Clinical rotation at Georgetown

[desiree]

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hello
I am about to do a one month rotation at Georgetown Medical School in Endocrinology.
I am an IMG and this will be my first time to do a rotation in the US. Does anyone have any advice on what i should do to make a good impression What do US doctors expect from visiting students. I have finished the basic science classes at my med school, but don't have any clinical experience. I am a bit worried that i will be thrown into the deep end, so i really need your advice. thanks

 

[ckent]

I think that the most important thing for you will be to know the basics about taking a history and how to present patients here in the US. It goes HPI (history of present illness), PMHx (past medical history), meds, allergies, FHx (family history), SHx (social history), ROS (review of systems), PE (physical exam), and then your assessment and plan. I would of course also be familiar with your bread and butter endocrine disorders (thyroid disorders, diabetes, and parathyroid disorders), and know how to present pertinent negatives and positives. If you have any difficulty with this, I would recommend picking up a book on interviewing and presenting skills or just looking up some tips on different US websites.

 

[desiree]

Thanks Ckent
I can definitely learn how to take a good history, but i am more worried about doing the physical exam. I've never done one! When US students start their 3rd yr clinical rotations, do the doctors teach them how to do a full PE, or are they expected to learn it all by themselves? i mean are you just supposed to READ how to do a PE from a book and then try it out on a patient? Or do you think the residents will walk you through the exam with a patient?

 

[ckent]

In the US, most medical students learn the basics of physical exam as a second year medical student. If you have not been taught how to complete a physical exam yet, I would recommend that you purchase a physical exam book such as Bates. You can ask a resident or intern to walk you through the basic physical exam the first couple of days there too. Make sure that you pay attention to what the attending says about his/her physical exam, and always re-examine the patient when they find something that you did not notice to make sure that you are able to find it yourself. Whenever you hear that a patient has an abnormal physical exam, you should ask to do that part of the physical exam on the patient yourself so that you can get experience with abnormal physical exams.

 

[irlandesa]

at my school, we used Swartz's Textbook of Physical Diagnosis: History and Examination. It's pretty helpful, although stronger in CV and Pulm. Exam than for other systems. Another thing I'd suggest is looking into participating in some of the student-run evening/weekend health clinics that might be available through G-town or GW or even one of the 2 schools up in B-more. We have a student clinic here in Boston where student volunteers from Harvard, Tufts, and BU work with physician and upper-level student volunteers to learn how to interview patients and do a physical exam, and I found it to be a good experience. If that isn't a feasible option, you might look into shadowing docs at a free clinic or primary care site that is available on weekends/evenings, often docs in these settings have more time to sit down and discuss things and show you a complete physical exam. Otherwise, the DC area is great (I grew up not far away), be sure to take advantage of it and enjoy while you're here! good luck!

 

[desiree]

Thanks Irelandesa, I will definately look into volunteering at student run clinics or even shadowing a doctor on weekends/eve like you recommended. That's a great idea.