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IM clerkship Last... what can I do?

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troopersmama

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Hi All


Unfortunately I got one of the lowest lottery numbers and ended up with less than ideal situation for order of 3rd year rotations. I have peds - ob gyn - fmed - psych - 2.5month elective/break including christmas break - surgery - medicine.

It is unfortunate that my schedule is "back heavy" with medicine and surgery last. And Ive been getting back feedback about doing medicine clerkship last, especially before surgery.

I am interested and surgery, and it seems like people are saying that medicine should always go before surgery since the surgery boards are a large part medicine content

Since I have a long break before surgery/medicine clerkship I was wondering if anyone had any advice on what elective I can take in order to help me prepare for surgery, in lieu of the fact that I am not taking medicine last.

Please let me know!


thanks!!!
:)
 

troopersmama

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Also is there any specific book/resource I can read ahead of my surgery clerkship to prepare me for my lack of medicine clerkship experience?


Thanks



:)
 

smq123

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Unfortunately I got one of the lowest lottery numbers and ended up with less than ideal situation for order of 3rd year rotations. I have peds - ob gyn - fmed - psych - 2.5month elective/break including christmas break - surgery - medicine.

It is unfortunate that my schedule is "back heavy" with medicine and surgery last. And Ive been getting back feedback about doing medicine clerkship last, especially before surgery.

I am interested and surgery, and it seems like people are saying that medicine should always go before surgery since the surgery boards are a large part medicine content

Since I have a long break before surgery/medicine clerkship I was wondering if anyone had any advice on what elective I can take in order to help me prepare for surgery, in lieu of the fact that I am not taking medicine last.

There isn't much in the actual surgery rotation that medicine can help you with. Learn how to present your patients quickly, succinctly, and (above all) be precise when presenting at AM report.

Getting a good grade in surgery involves helping your resident out, being "present" for the rotation (i.e. not sneaking off at the first opportunity), and not complaining. That's basically it.

If you are on the transplant or oncology service, and have a lot of sick patients, knowing how to decipher a patient's electrolytes may be useful. And knowing acid/base status, and how to read an ABG will be good too. Other than that...not too much.

You could take any surgical sub-specialty as an elective. I did ENT before surgery, and that helped quite a bit.

Also is there any specific book/resource I can read ahead of my surgery clerkship to prepare me for my lack of medicine clerkship experience?

You can try reading Schwartz, I guess, but it's a bit dense.

Honestly, doing well in surgery is more a matter of ATTITUDE, and not really knowledge. I know that sounds like it's putting surgery down, but I think that that's the best part of the third year surgery rotation - you know what they want of you. They want you to work hard, care about your patients, and make the residents' lives a little bit easier. If you try hard to be a team player, they will often let you into their team, and reward you for it.

I think that reading case files and Pestana (if you can get your hands on a copy) will help with the shelf, because they highlight important topics that you should really know well.

Good luck!
 

Anka

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The whole "you need medicine to do well on the surgery shelf" is a bit of a myth. The myth originates in the idea, held by many, that surgeons are not real doctors. In fact, if you follow your surgical patients, you'll find they have many of the same medical problems as your medicine patients, but they've been operated on. They will have electrolyte abnormalities, labs to be interpreted, physical exam findings, chest x-rays, abdominal films, CT scans, and so on. Your surgical team will attend to and address these issues; they will simply not jerk off for hours over a sodium that is one point too low. As the medical student following your patient, you should likewise attend to and address these "medical" issues in your surgical patients. Thus, you will learn the medicine you need for your shelf. And it's that kind of stuff (medicine you see in surgical patients) that's fair game for your surgery shelf, as they appear in surgical patients. However, you will not be tested on the various types of Lupus Nephritis on your surgery shelf. Does that make sense? I did surgery first and medicine last, and I learned far more medicine on surgery than I did on medicine.

Anka
 
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Order of clerkships during third year does not matter. Every student has to do all of the required clerkships. At the beginning of third year, you are green and at the end of third year you are expected to be more sophisticated. Coming from a school where we had NO choice, I ended with Internal Medicine, took Step II CK three weeks later and aced it.

Fast forward to residency interview time, and I got some great interviews (and great match) where just about every interviewer commented on my great performance and early completion of Step II. By having IM last, this cut my study time way back. I also had the period between the MATCH and the end of fourth year as pure vacation. There was nothing between me and the diploma except to show up and graduate.

You have been given a huge advantage in terms of Step II by having IM last. Take full advantage of this.
 

troopersmama

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hi all

thank you so much for the posts. teachers always told me that order really doesnt matter, but then i got bombarded with "advice" from fellow students to somehow switch my schedule because "medicine last was kiss of death". the switching did not work out for me, and i now know that it wont be that bad experience everyone has been telling me.

thank you again! this will help me face and enter third year with reassured attitude.
 

The Buff

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The whole "you need medicine to do well on the surgery shelf" is a bit of a myth.

Very true. In fact, there were more peds questions on my suregery shel than medicine questions. I aced the surgery shelf, am on medicine now, and didnt do any extra medicine reading beforehand. Just go in knowing the surgery shelf will be on medical management of surgical problems/sequlae (and not "where should you make the incision for a parathyroidectomy") and you will be fine.
 

vtucci

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Very true. In fact, there were more peds questions on my suregery shel than medicine questions. I aced the surgery shelf, am on medicine now, and didnt do any extra medicine reading beforehand. Just go in knowing the surgery shelf will be on medical management of surgical problems/sequlae (and not "where should you make the incision for a parathyroidectomy") and you will be fine.

Really- peds questions on the surgery shelf?
 
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