I'm doing 3rd year scheduling and was just wondering if there at any clerkships that I should do at my main hospital (vs. less academic affiliated hospitals) in order to secure better recommendations later on. I will surely do my anesthesiology electives at the main hospital, but what about surgery? medicine? Is it alright to take them at not-so-academic hospitals?
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Both my surgery and internal medicine rotations were at private hospitals, where I was one of about a half-dozen students in the entire hospital. I liked it, and don't think that my medical education suffered. Rather than get in the hospital obscenely early to round on surgical patients, then have to peer over the shoulder of the MS4, junior, and senior residents in the OR, I stood across from the surgeon and first-assisted on every operation (and since neither of my surgeons regularly had inpatients, we didn't usually have to round). Now, if I wanted to be a surgeon, I might prefer the more "authentic" academic rotation, but I don't want to be a surgeon.
For internal medicine, I definitely noticed a difference between at the private hospital and at the academic hospital (did an inpatient family medicine rotation last month at the academic hospital...had more work there than my fellow students on IM at the same place). In the private system, I got in whenever I felt like to round on my 6-12 generally well medicine ward patients, do 30 second presentations on each as we're running down the hallway to see the next patient with the attending who covered 40-50 patients a day, then left after we finished rounding on my patients (since he already did all the others while I was prerounding on mine). At the academic center, I was pulling 12-16 hour days, getting in obscenely early to preround on my 2-3 ICU patients before early morning report, with full presentations given on each patient, followed by regular rounds, then divying up more work, then being kept around until after the night resident comes on, so I can admit anyone we get in the afternoon/evening. Now, considering I actually want to do CCM after whatever residency I settle on, I think that time in the academic center was useful, as I "ran our ICU service" as one of my attendings put it.
