Going back to clinics

[gbwillner]

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After a 4.5 year hiatus, I will be returing to medical school. Can anyone suggest a good rotation schedule for my return? I want to start off easy, given that I don't remember anything about medicine. I would like to get Surgery out of the way ASAP and do Path....

Suggestions?

 

[antinomian]

People here often start with OB/GYN because while no rotation is hermetically sealed with regards to content, this comes close. You should get the gist of some surgical and medical issues at the same time, and get what is often considered a tough rotation (for _other_ reasons) out of the way.

Peds is also a common back-to-wards rotation around here.



antinomian
Tri-I

 

[E Z Daring]

I understand where you're coming from. I too just wanted to get surgery over with, but in hindsight, going head first into the 110+ hour weeks of this rotation wasn't the best choice.

Ease into the clinical rotations IMO. Family, or Peds, ya' know? I think IM may be the best actually - it's the middle ground and you learn a lot of things that will be relevant in the other rotations.

good luck. Wow, 4.5 years! Make sure you get Step III taken care of before the deadlines in your state (7 years from StepI to StepIII in many states, with some leeway if you were doing MD/PhD)

 

[gbwillner]

Wow, 4.5 years! Make sure you get Step III taken care of before the deadlines in your state (7 years from StepI to StepIII in many states, with some leeway if you were doing MD/PhD)

You say that like that's a long time... Its shorter than average for MSTPs in my institution...

Thanks all for the advice. I've already done Pedi and IM (before PhD)... MAybe I'll ease into Path... but I'm cosidering path and I don't want to blow it... Perhaps family medicine will be a good choice....

I have until friday to make up my mind.

 

[Circumflex]

It took me 4.5 years in the lab as well - now I'm in my final year of med. school applying for pathology.

If you have already done IM and peds, I would start with a rotation that has a tough schedule, like Surgery or OB. Get it out of the way and try and have either Psychiatry or Family Medicine as your last rotation of the required clerkships. Family Med. will help prepare you for Step 2 CS and Psychiatry is great for having time to study for Step 2 CK if you want to take them early.

I would try and time the Pathology elective for the Summer before you apply, so you can get a letter of rec. or 2 from that rotation. Don't worry about "shining" in Path. It is very laid back and they don't expect you to remember much from 2nd year. It's just pure learning in a laid-back environment. Good luck!

 

[b&ierstiefel]

There are different schools of thought regarding this.

Here are my personal opinions...you got two options...start easy or start hard.

BUT...I would not recommend starting on medicine. You will start the rotation with a bunch of students who are at the top of their game because they're fresh out of 2nd year med school, just took Step 1, and will know a lot more than you could ever remember after a leave of absence like that.

Option 1 - start easy. Family med, neuro, or psych. Work hours aren't too demanding and you can get back into the frame of mind of clinical work. If you're interested in neuro or psych (not many mudphuds do family), don't do this option.

Option 2 - start hard. Surgery. You're not going to be writing lengthy patient notes but you will learn a lot about disease entities still (although you learn the most when you're on medicine). However, the hours can be long and you easily get "beaten down". Being "beaten down" is good because whatever comes next doesn't seem as much of a rude awakening and seems much more palatable. Now, if you're going into surgery, don't pick this option.

Overall, if you're interested in a field or two, do not do those rotations first. Why? Cuz you need to perform well and your chances to do so requires some warmup. Plus, you will need letters of recommendation. Unless you make a memorable impression early on in your 3rd year, you will be easily forgotten. If you're interested in a field, it's better to do that rotation sometime in the spring. By that point, you're all warmed up, sufficiently "beaten down", and it is easier to ask for letters (i.e., your letter writers will more likely be able to remember you when you ask for the LORs the summer after your 3rd year when you're applying for residencies).

 

[gbwillner]

There are different schools of thought regarding this.

Here are my personal opinions...you got two options...start easy or start hard.

BUT...I would not recommend starting on medicine. You will start the rotation with a bunch of students who are at the top of their game because they're fresh out of 2nd year med school, just took Step 1, and will know a lot more than you could ever remember after a leave of absence like that.

Option 1 - start easy. Family med, neuro, or psych. Work hours aren't too demanding and you can get back into the frame of mind of clinical work. If you're interested in neuro or psych (not many mudphuds do family), don't do this option.

Option 2 - start hard. Surgery. You're not going to be writing lengthy patient notes but you will learn a lot about disease entities still (although you learn the most when you're on medicine). However, the hours can be long and you easily get "beaten down". Being "beaten down" is good because whatever comes next doesn't seem as much of a rude awakening and seems much more palatable. Now, if you're going into surgery, don't pick this option.

Overall, if you're interested in a field or two, do not do those rotations first. Why? Cuz you need to perform well and your chances to do so requires some warmup. Plus, you will need letters of recommendation. Unless you make a memorable impression early on in your 3rd year, you will be easily forgotten. If you're interested in a field, it's better to do that rotation sometime in the spring. By that point, you're all warmed up, sufficiently "beaten down", and it is easier to ask for letters (i.e., your letter writers will more likely be able to remember you when you ask for the LORs the summer after your 3rd year when you're applying for residencies).

Thanks.... Unfortunately, I will in essence miss the fall of my thrid year and start in the spring. I'm planning to go back in Feb/March, but I need to set up my schedule now (this week). So I pretty much have to start with what I want to do.

 

[Ecthgar]

There are different schools of thought regarding this.

Here are my personal opinions...you got two options...start easy or start hard.

BUT...I would not recommend starting on medicine. You will start the rotation with a bunch of students who are at the top of their game because they're fresh out of 2nd year med school, just took Step 1, and will know a lot more than you could ever remember after a leave of absence like that.

Option 1 - start easy. Family med, neuro, or psych. Work hours aren't too demanding and you can get back into the frame of mind of clinical work. If you're interested in neuro or psych (not many mudphuds do family), don't do this option.

Option 2 - start hard. Surgery. You're not going to be writing lengthy patient notes but you will learn a lot about disease entities still (although you learn the most when you're on medicine). However, the hours can be long and you easily get "beaten down". Being "beaten down" is good because whatever comes next doesn't seem as much of a rude awakening and seems much more palatable. Now, if you're going into surgery, don't pick this option.

Overall, if you're interested in a field or two, do not do those rotations first. Why? Cuz you need to perform well and your chances to do so requires some warmup. Plus, you will need letters of recommendation. Unless you make a memorable impression early on in your 3rd year, you will be easily forgotten. If you're interested in a field, it's better to do that rotation sometime in the spring. By that point, you're all warmed up, sufficiently "beaten down", and it is easier to ask for letters (i.e., your letter writers will more likely be able to remember you when you ask for the LORs the summer after your 3rd year when you're applying for residencies).

Not sure if I'd jump into family med first.......from what I hear, it integrates alot of other fields (some peds, some IM, some OB, etc.) and going in "green", so to speak, is difficult even for standard MD students. A friend of mine did family med first and said it turned out to be pretty tough because of all the stuff he hadn't seen. I think I'm going with OB first......definitely don't want to do it and heard the note writing and rounding is fairly easy compared to other rotations.

 

[b&ierstiefel]

Not sure if I'd jump into family med first.......from what I hear, it integrates alot of other fields (some peds, some IM, some OB, etc.) and going in "green", so to speak, is difficult even for standard MD students. A friend of mine did family med first and said it turned out to be pretty tough because of all the stuff he hadn't seen. I think I'm going with OB first......definitely don't want to do it and heard the note writing and rounding is fairly easy compared to other rotations.

I agree with you but if you're not going into family med, it's a great blowoff rotation since you have good hours. Plus, when you're on your first rotation, looking and sounding enthusiastic (regardless of bad fund of knowledge) goes a long way. Remember, these family attendings are touchy feely folks and they're not out there to screw you.

 

[gbwillner]

I agree with you but if you're not going into family med, it's a great blowoff rotation since you have good hours. Plus, when you're on your first rotation, looking and sounding enthusiastic (regardless of bad fund of knowledge) goes a long way. Remember, these family attendings are touchy feely folks and they're not out there to screw you.

Thanks for the advice... I'm thinking Family med, then Path, then surgery.
I need to take Step 2 early (Oct/Nov 4th year) to make up for horrid (below ave) Step 1 scores. I basically took the exam without studying for it during grad school. I think I had a stroke just thinking of how stupid that was. I want to have the results during inverviews.
Any opinions on this?

Thanks again

 

[kassie]

I took Psych first - it was good to adjust to the lay of the land (navigating a chart etc) without having to figure out the physical exam until I took medicine 2nd. I didn't start getting it together until a few months in, so I wouldn't suggest taking anything that you might want to do in the future until a couple of rotations in...

Don't worry, it's not too bad!

 

[tr]

Thanks.... Unfortunately, I will in essence miss the fall of my thrid year and start in the spring. I'm planning to go back in Feb/March, but I need to set up my schedule now (this week). So I pretty much have to start with what I want to do.

I did exactly this (went back last March, had only 4 rotations before application season).

Since you've already done medicine and peds, I would advise starting with family med. It is sufficiently laid back to give you time to get used (or re-used in your case) to being in the clinic, and has a good overview of many different topics, which will be useful to you in the following rotations.

It is going to be pretty difficult to honor whatever you start with since you are going in rusty and will be matched against students who are already more than halfway through their third year. So as others have said, it's a bad idea to start with what you want to do.

If you want to do path, I would do your path rotation second. You've already had medicine and peds, you'll have had one rotation to refresh, and in case you find out you don't like path as much as you thought you would, you'll still have 1-2 more rotations before you have to start getting your app together.

The other thing I would remind you to do is be on the lookout for LOR writers. The regular med students get all of 3rd year plus a sub-I and a couple of electives to ferret out attendings who loved them; you only have five months to do the same. If you got along well with any attendings from med or peds back in the day, I would hunt them down and remind them you exist. Drop in, tell them you're coming back to the wards, ask for some advice. Then you won't feel so weird asking them for a letter a few months down the road.

Good luck! This is a long road, but we've hit the light at the end of the tunnel (even though that light is flashing 'intern year! intern year!'... )

 

[tr]

Thanks for the advice... I'm thinking Family med, then Path, then surgery.
I need to take Step 2 early (Oct/Nov 4th year) to make up for horrid (below ave) Step 1 scores. I basically took the exam without studying for it during grad school. I think I had a stroke just thinking of how stupid that was. I want to have the results during inverviews.
Any opinions on this?

Family med - path - surg sounds good to me. That'll put you at about June or July (depending on how many weeks your rotations are).

Will you finish all your required rotations before taking Step 2? If so, schedule the rest however you want, with Psych a good one to do for the month or so before Step 2 - plenty laid-back so you can study.

If not, you might want to consider which rotations will be least important for Step 2. I am leaving Surg until after Step 2 because I was told that the tested knowledge is mostly medicine, and not having had the rotation should not cost me much on the boards.

 

[fantasty]

I'm going to do psych, neuro, family (each 4 weeks) then my biggies (peds, ob-gyn, surg, each at 6 weeks). I figure that will get me prepared for my sub-i (late summer) and I can knock out step 2 kind of early since i'll have the m3 core done early.

Although I'm mildly interested in psych, I felt like it was self-contained enough that I could adequately prepare for it beforehand, and yet use it as a chance to get reacquainted with the hospital system. I fear neuro but dovetailing it against psych might help. Although I agree with the comments about family above (that you will be exposed to a lot), most family docs I know are pretty nice and constantly trying to recruit students to their field (so I doubt they will be too hard-ass - plus we select who we rotate with for that clerkship, and many have the reputation of being good teachers). I've also tried to volunteer a lot during grad school at the local Free Med clinic, which I hope will be good prep for family. I hope to get a little OB/Gyn experience through family, and then a little surgery experience through OB/Gyn.

 

[TheCybermen]

You say that like that's a long time... Its shorter than average for MSTPs in my institution...

Thanks all for the advice. I've already done Pedi and IM (before PhD)... MAybe I'll ease into Path... but I'm cosidering path and I don't want to blow it... Perhaps family medicine will be a good choice....

I have until friday to make up my mind.

out of curiosity -- what *is* your institution??

 

[gbwillner]

out of curiosity -- what *is* your institution??

I'm not sure I should say!

G

 

[Neuronix]

There's only one place I can think of that has half their clinics before going into the PhD and has a long average time to graduation as reported by current students I've met in person and on SDN. That being said, since gbwillner is remaining mum about it, so will I...

 

[gbwillner]

There's only one place I can think of that has half their clinics before going into the PhD and has a long average time to graduation as reported by current students I've met in person and on SDN. That being said, since gbwillner is remaining mum about it, so will I...

Thanks!

 

[antinomian]

-

 

[tr]

There's only one place I can think of that has half their clinics before going into the PhD and has a long average time to graduation as reported by current students I've met in person and on SDN. That being said, since gbwillner is remaining mum about it, so will I...

Mrm? I can think of two, I think... but I'm not going to be the one to break the omerta! 😉