Third year rotation advice

[deleted648625]

I will be starting my third year with surgery and part of the rotation includes an elective specialty month, I have been assigned urology and I am super pumped, since it is my top choice at the moment. However, I am apprehensive about having it first without really knowing anything about clinical medicine. Is there any advice for me to impress and connect with mentors without having a solid clinical foundation yet?

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[cpants]

Just show up early, work hard, read for your cases. Suggest reading about kidney stones/acute stone episode, hematuria evaluation (prime pimp question), BPH, PSA and prostate cancer. Good idea to practice tying knots, basic suturing if at all possible -- this is really all you will be allowed to do in OR anyway.

 

[DoctwoB]

In addition to the above, do your best to make yourself useful to the rounding team of residents. Get there early and print the list/get numbers for the team or help the intern to do so. If your EMR allows, pre-write progress notes for the intern to take over and sign. Carry a bag of useful supplies, including saline flushes, empty syringes for foley removals, suture removal kits/staple removers for removing drains/staples etc. Basically in your first couple days see what you could do to make rounds run smoother/faster and then do it.

Most of these things are more what we would expect an AI/subI to do rather then a 3rd year on your first rotation, but if you can manage all that without being in the way you will stand out. The residents will see this more then the attendings, but we are the ones who generally give the attendings feedback regarding the med students.

 

[JeBrAs]

For studying I recommend starting by reading the sections in the Medical Student Curriculum on the AUA website. Gives you a good general overview of Urology and its free! For reading up on your surgery cases you will be involved with I recommend Hinman's Atlas of Urological Surgery. As for working with the residents be present yet invisible, interested but not annoying, and silent until invited in on conversations. You don't need to know all the answers or how to do all the procedures but show improvement in skills and growth in knowledge over the course of the rotation. Always be willing to give things a try (be a yes man) but also don't be afraid to admit when you have never done something before and need a walk through. And lastly, smile and enjoy the occasional penis joke!

 

[deleted648625]

Thanks everyone for the advice. I am very eager to learn and I hope it comes through in person.

 

[A_UROLOGY_RESIDENT]

@CirclingtheDrain @JeBrAs @DoctwoB @cpants

I also wanted to say thanks for the great replies since I have a urology rotation coming up the end of my third year as well. What would you say are the expectations for a Sub-I or away rotation? Any tips on how to shine during those rotations?

 

[JeBrAs]

Each site has their own expectations for Sub-Is so just follow what they tell you to do when you get there. Some sites want you in the OR almost 100% of the time, others want to see you in clinic as well as the OR. As for rounding on patients, that is also site dependent as to how they want you to participate in that. Some places just want you to just show up for team rounds others will assign you patients you will round on your own. In the OR you are expected to know information about the patients and the surgical procedures that you will be scrubbed in on. Most places will assign you a presentation to give at grand rounds sometime during the rotation. The presentation requirements are also site dependent, it could range from giving a simple talk on an interesting surgery you saw or a big in-depth presentation in front of the whole department that needs to be very professional/formal. You will also be required to show up to didactics every week.

As for shining on rotations aside from what has already been mentioned above. Here are the classics: arrive early, stay late, be on time for all meetings. Show interest even if it is not super exciting. Study up on the surgery cases and patient information. Find ways to be helpful (rotation dependent) as mentioned above, help the intern with starting notes, carry around supplies during rounds and gain the trust to change bandages, pull drains etc on your own (super helpful in keeping rounds going at a good pace). Rounding on the weekends is also site dependent, some places it is expected, some places it is a way to shine and some will say do not come in on weekends. Also if there are 3rd year medical students there, work with them and show them the ropes, your efforts won't go unnoticed. Personality is very important in Urology so make sure to hang out with the residents while at work and show up and have a good time at social get togethers outside of work.