ICU elective good for radiology?

[dopetown]

I keep reading that imaging heavy electives like ortho or urology are good electives to take to prepare for a radiology residency.

But what about the the medicine aspect of interpreting images? It seems like a few weeks in ICU would also be a good choice. What do you guys think?

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[NAGNAM]

I keep reading that imaging heavy electives like ortho or urology are good electives to take to prepare for a radiology residency.

But what about the the medicine aspect of interpreting images? It seems like a few weeks in ICU would also be a good choice. What do you guys think?

Pros:
-Daily CXRs on lots of patients
-Procedure heavy

Cons:
-Awful hours

A pulmonology rotation will have lots of CXRs as well. Some procedures (thoracentesis, can probably worm your way into a line placement or two) without as bad hours. So far through intern year, ICU and pulm have been my two favorite rotations. That being said, ICU is a hard rotation. You basically work and sleep and do nothign else for a month.

 

[dopetown]

Pros:
-Daily CXRs on lots of patients
-Procedure heavy

Cons:
-Awful hours

A pulmonology rotation will have lots of CXRs as well. Some procedures (thoracentesis, can probably worm your way into a line placement or two) without as bad hours. So far through intern year, ICU and pulm have been my two favorite rotations. That being said, ICU is a hard rotation. You basically work and sleep and do nothign else for a month.

thanks nagnam.

Are there non-imaging aspects of ICU or pulm that you found helpful?

I have the option of doing a 2 or 3 week elective. Should I go for 3 weeks?

 

[PMPMD]

I keep reading that imaging heavy electives like ortho or urology are good electives to take to prepare for a radiology residency.

But what about the the medicine aspect of interpreting images? It seems like a few weeks in ICU would also be a good choice. What do you guys think?

I'm not sure where you guys are, but where I've worked, the ICU hours for med students were about 7-5. Not THAT bad. And none of them required call.

I think an ICU rotation is great preparation for intern year also.

 

[fun8stuff]

useless. dont waste your time!

 

[dopetown]

I think an ICU rotation is great preparation for intern year also.

useless. dont waste your time!

elaborate please!

 

[PMPMD]

elaborate please!

Well if you have to do any inpatient rotations in your intern year, an ICU month would be good experience when your pts are hypoxic, hypotensive, coding, etc. I'm a critical care fellow so of course I'm biased.

 

[PMPMD]

Or if someone codes in the scanner.

 

[officedepot]

from my experience the best radiologists know the most medicine. Yes they don't always know specific drugs to give to treat certain conditions but they know how most things present and know the respective imaging findings. They can take the HPI with an image and give a really good differential. (unfortunately most docs don't give the radiologist any history and then complain when they miss something or the image ordered is unhelpful - because they got a ct w/o contrast when they really needed one w/ contrast for example).



Anyway back on topic, doing a rotation that gets you lots of interaction with patients who will need imaging is a good idea. You can take the time to learn presentation, pathophys, and imaging findings. You can also learn treatments for intern year and future moonlighting opportunities.

my school requires an ICU rotation. If you have to pick an elective beyond rads choose one where you can learn lots of medicine and look at lots of images. Personally I don't think ortho would fullfill that. Sure you see lots of images but you will not learn lots of medicine.

so I'd say an ICU elective perhaps meets what I think is important. The best in my opinion is an EM rotation.

 

[myhandsarecold]

I just finished ortho, uro, and neurosurg. will be doing surg icu and ED soon. you will learn A LOT of imaging in the surgical subspecialties and the surgeons will make sure you will be able to produce reports that will actually be useful to them!

also did pulm and cards which helped me improve my history taking and auscultation skills (not very useful in your radiological future)

 

[drizzt3117]

I personally did heme-onc as my medicine sub-I, and think that or general med would be the best medicine rotations. You read lots of plain films in the icu and get used to tubes/lines but learning to manage a vent and phenyl drip isn't as useful to radiology as making initial reads on cts on pts with suspected fungal infection/malignancy etc IMO.

 

[fun8stuff]

Or if someone codes in the scanner.

A ICU (and intern year in general) is good in theory and lot of 'higher ups' think these things are valuable, but imho it is practically a complete waste of time the way it is currently done. As an intern, you go into survival mode where your main goal is to get work done and 'do no harm'. You are taught stuff in such a way that is important to many other fields of medicine, but not radiology. You don't know what is important to know for radiology and your attendings/senior residents/fellows either don't know or will not spend a sufficient amount of time to teach you these things. It is helpful to know their perspective, but you will have no or little idea on what you should key-in on. The things you do learn, will either change (management algorithm) and/or you will forget the fine details because you will not use any of it on an every day basis. Intern years are designed for medicine/surgery and their subspecialties....

The number of radiology films and variety of pathology you see during a month of ICU is very small in the grand scheme of your radiology career. You will learn just as much after 2 or 3 days on chest during your first chest rotation.

Sure, the first few months or year you may be able to "help" if someone codes. But, eventually you will become rusty and forget stuff because you will not be using those skills every day. In "real life", if someone codes you will be doing "the minimal", perhaps managing contrast reactions (which you will learn during radiology residency anyway) and then calling for help, and they will take over. You won't be running codes as a radiologist.

"Intern year" for radiology would be much better if it was done after you have had a couple years of radiology under your belt and you rotated with the team and acted as a consultant (as PharmDs do). Not only would you be able to more intelligently discuss the radiology findings of the patients, but you would be able to better key in on the what is important for you to learn and what information is important to your ordering clinicians. Both sides would benefit.

 

[dopetown]

A ICU is good in theory and lot of 'higher ups' think these things are valuable

I'm glad you mentioned this because the other reason I'm considering an ICU elective is that it will improve my application come interview invites. We (in Canada) have been advised against filling all our electives with radiology.

If ICU is worthless, is it worth taking just for the resume alone?

 

[fun8stuff]

I'm glad you mentioned this because the other reason I'm considering an ICU elective is that it will improve my application come interview invites. We (in Canada) have been advised against filling all our electives with radiology.

If ICU is worthless, is it worth taking just for the resume alone?

From the viewpoint of this 3.5 yr rad resident, it is useful for the resume and to help you feel more like a real doctor. Perhaps it would help to do one in med school if you knew you would have to during intern year... But why go through that kind of pain twice? You should enjoy life fourth year!

 

[NAGNAM]

A ICU (and intern year in general) is good in theory and lot of 'higher ups' think these things are valuable, but imho it is practically a complete waste of time the way it is currently done. As an intern, you go into survival mode where your main goal is to get work done and 'do no harm'. You are taught stuff in such a way that is important to many other fields of medicine, but not radiology. You don't know what is important to know for radiology and your attendings/senior residents/fellows either don't know or will not spend a sufficient amount of time to teach you these things. It is helpful to know their perspective, but you will have no or little idea on what you should key-in on. The things you do learn, will either change (management algorithm) and/or you will forget the fine details because you will not use any of it on an every day basis. Intern years are designed for medicine/surgery and their subspecialties....

The number of radiology films and variety of pathology you see during a month of ICU is very small in the grand scheme of your radiology career. You will learn just as much after 2 or 3 days on chest during your first chest rotation.

Sure, the first few months or year you may be able to "help" if someone codes. But, eventually you will become rusty and forget stuff because you will not be using those skills every day. In "real life", if someone codes you will be doing "the minimal", perhaps managing contrast reactions (which you will learn during radiology residency anyway) and then calling for help, and they will take over. You won't be running codes as a radiologist.

"Intern year" for radiology would be much better if it was done after you have had a couple years of radiology under your belt and you rotated with the team and acted as a consultant (as PharmDs do). Not only would you be able to more intelligently discuss the radiology findings of the patients, but you would be able to better key in on the what is important for you to learn and what information is important to your ordering clinicians. Both sides would benefit.

Frankly intern year for radiologists should in some way involve a review of anatomy. Essentially none form M2 to PGY2 year is pretty garbage