ENT rotation - help!

[tony montana]

Ok I start my third year with an ENT rotation, in about a week, and I have NOOO idea what to carry on my white coat...

And what to expect and any advice as to what I should do to be ready, arggg

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[smq123]

Ok I start my third year with an ENT rotation, in about a week, and I have NOOO idea what to carry on my white coat...

* A good penlight
* Wooden tongue blades (= "tongue depressors")
* Alcohol wipes (always a good idea, regardless of the rotation)
* A couple of pens

Don't carry an otoscope - it'll probably fall out and break. And you probably won't really need one anyway.

I guess you could carry a stethoscope...not really sure what good it would do, but you could.

When I was on that rotation - I was pre-rounding on a patient, out of sheer habit, I did a lung and heart exam, and documented it in my SOAP note. One of the residents, as he was checking my note, just gave me this look, and was like "Why the hell did you do that?!" and pointed at the part that said "CV: Regular rate, no m/r/g, Pulm: CTAB." Ooops.

And what to expect and any advice as to what I should do to be ready, arggg

My ENT rotation was very surgery-heavy. I don't know if your school wants to focus more on the clinic aspect, or on the surgery aspect, so that's a good thing to find out from incoming 4th years.

If it's surgery heavy - review proper sterile technique. (There are some threads in this forum on that.) But just keep in mind that since so many ENT operations occur inside the mouth and esophagus (which aren't sterile anyway), they don't really observe strict sterile technique for those. But if you scrub into a radical neck dissection, or a thyroidectomy, or something along those lines, then you'll have to know how to stay sterile.

If it's surgery heavy - know where to find scrubs in your hospital! Don't waste time in the morning wandering around the laundry room. But remember, if you're in the clinic, be sure to wear a button up shirt and tie. As a med student, don't wear scrubs to clinic. Ever.

For the first few days, don't talk unless spoken to. Don't ask questions unless invited. The ENT guys at my school were very laid-back, but there were definitely some guys who like a quiet OR. Until you get a hang of the social dynamics of the team, it's best just to hang back and stay quiet.

And be willing to work - even scut work. I feel like surgeons (in general) are willing to reward you and let you do fun stuff if you work hard. By filling out post-op notes, doing scut work, and seeing patients in the morning and writing progress notes on them, the residents let me suture in the OR. They taught me the instrument tie, and one of them let me do the initial incision for one of the cases. All in all, it was one of my favorite rotations of third year - so have fun! Good luck!

 

[tony montana]

Hi smq, thanks:

My clinical coordinator says this rotation is outpatient, so does that mean no surgery time for me? If no surgery time, what should I expect to do in it?

thanks for the othr advice too.

 

[smq123]

My clinical coordinator says this rotation is outpatient, so does that mean no surgery time for me? If no surgery time, what should I expect to do in it?

If there's no OR time, it's probably mostly outpatient clinic, I would imagine. Maybe with consults thrown in there, too.

In clinic, you just see patients - same as you do on any outpatient rotation. It could very well be mostly shadowing. I hope not, though.

In that case - for your white coat, I'd still carry the penlight, the tongue blades (just in case), and alcohol wipes. A packets of 4x4 gauzes wouldn't be bad - it helps the attending to have those handy, sometimes. A small notebook, to take notes.

I hope they'll teach you how to drive the bronchoscope. That'll be fun.

I really do hope, though, that they'll let you get into the OR at least once. And hopefully for some crazy case, like the ones where they start taking off crazy amounts of skin from the face and neck. Because, really, what's the point of third year if you can't go home and call your grandmom, and say, "You won't believe what I saw today....."

 

[tony montana]

If there's no OR time, it's probably mostly outpatient clinic, I would imagine. Maybe with consults thrown in there, too.

In clinic, you just see patients - same as you do on any outpatient rotation. It could very well be mostly shadowing. I hope not, though.

In that case - for your white coat, I'd still carry the penlight, the tongue blades (just in case), and alcohol wipes. A packets of 4x4 gauzes wouldn't be bad - it helps the attending to have those handy, sometimes. A small notebook, to take notes.

I hope they'll teach you how to drive the bronchoscope. That'll be fun.

I really do hope, though, that they'll let you get into the OR at least once. And hopefully for some crazy case, like the ones where they start taking off crazy amounts of skin from the face and neck. Because, really, what's the point of third year if you can't go home and call your grandmom, and say, "You won't believe what I saw today....."

hahaha I hear ya

I really hope it's more than shadowing too and I can get some gruesome experiences to call back home about.

Thanks smq

 

[Law2Doc]

Hi smq, thanks:

My clinical coordinator says this rotation is outpatient, so does that mean no surgery time for me? If no surgery time, what should I expect to do in it?

thanks for the othr advice too.

I've never seen an ENT clinic that didn't have everything you needed (in terms of tongue blades, light sources, oto/ophthalmoscope). So I doubt you need much in your white coat, other than a good pen.

 

[tony montana]

I've never seen an ENT clinic that didn't have everything you needed (in terms of tongue blades, light sources, oto/ophthalmoscope). So I doubt you need much in your white coat, other than a good pen.

Cool,

Any online sources to learn how to write prescriptions and also soap notes? I think I am really weak with Rxs and somewhat weak with SOAP notes.

 

[blz]

Cool,

Any online sources to learn how to write prescriptions and also soap notes? I think I am really weak with Rxs and somewhat weak with SOAP notes.

I would learn to read an audiogram.

 

[Blade28]

Cool,

Any online sources to learn how to write prescriptions and also soap notes? I think I am really weak with Rxs and somewhat weak with SOAP notes.

Maxwell's may help with SOAP notes, no?

 

[DrDre311]

Blade, sweet, you finally fixed your sig

 

[Blade28]

Blade, sweet, you finally fixed your sig

What was wrong with it?

 

[DrDre311]

What was wrong with it?

Last time I looked at it I don't think it had the moonlighting stuff on it...could be a tired brain making things up.

 

[smq123]

Any online sources to learn how to write prescriptions and also soap notes? I think I am really weak with Rxs and somewhat weak with SOAP notes.

For prescriptions: http://www.healthcare.uiowa.edu/pharmacy/PTNews/2003/august.html

This isn't how I write prescriptions (since our script pads never look anything like that), but if you follow that basic outline, you'll be fine.

Except you'll probably write "q 4-6 hours" instead.

For SOAP notes: Follow the basic outline in the yellow pages in Maxwell's, if you have it. It's not quite detailed enough for the internal medicine notes (I'll spare you the bitter rant ), but good to follow for surgical and OB services.

I'd also tell you to brush up on those "skeletons" that people use to write down the patient's CBC, chem 7, coags, and LFTs. Maxwell's decodes the CBC and chem 7 for you, but I don't think that they explain the coags and LFTs. Let me know if your school didn't go over that with you.

 

[Blade28]

Last time I looked at it I don't think it had the moonlighting stuff on it...could be a tired brain making things up.

I think residency is beating you down...my sig's included my moonlighting stuff since November.

 

[drfunktacular]

Ok I start my third year with an ENT rotation, in about a week, and I have NOOO idea what to carry on my white coat...

And what to expect and any advice as to what I should do to be ready, arggg

Depending on how intensive the rotation is, and how good you want to look, you can never ever go wrong with carrying ENT Secrets around, or at least studying it in your off-time.

One of our ENT interns told me that book alone was enough to get through PGY-1 ENT rotations.

 

[DrDre311]

I think residency is beating you down...my sig's included my moonlighting stuff since November.

Duly noted.