Third year rotations: Purely shadowing. What to do for fourth year?

[Geraltofrivia]

Hello all,

I'm a DO student. My third year rotations are purely shadowing. I'm now 6-7 months in, I've complained, nothing doing. Nobody cares. I've been shadowing the entire time. Haven't written a single note, haven't done anything. I don't know how to round or do anything. So anyway, I am setting up my fourth year schedule and am wondering how exactly to do it? I would like to go into psychiatry ideally.

I'm quite concerned due to my lack of experience. Does anybody have any suggestions for me? My academic year ends in May and I have the month of June to study for boards. Thank you.

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[cbrons]

Sub internships at outside hospitals. Make sure on your exit survey you make it clear your school violated accreditation standards by shadow-only clerkships.

Sent from my SM-N910P using SDN mobile

 

[cluelessmedstudent411]

Sorry to hear about your 3rd yr experience.

If you're planning on applying to AOA residencies, you should look up psych AOA programs and call/email to set up auditions for 4th yr!

If you're applying ACGME, take a look at VSAS application. That's where you'll be applying from to set up your auditions for 4th yr. Most AOA programs dont use VSAS and fill up quickly so you should get on that ASAP.

 

[Mad Jack]

Hello all,

I'm a DO student. My third year rotations are purely shadowing. I'm now 6-7 months in, I've complained, nothing doing. Nobody cares. I've been shadowing the entire time. Haven't written a single note, haven't done anything. I don't know how to round or do anything. So anyway, I am setting up my fourth year schedule and am wondering how exactly to do it? I would like to go into psychiatry ideally.

I'm quite concerned due to my lack of experience. Does anybody have any suggestions for me? My academic year ends in May and I have the month of June to study for boards. Thank you.

You should come back and report which school you went to post-rotations, that's unacceptable.

 

[ortnakas]

You should come back and report which school you went to post-rotations, that's unacceptable.

Agreed. A crappy rotation or two is par for the course, unfortunately, but seven months without writing a note or rounding really isn't okay.

 

[Geraltofrivia]

Sorry to hear about your 3rd yr experience.

If you're planning on applying to AOA residencies, you should look up psych AOA programs and call/email to set up auditions for 4th yr!

If you're applying ACGME, take a look at VSAS application. That's where you'll be applying from to set up your auditions for 4th yr. Most AOA programs dont use VSAS and fill up quickly so you should get on that ASAP.

I am planning on applying to ACGME residencies.

 

[Geraltofrivia]

Sub internships at outside hospitals. Make sure on your exit survey you make it clear your school violated accreditation standards by shadow-only clerkships.

Sent from my SM-N910P using SDN mobile

Sorry for double post. How can I best "catch up" before starting the sub-internship? I am there to try to impress and now I'm afraid I will instead be catching up.

 

[deutsche]

/deleted

 

[cbrons]

Sorry for double post. How can I best "catch up" before starting the sub-internship? I am there to try to impress and now I'm afraid I will instead be catching up.

Sadly not much. Your experience is becoming more and more common these days, for reasons which have been discussed at length in Allopathic. The simple fact is that certain tasks are difficult to learn without adequate on-the-job training.

H&P skills including oral case presentation skills should be high on your priority list at this point. You can also check out FOAM resources and try to learn next-level management stuff on your own.

I suggest also scheduling sub-Is outside of your home institution. I did 5 of them this year.

Sent from my SM-N910P using SDN mobile

 

[Geraltofrivia]

Sadly not much. Your experience is becoming more and more common these days, for reasons which have been discussed at length in Allopathic. The simple fact is that certain tasks are difficult to learn without adequate on-the-job training.

H&P skills including oral case presentation skills should be high on your priority list at this point. You can also check out FOAM resources and try to learn next-level management stuff on your own.

I suggest also scheduling sub-Is outside of your home institution. I did 5 of them this year.

Sent from my SM-N910P using SDN mobile

What are FOAM resources and where can I look them up? I was going to try to schedule my sub-Is outside of my home institution as well

 

[KShah1]

What are FOAM resources and where can I look them up?

Disappointing for someone so gung-ho.

http://lmgtfy.com/?q=FOAM+resources

 

[ortnakas]

Sorry for double post. How can I best "catch up" before starting the sub-internship? I am there to try to impress and now I'm afraid I will instead be catching up.

Is your rotation with residents? Can you ask for something to do? "I want to work on case presentations, can I practice presenting this patient to you?", write notes on patients you see and ask for feedback, things like that. You could try to be proactive if you're with attending preceptors as well, but it might be a little trickier. (Also, I had one elective rotation I was excited for that turned out to be vitals + shadowing, so I get that it sucks and sometimes being proactive isn't possible, but I figured I'd throw it out there).

 

[Geraltofrivia]

Is your rotation with residents? Can you ask for something to do? "I want to work on case presentations, can I practice presenting this patient to you?", write notes on patients you see and ask for feedback, things like that. You could try to be proactive if you're with attending preceptors as well, but it might be a little trickier. (Also, I had one elective rotation I was excited for that turned out to be vitals + shadowing, so I get that it sucks and sometimes being proactive isn't possible, but I figured I'd throw it out there).

Unfortunately I tried that and it just didn't work. I have no residents and am directly with attendings. It would usually go something like "Yeah sure let's do it" and as I'd present they would pay zero attention. Then when I tried to review the notes they would just take it, look it over, put a check in the corner and I'd be on my merry way. No feedback.

 

[Giovanotto]

I have nothing to add here, but I really feel for you. Definitely hope it's not like this for me in a couple of years, I'd be heated.

 

[floridaorbust]

Hello all,

I'm a DO student. My third year rotations are purely shadowing. I'm now 6-7 months in, I've complained, nothing doing. Nobody cares. I've been shadowing the entire time. Haven't written a single note, haven't done anything. I don't know how to round or do anything. So anyway, I am setting up my fourth year schedule and am wondering how exactly to do it? I would like to go into psychiatry ideally.

I'm quite concerned due to my lack of experience. Does anybody have any suggestions for me? My academic year ends in May and I have the month of June to study for boards. Thank you.

Are you alone at your clinical site? If not can your group complain together? They might not listen to one voice but if everyone speaks up they need to look into it. Especially if they plan on sending more students there.

If I were you I'd start with a low stress rotation in an academic setting to learn how to round. It isn't difficult but practicing how to present is important. Try reading this: https://meded.ucsd.edu/clinicalmed/oral.htm, present to friends who have more traditional rotations.

 

[orthogenes]

Unfortunately I tried that and it just didn't work. I have no residents and am directly with attendings. It would usually go something like "Yeah sure let's do it" and as I'd present they would pay zero attention. Then when I tried to review the notes they would just take it, look it over, put a check in the corner and I'd be on my merry way. No feedback.

So keep writing the notes. It's still worth something to write them. And keep asking. Sometimes getting feedback is about persistence.


Still, that sucks that you are having such a boring third year.

 

[byaaaaaaah23]

Spend some time reading charts of patients on your service to get an idea of what good notes and bad notes look like-- it's too bad you aren't able to get one on one feedback but hopefully you can pick up a lot this way too.

 

[KShah1]

It sounds like the problem isn't with the rotation:

You never rounded?

No feedback?

What exactly is the issue here?

 

[Geraltofrivia]

It sounds like the problem isn't with the rotation:

View attachment 214190

You never rounded?

View attachment 214194

No feedback?

View attachment 214195
View attachment 214196


What exactly is the issue here?

Hey thanks. That was my first surgery rotation, I have since not really wanted to do surgery either. All my rotations since then have been shadowing unfortunately. I haven't presented patients. I haven't written notes. I haven't really done much. I've complained and nothing doing. So, the issue is I just don't really know what I'm doing. I'm just shadowing. That's the issue.

 

[spartanracer21]

@Geraltofrivia check your PM. What school do you go to?

 

[ortnakas]

Hey thanks. That was my first surgery rotation, I have since not really wanted to do surgery either. All my rotations since then have been shadowing unfortunately. I haven't presented patients. I haven't written notes. I haven't really done much. I've complained and nothing doing. So, the issue is I just don't really know what I'm doing. I'm just shadowing. That's the issue.

What rotations have you had since surgery?
Are other students having the same issues?
Is there a clinical education coordinator or someone you can talk to?

 

[spartanracer21]

??? any update?

 

[LUCPM]

It's very unfortunate that COCA is allowing schools run their clinical education like this. The only thing you can do now is to do your 4th year rotations at bigger teaching hospitals that are associated with residency programs.

 

[spartanracer21]

are community hospital typically where clerkship turns into shadowing?

 

[IslandStyle808]

are community hospital typically where clerkship turns into shadowing?

Nah, if there are community hospitals with residency programs it is less likely to happen (doesn't mean it can't happen in this setting or even an academic one). On the other hand, if your rotation is done with just a preceptor, it is more likely to turn into a shadowing experience (doesn't mean it will turn into one). However, there is always a pattern (ex. preceptor rotations, small office rotation, constant last minute change of rotation site).

 

[ortnakas]

are community hospital typically where clerkship turns into shadowing?

Community hospitals aren't necessarily more likely to keep you in shadowing territory. In some instances, you're actually likely to get more hands-on experience at a community hospital because there are fewer or no interns around who need the procedures more than you (the pros and cons of this phenomenon are described all over SDN so I won't get into it).

Also, I aree with @IslandStyle808. Preceptor-based rotations can be good if they let you "do stuff," and I've had some friends get a lot of hands-on experience at these rotations, but they're far more likely to be the shadowing variety than if you're with a team of residents.