if you can look into it and plan it out, i would highly, highly recommend doing the Burn ICU rotation at New York Presbyterian - Cornell Medical Center.
All in all, the Burn Unit was one of the most excellent experiences i've had during my medical school career for the following reasons:
1) NYPH-Cornell is THE regional burn center for new york city, and one of the largest in the world (48 beds: all acuity), and was the unit that cared for all burn patients from September 11th. Needless to say, it takes all comers from NY firefighters, pediatric child abuse cases, geriatric patients, chefs who've been burned at restaurants, to psychiatric patients (who've torched themselves), workmen with steam injuries, and people of house fires.
1b) INTERESTING PHYSIOLOGY: thus you have ventilator issues for those with inhalational injury and/or ARDS, massive fluid issues for patients with partial thickness-deep wounds (2nd degree) or above (3rd or 4th degree), you have nutrition issues b/c of the unique metabolic physiology of burns (sometimes using calorimetry). you can have rhabdo issues with massive tissue/muscle destruction.
there are also many infectious disease issues with burns that need to be washed, debrided each day. tremendous pain issues that need to be addressed and (i'd respectfully say which could be improved upon). Also this center is the regional center for Toxic Epidermal Necrolysis and takes care of a number of patients here as well (issues related to massive epidermal loss / fluid issues / metabolic derangement). The unit is also the center for referral cases for difficult wound healing issues as well (massive degloving injuries, difficult DM-related ulcers, etc).
1c) SOCIALLY INTERESTEING: issues such as working through potential child abuse cases, End of life care, patients who often do not speak english (i.e. many latin or south american, asian, or eastern european immigrants), dealing with loss of loved ones in fires, etc.
2) TEAMWORK: excellent on all parts of the team. it truly epitomizes what a "multi-disciplinary team" ought to be. A nutritionist, the nurses, the nurse practitioner, along with the residents and fellows all round on the team. pediatric cases also have the 3rd year peds resident also round on these cases. child abuse cases also have a special peds attending involved. social work support is excellent, two of the best in the hospital.
3) attendings (Drs. Yurt who is a giant in the field, Bessey an expert in all types wound healing, Turkowski more junior but also excellent) who take turns to round on all their and their partner's patients every day (only 3 attendings for the entire unit). they all love to teach.
4) fellows (Gerry and Brandon) are among the best and most approachable that i've ever worked with. also are excellent teachers.
5) some of the strongest nurses in the hospital = everyone, needless to say has a very cohesive esprit de corps among them = and are a pleasure to work with.
6) PROCEDURES: they change lines q3: thus more than enough central lines to do for everyone. one can go to the OR for all skin grafts and have hands on experience with this side. Or you can go to the OR and be on the anesthesia side if you ask beforehand.
6) RESPONSIBILITY: if you so choose, you can carry as many (or as few) patients as you want. one presents them daily to the attendings & team / suggests therapeutics / follow effect / is involved in all conversations w/ patients. I usually had 4 or 5 patients that i took care of (except write orders which was done by the intern on call). Since I speak a foreign language, these patients in particular would be given to me and most day-to-day stuff would be my responsibility (tho with medical oversight of course). However, never did i feel like i was a scut monkey. One can take call if one chooses. You will end this month with much more experience in taking care of all types of burns than even the ER (!), as you will see things on a daily basis, and be present for the FULL COURSE of each injury.
7) i'd recommend the winter months as these tend to be the busiest and most varied for the unit (people lighting candles for light / warmth, or smoking in bed = fire hazards)
Check with the NYPH dept of surgery office at this link:
http://wo-pub2.med.cornell.edu/cgi-bin/WebObjects/Electives
it's under the surgery electives and the elective is entitled: "Management of the Severely Injured Patient with Thermal Injuries"
As they only take one medical student each month (though this rotation is not well known to the students at Cornell) there's probably be a good chance to get patched in. Better to start early than later however. Cornell also may have housing for international med students, however I am not clear on the specifics of these arrangments.
all the best, and good luck in your search for an ICU rotation!
