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How bad is it that I'm not doing an ICU rotation in 4th year?

nope80

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    So I decided to be lazy and forgo an icu rotation in the spring of my 4th year to do a month of outpatient medicine instead. I feel bad about this and its actually giving me anxiety, thinking that i'm going to be totally lost and incompetent as an intern since i will not have had icu experience. in all reality, how bad is this? What can I read to compensate? I feel really bad about it but the thought of working surgery hours and weekends and call etc etc in the spring just killed me. I guess its a trade off but I hope I dont pay for the consequences as an intern. Any input or advice?
     

    ShyRem

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      Depends on what you are going into. In general, I don't think it will hurt you much. I didn't do one either. I'm doing fine in intern year. Then again, I was a nontrad with significant acute medical experience before I went to med school. I think it depends more on you.

      From your post it sounds like you haven't had any icu experience. This I think would be bad if you are going into int med where you should at least be familiar with handling acute problems. If you're doing psych however, no problem.
       
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      atsai3

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        So I decided to be lazy and forgo an icu rotation in the spring of my 4th year to do a month of outpatient medicine instead. I feel bad about this and its actually giving me anxiety, thinking that i'm going to be totally lost and incompetent as an intern since i will not have had icu experience. in all reality, how bad is this? What can I read to compensate? I feel really bad about it but the thought of working surgery hours and weekends and call etc etc in the spring just killed me. I guess its a trade off but I hope I dont pay for the consequences as an intern. Any input or advice?

        You will probably feel lost anyway (i.e., a lot of your intern learning will involve trying to learn how to be efficient in a new system). That being said, my intern experience was similar to the others-- you'll be fine.

        -AT.
         

        Luv2Cut

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          I wouldn't worry about it. You'll do fine as an intern. I mean some familiarity with ICU would be good. But working in the ICU as a student and the responsibility you have as an intern are entirely different.
           

          dpmd

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            I wouldn't worry about it. You'll do fine as an intern. I mean some familiarity with ICU would be good. But working in the ICU as a student and the responsibility you have as an intern are entirely different.

            I was just going to comment that it depends on how your ICU rotation is run whether it would make any difference (not that you would be abysmally behind if you didn't do it, but rather that a good rotation could help you feel more comfortable). At my school my surgical ICU rotation was run with an attending supervising the two fellows and me in a 15 bed ICU. Obviously I didn't do overnight call by myself or anything, but during the day we divided the ICU in thirds and I took care of my five patients (with the guidance of the fellows and attending). The fact that I did it just after having worked in an ICU for 14 months (as an army nurse during a deployment overseas) meant that I was able to come up with intelligent plans and I thought it really helped me solidify a way of taking care of criticall ill/injured patients that made me less scared when I was taking care of them as an intern.

            A rotation where you regurgitate info onto a note and get the plan from the resident you are rotating with will not likely help you except for whatever little bit you might recall from what they tell you (then again that applies to all rotations, and I am always frustrated when my current students don't even try to come up with plans even if it is just as simple as coming up with something to add for the patients pain control or something.)
             

            gutonc

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              +12 on dpmd's post.

              A good/great ICU rotation as a 4th year is invaluable. A bad ICU rotation is a waste of a vacation month. Ask around and see if you have access to the former (recognizing that it's going to be somewhat attending/fellow/resident dependent from month-to-month). If not, go on Radiholiday and be done with it.
               

              dragonfly99

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                You'll survive without it, but I think that a 4th year ICU month would be helpful for anyone going into surgery, medicine, peds and probably OB. If you are doing path, derm or rads then no need for it.
                 

                LumenOus

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                  my med school didn't let 4th years do an ICU rotation unless you had multiple letters signed from attendings - which at the time seemed like too much trouble. Spent most of 4th year on vacation/interviewing/taking easier rotations.... matched into a great program, and didn't find the lack of ICU experience to hut me at all. Am a resident now on my ICU rotation and - though there's a steep learning curve during intern year, its very do-able. I'd vote for enjoying 4th year as much as you can and buckling down in a couple of months.

                  just my 2 cents. good luck with interviews and the match!
                   
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