ICU rotation advice

[waitingtobeadoc]

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Hi boys and girls,

I am making some last minute changes to my 4th year electives and I need some advice. I am hoping to apply to anesthesiology as #1 and IM as backup. I am having a hard time deciding between ICU 4th year elective versus a cardiology 4th year elective.

I am heard lots of good stories about ICU. However, I fear that I may not be able to impress the attendings in order to get a strong reference letter. It is simple to impress cardiology attendings if you have read your stuff and you put in some hard work. But, how could one prepare for ICU? Even if you did prepare, how much independent work could a student do in an ICU setting?!

My first goal of 4th year is to collect some strong reference letters. It might sound sad, but learning comes second.

Let me know what you guys think.

 

[jdh71]

Hi boys and girls,

I am making some last minute changes to my 4th year electives and I need some advice. I am hoping to apply to anesthesiology as #1 and IM as backup. I am having a hard time deciding between ICU 4th year elective versus a cardiology 4th year elective.

I am heard lots of good stories about ICU. However, I fear that I may not be able to impress the attendings in order to get a strong reference letter. It is simple to impress cardiology attendings if you have read your stuff and you put in some hard work. But, how could one prepare for ICU? Even if you did prepare, how much independent work could a student do in an ICU setting?!

My first goal of 4th year is to collect some strong reference letters. It might sound sad, but learning comes second.

Let me know what you guys think.

I don't know. I'd do the medical ICU. Cards attendings are so used to people kissing and sucking up and trying to "look" good, I'm sure they are more than a little immune. So if you overly strategy is to look good and get get recs, I say tactically speaking medical ICU is your best bet. Plus, MOST med students avoid the medical ICU like the plague.

You know everything you need to know for ICU, you merely need to start putting the pieces together. I think two topics would could potentially make you shine is 1) vent management and 2) septic shock

 

[lord_jeebus]

At my institution, the SICU is co-run by Anesthesia, and because I was going into that field, it was the obvious choice.

I didn't think honoring that rotation was much different from others - read a lot (The ICU Book by Marino is a good choice) and look good on rounds. Know lots of criteria for things like sepsis, ARDS, VAP, etc. Know how to read a CXR. Procedural skills were not part of my evaluation.

 

[ArcherM2]

I did two months of ICU as a third-year because I was bored out of my mind with my first month of general medicine. It was the most valuable of my clerkships - aside from mastering things like vents, antibiotics, chest x-rays - you get to do procedures! I'm going into surgery, so I guess it's a touch different, but as someone going into anesthesia, learning the in and outs of central and a-line placement are going to be huge for you. I'd go ICU...if not for a letter, definitely for the experience.

 

[Anka]

Check out

http://www.ccmtutorials.com/

Especially the part on the problem oriented approach.

Anka