My SubI rotation sucks...

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flashgordon

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I just started my subI and so far, things aren't working out. Things are chaotic in the morning so nobody is aware of my existence, not even the attendings. No lectures whatsoever. I'm the only student on the rotation...

Is this what a subI in gas is supposed to be like? Any suggestions? I'd like to say something, but I don't want to piss anyone off since I need to get a good letter.

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Are there no residents to work with? It seems pretty inappropriate to be putting a 4th year medical student with a CRNA. I can understand that there are no medical student specific lectures, but there ought to be at least one or two department conferences a week to attend. As far as intubating, as long as it's not a predicted complicated airway (e.g. neck wider than the ears) or something like a double-lumen tube, you should be given adequate time to try.

Can you spend some time with an attending going from room to room instead of staying in the same room all day long? Again, any fellows or residents to be with instead?
 
There are residents I think (small community program?), however, I'm never paired with them. I'll wait until the end of this week. Hopefully, things will change for the better.
 
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I would agree with the idea of floating room to room. I'm sure you've done this, but let the faculty know that you are interested and they may take you "under their wing" so to speak. No point in you staying in the room for a fairly routine case at this point in the game until you get a better understanding of what is going on. I would go room to room at case starts at least to get as many intubations as you could. Good luck.
 
it does sound like it sucks...i'm sorry you have to go through that, i've had a similar experience at a top 10 program so don't feel to bad, but i would suggest you continue to show enthusiasm.
 
Some ideas....

You could find an attending who is a good teacher and stick with his/her rooms. Avoid rooms where the attending is not a good teacher or doesn't care (this is not a good use of your time if you need a letter of recommendation). Remain in the room when the attending comes to give breaks -- this is a good time to ask questions and show that you've been reading.

Show respect to the CRNA's. Get out of the "just a CRNA" mentality and remember you're in their room, it's their case, it's their territory and you have a lot to learn from them. If you are respectful rather than demanding, you will get a lot more out of those cases. And, avoid the rooms of any CRNA or resident who doesn't like to share and let you participate in the case.

If going to a resident-run case, pick 2nd and 3rd year residents. They are more able to share their cases than 1st year residents at this time of year.

Bring a book (anesthesia book) to read. Don't be afraid to just grab a stool, sit down and read during the case to keep yourself busy.

Be cautious about asking (anyone) for the intubation too early. This can be awkward -- oftentimes people like to get to know you before offering you any procedure of their own accord. Make yourself available and let them tell you what they want you to do -- if they want you to bag-valve-mask, just do that (it's equally hard and the more basic skill to learn).

Anesthesia for students really is a lot of shadowing. The best way to get a lot out of the rotation is to read around each case, ask lots of pertinent questions (that's how you do well in the rotation also), and once you establish a relationship with whomever you're watching and demonstrated that you are curious, participation in the case will come your way.
 
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