Clinical clerkships/postings. Are they well organized in your med school?

[Polycherry]

Hey guys! I was wondering how clinical postings are elsewhere. In our med school, it's too casual and no one gives a damn. 2 guys (the gunners sorts) workup a case, post on the group before class starts and everyone manages to turn up before the proff walks in. There is no dearth of clinical material but we don't make the fullest use of it.

I'm in 3rd yr now and even when the proff discusses the case with us, we are mostly stuck on history/examinantion and rarely we proceed to discussing differentials and management.

I'm sure it isn't the same everywhere. How are clinical postings/clerkships structured in your medschools? Do you guys have rounds too at MD (medschool) level? Are there assessments, pretests, etc etc?

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[PhillyMed777]

I honestly have no idea what you are talking about. What is a posting and how can it be "casual" ?

If you are asking about clerkship: At my school, we are broken into small subgroups and rotate through different specialties for one year total, each rotation lasting 6-9 weeks (fam med, int med, peds, psych, ob-gyn, surgery). We are expected to follow the expectations of the residents/attendings day-to-day. Inpatient wards involves pre-rounding, writing a note, and presenting patients with plans during formal Rounds in the hospital. Same on clinic but faster paced. We help as much as allowed/possible during new admissions, consults, surgeries, etc. and get "pimped" all day (i.e asked questions to assess our knowledge and inflate someone else's ego at the same time) Some have down time, while other rotations may be non-stop during the day (all day surgeries, days on the Labor and delivery, etc). We also have centralized responsibilities at the end of each rotation that include random assignments/essays, tracking our patients, taking a national standardized exam lovingly called the "shelf," and taking a clinical skills exam. All these are specifically geared to each rotation.

Most sites for our rotations pay close attention to us and demand excellence and that we show constant improvement/evidence of learning. A few sites are lower quality and we waste lots of time through the day and/or have highly malignant and abusive faculty. It's a very tough year and a lose-lose from any angle. You are the bottom of the totem pole and many people won't let you forget that.

In summary they are well organized on the large scale, but variable day-to-day and person-to-person.

 

[Lawpy]

I honestly have no idea what you are talking about. What is a posting and how can it be "casual" ?

I don't think OP is in a US medical school so different standards/rules apply.

 

[MSTP18]

I'm sure it isn't the same everywhere. How are clinical postings/clerkships structured in your medschools? Do you guys have rounds too at MD (medschool) level? Are there assessments, pretests, etc etc?

I think the answer I could give to your questions is that it depends on the clerkship. We do have rounds but who is present varies from service to service (on surgical specialties like GYN and gen surg they were with residents only, on peds and medicine we would round with the residents first and then again with the attendings, on neuro, psych, and SICU there was just one set of rounds with the attending). Students have their own patients so there's no way you could leech off the work of another student. I also was typically the only student on my team so there would have been no one to leech off of anyway. For every clerkship we are assessed generally on floor performance by residents and attendings as well as the standardized exam at the end of the block. Other rotations have more or less other assignments that are part of the grade (e.g. patient write ups +/- academic discussion citing recent literature, oral presentations on some topic, a designated supervised patient encounter, etc.)

 

[Polycherry]

We call clerkships postings. I think it is the term used in most commonwealth countries. We do the shadowing in our internship (PGY1) equivalent, at the end of medschool. But shadowing residents, during clerkships i think is a great way to learn. Its easier to relate to and communicate with residents who are younger and more understanding than old and nasty professors. I'll try suggesting this to our curriculum advisors. Thanks!

 

[MSTP18]

We call clerkships postings. I think it is the term used in most commonwealth countries. We do the shadowing in our internship (PGY1) equivalent, at the end of medschool. But shadowing residents, during clerkships i think is a great way to learn. Its easier to relate to and communicate with residents who are younger and more understanding than old and nasty professors. I'll try suggesting this to our curriculum advisors. Thanks!

Shadowing might also be used differently for you guys. Shadowing in the US means simply observing. That's what students do prior to medical school or in the first couple years. In the final 2 years (our clerkships) we should be more than just shadowing.