German student wants to know more about US medical schools

[Medizinstudent]

I am student of medicine at a German university. Nevertheless I am interested in the way medicine is taught at universities in the US. If I understand correctly, the first two years mainly consist of courses in which basisc subjects like pathology are taught and then tested in written exams. In the third and fourth year students do clinical rotations in teaching hospitals thus working with doctors in direct patient care. This is something we don't really have here in Germany. Do you still have courses during your rotations in which you are taught the theoretical basisc of the specialty you are doing your rotation in? What are the tasks of a student doing such a rotation? How do students get letters of recommendation? Does this depend on the performance in the theoretical courses? I would be very glad if you would answer these questions.

Ciao,

Andreas

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[Anka]

During the clinical years, there is usually some didactic component, although it is far more hit or miss than the preclinical years. On medicine, for example, we had a conference we shared with the residents every noon, and on Fridays we'd have several additional hours of didactics which were directed toward medical students. On surgery, we had a couple of conferences per week with the residents, and all day Friday in class.

What degree of responsibility you have for patient care depends on the rotation. On medicine you carry 4 or so patients, see them every morning, come up with a preliminary plan, write notes on them each day for your resident to cosign, write orders on the patients for your resident to cosign, call consults, arrange discharge, etc. On surgery, at least here, you're part of the team -- I prerounded on half to the entire service every day (depending on how many other students were on the rotation), wrote the notes, made sure labs were drawn before the residents showed up, went to the OR all day (usually at least get to sew skin, as time went on I got to do more and more), then got numbers for afternoon rounds, rounded, helped the intern finish up, then went home.

Does that answer your question? Of course, every school is a little different. How does it usually work there?

Anka