Daily signout vs. 3 day cycle

[Prairie]

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So I'm done with most of my interviews and I'm trying to figure out which program is best for me - not going to be an easy task. It seems that the biggest difference in the way surg path rotations are done is those with daily signout/previewing/grossing and those with 3 or 4 day cycles.

How do those of you in residency feel about this issue? Does it matter in the grand scheme of things?

(I've been lurking for a few weeks and haven't seen anything on this subject yet but I apologize if it's a repeat.)

Thanks for your help...

 

[beary]

Welcome to the forum! 👍

I think there is a little bit about this in the "interview experiences" thread, but I would be interested in seeing more discussion about this as well. I have my ROL down to a "top 4" and after that can't seem to make any progress.

 

[AngryTesticle]

So I'm done with most of my interviews and I'm trying to figure out which program is best for me - not going to be an easy task. It seems that the biggest difference in the way surg path rotations are done is those with daily signout/previewing/grossing and those with 3 or 4 day cycles.

How do those of you in residency feel about this issue? Does it matter in the grand scheme of things?

(I've been lurking for a few weeks and haven't seen anything on this subject yet but I apologize if it's a repeat.)

Thanks for your help...

I don't think this matters all that much in the grand scheme of things. These systems seem to be set up to maximize efficiency in workflow.

Personally, I'm less of a fan of the "do a little bit of everything everyday" approach. For me, that would be a little too chaotic. I would rather have certain duties compartmentalized into different days.

That being said, it's really not something that I think a lot about everyday. Wherever you end up, you'll gonna have to adjust to growing pains and get used to how things are done. Many programs do a lot of things differently and each way has its pros and cons--you'll like the way some things are done and other things will make you rageful. That's just part of the job.

 

[deschutes]

Keep in mind that surg path is only a portion of an AP/CP residency. People ask about how surg path runs because it is what most med students interested in pathology are exposed to.

Now, extrapolate this to asking about how transfusion medicine/hemepath/autopsy/cytology/molecular diagnostics etc, run.

They're all going to be different. Not good or bad, just different.

Will it really impact your decision-making? Probably not.

 

[miko2005]

From the perspective of a 4th year med student who has rotated at programs with both types of signout (daily and 3 day cycle), I think the hours are better on a surg path rotation with a 3 day cycle. It also depends if there is a true preview day or if you are busy most of the day doing something else and don't get to start previewing till 5 pm anyways on the preview day. If you are AP/CP that may not matter all that much, but I am AP only 🙂 .

 

[pathdoc68]

From the perspective of a 4th year med student who has rotated at programs with both types of signout (daily and 3 day cycle), I think the hours are better on a surg path rotation with a 3 day cycle. It also depends if there is a true preview day or if you are busy most of the day doing something else and don't get to start previewing till 5 pm anyways on the preview day. If you are AP/CP that may not matter all that much, but I am AP only 🙂 .

Miko,
I am just curious, but why are you doing straight AP? My program is AP/CP only and I rarely meet AP only residents?

 

[AngryTesticle]

Yes, and many applicants won't understand the implications of designing rotations in different ways until they go through it. And when people go to interviews, there will always be those who argue for general over subspecialty signout vs. vice versa. There will always be those who argue why doing a little bit of everything everyday is better than a cycle. It seems that this is the kind of rhetoric I heard a lot when I went on interviews.

"We do X this way and it is better than doing it that way because..."

C'est la vie. Nap time.

Keep in mind that surg path is only a portion of an AP/CP residency. People ask about how surg path runs because it is what most med students interested in pathology are exposed to.

Now, extrapolate this to asking about how transfusion medicine/hemepath/autopsy/cytology/molecular diagnostics etc, run.

They're all going to be different. Not good or bad, just different.

Will it really impact your decision-making? Probably not.

 

[miko2005]

Miko,
I am just curious, but why are you doing straight AP? My program is AP/CP only and I rarely meet AP only residents?

I am applying for "AP only" at the programs which allow and encourage that option. At this point in time, I am convinced that I want to go into academics and thus I don't need the CP portion for that. If I change my mind in a year or two, I could add back the CP portion (I asked). I also plan to do a surg path fellowship and probably a hemepath fellowship. I don't know...it could be a huge mistake, but most faculty I have talked to at my home institution as well as the program I am interested in say that I don't need the CP portion if I want to do academics and I definitely do.

 

[yaah]

Well, I like the way my program does it, which is doing everything daily. It does make for some busy days, but you see more volume and learn to integrate things very well. I am not sure you should base your decision on a program based on which you prefer though. Every program is different, and just because there is a 3 day (or whatever) cycle at some programs doesn't mean that they prioritize residency training.

 

[CameronFrye]

A better question would probably be to inquire about previewing time and emphasis on teaching residents (does the need to plow through the cases limit teaching?). This seems to be independent of the rotation set-up. For example, even though Michigan does everything everyday, I got the impression that there was still plenty of time for previewing and teaching (although the room 1 months are very busy). I then saw other programs who had variations of the 3 to 4 day cycle and their residents were really pushed to the brink.

 

[yaah]

A better question would probably be to inquire about previewing time and emphasis on teaching residents (does the need to plow through the cases limit teaching?). This seems to be independent of the rotation set-up. For example, even though Michigan does everything everyday, I got the impression that there was still plenty of time for previewing and teaching (although the room 1 months are very busy). I then saw other programs who had variations of the 3 to 4 day cycle and their residents were really pushed to the brink.

Yeah, that is kind of what I meant to say. Previewing time is important. Here the slides come out in the early afternoon, and we have from lunchtime onward to preview and gross. It helps a lot to be able to preview the day before and think about things or read about them. Many programs will say they have previewing time, but what they mean is that the slides come out between 10am and noon, and signout is at 1pm, and this is less conducive to learning.

 

[hzma]

What about the CP/AP integration?
Is 6mo/yr of both better,
or 2y/each separate,
or 1y AP, 1yCP, and 2yAP/CP 6 mo each?
What do you all think?

 

[pathdoc68]

What about the CP/AP integration?
Is 6mo/yr of both better,
or 2y/each separate,
or 1y AP, 1yCP, and 2yAP/CP 6 mo each?
What do you all think?

I could not stand 6 months or worse 1-2 years of either AP or CP as a resident. One feature that was a program requirement for me was month by month integration. I do one or two months AP followed by one or two months of CP, I believe this is most conducive to learning and SANITY!!

 

[AngryTesticle]

If I were AP/CP, I would totally want integration of AP and CP rotations. You then have the option to read about your AP cases from the previous months during your lighter CP months (with the exception of blood bank).