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is this normal for rotations?

Discussion in 'Clinical Rotations' started by qqw, Aug 8, 2015.

  1. qqw

    qqw

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    at my site, we have mandatory meetings almost daily, journal clubs twice weekly, and since im the rotating student, i must give presentations bi weekly.

    A lot of it seems like a waste of time. seemingly 80% small talk, 20% actual medical talk. Basically it extends 20 min of work into 1 hour.

    is this the norm for rotations for 3rd year? i guess i was expecting to just do rotations then go home and study what i saw. maybe attend a meeting a week or something. but with all this ive been getting home at 5pm and often too tired. i still study but not as much as i had planned. it would be fine but like i said i feel most of these meetings/clubs/blah blah are more about chit chat than learning...
     
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  3. Frazier

    Frazier Emergentologist
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    Yes. Hours per day, but they are more on task than what you describe. That said, not sure of the increased utility. Listening to 4+ classmates doing their rotation at some other hospital each give 20-minute lectures on XYZ is nice in concept...but the learning could have been done solo in a fraction of the time. This is not a new tune in medical education.
     
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  4. bashwell

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    My experience was the same as yours, OP. There's a lot of time wasted on rotations, etc. :(

    In fact, some or many attendings seem to think so as well. For example, that's apparently the driving impetus behind Dr Dustyn Williams' OnlineMedEd (sorry for sounding like I'm advertising for him, I don't know him or anything though, just using him as an example here, though I think OnlineMedEd is a very good resource):
     
  5. pathologyDO

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    Youch! I'm doing peds right now and we don't have didactics or mandatory meetings. 100% of our time is spent seeing patients or in the docs room reading and discussing cases we see through the day. This is probably because my rotations are through hospitals that are not academic or associated with a school of medicine.
     
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  6. J ROD

    J ROD Watch my TAN walk!!
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    You will find a ton of BS in academia. Just grin and bare it
     
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  7. hallowmann

    hallowmann SDN Lifetime Donor
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    Lots of journal club, didactics, workshops, etc. Most are useful to some degree (not really filled with chitchat at all), but they fill my days which are already full of pre-rounding, rounding, procedures, note writing, looking up stuff related to the cases, etc. Spending 12+ hours in the hospital just to get through the day. I have no idea how I'm supposed to study for shelves.. I guess on a weekend that I don't have to be there for call...
     
  8. Jlaw

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    Thats how it is if you are at an academic center. If you rotate through community based hospitals and private practice you work directly with attendings and don't have it deal with all the BS.
     
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  9. WinslowPringle

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    Sounds entirely normal.
    Not entirely true for all places - definitely rotated through some community based hospitals with more meetings and presentations than at the big academic medical center.
     
  10. GUH

    GUH Underdawg
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    I've had two rotations so far - one at a prison with about 1.5 hours of meetings mostly discussing patients per 8-hour day and the other at an outpatient FM solo private practice where there were no meetings at all aside from weekly drug rep free lunches. No formal presentations yet, just <1 minute reporting of information that I was told to look up by my attending.

    Next one is at a county/teaching hospital with lots of students and residents so we'll see how that goes.
     
  11. Siggy

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    So Patton for Psych, an FM physician (I think I know who, given the weekly (was it more daily?) free lunches), and now you're up for Arrowhead?

    Which rotation at ARMC?
     
  12. JustPlainBill

    JustPlainBill Attending
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    yes -- at our school it was even advertised that learning medicine was asynchronous and that we should get used to it -- there was a lot of wasted time by people wanting to make themselves feel important and some by people who wanted to be sure you had the basics and they didn't know what you had been taught due to the asynchronous nature in which medicine is taught ---

    plus there are a lot of people who are good at what they do---which doesn't always mean they are good teachers -- something medical educators have yet to grasp.
     
  13. Kaustikos

    Kaustikos Archerize It
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    Yes,
    Welcome to third year. Don't miss lectures or you'll be victim of the admins wrath.
    There's a lot of bull**** and residents/etc hate it too. It will impair your knowledge during clinic. It will hinder your chances at excelling in clinic. It will annoy you. But you have to do it.
     
  14. GUH

    GUH Underdawg
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    My next rotation is surgery (I won't confirm or deny ARMC). No idea how I'm going to fare given that I get drowsy when sleep-deprived, let alone study for the FM and Surgery shelves simultaneously. Not to mention a (fairly distant) past history of syncope at the sight of arterial bleeds. I guess dealing with it is just part of the rite of passage. I'd be glad to hear any survival tips.
     
  15. Siggy

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    To be honest, when I rotated at ARMC for surgery I ended up with a vascular surgeon and scrubbed into something like 4 surgeries the entire rotation... and AV fistula formation wasn't exactly the most bloody surgery. However, when it comes to surgeries, your millage will vary considerably. The most blood you're likely to see is in the trauma bay, but the surgery residents generally don't care provided some student shows up.
     
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  16. zidanetribal

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    .
     
    #15 zidanetribal, Aug 31, 2015
    Last edited: Sep 25, 2015
  17. Jlaw

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    What exactly are you complaining about? You should make sure that you have a valid complaint before taking it anywhere. Rome wasn't built in a day and your clinical medical education won't be built in a year, some rotations you are going to learn because they are so good, others your learn because they are so bad. Kinda like life, you are probably learning the most when you don't even realize it.
     
  18. zidanetribal

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    #17 zidanetribal, Sep 1, 2015
    Last edited: Sep 25, 2015
  19. snowpea28

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    First of all- getting home at 5 PM is a TREAT.

    Second of all- I hope you understand that these meetings and presentations are for YOUR benefit. Everyone else probably has more important things to do than listen to you give a talk about things they know.
     
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  20. Light Yagami

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    You just have to grin it and bear it. Personally, I'm finding the entirety of third year a waste. If it were up to me, med school would be 2.5 years. 2 years of basic sciences and half a year of cores and electives with the sole purpose of exposing you to different fields to learn what residency you want to go into. Not for learning anything. It would save 1.5 years of time and a lot of student debt. Let them extend residency by a year and pay me while I learn. I just got back from my Ob/Gyn rotation where the chief function of students is to maintain the dept's precious pt. list. Complete scutwork. Then I stood around for 3 hours for a hysterectomy with complications. Nothing I did today will help me pass the shelf. I'd rather have sat at home and read all day. In short, 3rd year has been pure hell for me. I'm rotating at an academic facility, so there have been plenty of time wasters such as student presentations and didactics.
     
  21. Bacchus

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    You're getting disillusioned. This is scary. Didactics and presentations are not time wasters. You are learning while you do them. Although ultimately one can argue it's the rotation grade which will help you, you shouldn't be solely focusing on just the shelf. You need practical experience regardless of what field you go into. A 3 hour hysterectomy is plenty of time to ask questions and use the time as a learning opportunity. Grades matter, I get it. But 3rd and 4th year are the time you're going to learn and gain some practical knowledge. Unfortunately, this attitude I think is going to give you problems in the future and you're going to find difficulty enjoying the rest of medical school or residency. You're always answering to someone and there is always someone that's more senior than you. With all that said, 6 months is NOT enough time to rotate through all the specialties and decide which career one wants to pursue. Your attitude definitely isn't rare, but it is dangerous and for your own good I would try changing it so you don't become disgruntled, burned out or a difficult resident to work with.
     
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  22. tco

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    So your only goal is to pass the shelf and get done with third year?

    Path or Rads?
     
  23. 22031 Alum

    22031 Alum At the baby factory.
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    If you think being present for a hyst with complications was useless for the shelf, you're in for a shock come shelf time. I can think of a bunch of applicable shelf questions without even trying.
     
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  24. mcloaf

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    If you're not learning anything from your time in the hospital at some point that's on you.
     
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  25. Psai

    Psai Snitches get zero vicryl
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    I'm all about complaining about wasting time but maintaining the list is good because if you keep your eyes open, you will learn how to manage patients. If you paid attention in the surgery, you would learn what it's like to be in an operating room. You could learn what the anesthesiologist did, maybe get an iv or intubation. You could brush up on pelvic anatomy as hitting ureters is not uncommon. You can see what ob gyns do and understand a little more when your future patient comes in with a history of hysterectomy because you would have read up on the case, know the indications for surgery, etc. You will be able to ask your patient if they had uncontrolled bleeding or cancer or whatnot. I totally get the third year mentality of wanting to read and pass shelves but honestly, besides the grades, shelves are a waste of time. You do your real learning at the bedside, by talking to patients and taking care of them in the hospital. It's hard to appreciate when you're not an active member of the team though. And tip toeing around jerks because you don't want them to tank your grade is also a huge negative
     
  26. Tots

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    I wish I could maintain the list, then maybe I would actually learn how to manage patients on surgery and be of some use :p. The most frustrating thing about third year for me has certainly been that there is just a lot of time I am completely useless, sometimes even a detriment, to the team. This has been incredibly frustrating to me as I would be happy putting on SCDs all day if that would be helpful or hell send me to get coffee if that if that would be helpful.

    Maybe the only complaint I have about education on surgery is that there is certainly a mentality among residents and surgeons that on my rotation I should spend absolutely as much time as possible in the OR. Certainly seeing a wide variety of cases in the OR is beneficial to my education but at some point I would have appreciated if they let me go to more consults or things happening on the floor over time in the OR. Its frustrating to ask to go workup(or watch the workup of) the SBO in the ED and be told that my time is better spent in the OR seeing the 7th lap chole of the day with a surgeon who doesn't even realize I exist. We also have almost daily lectures which happen to be during rounds....which is kinda crazy since thats when some best learning happens. Especially frustrating when 50% of the lectures are terrible.

    All that being said, 3rd year is miles better than 1st/2nd year both in daily awesomeness and amount I am learning. My brain hurts so much. I have almost a completely opposite opinion than you, in that I think it would have been a better use of my time to make 1st/2nd year shorter and have me spend more time in the hospital working up, talking to and coming up with plans for patients.
     
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  27. hallowmann

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    Completely understand this. That said, "seeing" a 7th lap chole of the day (or even week for that matter) is useless to me, but depending on the doc, you might be doing something like driving the camera or suturing the ports. That's fun at least.

    That's ridiculous that you have lectures during rounds. Rounds is when you actually see everyone. What do you do with the post-op patients after you see them in the OR? Where's the benefit of seeing someone's entire stay, so you actually know what to expect pre and post-op. I hope you still round/follow-up on them at some point, even if it's not with the team in the morning.

    Completely agree, but for me at least some days are slower than others, and some services are slower than others.
     
  28. Siggy

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    Ah, the three main OB surgeries:
    Total abdominal hysterectomy
    Transection of the right ureter
    Transection of the left ureter.
     
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  29. NurWollen

    NurWollen Strong with the Force
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    How many patients does an MS3 typically carry on a ward based rotation?
     
  30. Kaustikos

    Kaustikos Archerize It
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    2-3 is the norm. Fourth year: it varies from 4 to all patients on your sheet. It just depends on how comfortable you are and how well you do.
    But knowing something about what's going on with all patients goes a long way. If a resident asks what X consult said about a patient and you don't technically have them, it's better to know if a note was posted or they said something vs "Iunno, not my patient."

    Sent from my One using Tapatalk
     
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