So what was it like?

Discussion in 'Clinical Rotations' started by kedhegard, Apr 27, 2004.

  1. kedhegard

    kedhegard Senior Member
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    This is from an upcoming third year to those who have just finished their's. Care to share any stories? I'm starting off with Surgery, then peds, but stories about what to expect in any of the rotations will be much appreciated. What were your hours like? Which rotations were more demanding, and which were not. Did you rotate out for family practice, etc? Thanks for anything you can come up with.

    -KE
     
  2. 2ndyear

    2ndyear Senior Member
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    This is from a 4th year, all done with rotations. What you experience will be highly variable depending on what institution you are at. Typically though you keep hours similar to a resident on whatever service you are on, but less. Likely you will take slightly less call, spend less time rounding and spend less time in clinics.

    It's great that you're starting out with surgery. It was my favorite 3rd year rotation, even though I was scared going into it. You'll put in long hours and stand up until your legs cramp, as well as hold pieces of the body out of the way for what seems like eternity. It's also really rewarding and exciting.

    A good idea before rotations start is to buy First Aid for the Wards or a similar book. It shows how to write a good progress note on each rotation and has some high yield facts about the major diseases. Also a palm with epocrates or a pocket pharm book is a must.

    Making yourself a part of the team will help a lot. When you are assigned to a patient, know everything about them. Write the progress notes before your resident or intern does. Think about management and the next steps in their care. Be enthusiastic! The one thing to remember is that even if you don't like the rotation, the residents and attendings have chosen this as their career and life and put in huge amounts of work. It goes a long way to show everyone some respect and be interested, asking questions, and absorbing information.
     
  3. DOtobe

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    I'm a third year who has 3 weeks and a few days left until fourth year. The rotation I am on now is Peds, and since I am typing on SDN at around 10 am, that tells you how laid back it is! As 2nd (well, now 4th ;) )year said, your experience really will depend on which type of hospital you are at, teaching vs. nonteaching, etc.

    Here have been my experiences so far.
    Psych/Neuro - my first rotation. Was an easy rotation to start off with. I would get to the clinic (I ended up doing outpatient psych) around 8:00 and would be done by 3:00. And this was MWF. T/Th I didn't have to go because no patients came to the clinic. It was a good way to ease myself into rotations. For neuro I would get to the hospital around 7:30 and go to morning report, then see patients. Was also pretty laid-back, but the attendings rounded in the afternoon and that kind of sucked.
    FP - I did FP with a DO in his office - and I loved it. I want to go into FP, and I like the outpatient experience more than the hospital stuff. Hours were 9-5.
    Medicine - I did my rotation at a non-teaching hospital, so I kind of got shuffled around from attending to attending. Make sure you know everything about your patient - any medication changes, significant past medical history, etc. Hours varied depending on the attending, but usually I was there from 8-5 or so.
    Surgery - I was terrified of surgery at first, but I ended up kind of liking it. This is the rotation that the hours suck for though - getting to the hospital at 5:30 am and not leaving until around 5 or 5:30 pm. I did the rotation in December-January, so I hated going to the hospital when it was dark and leaving when it was dark. At least you won't have that problem doing surgery in the summer! Make sure you have comfortable shoes! And make sure you ask the cardinal questions: any BM, flatus, if they are using their incentive spirometer, tolerating diet...
    Ob/Gyn - I thought I would hate Ob/Gyn, but I actually liked it too. I think your experience will vary depending on if you are male or female. The male students I have talked to don't necessarily get to do as many paps, pelvics, etc. as a female student does. I am a female so I got to do a lot. My rotation consisted of outpatient, OR, and L&D duties, as well as writing notes on post-op and postpartum patients. Usually hours were from 6:30-4:30.
    Peds - last rotation! Great one to end the third year with (as I am quickly losing motivation). I get here at 7 and am done by 4 or 4:30.

    Whew, I think this is the longest post I have ever typed. Hope it helped! :)
     
  4. GeddyLee

    GeddyLee Bad-ass Guitarist
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    Dude...you were home by 5 or 6PM on Surgery? My typical day was 4:30AM to 7:30PM. At least once or twice a week we'd be there until 9PM. Then overnight call Q4.

    Anyway....Peds, FP, Psych have decent hours, although Psych was hands-down the best. Surgery was nightmarish. Medicine wasn't half bad, but I guess that depends on whether or not you take overnight call. FP despite the decent hours was most mentally draining for me....100% shadowing, no independence..and it was my final third year clerkship.
     
  5. jcg179

    jcg179 Junior Member
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    Not Related:

    GeddyLee:

    Nice to see another Rush fan!!
     
  6. DOtobe

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    Yeah, my surgery rotation was a lot easier compared to other students I have talked to. And we didn't have to take call either. Ob/Gyn is the only rotation I have had to take call on, and it was q 4.
     
  7. Mr. Plow

    Mr. Plow Yes, that's my name
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    I have another 6 weeks to go until 4th year, still have surgery left. As others have said, your experience will be highly variable and dependent on a number of factors, including where you do your rotations (community vs. academic), who your attendings/residents are, etc. My best advice would be to try to get what *you* want out of your rotations. After all, this experience is for your education and you're paying a high price for it. I think I spent far too much time trying to please my attendings at the beginning. The moment I decided to forget that approach and take learning into my own hands, third year was much more interesting and rewarding. Plus, I have gotten better evaluations and grades. So if there was any advice I would give, that's it. Oh, and take everything your classmates tell you with a grain of salt. :)
     
  8. mig26x

    mig26x Senior Member
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    I thought i would hate Ob/gyn and to me surprise I loved it. The mixture of been able to performed some surgeries and the primary patient-doctor contact makes me think twice about this specialty. Im gonna do IM but i never thought I would have liked this rotation so much!!! Maybe i end up as an Ob/Gyn after all, who knows!!
     
  9. ktat72

    ktat72 Senior Member
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    surgery - we had it pretty easy. there were a lot of cases the first month but only like 2 or 3 cases a week the second month. nobody received honors at the hospital i was at, but our chief was real laid back. the residents were real cool.

    OB/GYN - the residents at my hospital were mostly malignant. this is where i started to learn the rule about scutwork. the worst part of it is that the residents make you do all the work and some say they do not know you well enough to evaluate you - had this happen with two of the residents - or they will just give a satisfactory.

    Peds - i was lucky because i had the laidback attendings and residents. we had a busy month on inpatient since it was in February, AKA rotavirus and RSV season, and the team had around 30 patients each day, although the residents gave us each 4-6 patients to see. Had call on Friday the 13th, which was back to back admits, but our chief was real sweet. our attending on the general service would buy us scratch and win lottery tickets each day for the pool for a pizza party

    FP: the rotation is real boring, but the exciting part of this rotation is that you get exposed to other specialties on the rotation, like radiology, ortho, derm, etc.

    IM: currently on it right now. enjoy it. the only painful part of it is the long four page H&P forms that the students have to fill out for each admit.
     
  10. Yosh

    Yosh Livin' in the WINDY CITY
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    As you can see...experiences vary by person and hospital...so there is no real way to generalize...

    As for me... I really loved 3rd year..and am finishing up with OMT. What an amazing way to end off the year...Thursdays off...Mondays in at 10am....WONDERFUL!!!!
    The main thing to realize is to be hinest, enthusiastic, and work hard. Impressions are made early...and an enthusiastic student is almost always well recieved.
    I have also seen nurses MAKE students SHINE..and also seen them KILL students...its very important to treat people well..and just be respectful and willing to learn...

    You will LOVE it.....my best day of 1st & 2nd year pales in comparison to my 3rd year rotations.
     
  11. Jaded Soul

    Jaded Soul Proloxil > Zoloft
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    It's always different depending on where you go. Obviously, the best idea of what to expect will come from the class ahead of you. I could tell you all about my program and it wouldn't make a difference.

    However, in stereotypical terms, here's what I think... Psych and FP tend to be better in terms of hours and what is demanded of you. Psych, FP, and peds tend to have "nicer" residents and attendings. Surgery and its subspecialties have the longest hours. You will get scutted on these services more than the aforementioned. Surgery and ob/gyn residents and attendings, while not inherently "mean," tend to come across that way to students for whatever reason. For me, it was because these were the services I was made to feel completely superfluous. Medicine seems to be in the middle somewhere, in terms of hours, what they expect of you, and the kind of people you'll come across. Of course, stereotypes don't always hold true, so it's just best to go into everything with an open mind.
     
  12. DOtobe

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    This is so true! Even on my worst day during my rotations, I am still glad I am on rotation as opposed to sitting in lecture. It's so nice to wake up happy every morning (maybe that is because I am on peds now and I love the kiddies :) )
     
  13. We had a similar (tough) schedule. Typical day starts at 0430, lasts until 1700. Call schedule was q3, overnight. One day off every 7-10 days. No "post-call" rules. Tough tough tough. (But fun. :) )
     
  14. Machiavelli

    Machiavelli Junior Member
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    Excellent advice. Your hours and what is expected of you will vary widely depending on what service you are on, let alone the rotation. Focus on what you can control: how enthusiastic you are, how hard you are willing to work to help the team, how professionally and courteously you treat your fellow students, residents, attendings, nurses, techs, janitors...these will play a big factor in your evaluation and, more importantly, your learning and being a decent human being.

    As a generalization, surgery has the longest hours: surgeons have to see patients in clinic and round on inpatient wards, plus they also do surgeries that can last 4, 6, 8, 10, 12 hours. On my surgery clerkship I was in at 5 and left at 6-6:30 on a typical day. Fortunately, no call on my service, but other students I know got Q3 or even Q2 call (transplant is notoriously brutal). Medicine was typically 6-5 plus Q4 overnight call. Peds was 7-4 on a typical inpatient day. OB/Gyn was 6:30-4:30 with Q5 call. Outpatient rotations tended to be 8-5 or 9-5. Responsibilities vary, from observation to "act like an intern." How much responsibility and autonomy you have will depend on your attending, the workload of the residents (the more they have, the more they will ask you to do), and how much you ask for. If you're thinking about going into a patient care speciality (e.g. not diagnostic radiology or path), my advice is to ask for as much responsibility as you think you can handle, then take a little more. Nothing beats actually getting to actively take care of patients. I can't agree more than the 3rd and 4th years are infinitely better than the pre-clinical years.
     
  15. rubyness

    rubyness Senior Member
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    Nothing beats experience in terms of deciding what specialty you want to go into.

    I always wanted to do OB/GYN, and now I'm doing it and I hate it. But, I loved surgery.

    Go figure. Now I don't really know what to do!
    ---

    Third year is always better than second year on any given day, hands down.

    ---

    Sometimes it feels like the amount you learn is directly proportional to the amount you suffer. This is because the harder you work, the more you challenge yourself, the more you put yourself out there by asking questions and trying to jump in and participate, the more you risk looking like an idiot (and being treated like one!) the more you get out of the experience. The more time I spent in the county hospital, the more I suffered, but I got to be on the front lines of taking care of my patients and I learned the most there.
    So sign up for some things that may be hard, but are chances you won't get again or elsewhere.
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    A big lesson of the year-- don't take anything personally. I have to repeat this to myself about five bajillion times a day. Maybe it will start to sink in soon so I can develop a thicker skin.

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    The lessons of this year will often be cloaked in b-s, bureacracy, scutwork and personality conflicts. No matter how much it sucks at times, try to focus on what you're being taught. Don't let the meanness of a resident distract you from the fact that he's actually teaching you something at the moment.

    ---

    It's a long calendar year, but the time flies!!
     
  16. Whisker Barrel Cortex

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    I would actually recommend the same for people going into radiology (and probably path). You learn a great deal during clinical rotations that will help you immensely in radiology. People also forget that radiologists must do a year of clinical medicine (often the toughest year of a medicine or surgery program if doing a prelim) and learning as much as you can in third year is essential.
     
  17. roja

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    Again with the variability! You will have to check with the students above you to find out the particulars about the rotations. But again, this is even goign to vary with who is running your team (chiefs or senior residents) and attendings prefrences and the ever nebulous, are you a white cloud or a black cloud or gray cloud!

    I was a white cloud. Some of my group was a white cloud. My worst (time wise) rotation was medicine. We did not do overnight call on surgery. Trauma was horrible but the revised it after I left.

    The only classic standard? EM of course! Its shift work. but just show up on time, do you work, don't b**tch and moan and you will do well. Realize that no matter what field you go into, the other fields will cross yoru path and its good to have a cursory understanding of your consultants....
     

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