Starting rotation soon! How to be ready?

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Zytiga

Zytiga

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How did you prepare for rotations? What study material do you recommend? I have acute care, community, ped icu, antico, long term care, amb care.
 
Know your guidelines - CHEST, GOLD, JNC, ATP, ADA, ATS, etc. Get together your reference materials and organize by disease state. Know the gist of recent landmark trials. Review/learn/relearn statistics which you will need to know for journal club. What is relative risk, absolute risk, NNT, NNH, CI, p-value, what is clinical significance, stuff like that.
 
Zytiga said:
How did you prepare for rotations? What study material do you recommend? I have acute care, community, ped icu, antico, long term care, amb care.
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Internal med/MICU: know the guidelines, the standard of care, as previous poster mentioned. I would say also brush up on infectious diseases.

Community: Just get there on time and work diligently. Not much studying needed before hand.

Ped: Totally different from adult medicine. You'll likely be learning most of everything from scratch.

Amb care/anticoag: guideline galore again. Diabetes is big, which covers also BP and lipids. Anti-coag can get dry pretty fast, dealing with the same few meds. Amb Care with VA rocks since RPh has near full prescribing rights/autonomy.
 
IMO not much preparation needed before rotations. Maybe brush up on a few disease states you forgot (like ACS), but you can learn most of the stuff on rotations. Preceptors typically don't expect you to know everything about every disease state. Don't be nervous.
 
1) Know your guidelines (as posted above)
2) Buy a sanford guide, it's small and cheap
3) Keep your white coat stocked with a calculator, some granola bars, and small gauge pens (like 0.3)
4) ICU: review sedation, analgesia, and vent settings (more for familiarity), don't know if these apply to peds.
5) Review statistical analysis for the inevitable journal clubs as mentioned above
6) Buy comfortable shoes
7) Community: brush up on your "finesse" in calling for copies/transfers
 
bacillus1 said:
IMO not much preparation needed before rotations. Maybe brush up on a few disease states you forgot (like ACS), but you can learn most of the stuff on rotations. Preceptors typically don't expect you to know everything about every disease state. Don't be nervous.
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Of course not, but it really helps (not to mention scores points) if you don't have to review the duration of warfarin therapy or the place in therapy of metformin (or what it even does - true story).
 
pharm B said:
I was told NeoFax is the way to go for most drug stuff involving peds.
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NeoFax addresses neonates (that is, babies < 30 days old), so it'd only be useful if you have a NICU rotation. For older kids, you'll want to look at the Teddy Bear Book. I forget the book's official name, but everybody calls it the Teddy Bear Book since there's a picture of a teddy bear on the cover. 🙂
 
Zytiga said:
How did you prepare for rotations? What study material do you recommend? I have acute care, community, ped icu, antico, long term care, amb care.
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PICU: Lots to learn. Ask your preceptor (in advance if possible) for articles to read. There are several foreign concepts to many students in the PICU and in general it is a steep learning curve.
 
It doesn't hurt to prepare for a rotation, but its not necessary. Its better to be someone who takes the initiative to learn. Its easy to get complacent and get away with doing nothing. Keep a open mind, open yourself to new projects, and try to push yourself and your workload. In a good rotation, you will learn alot just by participating, and having a good amount of homework.


As a preceptor there are 3 general things I hate:

1. Guessing at questions. Don't know it, look it up. Preceptors give students questions mainly because we know that the student doesn't know, and its a polite way of giving you homework, so it doesn't hurt to say "I don't know, but I will have the answer tomorrow".

2. If assigned homework or given a question to answer. You should do it as soon as you can, and tell us what you found out before we come hunting for the answer. Students think that preceptors forget. No we don't (well sometimes we do). I had a student who said that she would do all these wonderful projects and reports, and I would assign her homework questions after a presentation. I don't think she ever did any of them, unless I brought it up again, and asked for it at the end of rotation.

3. Until you pass the Naplex, you are not god's gift to pharmacy. So leave the ego at the door please.


Treat all rotations as a extended interview. Even if the facility is not hiring, it never hurts to get a good recommendation for your resume or CV. I will always pass a student no matter how horrible or good they are. Giving references is a whole different ballgame.
 
Pharmacopia said:
1. Guessing at questions. Don't know it, look it up. Preceptors give students questions mainly because we know that the student doesn't know, and its a polite way of giving you homework, so it doesn't hurt to say "I don't know, but I will have the answer tomorrow".
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Agreed. I get annoyed when students guess because after graduation, guessing at the answers is unacceptable. You need to get used to that on rotations so that your first job isn't a total shock.
 
Thank you for the great inputs! I am thinking about doing a residency at the VA (outpatient). I am hoping to do well at my sites and be well prepared for the residency interview. I know I need good recommendation letters. What did you do that impressed your preceptors?
 
Has anyone done a rotation at the FDA? How was it?
 
Zytiga said:
Thank you for the great inputs! I am thinking about doing a residency at the VA (outpatient). I am hoping to do well at my sites and be well prepared for the residency interview. I know I need good recommendation letters. What did you do that impressed your preceptors?
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If you want a recommendation, be upfront about it. Tell your preceptor you are interested about residency, and you are willing to work hard for it. Do not beat around the bush. FYI, , it maybe in your best interest to not let other interns you share a rotation with know that you are interested in residency.
 
Tell each preceptor that you are very interested in their respective areas of practice and is dying to get into them.

It strokes their egos, which fosters good relations and eventually leads to good grades. Dont one-up your preceptors. I came to realize that I knew much more clinically than any of my retail preceptors. However, I made them feel like knowledgeable preceptors which led to pretty much all As.

That said,(good) precepting is a gift. Now that I am a pharmacist, I would be hard pressed to precept anybody. Not that I dont like teaching, but the fact that it requires a certain amount of commitment and focus.
 
spacecowgirl said:
Know your guidelines - CHEST, GOLD, JNC, ATP, ADA, ATS, etc. Get together your reference materials and organize by disease state. Know the gist of recent landmark trials. Review/learn/relearn statistics which you will need to know for journal club. What is relative risk, absolute risk, NNT, NNH, CI, p-value, what is clinical significance, stuff like that.
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This is good information. I have it all down except for recent landmark trials. Will they really ask you about that stuff?

What reference material do you recommend?
 
SHC1984 said:
This is good information. I have it all down except for recent landmark trials. Will they really ask you about that stuff?

What reference material do you recommend?
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Yes, they sometimes ask, depending on the rotation. Don't freak out if you don't know everything though. Your preceptors don't expect you to know everything.
 
bacillus1 said:
Yes, they sometimes ask, depending on the rotation. Don't freak out if you don't know everything though. Your preceptors don't expect you to know everything.
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What references do you recommend that we buy before we start our rotations? What are some must haves?
 
The best way to get people invested in you is to introduce yourself to EVERYONE. Your preceptor and other health professionals want to help you but if you want to get the most out of your rotation, you need them to invest in you. A simple "hey I'm Zytiga and I'm a pharmacy student. I'll be here for 6 weeks so if you have any interesting cases, please let me know".
 
SHC1984 said:
What references do you recommend that we buy before we start our rotations? What are some must haves?
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I like Lexi-comp for my phone, nice to be able to look things up quickly and it has lots of other databases besides Lexi-drugs that are easy to use (interactions, medical dictionary, abbreviations, labs, etc...). Other than that, nothing really. When they've asked me stuff, sometimes I pull out my Lexi-comp on the spot to look things up. That's expensive enough, don't buy other stuff. I haven't had ID yet, so I'm not sure if I'll be using my Sanford guide there.
 
I do ask about recent landmark trials. But I don't expect you to know everything. Having a clue helps though.

You don't need to buy anything, all of that should be available through your library's e-journal system.
 
spacecowgirl said:
I do ask about recent landmark trials. But I don't expect you to know everything. Having a clue helps though.

You don't need to buy anything, all of that should be available through your library's e-journal system.
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Is there a good primer on recent studies that are need-to-know?
 
I really don't like ATPIII's guidelines on lipids. I prefer everyone be as close to 100 as possible, I don't agree with this BS of 130 to 160 and up to 190. 100-130, and if you have the factors or known CAD, make it as close to 70 as possible.
 
pfaction said:
I really don't like ATPIII's guidelines on lipids. I prefer everyone be as close to 100 as possible, I don't agree with this BS of 130 to 160 and up to 190. 100-130, and if you have the factors or known CAD, make it as close to 70 as possible.
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Ideally everybody would be 70, sure. However, you can't rely on somebody actually following a diet, and even a 60% reduction isn't going to do it for patients who are in the 200-300s. I don't see the rationale for goals of 160 though. It's not like htn where you worry about overshooting and having hypotension. Unless you've got a chronic infection or malignancy, you probably wouldn't be concerned with hypolipidemia.
 
Anybody worked more than 8 hrs a day for rotation? I am currently working 16 hours a day (two-4 hr shift plus an 8 hr shift) at an outpatient pharmacy and wondering if I should cut down on my work hours while I am on rotation. Any opinion?
 
Zytiga said:
Anybody worked more than 8 hrs a day for rotation? I am currently working 16 hours a day (two-4 hr shift plus an 8 hr shift) at an outpatient pharmacy and wondering if I should cut down on my work hours while I am on rotation. Any opinion?
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Sorry, I misread your post. Thought you meant you were working 16hr/day at your rotation site. Anyway my reply is referring to people who get taken advantage of at rotation sites.

Yes, that is abuse. You need to tell them that you work a total of 40 hours/week (if this is what is required by your school) and tell them they may break up the hours anyway they like. But once your 40 hours are complete, BYE BYE !! If you are working 16 hour days then you should do 16 on Monday, 16 on Tuesday, and 8 on Wednesday. After those 8 are done on Wednesday turn to everyone and say, "See ya next week." Don't allow yourself to be taken advantage of. Unfortunately this is what many rotations are about, abuse. While on my rotations I faced sexual harassment: homosexual and heterosexual, verbal abuse, unwanted touching, and all types of other needless crap.
 
diplomat said:
Sorry, I misread your post. Thought you meant you were working 16hr/day at your rotation site. Anyway my reply is referring to people who get taken advantage of at rotation sites.

Yes, that is abuse. You need to tell them that you work a total of 40 hours/week (if this is what is required by your school) and tell them they may break up the hours anyway they like. But once your 40 hours are complete, BYE BYE !! If you are working 16 hour days then you should do 16 on Monday, 16 on Tuesday, and 8 on Wednesday. After those 8 are done on Wednesday turn to everyone and say, "See ya next week." Don't allow yourself to be taken advantage of. Unfortunately this is what many rotations are about, abuse. While on my rotations I faced sexual harassment: homosexual and heterosexual, verbal abuse, unwanted touching, and all types of other needless crap.
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gosh, this is grim 🙁
 
diplomat said:
Sorry, I misread your post. Thought you meant you were working 16hr/day at your rotation site. Anyway my reply is referring to people who get taken advantage of at rotation sites.

Yes, that is abuse. You need to tell them that you work a total of 40 hours/week (if this is what is required by your school) and tell them they may break up the hours anyway they like. But once your 40 hours are complete, BYE BYE !! If you are working 16 hour days then you should do 16 on Monday, 16 on Tuesday, and 8 on Wednesday. After those 8 are done on Wednesday turn to everyone and say, "See ya next week." Don't allow yourself to be taken advantage of. Unfortunately this is what many rotations are about, abuse. While on my rotations I faced sexual harassment: homosexual and heterosexual, verbal abuse, unwanted touching, and all types of other needless crap.
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Did you report it to the school?
 
diplomat said:
Sorry, I misread your post. Thought you meant you were working 16hr/day at your rotation site. Anyway my reply is referring to people who get taken advantage of at rotation sites.

Yes, that is abuse. You need to tell them that you work a total of 40 hours/week (if this is what is required by your school) and tell them they may break up the hours anyway they like. But once your 40 hours are complete, BYE BYE !! If you are working 16 hour days then you should do 16 on Monday, 16 on Tuesday, and 8 on Wednesday. After those 8 are done on Wednesday turn to everyone and say, "See ya next week." Don't allow yourself to be taken advantage of. Unfortunately this is what many rotations are about, abuse. While on my rotations I faced sexual harassment: homosexual and heterosexual, verbal abuse, unwanted touching, and all types of other needless crap.
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You are making me scared to go on my rotations now!

I thought you are more there to learn than anything else...I am friends with one of my future preceptors and he told me that he never uses his students for "work"...the students are there to learn only.
 
SHC1984 said:
You are making me scared to go on my rotations now!

I thought you are more there to learn than anything else...I am friends with one of my future preceptors and he told me that he never uses his students for "work"...the students are there to learn only.
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Depends on the rotation and preceptor, unfortunately. Retail rotations tend to seem more like "work" than the others, simply because in order to learn, you have to work. There simply isn't time or opportunity in retail to do the didactic things inherent to other areas you rotate through.

As an extremely broad generalization, I'd say that rotations with faculty members tend to be more educational than those with pharmacists employed by the site, but that is a generalization to the point of almost being useless. The best way to figure out what you're getting into is by talking to students who have previously completed the rotation.
 
SHC1984 said:
I thought you are more there to learn than anything else...I am friends with one of my future preceptors and he told me that he never uses his students for "work"...the students are there to learn only.
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That depends on the rotation. My ambulatory and internal medicine rotations were great learning experiences. In my retail and hospital rotations, I was used as a tech a lot of the time (though of course there was some learning involved in both of these). In my hospital rotation, I sometimes had to invent busywork for myself just to stay compliant with the task list provided by my school. My industry rotation was a lot of going to meetings and meeting pharmacists in different practice settings.
 
diplomat said:
Sorry, I misread your post. Thought you meant you were working 16hr/day at your rotation site. Anyway my reply is referring to people who get taken advantage of at rotation sites.

Yes, that is abuse. You need to tell them that you work a total of 40 hours/week (if this is what is required by your school) and tell them they may break up the hours anyway they like. But once your 40 hours are complete, BYE BYE !! If you are working 16 hour days then you should do 16 on Monday, 16 on Tuesday, and 8 on Wednesday. After those 8 are done on Wednesday turn to everyone and say, "See ya next week." Don't allow yourself to be taken advantage of. Unfortunately this is what many rotations are about, abuse. While on my rotations I faced sexual harassment: homosexual and heterosexual, verbal abuse, unwanted touching, and all types of other needless crap.
Click to expand...

Can they really make you work more than 8 hours a day while you are on rotation?
 
Depends. According to our school, pre-rounding does not count as a part of the 8 hours, so that way you could stay 9-10 hours at some clinical sites. Otherwise, there's really no reason you should be there over 8 hours.
 
EBT12 said:
Try to get a community site where you don't have to act as a tech if possible. During my 2 months in a community pharmacy, I only did about 4-8 hours of work per week in the actual pharmacy - and it was almost all counseling. Otherwise, I did flu shots, led MTM visits, taught IPPE students on site, gave lectures at the university, wrote articles etc.
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That sounds really good! Did you do your rotation at a community pharmacy or retail? I don't have much retail experience but I do have a lot of outpatient experience.
 
diplomat said:
You need to tell them that you work a total of 40 hours/week (if this is what is required by your school) and tell them they may break up the hours anyway they like. But once your 40 hours are complete, BYE BYE !! If you are working 16 hour days then you should do 16 on Monday, 16 on Tuesday, and 8 on Wednesday. After those 8 are done on Wednesday turn to everyone and say, "See ya next week."
Click to expand...

That is just ridiculous to me. I'm not saying that you should be spending 80 hours a week at rotation, but most rotations will require more than 40 hours (especially if you're slow at pre-rounding or have a lot to look up regarding your patients during the day). I think the only P4 rotation I put in 40 hours a week for was my community rotation.

We had students telling preceptors that they had already put in their required 160 hours for the rotation so they wouldn't be in again, and it did not go over well. I don't know what the school said to the individual students but the whole class got an angry email reminding us that we were expected to be at rotation Monday-Friday for the duration of the rotation.

If a student on rotation told me they were only going to work 40 hours a week, they would likely get a poor evaluation and no letter of recommendation from me. That isn't to say I expect ridiculous hours, I just think it's a horrible attitude coming into a learning experience.
 
ucrx said:
That is just ridiculous to me. I'm not saying that you should be spending 80 hours a week at rotation, but most rotations will require more than 40 hours (especially if you're slow at pre-rounding or have a lot to look up regarding your patients during the day). I think the only P4 rotation I put in 40 hours a week for was my community rotation.

We had students telling preceptors that they had already put in their required 160 hours for the rotation so they wouldn't be in again, and it did not go over well. I don't know what the school said to the individual students but the whole class got an angry email reminding us that we were expected to be at rotation Monday-Friday for the duration of the rotation.

If a student on rotation told me they were only going to work 40 hours a week, they would likely get a poor evaluation and no letter of recommendation from me. That isn't to say I expect ridiculous hours, I just think it's a horrible attitude coming into a learning experience.
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Ya, I had my 160 hours by the end of my 3rd week on my Internal Med rotation but the school sent a nice reminder out that we're supposed to be there Monday-Friday for the entire month, not just to fill the minimum hourly requirement.

Other thing that helped me, plan out the wardrobe for the whole week on Sunday.
 
Sparda29 said:
Other thing that helped me, plan out the wardrobe for the whole week on Sunday.
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This saved me lots of morning time when I was a student. Iron everything on Sunday, and you save yourself several minutes every morning (or evening). This is especially helpful if you have a hard time adjusting to a new schedule every month/x weeks. I also started getting lazy and didn't iron my shirts (or at least the back) because the white coat hid it... Unfortunately I take my coat off wayyyy too much now to do this!

Post-it notes make good to do lists. Write everything that needs to be looked up on one and keep it at the front of your binder, when you're done and have discussed it with your preceptor you can rip it off and throw it away.
 
ucrx said:
If a student on rotation told me they were only going to work 40 hours a week, they would likely get a poor evaluation and no letter of recommendation from me. That isn't to say I expect ridiculous hours, I just think it's a horrible attitude coming into a learning experience.
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Yeah, and don't be THAT student who watches the clock and is out the door at 5PM no matter what's happening. If we're slammed and patients are waiting, stay and help out. Also, effing something up in the compounding lab and then leaving it for someone else to fix because "you have to work your real job" that night is a no-no. In fact, "end time" in pharmacy are flexible, so it's good for students to get used to that. Yes, our clinic closes at 6PM. But we schedule the last patient at 6PM and sometimes people are late, so be smart and don't arrange to meet someone somewhere at 6:30PM. Students aren't leaving until I leave. In fact, it's often the students who slow down the work flow, so if I'm going to be stuck there, you can bet they will be too. I feel like these principles should be self evident, but apparently they are not. I have run into some very stuck up/entitled/lazy students over the course of the year. 🙁
 
How important are rotation grades for residency? There a hospital that offers few blocks of rotation. They are known to be hard but you learn a lot. I am leaning toward taking them but I am worried that I may not get the best grades. Please advise!
 
your question has been asked and answered a million times. Check the residency thread.
 
ucrx said:
This saved me lots of morning time when I was a student. Iron everything on Sunday, and you save yourself several minutes every morning (or evening). This is especially helpful if you have a hard time adjusting to a new schedule every month/x weeks. I also started getting lazy and didn't iron my shirts (or at least the back) because the white coat hid it... Unfortunately I take my coat off wayyyy too much now to do this!

Post-it notes make good to do lists. Write everything that needs to be looked up on one and keep it at the front of your binder, when you're done and have discussed it with your preceptor you can rip it off and throw it away.
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Ya, for example if I gotta be there at 8AM. I set my alarm for 545AM, but I don't get out of bed till like 645AM. I usually gotta be out of the house by 7:15AM. That leaves me only 1/2 hour to get ready and eat some breakfast.

If not, I'll just pack the clothes in a bag, get to the rotation site early, change at the locker rooms, and then have breakfast in their cafeteria.
 
xtsukiyox said:
What do you wear to the rotation site...?
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I was in a similar situation during my IPPE rotation when I spent a week in an OR pharmacy satellite. I dropped the long sleeve and tie for a polo in case a meeting came up that I had to attend (didn't want to go too casual). I'd go in and change into OR scrubs in the surgery locker room everyday. It was pretty fabulous.
 
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