advice for a 4th year student

[discharged]

I've been unfortunate during my 3rd year in regards to procedures. I would love to do them, but having my rotations done at a big teaching institution where all procedures are saved for the residents did not help at all. I'm speaking of even little things like ABG's and pelvic exams. I would chime in and say that I would like to do the procedures, but I figure I should save the trouble as even the residents are fighting over the procedures themselves.

Any advice with this? I would like to be fully prepared coming into residency, and am envious of other students in other programs who brag about drilling bones and doing central lines like it's a walk in the park. I mean.. even during surgery, I got the opportunity to suture TWICE. The rest were given to the surgical assistant for "efficiency" purposes...

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[dotcb]

Rotate at county hospitals, or at rotations where students say you get to take ownership and do procedures.

 

[RustedFox]

Don't sweat it. Your time will come. Third year is lean on procedures yes... the fourth-years who are audition-rotationing should get them. Just pay close attention to how and when they screw up... so you don't make the same mistakes.

 

[docB]

Take the time to know how to do the procedures. Read Roberts and Hedges. Once you're being taught procedures you should be being coached on technique, not having to be told "hold the laryngoscope in your left hand." Assist others doing the procedures. It makes you look helpful and it gives you an opportunity to see others struggle which is learning gold.

 

[ztaw15]

I agree with the above comment. I was one of the more fortunate third years, and have had some great procedural opportunities, almost all of which would not have happened without advanced reading - That's what I have told all of the new third years, because every procedure I have gotten with a new attending/resident they say "can you do this" and then "tell me how you are going to do it" and sometimes follow with "what are the complications/how will you deal with them"

I think if you can answer those then they feel good about it.

The best rotations for procedures for me where Trauma Service/TICU, FM, Neuro(LP only), OB, and then EM. I think ICUs and surgical services are great for lines/airways/tubes, and FM was surprisingly great for me as far as other minor procedural practice (joint aspirations/injections, splinting/casting, and USG), EM is like a mix of everything, but the minor stuff tends to get left out and a lot of it is done by an army of various "techs", though they are receptive to letting you do smaller lines like EJ, US guided peripherals, splinting, or whatever else.

Also the attendings like it when you "pay back" for good procedures - central lines/intubation - by covering all the small stuff like lacs/abscesses/ngt/etc, so it's nice to be proficient with that stuff so they feel like you can kind of contribute to the flow of work, which you certainly aren't doing with your intubation attempts.

 

[engineeredout]

Any suggestions for a (non textbook) book to read during a 4th year EM rotation? Not for a shelf exam but for someone who wants to go into EM.

 

[pianoman511]

Emergency Medicine Secrets

http://www.amazon.com/Emergency-Medicine-Secrets-Vincent-Markovchick/dp/0323071678/ref=sr_1_1?ie=UTF8&qid=1338172465&sr=8-1

 

[Aesculapius]

Case Studies in Emergency Medicine is pretty good.

 

[tkim]

http://www.amazon.com/Bouncebacks-E...8619/ref=sr_1_1?ie=UTF8&qid=1338244676&sr=8-1

 

[RustedFox]

...Be great if someone had that book on .pdf