THird/fourth year details

[toothless rufus]

Ok, just how bad are they? From what I've read on SDN, they sound horrible, and its kinda freaking me out! What kind of hours are typical: weekly, daily? What's the average amount of personal time? Do you get a vacation during the year? Can you have a life?

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[Law2Doc]

Ok, just how bad are they? From what I've read on SDN, they sound horrible, and its kinda freaking me out! What kind of hours are typical: weekly, daily? What's the average amount of personal time? Do you get a vacation during the year? Can you have a life?

Third and fourth year are night and day. Fourth year is very reasonable hours (often 9-5 with the opportunity to schedule in nice vacation time). The only catches in 4th year are that you have to apply and interview for residencies, which is an ordeal, you will have to do sub-Is and away rotations which can have more intense hours for a month or two, and you have to take the two parts of Step 2.

Third year, by contrast, will be your hardest year of medical school. Most people find it "better" because you finally get out of the classroom and onto the wards, but the hours in some rotations will be rough. in-patient medicine, in-patient OB/GYN and surgery all tend to have the longest hours. Being on-call, meaning you don't get to leave the wards for 30 hours, can occur as frequently as every 3rd or 4th night on some portions of these rotations. In surgery, it's not uncommon to have to be in the hospital before 5am (it's a very morning oriented field). And not getting days off on the weekends during parts of these rotations is not uncommon. The biggest issue tends to be that your time is not your own during third year. You really can't schedule things. Also bear in mind that there tends to be a shelf exam at the end of each rotation, so you are expected to be studying for an hour or two each day after your 13 hours on the wards. On some rotations there will be down time during the day to study, but others not. And you will frequently be pimped on your lack of knowledge and have to spend time looking up things you don't get right. And you will have presentations during some rotations that you have to prepare for. So yeah, it's rough. An ordeal to get through. you will also have your share of outpatient things, and the less hour intense (more 8-5) rotations like family medicine and psych, to break up the intensity.
You will probably get the major federal holidays off (memorial day, labor day, thanksgiving) and will likely get a winter break (xmas to new years). Usually not much of a summer break after third year -- maybe a week before 4th year starts.

 

[toothless rufus]

Third and fourth year are night and day. Fourth year is very reasonable hours (often 9-5 with the opportunity to schedule in nice vacation time). The only catches in 4th year are that you have to apply and interview for residencies, which is an ordeal, you will have to do sub-Is and away rotations which can have more intense hours for a month or two, and you have to take the two parts of Step 2.

Third year, by contrast, will be your hardest year of medical school. Most people find it "better" because you finally get out of the classroom and onto the wards, but the hours in some rotations will be rough. in-patient medicine, in-patient OB/GYN and surgery all tend to have the longest hours. Being on-call, meaning you don't get to leave the wards for 30 hours, can occur as frequently as every 3rd or 4th night on some portions of these rotations. In surgery, it's not uncommon to have to be in the hospital before 5am (it's a very morning oriented field). And not getting days off on the weekends during parts of these rotations is not uncommon. The biggest issue tends to be that your time is not your own during third year. You really can't schedule things. Also bear in mind that there tends to be a shelf exam at the end of each rotation, so you are expected to be studying for an hour or two each day after your 13 hours on the wards. On some rotations there will be down time during the day to study, but others not. And you will frequently be pimped on your lack of knowledge and have to spend time looking up things you don't get right. And you will have presentations during some rotations that you have to prepare for. So yeah, it's rough. An ordeal to get through. you will also have your share of outpatient things, and the less hour intense (more 8-5) rotations like family medicine and psych, to break up the intensity.
You will probably get the major federal holidays off (memorial day, labor day, thanksgiving) and will likely get a winter break (xmas to new years). Usually not much of a summer break after third year -- maybe a week before 4th year starts.

Thanks for the great post! Lots of good info. (Most) weekends and holidays off! Hooray!! And fourth year sounds nice!

 

[Law2Doc]

Thanks for the great post! Lots of good info. (Most) weekends and holidays off! Hooray!! And fourth year sounds nice!

I'm not sure I said most weekends. I said having to work through weekends is not uncommon during some rotations. And a lot of the ones you get off are going to be spent sleeping and studying for the shelf.

 

[toothless rufus]

I'm not sure I said most weekends. I said having to work through weekends is not uncommon during some rotations. And a lot of the ones you get off are going to be spent sleeping and studying for the shelf.

Ah. Thanks for the clarification. So, then anticipate maybe most weekends on. Not so good. I see the ugly potential for months without a day off. That kind of scheduling seems unnecessarily brutal. And there's no way I will do anything remotely related to medical school on a precious day off!

 

[BigRedBeta]

Ok, just how bad are they? From what I've read on SDN, they sound horrible, and its kinda freaking me out! What kind of hours are typical: weekly, daily? What's the average amount of personal time? Do you get a vacation during the year? Can you have a life?

Agree with Law2doc that they're busier/more time consuming, but I can't say that third year was harder in my opinion. I was miserable the first two years - by the end I probably could have gotten a diagnosis of dysthymia - but going to the hospital every day is soooo much better.

A couple things: remember how much med students in general love to complain. Add to that the anonymity of the internet, and the one-ups-manship of SDN, and being an M3 sounds like the worst thing ever. You'll get a much much much more accurate picture of third year from the older students at your school. They're the ones you should be asking this question, because they're actually going through the schedules you'll confront.

If you can't have a life outside of medicine during the third year, then you're doing it wrong. You do lose control over your time to a great extent, but you have to make time for the things that are important to you, the things that will keep you sane and the things that you REALLY want to do. But you won't be able to do everything you want, and you absolutely have to be flexible. That might mean missing the friday night premiere of a movie and seeing it on tuesday night, that might mean working out some days at 2:30pm and other days at 8pm.

 

[elr1983]

Ah. Thanks for the clarification. So, then anticipate maybe most weekends on. Not so good. I see the ugly potential for months without a day off. That kind of scheduling seems unnecessarily brutal. And there's no way I will do anything remotely related to medical school on a precious day off!

Good post above. Just wanted to add that it won't be months....at my school, we're supposed to have 1 day off in 7 or 2 in 14. It doesn't always happen that way, but generally, the residents and attendings are pretty good about looking out for us. (Other schools may be less so.) So yes, you're working a lot but even on the busiest rotations, the most I ever worked in a row was 14 days. Also, on the weekends, if I wasn't on call, all I was expected to do was come in, help pre-round, stay through rounds and then sometimes help with some floor work after if the census was really high. Even still, I often got to go home at 11 or 12, especially on surgery b/c they rounded so early. Finally, the weekends between rotations were weekends off because all our shelf exams are given on friday mornings. So yea...it's a really busy year, but there is some time off!

 

[Law2Doc]

the most I ever worked in a row was 14 days. Also, on the weekends, if I wasn't on call, all I was expected to do was come in, help pre-round, stay through rounds and then sometimes help with some floor work after if the census was really high. Even still, I often got to go home at 11 or 12, especially on surgery b/c they rounded so early.

It's not unheard of to go more than 14 days without a day off in some rotations. And when you do get a day off, it's not unheard of for it not to be on a weekend. As for just coming in and rounding on the non-call weekends, sometimes it works out that way, but all too frequently I found the rounds lasting longer than you suggest and are followed by a variety of scut, so you might find yourself not getting out until closer to 2 or 3.

 

[JustPlainBill]

To put this into perspective-- pause and consider what other professions are doing in terms of time....

Police work -- rookies start out with night shift and usually aren't paid real well. Most have to work another job so their weekends/time off is sometimes spent in other places (malls, banks, etc.) where a cop is wanted as a presence.

Computer science/software engineering - during a development cycle, all bets are off. You can count on long days (14 hours is the norm), some all nighters (usually one or two every two weeks) and definitely weekends -- usually saturdays until around 4 and sunday afternoon/evenings --- can go on for weeks/months at a time.

In place where people have been laid off, some work a full time job and two part timers just to keep famlies going......

If you're looking for an 8 to 5 with no weekends, you're in the wrong decade/century. That's not meant to be sarcastic but just a reality check. In the business world, there's hundreds of people out there just like you waiting to fill you slot, so get to work - is the general attitude from management. Usually for half the pay -- can you say outsourcing?

So, turn the pain into pleasure -- you get to see more patients, fill your head with more medical knowledge and really enjoy your chosen profession. Think of this as a chance to learn and make the most of an opportunity to build a firm foundation. Then, 5 years from now when people are in your office and they say,'What do we do, Doctor?' you'll have all this experience to draw on and give them a solid, well informed response.....

 

[smq123]

To put this into perspective-- pause and consider what other professions are doing in terms of time....

So, turn the pain into pleasure -- you get to see more patients, fill your head with more medical knowledge and really enjoy your chosen profession. Think of this as a chance to learn and make the most of an opportunity to build a firm foundation.

While I agree with the gist of your post, please, please, please - learn NOW that "longer rotations hours" do NOT equal "seeing more patients." Nor does it necessarily mean filling your head with more medical knowledge. There is an extremely real possibility that it will mean sitting around in a corner waiting for a resident who has forgotten all about you.

 

[Law2Doc]

To put this into perspective-- pause and consider what other professions are doing in terms of time....

Not sure if I agree with your use of profession as a synonym for job (an organized profession has certain duties and obligations and rules of conduct of its membership and policing arms a job doesn't), but yeah, I worked at least part of every weekend during my first year out of law school. It's part of being a professional -- you unfortunately have to learn by being there, being the grunt.

There are 8 to 5 jobs in life, but they tend not to be in the professions. And for sure aren't in the training years leading up to being a professional.

 

[NPR]

While I agree with the gist of your post, please, please, please - learn NOW that "longer rotations hours" do NOT equal "seeing more patients." Nor does it necessarily mean filling your head with more medical knowledge. There is an extremely real possibility that it will mean sitting around in a corner waiting for a resident who has forgotten all about you.

This was the biggest source of complaints from 3rd years at my school.

It's not the long hours. It's WHY the long hours are present.

There were days in OB clinic I was asked to stay even though not a single patient wanted to see a medical student.

I was fortunate enough to have residents in medicine that would send me home once rounds were done because they knew nothing else was left for me. But those godsends-of-a-resident are few and far in between.

Even on surgery call, I was never woken up in the middle of a night for a call. But then the question becomes, why ask me to stay here? Why can't I just go home?

And oddly enough, pediatrics was one of the worst time waster rotations. I'd be putting in 12 hour days but 6 of them were spent bugging the resident on what to do next. The entire team had 6 patients total (1 chief, 2 interns, 2 sub-I's, 2 MS3) so I'm sitting there wondering if I really have to stay until signout.

 

[Ypo.]

To put this into perspective-- pause and consider what other professions are doing in terms of time....

Police work -- rookies start out with night shift and usually aren't paid real well. Most have to work another job so their weekends/time off is sometimes spent in other places (malls, banks, etc.) where a cop is wanted as a presence.

Computer science/software engineering - during a development cycle, all bets are off. You can count on long days (14 hours is the norm), some all nighters (usually one or two every two weeks) and definitely weekends -- usually saturdays until around 4 and sunday afternoon/evenings --- can go on for weeks/months at a time.

In place where people have been laid off, some work a full time job and two part timers just to keep famlies going......

If you're looking for an 8 to 5 with no weekends, you're in the wrong decade/century. That's not meant to be sarcastic but just a reality check. In the business world, there's hundreds of people out there just like you waiting to fill you slot, so get to work - is the general attitude from management. Usually for half the pay -- can you say outsourcing?

So, turn the pain into pleasure -- you get to see more patients, fill your head with more medical knowledge and really enjoy your chosen profession. Think of this as a chance to learn and make the most of an opportunity to build a firm foundation. Then, 5 years from now when people are in your office and they say,'What do we do, Doctor?' you'll have all this experience to draw on and give them a solid, well informed response.....

Disagree. I worked 70 hours a week for a year prior to starting medical school. It doesn't compare to third year, and I guarantee it doesn't compare to residency.

Working two part time jobs is hard, but it is not as physically (usually) or mentally challenging as third year. Psychologically speaking I haven't really done anything more challenging than third year (yet).

 

[Ypo.]

Even on surgery call, I was never woken up in the middle of a night for a call. But then the question becomes, why ask me to stay here? Why can't I just go home?

Dude, you got the long end of the stick. Do you know how happy I was when I got to sleep 2 hours on a 30 hour call? (that happened all of two times during 2 months of surgery).

But yes, third year is a lot of waiting around. I always had something to read in my pocket. But then I would worry about not looking professional or interested enough. I even had a few neurotic residents tell me that I should be reading on my own time. (like my time during third year was being paid for by someone else?)

 

[elr1983]

It's not unheard of to go more than 14 days without a day off in some rotations. And when you do get a day off, it's not unheard of for it not to be on a weekend. As for just coming in and rounding on the non-call weekends, sometimes it works out that way, but all too frequently I found the rounds lasting longer than you suggest and are followed by a variety of scut, so you might find yourself not getting out until closer to 2 or 3.

OK. That's your experience. I'm pretty sure I'm not wrong about mine. I'm also pretty sure I made it clear in my post that this is the way things are at my school, in my experience and that not all schools/rotations work that way.

 

[OnMyWayThere]

People come here to vent... so you are reading posts from people who were recently PISSED OFF!! It's not nearly as bad as it sounds. I was terrified before 3rd year too but it was the complete opposite of what I feared for months leading up to my first rotation. Chill out and have fun. The more relaxed and non-gunnerish you are, the better your grades (at least that how it was for me compared to people I was rotating with). I do have to disclaim that I chose the "easier" sites that had the least call and weekends possible.

 

[Ypo.]

People come here to vent... so you are reading posts from people who were recently PISSED OFF!! It's not nearly as bad as it sounds. I was terrified before 3rd year too but it was the complete opposite of what I feared for months leading up to my first rotation. Chill out and have fun. The more relaxed and non-gunnerish you are, the better your grades (at least that how it was for me compared to people I was rotating with). I do have to disclaim that I chose the "easier" sites that had the least call and weekends possible.

Ha ha. That's true. But certain rotations don't want you to appear relaxed. (not mentioning names).

 

[Law2Doc]

People come here to vent... so you are reading posts from people who were recently PISSED OFF!! It's not nearly as bad as it sounds. I was terrified before 3rd year too but it was the complete opposite of what I feared for months leading up to my first rotation. Chill out and have fun. The more relaxed and non-gunnerish you are, the better your grades (at least that how it was for me compared to people I was rotating with). I do have to disclaim that I chose the "easier" sites that had the least call and weekends possible.

Nah, I don't see too much venting on here. Third year is long hours and no control over your hours and a shelf at the end of each rotation, and largely subjective grading. No way around any of that for most of us (if your "easier sites" let you avoid this, then I'm afraid most of us simply didn't have that cushy option). It doesn't mean third year is "bad", just means it's different than anything you will have done prior (and so timewise it is harder than the prior two years). I think it's hard to deny the following facts about third year: You WILL be sleep deprived at times during third year. You WILL be getting up in the dark and coming home in the dark at many times during third year. You WILL be doing overnight calls. You WILL be working many weekends. You WILL be standing on your feet until they are sore during some rotations. If you read my initial post in this thread, I don't think I wrote anything that isn't accurate or is exaggerated about what some of us actually experienced.

These are truisms, not venting. I agree you can (and should) try to be as relaxed and non-gunnerish as you can. But it doesn't make the number of hours on the wards any fewer. Too many people on SDN try to sweep away comments they don't like by asserting that folks are "venting" or "PO'ed" or "exaggerating". But I think all too often it's an excuse to stick your head in the sand and ignore the facts -- you are just kidding yourself. The facts are that for most, the hours will be long, working throughout the night every 3rd or 4th night during portions of rotations is tough on your sleep cycle no matter how you slice it, you don't get nearly the number of weekends off you want, and there are no shoes that won't hurt during an 8 hour surgery. And I'm coming from the perspective of someone who actually enjoyed a lot of aspects of that year. But hey, believe what you want.

 

[njbmd]

Ok, just how bad are they? From what I've read on SDN, they sound horrible, and its kinda freaking me out! What kind of hours are typical: weekly, daily? What's the average amount of personal time? Do you get a vacation during the year? Can you have a life?

Have you spoken with any of the students at your school that are currently in third year or fourth year? My guess is that they are not running around enduring any "horrible" conditions. Your upper class folks are the best source of amount of free time and vacation time as this varies from school to school and rotation to rotation.

Yes, you do have to take overnight call on some rotations at most schools and yes, your hours may be longer than when you were sitting in class but third and fourth year mirror what you are likely to be doing for the rest of your life rather than first and second year where you are sitting in class.

Most people would rather take constant overnight call rather than sit in a classroom any day.

 

[Law2Doc]

Most people would rather take constant overnight call rather than sit in a classroom any day.

I'm not sure the volume of people competing for lifestyle specialties these days bears this statement out.

 

[OHMAN0125]

Nah, I don't see too much venting on here. Third year is long hours and no control over your hours and a shelf at the end of each rotation, and largely subjective grading. No way around any of that for most of us (if your "easier sites" let you avoid this, then I'm afraid most of us simply didn't have that cushy option). It doesn't mean third year is "bad", just means it's different than anything you will have done prior (and so timewise it is harder than the prior two years). I think it's hard to deny the following facts about third year: You WILL be sleep deprived at times during third year. You WILL be getting up in the dark and coming home in the dark at many times during third year. You WILL be doing overnight calls. You WILL be working many weekends. You WILL be standing on your feet until they are sore during some rotations. If you read my initial post in this thread, I don't think I wrote anything that isn't accurate or is exaggerated about what some of us actually experienced.

These are truisms, not venting. I agree you can (and should) try to be as relaxed and non-gunnerish as you can. But it doesn't make the number of hours on the wards any fewer. Too many people on SDN try to sweep away comments they don't like by asserting that folks are "venting" or "PO'ed" or "exaggerating". But I think all too often it's an excuse to stick your head in the sand and ignore the facts -- you are just kidding yourself. The facts are that for most, the hours will be long, working throughout the night every 3rd or 4th night during portions of rotations is tough on your sleep cycle no matter how you slice it, you don't get nearly the number of weekends off you want, and there are no shoes that won't hurt during an 8 hour surgery. And I'm coming from the perspective of someone who actually enjoyed a lot of aspects of that year. But hey, believe what you want.

It sure sounds like ur venting to me. Lol. Nothing wrong with that though. I feel you.

Just want to add, that everyone gets through 3rd yr so dont worry, u'll make it, just stick to it.

 

[Law2Doc]

everyone gets through 3rd yr so dont worry, u'll make it, just stick to it.

Agree. It's hard. It's supposed to be hard. But nobody dies from it. (except maybe a patient or two, or perhaps if you fall asleep at the wheel).

And no, I'm really not venting. I just think folks shouldn't get blindsided, that's sort of been my self-defined role on SDN. Too many leap before they look.

 

[surrender903]

first and second year your "job" was to go to class and learn.

now third and fourth year your "job" is to go to a hospital/clinic/morgue/OR. you wanted to be a doctor right? every month you learn what it is like to do a specefic job.

as a side note its easy to be bright eyed and bushy tailed when its nice and warm, wait till december and hope you arent in long rotation where you get up at dark and come home at dark with the holiday season looming. Do you remember that simpsons episode where bart is stuck studying in the house while everyone is enjoying "snow day?" thats december in a hospital.

what got me through that month was the luck of only being on call three times that month and having an OR with a window that I could see snowy Philadelphia.

 

[OHMAN0125]

first and second year your "job" was to go to class and learn.

now third and fourth year your "job" is to go to a hospital/clinic/morgue/OR. you wanted to be a doctor right? every month you learn what it is like to do a specefic job.

as a side note its easy to be bright eyed and bushy tailed when its nice and warm, wait till december and hope you arent in long rotation where you get up at dark and come home at dark with the holiday season looming. Do you remember that simpsons episode where bart is stuck studying in the house while everyone is enjoying "snow day?" thats december in a hospital.

what got me through that month was the luck of only being on call three times that month and having an OR with a window that I could see snowy Philadelphia.

Have to say that once 3rd yr is over, 4th is sweet. There is still alot of other stuff to do though(Applying, personal statement, Step2). But overall, at least for my school, i really only have a sub-i left and then that's it. Lol. Everything else is electives and some other random stuff the school makes u do but is basically irrelevant.

 

[marie337]

While I agree with the gist of your post, please, please, please - learn NOW that "longer rotations hours" do NOT equal "seeing more patients." Nor does it necessarily mean filling your head with more medical knowledge. There is an extremely real possibility that it will mean sitting around in a corner waiting for a resident who has forgotten all about you.

Also, not being allowed to sleep at all overnight because the surgical resident wants to discuss why surgeons are more intelligent and superior to internists . At 3 am that is just not necessary!! That is definitely one downfall of the resident night float system. They come in all ready to go and are expected to stay up all night.

 

[cubsrule4e]

as a side note its easy to be bright eyed and bushy tailed when its nice and warm, wait till december and hope you arent in long rotation where you get up at dark and come home at dark

True that the Vitamin D deficiency kicks in, but at least here, you cant beat a January trauma call like I had....instead of going out and shooting each other up, everyone just stays at home during the night cause its too damn cold

 

[Law2Doc]

True that the Vitamin D deficiency kicks in, but at least here, you cant beat a January trauma call like I had....instead of going out and shooting each other up, everyone just stays at home during the night cause its too damn cold

Well, you might lose the gunshot wounds but would get all the car crashes from folks who can't drive in the snow, and all the old people who slip on their icy sidewalks.

 

[yohimbine1]

I slipped on an icy sidewalk last year and took a hard fall. I was hurting for several days at least. It's easy to see now how people get serious injuries from it. That ice is unforgiving.

 

[Ypo.]

Also, not being allowed to sleep at all overnight because the surgical resident wants to discuss why surgeons are more intelligent and superior to internists . At 3 am that is just not necessary!! That is definitely one downfall of the resident night float system. They come in all ready to go and are expected to stay up all night.

Ahhhhh...the memories. I wonder when they'll shift students to the nightfloat system. When they're good and done with torturing us I suspect.

 

[cubsrule4e]

Well, you might lose the gunshot wounds but would get all the car crashes from folks who can't drive in the snow, and all the old people who slip on their icy sidewalks.

No snow in Louisiana ....at least not since the 2002 Sugar Bowl