Longitudinal Clerkships?

[deleted980662]

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My school offers a "longitudinal clerkship" in which we spend six months of third year in a rural community, completing half of each of our core rotations simultaneously. It sounds like fun (and might be a neat thing for residency applications) but I'm worried it could also feel scattered or overwhelming.

Have any of you SDNers completed one of these? How did you like it? Did it come up on the residency interview trail at all?

 

[Mass Effect]

What's your other option? Does your school have its own hospital? Can you go to an academic center? I'm a DO and DO schools are the kings and queens of rural rotations. Trust me when I tell you there can be a huge difference in quality between rural rotations and rotations at major academic centers. Sure, you may get to first assist in surgery, but 8 times out of 10 it'll be a hernia repair or cholecystectomy. Great if you want to be a rural surgeon yourself. Otherwise, I'd stick with the academic center.

Just to give you both sides of the coin, there are some rural areas where the PCP is the only doctor for hundreds of miles and those folks see a lot more. If this isn't a place like that, I'd pass. Treating a cold, DM, HTN, HLD, and allergies is fine, but at some point, you need to learn more.

 

[deleted980662]

What's your other option? Does your school have its own hospital? Can you go to an academic center? I'm a DO and DO schools are the kings and queens of rural rotations. Trust me when I tell you there can be a huge difference in quality between rural rotations and rotations at major academic centers. Sure, you may get to first assist in surgery, but 8 times out of 10 it'll be a hernia repair or cholecystectomy. Great if you want to be a rural surgeon yourself. Otherwise, I'd stick with the academic center.

Just to give you both sides of the coin, there are some rural areas where the PCP is the only doctor for hundreds of miles and those folks see a lot more. If this isn't a place like that, I'd pass. Treating a cold, DM, HTN, HLD, and allergies is fine, but at some point, you need to learn more.

Thanks for your reply! At my institution, the alternative is kind of a mixed bag. Some rotations are at our rmajor academic center, while a lot of others are at community hospitals or rural clinics.

I think the main draw for me is continuity of care, the "uniqueness" factor, and building long-term relationships with attendings who could write stronger letters for ERAS. But you bring up a good point about breadth of experience. I'll have to give it more thought...

 

[OnePunchBiopsy]

I did a full year longitudinal clerkship.

The pros were that you were able to keep all the subjects fresh in your mind working up to Step 2. Also, since you build a longer relationship with your clinical staff, if you’re competent they let you do more things over time. If you like surgery, you get surgery exposure weekly the entire time and can be more hands on. I once got to close fascia by myself as an MS3 after an ex lap (this was at the end of the year after the attending had shown me multiple times).

The cons are that the learning curve is steeper since you need to learn everything all at once. Also, if you’re rotating at multiple hospitals, this could mean driving to multiple sites all in one day. If you like surgery, you’ll need to make sure to either do an away rotation or a sub-I where you work with a full team (intern, resident, Chief, etc.) to make sure you can work in that environment. This would be the same for almost any specialty working in a hospital.

Overall, I enjoyed it. I would do it again if given the chance.