PLEASE: If you had to choose Preceptor Based vs. Hospital Based, what would YOU DO?

[GonnaBeAnMD]

So if a school allows you to work with a physician and you're 1st assist to surgeries, there are no residents and interns giving you orders, no making you feel like an idiot for not knowing something (for the most part, there are the exceptions that I know of), but rather 1 on 1 teaching, work about 9am - 6pm for five or six days a week, would you take this schedule? This is a real option... vs. work in a teaching hospital where all I hear on these threads are nasty remarks about residents doing this, nurses doing that, med student aint ****, etc.
If I want to go into Family Medicine, doesn't the preceptor program sound better? I feel like I'm missing something

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[Hopefulmeds]

That depends on mainly who your preceptor is going to be. If he/she is the only one grading you and you get unlucky then your grade will suffer. In a resident based setting there might be more leeway because you could get multiple evaluations filled out depending on how you're school does the grading. Also, if you're always with your preceptor, then you have to be on your toes all the time whereas in a resident based setting you don't really have to care nearly as much when you're with your intern because they don't have much input.

 

[Anka]

It depends on what your role will be. Since the hours are 9 a.m. to 6 p.m., it sounds like ambulatory surgery. As someone going into family practice, that might be more congruent with your future practice (e.g., you might learn how to do a skin excision, and participate in some basic bread and butter surgery). However, there are limits to what you learn in the OR during cases like that -- you aren't going to get a whole lot on pathophysiology, clinical presentation, and workup/treatment of major surgical diseases. You may find you're pretty much used as an extra pair of hands. There also may not be a whole lot of pre- and post- op management, which is hard to learn from a textbook.

I did surgery at a major university hospital, and learned a ton from my residents (everything from how to write the note, to why we are doing this procedure vs. that). The preop and postop management of some of the sickest patients in the hospital also helped a lot when it came to other rotations, since a lot of what you're learning is medicine. Of course, some residents are malignant, but so are some attendings... and while there are usually enough residents on a team that you can avoid the one you don't get along with, if you get put with a preceptor you don't get along with it could be a pretty miserable month.

Hope that helps. Whatever you decide to do, try to have fun. It may be the last time you see this stuff!

Best,
Anka