British Student - Third Year rotation/elective/clerkship in the US?

[sallywahl]

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Hi,
I thought I would post here seeing as I want to do the rotation in the US not abroad.
I am looking for schools which offer third year electives / rotations to students from other schools.
Perhaps you may have met some of these students during your rotation. Please let me know. I found one or two so far, however I am hoping to do a rotation before my final year and would like to consider all schools available.

thank you in advance.

 

[McGillGrad]

As far as I know, you have to be in your final year and US schools only offer electives (not cores).

 

[sallywahl]

I am not looking to do cores. And yes majority of schools only offer final year electives. I found one or two schools which do not need you to be in the final year but require that you have completed the rotation at home. I'm just looking for more.

 

[McGillGrad]

That's the issue, you need to be in your final year for 99%. Even in your final year, you're still one year behind the final year students in the US. Once you start your foundation year, you are on the same level as 4th year US students. That's why they want you to be in your final year. By then you've at least done plenty of jobs and started to manage patients.

 

[sallywahl]

If we are still a year behind US final students in our final year then how is it possible to get residency positions for British students. I don't believe that's entirely the case. By the end of our final year I am sure we are at par with US students, the system is just different and any overseas student would have to learn the US way of things i.e drug names, ward rounds etc but I don't believe we are a year behind.

Otherwise the US would insist on not taking anyone from here until after FY1 or FY2.

 

[McGillGrad]

You can only realistically apply to residency in the US once you are a SHO. The timing of the beginning of your F1 year (in August) prevents you from being ECFMG certified in time to apply.

 

[bambi]

You can only realistically apply to residency in the US once you are a SHO. The timing of the beginning of your F1 year (in August) prevents you from being ECFMG certified in time to apply.

This is total nonsense. A UK grad is at least equal to a US grad, some would say superior in terms of clinical skill.

 

[McGillGrad]

This is total nonsense. A UK grad is at least equal to a US grad, some would say superior in terms of clinical skill.

You mean a British student that spends 2 more years in the hospital (than a US student) doings jobs all day (a.k.a. clinical skills) is superior in terms of clinical skills? Laugh.

You also do not go to theatre during surgery rotations and do not go to the clinics in order to build your clinical skills. I certainly hope that your clinical skills are superior after all of that.

 

[bambi]

You mean a British student that spends 2 more years in the hospital (than a US student) doings jobs all day (a.k.a. clinical skills) is superior in terms of clinical skills? Laugh.

You also do not go to theatre during surgery rotations and do not go to the clinics in order to build your clinical skills. I certainly hope that your clinical skills are superior after all of that.

I have no idea what kind of idiot you have been talking to but of course we go to theatre and clinics. Also it is generally well known that we are better clinically. You may be better for your system, you are taught to order every test so you don't get sued and fine, you have to. Suing a doctor here is practically unheard of, we don't need to practice defensive medicine, we only do the tests that are actually totally necessary and are taught to rely far more on our clinical skills, so they need to be, and are, better than yours.

 

[McGillGrad]

You think I know this much about your system because someone told me? 😀

I know exactly what you guys learn and everything that you are signed off for during clerkships. I know your students very well.

Running around clerking patients, taking bloods, cannulating, and chasing down results (whilst avoiding staying past half-three) is not impressing anyone, let alone your registrars or consultants.

I have no idea what kind of idiot you have been talking to but of course we go to theatre and clinics. Also it is generally well known that we are better clinically. You may be better for your system, you are taught to order every test so you don't get sued and fine, you have to. Suing a doctor here is practically unheard of, we don't need to practice defensive medicine, we only do the tests that are actually totally necessary and are taught to rely far more on our clinical skills, so they need to be, and are, better than yours.

 

[Blitz2006]

I would agree with Bambi.

I currently am a 4th year medical student at University of Birmingham, England. Grew up in Canada, did my BSc in Ontario, then decided to do meds in the UK since I'm a British citizen.

Anyways, I'm keen on doing residency in U.S, so last couple summers I have worked in hospitals in North America (Toronto, Johns Hopkins, Jefferson Philly and UPenn). At Hopkins I did neurosurgery and orthopedics, UPenn was Thoracic surgery and Jefferson was Neurology and Rad Onc).

In Toronto I did Med Onc, and Clinical Onc research for a summer.

And next year I'll be doing 4 months of electives at UMass/Mt. Sinai NYC.

So I'm quite experienced in healthcare in all 3 countries.

American medical students are very WEAK clinically. Brits are definitly stronger medical students from a clinical standpoint. However, pre-clinically (so 1st 2 years of meds), the Americans are stronger cause they have to do Step 1 (Brits have no such standardized exam at that stage).

So pre-clinically Americans > British, but for clerkship Brits > Americans.

And I've been scrubbing in since my 3rd year, assisting in the theatre. And my GSurg proper rotation isn't even until 5th year, but I've already scrubbed in on several cases.

But when it comes to post-graduate training (ie, residency vs. F1/Registrar), America is superior just because docs in the U.S work like dogs compared to British docs. And yes, private health care trumps NHS when it comes to procedures, etc.

For example, last summer at UPenn, 4th year student asked me (just finished my 2nd year) how to do a proper patella reflex....and she was interested in a Neurology residency....I was shocked. And this is UPenn, top 10 I reckon?

U.S is great, I will admit, but a lot of it is hype. When I was at Hopkins, don't get me wrong, they know what they are doing, but it wasnt as amazing as I thought it would be (considering they have tv shows like Hopkins 24/7, and shows about Benjamin Carson, etc.).

One thing I noticed about American students is that they know a lot about random, rare stuff that no one really cares about. I mean honestly, I'm glad you know how many strains of S.Pneumonnia there are, but if you can't do a proper resp. examination then whatever.

Another way to tell that the Brits are stronger clinically are the OSCEs. Step 2 CS is a joke compared to my Birmingham OSCEs. I have never been so humbled in my life.

So in conclusion, british medical STUDENTS > American medical students, but American RESIDENTS > British residents.

Just my 2 cents,

 

[jbz24]

I would agree with Bambi.

I currently am a 4th year medical student at University of Birmingham, England. Grew up in Canada, did my BSc in Ontario, then decided to do meds in the UK since I'm a British citizen.

Anyways, I'm keen on doing residency in U.S, so last couple summers I have worked in hospitals in North America (Toronto, Johns Hopkins, Jefferson Philly and UPenn). At Hopkins I did neurosurgery and orthopedics, UPenn was Thoracic surgery and Jefferson was Neurology and Rad Onc).

In Toronto I did Med Onc, and Clinical Onc research for a summer.

And next year I'll be doing 4 months of electives at UMass/Mt. Sinai NYC.

So I'm quite experienced in healthcare in all 3 countries.

American medical students are very WEAK clinically. Brits are definitly stronger medical students from a clinical standpoint. However, pre-clinically (so 1st 2 years of meds), the Americans are stronger cause they have to do Step 1 (Brits have no such standardized exam at that stage).

So pre-clinically Americans > British, but for clerkship Brits > Americans.

And I've been scrubbing in since my 3rd year, assisting in the theatre. And my GSurg proper rotation isn't even until 5th year, but I've already scrubbed in on several cases.

But when it comes to post-graduate training (ie, residency vs. F1/Registrar), America is superior just because docs in the U.S work like dogs compared to British docs. And yes, private health care trumps NHS when it comes to procedures, etc.

For example, last summer at UPenn, 4th year student asked me (just finished my 2nd year) how to do a proper patella reflex....and she was interested in a Neurology residency....I was shocked. And this is UPenn, top 10 I reckon?

U.S is great, I will admit, but a lot of it is hype. When I was at Hopkins, don't get me wrong, they know what they are doing, but it wasnt as amazing as I thought it would be (considering they have tv shows like Hopkins 24/7, and shows about Benjamin Carson, etc.).

One thing I noticed about American students is that they know a lot about random, rare stuff that no one really cares about. I mean honestly, I'm glad you know how many strains of S.Pneumonnia there are, but if you can't do a proper resp. examination then whatever.

Another way to tell that the Brits are stronger clinically are the OSCEs. Step 2 CS is a joke compared to my Birmingham OSCEs. I have never been so humbled in my life.

So in conclusion, british medical STUDENTS > American medical students, but American RESIDENTS > British residents.

Just my 2 cents,

If by very weak clinically that you mean American medical students physical exam skills are poor, then I would somewhat agree. We've become so accustomed to ordering various tests and images that we've definitely lost physical exam skills. However, if you mean diagnosing, treating, and knowing the evidence behind the two, then an American medical student on average will run circles around European students, including Brits. Maybe I've just been unlucky with the ones who've rotated on my teams before, but they didn't even know how to conduct and write up H&Ps properly with a good A/P. I'd like to think it was just a cultural issue, but I don't think so. And I don't like generalizing an entire country because I'm sure there are many fantastic British students.

No question about it, Step 2 CS is a joke. Don't let yourself think that it's a good gauge of how our education is. In fact, the main reason for the test, even if it's not explicitly stated, is to make sure foreign graduates can speak english proficiently enough to conduct an H&P here.

But I do agree that there is a certain hype involved in some of the hospitals here. Hopkins isn't one of the best hospitals because each of the physicians there are the best. It's one of the best because they conduct some of the best research. Being a top-whatever hospital does not necessarily translate into being the best clinically.

 

[KeyzerSoze]

For example, last summer at UPenn, 4th year student asked me (just finished my 2nd year) how to do a proper patella reflex....and she was interested in a Neurology residency....I was shocked. And this is UPenn, top 10 I reckon?

That's bizarre. We need to know how to do a proper patellar reflex to pass first year.

 

[Blitz2006]

That's bizarre. We need to know how to do a proper patellar reflex to pass first year.

Yeh, she probably knew how to do it 2 years ago, but obviously didn't really practice it since her exam....

Again, not bashing American med students, but just trying to put everything in perspective.

 

[Blitz2006]

Appreciate the honest response.

Yeh, I was talking about physical exam skills. And I agree, I'm sure there are some crappy brith med students as well. I'm just impressed with what I've seen here in Birmingham, and we're considered a 2nd tier school (the big guns are Oxford, Cambridge, Imperial and Edinburgh). So I can only imagine their skills...

But again, I also have a lot of respect for Americans. The USMLE is a very good exam, and impressive that it is compulsory for med students to pass medical school. The UK needs to bring in a standardized exam like that.

I guess my point is that the U.S is great, but not as amazing as they make it appear in the press/tv. And there are great hospitals outside of the states as well...which I noticed a lot of American med students don't believe.....

If by very weak clinically that you mean American medical students physical exam skills are poor, then I would somewhat agree. We've become so accustomed to ordering various tests and images that we've definitely lost physical exam skills. However, if you mean diagnosing, treating, and knowing the evidence behind the two, then an American medical student on average will run circles around European students, including Brits. Maybe I've just been unlucky with the ones who've rotated on my teams before, but they didn't even know how to conduct and write up H&Ps properly with a good A/P. I'd like to think it was just a cultural issue, but I don't think so. And I don't like generalizing an entire country because I'm sure there are many fantastic British students.

No question about it, Step 2 CS is a joke. Don't let yourself think that it's a good gauge of how our education is. In fact, the main reason for the test, even if it's not explicitly stated, is to make sure foreign graduates can speak english proficiently enough to conduct an H&P here.

But I do agree that there is a certain hype involved in some of the hospitals here. Hopkins isn't one of the best hospitals because each of the physicians there are the best. It's one of the best because they conduct some of the best research. Being a top-whatever hospital does not necessarily translate into being the best clinically.

 

[bambi]

. The USMLE is a very good exam, and impressive that it is compulsory for med students to pass medical school. The UK needs to bring in a standardized exam like that.

I agree, the BMA doesn't though! I'm in the middle of job applications and would much rather have my future depend on actual knowledge than just my ability to fit the right amount of buzzwords in a 200 word passage.

As for US residents being better than Brits I'm not sure you can generalise. After 2 post-grad years the general knowledge of a UK SHO would be better than the general knowledge of an equivalent US resident, their specialist knowledge would be better though. In the end it all ends up equal, we just take a lot longer to get there because of reduced hours.

 

[bambi]

The only way you could really know exactly what we do is if you were one of us! Seeing a few students or even a lot does not qualify you to say you know more about us than we do! Everything you have said is nonsense but you are free to believe what you like.

You think I know this much about your system because someone told me? 😀

I know exactly what you guys learn and everything that you are signed off for during clerkships. I know your students very well.

Running around clerking patients, taking bloods, cannulating, and chasing down results (whilst avoiding staying past half-three) is not impressing anyone, let alone your registrars or consultants.

 

[McGillGrad]

The only way you could really know exactly what we do is if you were one of us! Seeing a few students or even a lot does not qualify you to say you know more about us than we do! Everything you have said is nonsense but you are free to believe what you like.

You sound quite defensive. I would rank the students I have seen, from best-to-worst: Imperial/Oxford, King's College London, St. George's and finally Manchester.

Where do you fit in?

 

[Blitz2006]

I agree, the BMA doesn't though! I'm in the middle of job applications and would much rather have my future depend on actual knowledge than just my ability to fit the right amount of buzzwords in a 200 word passage.

As for US residents being better than Brits I'm not sure you can generalise. After 2 post-grad years the general knowledge of a UK SHO would be better than the general knowledge of an equivalent US resident, their specialist knowledge would be better though. In the end it all ends up equal, we just take a lot longer to get there because of reduced hours.

Yep, 100% agree. Gen Surg in U.S = 5 years. In UK = 10 years (with 2 years of Foundation, so 2 + 8).

So yeh, in the end consultant = attending. But thats my point right, American residents (or residency programs) are better than British residents because they have to 'catch up' I believe (because as I stated in my earlier post, British medical STUDENTS are much better than american medical students).


P.S. good luck with your F1 apps. I'll be doing that next year, so probably will be bugging you for advice come 10 months. I'm hoping to do F1 in Birmingham or London, but I know both are very competitive, might end up in a place like Sunderland 😛

 

[Blitz2006]

You sound quite defensive. I would rank the students I have seen, from best-to-worst: Imperial/Oxford, King's College London, St. George's and finally Manchester.

Where do you fit in?

Not sure what bambi thinks, but I would say that based on generalized reputation, that ranking sounds fairly accurate. Manchester used to be a great school, until they switched to PBL...

 

[bambi]

Not sure what bambi thinks, but I would say that based on generalized reputation, that ranking sounds fairly accurate. Manchester used to be a great school, until they switched to PBL...

I would say that unless you see entire year groups from each school you can't really rank. Just seeing a few means nothing. Everywhere has good and bad students, comparing the best of one place to the worst of another will obviously skew your views and no one will turn around and say "by the way I'm pretty crap compared to my friends in my year".

PBL at any school will lead to greater variety in knowledge base. Some students will go overboard and have far greater knowledge than those at traditional schools, others will do the bare minimum and have far worse knowledge. I personally think pre-clinical PBL is a terrible idea but it could be argued that it is more likely to produce at least some excellent rather than adequate students. Those on traditional courses are given all the info they need and therefore tend to learn just that or perhaps a bit more. Unless they are given extreme amounts their knowledge wont be equal to those super keen PBL students that read everything because they aren't sure how much they need to do. I think traditional courses are better for training everyone to the same standard but PBL encourages going beyond that. Most people wont, but some will.

 

[McGillGrad]

In other words, you're from Manchester.

Nice.

I would say that unless you see entire year groups from each school you can't really rank. Just seeing a few means nothing. Everywhere has good and bad students, comparing the best of one place to the worst of another will obviously skew your views and no one will turn around and say "by the way I'm pretty crap compared to my friends in my year".

PBL at any school will lead to greater variety in knowledge base. Some students will go overboard and have far greater knowledge than those at traditional schools, others will do the bare minimum and have far worse knowledge. I personally think pre-clinical PBL is a terrible idea but it could be argued that it is more likely to produce at least some excellent rather than adequate students. Those on traditional courses are given all the info they need and therefore tend to learn just that or perhaps a bit more. Unless they are given extreme amounts their knowledge wont be equal to those super keen PBL students that read everything because they aren't sure how much they need to do. I think traditional courses are better for training everyone to the same standard but PBL encourages going beyond that. Most people wont, but some will.

 

[bambi]

In other words, you're from Manchester.

Nice.

No. In other words I think you are full of it. You make outrageous generalisations. I think PBL is a bad idea early on but can potentially have a good outcome, it is however not the path I would advise. I have been to more than one university and have obviously had close experiences with medics at both and have friends at at least another 10 med schools in the country. From my experience you can't make such huge generalisations. I know students from traditional schools that are terrible in comparison to those at PBL schools but I also know students at PBL schools that are awful. Anywhere you go you will meet people and wonder how they even got in.

 

[McGillGrad]

You failed out of one school and had to go to another one? Why?

No. In other words I think you are full of it. You make outrageous generalisations. I think PBL is a bad idea early on but can potentially have a good outcome, it is however not the path I would advise. I have been to more than one university and have obviously had close experiences with medics at both and have friends at at least another 10 med schools in the country. From my experience you can't make such huge generalisations. I know students from traditional schools that are terrible in comparison to those at PBL schools but I also know students at PBL schools that are awful. Anywhere you go you will meet people and wonder how they even got in.