Jul 18, 2013
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I've heard 4th year is better then 3rd. What is different about 4th year from 3rd year that makes it much better. In particular I am referring to the surgical rotation, since I've opted for one in 4th year, what should I expect will be different in a positive/negative sense?

I would assume that all the lectures and didactics would be cut except for grand rounds and intern lectures, so I would be following the team more, but everyone mentions that it gets better is that really better?

The personalities of attendings remain the same and we're just picking up more slack than someone in 3rd year plus I should have a greater fund of knowledge which if I don't just means that I would get yelled more; I don't see it getting better in this regard. Also at my institution residents still have to sign off on all orders/notes so I don't get that much of autonomy, which I hope I would as it would better prepare me for intern year.

btw I'm not complaining about the surgery rotation, I enjoy it even the downside, I just wanted to know if anything besides the hours really gets better.
 

SouthernSurgeon

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I've heard 4th year is better then 3rd. What is different about 4th year from 3rd year that makes it much better. In particular I am referring to the surgical rotation, since I've opted for one in 4th year, what should I expect will be different in a positive/negative sense?

I would assume that all the lectures and didactics would be cut except for grand rounds and intern lectures, so I would be following the team more, but everyone mentions that it gets better is that really better?

The personalities of attendings remain the same and we're just picking up more slack than someone in 3rd year plus I should have a greater fund of knowledge which if I don't just means that I would get yelled more; I don't see it getting better in this regard. Also at my institution residents still have to sign off on all orders/notes so I don't get that much of autonomy, which I hope I would as it would better prepare me for intern year.

btw I'm not complaining about the surgery rotation, I enjoy it even the downside, I just wanted to know if anything besides the hours really gets better.
Well this is all very institution dependent, but I for one wouldn't expect that the hours would be better as a 4th year than a 3rd. We expect our fourth years rotating on surgery to work their A**ses off - this is supposed to be a month where they learn the fundamentals of being a surgical intern. Our good fourth years are working as hard or harder than just about anyone on the team (and their hard work/motivation can be a good way for senior residents to push the interns to work harder...); if someone slacks off on their fourth year rotation they can pretty much kiss their chances of matching at our program goodbye.

I think most people like their fourth year sub-I's better because
(a) a lot of the M3 BS is stripped away - no shelf exams, no hours upon hours of didactics.
(b) you're "comfortable" in your own skin and have a much better sense of the expectations and how to fit in on the wards
(c) you get a little bit more responsibility as a team member
(d) you chose the rotation and theoretically it's what you want to do with your life, so there is a bit of excitement to get started doing it.
 

KnuxNole

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1) post match day it is chill as ****.

2) no exams! Or at the very least shelves!

3) hours for the most part are not as long. No calls, nights.

4) people know you are a 4th year and question why you are still there at noon.
 
Jun 30, 2011
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1) post match day it is chill as ****.

2) no exams! Or at the very least shelves!

3) hours for the most part are not as long. No calls, nights.

4) people know you are a 4th year and question why you are still there at noon.
Haven't experienced #1 yet, but 2-4 are absolute truths.
 

VisionaryTics

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You work hard during your career subIs (and are held to a pretty high standard since they know you are trying to match to that specialty), but after the first couple months, it's no call, home by noon, no shelves, and zero expectations.
 

futuredoctor10

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You work hard during your career subIs (and are held to a pretty high standard since they know you are trying to match to that specialty), but after the first couple months, it's no call, home by noon, no shelves, and zero expectations.
Generally speaking. Some schools are not so relaxed, for instance ours they still require shelves for certain rotations (Neurology and Emergency Medicine) as well as call for some of the required Medicine and Surgery rotations in the fourth year (which not everyone can do in the fall due to away rotations).
 

JJMrK

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Mostly it's better because you have more control over your rotation schedule, and can do either things you are interested in or things that are easy. Also, your knowledge is better so you don't feel like you have no idea what's going on all the time. I wouldn't expect individual "tough" rotations (like a surgery sub-I) to be easier, though.
 
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I got sent home today at 10am from my anesthesia ICU sub-I on account of it being Saturday and me being a 4th year...but I have a 30 hour call starting tomorrow.

I know at my institution surgical sub-Is are pretty intense. Many of them you will rarely get to scrub into cases, especially if there are M3s on service as they get priority for OR time. Which leaves you being relegated to floor work -- probably much more realistic in the sense that as a surgery intern that's about all you'll be doing. Non sub-I surgery electives here tend to be a little more chill with more OR time.
 

Kaustikos

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I guess my school is different then...
We have exams for Emergency Med, Radiology, Sub-I and some Surgery subs. We also have OSCE's. Which still baffles me why they test us via OSCE when we have Step 2. It's backwards.

I'm just looking forward to not having to deal with bull****.
 

mommy2three

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It is very very school dependent.
I have yet to be dismissed from a rotation because I was a fourth year early or before noon. I am expected to show up and work - and give my all.
So while it is better because you have more electives therefore more control over what you do - I would say do not go in expecting to not do anything or get out early as this is not always the case.