Chronically overworked

[BigPikachu]

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Out of curiosity: When Med Students graduate in the United States, is Internship and Residency already streamlined for a specialty track? Or is it like Commonwealth countries, where the Internship and Residency are pre-vocational general rotation terms, and then a further Registrarship is the specialtry training phase?

 

[deleted480308]

Out of curiousity, and on a side note, how many of you guys in the US use a dictaphone to transcribe your notes?

Dragon for the win

 

[deleted480308]

Out of curiosity: When Med Students graduate in the United States, is Internship and Residency already streamlined for a specialty track? Or is it like Commonwealth countries, where the Internship and Residency are pre-vocational general rotation terms, and then a further Registrarship is the specialtry training phase?

Residencies are 3-7/8 yrs depending on the specialty, after that you are considered trained and pretty readyfor board certification. The first year of residency is called intern year even it’s part of the residency and not a completely different year elesewhere

Sub-specialist training is called fellowship and is 1 or more years after residency

 

[BigPikachu]

Dragon for the win

We use the same one here in Australia 😉
Do you guys also use Cerner / Powerchart or FirstNet?

 

[BigPikachu]

Residencies are 3-7/8 yrs depending on the specialty, after that you are considered trained and pretty readyfor board certification. The first year of residency is called intern year even it’s part of the residency and not a completely different year elesewhere

Sub-specialist training is called fellowship and is 1 or more years after residency

In Australia:
Intern = PGY1 / General Rotations
Junior Resident = PGY2 / General Rotations
Senior Resident = PGY3 / General Rotations
Registrar = PGY4-10 / Specialty Training Programs
Fellow = 1 year as a 'provisional specialist' or sub-specialising
Consultant = Fellowship attained and registered Specialist

 

[VA Hopeful Dr]

Except I wasn't talking about how to structure a primary care rotation. I was talking about excessive note-writing for an MS-3 and I do think I'm qualified to speak on the subject, having been an MS-3 myself and also a primary care intern with direct supervision over MS-3s. If you're attaching worth to the opinion of only primary care attendings on this subject, you'll have to discount 99% of this thread.

Way ahead of you

 

[kb1900]

Way ahead of you

just my .02$ as a student who had a similar experience to op about note writing:

I learned absolutely nothing from the 10+ obscenely comprehensive notes I wrote per day on my primary care rotation. Preceptor just attested them with a dot phrase and no feedback. 99% sure they were not even read by her.

It sucks to have to spend time doing that after already being kept extra late into the evening and still having to prechart 20+ of the next days patients. Meanwhile on chart review the attending’s own notes were just a bunch of autopppulated, often inaccurate garbage + 1-2 lines of history (“VF in tact b/l” in a blind patient etc.).

So as far as I’m concerned I wrote notes purely for the attending and patient’s benefit, not my own. At least prechart/chart review gives exposure/identifies weaknesses that can be read up on then reinforced the next day in real life.

Compared to writing notes, it was way more beneficial to present to my preceptor and get organizational + ddx framework tips and that kind of feedback....in real time...which rarely happened.

For better or worse, despite initial interest I was thoroughly driven away from primary care by the second week of the rotation despite enjoying most other parts of it. If you’re not going to give feedback verbally or when attesting a student’s note so they can learn, at best you are teaching them to write for the sake of writing (or “efficiency” if you want to call it that. Though nothing about it is efficient from a learning perspective IMO.)

 

[honey0102]

Note writing isn't mind numbing for an MS3 like it is for physicians who have done thousands of notes. It can be great learning for students just starting out.

Play how you practice. It's not unreasonable for a student to do more than 10 notes per day since they will be doing more than double that in practice.

The above is not an endorsement on what the preceptor was doing. I noted what I thought about that in an earlier post. However, students can definitely learn from writing notes, from writing a lot of notes.

It got to the point of diminishing returns. I was actually doing over 20 a day. Many super similar. Bread and butter cases. A tinyyyyy bit helpful? Maybe. But after note #15 on the same condition and a/p, having time to actually read on people's conditions more in depth from a textbook is definitely more helpful.

 

[Chemist0157]

It got to the point of diminishing returns. I was actually doing over 20 a day. Many super similar. Bread and butter cases. A tinyyyyy bit helpful? Maybe. But after note #15 on the same condition and a/p, having time to actually read on people's conditions more in depth from a textbook is definitely more helpful.

Yeah that's too much.