Bored to death on IM

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Waysensei

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I just started my 3rd year with IM. I came in expecting a fair workload and a 7am-5pm schedule, but so far, about 1 week in, I am at a loss of what to do on the floor. This is the first year my hospital has accepted students in their IM service, and there is no organization whatsoever or defined role for the medical student. Rounds typically end around 10am, and on the days where my team doesn't have afternoon admits, which is 2-3 days/week, there is nothing for me to do in the afternoon aside from following up on labs and imaging studies. I am trying to be as assertive as possible in obtaining responsibility, but the problem seems to lie in that there is a lack of events occuring. There is usually only 1 admit in the morning and today, I offered to follow him, only to be told that there is no need, since the resident and attending had already done everything necessary. Therefore, today, I was essentially done with my day at 9am. My attending recommended me to follow up on some imaging studies for a patient, but there is no way that is going to occupy the remainder of my day. It is like this many days of the week and as a person who enjoys being busy and having meaningful activities to complete, I am quickly becoming very dejected.

I want to learn and to become a better doctor, but 1 week in, I have only done 2 H&P's and no procedures, despite attempting to obtain as much responsibility as possible. All of my rotations are going to be at this hospital and if my other rotations are like this, I don't know what I am going to do.

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An osteopathic student....why am I not surprised.

Any medicine service that gets 1 admit per day is not a service conducive to teaching residents, let alone students. Clearly you've figured out by now that your education is in your hands, as your school obviously doesn't care about the quality of your clinical education. Procedures can be hit or miss, but if you are not doing H&P's and following patients on your core medicine rotation, you are wasting your time and money. If I were you, I would DEMAND that your school take action to send to another institution for your core clerkships. If that doesn't work, escalate your complaints.
 
I just started my 3rd year with IM. I came in expecting a fair workload and a 7am-5pm schedule, but so far, about 1 week in, I am at a loss of what to do on the floor. This is the first year my hospital has accepted students in their IM service, and there is no organization whatsoever or defined role for the medical student. Rounds typically end around 10am, and on the days where my team doesn't have afternoon admits, which is 2-3 days/week, there is nothing for me to do in the afternoon aside from following up on labs and imaging studies. I am trying to be as assertive as possible in obtaining responsibility, but the problem seems to lie in that there is a lack of events occuring. There is usually only 1 admit in the morning and today, I offered to follow him, only to be told that there is no need, since the resident and attending had already done everything necessary. Therefore, today, I was essentially done with my day at 9am. My attending recommended me to follow up on some imaging studies for a patient, but there is no way that is going to occupy the remainder of my day. It is like this many days of the week and as a person who enjoys being busy and having meaningful activities to complete, I am quickly becoming very dejected.

I want to learn and to become a better doctor, but 1 week in, I have only done 2 H&P's and no procedures, despite attempting to obtain as much responsibility as possible. All of my rotations are going to be at this hospital and if my other rotations are like this, I don't know what I am going to do.


Pretty much why I've said the things I have about my clinical experiences. Take heart, you will move on and hopefully get to a rotation where you "do things"...in my experience IM was the worst by far...so it can only get better for you.

And, you'll graduate and move on to real training in a couple years. Just study hard and learn as much as you can.
 
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Unfortunately I know what you mean. I am on a fairly busy IM service, but there's a ton of students so there isn't much to do. I just try and read up on the conditions and the management of the few patients I have. I also try to read Case Files and SUTM with my free time and do some MKSAP questions if there is any time left over. It isn't quite how I imagined it, but it's like everything else in medical school - it's as much of a test of knowledge as it is a test of endurance. Good luck, plow through it, and look forward to the next rotation.
 
Pretty much why I've said the things I have about my clinical experiences. Take heart, you will move on and hopefully get to a rotation where you "do things"...in my experience IM was the worst by far...so it can only get better for you.

And, you'll graduate and move on to real training in a couple years. Just study hard and learn as much as you can.

Even with patients to follow, IM blows. :thumbdown:

Take advantage of the free time to study for the shelf. It's a beast of an exam.

OK, so you all clearly didn't like your Medicine clerkships. That's not really the point here.

The OP is reporting that he is sitting around doing nothing on his core Medicine clerkship, and presumably paying a lot of tuition for this. Medicine isn't just about studying for the shelf exam (nor is any other rotation).

On a good medicine service, you should be seeing patients daily, following them from admit to discharge, and reading up on them as much as possible. Yes it is very tedious. But it is the best way to really learn Medicine. Hiding out in the library cramming information from Blueprints or First Aid is a poor substitute.

If you are interested in Medicine, a solid clerkship is very important in order to learn the fundamentals you'll use in residency. Even if you aren't interested in Medicine, the clerkship is the only real exposure you'll have to the field unless you're doing a preliminary Medicine year, and you won't survive that too long if you're weak in Medicine. There's a very good reason why the Medicine clerkship is the longest one in most medical schools, and the OP is basically being cheated out of this. To advise him that this is not a big deal and to wait it out until the next rotation is, frankly, ridiculous.
 
If you are interested in Medicine, a solid clerkship is very important in order to learn the fundamentals you'll use in residency. Even if you aren't interested in Medicine, the clerkship is the only real exposure you'll have to the field unless you're doing a preliminary Medicine year, and you won't survive that too long if you're weak in Medicine. There's a very good reason why the Medicine clerkship is the longest one in most medical schools, and the OP is basically being cheated out of this. To advise him that this is not a big deal and to wait it out until the next rotation is, frankly, ridiculous.

No more ridiciulous than advising him to 'demand' that his school do something about his problem. Have you ever tried demanding something in a situation where you have no leverage? It won't work and he'll see it bite him in the butt in his grade and, if he's loud enough, maybe his dean's letter too. If he has a clear solution (i.e. 'can you please transfer me to [blank] hospital that we have a relationship with and that I know has a slot open) then it might be worth it to politely ask if he can make a switch, but otherwise his best bet is to stick it out and study for the shelf. If he really feels like he's missing something I'm sure he can make up the clinical exposure with electives.

OP, I'll echo everyone else in saying it could be worse. As bad as it is not be learning anything, at least they aren't creating make work to fill your hours. If you can at least use the time you're not following patients to study you're ahead of a lot of medical students out there.
 
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No more ridiciulous than advising him to 'demand' that his school do something about his problem. Have you ever tried demanding something in a situation where you have no leverage? It won't work and he'll see it bite him in the butt in his grade and, if he's loud enough, maybe his dean's letter too. If he has a clear solution (i.e. 'can you please transfer me to [blank] hospital that we have a relationship with and that I know has a slot open) then it might be worth it to politely ask if he can make a switch, but otherwise his best bet is to stick it out and study for the shelf. If he really feels like he's missing something I'm sure he can make up the clinical exposure with electives.

OP, I'll echo everyone else in saying it could be worse. As bad as it is not be learning anything, at least they aren't creating make work to fill your hours. If you can at least use the time you're not following patients to study you're ahead of a lot of medical students out there.

If you wanted to say, "Hey I don't know what I'm talking about, but feel the urge to post anyway!" you could have done it more concisely (like I did just there).

Since you aren't an osteopathic student, let me explain for your benefit. I attended an "established" osteopathic school, and the degree of incompetence among the clinical deans and staff was truly breathtaking. The only way to ensure that you didn't get SCREWED in the third and fourth year, was to complain. A lot. Those who complained had their Dean's Letters sent out on time, had their transcripts correct before graduation, and got the good rotations and elective sites, while those students who took the polite wallflower approach you seem to be fond of got the shaft.

I'm not going to pretend that I know everything about other osteopathic schools but I've heard horror stories in real life and on SDN when it comes to their clinical rotations. I'm sure that waysensei's school is not cheap, so why settle for what sounds like a completely unsatisfactory clerkship site? Especially when the OP is interested in Medicine? Again, ridiculous.

(By the way, I read my Dean's Letter. It was just fine.)
 
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If you wanted to say, "Hey I don't know what I'm talking about, but feel the urge to post anyway!" you could have done it more concisely (like I did just there).

Since you aren't an osteopathic student, let me explain for your benefit. I attended an "established" osteopathic school, and the degree of incompetence among the clinical deans and staff was truly breathtaking. The only way to ensure that you didn't get SCREWED in the third and fourth year, was to complain. A lot. Those who complained had their Dean's Letters sent out on time, had their transcripts correct before graduation, and got the good rotations and elective sites, while those students who took the polite wallflower approach you seem to be fond of got the shaft.

I'm not going to pretend that I know everything about TouroCOM-CA but I've heard horror stories in real life and on SDN when it comes to their clinical rotations. I'm sure that TouroCOM-CA is not cheap, so why settle for what sounds like a completely unsatisfactory clerkship site? Especially when the OP is interested in Medicine? Again, ridiculous.

(By the way, I read my Dean's Letter. It was just fine.)

Yup sometimes incompetent people can be found everywhere. Unfortunately DO students rotate in private clinics or small hospital, and yes the learning is impaired because of it.

Complaining can help or hurt you. I know that some administrators put you on a "special" list if you complain. Unfortunately medicine is all about negotiating and making the best of the situation.

If you can go ahead and see every single pt on your list, or on the medicine service, than you can pick up cases that you are interested in. It will require more effort on your behalf.. and you will have to contact the primary physician and see if s/he is okay with that. You can even volunteer to write progress note (I have been doing at least 3 progress notes, everyday of my third year x 50 weeks). That repetition is great training. You don't know it till you get to the end of 3rd year.
 
I readily admit that IM is near the bottom of my lists of interests. However, up until my horrible experience on IM I truly believed that's what I would do. To me, there were better things to do than round all day with little/no instruction.

I think it was hospital IM service, in particular, that turned me off. Particularly the personalities I encountered.

As for DO schools, I have to agree, but complaining gets you essentially nowhere. So, you deal with it, learn as much as you can and move on.
 
Gotta love it. My how disappointed I have been.

Wanna_be_DO, please read your PM. I don't feel comfortable posting a tidbit I have on here. Thanks!
 
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