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What are rotations like at your school?

Discussion in 'Clinical Rotations' started by hotbovie, Jul 14, 2002.

  1. hotbovie

    hotbovie Member 7+ Year Member

    65
    1
    Jun 22, 2002
    USA
    When I first started my clinical rotations last year, I thought that they were pretty much the same at all schools. Since then, I've learned that isn't necessarily so. For example, I was suprised to learn that some schools don't require students to take overnight call. So I thought it would be interesting to compare basics of rotation experiences here.

    We do take overnight call on Medicine, Peds, Surgery, and OB. There is call on Psych and Family, too, but that consists of things like staying til 11pm, or 8-4 on a weekend, or an ER shift.

    We write H&P for all patients we see on call, and our H&P goes on the chart. The intern writes a separate H&P, often on a fill-in-the blank type form. We have to write it out fully. (I always thought that was redunant, but when I was on surgery, I learned that the residents often find the student H&P and notes gave them the best information about the patient). There are offical limits on the number of patients a student can carry, but the limits are not always adhered to.

    We have to see all our patients and have notes written and on the chart before the intern gets to the patients in the morning. Sometimes we write orders which are later cosigned. Sometimes the residents require us to write discharge summaries.

    Overnight call is usually q 4, but can be q5 or q3, often with a full day of clinic, or lectures, or other work following.

    Scut isn't too bad. We don't have to draw our own labs, all the hospitals have phlebotomy service. But it's often not done when ordered, so when that happens we have to spend some time on the phone trying to make it happen. Same thing happens with xray. We can start IV's and in fact need to get checked off on that for surgery, but don't have to on a regular basis.

    Procedures are pretty good. I know of classmates that did things like central lines, chest tubes and LP during the first weeks of clinical rotations. The services are so busy that the interns get the hang of procedures pretty quickly and pass them on to students. All students get plenty of chances to draw blood gases and get venous blood from the femoral vein during surgery. On OB, average number of delieveries done unassisted, with resident standing by but not touching the baby, is 10-15. It's not at all unusual for students to be allowed to close fascia on c-sections. And I know of a number of my classmates (myself included) who got to do several simple cases during surgery.

    Generally, the residents are very student friendly, and welcome even M1 to come observe and participate. M1 and M2 often come to the ER on breaks. One of my classmates got to do a chest tube during M1 year, another drilled a bore hole during a neurosurgery case. I got to do a central line as M1 (all but the stick) and float a swan early in my M2 year.

    I'd love to hear how this compares to other student's experiences.
     
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  3. merlin

    merlin Senior Member 10+ Year Member

    Up, Up, and Away. No other takers to this thread?
     
  4. univlad

    univlad Member 10+ Year Member

    212
    17
    Jul 14, 2002
    . [/B][/QUOTE]What med school do you attend?
     
  5. saori

    saori Senior Member 7+ Year Member

    As far as my rotations are concerned, my surgical rotation was hard, but rewarding also. I did my rotation at "Luis E. Aybar Hosp." here in Santo Domingo. It was not pretty, it was crowded, hot, no priviledges (not even for parking) and I had to do 3 weeks in urology as part of my rotation. I swear, the 3 longest weeks ever!

    A typical day consisted in getting to the hospital, doing rounds, writing up the patient's records, checking that all blood work was done and draw blood when it reports were not complete. Tues. and Thurs. we had "consults" (patients coming in for appointments) and afterwards, academic sessions (Grand Rounds and Class).

    The rest of the week (mon., wed. and fri.) OR. That meant the rest of the day in the OR assisting procedures.

    It was the other way around during urology rotations.

    On call duties: Hourly vital signs on all post-ops, draw blood, X-rays for all patients with chest-tubes. change dressings, measure secretions (from nasogastric tubes, drains, (-) drains, etc.), and so on.

    I was kind of surprised to read that someone mentioned that drawing blood from the femoral vein was only done in the OR (or something to that effect), but it was routine for us. Most of the vascular surgery patients can only be drawn from the femoral v. and it had to be done quite frequently.

    Also, transfusions were part of our list of chores, inserting Foleys and putting in nasogastric tubes were day to day things. Suturing, handling surgical instruments and assisting (I got a chance to assist the Neurosurgeon for sample harvesting for a possible brain tumor) were also frequent.

    I think all in all, it was very difficult, but very interesting. Lots of "hands on" practice and the satisfaction of a job well done at the end of the day.:D
     

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