any surgical internships with no prerounding

[entropy]

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if you know of any, please post.

thanx.

 

[LaCirujana]

Mine.😎

 

[entropy]

where is that?

 

[triathlete411]

UW-Madison - a fantastic program! I was tempted to rank it number one, but the cold Wisconsin winters deterred me from doing so.

 

[DoctorDoom]

St. Barnabas Medical Center, NJ... excellent community surgery program.

Although if you're trying to save that extra 30 mins you're in for a world of hurt...

 

[droliver]

Just some advice...... do not ask this question when you interview. The other question applicants threw out there this past year that (rightly or wrongly) reflected poorly on them during their interviews was an infatuation with the new work hr. rules for July. Both lines of inquiry imply that you're work ethic is different then that has been expected for surgical training. I'm not neccesarily espousing those views, but I have been @ the ranking committee meetings & these things are noted & discussed about particular applicants.


As far as the prerounding thing, I'm afraid I'll have to strongly disagree that it's this horrible thing to be avoided. An important part of your clinical maturity (both as a student and later a resident) is assessing things independently & you will lose a big part of this if all your daily patient assessment is in the context of some group rounds with upper level resident & attendings.

 

[walpk]

Pardon the intrusion of one who is yet to start her training, but I'm curious: Is it true that, In preparation for the new 80-hour limits, many programs are considering eliminating pre-rounding in order to shave off hours? I thought I heard this mentioned in one of the other threads.

 

[Jay Shoaps]

Michigan State University also has no prerounding.

 

[UI2003]

I, the applicant was *grilled* about the 80-hr workweek by my interviewers ("What do you think about the new changes?" "How do you think it will affect your training???"). So my advice on that front would be to stay silent on it unless they ask you, but have a well throught-out answer ready for when they do! Same thing for issues such as: fringe benefits, call sched, pay, etc.

 

[vuillaume]

I suspect that most programs are going to have to eliminate prerounding to meet the limits. So the absence of prerounding isn't likely to distinguish one program from another starting July.

While not having to wake up at 4.00 may seem to be an advantage, I'm not sure this makes life that much easier. Without the Intern (i.e. me or my compatriots in a couple of months) rattling the labs off, I imagine rounding will be just a little bit more painful.

I'd be curious to know if the programs that currently don't preround have good, efficient ways of doing this...Enlighten us before the pain begins.

 

[droliver]

Prerounding really is not a big contributor to the work hour issues @ many places (5-10 hors a week). Where the hours really add up is the in house call & this mostly affects pgy-1 & 2 residents. With no inhouse call, its hard to work >80hrs a week except on some services like tranplant which is very unpredictable. These new rules will mostly affect the most junior residents experiences by limiting their operative experience post-call (not neccessarily a bad thing, but all call nights are not created equal & these new rules can sometimes seem capricious & inflexible).

 

[Jay Shoaps]

It seems that there are a few ideas floating about regarding prerounding, here's my unsolicited 2 cents. If prerounds is just showing up, as Dr. Oliver described, maybe an extra 5-10 hours a week, with the result of making the day run more smoothly, it would be hard to argue against that. I, probably like most people entering surgery, consider myself a team player, and don't mind working for the group. When I interviewed however, some places with prerounding made the whole thing seem pretty unappealing. An example is an academic place I saw where the interns have virtually no OR time and yet were expected to arrive ~4am to start prerounding. When all you do all day is floor work/rounding the prospect of starting so early seemed pretty bleak. So I guess my point is that it is part of larger picture.

 

[dr.evil]

Although I agree with dr.oliver that pre-rounding is the least of the hours that are put in during a regular week, I don't think pre-rounding is as necessary as many places think. It's just a tradition thing.

The best way I've found is to split up all the patients among the residents and round on them. Then, meet for ~15 minutes or so and go over the patient list. This way you can concentrate on the more complex patients (and discuss them with your chief) and fly through the "pod #1, post-op ileus, npo, n/v, blah blah". This does not disallow the students from pre-rounding however. This system somewhat leaves out the hierarchy of intern vs. chief a little but is much more efficient and helps the interns develop autonomy when taking care of surgical patients. Then at 0730 everyone can go to the O.R. and do cases while doing paperwork, scutwork, consults, or whatever in between cases.

Although pre-rounding has/had it's purpose, in today's medical environment, efficiency must be a prime concern. It's amazing that my chief can go over all the patients, go do an APR, then in between cases run by and see the more complex patients. Makes the day a little bit busier though.

 

[handygirl]

And let's not forget the poor patients who have to be woken up every hour starting at 4 AM . . . Patients (especially elderly ones) need their sleep!

 

[entropy]

one of my friends is doing her residency in germany....

they only work 50 hours per week !

i asked her how is that possible, she mentioned that they just focus more on effeciency, and less paperwork, and minimal writing of notes......

if only that were possible here

sigh...........