Internship

[stassart]

Hello,
I would like to know what the opinon is concerning the internship period which exist in certain european countries (Scandinavia, Germany...). This is a perion of about 18-21 months where you work as a payed doctor divided in to surgery, internal medecin, psychiatry and to round it all of with a period of general practice before being able to start a specialty. In other countries one starts specialty directly after graduation. I have heard that some claims that the clinical rotations fulfill all the clinical practice you need in these areas, but I am not so sure. You learn much more in doing it yourself than following some resident looking over his back most of the time. I also think that a doctor should know how to take care of minor medical problems if someone claims to have one in his consultation, even if he is a plastic or cardiac surgeon, instead of immediately sending him to a generalist.

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[saori]

I believe the same system applies as well here in the DR, and in the States. Internship (from where I can see) in the States is the clinical practice you receive after graduation. You can either go into medicine or surgery, but you do get to go all around the clinical practice. Now, fourth year med students do clinical rotations, but here in the DR, these go by "internship", which is what i'm doing now. We do an average of two month rotations for 12 months (surgery, medicine, pediatrics, trauma, psych, ob/gyn, social clinics). This is all prior to graduation. See, since we get hands-on training on real patients starting anywhere between MS-1 and MS-2, clinical rotations are fairly simple, only difference is we have on-call duty, and fewer classes.

After graduation, we do a year of state-required work. The state provides salary in exchange of clinical practice. You are awarded a certain number of points depending on how far away from the city you choose to practice and in the end, they award you your medical license. No test.

If you want to do your residency, the more points you've gotten overall (your "pasantia" year, your residency admissions test, your graduating scores from MS, your journal publications, extracurriculars, etc.), the better your chances at getting a good spot at your choice of hospital.

This is not so in the good ol' US of A. If you want in, you must pass your USMLEs with outstanding scores...

All is different. Will I choose to do my "pasantia" upon graduation? Not likely, since I'll be taking Step 1 as soon as I present my thesis. Is it practical to do this type of work? Absolutely. You are alone in the woods, handling your own clinic, but you get a chance not only to test your skills, but to help others who would otherwise not have access to medical care.

Is this the way the system works in Europe? I'm kind of curious, since each Ministry of Public Health has its own views on graduating practicioners...