M3s...Anyone else not learning a damn thing?

[Old_Mil]

I'm 50 days into third year. One rotation down, #2 will be half over soon. Both have essentially been nothing but exercises in shadowing. The first month, the 12-16 hour days left no time for reading. This one, at least I get a couple of hours of that in.

Either way, I feel like I'm forgetting far more on a daily basis than I'm actually learning. They could wheel my pulseless corpse in for morning report, stick me in a closet till the day's end, and nobody would be the wiser for it.

Is this how it's supposed to be?

---

Members don't see this ad.

 

[Blade28]

What rotations have you done so far?

 

[Sage880]

Try doing your clincal years in Ireland. I could never show up and no one would ever notice or care. Shadowing in highschool was better then this. At least then someone at least glanced at me - even if it was only to remember that they have a student shadowing them.

Nice to hear it's not a rose garden every day in the US either. I basically feel that pre-clinical here was fine but now every day we fall further and further behind US medical students in our training.

 

[Old_Mil]

What rotations have you done so far?

Peds and FP.

 

[Old_Mil]

I basically feel that pre-clinical here was fine but now every day we fall further and further behind US medical students in our training.

Yep. That about says it. I'm just wondering if out there somewhere there's this mecca of third years who are learning all sorts of things and I'm getting shorted.

 

[Hard24Get]

Yep. That about says it. I'm just wondering if out there somewhere there's this mecca of third years who are learning all sorts of things and I'm getting shorted.

Sorry to break it to you, but that's true. Everyone has their time with lazy preceptors who don't teach and thus don't take away much, but most students end up learning a lot on most 3rd year rotations. Although sometimes you don't realize how much you have learned until you are looking back on it, it sounds like you are getting the shaft this time around.

Some strategies I used for the hum-drum lazy/busy resident/attending rotations:

1. Pay attention during the shadowing parts and think about what questions you would ask and what interventions/tests you would perform (still boring)
2. Show up with a little handout on an interesting disease/complaint you saw the other day to focus your studying and show interest
3. Ask if they mind if you see a patient or two on your own and then present to them so you can practice H&Ps; this actually often works
4. Be sure to blast the site on your evals for being a poor learning experience

I'm sorry, but shadowing should be for pre-meds, not senior med students

 

[Anka]

Not to argue with the general sentiment of this thread (it is quite accurate in a lot of ways)... it's important to realize that what you're learning in third year is different from what you learned in first and second years because not everything you learn is denotative knowledge anymore (e.g., today I learned the workup for new onset dementia). Instead, it is experiential -- you are getting a feel for what a person looks like when their "really sick" versus someone you can come back to in an hour; you're seeing different people's ways of diuresing someone, and as time goes on you pick up what's wrong and right about each way, etc. But you don't come home at the end of the day and say "I learned X Y and Z." Most days you come home and say "HOLY SH@@T I'M GONNA TOTALLY LOSE IT IF I HAVE TO SPEND ANOTHER MINUTE IN THAT PLACE!" At the end of the year, though, it's pretty easy to tell the difference between someone who just started their third year and someone finishing it. One day you realize you know what to do when you find someone unresponsive as you preround, or you look at an admission and call your resident to say "Come down and have a look, but this guy is too sick for the floor."

All of that is predicated, of course, on people letting you do enough that you can learn. It's nearly impossible when you're first starting out to learn by watching -- you have to be doing something to keep yourself engaged. Later on, when you're paradoxically less likely to be on the sidelines, you don't need to be doing something every minute in order to learn something. Some rotations and sites will be better about allowing you to do things than others. Peds is legendary for being hands off, as are sites that cater to rich private patients. If you want to be hands on, figure out where people are the busiest and sign up for that. Sure, sometimes you'll lose and be sidelined for 18 rather than 12 hours per day, but just as often you'll wind up a true part of the team because they need you bad.

Best,
Anka

 

[plastikosmd]

this is where you begin to make the change from passive learning to more active learning. up to this point your goals were made pretty clear, outlines, approaching tests etc. then comes 3-4 year and this progresses to residency...fellowship..attending etc and you learning must become much more self directed. you see something...then go read about it. if you rely on being "taught" you will fall behind. it is nice that there is nobody over your shoulder..or maybe no test that is bearing down on you but you still are responsible for the information. being an attending it is the hardest of all, falling into old patterns, becoming comfortable and stopping the learning process. it is much worse for the private guys...at least in academics i have 3 conferences a week, etc forcing you to keep up with the times.

 

[Shinken]

this is where you begin to make the change from passive learning to more active learning. up to this point your goals were made pretty clear, outlines, approaching tests etc. then comes 3-4 year and this progresses to residency...fellowship..attending etc and you learning must become much more self directed. you see something...then go read about it. if you rely on being "taught" you will fall behind. it is nice that there is nobody over your shoulder..or maybe no test that is bearing down on you but you still are responsible for the information. attending is becomes the hardest of all, falling into old patterns, becoming comfortable and stopping the learning process. it is much worse for the private guys...at least in academics i have 3 conferences a week, etc forcing you to keep up with the times.

Bingo! Nicely put.

In my experience, the best way to learn in those "shadowing" rotations where you don't do much is to:

- Study in your spare time (obviously)

- Pay attention to what's going on and carry a little something to write on. Write down things you don't know or don't know enough about. Study about them later. For example, in the peds rotation if the preceptor was dealing with a patient with RSV and you don't know much about RSV, jot it down. At the end of the day you should have a rather long list of things to look up and learn about. If you don't, you either were daydreaming too much or you should already be an attending.

- Try to anticipate the preceptor's response to a patient question to gauge how much you know. If the answer was different from what you thought, ask the preceptor (or look it up if the preceptor is not that approachable).

 

[t33sg1rl]

My favorite activity in FP was proving my preceptor wrong. I never said boo to her, of course, but I always checked the practice guidelines and literature on her management of common stuff, and she was usually wrong. I don't think she learned a darned thing since graduation from med school 20 years ago.

 

[diosa428]

One thing to think about is how you're presenting yourself to your preceptor. If your preceptor asks you to do something that you've never done before (and don't know how to do, or are nervous about doing), at least try. I found that, intitally, my preceptor didn't really ask me to do much, and I think it's because I seemed hesitant to do things b/c I was uncomfortable. Your preceptor isn't going ask you your opinion on an assessment or plan if you can't even get the history down. If you show that you can take a history and do a physical, they'll start asking you to do more and more. And if they aren't even letting you practice your history taking and presenting, ASK. You are there to learn, and you need to be at least learning this skill. I would also recommend trying to write up some SOAP notes and asking your preceptor to look at them and tell you if you're doing it correctly. You will eventually get to a rotation where you'll be expected to do things and know things, especially if you've been on multiple rotations, and you want to at least have had some practice with the things med students are expected to know.

 

[PrincessofBlood]

Try doing your clincal years in Ireland. I could never show up and no one would ever notice or care. Shadowing in highschool was better then this. At least then someone at least glanced at me - even if it was only to remember that they have a student shadowing them.

Nice to hear it's not a rose garden every day in the US either. I basically feel that pre-clinical here was fine but now every day we fall further and further behind US medical students in our training.

I did some rotations in the UK. It is definitely different than the U.S. system. In the english system you don't do alot in third year, you basically have to read your booty off, i.e. you are given time to read like heck, which will pay-off. The flip side is that during residency in the UK you get to do alot more procedures and stuff that residents in the US don't get to do. If you aren't reading during down time, then yes you are falling behind, but we all can read up on patients we have only just seen on shadowing.

 

[THP]

I did some rotations in the UK. It is definitely different than the U.S. system. In the english system you don't do alot in third year, you basically have to read your booty off, i.e. you are given time to read like heck, which will pay-off. The flip side is that during residency in the UK you get to do alot more procedures and stuff that residents in the US don't get to do. If you aren't reading during down time, then yes you are falling behind, but we all can read up on patients we have only just seen on shadowing.

What sort of procedures do UK residents do that US residents don't? I have yet to see a single procedure that residents don't do, that only attendings will do.

 

[Sage880]

I did some rotations in the UK. It is definitely different than the U.S. system. In the english system you don't do alot in third year, you basically have to read your booty off, i.e. you are given time to read like heck, which will pay-off.

Yes, that is the plus. All that down time reading got me a 245 on step 1 but I still don't know **** about patients. Surgery wound? What are those? I don't know, I've never seen one.

Today a consultant (an attending) actually showed up and talked to us for 40 min about lung cancer presentations (they might just have a cough!). Then sent us off. He's a cardiothoracic surgeon so we asked if we could stay and either see some of his patients or come view one of his surgeries. He didn't even stop walking away from us and said no because he doesn't like students coming into the OR. Yes, this is at a university hospital. So I'm back in the library studying for step 2 for the rest of the day.... in September! It's not like we actually have shelf exams or any other tests during the year. If you ever meet and IMG and wonder how they can score 260's and still not know anything then now you have the answer.

Uh, sorry to invade your thread by the way. I'm down on the Irish system right now but I will keep trying to make the best of it. It is frustrating though because people at home (Canada) and in the US don't understand how pretentious it is. We had an opthalmology lecture and I asked the doctor a quick question on the way out and he didn't even stop walking or respond. They won't even make eye contact. I have never even seen a nurse and a doctor talk... ever... about anything. They hate each other and the only thing in common is that they hate the students. The nurses will come around a little but you go into the relationship a huge underdog because they assume you'll be a jerk because you're going to be a doctor. Hell, a lot of 5th (final year) students wouldn't even make eye contact with a student from us lower years. Because that's how the system teaches you to act. I work taking blood on the weekends and most patients don't even know their doctor's name - much less ever met them. It's like how medicine used to be in the 1950's here minus having to taste urine.

But the good thing is I can study for 8 hours a day every day if I wanted and get 9 hours of sleep every night. Friends at home think I'm lucky... I don't know. I can't help but somehow feel cheated out of my 27,000 euros I'm paying every year.

Ok, sorry about the rant. I'm sure the grass just looks greener right now and it's probably not as great once you're there. I don't want to be a negative person so I'll quit complaining and try and just focus on the positives. There are some pluses too and I shouldn't focus on the negatives. Back to my study spot, mug of coffee, and "Step 2 secrets"!

 

[PeeWee137]

honestly, i went thru all of 3rd year without drawing blood once. i attempted like 2 abg's because i grabbed the syringe from the resident's hand. i got to suture once in the OR because i lied and said i knew how to do it, after countless times of not being allowed because i was honest and said i never did it before. one pap smear because i stayed late in clinic and bothered everyone to let me try. never got to catch a baby. ive stayed up all night during call to try and see some action even after i was told to go to bed. never did a foley. or a chest tube. its really sad. believe me, it wasnt due to lack of trying. and i've always received great evals and feedback from residents and attendings, they've all said ive worked hard, was a team player, knew my stuff, etc. maybe they think im a little girl and dont want to get dirty or something.
but honestly, WTF. luckily im going into psych so i really wont have to do much of that anyway. but i still wanted to learn, and i made that clear to everyone...

 

[ssg]

honestly, i went thru all of 3rd year without drawing blood once. i attempted like 2 abg's because i grabbed the syringe from the resident's hand. i got to suture once in the OR because i lied and said i knew how to do it, after countless times of not being allowed because i was honest and said i never did it before. one pap smear because i stayed late in clinic and bothered everyone to let me try. never got to catch a baby. ive stayed up all night during call to try and see some action even after i was told to go to bed. never did a foley. or a chest tube. its really sad. believe me, it wasnt due to lack of trying. and i've always received great evals and feedback from residents and attendings, they've all said ive worked hard, was a team player, knew my stuff, etc. maybe they think im a little girl and dont want to get dirty or something.
but honestly, WTF. luckily im going into psych so i really wont have to do much of that anyway. but i still wanted to learn, and i made that clear to everyone...

I know exactly what you are talking about. It is so unfortunate cause these interns and residents seems to have amnesia and forgot how it was when they were in med school even though it was a year ago. Part of their job is to teach their juniors in the first place. It sucks being a 3rd year.

 

[oldManDO2009]

On the first day of my rotation I ask my preceptor what he expects of me and what I can do for him. I shadowed for 2 weeks in peds and was ready to hang myself in the bathroom. I just kept asking questions about peds and asked the doc how his golf game was...

The last 2 weeks were good - I was allowed to see patients on my own and recommend treatment which was incorrect at times but a great learning experience. When I was wrong he had an opportunity to talk about treatments.

Bottom line I did not let my preceptor off the hook and pretended to be interested in all things

 

[smq123]

never got to catch a baby.

never did a foley.

Wow. That's really bad - hopefully your school will address these issues. (I know, it doesn't help you out much, but maybe they can do better for future classes?)

 

[Blade28]

I know exactly what you are talking about. It is so unfortunate cause these interns and residents seems to have amnesia and forgot how it was when they were in med school even though it was a year ago. Part of their job is to teach their juniors in the first place. It sucks being a 3rd year.

Make sure to remember this when you're an intern/resident - I wasn't always taught during my MS-III rotations, but I definitely appreciated those residents who took the time to teach me.

Also remember that it's still early in the year for the new interns, so they're probably too busy/stressed/overwhelmed/overworked for teaching right now.

Also depends on what rotations you're on.

 

[PeeWee137]

Wow. That's really bad - hopefully your school will address these issues. (I know, it doesn't help you out much, but maybe they can do better for future classes?)

i complained to our dean, he told me to complain to the DME of the hospitals. i complained to the DME, he told me to address it at school.... i love how everyone passes the buck.
the kid that caught the most babies in ob was the one the residents complained about the most, he was a jerk who hated ob, and they would constantly page him to do everything. go figure. do some residents actually think that catching a baby is punishment? especially when there are students who ask to do those things? wtf.
we have to evaluate our rotations at the end and I gave these places the lowest possible scores.
all i can do is warn the next group of students what they are in for.

i love 4th year by the way.

 

[PrincessofBlood]

If you want to learn phlebotomy skils just hang out with the phlebotomist or nurse technician who is doing this, that way when nobody can get an IV line, you can do it, or if you need to draw IV bloods then you can. If you can't, then when your are an intern and you need to draw blood you have to say, "I never learned how", and then somebody teaches you in 10 minutes, and then you know how. No big deal. People in the U.S. won't really care what you learn as a student, because when you really learn medicine is when you are a resident, you may admit 10 patients in a day, do 5 venous blood draws, maybe do an ABG, and on ICU block you can help or even intubate.

In two weeks of internship you will learn the "How" of medicine and more of the everyday little things than you ever could as a resident. While a medical student is impressed by someone who can draw blood or intubate, an attending is obviously not, especially if they do these things. Attendings, and residents are impressed by those who know how to manage patients and people who KNOW medicine are keep up with reading, etc. . . Nobody is overly concerned if a medical student doesn't know what a surgery wound is, if you do a surgery residency not only will you see thousands of surgery wounds, but you will know alot about them. If you do psychiatry you don't necessarily need to know alot about wounds. Basically, what you need to know about practical hospital skills and experience you will learn in residency, and even when you finish you are still a junior resident. Nobody who finishes surgery residency complains that they didn't see enough wounds (most would say that they did too many dressing changes, and may be happy when they have residents to help with that.)

 

[PrincessofBlood]

Part of their job is to teach their juniors in the first place. It sucks being a 3rd year.

While technicially it is part of the job of residents, in no way are residents paid or evaluated for teaching. Residents are there in order of importance to 1. See patients i.e. help run the service, 2. Learn from attendings how to better manage patients 3. Eat food and rest when not on call 4. "Teach" medical students.

This isn't college where the professor sits down and spoon feeds you, i.e. different lecture each day and a nice little problem set. If a teacher doesn't teach you in high school what happens to that teacher? They get fired. If a resident doesn't teach you what happens? NOTHING. The most important job of a resident is to keep patients alive, become a doctor, and maintain their own ADLs and sanity. Residents get fired for problems with patient care. At your level you need to be reading on your own, and studying a patient's chart on your own, no one will hold your hand. It is not that residents don't care, but they have bigger fish to fry, it is their turn (residents) to hog the attendings time and to learn their specific branch of medicine.

 

[Miami_med]

Wow,

I thought that I was getting short changed at times, but here we really do a lot compared to a lot of these posts.

I've done OB/GYN and Peds. I've done a million paps and pelvics on women from 16-60. I never caught a baby, but only because they sent all of the ones set out for me to C-section, and I did get to close one of those (for the most part). I've scrubbed on numerous surgeries with variable involvement. In Peds clinic, I saw all of my patients first without an attending, and I did all of my exams on the wards on my own before anyone else saw the patient in the morning. I even made an attempt at a blood draw on a 7 hour old for a culture.

Our ward politics can be unparalleled, but atleast I know were getting something for it.

P.S. We have residents from all sorts of institutions, including those in the UK. By about the 3rd month of residency, you couldn't tell the difference in training between anyone. Just survive.

 

[chagall]

I had a good 3rd year experience actually...but now I'm a 4th year and picked an outpatient psych rotation, thinking it would let me do a lot on my own and get a better feel for psych...so far, clinic is only a few hours a day, and residents are very reluctant to let me see their patients on my own (and believe me, I have asked). At least I'm getting more than my share of sleep every night...?

 

[Ypo.]

If you want to learn phlebotomy skils just hang out with the phlebotomist or nurse technician who is doing this, that way when nobody can get an IV line, you can do it, or if you need to draw IV bloods then you can.

That is an excellent point! I learned how to do subq injections during peds because I followed around a medical assistant.

In the afternoon we have free time to do whatever we want. I've started popping in and watching the techs do things and asking them if they mind teaching me. It's a great way to learn because they aren't as busy, are flattered when a medical student asks them and eager to teach.

I'm also planning on going down to the lab and checking out how they run things down there.

 

[jones173]

Third year has been great so far, yes even though I am an IMG over here in Israel I get to do tons. From the first day of Internal we are responsible for all of the blood draws and some of the IVs of all of the patients on the wards. We have also been taught how to intubate and run a code. The teaching has also been unparalled so far, we spend about 4 hours per day just with the attending. So I pretty damn happy

 

[Tired]

Third year has been great so far, yes even though I am an IMG over here in Israel I get to do tons. From the first day of Internal we are responsible for all of the blood draws and some of the IVs of all of the patients on the wards. We have also been taught how to intubate and run a code. The teaching has also been unparalled so far, we spend about 4 hours per day just with the attending. So I pretty damn happy

So you're in nursing school?

 

[Ypo.]

So you're in nursing school?

Ha ha. Nice.

On the other hand, it sure would be nice to at least be proficient in doing these things if the need arose. I've only drawn blood once, in 2nd year.

 

[Mallory Weiss]

I've found that the secret to learning new procedures is to make sure to work in a population with a lot of HIV or Hep C. The attendings and residents won't want to start a central line themselves, but they'll be happy to stand at the other end of the room and shout instructions to you. I haven't done OB yet but I'm pretty sure it will work similarly. Just don't stick yourself.

 

[fakin' the funk]

Ha ha. Nice.

On the other hand, it sure would be nice to at least be proficient in doing these things if the need arose. I've only drawn blood once, in 2nd year.

When exactly would the need arise? I favor minimizing my exposure to bloodborne pathogens and sharps.

 

[misery]

I'm glad there are other 3rd years out there that feel my pain. I'm on my 3rd month of MS3 and I'm absolutely miserable. I don't know if I just had an inflated thought of what I'd be doing, but I don't get to do jack squat. I did my outpt medicine first and spent the entire day looking at articles on the onion, doing work physicals, laughing at bad jokes as I sat uncomfortably for 8hrs a day in my attending's office. Then on OB, this was ok, I got to do a couple vag's, ~15 Csecs, and saw pretty much every patient by myself, but I only did one pap/pelvic. Now I'm on FP, with a lot of in patient medicine type stuff. I'm running circles around the 4th year student on my rotation, but I still feel like I'm not getting enough exposure. I'm 3 mos in, haven't intubated anyone, haven't done a single ABG, haven't even seen/done a central line. Am I expecting too much?

 

[smq123]

I'm glad there are other 3rd years out there that feel my pain. I'm on my 3rd month of MS3 and I'm absolutely miserable. I don't know if I just had an inflated thought of what I'd be doing, but I don't get to do jack squat. I did my outpt medicine first and spent the entire day looking at articles on the onion, doing work physicals, laughing at bad jokes as I sat uncomfortably for 8hrs a day in my attending's office. Then on OB, this was ok, I got to do a couple vag's, ~15 Csecs, and saw pretty much every patient by myself, but I only did one pap/pelvic. Now I'm on FP, with a lot of in patient medicine type stuff. I'm running circles around the 4th year student on my rotation, but I still feel like I'm not getting enough exposure. I'm 3 mos in, haven't intubated anyone, haven't done a single ABG, haven't even seen/done a central line. Am I expecting too much?

Well, I think part of that might be rotation-specific. You'll probably see some ABGs and central lines on internal med or surgery. But it sounds like you haven't done those rotations yet.

This is what I keep telling myself anyway. "It's okay that I didn't do that many DREs, I'll do them on other rotations...I think."

 

[Ypo.]

Well, I think part of that might be rotation-specific. You'll probably see some ABGs and central lines on internal med or surgery. But it sounds like you haven't done those rotations yet.

This is what I keep telling myself anyway. "It's okay that I didn't do that many DREs, I'll do them on other rotations...I think."

I hope so. I'm on IM and haven't done a DRE yet (oh, the joy...I can't believe I'm complaining about not having the opportunity to stick my finger up someone's butt). That's because we're not allowed to do DREs, breast exams, or pelvic exams unsupervised. Which I think is stupid because that means I'll probably have to wait until I'm an intern.

To tell the truth I have not seen a single intern, resident or attending do a DRE on anyone on the medicine rotation.

 

[Ypo.]

When exactly would the need arise? I favor minimizing my exposure to bloodborne pathogens and sharps.

I can think of plenty of situations. The point is wouldn't you at least like to be able to do it? I don't ever want to change a flat tire, but that doesn't mean I don't want to know how in case the need arose.

The truth is that I hate to go looking for a nurse everytime I freaking need something, especially if I want it right away.

 

[Blade28]

To tell the truth I have not seen a single intern, resident or attending do a DRE on anyone on the medicine rotation.

That's because you're on Medicine. We do them in G Surg ALL the time.

(Sometimes on consults when it's obvious no one else ever has. )

The saying goes, "there are only two reasons why you shouldn't put your finger up someone's rectum - either you don't have a finger, or they don't have a rectum!"

 

[Hard24Get]

That's because you're on Medicine. We do them in G Surg ALL the time.

(Sometimes on consults when it's obvious no one else ever has. )

The saying goes, "there are only two reasons why you shouldn't put your finger up someone's rectum - either you don't have a finger, or they don't have a rectum!"

Its true, there are only 3 services that do DREs - Emergency, Surgery, and GI

 

[Ypo.]

That's because you're on Medicine. We do them in G Surg ALL the time.

(Sometimes on consults when it's obvious no one else ever has. )

The saying goes, "there are only two reasons why you shouldn't put your finger up someone's rectum - either you don't have a finger, or they don't have a rectum!"

Thanks, that's good to know.

 

[fakin' the funk]

I'm 3 mos in, haven't intubated anyone, haven't done a single ABG, haven't even seen/done a central line. Am I expecting too much?

As if a lot of FP residents or attendings are doing intubations and central lines? Sounds like you're on the FP floor service, not cardiothoracic ICU/anesthesia.

 

[misery]

As if a lot of FP residents or attendings are doing intubations and central lines? Sounds like you're on the FP floor service, not cardiothoracic ICU/anesthesia.

Good point. But my classmates don't either take or have the opportunity because they haven't seen those things either. We'll see as those rotations tick by.

 

[Blade28]

Its true, there are only 3 services that do DREs - Emergency, Surgery, and GI

ER, not so often.

 

[Hard24Get]

ER, not so often.

that's cause I wasn't on the case, baby

 

[ChubbyChaser]

wow, some of these posts amaze me, I really thought that 3rd Year med students got to do alot more procedures than what they are doing. Im not in med school yet (hope to be in 2009), but it really suprises me that I've Intubated more patients (2- im an EMT) than most of the med students posting on this forum. O well, Im sure all of yall will be great doctors, nonetheless

 

[smq123]

wow, some of these posts amaze me, I really thought that 3rd Year med students got to do alot more procedures than what they are doing. Im not in med school yet (hope to be in 2009), but it really suprises me that I've Intubated more patients (2- im an EMT) than most of the med students posting on this forum. O well, Im sure all of yall will be great doctors, nonetheless

* Unless you go into anesthesia, Emergency med, or critical care, you won't intubate patients much. EMTs probably intubate more people and place more IVs than most doctors do.

* Third year and internship are obviously different. Interns do a lot of procedures/real work. Third year students sometimes have to ask/plead to do anything that remotely involves actual skill and thinking.

* Part of this depends on the resident that you're working with - some are more comfortable teaching students than others. It also depends on which hospital you are rotating through.

* As we've already pointed out, certain skills are required for certain rotations, but not for all. Learning how to deliver a baby is key to OB/gyn, but most people go through their psychiatry rotation without learning how to deliver one. It's still early in third year for many of us, so we'll pick up the skills that we need as we go through the year.

O well, Im sure all of yall will be great doctors, nonetheless

Ummm...gee, thank you.

Learning how to do basic procedures well (i.e. IV placement, foley placement, intubation) doesn't make you a good doctor, it makes you a good tech/nurse. I agree - we all need to learn how to do these things - but I don't think it makes me a better/worse doctor.

 

[ChubbyChaser]

Thanks for the Clarification SMQ

 

[Blade28]

that's cause I wasn't on the case, baby

Fair enough!

wow, some of these posts amaze me, I really thought that 3rd Year med students got to do alot more procedures than what they are doing. Im not in med school yet (hope to be in 2009), but it really suprises me that I've Intubated more patients (2- im an EMT) than most of the med students posting on this forum. O well, Im sure all of yall will be great doctors, nonetheless

It all depends on where you go to med school, and how much your residents let you do.

In terms of basic IVs, suturing, etc., I didn't do much of that in med school. Tied a bunch of sutures, cut suture ends, placed the rare a-line and central line. Even floated a few Swans. No intubations. Pressed on the chest during a couple of codes.

But then in residency? Whew!

Edit: this is why I try my best to teach my med students whenever a chance arises - even if it's something simple like an IV or a-line. If there's a chance for a central line or chest tube, even better!

 

[ChubbyChaser]

Is there anyway we can find out what medical schools actually let M3s and M4s do alot of hands on work?

 

[smq123]

Is there anyway we can find out what medical schools actually let M3s and M4s do alot of hands on work?

Probably not. Each individual rotation site is different, and each resident is different.

Some people say that you should do your rotations at sites that are busy, but do not have residency programs. Since there are no residents, theoretically you would have more opportunities to do hands-on stuff. This is not always true, but that's the theory behind it.

Sometimes you'll get lucky, and other times you won't. On my last rotation, my week of clinic was S-L-O-W - I mean, about 2 patients an hour. The week after that, they were getting about 10 an hour, so the med student on clinic had a lot more opportunities than I did.

 

[Miami_med]

Is there anyway we can find out what medical schools actually let M3s and M4s do alot of hands on work?

It's highly variable at the same school, based on residents, variations in patients, the alignment of the moon, etc...

As an example, I delivered no babies on OB/GYN, but we had a student do 3. In peds, one of our students caught C-section babies and did the assesments initially. I didn't, but I did a number of blood draws on infants (which can be tough if you need a culture out of a vein the size of your needle). One student got an LP in neuro, but the others didn't. It totally depends. Generally, you'll have better clinical opportunities at a county hospital. Private patients don't generally like students touching them, and that can definitely limit you.

 

[Blade28]

Is there anyway we can find out what medical schools actually let M3s and M4s do alot of hands on work?

It's too variable. It's highly resident-dependent.

The sad thing is, no matter what experiences you get in med school, you'll be brand-new as a starting intern anyway.

 

[Cthulu]

My medicine rotation is like this. I spent my first week staring at the walls so I read my residents the riot act. I had been used as a blood draw tech that week and the only reason I was able to do that was because I lied and said I had done it before. Today I was seeing patients by myself and writing notes because I did not leave my resident alone until he let me but I will see what tomorrow brings. If the boredom persists I will blow off all I can and just read.