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

[Cholinergic]

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I got quasi pimped today by the physician in charge of medical education and I was pissed because I floated to a different hospital and barely did or saw anything! But today he showed up and being the natural teacher that he is, he started asking me questions. I didn't want to sound like a whiner and say, well, I haven't been taught anything this week. 🙄 Ultimately, though, I just have to sit down with the book. And I'm going to be more "pushy" next week.

 

[bigapple34]

Wow! These posts amaze me. I guess for the most part I have been lucky... and i used to complain i wasn't doing/learning enough. Do all your rotations in busy inner city (NYC for me) hospitals. I guarantee you will do/see everything. I feel confident that when i go into residency in July, i will have at least attempted whatever procedure i need to do. I am more concerned that I won't know how to manage certain patients than i am with procedures. I really think this is what is important, learning patient diagnosis and management. Procedural tasks are like manual labor, you can teach any monkey to draw blood... how many times do you really think as a physician you will need to do this task? Probably not many, unless you have lazy nurses or techs, and you need something stat. I am not saying procedures are not important, but you will learn them in the first 3 months of internship. I would much rather judge a rotation based on learning patient management than on procedures, if your rotations are not at least attempting to teach this, than that is a true problem.

 

[Dr McSteamy]

man, it is funny how some of you are happy and satisfied with drawing blood and other brainless chit, like fetching charts?
hahahaha


i've been in one too many crap rotations. my solution is just to slip away and read on my own. If the attending is too lazy to teach, he is too lazy to care if I'm even there.


so, rule of thumb-- disappear and read on your own. That's how you learn.

if you want to see real live people, what's stopping you? your hospital badge gives you unlimited access to all pts. Study pt management and diagnosis on your own.

 

[smq123]

i've been in one too many crap rotations. my solution is just to slip away and read on my own. If the attending is too lazy to teach, he is too lazy to care if I'm even there.

Oh...if only that were universally true.... There are attendings who are too lazy to teach, but not too lazy to learn your name and periodically wonder why you're not there....

if you want to see real live people, what's stopping you? your hospital badge gives you unlimited access to all pts. Study pt management and diagnosis on your own.

😕 You mean write in people's charts (even if you're not on that team, and taking away actual patient care opportunities for the med students who ARE on that team)? You mean, randomly examine people who you've never seen before? You mean, randomly latch onto residents on different services?

 

[Dr McSteamy]

😕 You mean write in people's charts (even if you're not on that team, and taking away actual patient care opportunities for the med students who ARE on that team)? You mean, randomly examine people who you've never seen before? You mean, randomly latch onto residents on different services?

some hospitals let you follow anyone you want, so long as you ask first.
many residents and docs don't mind.

no, of course you don't write in charts randomly.

 

[Ypo.]

some hospitals let you follow anyone you want, so long as you ask first.
many residents and docs don't mind.

no, of course you don't write in charts randomly.

I don't know what medical school you go to, but the internal medicine director is not going to let me go see any patient I want. I get to pick out of a list of 10-20 patients who are on a specific service. And then I am expected to round for the rest of the morning. In the afternoon I am free to go hang out wherever I want, but that does not mean I can just walk into random rooms and do whatever.

 

[Acherona]

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.

damn people, enjoy your free time. My first day of IM: here are your patients, go take care of them.
Then, they wait for you to f-up, which is of course inevitable as you know nothing, and give "feedback" (=tell you how you suck) as needed until you start doing things properly.
No time to study because all your time is spent figuring out how to request consults or how to use the crappy computer software to look up a freakin lab value.

 

[Abducens]

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

Find a med school that is connected with a county owned hospital. I have heard that UT Memphis is one of the best programs for allowing students to get alot of hands on experience during the 3-4 years. They are affiliated with a city owned hospital, "The Med". It is located downtown and is the only level-1 trauma center in memphis. They also have one of the busiest EDs in the country. Great place to train. 👍

 

[leechy]

so, rule of thumb-- disappear and read on your own. That's how you learn.

Reading is great but one of the biggest problems I'm having with third year is not having enough time to read - too busy helping with scut tasks in hopes of getting decent evals. Probably won't work out in the end, but generally, I feel I can't ask permission to go off and read unless there is little going on.

 

[71263]

I'm 50 days into third year.

I stopped reading there. That's probably why you feel like youre not learning a damn thing. Its only October dude. I felt the exact same way this time last year during my M2 year, and then by the end of the year, everything suddenly made sense and I realized how much I actually had learned. Same things here. Its going to be somewhat slow for the first few rotations. I dont feel like ive learned a whole lot myself, but I also know Im still adjusting in. Give it time, and by the end of the year, youll realize how much more you really know.

 

[Old_Mil]

so, rule of thumb-- disappear and read on your own. That's how you learn.

I've been trying to do more of this, having reached the 90 day point in my clinical experience and having done a grand total of 3 H&Ps (one due to the generosity of an ER dept. that really didn't even have to let me do anything).

 

[Miami_med]

I've been trying to do more of this, having reached the 90 day point in my clinical experience and having done a grand total of 3 H&Ps (one due to the generosity of an ER dept. that really didn't even have to let me do anything).

Where on earth are you going to school? Have you done any rotations where you admit patients? I did 3 admissions, complete with H&P in the last 3 days on an off campus rotation at a somewhat slower hospital. Procedural experiences are highly variable between schools, but most students that I talk to at ANY school do enough H&Ps to do them in their sleep. Of course, if you haven't done medicine yet, that may be the magic rotation where you get to do 2 million H&Ps a day. Also, do you follow ANY patients? If you do, you might just want to do a thorough H&P on all of them when you pick them up, even if you don't admit them yourself.

 

[marooner]

i'm actually wondering a the earlier posts... don't you have a list of procedures and the number of times you should've done it before the rotation ends? also, don't you have a list of cases that you should see and manage? you're all ranting about not doing anything in your rotation... just wondering...

 

[JulianCrane]

Last year, the only rotation I had a list of requirements and such was during surgery. Other than that, nothing. I truly felt I learned very little during third year. It's just not an effective method of teaching. There needs to be more balance between clinical duties and formal instruction. Moreover, teaching institutions must realize that they have a responsibility to teach, not to harass, abuse or worst of all, neglect their students.

 

[Doowai]

I certainly did not feel I learned enough. As a Caribbean FMG I set up most of my own rotations - so was somehow closer to my preceptors.

I got to first assist on a tubal ligation, 11 c sections, a ton of cholecystectomies, some thyroidectomies, alot of mastectomies, and two appendectomies. I got to do a lipoma removal and a skin punch biopsy start to finish on my own under supervision. I got to do alot of field blocks with lidocaine for IM , derm and surgery. 3 DRE's - yahoo *puke*. I got to do alot of fetal monitoring with Doppler, got to set up and run quite a few EKGs. I only inserted one nasogastric tube. I got to close all superficial skin sutures every time on cholecystectomies even though it took me f-o-r-e-v-e-r , my surgeon was very patient...but now I don't think I could suture to save my life. I got to do one anoscopy. I got to do a few vaginals with speculums. I cauterized a childs nose once, and removed cerumen from pedes also. Freezing actinic keratoses was fun.

My inpatient subacute care sub-I was like getting thrown to the fire. I was given a list of patients, had to round, come up with a plan, present it and get it okayed - if anything was found in error, the preceptor was calm but certainly made it clear I had under performed ("I expect you to be here *gestures with hand at eyebrow height* but you are here *gestures with hand at groin height"). I got to do quite a few admits and some discharges, and lots of daily notes. Not all of my rotations had me chart - but ob/gyn, IM, FM, sub-I, surgery, psyche in patient, pain management, , cardiology and a few others had me chart. I prefered computerized charting.

I never inserted a foley either.

I could list more things I got to do - in retrospect it seems like a decent list of things I did, but considering the hundreds of hours I spent in clinicals, it really isn't....most of my time was just standing around trying to stay mentally present.

 

[fakin' the funk]

Where on earth are you going to school? Have you done any rotations where you admit patients?...Of course, if you haven't done medicine yet, that may be the magic rotation where you get to do 2 million H&Ps a day.

Your degree of involvement in the admission/H&P/daily note/orders activities is ENTIRELY determined by your chief's assumptions and preferences for how to deal with clerkship students.

As such, if you get stuck with a hands-off chief on a slow service for weeks, zero H&P's is very possible. Unfortunate, but possible.

 

[Arctic Char]

i sympathize with all of you. third year blows. its like in order for physicians to get their license, they have to sign some secret pact that they will maintain aloofness around med students, pretend that students have nothing to learn from them, and that they are always too busy to deal with us. WTF? i got more attention from attendings as an undergrad . . .

neglect. that is my third year so far. makes me not want to be involved in clinical medicine and go into pathology. if clinical med turns me into the same kind of ass**le, i don't want to do it.

 

[Miami_med]

Your degree of involvement in the admission/H&P/daily note/orders activities is ENTIRELY determined by your chief's assumptions and preferences for how to deal with clerkship students.

As such, if you get stuck with a hands-off chief on a slow service for weeks, zero H&P's is very possible. Unfortunate, but possible.

Not that it's an excuse, but it seems that one terrible chief on one rotation shouldn't be able to stop you from doing a lot of H&Ps on other services AND/OR rotations. I've had students get reamed at my school for failing to do the full H&P w/ complete writeup, as this meant that there was no note to cosign, thus costing the intern a good 10+ minutes. I always thought of the H&P as sort of the reward for the milling through 10 years of old charts to see what the patients PSA was when he last bothered to show up to clinic in 1998.

 

[Old_Mil]

Have you done any rotations where you admit patients?

Nope.

Also, do you follow ANY patients?

Nope.

At this point, I just want to pass step 2 and get the damn degree...forget residency, I can go do something else.

 

[TheFlash]

It's really early in third year. Remember that interns are still getting accustomed to daily functioning and residents are focused more on making the interns efficient than teaching medical students at this point. When you guys do "big" floor rotations like medicine and surgery, you'll feel like you're part of the team when you have your own patients to follow and pre-round on, report back to your resident/chief/attending during rounds, and then postulate about the A/P with the rest of your team. At least that's how it worked at my school, even for the floor components of peds and ob/gyn. It makes the reading worth it, but it may come later in third year when your teams become more efficient.

The shorter rotations, yeah, sometimes you get glossed over by residents and attendings. However, even those are dependent on WHERE you're doing the rotation. For example, the L&D component of ob/gyn was at a busy city hospital, so the residents and interns actually NEEDED medical students in order to function; we'd do the H&P's, sono's and FHR's in triage, and under resident supervision, manual exams if necessary to ensure that everyone got out of the hospital at a reasonable time. I ended up catching about 15 babies and repairing three lacerations with my intern as the assist. Given, this was in April, so you may just need to wait it out for a while before things get better. But sometimes it just doesn't, i.e. I was a fly on the wall for three weeks of outpatient peds in May. In M3, you win some and you lose some, but even when you're losing hopefully you can slink off to some corner of the hospital and do some reading.

 

[Cthulu]

Almost 9 weeks into my medicine rotation and no improvement. I have done a grand total of 4 H & P's. I have never written an admission or any other kind of order. My preceptor is pretty lazy and I have not learned anything. The only reason I did those H & P's was because my resident wanted me to leave him alone. I harassed him every minute of every day until he finally let me examine a patient "just for fun" and present to him. The look on his face was priceless when I told him I wanted to do that every day. I would just look through charts and see patients by myself, but without any feedback on what I did wrong it becomes pointless. I just page my residents when I get in so they know I am there. I then disappear for the rest of the day to read and avoid being ordered around like an LPN to do blood draws, foleys, ABG's etc.

 

[Arctic Char]

Almost 9 weeks into my medicine rotation and no improvement. I have done a grand total of 4 H & P's. I have never written an admission or any other kind of order. My preceptor is pretty lazy and I have not learned anything. The only reason I did those H & P's was because my resident wanted me to leave him alone. I harassed him every minute of every day until he finally let me examine a patient "just for fun" and present to him. The look on his face was priceless when I told him I wanted to do that every day. I would just look through charts and see patients by myself, but without any feedback on what I did wrong it becomes pointless. I just page my residents when I get in so they know I am there. I then disappear for the rest of the day to read and avoid being ordered around like an LPN to do blood draws, foleys, ABG's etc.

word. my experience in internal was almost exactly the same, and i couldn't have described it better myself. i always felt more like a burden on everyone around (docs, residents, nurses, etc), as opposed to someone there for a reason. no matter what i did, it was never witnessed by anyone, asked about by anyone, or of the least significance. i only did it by my own initiative "to learn" . . . even though the fact that i could do whatever it was i was doing, and do it all by myself, is pretty much indicative that i have frigin learned it already. so what the hell was the point?

i will say, however, that in looking through charts time after time, i started to catch on to patterns in terms of initial treatments and protocols. so that wasn't entirely useless. but - my question is:

how the f**k is anyone going to legitimately evaluate my performance when no one even let me do anything under observation? no one saw me do anything!!! besides present a patient - of which i did maybe 8? thats not a lot to evaluate someone on . . . the only people who let me do anything were interns - bless their hearts - but they have absolutely no input into my evaluation. wtf?

does anyone else out there feel this way about how they were viewed on the wards? or is it just my school?? i'd love to know if this is common . . .

 

[Cthulu]

word. my experience in internal was almost exactly the same, and i couldn't have described it better myself. i always felt more like a burden on everyone around (docs, residents, nurses, etc), as opposed to someone there for a reason. no matter what i did, it was never witnessed by anyone, asked about by anyone, or of the least significance. i only did it by my own initiative "to learn" . . . even though the fact that i could do whatever it was i was doing, and do it all by myself, is pretty much indicative that i have frigin learned it already. so what the hell was the point?

i will say, however, that in looking through charts time after time, i started to catch on to patterns in terms of initial treatments and protocols. so that wasn't entirely useless. but - my question is:

how the f**k is anyone going to legitimately evaluate my performance when no one even let me do anything under observation? no one saw me do anything!!! besides present a patient - of which i did maybe 8? thats not a lot to evaluate someone on . . . the only people who let me do anything were interns - bless their hearts - but they have absolutely no input into my evaluation. wtf?

does anyone else out there feel this way about how they were viewed on the wards? or is it just my school?? i'd love to know if this is common . . .

I think it is a product of the hospital I am in aka The Hospital Russia Forgot in Brooklyn. The policy there is students are not allowed to write in the chart. This combined with them taking on incompetent FMG's (you give all the knowledgeable, working ones a bad name) who have enough problems keeping up with their work means the students get pushed to the side. I am hoping that now since my attending has me rounding with him maybe things will change. He has been systematically teaching me how to do a history and physical. I am not totally satisfied but this has been a small improvement to me shuffling around like a zombie in Dawn of the Dead each day.

Bonehead Resident: You missed morning report today!!

Me: I know I haven't been in a month but I sure don't miss it (they never ask anything of the students there so I usually just fell asleep in the back).

 

[VFTW]

You guys need to stop complaining and start being more aggressive, in a non-dickhead way. On my Surgery rotation, I made it clear that I would do anything to help the team. They were busy, so once they believed I was competent, I was basically given the go-ahead to manage patients all on my own, but I had to work up to that by helping with stuff like getting dressing change supplies, anticipating what they would need on rounds and having it ready for them beforehand (shows an understanding of what you need to do to manage a post-op patient,) being aggressive about pre-rounding on patients, taking on a big patient load and making sure I was the one presenting them (even if that meant I had to stop the intern before he presented them for me - and I did do that, and he eventually realized it was a load off him because he didnt have to see those four patients in the morning, cutting his census from 20 to 16.)

It is so easy to get upset about being ignored, it is much harder to do something about it and keep yourself chipper. By the last week of my rotation I became much more aggressive about asking attendings to let me close the case because I figured, they are going to forget to let me unless I make it clear that I WANT THIS. I want to be involved, I am capable, and I will help, if you teach me. This is what they signed up for by choosing to work at an academic hospital, and interns and residents are only 1-5 years away from being where you were and are fools if they dont remember what it is like.

True, I have never had to deal with malignancy in my residents, I have been very lucky. But I have also turned the corner on rotations that could have been a huge waste of my time by finding a way to integrate myself into the team, starting small at first (always having a scut bucket of dressing change supplies in the morning, making myself somewhat valuable on morning rounds) and working up to - "Hey, Ms. Smith didnt get her portable chest in the morning, how about I go write that order and will you drop by and cosign it later?" to "I am taking care of this patient. Myself. Please supervise."

VFTW

 

[Arctic Char]

You guys need to stop complaining and start being more aggressive, in a non-dickhead way. On my Surgery rotation, I made it clear that I would do anything to help the team. They were busy, so once they believed I was competent, I was basically given the go-ahead to manage patients all on my own, but I had to work up to that by helping with stuff like getting dressing change supplies, anticipating what they would need on rounds and having it ready for them beforehand (shows an understanding of what you need to do to manage a post-op patient,) being aggressive about pre-rounding on patients, taking on a big patient load and making sure I was the one presenting them (even if that meant I had to stop the intern before he presented them for me - and I did do that, and he eventually realized it was a load off him because he didnt have to see those four patients in the morning, cutting his census from 20 to 16.)

It is so easy to get upset about being ignored, it is much harder to do something about it and keep yourself chipper. By the last week of my rotation I became much more aggressive about asking attendings to let me close the case because I figured, they are going to forget to let me unless I make it clear that I WANT THIS. I want to be involved, I am capable, and I will help, if you teach me. This is what they signed up for by choosing to work at an academic hospital, and interns and residents are only 1-5 years away from being where you were and are fools if they dont remember what it is like.

True, I have never had to deal with malignancy in my residents, I have been very lucky. But I have also turned the corner on rotations that could have been a huge waste of my time by finding a way to integrate myself into the team, starting small at first (always having a scut bucket of dressing change supplies in the morning, making myself somewhat valuable on morning rounds) and working up to - "Hey, Ms. Smith didnt get her portable chest in the morning, how about I go write that order and will you drop by and cosign it later?" to "I am taking care of this patient. Myself. Please supervise."

VFTW

yeah that all sounds good, and i like to think of myself as a pretty savvy person when it comes to getting what i want and anticipating things that need to be done. but, sometimes its simply easier said than done . . . and even when it is done, its the fact that it is of no significance that concerns me when it comes to my evaluation. the role of students is much different where i am, and this most likely has a lot to do with it. thats all. i hope surgery will be better than internal medicine . . . i imagine it will be.

 

[VFTW]

yeah that all sounds good, and i like to think of myself as a pretty savvy person when it comes to getting what i want and anticipating things that need to be done. but, sometimes its simply easier said than done . . . and even when it is done, its the fact that it is of no significance that concerns me when it comes to my evaluation. the role of students is much different where i am, and this most likely has a lot to do with it. thats all. i hope surgery will be better than internal medicine . . . i imagine it will be.

So make it be of significance. If you assume primary responsibility for your patients, then you are taking a lot of work off the intern's shoulders, saving them the 20 minutes they would have had to use to write four notes in the morning (and your notes are going to be better, trust me.) Keep writing the orders on your patients, keep the team updated with all new developments, round on your patients yourself, write their notes, etc, and suddenly you are like another (smaller census) intern to the team. MAKE IT MATTER.

 

[Cthulu]

So MAKE it be of significance. If you assume primary responsibility for your patients, then you are taking a lot of work off the intern's shoulders, saving them the 20 minutes they would have had to use to write four notes in the morning (and your notes are going to be better, trust me.) Keep writing the orders on your patients, keep the team updated with all new developments, round on your patients yourself, write their notes, etc, and suddenly you are like another (smaller census) intern to the team. MAKE IT MATTER.

Where I am they don't let the students write orders or write in the chart. They really treat us like extra appendages.

 

[Arctic Char]

Where I am they don't let the students write orders or write in the chart. They really treat us like extra appendages.

ditto.

believe me VFTW - i do all these things you mention. and no one is saying "gee thanks, you really saved me 20 minutes" its more like "aww, thats cute. now leave." hell, maybe i'm wrong, maybe people did notice and it'll factor into my eval . .. but i just never got the impression that anyone gave my presence or actions the slightest bit of regard.

 

[Cthulu]

ditto.

believe me VFTW - i do all these things you mention. and no one is saying "gee thanks, you really saved me 20 minutes" its more like "aww, thats cute. now leave." hell, maybe i'm wrong, maybe people did notice and it'll factor into my eval . .. but i just never got the impression that anyone gave my presence or actions the slightest bit of regard.

Are you sure we aren't rotating in the same hospital Mt?

 

[drfunktacular]

Are you sure we aren't rotating in the same hospital Mt?

Ha, I felt like asking the same question 🙄

 

[bth7]

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?

Just wanted to say, I totally relate to your sentiment.

3rd year is really weird. After 5 months, I'm trying to take the attitude that I am in fact learning something, though its very different from what I was expecting to learn. At times, I really struggle to identify what that something is.

In many ways, the biggest lesson I'm learning is emotional stability. (Oh, he's crazy your thinking.) Seriously though, its a skill to be able to stay engaged and to keep showing up with some enthusiasm, even when you feel like no one is noticing and your main function is to ensure that the wallpaper stays securely attached. I'm trying to cultivate that skill.

I've found in general that attendings live on a planet that is too far away from Earth for me effectively contact. While interns and residents generally live on a planet that I can actually communicate with, and perhaps even vist occasionally. I try to identify the interns/residents who I think I might actually connect with, and then look for ways to engage them in something meaningful.

I can't say I'm very successful at this strategy, but I'm sort of desperate at this point. 🙂

bth

 

[jocg27]

I think that, for me at least, a lot of the struggle of third year is that everything is always changing. You never really get totally comfortable anywhere; you're always the new guy, and always trying to figure out how the place and the system and the attendings and the residents work. By the time you start to get all that figured out, the test is just about upon you and it's time to switch.

I like to think that at the end of each month rotation, I am doing better than I was at the end of the previous rotation; ie honestly I can tell I'm learning and getting better at the whole thing, because at the end of the process each month I'm basically functioning at my highest level so far, and am able to surpass that level at the end of the following month.

But for some inexplicable reason, these gains are all pretty quickly lost over the single weekend between rotations. For the first, say, week of each rotation I feel every bit as completely clueless as I did the first week of the first rotation of the year in July.

I don't know, maybe I'm crazy. That experience make sense or sound familiar to anyone?

 

[Arctic Char]

Just wanted to say, I totally relate to your sentiment.

3rd year is really weird. After 5 months, I'm trying to take the attitude that I am in fact learning something, though its very different from what I was expecting to learn. At times, I really struggle to identify what that something is.

In many ways, the biggest lesson I'm learning is emotional stability. (Oh, he's crazy your thinking.) Seriously though, its a skill to be able to stay engaged and to keep showing up with some enthusiasm, even when you feel like no one is noticing and your main function is to ensure that the wallpaper stays securely attached. I'm trying to cultivate that skill.

I've found in general that attendings live on a planet that is too far away from Earth for me effectively contact. While interns and residents generally live on a planet that I can actually communicate with, and perhaps even vist occasionally. I try to identify the interns/residents who I think I might actually connect with, and then look for ways to engage them in something meaningful.

I can't say I'm very successful at this strategy, but I'm sort of desperate at this point. 🙂

bth

well said. i've never heard it put this way, but reading sounds so familiar and accurate.

and jocg27 - i can understand where you are coming from. it seems to be a common sentiment - except of course your level of fulfillment with your intellectual or skill progress. i for one feel like i get worse every rotation because i am conditioned to think that everything i do is unimportant and that what little knowledge i have is so useless that i might as well go do an apprenticeship with the custodial staff

 

[Old_Mil]

Just wanted to say that I finally got to a rotation where the attending took one look at me and said, "you're behind." Then, he took the time to fix it. Between appropriate pimping, reading assignments, seeing patients, and debriefing, it was a workout but I ended up honoring the rotation.

The benefits of that month have stuck with me.

Thanks Dr. X - you really saved my butt.

 

[bth7]

Just wanted to say that I finally got to a rotation where the attending took one look at me and said, "you're behind." Then, he took the time to fix it. Between appropriate pimping, reading assignments, seeing patients, and debriefing, it was a workout but I ended up honoring the rotation.

The benefits of that month have stuck with me.

Thanks Dr. X - you really saved my butt.

Awesome! Fascinating story.

In what areas do you think you behind? Which rotation was it?

 

[Cthulu]

Awesome! Fascinating story.

In what areas do you think you behind? Which rotation was it?

Well I have one week left to medicine and it was a total exercise in futility. At least my new team lets me leave at noon so I go home and study. I know I will be behind by a lot on my next rotation since I will be going to a real teaching hospital. I am prepared to get slapped around for the first week, but I think I should catch up.