More clarification on how rotations work is needed

[soso809]

Advertisement - Members don't see this ad

I have tryed looking all over this web forum and can't seem to find exactly what I am looking for all in one spot. I was curious to learn about rotations and exactly how they work for 3rd and fourth year students. My questions are: During 3rd and 4th year on rotations do you mainly just observe and do very little procedures? Like mainly observe in 3rd and 4th and do more procedures in residency when you actually pick your specialty? Or do they still expect you to do a lot of procedures during rotations? And if you did have to do a lot of procedures can you please explain the different procedures you had to do for all rotations. For example: During EM we had to do this and then in IM we had to do this etc. etc.

Any help would be greatly appreciated thanks!🙂

 

[felipe5]

the thing is, this definitely varies from school to school, so you might get a better account from older med students that go/have gone to your school. That being said, SDN did used to have a guide (big guide to med school or something like that?) that would list the basic gist of each different rotation....i'm not sure if that link is still around.

 

[vwhan]

Just as Felipe said, it will vary from school to school and vary at different hospitals associated with that school. I think it is ok to make the generalization that procedures follow a pecking order: upper level resident, intern, 4th yr med student than 3rd yr med student. Residents are required to complete a certain number of procedures and have to have them signed off by the attending. Therefore, any procedures are usually thrown their way first. If they have done enough procedures then the intern will get a shot, then the med student. If you spend most of rotations at an academic hospital then you have to fight for procedures. The following are what I did, but may not be reflective of all schools.

IMid not do many procedures, except collect a few arterial blood gases and 1 LP. I observed the residents do a few paracentesis and place central lines.

OB: a lot of pelvic and pap smears (I was on GynOnc), mostly held bladder blades during C/S. Got to do some suturing.

Surgery: did this at a private practice, so I got to place central lines, intubate a few patients, suturing, make incisions, drive cameras. I did the most b/c it was me, the attending and his PA. I didn't have to fight with any upper levels.

Peds: I don't remember doing any procedures

Neuro: did an LP

 

[wiscbadger]

Third and fourth year are less about 'doing procedures' and more about learning to take better histories, perform thorough exams, improve your clinical decision making capacity, give concise oral presentations, and manage numerous patients on the service. And in the process... learning what we want to be when we grow up. Procedures tend to be a small part of the puzzle, and if your clinical rotations are at a hospital where residents are also trying (needing) to gain experience, the med students role in procedures is often limited. There are always exceptions to this, and it really depends on what experience you seek as a medical student. During fourth year, you can load up your schedule with rotatations where you'll get your hands a little more dirty -- anesthesia, surgery sub-I, any rotation in a rural setting, etc.

With that said, as a medical student, I did lumbar punctures, delivered 5 babies, first assisted on about 10 surgical procedures, placed 2 art lines, became handy with a speculum, intubated a handful of patients, sutured here and there, did a sonohysterogram and a colonoscopy (all with close supervision and help, of course). Enough to feel comfortable with each of these procedures? Heck no. But it helped me learn whether I was a procedural oriented person or not. Did I like scrubbing in and participating in OR cases or did I prefer rounding on patients for 5 hours straight? Each rotation is not really about teaching you how to 'be' that type of doctor. Our surgery director told us on the first day of our third year clerkship something along the lines of, 'I don't care if surgery bores your to tears and you never step foot in an OR again. But for 8 weeks you get to live like a surgeon, so suck it up, and when you are a phyician out there you'll understand what we do and when to refer patients to us.'

Hope this helps.