Any others rotating a non-teaching hospitals?

[buccsmf1]

So I just started my 3rd year and I'm currently rotating at a non-teaching hospital. I'm on surgery and am assigned to a certain physician. These have been my days so far

Monday 9-12 Just followed the physician around while he rounded on patients
Tuesday 12-7 Day started with rounding and ended with a bowl obstruction emergency which I scrubbed for and got to do lots of sutures, staples, etc. Pretty awesome.
Wednesday 11-230. Rounded on one patient. That's it.....

With that being said, my physician had a procedure done on Monday (I obviously didnt ask what), so he said his staff gave him a "light" workload for the week. So there is the possibility that everything could get better. My school does year-long rotations for some students and I am currently set up to do ALL of my core rotations at this hospital.

I am starting to get nervous that I'll actually be prepared for my 4th year and beyond. I'm not worried about shelves, I can study review books just fine, but I am worried about the clinical aspect. When I hear everyone else putting in 12 hours a day during surgery and I'm there 3-4.... there is no way I am possibly getting the same education.

Next month I have my core elective, I chose IM for a month and I WILL be in a teaching hospital for that month. So I guess I'll get a better idea of the difference.

Have any of you guys rotated at non-teaching hospitals? And if so, did you fell like you were prepared clinically?

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[FSU2013]

We rotate at "non-teaching hospitals" - I wouldn't stress about it for a few reasons. First, it probably is just a light week. I had some rotations that were real slow and others that were slammed and it all evened out in the end. Second, I don't know how much "clinical" stuff you need to learn in your third and fourth year. You learn how to suture then get to your externships and/or residency and they tell you they want you to do it their way. You learn how to write a progress note, then they tell you they want it a different way.

Bottom line: your residency is going to want to teach you their way of doing everything and you have many years and hundreds or thousands of patients to see before you are an attending. You'll be fine. Relax and enjoy third year.

 

[Socrates25]

So I just started my 3rd year and I'm currently rotating at a non-teaching hospital. I'm on surgery and am assigned to a certain physician. These have been my days so far

Monday 9-12 Just followed the physician around while he rounded on patients
Tuesday 12-7 Day started with rounding and ended with a bowl obstruction emergency which I scrubbed for and got to do lots of sutures, staples, etc. Pretty awesome.
Wednesday 11-230. Rounded on one patient. That's it.....

With that being said, my physician had a procedure done on Monday (I obviously didnt ask what), so he said his staff gave him a "light" workload for the week. So there is the possibility that everything could get better. My school does year-long rotations for some students and I am currently set up to do ALL of my core rotations at this hospital.

I am starting to get nervous that I'll actually be prepared for my 4th year and beyond. I'm not worried about shelves, I can study review books just fine, but I am worried about the clinical aspect. When I hear everyone else putting in 12 hours a day during surgery and I'm there 3-4.... there is no way I am possibly getting the same education.

Next month I have my core elective, I chose IM for a month and I WILL be in a teaching hospital for that month. So I guess I'll get a better idea of the difference.

Have any of you guys rotated at non-teaching hospitals? And if so, did you fell like you were prepared clinically?

Let me guess. You go to an MD/DO program that has opened up in the last 5-8 years. One of those programs with a name nobody has ever heard of before. A place where they lied and promised a "revolutionary" clinical curriculum that is designed to solve the physician shortage. Probably a place that is not located in a major metropolitan area.

Folks, this is what happens when you choose a med school, MD or DO, that has NO BUSINESS OPENING BECAUSE THEY TREAT CLINICAL ROTATIONS LIKE AN AFTERTHOUGHT. You end up shadowing some crappy doctor who is not invested in your education. He probably views you as a burden.

 

[peppy]

That does sound pretty light for surgery. I would suggest asking if you can get permission to scrub in on some other doctors' cases that sound interesting. I wouldn't put it as that they're not giving you enough to do - maybe just try to make it sound like you're SO interested in surgery that you are very curious about seeing everything you can.

 

[buccsmf1]

Let me guess. You go to an MD/DO program that has opened up in the last 5-8 years. One of those programs with a name nobody has ever heard of before. A place where they lied and promised a "revolutionary" clinical curriculum that is designed to solve the physician shortage. Probably a place that is not located in a major metropolitan area.

Folks, this is what happens when you choose a med school, MD or DO, that has NO BUSINESS OPENING BECAUSE THEY TREAT CLINICAL ROTATIONS LIKE AN AFTERTHOUGHT. You end up shadowing some crappy doctor who is not invested in your education. He probably views you as a burden.

The school is fairly new, but I am in this position because I chose to be, not because of my school. We have tons of options for rotations, nearly all of them being at teaching hospitals, but after 3 years of a long distance relationship with my gf->fiancee-> and in 1 week wife, I chose a year long rotation at the closest hospital that would allow me to live with her and have a relatively short commute (30-45 minutes). My hospital might actually be the only hospital we are associated with that isnt a teaching hospital.

You end up shadowing some crappy doctor who is not invested in your education. He probably views you as a burden.

And this actually couldn't be farther from the truth. Since it's a non-teaching hospital, all the docs here VOLUNTEERED to teach students.... The doc I'm with is extremely nice and always doing is best to teach. Second day ever on a rotation and I was suturing and stapling, not too bad. Hell, when I was shadowing a thoracic surgeon pre-med school I remember a 3rd year medical student being there. During the entire 6-7 hour esophagectomy my doc said NOTHING to the medical student, literally not a word. Protractor holding for 7 hours. Later that night I asked my dad about it (physician that also works at teaching hospitals) and his comment was, "medical students are furniture, I don't acknowledge there existence." So I wouldnt assume that just because you're at a teaching hospital, that the doctors are going to be more invested in you learning. But I guess that's where residents come in.

But thanks for the replies everyone! We'll see how things go next week when his schedule picks up.

 

[Siverhideo1985]

I've been rotating at a teaching hospital for surgery now for 7 weeks....7 WEEKS! and i have gotten to suture 4 times...retract here and there...taken staples out a handful of times (and just because I was on palstics for 2 weeks)

There is a chief, a senior, an intern and a 4th year med student who wants to do surgery...all of whom are in line before me for "doing things".

Stick with the non-teaching hospital. For god sake I took out a uterus (under close supervision) at a non-teaching hospital on my Ob-Gyn rotation.

 

[FSU2013]

Wow, Socrates, chip on your shoulder much?

I've found all the MD's that I work with love teaching and we only retain those that enjoy teaching and are good at it. Like previously stated, at a "non teaching" hospitals, you do way more. I was first assist on every surgery on my gen surg rotation, doing a decent amount of each surgery. On my first surgery, the surgeon handed me a scalpel after drawing a line on the patient and said "cut from here to here". He put in one trochar, then gave me the next two. I drove the scope. I used the bovie a ton, sutured and did some minor manipulations in a laproscopic procedure THE FIRST DAY OF MY ROTATION! There is not a single part of a lap chole or lap hernia repair I have not done. Don't get me wrong, I am NOT saying I could do any of this on my own or that anything I did wasn't under direct supervision. What I am saying is that you do immeasurably more at a "non teaching" hospital.

Oh, and 5 of my 6 NMBE scores were >90th percentile - this is because I spent the past year working in the 'real world' as opposed to academia. I saw tons of patients every day.

Get off your high horse, buddy.

Edit: And as far as the attending's not feeling invested, that's a joke. When you spend 2 months working one on one with an attending, you become friends. Almost all of my attendings have either invited me to their house for dinners/parties, taken me out to lunch, etc. My Med attending bought me a wedding present and made my wife come by the clinic so he could meet her. My family med attending gave me a cohiba and an outback gift card at the end of the rotation so I could take my wife (then fiancee) out to a nice dinner. These are just a few examples, there are many more. Yea, clearly thought I was a burden.

 

[ruiner]

Wow, Socrates, chip on your shoulder much?

I've found all the MD's that I work with love teaching and we only retain those that enjoy teaching and are good at it. Like previously stated, at a "non teaching" hospitals, you do way more. I was first assist on every surgery on my gen surg rotation, doing a decent amount of each surgery. On my first surgery, the surgeon handed me a scalpel after drawing a line on the patient and said "cut from here to here". He put in one trochar, then gave me the next two. I drove the scope. I used the bovie a ton, sutured and did some minor manipulations in a laproscopic procedure THE FIRST DAY OF MY ROTATION! There is not a single part of a lap chole or lap hernia repair I have not done. Don't get me wrong, I am NOT saying I could do any of this on my own or that anything I did wasn't under direct supervision. What I am saying is that you do immeasurably more at a "non teaching" hospital.

Oh, and 5 of my 6 NMBE scores were >90th percentile - this is because I spent the past year working in the 'real world' as opposed to academia. I saw tons of patients every day.

Get off your high horse, buddy.

Edit: And as far as the attending's not feeling invested, that's a joke. When you spend 2 months working one on one with an attending, you become friends. Almost all of my attendings have either invited me to their house for dinners/parties, taken me out to lunch, etc. My Med attending bought me a wedding present and made my wife come by the clinic so he could meet her. My family med attending gave me a cohiba and an outback gift card at the end of the rotation so I could take my wife (then fiancee) out to a nice dinner. These are just a few examples, there are many more. Yea, clearly thought I was a burden.

nice dinner?

 

[KnuxNole]

Teaching hospitals seem to view students as lowly lame burdens as well. It seems its better to rotate with an attending as far as teaching. With residents, it gets so boring and sitting around most of the day >.>

Teaching hospitals are meant for residents first and STUDENTS are the afterthought. With only an attending, I find you learn more, get to see/do more. And no lolscut

 

[medgrad2013]

Just wanted to give some of my experiences for the year at a "non-teaching" hospital.. First off, I want to say that you will basically learn as much as you want at either a teaching hospital or non teaching. In third year, much of your education really is up to you.

Now, I enjoyed working one on one with preceptors who were, mostly, very interested in teaching and helping. Now in obgyn, that was not true at all. But in IM it was more true than at the main teaching hospital. In surgery I noticed that I was in way more surgeries and parcipated much more than those at the main campus and saw way more patients in the ER. However, I was not as involved in the day to day care of patients on the floor as much. Hours were definitely shorter at the hospital I was at in most rotations, however we had very little lecture time that took up the day and very little "sitting around waiting for the resident to page" time. My NBME grades have been much higher than they were in first and second year, and I am not sure how to measure that because I have been much happier this year than the other 2.

One of the things I miss about not being at a big teaching hospital is the lack of contact I have with other med students and not getting to work in teams. People really do seem to bond on some of their rotations and at some teaching hospitals med students really do become part of the care team (although that also leads to having to do lots of non learning activities (or scut, if you will) to pull your weight for the team).

One big thing I noticed was everyone who is rotating at the non-teaching hospital has been much happier all year. It seems that many at the teaching hospital who work super long days with not much learning going on get burnt out, cynical and flat out depressed at various times during the year. That environment normally does not exist in med students at nonteaching sites. (and this could be due to self selection of students who are less anal and more chill and thus choose to go to non-teaching hospitals)

 

[FSU2013]

nice dinner?

Oh common, I'm a med student......a nice dinner is anything other than Ramen. Outback is super nice for my level of income (i.e. negative dollars).

 

[sylvanthus]

Start finding some drug rep dinners in the area yo. Free food and wine at a decent restaurant and only have to deal with a 10-15 min spiel on a drug.

 

[Disinence2]

Just consider yourself astoundingly lucky. I would have killed for a gen surg schedule like that . Unless you want to go into surgery... then that sucks.

I did an ICU rotation at a "non-teaching" hospital and it was amazing. Got first shot at all procedures. Did more procedures there than during my intern year ICU rotation.

 

[illegallysmooth]

When you rotate at non-teaching hospitals, the experience can fall anywhere on a spectrum from super light to super heavy. I am with an attending who has one other medical student, we bust our asses to complete our responsibilities. We are expected to know everything about our patients. There are no residents - the attending depends on us, instead.

So make the most of it now. If you have one patient, learn everything you can about that patient. Can you name the MOA and side effects of every drug used in the case? Can you account for the mechanism every sign and symptom? Do you know what to do in case the patient experiences X, Y or Z post-op?