M3 early exposure

[honsano]

So I decided after I finish my Family Medicine rotation, I was going to try and complete a PMR rotation at Schwab. I will have completed only 2 rotations by that time, Surgery and Family Medicine. That brings me to my question, is it too early to do this elective rotation as an M3? I mean I'll still be prone to silly errors because I'll still be relatively new, but this is about the only time I can substitute this rotation in as a 3rd year. If I don't do it now then I'll have to wait til my fourth year to schedule it. This is a field I'm pretty interested in so I figure it'll be great to do it semi-early and see if it's something I can really see myself doing as a career. I'm just mainly scared that the residents won't recognize that I won't be as advanced as them...sort of how it is now in my surgical rotation. Comments, advice, I'm interested in hearing what my more experienced elders may think. Thanks guys.

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[Ludicolo]

Gotta admit, haven’t worked with an M3. But if you can swing it, I don’t see why it should be a problem. It’s good to get exposure early. Let ‘em know early you’re an M3 – hopefully your attendings and residents will adjust accordingly – but try not to use it as an excuse too often. Be the good student – show up early/on time, look interested, read about your patients, be prepared to help out when needed, do it with a smile. Maybe get a good LOR out of the deal.

Good luck!

 

[honsano]

haha for sure. I think the fact that I'll have a lot of energy will be a big positive. I don't plan on using hte M3 thing as a crutch but there are things that may be common in a hospital setting that I just won't know because my lack of experience. For instance, when writing progress notes in Surgery they kept tearing mine out. After a few days my resident finally told me they were too long (about 3/4 a page). I didn't realize that in surgery they are supposed to be half a page at MAX. I know that is a small detail but it really annoyed my resident that I didn't know that inspite of my explanations that it was my first roatation...ever. I know each field has their own little quirks and I just hope to discover them early enough without looking like an idiot. Advice on books? I'm gonna head over to the other thread that has been stickied but if anyone has some for a lowly M3 by all means share. Thanks guys.

 

[axm397]

haha for sure. I think the fact that I'll have a lot of energy will be a big positive. I don't plan on using hte M3 thing as a crutch but there are things that may be common in a hospital setting that I just won't know because my lack of experience. For instance, when writing progress notes in Surgery they kept tearing mine out. After a few days my resident finally told me they were too long (about 3/4 a page). I didn't realize that in surgery they are supposed to be half a page at MAX. I know that is a small detail but it really annoyed my resident that I didn't know that inspite of my explanations that it was my first roatation...ever. I know each field has their own little quirks and I just hope to discover them early enough without looking like an idiot. Advice on books? I'm gonna head over to the other thread that has been stickied but if anyone has some for a lowly M3 by all means share. Thanks guys.

First of all, it was the surgery resident's lack of ability to teach you that was the problem - not your over-enthusiastic note writing. So I wouldn't take that as something you didn't do well.

Schwab is pretty friendly. I have friends who are attendings there so if you pm me I can put in a quick word for you.

I would recommend the pocketpedia (Howard choi et al.) for a quick easy read on various topics. If you can, put in some face time with the program director who is super chill - set up an appointment with her to discuss your career options, etc.

The key is to not be lazy and act happy about doing work and helping out even if you are not. Most people who don't do well on their rotations usually have a bad attitude - like leaving early without asking, showing no interest in the topic, falling asleep during rounds or lecture, not following through with their assigned tasks however small that may be. The nurses are usually very helpful at most institutions and they can help show you the ropes as well. Just be friendly and interested and you can't go wrong.

 

[SSdoc33]

First of all, it was the surgery resident's lack of ability to teach you that was the problem - not your over-enthusiastic note writing. So I wouldn't take that as something you didn't do well.

Schwab is pretty friendly. I have friends who are attendings there so if you pm me I can put in a quick word for you.

I would recommend the pocketpedia (Howard choi et al.) for a quick easy read on various topics. If you can, put in some face time with the program director who is super chill - set up an appointment with her to discuss your career options, etc.

The key is to not be lazy and act happy about doing work and helping out even if you are not. Most people who don't do well on their rotations usually have a bad attitude - like leaving early without asking, showing no interest in the topic, falling asleep during rounds or lecture, not following through with their assigned tasks however small that may be. The nurses are usually very helpful at most institutions and they can help show you the ropes as well. Just be friendly and interested and you can't go wrong.

"The nurses are usually very helpful at most institutions and they can help show you the ropes as well. Just be friendly and interested and you can't go wrong."

uhhhh.... what?!?!?!?!?!?!?!?!?!?!?!?!?!?!?!?!?

i dont know where your interests lie within the field (and you probably dont etiher), but if you do decide to do a rotation, make sure you get some outpatient time as wel.. a lot of residencies, and especially med student rotations, will stick you on an inpatient rehab ward. you'll be doing internal medicine on rehab patients, which is hard enough if you HAVE done a medicine rotation, let alone if you havent.

the field of PMR is moving towards more of an outpatient basis, with something like 70% of grads starting off doing outpatient physical medicine. if you can, try to get a glimpse of that. you probably wont be asked to participate much, and you can get a sense of the field that way.

and, trust me, there is more than one way to skin a cat. showing up early, leaving late, and being enthusiastic is one way. actually being GOOD at what you do is another. if you like the field and the work, all of the other stuff will come naturally.

 

[Ludicolo]

"The nurses are usually very helpful at most institutions and they can help show you the ropes as well. Just be friendly and interested and you can't go wrong."

uhhhh.... what?!?!?!?!?!?!?!?!?!?!?!?!?!?!?!?!?

Well…we are talking about rehab nurses here. I think they tend to be more student/resident friendly (the whole team approach thing) than other specialty nurses. Can't speak specifically for the Schwab nurses though. And if there are any Schwab residents lurking about, I challenge you to be more helpful and understanding than the aforementioned surgery resident.

i dont know where your interests lie within the field (and you probably dont etiher), but if you do decide to do a rotation, make sure you get some outpatient time as wel.. a lot of residencies, and especially med student rotations, will stick you on an inpatient rehab ward. you'll be doing internal medicine on rehab patients, which is hard enough if you HAVE done a medicine rotation, let alone if you havent.

the field of PMR is moving towards more of an outpatient basis, with something like 70% of grads starting off doing outpatient physical medicine. if you can, try to get a glimpse of that. you probably wont be asked to participate much, and you can get a sense of the field that way.

Good advice. Not sure how the rotation at Schwab is set up, but if you can try and get a mix of inpt/outpt. If it is primarily inpatient, then I would try setting up an outpatient PM&R elective sometime down the road. Good to get as broad an exposure to the field as possible.

Schwab is pretty friendly. I have friends who are attendings there so if you pm me I can put in a quick word for you.

Look at honsano, already making connections as an M3...

 

[ampaphb]

i dont know where your interests lie within the field (and you probably dont etiher), but if you do decide to do a rotation, make sure you get some outpatient time as wel.. a lot of residencies, and especially med student rotations, will stick you on an inpatient rehab ward. you'll be doing internal medicine on rehab patients, which is hard enough if you HAVE done a medicine rotation, let alone if you havent.

the field of PMR is moving towards more of an outpatient basis, with something like 70% of grads starting off doing outpatient physical medicine. if you can, try to get a glimpse of that. you probably wont be asked to participate much, and you can get a sense of the field that way.

When you make this request, do it VERY cautiously, however - a lot of the academic attendings are still primarily inpatient docs, and so telling them up front that your interest lies in the outpatient aspect of the field can be viewed as a slight if not handled delicately. Tell them you want to get a broad exposure to all aspects of the specialty, or figure out another way to dance around the topic - this remains a field in transition, and there are gray hairs with fragile egos you would do well not to run afoul of.

 

[ShrikeMD]

When you make this request, do it VERY cautiously, however - a lot of the academic attendings are still primarily inpatient docs, and so telling them up front that your interest lies in the outpatient aspect of the field can be viewed as a slight if not handled delicately. Tell them you want to get a broad exposure to all aspects of the specialty, or figure out another way to dance around the topic - this remains a field in transition, and there are gray hairs with fragile egos you would do well not to run afoul of.

Agreed.

It is perfectly acceptable for a medical student to want a broad exposure, but I would be cautious about conveying the impression of a strong PREFERENCE for outpt-related aspects of our field (even if you think that is the way you want to go.) Enthusiasm for the outpt musculoskeletal aspects of the specialty should not mean "avoidance" of the inpt experience. Many programs have lost an R2 who expressed disappointment about the inpatient aspects of the specialty (even if there were other reasons for quitting). Those programs would want to avoid repeating that scenario.

I would argue that it is better to have the broader exposure first, including an outpt MSK exposure, then allow the student to decide if they think they can handle the breadth of the clinical experiences they will need to master to complete their residency training.

 

[PMR 4 MSK]

I would advise against doing it this early as an M3 - you're still trying to figure out where to stand, what not to touch, what to ask, and when silence is golden. Your learning curve is accelerating so fast that in 1 year you'll be miles ahead of now for a specialty elective. Get the basics under your belt first.