Best Clinical Rotation Sites?

[xajtx]

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Hey Everyone,

I'm trying to decide between med schools right now and have come to the conclusion that the quality of clinical rotation sites will be my number one factor when choosing a school. My question to all of you is: What determines what makes a clinical rotation site good? So far, I've been looking for Level 1 Trauma Centers which NSU seems to really excel at. Anything else I should be taking into consideration?

Thanks!

 

[bucks2010]

http://forums.studentdoctor.net/showpost.php?p=1178185&postcount=1

 

[sylvanthus]

Level 1 trauma center is not a good thing to consider as a factor. As a medical student, there will be tons of people above you and you will do few, if any, procedures. You have the 4th years to worry about, the interns, the second year residents, 3rd year, chiefs, etc etc etc. You'd spend more time doing scut work.

Also, level 1 trauma center doesn't really mean jack, there isn't much difference between a level 2 and a level 1. It has more to do with the availability of surgeons.

Sometimes, it is best to do some rotations in the middle of freakin nowhere, so that you can do way more procedures. I am in a crappy town in the middle of nowhere and have done 2 central lines and 2 abdominal paracentesis and it is early into 3rd year.

 

[turkeyjerky]

http://forums.studentdoctor.net/showpost.php?p=1178185&postcount=1

Man, that guy does a pretty good job of summing it up. Unfortunately for the OP, there really is no way for an applicant to find out the information you're looking for. School's don't make this information available (partly because the admin they doesn't have it or take as much interest in the clinical years). You could try to find 4th years at the schools you're interviewing at to ask them, but, odds are, that most will lie to you and tell you that it's great (b/c they don't want to admit that they got screwed, and also b/c most med students are pathologically enthusiastic).

Also, the truth is that most schools are going to have a varied quality of rotations. Even the same rotation at the same site is going to vary a lot depending on which residents you're assigned to. And whether the hospital is a level 1 trauma center, a stroke center, or one of the "best hospitals in america" has very little to do with the quality of students' experience there.

Just save yourself the time and effort, and go to the school in a nice location with the lowest tuition.

 

[NYCMS2]

Just save yourself the time and effort, and go to the school in a nice location with the lowest tuition.

Agree 100 percent on this.

 

[xajtx]

Thanks for the replies everyone! You're all absolutely right in that I shouldn't gat caught up in trivial things like facilities and impressions of the tour guides on interview day. One thing that really concerns me about NSU is that there are no electives 3rd year and students are mandated to do a three month rural rotation 4th year and don't get a say in when they can schedule them. So they could fall smack in the middle of audition rotation season, when students are trying to rotate at programs they wish to match at. I also would like to go back to CA for residency, and doing an elective out there wouldn't even be feasible until AFTER my residency applications are in. I don't know exactly what I want to do yet, but I'd like to have my options to pursue a specialty outside of primary care. Definitely have a lot to think about...

 

[turkeyjerky]

Thanks for the replies everyone! You're all absolutely right in that I shouldn't gat caught up in trivial things like facilities and impressions of the tour guides on interview day. One thing that really concerns me about NSU is that there are no electives 3rd year and students are mandated to do a three month rural rotation 4th year and don't get a say in when they can schedule them. So they could fall smack in the middle of audition rotation season, when students are trying to rotate at programs they wish to match at. I also would like to go back to CA for residency, and doing an elective out there wouldn't even be feasible until AFTER my residency applications are in. I don't know exactly what I want to do yet, but I'd like to have my options to pursue a specialty outside of primary care. Definitely have a lot to think about...

That rural rotation thing sounds like it sucks. But I wouldn't worry about the electives in third year thing--my school allows it, and it really f's up the schedule w/ a bunch of people being forced to take several electives before their core rotations in third year b/c the required rotations are filled up w/ 4th years.

 

[wannabeOBGYN]

Thanks for the replies everyone! You're all absolutely right in that I shouldn't gat caught up in trivial things like facilities and impressions of the tour guides on interview day. One thing that really concerns me about NSU is that there are no electives 3rd year and students are mandated to do a three month rural rotation 4th year and don't get a say in when they can schedule them. So they could fall smack in the middle of audition rotation season, when students are trying to rotate at programs they wish to match at. I also would like to go back to CA for residency, and doing an elective out there wouldn't even be feasible until AFTER my residency applications are in. I don't know exactly what I want to do yet, but I'd like to have my options to pursue a specialty outside of primary care. Definitely have a lot to think about...

Actually, you are assigned 2 of the rural rotations and the third is up to you as to when and where... so you can essentially go anywhere in the world and have a random doc sign a form that says you're helping underserved patients and you could spend the month snorkeling the great barrier reef, or at home with family doing nothing. That being said, a lot of people get screwed with the other two months. The people who went out of state for rotations (NY, GA, AL, MS) had better chances because the program directors had fewer schedules to create, so I heard some people got to put their rurals wherever they like.

 

[xajtx]

Actually, you are assigned 2 of the rural rotations and the third is up to you as to when and where... so you can essentially go anywhere in the world and have a random doc sign a form that says you're helping underserved patients and you could spend the month snorkeling the great barrier reef, or at home with family doing nothing. That being said, a lot of people get screwed with the other two months. The people who went out of state for rotations (NY, GA, AL, MS) had better chances because the program directors had fewer schedules to create, so I heard some people got to put their rurals wherever they like.

Oh, thanks for the info! Do you mean people who went out of state had a better chance of their rotations falling where they like? Because I thought that was randomly assigned to you?

Also, I thought the rural rotations were in S. Florida? (From what I saw on the website).

 

[msupaintballer]

Level 1 trauma center is not a good thing to consider as a factor. As a medical student, there will be tons of people above you and you will do few, if any, procedures. You have the 4th years to worry about, the interns, the second year residents, 3rd year, chiefs, etc etc etc. You'd spend more time doing scut work.

Also, level 1 trauma center doesn't really mean jack, there isn't much difference between a level 2 and a level 1. It has more to do with the availability of surgeons.

Sometimes, it is best to do some rotations in the middle of freakin nowhere, so that you can do way more procedures. I am in a crappy town in the middle of nowhere and have done 2 central lines and 2 abdominal paracentesis and it is early into 3rd year.

You cannot be more wrong! The difference between a real Level 1 & Level 2 ER is immense. I rotated my first month as a 4th year at the ER at St. Barnabas in the Bronx, NY. That month I put well over 150 IV's, foleys, lines, Peds ER, lacerations assisting in codes and traumas, as well as full aspect of Gyn consults. So know there is a difference. But also up to the individual and their eagerness to progress.

 

[123165]

I wanted to bump this.

What if you have a choice between going to a hospital with no residencies at all, vs one with a ton of residencies?

Would a LOR be less valuable from a 300 bed and no resident hospital? Would the ability to do more procedures outweigh this?

Would a bigger hospital with more residents and better didactics but less procedures be better?

 

[thepoopologist]

I wanted to bump this.

What if you have a choice between going to a hospital with no residencies at all, vs one with a ton of residencies?

Would a LOR be less valuable from a 300 bed and no resident hospital? Would the ability to do more procedures outweigh this?

Would a bigger hospital with more residents and better didactics but less procedures be better?

My opinion is that as a third year student, the more you do, the better.

 

[thepoopologist]

My opinion is that as a third year student, the more you do, the better.

Frankly you will have just finished two years of didactics. **** didactics. Time to perform

 

[MossPoh]

Agree 100 percent on this.

Yup.

While there is a lot of crap I don't like with my school, most of it is stuff of the "grass is always greener" variety. Getting instate in Florida has been great. It will cost me less to get my medical degree than my undergraduate. My third and fourth year are a couple hours from New Orleans and a quick drive to very nice beaches.

I would say that the Trauma center designation is dependent on the hospital. If affiliated with a school and a bunch of residency programs, I don't think it is really worth much for your education in the end. We have two trauma centers in the same town here and only three residencies, with all very friendly people. If you want to see trauma and get to do stuff, it is very possible here.

My biggest problem with my school is also its blessing. We are 1 on 1 with attendings. It really is a preceptor/mentor type atmosphere. I get great experiences with it, get to do a TON of stuff and generally have better hours than the traditional school. The problem is that there aren't many networking opportunities with residencies and for some specialties (surgery) it paints a very rosy picture of the lifestyle relative to what the training is like.

I worked hard on my surgery rotation and routinely got in and rounded/wrote notes on my patients, but my surgeon is in the twilight of his career and never took ER call. He also did mostly elective cancer surgeries since he was a surgical oncologist. He'd often finish early afternoon and would give me time to exercise, eat, or in my case...scrub in on a variety of other cases as first assist. The result was that I got to do all the really fun stuff and did well on my shelf, but I'm also pretty sure I would be a complete idiot when it comes to an academic medical center. I'm used to having my attending's cell, playing tennis with them, drinking coffee and just joking around.

While that is a very lengthy reply with very little substance, the point is that there are pros and cons to all rotation sites and even variations at the same site.

The best bet is to contact current third and fourth year students and listen to what they say, which is easier said than done.