Trauma Elective in the US- any advice?

[Mordecai]

Hi,

I'm a 4th year Monash Uni med-student (undergrad med). I'm trying to arrange a trauma elective in the US for next year. I'd ideally like to be somewhere that has decent exposure to penetrative and blunt force trauma.
Why?.... Guess it's cause I am the deranged type who would like to fix trauma for a living!!

I haven't come across any Aussies who have done something similar so I am a bit stuck for ideas.

Thanks for any ideas you may have.

---

Members don't see this ad.

 

[pitman]

Hi,

I'm a 4th year Monash Uni med-student (undergrad med). I'm trying to arrange a trauma elective in the US for next year. I'd ideally like to be somewhere that has decent exposure to penetrative and blunt force trauma.
Why?.... Guess it's cause I am the deranged type who would like to fix trauma for a living!!

I haven't come across any Aussies who have done something similar so I am a bit stuck for ideas.

Thanks for any ideas you may have.

4th year UQ students do electives at Mt. Sinai in NYC every year, so I know they're receptive to Aussie students. From my understanding they see a fair amount of trauma.

 

[Winged Scapula]

I have no idea whether the following accept foreign students for clerkships but these are considered some of the premiere places for trauma in the US:

Baltimore Shock Trauma
USC/LA County Gen
Jackson Memorial Ryder
UT Memphis
Cook County
Baylor
Parkland
VCU
the entire state of New Jersey (especially Camden and Newark)

(there are many others, this is just to get you started)

 

[Mordecai]

Jackson memorial have been in touch with me, offering what they call an "externship".

They stress that I cannot touch patients and will just be doing an observership (understandable ). The insurance coverage they mention is huge but doable, there is a $250 fee but they state that will not be providing me with any document stating that I was there
Does this differ from anything else I might get elsewhere?

P.

 

[Ezekiel20]

A medical student wanting to become a trauma surgeon won't raise any eyebrows anywhere.

Unless your school has official ties with US hospitals/universities, it's a matter of contacting them directly and enquiring about the process. There is often a hefty fee, but it's a good opportunity for exposure to something different.

The 'observership' sounds reasonable, there is not much you can offer as a student during a trauma resuscitation or surgery.

It will definately open your eyes to major penetrating trauma, which we (thankfully) see very little of in Australia - even where I work currently, emergency department in a major trauma centre in Sydney.


Good luck

 

[Winged Scapula]

Jackson memorial have been in touch with me, offering what they call an "externship".

They stress that I cannot touch patients and will just be doing an observership (understandable ). The insurance coverage they mention is huge but doable, there is a $250 fee but they state that will not be providing me with any document stating that I was there
Does this differ from anything else I might get elsewhere?

P.

I don't think that sounds reasonable but it depends on your goals. If your goal is to simply watch and hang around, I suppose it would be sufficient.

But if your goal is to either get a US residency or get into the thick of things, it is not sufficient. The problem (I think) is that if you are applying as anything other than a final year medical student, you are generally not eligible for electives. Whomever you spoke with probably thought you would be a graduated physician next year (I'm assuming Monash undergrad med is 5-6 years right?). Graduated physicians are not eligible for anything other than an observership. Remember most program coordinators in the US would have no idea about undergrad medicine outside of the US and if you said something about being a 4th year medical student, they probably assumed that next year you will have graduated.

Medmal is a big deal however; if Monash is not providing it to you, you may find that your opportunities to do anything other than watch are limited. You must get malpractice insurance that will cover you in the US. Many years ago when I did a rotation at Baylor they provided it as part of the rotation. Not sure if they still do, most program don't.

I cannot fathom why they won't be providing you with any documentation that you were there. Again, it goes back to what your goals are. I see no sense in coming here without getting school credit for it - ie, a real clerkship. If Ryder won't give it to you, look at some other places. Unless I'm missing something, I don't think what their offering you is worth much at all. Almost anywhere with a Level 1 trauma center in the US is going to give you more action than you will see in Australia. J-burg or Cape Town are also popular, as you probably know.

 

[Raigon]

I don't think that sounds reasonable but it depends on your goals. If your goal is to simply watch and hang around, I suppose it would be sufficient.

But if your goal is to either get a US residency or get into the thick of things, it is not sufficient. The problem (I think) is that if you are applying as anything other than a final year medical student, you are generally not eligible for electives. Whomever you spoke with probably thought you would be a graduated physician next year (I'm assuming Monash undergrad med is 5-6 years right?). Graduated physicians are not eligible for anything other than an observership. Remember most program coordinators in the US would have no idea about undergrad medicine outside of the US and if you said something about being a 4th year medical student, they probably assumed that next year you will have graduated.

Medmal is a big deal however; if Monash is not providing it to you, you may find that your opportunities to do anything other than watch are limited. You must get malpractice insurance that will cover you in the US. Many years ago when I did a rotation at Baylor they provided it as part of the rotation. Not sure if they still do, most program don't.

I cannot fathom why they won't be providing you with any documentation that you were there. Again, it goes back to what your goals are. I see no sense in coming here without getting school credit for it - ie, a real clerkship. If Ryder won't give it to you, look at some other places. Unless I'm missing something, I don't think what their offering you is worth much at all. Almost anywhere with a Level 1 trauma center in the US is going to give you more action than you will see in Australia. J-burg or Cape Town are also popular, as you probably know.

Have to agree with her mate. Not allowing you to practice and only watching limits what you can learn and any hands on experience. Not giving you any official documents or paperwork of being there adds salt to the wound. It really does give you little benefit, unless you're there just to enjoy yourself and observe. To me, it serves no purpose because being there won't help get you a US residency.

Try contacting other hospitals or see if Monash has affiliations with other hospitals. I know Flinders (where Winged_Scapula graduated I believe) has quite a few affiliations so I think Monash should have at least some, too. If not, then you can contact other hospitals individually. Try to get the malpractice insurance, because being a foreign student, the coverage will be extremely expensive and not a risk most hospitals will want to take for a student who's not even from a US medical school.

Mt. Sinai sounds good. I think my cousin did his clinical rotations there before he dropped out and he said he's seen quite a few Australians, but that's probably UQ has affiliations with that place.

Again, ask Monash to see if they could help you arrange. If in doubt, contact Winged_Scapula. Listen to her. She knows these things. In fact, she knows more than you to think, plus she's an attending physician who successfully returned to the United States from Australia (Flinders) and matched into SURGERY. She's a freaking GOD (Goddess) on SDN. She'll help you out, no doubt.

 

[Winged Scapula]

If in doubt, contact Winged_Scapula. Listen to her. She knows these things. In fact, she knows more than you to think, plus she's an attending physician who successfully returned to the United States from Australia (Flinders) and matched into SURGERY. She's a freaking GOD (Goddess) on SDN. She'll help you out, no doubt.

Thank you for the kind words.

But yes, I am happy to help if I can.

 

[Mordecai]

Thanks for the info. I had thought about South Africa, but my aim is not just to see Trauma, but to see how it is managed at the cutting edge. If I merely wanted to get hands on with lots of penetrative stuff SA would be fine.

I'll have a word with Monash uni today, and see if they have any US affiliations.

Once again, thanks for the info

 

[freshclay]

Hi Mordecai,

I might be able to help with this. I was a med student at UniMelb and did my elective in trauma surgery at the John H. Stroger (previously Cook County) Hospital in Chicago in January 2009. It was a fantastic experience. The medical students on rotation with me were basically sub-interns, doing a good chunk of the work with residents looking over us. We got worked very hard, but if you're seriously considering a career in the area I couldn't recommend this more. Most US hospitals with "County" in them aren't in the best neighborhoods which generally translates to a steady stream of trauma arriving. There's a decent amount of scutwork involved, but there's plenty of chances to get into the OR as well. They also have a Trauma ICU and the elective included a one-week rotation in the Burns unit which was eye-opening for me.

They are receptive to Aussie medical students as someone a year ahead of me had gone through, which is how I got wind of it. Another med student from the UK was also there my year. One of the admin ladies was quite inefficient but if you start applying early it should be fine. No application fee and no USMLE required either.

Overall, the team was very supportive from top to bottom. I remember feeling overwhelmed and over my head on my first day wondering what I was doing there, but by the end I was doing just fine. They also love Aussie accents so that will help you out too.

If you decide to pursue this option, let me know. I'd be happy to give more advice and pass on some of the little tips I had to learn the hard way.

 

[Mordecai]

Thanks clay. How much did you actually get to do? Sounds fantastic from what you are describing.
I most definately am interested.
Have pm'd you.

 

[Mordecai]

Thank you for the kind words.

But yes, I am happy to help if I can.

Thanks Scap.
I am not really planning for a US residency. I would like to do a fellowship in the US later, but I have my eye set on a surgical training program in Australia. I am also a member of the association of military medicine here and would like to help work with those developing some of the military trauma protocols.I am very patriotic...as you can see

There is no doubt in my mind (vast as my experience is-sarc) that the US is the best in trauma, and I would love to have a continuing association with people in the field there. All that aside- my heart lies here. Mind you , America is my second favourite country (sorry Kiwis- you come 3rd).

 

[Raigon]

Thanks Scap.
I am not really planning for a US residency. I would like to do a fellowship in the US later, but I have my eye set on a surgical training program in Australia. I am also a member of the association of military medicine here and would like to help work with those developing some of the military trauma protocols.I am very patriotic...as you can see

There is no doubt in my mind (vast as my experience is-sarc) that the US is the best in trauma, and I would love to have a continuing association with people in the field there. All that aside- my heart lies here. Mind you , America is my second favourite country (sorry Kiwis- you come 3rd).

Fair enough - you're Australian. Of course you love Australia. Haha, I'm from the US, so I love America. But Australia will be my 2nd favorite country if I get into medical school here. It's understandable.

Have you talked with Monash about any affiliations or any programs you can try yet? If you have, how did it go? If you haven't, do it quick because they may be more helpful than you think.

Trauma medicine definitely sounds good for military medicine, as military will always be full of trauma if there's war. But we all hope there will never be war of course, because it's scary and devastating and I know that even without having been in war. But I'm interested in trauma as well - lots of action and I have a really short attention span.

 

[Mordecai]

Here we go. Big NEGATORY from UT memphis- no non american med students need apply. VCU have asked me to do USMLE part I and pass before applying to them (deadline for application is August 2010 for an elective in 2011).
Cook County on the other hand are seeming to be a no worries bunch, and I have been in communication with them. Things are looking good on that front.

Jackson Ryder... all that $$$ and no paper at the end to say I was there? I am afraid that I might have to give that a pass.

BTW, Monash provide no help or assistance at all apart from a paper to say that you are a student in good standing. The rest is up to you matie.

 

[Raigon]

Here we go. Big NEGATORY from UT memphis- no non american med students need apply. VCU have asked me to do USMLE part I and pass before applying to them (deadline for application is August 2010 for an elective in 2011).
Cook County on the other hand are seeming to be a no worries bunch, and I have been in communication with them. Things are looking good on that front.

Jackson Ryder... all that $$$ and no paper at the end to say I was there? I am afraid that I might have to give that a pass.

BTW, Monash provide no help or assistance at all apart from a paper to say that you are a student in good standing. The rest is up to you matie.

Damn... that sucks. I'm sorry.

Yeah, don't do Jackson Ryder - that would be a punch in the face, literally. I would have thought Monash would at least have some affiliations... =/

Hope Cook County works out for you. That's definitely a top place to go when we think of trauma; first trauma center ever in the history of the United States. Would definitely be a pleasant experience and plus there's a TON of action in Chicago from car crashes to fire to gang bangers. Would personally ask to arm yourself with a knife there (Chicago's crime rates are mad high), but hospital's got security. So don't worry. Haha.

Make sure that they do allow hands on experience AND proof of being there. Hands on experience allows you to learn what trauma is instead of just standing there and watching and proof of clinical rotations will definitely be prove to be helpful in the long run whether you want to go to the US or stay in Australia. If Cook County can provide both, then go for it. I wish you all the best.

Hope everything works out, mate. Once again, thanks for your help with my interview.

 

[Winged Scapula]

You guys seem to be stuck on this idea of "proof you were there".

Rotations here don't give you certificates. Your "proof" will be in the form of being noted on your medical school transcript (how detailed that transcript is depends on the school), an evaluation required by your school or a letter of recommendation from a faculty from that rotation.

You shouldn't expect some sort of formal "proof" other than the above.

 

[Raigon]

You guys seem to be stuck on this idea of "proof you were there".

Rotations here don't give you certificates. Your "proof" will be in the form of being noted on your medical school transcript (how detailed that transcript is depends on the school), an evaluation required by your school or a letter of recommendation from a faculty from that rotation.

You shouldn't expect some sort of formal "proof" other than the above.

Letters of recommendations and being noted on your transcript of being there is generally what we meant by proof of being there.

Some of the hospitals above won't give you either of them. That's what we meant by not giving us proof of being there.

 

[Winged Scapula]

Letters of recommendations and being noted on your transcript of being there is generally what we meant by proof of being there.

Some of the hospitals above won't give you either of them. That's what we meant by not giving us proof of being there.

The hospital doesn't decide who gets a letter of recommendation. The onus is on the student to ask faculty who then write the letter and submit it. So this is a non-issue IMHO. I have never met faculty that are forbade from writing LORs by their hospital.

As for proof on your transcript, I am suprised any medical school would even allow you to rotate somewhere, especially if they are required to supply malpractice insurance for that experience, without some evaluation and proof that you were there. But if there are programs out there that don't evaluate your performance or do anything in the way of proving to your school you were there, I'd say avoid them with a 10 foot pole.

 

[Raigon]

The hospital doesn't decide who gets a letter of recommendation. The onus is on the student to ask faculty who then write the letter and submit it. So this is a non-issue IMHO. I have never met faculty that are forbade from writing LORs by their hospital.

As for proof on your transcript, I am suprised any medical school would even allow you to rotate somewhere, especially if they are required to supply malpractice insurance for that experience, without some evaluation and proof that you were there. But if there are programs out there that don't evaluate your performance or do anything in the way of proving to your school you were there, I'd say avoid them with a 10 foot pole.

I agree. Definitely avoid them. And from what I've heard, Jackson Memorial Ryder is the very definition of what you said. But what about electives? I remember Flinders, Sydney, or Queensland allows you 6 weeks electives overseas (as most schools). Isn't that what I mean by transcripts? And I know those three have strong ties with US hospitals, so don't they resolve the malpractice issue for you?

Wait, but you said something about arranging clinical rotations on your spare time (i.e. summer vacation/winter break). However, I don't think can be substituted as part of your electives and I don't think you can substitute that experience for any of your credits. So is doing arranging those rotations simply to get letters of recommendations or is there another goal?

 

[Winged Scapula]

I agree. Definitely avoid them. And from what I've heard, Jackson Memorial Ryder is the very definition of what you said. But what about electives? I remember Flinders, Sydney, or Queensland allows you 6 weeks electives overseas (as most schools). Isn't that what I mean by transcripts?

As you know, a transcript is a documented detailing of your medical education. Many medical schools, even those in the US, do not clarify what or where you did for an elective - the transcript simply says something vague like "Elective Term".

BUT, my medical school and most others I know require that if you are using elective time to rotate outside of the main educational institution, that THEY have some proof you were actually doing the elective and not lying about on some beach on Fiji. This is also a must for US residency as you will be required to prove that you did X weeks of medical school and clinical rotations, thus the elective time must be accounted for on your transcript. These are submitted to ECFMG for your certificate after source verification.

And I know those three have strong ties with US hospitals, so don't they resolve the malpractice issue for you?

They resolve the malpractice issue by providing it for you. At least Flinders did, but that was after we (US students) insisted that to make us competitive for US residencies that we had to do US electives and the malpractice insurance had to cover us in North America. Prior to that, they did not cover electives in the US. I do not know whether they still do or if the other schools do. This is a major issue for many FMGs/IMGs - they cannot get malpractice insurance good in the US and their medical school won't provide it.

Wait, but you said something about arranging clinical rotations on your spare time (i.e. summer vacation/winter break). However, I don't think can be substituted as part of your electives and I don't think you can substitute that experience for any of your credits. So is doing arranging those rotations simply to get letters of recommendations or is there another goal?

You're right - doing clinical rotations during vacation time or outside of the school's requirements (ie, I extended my last year so I would still be a student and do more electives) will not generally count toward elective time. The point was to get as many US letters as possible, get US experience and to make connections. In general, this isn't necessary unless your program only allows you 1 elective term abroad and you feel you cannot get enough LORs/experience/connections.

 

[Raigon]

As you know, a transcript is a documented detailing of your medical education. Many medical schools, even those in the US, do not clarify what or where you did for an elective - the transcript simply says something vague like "Elective Term".

BUT, my medical school and most others I know require that if you are using elective time to rotate outside of the main educational institution, that THEY have some proof you were actually doing the elective and not lying about on some beach on Fiji. This is also a must for US residency as you will be required to prove that you did X weeks of medical school and clinical rotations, thus the elective time must be accounted for on your transcript. These are submitted to ECFMG for your certificate after source verification.

They resolve the malpractice issue by providing it for you. At least Flinders did, but that was after we (US students) insisted that to make us competitive for US residencies that we had to do US electives and the malpractice insurance had to cover us in North America. Prior to that, they did not cover electives in the US. I do not know whether they still do or if the other schools do. This is a major issue for many FMGs/IMGs - they cannot get malpractice insurance good in the US and their medical school won't provide it.

You're right - doing clinical rotations during vacation time or outside of the school's requirements (ie, I extended my last year so I would still be a student and do more electives) will not generally count toward elective time. The point was to get as many US letters as possible, get US experience and to make connections. In general, this isn't necessary unless your program only allows you 1 elective term abroad and you feel you cannot get enough LORs/experience/connections.

Ah okay - I think I understand a bit more now! Thanks! That makes me feel better if I make it to Flinders. I guess it's because thanks to you guys fighting for our rights (revolution in Flinders!) that things may be a bit easier.

But I do believe arranging some time outside might be necessary because it's still only 2 blocks electives I can do overseas (roughly 2 months). We may need at least 6 months to get to know some hospital better.

Wow, leave it to Winged_Scapula to clear everything up XD.

 

[Winged Scapula]

Ah okay - I think I understand a bit more now! Thanks! That makes me feel better if I make it to Flinders. I guess it's because thanks to you guys fighting for our rights (revolution in Flinders!) that things may be a bit easier.

But I do believe arranging some time outside might be necessary because it's still only 2 blocks electives I can do overseas (roughly 2 months). We may need at least 6 months to get to know some hospital better.

Wow, leave it to Winged_Scapula to clear everything up XD.

I"m not sure you need 6 months to "get to know some hospital better" - for one, most places will not let you stay longer than 4 weeks, so you'd need to look for 6 placements and two, you don't generally need that much time to get LORs, USCE, etc.

So some time is preferred, more time may be better, but there is no magic number as to how much time is enough. 6 months is probably beyond the pale and I don't think you'd find many programs willing to give you that much unless you use vacation term, etc.

 

[Raigon]

I"m not sure you need 6 months to "get to know some hospital better" - for one, most places will not let you stay longer than 4 weeks, so you'd need to look for 6 placements and two, you don't generally need that much time to get LORs, USCE, etc.

So some time is preferred, more time may be better, but there is no magic number as to how much time is enough. 6 months is probably beyond the pale and I don't think you'd find many programs willing to give you that much unless you use vacation term, etc.

Ah, okay. It's just that I found on the Caribbean thread that they claim that 2 years of clinical rotations in the US will definitely be far more powerful than our 2 blocks overseas electives and I was wondering why.

 

[Winged Scapula]

Ah, okay. It's just that I found on the Caribbean thread that they claim that 2 years of clinical rotations in the US will definitely be far more powerful than our 2 blocks overseas electives and I was wondering why.

Yeah, there's no evidence to substantiate that <widely held> belief. YOU have the advantage of being able to set up visiting clerkships at top notch/big name programs (or wherever you wish).

I've NEVER heard a faculty member prefer a student over another because of the length of US clinical experience except in the rare instances of programs that want 1 year USCE (which is simply a way to discourage FMGs from applying) and this is typically an adminstrative decision, not a personal one.

 

[Raigon]

Yeah, there's no evidence to substantiate that <widely held> belief. YOU have the advantage of being able to set up visiting clerkships at top notch/big name programs (or wherever you wish).

I've NEVER heard a faculty member prefer a student over another because of the length of US clinical experience except in the rare instances of programs that want 1 year USCE (which is simply a way to discourage FMGs from applying) and this is typically an adminstrative decision, not a personal one.

Okay then, so much for THAT rumor.

That being said, the health care bill passed; wow never thought I'd see the day it passes [sarcasm - sorry, couldn't resist =P]. How will that affect IMGs I wonder? Will the result be residency programs accepting less IMGs? Because if so, I think I may want to stay in Australia after all.

Then again, I'm still at the interview phase of Flinders admissions. We can talk about overseas electives when (or if, *shudders*) I get in, I suppose. The 4 years can allow me to observe what happens with the US.

Then again the world is supposed to end in 2012[sarcasm], why should that matter? =D I just want to study medical school before the world ends [sarcasm - okay, I need to stop doing that].

 

[Mordecai]

Okay then, so much for THAT rumor.

That being said, the health care bill passed; wow never thought I'd see the day it passes [sarcasm - sorry, couldn't resist =P]. How will that affect IMGs I wonder? Will the result be residency programs accepting less IMGs? Because if so, I think I may want to stay in Australia after all.

Then again, I'm still at the interview phase of Flinders admissions. We can talk about overseas electives when (or if, *shudders*) I get in, I suppose. The 4 years can allow me to observe what happens with the US.

Then again the world is supposed to end in 2012[sarcasm], why should that matter? =D I just want to study medical school before the world ends [sarcasm - okay, I need to stop doing that].

I share your fears about the healthcare bill. Those of us who have experienced the wonders of public healthcare dread what it will do to the US.
I would LOVE to do a fellowship in the US after I finish my specialisation here.. but will have to wait and see what develops. I am committed long term to work here in Aus- but the option of popping over to the US to learn and work in my specialty would be awesome.... for as long as that fantastic health system stands.

 

[Mordecai]

Am off to Cook County this Saturday arvo. I start on Monday 7th March and Finish on Friday 15th April.
ATLS book packed, Trauma Essentials packed, Steth check, inflatable white pointer check, willingness to learn... double check

Thanks heaps to all of you who made this possible. Will write some feedback when I get back.

M.

 

[Mordecai]

First day post call at County.
All I can say is:

LEGENDARY.

More details when I can get my breath back.... and that will likely be when I back in Oz, and at the Alfred in my ENT rotation.

Later.

M.

 

[Winged Scapula]

First day post call at County.
All I can say is:

LEGENDARY.

More details when I can get my breath back.... and that will likely be when I back in Oz, and at the Alfred in my ENT rotation.

Later.

M.

Will look forward to hearing your report. Hope you are enjoying yourself.

 

[ibma]

@everyone,

hello, I am scheduled for trauma rotation startin may 30th at cook county, freashclay and mordecai both of you have done your rotation; I have certain queries:

(1) what books are required for the rotation?
(2) what is the routine like? timings etc

mordecai, your rotation must be coming to an end..please share your experience! hope your having a nice time there

 

[Mordecai]

@everyone,

hello, I am scheduled for trauma rotation startin may 30th at cook county, freashclay and mordecai both of you have done your rotation; I have certain queries:

(1) what books are required for the rotation?
(2) what is the routine like? timings etc

mordecai, your rotation must be coming to an end..please share your experience! hope your having a nice time there

As far as books are concerned, you can actually get by without them, since the Cook County Unit follows their own trauma protocols which can be found on the Stroger Hospital intranet. However if you want to shine and actually have an understanding of what is happening to the patients you are seeing..
I would suggest the following:
1.ATLS student handbook
2."The ICU BOOK" by Paul Marino
3."Essential Emergency Trauma" by Shah, or "Emergent Management of Trauma" by Bokhari.
(Bokhari is one of the attendings at county and may soon become chair of trauma)

Students are expected to do 7 calls over the 4 week rotation. At least 2 of these must be on the weekend. Calls last in general around 24-30 hours during which you will stay in the unit. The call starts at 0800 with the handover from the previous team and is followed by a round of the resus, the obs room and the Trauma ICU. Then you wait for the hits to come in, until you hand over the next morning at 0800. Post call you are required to attend the round and any post round activity like lecture or meeting (which can be really hard as by then you will be very tired). You leave the hospital in general between 1200 and 1300.
Calls will end up being Q3 (every 3rd day) with one or two Q2s to pick up the required numbers for your 7 and your weekend 2.
On Mondays, Wednesdays and Fridays you will need to present your ICU patient. (Each student is expected to pick up an ICU patient either from resus when they come in OR as a handover from a leaving student). You are expected to follow your patient's treatment and report on those 3 days. This means coming in early on the days when you are not on call to round on your patient BEFORE the 8am meeting. Liaise with the primary resident and nurse in charge of the patient- this is essential.
There are weekly lectures, a fornightly journal club and mortality and morbidity meeting as well as presentations by pharmaceutical companies. There is a once monthly trauma/ER joint lecture as well.
Students are also required to spend 3 days in a row on the burn service.

Your job on call is firstly to ensure that the history and physical exam sheet is filled out and secondly to help with resus and treatment. How much you get to do depends on how sick the patient is, how friendly the resident is and how much effort and enthusiasm you have shown, and how much knowledge and ability you have. Expect to do some "scut work". You will get to suture lacerations, and help splint limbs. I've been here for close to 6 weeks now and have been able to help with 2 chest tubes, I've done CPR 4 times, I've been in "charge of the head", removed 2 superficial bullets, irrigated lots of bullet wounds, splinted a half dozen limbs with ortho, dressed a dozen burns, ... I am sure I am forgetting. And May will be much busier than March and April have been.
You get as much out of this rotation as you put in. And the more you put in the better your evaluation at the end.

Hope that helps.
Are you Australian?

M.

 

[ibma]

This is some experience!!! Thanks for the detailed information. I am looking forward to this rotation.
(1) Were there other medical students too with you?
(2) Did you easily managed a letter of recommendation? Or you had to run after the consultants to get one?
(3) Would you rate this rotation as very very difficult? I mean I read that somewhere that “they leave students to handle patients on their own” is this an exaggeration.
(4) The presentation you talked about on mon, wed, fri is a bedside case presentation rite?


I am from Pakistan. Final year medical student.

 

[Mordecai]

This is some experience!!! Thanks for the detailed information. I am looking forward to this rotation.
(1) Were there other medical students too with you?
(2) Did you easily managed a letter of recommendation? Or you had to run after the consultants to get one?
(3) Would you rate this rotation as very very difficult? I mean I read that somewhere that "they leave students to handle patients on their own" is this an exaggeration.
(4) The presentation you talked about on mon, wed, fri is a bedside case presentation rite?


I am from Pakistan. Final year medical student.

You will NOT let me repeat this NOT be left to handle patients on your own. That would be a serious breach of care for the patients. As a student you would be expected to treat patients as part of a team. Everything you do will be supervised, and you will be extremely limited initially in what you are allowed to do until your team, and chief residents are sure of your competency. Even when you are allowed to suture lacerations etc, there will be someone keeping an eye on things. The care of the patient is the responsibility first of the attending on call, then the surgical chief and ER chief, then the resident who is the primary carer for the patient and lastly you. The buck stops with the attending, and everyone is responsible to the person above them. So no, you would not be left on your own, and I wouldn't advise attempting anything on your own either.

Is this rotation difficult? It depends what you mean. Trauma electives are not for everyone. If you find the thought of sometimes having NO sleep at all over 30 hours inspite of having to help out in patient care AND present a patient the next day, AND attend a lecture after whilst knowing you are being assessed for the same hard........ then yes it is. But if the knowledge and experience that one gains from this is worth it, then it isn't hard really. In my case, I have always liked trauma, and I thrive in the quick decision making chaotic environment. I would find aged care, or internal medicine "hard".

There are always students rotating on the trauma service, including many from local illinois and Chicago schools. There are also a number of foreign students who rotate through. The local students are ofcourse more familiar with the practice in the hospital. I would suggest that you ask them to show you the ropes. Australian medical practice and American practice only has a few differences, but my time was made much simpler by tips from the local students.

The presentations take place on rounds, and students present a patient when the round gets to the ICU. So yes I suppose it can be counted as "bedside", even though the round never enters the actual rooms (this is for practical reasons as the people on a round can number up to 20, and some patients have contact precautions or are sedated etc).

I am not sure about a the whole "letter of recommendation" bit. I know that some students may have sought them, but I have not (I might actually seek one a little later-if so, I will email the attendings who have got to know me). I have made due with the usual local assessment as well as another form that my uni asks that the head of unit at your elective placement complete. Students hand assessment forms to the ER chief resident and the Surgery chief resident in the last week of their rotation. These are then passed on to the attending in charge of student education and an assessment is made at a joint committee meeting. My understanding is that this is usually sent straight to your med school. If you want to have yours given to you instead have a chat to the student rotation coordinator in admin Adriana alvarez (www.cookcountytrauma.org).

Trauma Attendings are in general very busy people, and often will not even know who the individual students are (you rotate every 4 weeks after all!). You can stand out by being either very good, very bad, or very bizarre. I suggest you do the first. Once you have done a few calls with them, they will get to know you and you can approach them in the last week or so of your rotation to ask for a letter.

 

[freshclay]

Hey M. -

It sounds like you had a spectacular time in Chicago and gained a lot of knowledge, experience, and confidence. I'm glad everything worked out and can't wait to hear the details.

All the best for intern apps if this is the year!

 

[Mordecai]

Hey thanks,

The best description that I have for my elective is "life changing". I feel frankly that there is difference between the Mordecai before and the Mordecai after.
Trauma is intense, it is both rewarding as well as frustrating. I have has as many new questions posed as I have had old ones answered. For those interested in it, I highly recommend a level 1 US Trauma rotation.
Nothing that we do here compares- to be brutally honest... in terms of the volume, or the range of different things offered.
And the experience of the attendings there is incredible.
Truth be told, I found that American residents and attendings work harder (at least those in the trauma setting) than those I have seen here.
Winged scapula might have something to add.

As far as internship goes,I will most likely be at Southern Health as I have won an academic scholarship that involves doing internship there as well as conducting research with them.

I was so impressed with what I saw in Chicago, that I have decided to try to do my Fellowship in the US,post specialisation here in Australia.

 

[ibma]

@ mordecai.

Thanku so much for the deeetailed overview,

can you please tell me the procedure on the first day? I have to go to Luann Jointer before i start my elective. how long will it take?

thanks

 

[Mordecai]

@ mordecai.

Thanku so much for the deeetailed overview,

can you please tell me the procedure on the first day? I have to go to Luann Jointer before i start my elective. how long will it take?

thanks

As soon as you are done with the paperwork with Miss Jointer, see Adriana and arrange to get the ID. Then book for the OR scrubbing course. The handover etc is in the morning at 8am. When you can, get down there and introduce yourself to your fellow medstudents and the Trauma fellow. They will be the most helpful in showing you the ropes.
Be polite, be on time, be willing to learn and help.. that'll get you very far.

 

[Raygun77]

Hey thanks,

As far as internship goes,I will most likely be at Southern Health as I have won an academic scholarship that involves doing internship there as well as conducting research with them.

I was so impressed with what I saw in Chicago, that I have decided to try to do my Fellowship in the US,post specialisation here in Australia.

Hey Mordecai

Really enjoyable reading about your experience in the states. Glad you had a lifechanging time- that's what it's all about eh!

Your last point about academic scholarships offered for 'terns at southern health caught my eye though. I just googled it and couldn't find any information...but it sounds like something up my alley (im a 5th year melbU student, research has been good to me so far and definitely want to continue)

Could you pass on any information?

Thanks in advance!

Ray

 

[Mordecai]

Hey Mordecai

Really enjoyable reading about your experience in the states. Glad you had a lifechanging time- that's what it's all about eh!

Your last point about academic scholarships offered for 'terns at southern health caught my eye though. I just googled it and couldn't find any information...but it sounds like something up my alley (im a 5th year melbU student, research has been good to me so far and definitely want to continue)

Could you pass on any information?

Thanks in advance!

Ray

Pmd you about it

 

[optimusprim]

Can some please let me know the application procedure for the cook county trauma elective? I have contacted Adrianna Alvarez and she has given me the elective dates. I have got the application signed from my school. But my school doesn't provide professional liability insurance for away students. Any suggestions which companies provide them which would be accepted by cook county.

 

[I'mNotGroot]

I'm bringing up an old thread here, but hoping that some members are still around.

I'm thinking of applying Cook County for my electives next February. Only problem for me is finance cause I've looked up the prices of accommodation around the hospital and I'm not sure if I should spend that money. Could anyone who's been there share their experience in terms of where they stayed and their prices? Much appreciated.

@Mordecai

 

[dab2606]

Can someone help me with the application?

I have been sending the co-ordinator the application, but she keeps on telling me to send complete application and never mentions which documents are missing. According to my understanding, I have to send the application form and a health Profession students agreement.

Can someone tell me if any other documents are needed?

 

[Sadhvika]

Can you please give me more details about to ? I want to do a trauma elective at cook county please







68978"]
Hi Mordecai,

I might be able to help with this. I was a med student at UniMelb and did my elective in trauma surgery at the John H. Stroger (previously Cook County) Hospital in Chicago in January 2009. It was a fantastic experience. The medical students on rotation with me were basically sub-interns, doing a good chunk of the work with residents looking over us. We got worked very hard, but if you're seriously considering a career in the area I couldn't recommend this more. Most US hospitals with "County" in them aren't in the best neighborhoods which generally translates to a steady stream of trauma arriving. There's a decent amount of scutwork involved, but there's plenty of chances to get into the OR as well. They also have a Trauma ICU and the elective included a one-week rotation in the Burns unit which was eye-opening for me.

They are receptive to Aussie medical students as someone a year ahead of me had gone through, which is how I got wind of it. Another med student from the UK was also there my year. One of the admin ladies was quite inefficient but if you start applying early it should be fine. No application fee and no USMLE required either.

Overall, the team was very supportive from top to bottom. I remember feeling overwhelmed and over my head on my first day wondering what I was doing there, but by the end I was doing just fine. They also love Aussie accents so that will help you out too.

If you decide to pursue this option, let me know. I'd be happy to give more advice and pass on some of the little tips I had to learn the hard way.
[/QUOTE]
Can you please give me more details about how to appro