Preparing to enter my first rotation

Discussion in 'Clinical Rotations' started by Halcyon902, May 6, 2008.

  1. Halcyon902

    Halcyon902 New Member

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    Hello everyone,

    I’ve read a lot of useful information here at SDN, but I have some specific questions I’m hoping you experienced future physicians can help me with.

    1. What are the best resources for learning how to do a proper H/P?
    2. What are the best resources for learning how to properly interpret an EKG?
    3. Where can I find a question book/bank for specific rotations?

    Some general questions I have yet to find answers to:

    1. What type of exams will be given during my rotations?
    2. Do rotations follow some sort of curriculum or is it dependently solely on patient experience?
    3. How often do people ‘fail’ rotations?

    My first rotation is internal medicine. It starts in about a month. I’m currently studying FirstAid for internal medicine and casefiles for internal medicine. I’m trying to study everyday, but I feel like I’m walking into this thing blind. I really appreciate any suggestions/answers.

    Thanks
     
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  3. Ashers

    Ashers Bacteria? Don't exist.
    Physician Faculty

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    For the general questions first:
    Exams depend on rotation and school. Some are the national standardized shelf exam, some are departmental exams.
    Rotations usually have curricula and syllalbi. Also, I'm sure there are variations between schools
    Failing rotations -- probably school and person dependent. Someone at my school, who is no longer in my school failed medicine 3 times.

    Why are you studying for medicine now? Shouldn't you be studying for step 1?

    Other questions
    Did your school teach you how to do and H&P? We had an entire class on it M2 year.
    EKG? There's some book by Dubin. We're learning in my last rotation (medicine).
    Pre-test, I think, has questions for rotations, though I've never used it. I've relied on Case Files and Blue Prints.

    BTW. You're not expected to know much, except for basic science stuff, when you start clinicals. There's been several threads related to this topic recently.
     
  4. Please do a search for this frequently-asked topic.

    There are lots of threads on this, both in Allo and Clinical Rotations.
     
  5. Halcyon902

    Halcyon902 New Member

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    Ashers,

    Thanks for the reply. I did have a course (physical diagnosis) in which we did H/P, however, I'm looking for a concise review of H/P procedures. I forget things pretty fast :rolleyes:. And I have already passed step I.
     
  6. vtucci

    vtucci Attending in Emergency Medicine
    Moderator Emeritus

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    1. H&P Forms- Every system is difficult even within the same internal med program at a COM. For example, at USF, we had rotations in medicine through the VA system as well at as our local hospital. The VA had an electronic record system and template H&P where we could import data and the local hospital had H&P forms. I would suggest e-mailing your clerkship director and asking for these resources. Also, keep in mind that most attendings have their own take on how an H&P should be done and you will need to learn to go with the flow. This is part of third year- just when you think you have the system down, the expectations will change when you change teams.
    2. EKGs- use Thayer or Dubin.
    3. Question banks- USMLEWORLD is an excellent question bank for all rotations. You can also use Kaplan Qbank. MSKAP-3 is a question book used by many during medicine. I also liked the questions in Case Files Medicine.

    General questions:
    1. Exams- are school specific. Most schools use a shelf exam though- this is an NBME administered tests. Some schools also have final exams, clinical performance exams, clinical skills exams (i.e., practicals). You will find out in your syllabus.
    2. Curriculum- will also be laid out for you in your syllabus. Your patient experience may be vastly different from your classmates. Read on your patients. Buy a review book to cover items that you will not see (e.g., Step Up Medicine and/or First Aid medicine). Use Pocket Medicine or Care of the Medical Patient on the Wards on a daily basis to reinforce items learned with your patient.
    3. Failing a clerkship- there are a few ways to fail a clerkship: 1. fail the shelf exam (if passing is required by your school) 2. have a major personality issue with an attending 3. ethical or academic dishonesty. Most people who fail a clerkship do so because of #1. Do not be complacent about studying for shelf exams. Third year can be exhausting and sometimes the last thing you want to do is study after a long day. Try to keep up the enthusiasm. If you encounter a majority problem with an attending, speak up quickly to your clerkship director- they can switch you to another team or address the issue to everyone's satisfaction. Do not wait until the end of the rotation to get feedback on how you are doing- ask early and often and then incorporate the advice you are given.
     

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