Preceptor or Educational Hospital Rotations? PROs and CONs ANYBODY?

[GonnaBeAnMD]

I am naive to what the real pros and cons are between the two types of rotations. I do not want to take the easy route, however some of these threads like " 3rd year burnout " and " sarcastic remarks " make me think a lot can be prevented by doing a preceptor program instead of dealing with the politics (nurse vs. med student vs. resident vs. attending .....) in the hospital setting. Can anybody shine some light on the pros and cons on the two types? Thanks in advance

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[electra]

I am not too sure about how your school determines your rotations, but really, a mix of the two types is just about perfect. Let's face it, you are going to have to be able to get along on the wards to be a successful intern, and the experience you get as a med student is a big part of that.

1. There is burnout in everything, especially when you work hard. The burnout of third year may be that you have finished many of your required rotations, you still have no idea what you are going to do and decision time comes up too fast, and you are just plain tired. You have Boards to look forward to (yay! the comlex! where's my gun?) and then people just telling you how much better/worse/the same 4th year is. At the same time you want to be a doctor, you know you're not ready.
2. Part of getting along with all the ancillary staff is understanding that they didn't necessarily sign up for the "teach a new group of students every month" club. Their jobs are not easy and sometimes the student can make it even harder. Remember that there is no law against saying good morning/hello/how are you/hope you have a good weekend to anyone.
3.The advantage to office/clinic based is that you have more attention from the preceptor and see more ambulatory care, which allows you to practice your physical exams skills and coming up with assessment and plans. The advantage to the hospital is that you see the acute/sick/injured patient and get practice in management and working with a team. Always remember that everyone's job is important - we ALL work together to take care of these people.

Above all, remember to look forward to your clerkships. The most important thing you might learn is how glad you are that there are people who want to do things like xyz for their profession. Third year is likely the first time you get to really feel like you are learning what you need to know to be a good clinician. There is learning every day.

 

[SammyK]

One determining factor relating to the learning process both in preceptor or hospital based rotations deals with the personalities involved. If there is a way to talk with people in the classes ahead of you and learn of their experiences with specific preceptors or hospital settings, it is strongly to your advantage to do this if you have the ability to set up or influence your rotation selection. In doing some research in advance, you may be able to find specific preceptors that love to teach enthusiasitic students and allow you some great hands-on experience. This also can help give some insight on preceptors who might be great mentors in a field of interest. This also follows for hospital-based rotations. I agree with the above advice in that regardless of what your chosen field, it will be necessary for you to have a skill set that allows you to function in a hospital setting as an intern/resident. Again, the opportunity to speak with those who have "blazed a trail before you" so to speak can help give you feedback on specific rotations that give ample opportunity to actively function in that environment as it pertains to your school and its specific protocol. I think Electra's advice was very appropriate and practical. In following that, the politics in both settings and the experience you take away from specific rotations can be affected largely by your own approach. Treat everyone with respect in the way you would like to be treated. While it is true that you will encounter an angry Santa from time to time 'cause we all have our moments, if you try not to let their initial encounter get to you it may turn out some of them may end up being a great ally when you need a little help. Learning how to use the politics of the system to your advantage is a great and often under-utlized tool that can help you both in getting your work done quicker and in making you look like a rock star student when you can work effectively with those deemed "difficult."