Question about choosing a 3rd year site?

[Wo1verine7DO]

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In your opinion, is is better to go to a small hospital with a ton of procedures vs. a hospital with no residents, only attendings? I', still trying to decide because didactics just seem like a repeat of the first 2 years, I want to be prepared for board exams as well as my first year of residency...if anyone can help or provide me with feedback, its greatly appreciated.

 

[Seaglass]

If you are considering an allo residency then you should really do your rotations at a hospital with residency programs - those are the letters of Rec that count the most for residency applications. Preferably a university allo program.

Otherwise I would still choose a propgram with residents - the on the wards teaching can be variable and random, lectures help fill in the gaps so that when it comes time to take boards you are a little more well rounded.

 

[Sugar72]

In my opinion you should do some of both. I did an OB rotation at a small non-teaching hospital and not only did I deliver babies solo, but when I was in gyn surgery the anesthesiologists let me intubate pts. This was my 3rd rotation of my 3rd year. I am lucky to drive a camera in the OR on my current "teaching" rotation. You definitely learn a lot at teaching hospitals and all of the other things that seaglass said - but there are a lot of great options out there.

 

[DrSmiles]

It is really a tough call. Yes you will get lots of hands on experience at a small hospital, but less teaching. And the teaching is different than the 1st two years. It really is not repeating what you already learned, rather it is applying what you learned your first two years. I am only 3 months into my 3rd year, but I can say that I appreciate being at a bigger hospital that does have the teaching. Yes it is true, I do less hands on procedures, but I figure I will get more than enough hands on in my residency.
Since you go to KCUMB also keep in mind that the majority of your 4th year is electives that you can do anywhere.
For your 3rd year, I would pick a place that the students are happy at. E-mail some of the 3rd years and find out the pros and cons about the site you are interested in. Most of the KCUMB sites are pretty good, but would you be happy at a remote Missouri site like Moberly or Joplin, where you might be the only student at this site? And what are the preceptors like at the various sites?
Personally, I emailed a bunch of 3rd/4th years to get feedback on sites. This really helped me in making my decision before the class lottery.
Good luck.

KCUMB CLASS OF 2006

 

[minime]

Drsmiles,
I'm a fourth year at KCUMB and am at a fairly large community hospital that does not have any residents-there are about 10 students here including students from other schools. I have not rotated at an actual "teaching" hospital because my family is planted here and didn't want to be away from my family for that long.
I have no regrets about coming here. Most of the attendings are used to having students and really try hard to make sure that you learn something everyday. I am going into OB and have done appx. 45 vag. deliveries on my own (attending present of course) and have been the primary surgeon on 2 c-sections. On my surgery rotation I did an above the knee amputation and many, many other procedures. I was first assist on just about everything except for very complicated things like carotids.
You must really be a self starter to be at a small place. You could be lazy and not really learn or do much.
As far as boards go I did about the same on step 2 as I did step 1, some of my friends who stayed in KC did the same or went down.
As far as residency goes I'm applying to OB which is not competitive, but I have gotten interviews at some prestigious places (UT memphis which writes William's Obstetrics and many others-14 interviews so far) and I have not taken the USMLE.
Just my two cents.

 

[DrSmiles]

Hi minime,
You probably have a better idea on all this than me, since I have only been out doing rotations for my first 3 months. I was only comparing info from what I have heard from other 3rd years in my class. I don't think being at a program that doesn't have a residency doesn't mean you will get less teaching at all. In fact, I just finished a rotation at my hospital that doesn't have a residency program in this particular specialty, so I spent a lot of one on one with the attending, which can be a great experience. Since you have 10 students at your site, that sounds pretty big compared to some of the other smaller KCUMB sites. But wouldn't you agree with me that it would be helpful to e-mail 3rd/4th year students at the site you are interested in to see if it sounds like a place you would want to go? Personally, I wouldn't base a decision on if it has didactics, or how large it is. I thought it was much more helpful to e-mail students that are already at their core sites to see what they liked about it. Of course you have to take it with a grain of salt, because it is only one or two opinions, but it is generally helpful.
For example, last year KCUMB had a site in Las Vegas, a site I thought I was interested in. I emailed one of the students who told me they were not happy with the site, and gave me examples of why. So I decided not to rank it in our class lottery and as it turns out KCUMB dropped it as a site anyway.

 

[minime]

Sorry Drsmiles, when I wrote the response I mistakenly thought you were the original poster-I didn't mean to sound like a know it all. I completely agree that you should email students at any site that they are considering. It is a big choice, almost as big as what medical school you are at because you are stuck there for at least a year and two months.
I think that the type of place that you want to go really depends on you and what specialty you think you are going to do. If I were going to do something more competitive I would def. want LORs from someone at a teaching university hospital. I also agree that didactics can be a good thing depending on what type of learner you are. Personally, I really learn better on my own. If I have a big case the next day I read everything I can about it. If I see an interesting case I read about it. Above all I try to know my stuff so I won't look like an idiot (something I have definitely experienced).

Definitely above all you need to know how the students at the site are doing. It could look great on paper (such as Las Vegas) but really suck.

 

[Wo1verine7DO]

I marked Pontiac osteopathic, st joe mercy of macomb a new site for out class, and st vincent in toledo ohio, I handed in my sheet already. Do you know good or bad about them. Thanks for your input...what are your names? Maybe I met you randomly one time? I did a summer rotation with Dr. Johnston at MCI...as an MS 1

 

[DrSmiles]

I am not at any of the sites you listed, but I have a few friends at Pontiac and they have nothing but great things to say about this site. Plus you are really close to other KCUMB core sites in Michigan, so you have more options if you want to do your core electives at another site.

 

[electra]

hello there,

I am a KCUMB 4th year. Here's just some thoughts.
I also agree that a mix of sites is a good idea. On one hand, an advantage to going to a larger (not necessarily university) program is that you are exposed to more specialties. Another is that the interns and resients ahead of you have also done a lot of legwork ahead of you, and those people tend to be good for advice on everything from where to live to the Boards to the Match and different residency programs. As stated in the previous threads, many of these people are the ones who write your evals and letters of rec. In many cases, they can put you in touch with the right people that you need to get information/experience/interviews, etc.
A smaller site without anyone standing in front of you has the advantage of no one standing in front of you. Of course, no is stanidng alongside you either. If you are a procedure person, this can be GREAT experience. Even if you are not a procedure person, you might not ever have the chance to do some of this work again. If you are person who really does not want to be in the limelight (or on the hotseat, depending on how you think about it), you might look to a larger program where you will not be the go-to-it person.

Just my $.02. YOU will make your 3rd and 4th year. YOU will get out of it what you put in to it. When you talk to students who know what they wnat to do, what they are doing at their site, how they got honors or did well on rotations, you will notice a few things. One, they do their homework. Two, they are engaged in the rotation. Don't wait to be asked to do something. OFFER to do something. "Is there something I can help you with?" is the best question I have ever asked. Three, don't be afraid to make mistakes (this was hard for me, you learn it as you go.) Keep trying. Ask for feedback and accept it constructively. Four, always try to give something of yourself to the rotation. You know when you are going through the motions. You will not have the chance to do much of this work again, so jump into it! Looking back, my clinical years have been great!
This month has been really fun for me. I'm doing orthopedics in Boston, through the HMS system. My preceptors are three orthopods who specialize in sports medicine and do a lot of ambulatory surgery. I see all the new paients, interpret the imaging, write an assessment and do a plan. I present the patient to the attending, go in for their assessment and then receive feedback. I also am invovled in the surgeries and did almost an enitre knee arthroscopy by myself. I'm not actualy going in to ortho, but the rotation itself is so good, that I get more and more teaching. I was invited to ortho education day by my resident and have spent two nights in the ER doing call for ortho. I will never have this chance again, and I get so much more out of it by putting more of myself into it, that I will remember this as one of my best rotations.
FYI, I'm at POH. I welcome any PMs from people who have questions.