Shutting down M3/M4 clinical rotations

Burrell College of Osteopathic Medicine
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MerYangBey said:
In all seriousness do you guys really think that an average med student will be helpful in the hospital if they don't have someone to teach them and supervise them? I mean legally we need supervision? what do you guys think you're gonna do? grab a blanket? run errands?
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I was a student during the Boston marathon bombing. Everyone wanted to help. Every med student wanted to be front and center. Every single one. They claimed similar things that are in this thread about duty and oaths and how helpful they could be.

I took the hint when I saw med students literally getting in the way. There was an attending there who told us about med students always eager to help that sometimes, it's altruism, sometimes people run to help to see things they've never seen, and many times people want to roll up their sleeves so they can later talk about the battle scars.
 
Mass Effect said:
Notice how nowhere in the events you mentioned does it say that students served as incubator of a highly contagious and potentially fatal disease?
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I see you too would rather have an NP in that role compared to an M4. somehow when med students don PPE the PPE immediately becomes useless.


On a seperate note, some of the loudest voices on this site regarding the value of medical students vs NPs , now think that medical students have little value to a team , even if the team is missing 50% of its members.
 
Mass Effect said:
I was a student during the Boston marathon bombing. Everyone wanted to help. Every med student wanted to be front and center. Every single one. They claimed similar things that are in this thread about duty and oaths and how helpful they could be.

I took the hint when I saw med students literally getting in the way. There was an attending there who told us about med students always eager to help that sometimes, it's altruism, sometimes people run to help to see things they've never seen, and many times people want to roll up their sleeves so they can later talk about the battle scars.
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no one is advocating reporting to ed in an n95. We are fine with staying home if our schools and hospital systems advocate us to stay home to save supplies or to decrease liability to the school in the case of an adverse event for a student.

There are literally many of us saying , if there comes a point where you need us, we would be willing to help.
 
libertyyne said:
do you think there is a massive difference between an m4 and an intern?
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This time of year? Hell yes! An M4 in March versus an intern in March is not even comparable. An M4 in June versus an intern in July may be the same, but good thing we're not in June or July then.

assess patients and generate basic plans for the attending to check off on?
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As an attending, I would never "check off" on a plan a med student made without doing my own complete H&P. You doing it would only delay my exam and put you and the patients at risk.

MerYangBey said:
I don't want to disagree with you. I'm curious what an attending has to say about MS3-4 usefulness during a pandemic.
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See above.
 
kb1900 said:
Again, it’s about the time when the hospital becomes short staffed. I am not opposed to canceling education rotations and electives.
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I'm not talking about when all the attendings/residents are out. I'm talking about right now. Once we get to the point where it truly is all hands on deck, fine bring out the med students. But as of right now, med students are much more a liability than a help.
 
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Mass Effect said:
I was a student during the Boston marathon bombing. Everyone wanted to help. Every med student wanted to be front and center. Every single one. They claimed similar things that are in this thread about duty and oaths and how helpful they could be.
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Last I checked the doctors during the Boston marathon bombing weren't at risk of being blown up with every patient they treated.....

You are repeatedly creating strawman arguments and then knocking them down.
 
Mass Effect said:
I'm not talking about when all the attendings/residents are out. I'm talking about right now. Once we get to the point where it truly is all hands on deck. But as of right now, med students are much more a liability than a help.
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The bolded is literally what we are talking about. No one is saying we should just show up today and think we will be helpful. No one.

What started this was someone saying that in the event where it truly was all hands on deck, as you put it, a church volunteer would be better than a medical student.
 
libertyyne said:
I see you too would rather have an NP in that role compared to an M4. somehow when med students don PPE the PPE immediately becomes useless.

On a seperate note, some of the loudest voices on this site regarding the value of medical students vs NPs , now think that medical students have little value to a team , even if the team is missing 50% of its members.
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Your argument is a lot more convincing when you don't put words in people's mouths. Where exactly did I say that I'd rather have an NP? But yes, if you're my med student in this time, spare the PPE for the residents and attendings.

This whole "if the team is missing 50% of its members" and "dropping like flies" is something that was inserted into this thread just to prove a point. That is NOT how the discussion started, so forgive some of us if we're talking about what's happening NOW rather than what might happen in a few weeks.
 
libertyyne said:
no one is advocating reporting to ed in an n95. We are fine with staying home if our schools and hospital systems advocate us to stay home to save supplies or to decrease liability to the school in the case of an adverse event for a student.

There are literally many of us saying , if there comes a point where you need us, we would be willing to help.
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So sometime during the day, you changed your position. Because as of this morning, you made the absurd assertion that if med students aren't essential, neither are residents.
 
Mass Effect said:
So sometime during the day, you changed your position. Because as of this morning, you made the absurd assertion that if med students aren't essential, neither are residents.
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That assertion was made to the point of limiting number of people involved in the care of a covid patient.
you still havent told me how academic medicine attendings carry higher caseloads compared to private counterparts with the help of residents. Protip they do not.

but you clearly see medical students provide no value in any circumstance so it shouldnt change your position.
 
kb1900 said:
Then maybe it’s just a nyc thing because half my patients don’t even get their AM labs on time unless someone from my team draws them at 5am



I have no doubt that you are right and that is the driving reason schools stop rotations. And I am not opposed to stopping rotations either.

My post is about the inevitable time when hospitals become short staffed and this fellow medical student is suggesting a church volunteer would be better to call in than a m3.....
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Interesting you mention NY bc my surgery attending trained in NYC and said she had to do a bunch of nursing duties stuff even as a gen surg resident bc of the nursing unions in NY. Def not the case in the Midwest.
 
AnatomyGrey12 said:
Last I checked the doctors during the Boston marathon bombing weren't at risk of being blown up with every patient they treated.....

You are repeatedly creating strawman arguments and then knocking them down.
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It's not a strawman. I wasn't comparing that to this. I was saying this is what attendings tend to think when med students rush to help even after being told to stay back.

AnatomyGrey12 said:
The bolded is literally what we are talking about. No one is saying we should just show up today and think we will be helpful. No one.

What started this was someone saying that in the event where it truly was all hands on deck, as you put it, a church volunteer would be better than a medical student.
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No, that's what started your comments. Earlier today, some were suggesting that residents were no more essential than med students.
 
libertyyne said:
That assertion was made to the point of limiting number of people involved in the care of a covid patient.
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Except that the resident IS essential to the patient's care.

you still havent told me how academic medicine attendings carry higher caseloads compared to private counterparts with the help of residents. Protip they do not.
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I had to go back to see what the hell you were talking about since I don't even remember that question. Turns out, you edited your original post about 20 minutes after making it. LOL. You'll forgive me if I didn't see it as I was, you know, working.

Academic attendings have a number of obligations that private counterparts don't - talks, lectures, Grand Rounds, research, teaching (at bedside and didactics), publishing, conferences (some of which are required), etc, etc, etc. And yeah the gig is much better than private practice in my opinion because of the above. It feels way more cush than seeing patients q15 minutes and churning out 40 visits a day.

but you clearly see medical students provide no value in any circumstance so it shouldnt change your position.
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Med students in this circumstance at this moment provide more risk than value. Again, your position would be a lot more convincing if you didn't put words in my mouth.
 
Mass Effect said:
Except that the resident IS essential to the patient's care.



I had to go back to see what the hell you were talking about since I don't even remember that question. Turns out, you edited your original post about 20 minutes after making it. LOL. You'll forgive me if I didn't see it as I was, you know, working.

Academic attendings have a number of obligations that private counterparts don't - talks, lectures, Grand Rounds, research, teaching (at bedside and didactics), publishing, conferences (some of which are required), etc, etc, etc. And yeah the gig is much better than private practice in my opinion because of the above. It feels way more cush than seeing patients q15 minutes and churning out 40 visits a day.



Med students in this circumstance at this moment provide more risk than value. Again, your position would be a lot more convincing if you didn't put words in my mouth.
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The edit was made prior to you or anyone else responding to it.

You additional obligations literally do not add to patient care at the bedside. SO literally if you worked like the private practice counterparts you could cut out the need for residents doing stuff and unnecessarily adding to the exposure and risk of transmission to a novel virus.
 
libertyyne said:
The edit was made prior to you or anyone else responding to it.
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Except that I never responded to it nor did I read it after you edited it.

You additional obligations literally do not add to patient care at the bedside. SO literally if you worked like the private practice counterparts you could cut out the need for residents doing stuff and unnecessarily adding to the exposure and risk of transmission to a novel virus.
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Oh for cripes sake, this is the most ridiculous argument ever. Go ahead and throw your tantrum because residents are essential and med students aren't. I'm done trying to talk to a wall.
 
Mass Effect said:
Except that I never responded to it nor did I read it after you edited it.



Oh for cripes sake, this is the most ridiculous argument ever. Go ahead and throw your tantrum because residents are essential and med students aren't. I'm done trying to talk to a wall.
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I literally said residents are theoretically non-essential after you made a big deal about limiting exposure. You somehow cant wrap your brain around that.
 
libertyyne said:
You keep saying that medical students are claiming to be as useful as an attending. Literally no one in this thread has ever said that. Keep on building those strawmans and knocking them down.
You dont want to take the risk, and literally no one here is advocating to force you to take a risk that you are uncomfortable with. But some of us are willing to take the risk if our communities need us.
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There is no strawman. After I see a patient, I present the patient to the attending. Then the attending sees the patient themself. If the attending needs something done, they ask me to do it and the nurse helps.

In every single scenario, I add work to the team, I do not reduce the workload. There is no argument for you here. I state again, I have never seen a medical student reduce the workload of the team. Never.
 
My school isn't shutting down rotations completely but is offering "alternative experiences" for certain rotations, like online videos and small group lessons. I think this might happen more and more as time goes on and the situation gets worse.
 
7331poas said:
There is no strawman. After I see a patient, I present the patient to the attending. Then the attending sees the patient themself. If the attending needs something done, they ask me to do it and the nurse helps.

In every single scenario, I add work to the team, I do not reduce the workload. There is no argument for you here. I state again, I have never seen a medical student reduce the workload of the team. Never.
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literally a number of examples above of what you call scut reducing time for the team. Literally examples of drawing labs, carrying the pager, transporting patients, writing notes. Come on dude. Somehow you cant stop talking about how M4s are better than midlevels yet, you simultaneously argue that m4s cant do anything to help their team.

EDIT: ALso you think we cant help when 50% percent of people are literally in self quarantine ?
 
Is there any comprehensive list of what schools have rotations on shutdown?

The other MD school in my city shut down rotations until June and one of my school's hospitals just kicked out the medical students, so we're down to 2 that don't have the capacity for every one of us to rotate and I'm crossing fingers that my IM clerkship doesn't get cut in half

I'm wondering if anyone whose rotations are actually shut down altogether knows whether his or her school has ironed out how this is going to affect the curriculum for the next 1-2.5 years and whether it may delay graduation in the long run. I have some doubts of whether given LCME rules cutting off parts of the M4 curriculum is even feasible.
 
7331poas said:
There is no strawman. After I see a patient, I present the patient to the attending. Then the attending sees the patient themself. If the attending needs something done, they ask me to do it and the nurse helps.

In every single scenario, I add work to the team, I do not reduce the workload. There is no argument for you here. I state again, I have never seen a medical student reduce the workload of the team. Never.
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In my experience, I see the new admit and present. And the resident/attending are able to be in and out of there in less than 3 minutes because I already got 97% of what they need from the patient bundled into a neat package, and they can just asking the 2 questions I didn’t think of at my level. And thus learn what else I should have considered.
 
sunshinefl said:
In my experience, I see the new admit and present. And the resident/attending are able to be in and out of there in less than 3 minutes because I already got 97% of what they need from the patient bundled into a neat package, and they can just asking the 2 questions I didn’t think of at my level. And thus learn what else I should have considered.
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Realistically, if you weren't there they wouldn't have asked many more questions anyway. In private practice the notes are 1/5th the size and they don't bother with half the **** that medical students ask and present.
 
sunshinefl said:
In my experience, I see the new admit and present. And the resident/attending are able to be in and out of there in less than 3 minutes because I already got 97% of what they need from the patient bundled into a neat package, and they can just asking the 2 questions I didn’t think of at my level. And thus learn what else I should have considered.
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It’s not about reducing the workload of the attending and residents (although that can be a separate discussion if this is actually true or not). It’s about reducing the number of personnel seeing each undifferentiated patient, thus reducing potential spread of the virus to other patients. IMO it’s selfish to want to be there as a medical student to “help out” if you are having direct contact with potentially infected patients. If you want to go and do non-direct patient care activities (gathering supplies, disinfecting common areas, etc), that’s fine. But being there as an unnecessary potential vector going from patient’s room-to-room is doing far more harm than good
 
libertyyne said:
The resident theoretically is non-essential as well , you could say that they are increasing the number of people in that room considering the attending has to see the patient anyway .
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No.

Academic attendings don't contribute much to clinical care. They take a pay cut to pontificate and get stroked by med students and interns, and that's about it. The senior residents run the service. By senior, I mean the ones halfway through their training. The attendings eye the patient and attest the note for insurance payments. The senior, senior residents are usually mentally or physically checked out and are moving on to better pastures and sign-on bonuses.
 
Candidate2017 said:
No.

Academic attendings don't contribute much to clinical care. They take a pay cut to pontificate and get stroked by med students and interns, and that's about it. The senior residents run the service. By senior, I mean the ones halfway through their training. The attendings eye the patient and attest the note for insurance payments. The senior, senior residents are usually mentally or physically checked out and are moving on to better pastures and sign-on bonuses.
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literally the point. The attending can do their own work and not have added hands in the kitchen.
 
Rumors that HMS is suspending rotations for a week and preparing to train students for telemedicine? Has anyone heard?
 
gyngyn said:
It appears that this would be a good time to remember that name-calling and belittling others is not acceptable in a professional forum.
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Seems like half of the people feel they’re actually training to be professional physicians, the other half think they’re only students.
 
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7331poas said:
Ok. Then call in the nurse. Why have a medical student there?

There are no good arguments about why we need to be sending M3s into the emergency department. none.
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Completely disagree man. Not all of us are useless slugs, and some of us (may) have had life experiences where we were doing similar jobs before school anyway
 
Can we stop with the back and forth about whether medical students would be useful in the pandemic and focus on getting info about whether rotations are being cancelled/how this will affect our ability to graduate?

I am an M4 in the northeast whose EM rotation just got cancelled half way through with 8 weeks remaining til graduation and every week counting towards necessary credits for graduation. That is my main concern and I'm sure others are in the same boat.
 
Ducky8989 said:
Can we stop with the back and forth about whether medical students would be useful in the pandemic and focus on getting info about whether rotations are being cancelled/how this will affect our ability to graduate?

I am an M4 in the northeast whose EM rotation just got cancelled half way through with 8 weeks remaining til graduation and every week counting towards necessary credits for graduation. That is my main concern and I'm sure others are in the same boat.
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I’m scheduled to start surgery in 1 week but the hospital isn't taking students so idk
 
Ducky8989 said:
Can we stop with the back and forth about whether medical students would be useful in the pandemic and focus on getting info about whether rotations are being cancelled/how this will affect our ability to graduate?

I am an M4 in the northeast whose EM rotation just got cancelled half way through with 8 weeks remaining til graduation and every week counting towards necessary credits for graduation. That is my main concern and I'm sure others are in the same boat.
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Was worried about this too. But school reassured that it is within everyone’s best interest to graduate us in time. If they pull us from clinical they will make us do some virtual course to make up for required rotations. There is no way they can delay our graduation etc.
 
lawrencewellsbourne said:
my school went extreme and cancelled our white coat ceremony. shut down the campus. cancelled all rotations and sent the interns home. hours are going to be made up during summer vacation. and graduation is being pushed back.
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how does that work? Residencies usually have a non negotiable timeline for starting. Is an entire class going to go unmatched?
 
libertyyne said:
I guess, but realistically the Nursing staff, the PCAs, the food workers, the residents, the attendings seem to be a larger nidus of infeciton. I understand that I am not essential to the care of patients. But then it seems like it s problem with the system not utilizing me.

The resident theoretically is non-essential as well , you could say that they are increasing the number of people in that room considering the attending has to see the patient anyway .

To everyone talking about how not going into these rooms is going to be somewhat protective of them, community spread is probably the largest risk right now, and once they graduate they magically will not have this option left to them to not see patients as a resident.
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Can I use this post to rant about how crowded hospitals have become? Nurses, PAs, techs, MAs (and all of their students) and then medical students, interns, residents, fellows, attendings, etc. I've never felt more useless in my entire life.

Things seriously need to change. At this point I'd say schools should be sending kids to Africa or India, somewhere they can actually get their hands dirty. I'm getting really, really tired of being on the bottom of the hospital's totem pole, while nurses advocate for their students. Why aren't attendings or residents doing a better job of involving students or standing up for them? What am I paying for then? Might as well have me start residency after interviews and make med school 3.5 years.
 
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