I hate my med rotation

[volvulus]

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It's been an awful first couple of weeks. We have to get here at 5:30 in the morning and leave at 6pm. That's almost like suregry hours. I hate examaning patients for an hour and then talking about them for another hour and a half. Does anybody feel the same way or is having a different experience.

 

[Jim Picotte]

Hehe...welcome to the club.

 

[njdevil]

suck it up...we all signed up for it...

 

[Winged Scapula]

What your rounds are only an hour and a half long? Why that's sheer LUXURY!! I've had medicine rounds last ALL DAY...sheer PAIN. 😉

Fact is, everyone hates something about their clinical rotations, even rotations they thought they'd love or otherwise do love. If you are only in the hospital 12 hours a day, I'd consider that good, even if I weren't a surgical resident. With the exception of purely outpatient rotations/specialities, most doctors will work that much during residency and most attendings/practicing physicians work more than 8-10 hrs/day. But you knew that.

Try to find something you like about the rotation - maybe a patient with a particularly interesting disease/finding, etc. which you can focus on. You might find that another field is better suited to your needs and interests once you get through your medicine rotation.

You may even find that a patient-oriented field is not for you - there is no shame in finding out that you don't like dealing with/treating patients. There are plenty of other options which limit patient contact should this be the case - thousands of others before you have had the same experience.

To put it blunty, as others have said, you just have to suck it up.

 

[volvulus]

I don't mind working long hours. I worked a lot harder and much longer during my surgery rotation. The problem is sitting down with the team and discussing one freking patient for an hour and a half. Rounds suck to. We have rounds with the intern, then rounds with the senior resident and finally rounds with the attending. Surgery was tough but more fun and the day flew by.

 

[JANCHEL]

Well at least you definitely know what field NOT to go into! You have to be thankful for that at least.

 

[hotbovie]

Hmmmm..... seems like you meet one of the requirements for being a surgeon...intolerance of long rounds! (That's what I was told by my surgeon friends when I saw them and vented the pain of medicine rounds) At least you get to sit!

I feel your pain. As a M4, I recently transitioned from my last elective (trauma ICU) to the most dreaded requried rotation for many..Neurology. The day I started Neruology, I was coming off trauma call. We have 23 TICU beds. During turnover rounds, we saw all 23 TICU pts, stopping partway through because one coded and needed bronchocsopy (to remove the mucus plug that caused him to brady down to asystole) and finished in 2 hours. I then changed clothes, and reported to the starting point for my neuology rotation. That afternoon, we hooked up with the residents, and then got with the attending for neuology rounds. We rounded for 2.5 hours....and saw the 3 new pts on the service. Since I've done nothing but surgery rotations so far this year, I felt as though I had been captured by enemy spies and been tortured to reveal secrets I don't know.

The only way to get though a rotation like that is to look for the information that will be useful to whatever you go into, and try to learn those aspects.

Hang in there. You can survive. Millions before you have.

 

[SomeFakeName]

Volvulus, as I've been told and experienced numerous times myself, the theme of those endlessley long medicine ward rounds is best summed up by the following quote:

"They sure talk a lot, but they don't actually say anything."

This was said by a former medical intern who switched over to surgery because he couldn't stand the mundane discussions that drag on for hours, when they can instead be effectively discussed in about 15 minutes if people stuck to relevant info instead of bringing up esoteric bits of medical trivia that have very little to do with patient care or management. I just get the feeling like they love to hear themselves talk, even if it has very little value to patient care or resident education.

 

[Neurogirl]

Sorry you haven't found much sympathy with your post, but as you can tell, we have all "been there, done that". However, I do understand your frustration. I HATED general medicine...with a passion! The thing to keep in mind is that your medicine clerkship is probably THE most important rotation of med school! I can't think of a single specialty that doesn't utilize the knowledge of internal medicine. So, take comfort in the fact that you are gaining knowledge that will be useful no matter field you go into.

Also, I have a question about a comment made by someone in this thread. Why do SOOOOOO many students genuinely hate neurology. I don't expect people to love it, but it does seem to be universally hated! Is there anything in particular that turns people off? Just curious.

 

[Winged Scapula]

Originally posted by Neurogirl

Also, I have a question about a comment made by someone in this thread. Why do SOOOOOO many students genuinely hate neurology. I don't expect people to love it, but it does seem to be universally hated! Is there anything in particular that turns people off? Just curious.

Hmmmm....haven't we answered that question before? 😉

As I recall, the answers were:

1) while interesting, too "hard" or too "cerebral" (for us dumb procedural types)

2) don't like all those nasty fatal diseases

3) lots of patients are elderly; don't like old people

4) don't like medicine in general, and especially fields in which there aren't many effective treatments

5) Neurologists are weird 😉

 

[mikecwru]

Originally posted by Neurogirl
Also, I have a question about a comment made by someone in this thread. Why do SOOOOOO many students genuinely hate neurology. I don't expect people to love it, but it does seem to be universally hated! Is there anything in particular that turns people off? Just curious.

Neurology for me was the medicine complaints on this thread to the max! I literally sat and listened to people talk at length whether the reflexes were 2+ or 3-. On a patient where there would be no regain of function. I've also listened to length diatribes to have a neurologist come to the conclusion "Yes, it's definitely in the brain, not the spinal cord." WTF??

You have to be wary of a note that has a huge assessment and a one sentence plan.

Now, some of the neurosciences can be more important acute processes that can be halted (stroke) but you don't need the esoteric reflexes, etc, for that. My view was ... show me the exam I can use to make a decision. If I've already seen that her frontal lobe is eaten up, I don't need 15 reflexes to confirm that point.

And yes, neurologists are weird. Very weird. At least in my area, they're known for shifty eyes---they never make direct eye contact and they always wear goddamned bowties.


mike

 

[volvulus]

It's nice to see others feeling the same way as me. I think the main reason I get pissed off is the inefficiency of the medicine teams. I know it's only been a week but all i see is a whole lot of talking and very little of doing. They talk about we can do this we can do that but in the end it's the same generic thing. I've followed 5 patients so far and all of them have gone home a trace better or the same as when they came in. I just don't see any satisfaction in that.

 

[jdog]

Son, I have just the remedy for you. You have to read the House of God ASAP. At least read the first 150 pages or so. It will take you no time and you will see that it ist he same sh-t everywhere and millions before you myself included have hated medicine with a passion. There are so many fields out there that are nothing like medicine that you will learn to appreciate, but don't fool yourself, the information you learn in medicine is the backbone of medicine itself. Even if you are a surgeon, you will need a great medical knowledge.

READ HOUSE OF GOD.

 

[Neurogirl]

Well...I did ask for it. However, I'd like everyone to remember that stereotypes are just generalizations. Nothing more, nothing less. I'm sure I don't have to remind people about the stereotypical surgeon (arrogant, egotistical) or psychiatrist (afflicted with psychopathology) or radiologist (spoiled and detached), etc. The point is, while there are some who match their respective stereotype, most don't. I'll admit that I work with one or two people even I consider "weird", however, most are very normal. I can't honestly say I've met more unusual personalities in neurology than in any other specialty. And I've never seen anyone wear a frickin bowtie.🙄

 

[Winged Scapula]

Tee hee...well you DID ask for it! 😉

I rather like our Neuro residents here and frankly, have seen more bow-ties on the IM and Path attendings than the Neurologists (although the Neurologist I did research for before med school had an atrocious fashion sense).

Signed, the egotistic surgeon 😀

 

[hotbovie]

Since I brought up the Neruo thing, I'll chime in again. And it's not really that I hate Neuro so much per se, it's just that the format is so much like general internal medicine. Plus I did medicine first in my third year, so it's a distant memory (however, the first day of that was horrible...we had only something like 12 pts on service and attending rounds lasted 3-4 hours, stopping to debate some point outside of each pts room!) Keep in mind that I'm a surgeon to be, and so far this year all I have done is surgery electives, most recently our trauma ICU, which is the best elective in terms of hands on for students. So, to go from a servide that is very busy, anything can happen at any moment (and often does) and when it does the student is right there in the thick of things, to the Neurology service where we had 6 pts and 7 students and took longer to round on 3 new pts than it takes to round on all 23 trauma ICU pts, and to have to wear regular clothes and shoes instead of scrubs and comfortable shoes...well, it was pure torture.

Having said that, our residents are great ...no bow ties (in fact, no ties at all and they are often reprimanded by stuffy faculty for "sloppy" dress). And I have learned some useful stuff, like how to tell if an old stroke has been unmasked, that infection can trigger seizures in a pt with previously controlled sz disorder, and I'm getting better at reading head CT.

Part of the problem with our neuology rotation is that there is an exam (yep, it's a 4th year rotation and there's a test) that is written by the department here and is notoriously hard, designed to limit the number of A's to 20%. So we have that hanging over our heads as well.

What I don't like about neuro is that there is mostly problems you can't fix "Sorry, sir, you've had a stroke and we can't help you see again. We can do a bunch of tests and maybe prevent you from having another stroke" or "Sorry, you have movement disorder, we can calm it down for a while with medicines that have bad side effects but ultimately you will be disabled"

Sorry, I'm glad there are people that like neuro and medcine. But I need a little less talk (ok, a lot less talk) and a lot more action!

 

[volvulus]

word

 

[yaoming]

i'd rather do that than study for my classes and boards I anyday. but here I am, as an MS1, doing it. hope i get there soon.

 

[EJS]

Volvulus, how excited am I that someone else is having a most boring experience on the medicine service!!!!!! I thought it was only my hospital! We have lecture for at least 3 hours a day and then rotations with the attending. I see 2 patients a day! 2 patients!!!! I actually just finished surgery, and although hard, and I don't want to be a surgeon, it was at least interesting!! and fast paced so that the day went by fast!! I am starting to wonder if it was better to be back in class at school!!!

 

[jimdo]

As an MS4 going into Neuro, Id like to chime in here. In defense of neuro, Id like to say that i would much rather go into either it or medicine than into surgery. Why would anyone want to stand in one spot for hours on end, unable to move or touch anything while covered from head to toe. Heaven forbid you have to sneeze, are sick or get an itch. On top of that, as a student youre sitting there for hours holding a friggin retractor!! The hours suck, call is worse and you pretty much have to sign away any free life you may have. At least on those long, boring medicine rounds you can step away for a minute, get a drink, go to the bathroom and come back.
Ive got great respect for surgeons, but I could never do it myself. It would be more of a sentence than a career for me.

 

[Stickboy]

Hi Guys-

Interesting discussion. From your "in the trenches" perspective, perhaps you can help me.

I'm an M2 at Nova Southeastern University, College of Osteopathic Medicine. Since we don't have a hospital of our own, we do rotations at a variety of sites. I need to select a site for my core rotations, and I'm finding it hard to decide among two of the more popular ones.

One site (let's call it "Broward" for the sake of argument ;-) has a reputation for a brutal internal medicine service. It involves long hours, call every 4th night, ample pimping plus tons of scut work. It sounds like a good opportunity to *do* a lot, but there's also the impression that med students are used as slave labor: You never really have the time to "learn" anything (that is: read about stuff) because you're being run so ragged. (Oh, by the way, the Peds and OB/GYN rotations are hard, too, but probably not quite as bad)

The other site (let's call it "Memorial") is supposed to have a top-notch surgery rotation, but a little softer in medicine. The "pro's" here (allegedly) are that with a less intense setup, you have the time to read and learn about the pathophys about a patient rather than just scurry from one to the other trying to keep ahead of the scut. The caveat here is that they don't have classic residencies in medicine...you generally work directly with the attendings.

I know this is just a snapshot, but anybody care to offer an opinion? I want to do and learn as much as possible as an M3, but at the same time I don't want them to start sucking the life out of me any earlier then they have to! (By the way, on my medicine rotation, I plan on having the Washington Manual in one pocket, and "House of God" in the other! <grin>)

Thanks for the help!
-Stickboy

 

[Duke]

Dear volvulus,

I guess I could say suck it up, but I remember I said the same thing to myself last year. Medicine can suck sometimes, but you'll look back on it and it will teach you a lot about disease processes, treatment protocols, etc, etc. When I got to the rest of my rotations, I knew what questions to ask the patient, what labs to run, what signs and symptoms to look for, how to present a patient to an attending and where to go to get free food.

When I look back on medicine now, I am glad I went through it and appreciate it.
If it makes you feel any better, during my medicine rotation I remember my attending telling me that the medical student was a necessary role player in the medicine team. It was the med student that knew the most about the patient. (Who's going to know if the patient's mother's sister had cancer?).

What about your call schedule? You forget to mention that?

You'll live...

Duke, KCOM 03

 

[ckent]

You should do your rotation wherever you will be able to take care of more patients. I suspect that will be where you have residents and there is a reputation for a brutal medicine service. Pimping is always a plus in medicine if done nicely, it will help you learn too. Don't over-estimate the amount that you can learn from a book. Think about how comfortable you would be taking care of a patient right now after having all of your "book" learning. And leave your house of god book at home, your pockets will be full of other stuff.

Originally posted by Stickboy
Hi Guys-

Interesting discussion. From your "in the trenches" perspective, perhaps you can help me.

I'm an M2 at Nova Southeastern University, College of Osteopathic Medicine. Since we don't have a hospital of our own, we do rotations at a variety of sites. I need to select a site for my core rotations, and I'm finding it hard to decide among two of the more popular ones.

One site (let's call it "Broward" for the sake of argument ;-) has a reputation for a brutal internal medicine service. It involves long hours, call every 4th night, ample pimping plus tons of scut work. It sounds like a good opportunity to *do* a lot, but there's also the impression that med students are used as slave labor: You never really have the time to "learn" anything (that is: read about stuff) because you're being run so ragged. (Oh, by the way, the Peds and OB/GYN rotations are hard, too, but probably not quite as bad)

The other site (let's call it "Memorial") is supposed to have a top-notch surgery rotation, but a little softer in medicine. The "pro's" here (allegedly) are that with a less intense setup, you have the time to read and learn about the pathophys about a patient rather than just scurry from one to the other trying to keep ahead of the scut. The caveat here is that they don't have classic residencies in medicine...you generally work directly with the attendings.

I know this is just a snapshot, but anybody care to offer an opinion? I want to do and learn as much as possible as an M3, but at the same time I don't want them to start sucking the life out of me any earlier then they have to! (By the way, on my medicine rotation, I plan on having the Washington Manual in one pocket, and "House of God" in the other! <grin>)

Thanks for the help!
-Stickboy