How is your rotation?

[MDpride]

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Hii

2 days into FM rotation.

Its basically observational/ shadowing. Not going to assign patient to me.

lets me put stethoscope on patient while he is doing it. He moves so fast, it doesn't give me chance to listen properly.
Doesn't let me take history or anything.

How am i supposed to build confidence and improve clinical skills?

My college has left to preceptor to whether assign patient to us or do anything clinical including history taking. So everybody's learning and experience at the end of rotation is different.

Active participation is so imp. to motivate me to do more reading and learning.

how is your rotation?

similar to mine or you get to do things.

 

[illixir]

At most rotations at my school you see a patient first on your own, write a note and then see the patient again with your attending or maybe resident depending on the circumstances. I'm only one rotation in(almost done, psych) but we usually see 2-4 patients a day on our own and write their notes prob 2/3 are follow-ups. Ours is all inpatient though. Lots of times the attendings don't bother seeing the follow-ups, esp one of them, probably for good reason.

FP can be different though esp if its outpatient, you could try asking if you could see a patient first while he's in with another and then he'll see that patient with you; if there are multiple patient rooms.

 

[ZagDoc]

FM was definitely my most worthless rotation of 3rd year. Was basically glorified shadowing and memorizing the preventative medicine screening chart. And dealing with opiate abuse.

Don't worry, you get to do a lot more once you go inpatient. The workload is enough that residents will send you to do s**t just because they don't have time to do it themselves. You'll generally find in the clinical world, the more work there is to do, the more you learn and the more you get to do.

 

[ShyRem]

My FM rotation I had my own patients and my own preceptor. I think I had two or three days of shadowing an attending thrown in there. But all the procedures were mine, the follow-up, arranging services, etc. I was treated like an intern except I couldn't write prescriptions (preceptor did that for me). I also got procedure days and ended up having more procedures done than some of the residents. It was actually a really good rotation.

 

[RisingSun]

Totally agree - FM most worthless rotation.

Try to let your preceptor know that you would like to interview patients on your own, though. While he/she is unlikely to let you actually present the patient or come up with an assessment and plan, at least getting the practice in interviewing on your own is important because when you are on rotations that actually matter and where the learning curve is high (surg, medicine), you'll want to make sure that you have the basics down.

At least you don't have to videotape yourself interviewing patients two or three times a week and then go over it with your preceptor like one of my buddies on his FM rotation right now.

 

[MDpride]

he thinks time and pt load are issue.

he doesn't take new pt and his pt have been with him for 20-25 yrs. So there are multiple and thick charts. he says he has all in his brain.

Letting me do H&P will slow things down according to him.

why in the world would you agree to taking students when u think they are obstacles?

few hours in hospital ( 7-9) and rest clinic.

 

[Waysensei]

I'm sorry, this really blows. Maybe you should consider complaining through the proper channels in your school.

he thinks time and pt load are issue.

he doesn't take new pt and his pt have been with him for 20-25 yrs. So there are multiple and thick charts. he says he has all in his brain.

Letting me do H&P will slow things down according to him.

why in the world would you agree to taking students when u think they are obstacles?

few hours in hospital ( 7-9) and rest clinic.

 

[ACSurgeon]

he thinks time and pt load are issue.

he doesn't take new pt and his pt have been with him for 20-25 yrs. So there are multiple and thick charts. he says he has all in his brain.

Letting me do H&P will slow things down according to him.

why in the world would you agree to taking students when u think they are obstacles?

few hours in hospital ( 7-9) and rest clinic.

Most primary care docs have 2-3 clinic rooms going on at the same time. My FP's would have me go into a room, then they'd go and see 1-2 other patients and then join me. If I finish before they come in, I get to present what I learned and my assessment and plan. If they came in first, sometimes they'd do their thing, and other times they'd have me bring them up to speed.

I had my FM rotation two months ago, so I was a seasoned M3. I'm assuming you're just starting 3rd year, so maybe in 1-2 weeks you'll gain enough insight to fly solo. You can ask your preceptor if he can assign you 1-2 patients in the morning for you to see on your own. Then, around the time 'your' patients come to clinic, you can wait for them (instead of follow him into other patients' rooms) and go see them for 10 minutes until your preceptor joins. This way you get a better experience without slowing things down.

Good luck!

 

[radiodoc99]

Try to jot down cases and review them when you come home. You can ask if you can talk to the patient first and present the case. That way you will get ready for the PE exam. Keep Pocket Medicine or a FP book with you to review. You can use the time to study as you are standing and listening. Surgery rot will be diff! Seeing and interviewing patients even if it just one or two helps a lot because you will remember the cases rather than just standing and listening

 

[Mattchiavelli]

I agree with speaking to your clerkship director about this- it might not change your rotation but the preceptor might get dropped an other people won't have to deal with that. You're paying a lot of money for this education and unfortunately sometimes you have to advocate for your right to be taught.

My fam med preceptor was an alright guy but there was a lot of smiling and nodding and biting my tongue while he went on rants about Obama.

 

[MDpride]

Try to jot down cases and review them when you come home. You can ask if you can talk to the patient first and present the case. That way you will get ready for the PE exam. Keep Pocket Medicine or a FP book with you to review. You can use the time to study as you are standing and listening. Surgery rot will be diff! Seeing and interviewing patients even if it just one or two helps a lot because you will remember the cases rather than just standing and listening

I did ask him about talking to patient first. But that didn't change his mind. His being a private practice, its all about time management and not making patient wait for long time or go through process longer than needed.

I have to pay attention because sometimes he asks what did i learn.

 

[MDpride]

I agree with speaking to your clerkship director about this- it might not change your rotation but the preceptor might get dropped an other people won't have to deal with that. You're paying a lot of money for this education and unfortunately sometimes you have to advocate for your right to be taught.

My fam med preceptor was an alright guy but there was a lot of smiling and nodding and biting my tongue while he went on rants about Obama.

Preceptors are not paid for their service. they have volunteered to teach us which college thinks as a great act on their behalf. As I said before, My college has left it to preceptor to whether assign patient to us or do anything clinical including history taking.They have made it clear beforehand that NOT ALL preceptor will let u do everything. You might have to just shadow/observe. That means they knew that there are preceptors like mine and it sucks that they are not willing to replace them.


In such cases, we have to show competency to impress preceptor to let us do things. So clerkship director thinks that I should give preceptor time for him to know me because its only first week of rotation. But other preceptors ( based upon what classmates are posting on FB) are letting their students do everything from day one.

BUT, my preceptor has ISSUE w/ TIME, NOT competency which he made it clear day one of rotation.

My preceptor has earned good reputation in community as well as among my seniors for being amazing because of excellent patient care skills. When I share my exp. w/ classmates they look surprised because of his reputation for being amazing. But observing his great skills does no good to improving my skills without practicing it.

 

[SeminoleFan3]

Preceptors are not paid for their service. they have volunteered to teach us which college thinks as a great act on their behalf. As I said before, My college has left it to preceptor to whether assign patient to us or do anything clinical including history taking.They have made it clear beforehand that NOT ALL preceptor will let u do everything. You might have to just shadow/observe. That means they knew that there are preceptors like mine and it sucks that they are not willing to replace them.


In such cases, we have to show competency to impress preceptor to let us do things. So clerkship director thinks that I should give preceptor time for him to know me because its only first week of rotation. But other preceptors ( based upon what classmates are posting on FB) are letting their students do everything from day one.

BUT, my preceptor has ISSUE w/ TIME, NOT competency which he made it clear day one of rotation.

My preceptor has earned good reputation in community as well as among my seniors for being amazing because of excellent patient care skills. When I share my exp. w/ classmates they look surprised because of his reputation for being amazing. But observing his great skills does no good to improving my skills without practicing it.

That's horrific. Private practice or not, you're learning very little by just shadowing. You can shadow at any point in your medical school (or pre-med) curriculum. The idea of third year is to learn by doing. There's not a whole lot to do in FM, but you should be able to take a decent H&P at the end of it, and it doesn't sound like you're getting that experience at all. It's great that he has excellent patient-care skills, but if he doesn't let you practice and develop yours, it's virtually worthless. I can understand a few days of shadowing, especially if it's your first rotation, but I can't imagine doing it for the whole month. I would think your school/clerkship director would be more receptor to your issue.

 

[cpants]

A pure shadowing rotation really isn't appropriate, and you aren't getting your money's worth. I would see if there are any other available preceptors to which you could switch. If not, you'll have to grin and bear it. Make sure to pan the preceptor on your evaluation, and spread the word to other med students not to sign up for this preceptor. Rest assured, your other experiences should be better than this.