4th year rotations

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nampa1

nampa1

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What's a good profile for fourth year rotations? We have ten at my school. I'd like to be competitive with other students. What do most do, clinical (and in what capacity), ambulatory, and retail?
Thanks.
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I think it depends on what your goals are. I was advised (for residency) to try to get the most challenging rotations possible.
 
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They said to try to do faculty rotations. For me if I did a teaching rotation, that would be a guaranteed faculty rotation. I didn't do one of those, but my 3rd one is ambulatory care with one of our better faculty members, which is awesome since I want to go into am care. I also tried to sign up for am care electives (HIV, anticoag, psychiatry). I guess I'll see which of those I end up getting in future rotations.

I also felt like doing something I have never experienced before, and that few pharmacists get a chance to experience, and therefore my first rotation is regulatory affairs in a very well known pharmaceutical company.
 
I'd suggest a drug info rotation and try to get it in early if possible. Otherwise it depends on your options and interests. We had only 6 possible. 4 are required (community, amcare, acute care, systems/staffing) My community rotation is at a target (already done CVS, independent, Albertson's/Sav-on), AmCare was the same one the USC residents do, Acute care with cardiology faculty, systems at peds hospital. Electives I did were Drug Info and Peds rotation. I feel like I got a fairly well rounded experience given the limited number of experiences we're allowed.
 
For residency, you want strong rotations, preferably with faculty/pharmacy bigwig/pharmacist who publishes. Learning is good, but letters of recommendation from these individuals are more essential. If you're able to, try and get the hard rotations done early on...you'll learn more and have some experience to talk about when midyear comes around.

Additionally for rotations other than IM/amcare/retail, I would suggest at least 1 critical care (preferably MICU, no better place to refine your PK/ADME knowledge), 1 "specialty inpatient" such as ED/cards/ID/onc, and 1 elective of whatever you want. I personally did 2 ICUs + pain & palliative care.

For industry fellowship, any industry exposure or FDA rotation is essential IMO.
 
Here's a thread hijack/related question: How far from "home" did you guys have to go for your APPEs? I'm still 2 years out, but it's something I'm always thinking about out of curiosity. And if it was far enough, what were your living arrangements?
 
apteryx said:
Here's a thread hijack/related question: How far from "home" did you guys have to go for your APPEs? I'm still 2 years out, but it's something I'm always thinking about out of curiosity. And if it was far enough, what were your living arrangements?
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I think this depends on the availability of rotations near your school. I don't plan on having any rotations that are more than a 40-minute drive away from where I will live next year. I will be living with my parents about a 35-minute drive from the school. Moving back in for a year, since I'll need a car anyway and pointless to pay rent if I can get all or most of my rotations there.
 
bacillus1 said:
I think this depends on the availability of rotations near your school. I don't plan on having any rotations that are more than a 40-minute drive away from where I will live next year. I will be living with my parents about a 35-minute drive from the school. Moving back in for a year, since I'll need a car anyway and pointless to pay rent if I can get all or most of my rotations there.
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I'm in an IPPE that is 77 mi one-way and I commute daily. But the facility is pretty amazing, so no complaints.
 
apteryx said:
Here's a thread hijack/related question: How far from "home" did you guys have to go for your APPEs? I'm still 2 years out, but it's something I'm always thinking about out of curiosity. And if it was far enough, what were your living arrangements?
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I arranged for a rotation that was 3.5 hours away from home. Rented a room for $400 for the 6 week rotation. It suited my interests and had a residency program available. Didn't work out the way I hoped it would, but otherwise was a decent rotation.
 
apteryx said:
Here's a thread hijack/related question: How far from "home" did you guys have to go for your APPEs? I'm still 2 years out, but it's something I'm always thinking about out of curiosity. And if it was far enough, what were your living arrangements?
Click to expand...


The majority of my rotations were >2 hours away from "home". What I ended up doing was storing all of my belongings and living like a vagrant basically. I was based out of Minnesota and I did one rotation in Colorado. The preceptor let me stay at her house. The rotations that were in the same state, I either stayed with friends, or rented out an extended-stay hotel room. So basically the summer resorts/cabins which are furnished. Some were more expensive than others. Typically between $400-$900. For my Alaska rotations, the hospital I am at arranged and paid for the housing. My advice if you choose to have rotations far away from your home base is pack light and be open to living in less than perfect conditions.
 
Well, hopefully it's nothing too far. I'm married, and I'm already trying to warm my wife up to the idea that I MAY have to live away from her for a little while. Don't know if she could handle it (me either, to be honest.) Meh, I'll cross that bridge when I get to it I guess.
 
Wow, i never even had to live away from home for any of my rotations. All of my rotations were within 30 minutes from my home. Three of my rotations were within 10 minutes from home. I guess I was fortunate.
 
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apteryx said:
Here's a thread hijack/related question: How far from "home" did you guys have to go for your APPEs? I'm still 2 years out, but it's something I'm always thinking about out of curiosity. And if it was far enough, what were your living arrangements?
Click to expand...

I went to Brazil for one, North Carolina for another (I live in Florida). These were by choice of course. Did a mission trip in the Amazon, which counted as an elective, and had Ambulatory Care at a native American hospital in North Carolina.
 
apteryx said:
Well, hopefully it's nothing too far. I'm married, and I'm already trying to warm my wife up to the idea that I MAY have to live away from her for a little while. Don't know if she could handle it (me either, to be honest.) Meh, I'll cross that bridge when I get to it I guess.
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I selected two rotations that were away from home (about an hour each) but I didn't have to. I would have been able to do all my rotations in the metro area. There are some schools that require one or more out of town, but mine doesn't. We are permitted to do up to four "away" rotations if the student desires.
 
Doctor Rock said:
The majority of my rotations were >2 hours away from "home". What I ended up doing was storing all of my belongings and living like a vagrant basically. I was based out of Minnesota and I did one rotation in Colorado. The preceptor let me stay at her house. The rotations that were in the same state, I either stayed with friends, or rented out an extended-stay hotel room. So basically the summer resorts/cabins which are furnished. Some were more expensive than others. Typically between $400-$900. For my Alaska rotations, the hospital I am at arranged and paid for the housing. My advice if you choose to have rotations far away from your home base is pack light and be open to living in less than perfect conditions.
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How was that? I would think it would be awkward. My preceptor this month is actually taking the day off on Friday to go to a protest in Washington DC(its about how the USA is ignoring the tyranny in Bahrain while @ the same time supporting the Egyptian and Libyan rebels) and invited me to stay at her house the night before the protest.
 
nampa1 said:
What's a good profile for fourth year rotations? We have ten at my school. I'd like to be competitive with other students. What do most do, clinical (and in what capacity), ambulatory, and retail?
Thanks.
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I think I ended up with a pretty diverse schedule. I had to cancel my away rotations (Board of Pharmacy and Army Pharmacy) because of a high risk pregnancy, but I still came out pretty good, I think:

Amb Care: Geriatrics
Adv Comm: family health center (clinic and pharmacy)
Inpatient Psych
Informatics
Advanced Hospital at a VAMC
Critical Care/ICU with the opportunity to do pulmonary clinic
IM/Cardiology at a community hospital
Amb Care: Diabetes
 
Anyone know the typical start times for acute care blocks? industry?

i need to know when to cut myself off SDN and get some sleep, haha
 
confettiflyer said:
Anyone know the typical start times for acute care blocks? industry?

i need to know when to cut myself off SDN and get some sleep, haha
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Acute care is pretty variable, depending on what you're rotating in. If you're on an admitting service, rounds typically start anywhere from 0700 (more commonly surgery) to 0930 (typically medicine) or anywhere in between. Plan on arriving 1 - 1.5 hours earlier to prep, depending on how many patients you're covering and how efficient you are. Consult services (infectious disease mainly, transplant/cardiology sometimes) round later in the day, typically after the primary service has seen the patient and written their notes for the day. You won't have to get in quite so early for those, but you end up staying in-house later in the day.

Can't speak for industry rotations, but I'd imagine that those are more closely aligned with normal business hours. All bets are off if you're running PK or time-kill studies, though.
 
Praziquantel86 said:
Acute care is pretty variable, depending on what you're rotating in. If you're on an admitting service, rounds typically start anywhere from 0700 (more commonly surgery) to 0930 (typically medicine) or anywhere in between. Plan on arriving 1 - 1.5 hours earlier to prep, depending on how many patients you're covering and how efficient you are. Consult services (infectious disease mainly, transplant/cardiology sometimes) round later in the day, typically after the primary service has seen the patient and written their notes for the day. You won't have to get in quite so early for those, but you end up staying in-house later in the day.
Can't speak for industry rotations, but I'd imagine that those are more closely aligned with normal business hours. All bets are off if you're running PK or time-kill studies, though.
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This was my experience. I had CT surgery and was required to be there by start of rounds at 7am. I probably should have pre-rounded, but it wasn't required, and 7am seemed early enough already.
 
do you find that most students get job offers from their rotations?
 
freckles17 said:
do you find that most students get job offers from their rotations?
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I've heard of it happening but I don't think it's very common...but I could be wrong
 
freckles17 said:
do you find that most students get job offers from their rotations?
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I imagined my rotations to be a month long interview. If you work hard and make an effort to get to know the people working there, it's not uncommon to get a job offer at the end of the rotation. I actually got three offers from my rotations, and accepted one.
 
MindOverMatter said:
I imagined my rotations to be a month long interview. If you work hard and make an effort to get to know the people working there, it's not uncommon to get a job offer at the end of the rotation. I actually got three offers from my rotations, and accepted one.
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Yep, I got a job as an intern from my rotation that was at a nursing home.

I even got an offer from this other hospital as a tech that I did my regular hospital rotation at even though I was late almost every day. They offered $25/hour + medical/dental/pharm benefits but I had to decline it because they were looking for someone to work 8PM-8AM starting Friday night, and then again 8PM-8AM starting Saturday night. That schedule would have driven me crazy.

Imagine doing your 40+ hours of rotations Monday-Friday, don't even go home on Friday, just take a 4 hour break, come back, work 12 hours, go home, sleep, get ready, work 12 hours, go home, stay awake during the day/chill, then go to sleep, and back to rotations.
 
bananaface said:
My acute care rotation starts at 7am.
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Thank you (& everyone else who responded), the consensus I'm getting is 0700 for acute care, 0800 for most other electives/blocks. My community pharmacy doesn't even open until 0900, so yay for that.

I spoke to my other preceptor who said students on the ID block at that institution arrive at 0630 on 2-3 days a week and round "in the evening" for 2 nights/week. I guess it's institution specific.
 
Very institution and preceptor-based. I know some acute-care rotations that wanted you in at 5-5:30AM so you would be the first one to touch the patient chart.
 
The earliest I've had to report was 7AM for Advanced Hospital. 8 AM for inpatient Psychiatry. 8AM for ICU and Geriatrics. 830 AM for Cardiology and Informatics. 9AM for AmbCare Diabetes and Advanced Community.

It all depends on what time the team rounds. Some of my classmates (those on peds surgery, for example) started at 5:30 or 6 AM every single day. :eek:
 
All4MyDaughter said:
The earliest I've had to report was 7AM for Advanced Hospital. 8 AM for inpatient Psychiatry. 8AM for ICU and Geriatrics. 830 AM for Cardiology and Informatics. 9AM for AmbCare Diabetes and Advanced Community.

It all depends on what time the team rounds. Some of my classmates (those on peds surgery, for example) started at 5:30 or 6 AM every single day. :eek:
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I wouldn't mind 6am as long as I was outta there by 2-3pm (beat the afternoon rush at the grocery store, etc...)

Even after forcing mornings for a prolonged amount of time, 2am is my magic hour of getting things done. I have 2 ICU blocks + 1 hospital block coming up, this should be interesting.
 
I heard our UMC is brutal with 5am rounds and 12-14 hour days. I also heard the attendings don't give a crap about pharm students unless they "prove" themselves. Of course this is all hearsay from the 4th years. I still want to do a rotation there, especially ED since it is one of the best in the country for that. I like to make up my own mind about that stuff. Sorry for the tangent.
 
At all of my inpatient rotations, no service started rounding until at least 8AM...so to preround 7-7:30 is fine. After working in a hospital I got really good at scanning med lists, but this works a lot easier if there is EMR/EMAR instead of rifling thru horribly written consult notes.

If you're not a morning person, don't pick a surgical service (SICU generally excluded), as they generally round before then so that they can immediately go to the OR. ID or a consult team is preferred as they usually round later in the day after morning rounds. Most AM labs didn't get back til 7 or 8, so there was no use prerounding before then.

re: scrubs, the only time i ever saw rotation students wearing them is in ED or if you got to watch an OR case. there really is no need to, since you're not gonna be in a sterile enviroment/on call/getting puked on.
 
rxlea said:
I heard our UMC is brutal with 5am rounds and 12-14 hour days. I also heard the attendings don't give a crap about pharm students unless they "prove" themselves. Of course this is all hearsay from the 4th years. I still want to do a rotation there, especially ED since it is one of the best in the country for that. I like to make up my own mind about that stuff. Sorry for the tangent.
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See that would annoy me, I'm there to learn, not "prove myself." I can understand this type of schedule/process for a resident, hell I can understand pushing to 9-10 hours a few days here and there...but to push this onto a P4 unpaid student seems funny.

But if everyone is up front about this particular ED rotation, then by all means go for it. If I were to pick it purely off interest and on day 1 they told me my days were 12-14 hours, I'd be very very annoyed.
 
confettiflyer said:
See that would annoy me, I'm there to learn, not "prove myself." I can understand this type of schedule/process for a resident, hell I can understand pushing to 9-10 hours a few days here and there...but to push this onto a P4 unpaid student seems funny.

But if everyone is up front about this particular ED rotation, then by all means go for it. If I were to pick it purely off interest and on day 1 they told me my days were 12-14 hours, I'd be very very annoyed.
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Good point. At least we know in advance. I am used to waking up hella early anyway (I work at 6am every sat and sun). But yeah, their ED and ICU rotations are awesome from what I hear, if you can deal with the hours and attitudes of the attendings. The "proving" yourself part sucks for sure, though. I heard that if you do "prove" yourself though, they treat you on the same level as the med students/residents and you are no longer a lowly pharm student in their eyes. Isn't that a bunch of crap, though? I guess I will find out 4th year. I hope all this was a bunch of exaggeration on the part of some jaded P4s
 
confettiflyer said:
See that would annoy me, I'm there to learn, not "prove myself." I can understand this type of schedule/process for a resident, hell I can understand pushing to 9-10 hours a few days here and there...but to push this onto a P4 unpaid student seems funny.

But if everyone is up front about this particular ED rotation, then by all means go for it. If I were to pick it purely off interest and on day 1 they told me my days were 12-14 hours, I'd be very very annoyed.
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Ditto. I think it's just a form of hazing, honestly. And anywhere where medicine has a baseline disrepect for pharmacy and pharmacy students has the potential to be a bad learning environment.

*waiting for the inevitable post telling me I'm not dedicated and will never be a good pharmacist, etc* :p
 
All4MyDaughter said:
Ditto. I think it's just a form of hazing, honestly. And anywhere where medicine has a baseline disrepect for pharmacy and pharmacy students has the potential to be a bad learning environment.
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You will never be a good pharmacist with that attitude!
 
I think it is a form of hazing, too. The med students are quite open with us pharmies about how they are treated. From what I hear, there are really good attendings and then there are some bad apples. It's the bad apples that ruin it for everyone. The pharmacy faculty is really great, though, from what I hear and what you learn on the rotation is invaluable. But, getting up at the ass crack of dawn to round with an attending who thinks you are at the bottom of the totem pole? That would suck.
 
rxlea said:
I think it is a form of hazing, too. The med students are quite open with us pharmies about how they are treated. From what I hear, there are really good attendings and then there are some bad apples. It's the bad apples that ruin it for everyone. The pharmacy faculty is really great, though, from what I hear and what you learn on the rotation is invaluable. But, getting up at the ass crack of dawn to round with an attending who thinks you are at the bottom of the totem pole? That would suck.
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Just from the past year or two, I've noticed attendings (good and bad) really don't know how to treat (or what to expect of) the pharm students tagging along for rounds. I'll get an occasional "random info" question, or get lumped in with the med students in getting TTP explained to me, but that's about it.

Anyone else get that vibe?
 
rxlea said:
I think it is a form of hazing, too. The med students are quite open with us pharmies about how they are treated. From what I hear, there are really good attendings and then there are some bad apples. It's the bad apples that ruin it for everyone. The pharmacy faculty is really great, though, from what I hear and what you learn on the rotation is invaluable. But, getting up at the ass crack of dawn to round with an attending who thinks you are at the bottom of the totem pole? That would suck.
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Yeah, when I was on my acute care rotation I noticed that my favorite attending (also the Chief of Internists) would take time to do teaching while on rounds, and it would take about 2-3 hours to do rounds. Then I was walking by a different wing and I overheard the attending saying, "There will be no teaching on my rounds, I want information presented fast and to the point." I didn't like that attending too much.
 
Some people consider pimping to be a way of providing a rigorous learning experience. I prefer to think that if the attending didn't give a damn, they wouldn't bother with you.

That said, I prefer other learning methods.
 
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