will help you tremendously when you are an intern/resident, especially if your rotations are opposed. OB is one where if you demonstrate capability early, you will garner people's respect, and hit your numbers early (ICU is the other one that I highly recommend).

As far as the fun ones that you may not have a chance to do again, I recommend re-doing Gross Anatomy, as a TA doing the prosection. With the clinical experience, it's nice to go back to the basic science, and it'll help you (re-)learn MSK. I would place this experience in front of ortho, personally, if you had a choice; or ask if you can combine anatomy with ortho clinic as an independent study/self-designed rotation.

 

[Dr Magpie]

One of the best things I did in med school was to finish on ER--- it was not a cushy rotation where I went to school, but I learned a heck of a lot and got a lot of practice managing things (somewhat) independently. I was "extra", so I got to choose my cases and go to every trauma--- by my own preference I did tons of sewing. (The interns were happy to hand over the busywork and I needed the experience.) I worked hard, and a lot, but it was a completely invaluable experience that helped me to realize/remember:

A) I don't know a lot
B) I can learn a lot
C) I can function semi-independently as a fourth year med student which bodes well for internship.