bigneonglitter

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I am starting MSIII tomorrow and have no clue what to expect. How much free time will I have? How does it compare to MSII? Will I have any down time on the weekends? I've heard from a lot of people that MSII was the most difficult year, and that MSIII is much better. Can anyone give me some perspective? Thanks!
 

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bigneonglitter said:
I am starting MSIII tomorrow and have no clue what to expect. How much free time will I have? How does it compare to MSII? Will I have any down time on the weekends? I've heard from a lot of people that MSII was the most difficult year, and that MSIII is much better. Can anyone give me some perspective? Thanks!
I'm only on my third week of IM and hating it. On call days post call days, hours of just sitting around doing nothing, waiting to be paged, pretending to study and wanting to go home. Interns giving you a hard time and stupid little errands just cuz they are hating life right about now. Rounds that take 3-4hours. I know what I DON'T want to do. INTERNAL!!! Actually, I already knew that. Anyway, hope your other responses are more positive.
 

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bigneonglitter said:
I am starting MSIII tomorrow and have no clue what to expect. How much free time will I have? How does it compare to MSII? Will I have any down time on the weekends? I've heard from a lot of people that MSII was the most difficult year, and that MSIII is much better. Can anyone give me some perspective? Thanks!

It will depend on what rotation you are on. Some you will have more free time than you ever had in 2nd year, others you will be perpetually sleep deprived. I had a great year. Just remember that you are there to learn so soak in as much as you can, ask lots of questions, do extra stuff, and it will be a lot more fun.

I thought it was fun doing something new every 4-8 weeks. It's also scary because you might have to learn a new hospital or clinic. The most stressful part for me were the interpersonal landmines...you have to learn to read people (attendings, residents, nurses) really well if you aren't already good at that. Then fly low under the radar, work hard, be good to patients, and have fun!
 
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chocomorsel said:
I'm only on my third week of IM and hating it. On call days post call days, hours of just sitting around doing nothing, waiting to be paged, pretending to study and wanting to go home. Interns giving you a hard time and stupid little errands just cuz they are hating life right about now. Rounds that take 3-4hours. I know what I DON'T want to do. INTERNAL!!! Actually, I already knew that. Anyway, hope your other responses are more positive.
Sorry to hear you are hating IM. Is there any reason you are just pretending to study instead of actually studying? I find that I can get a lot of reading done at work when things are slow, which is nice because it means more free time when I'm not at work. For instance I'm on OB right now and the other night my patient delivered at 9pm, and after that it was dead quiet - I didn't have another patient for the rest of the night. I read on and off from 10pm - 6am. It really makes me feel like I'm not just sitting there watching hours of my life waste away.
And look at it this way - at least you get IM out of the way for the year. Hopefully you will like your next rotation more.
 

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4 weeks into 3rd year, and so far i love it. i am on peds, which is not my calling in life, however, there is much more free time during 3rd year. usually most of the people who have a hard time adjusting to 3rd year are ones who are straight from college into medical school, and haven't worked a "real" job. by real i mean, they haven't had an 8-5 job for a year, in which you only get a day or 2 for christmas, and there is no such thing as spring break.

look at 3rd year as a job, and it is great. as for the studying, i haven't done the first bit outside of the hospital. we have a test in 2 weeks so i'll start doing a little reading, but my friends that have already been through 3rd year didn't stress over tests like they did during 1st and 2nd year.

good luck tomorrow, you will have a blast. just remember that the residents and attendings alike have been in your shoes before. they dont' expect you to know your way around right off the bat.
 

Anka

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It's a big adjustment going from second to third year. Especially at first, you'll probably feel a bit lost. There will be a lot of "mechanics" you just aren't comfortable with yet, and it won't be immediately clear how to get to the level you'd like to be at. There is, as has been pointed out, a lot of downtime on some rotations, which you'll learn to use effectively as time goes on, but at first will leave you feeling really useless. You'll also have an unclear role on the team and there will be some difficult interpersonal challenges to negotiate. All of this can be discouraging. On top of that, you'll meet some people who will purposely discourage, embarrass, or shame you.

However, you're also going to meet some wonderful role models, discover what specialty you're going to go into, and define what kind of doctor you're going to be. You will have some of the most rewarding experiences this year -- seeing and perhaps even touching the beating human heart, delivering a baby, listening to the life story of a dying patient, and more.

A couple of pieces of advice to make things as rewarding as possible. First -- always do an HONEST history and physical [it may not be complete in some settings]. Depending on the service, you'll find yourself rushed and everyone around you will be cutting corners, and you'll be tempted to do the same. As an example, an honest abdominal exam in the emergency room patient with the sudden onset of abdominal pain includes checking the hernial orifices, even if the patient is rude, smells bad, is visibly intoxicated, or vomits on you. To do this, you may need to get a patient who was triaged to a chair in the hallway into a bed in a room. Some of my most rewarding moments were the result of a good H&P on services where everyone is extremely busy -- catching a yeast endocarditis because I really listened to the heart the day a patient was going to go home that day, or finding an incarcerated femoral hernia because I "borrowed" a bed in which to examine my patient, or helping find the source in a bacteremic patient because I was the only one who knew that they had a MedComp [central line for dialysis] in place when the teams changed over. Second piece of advice, talk to everyone. You'll be much happier (and you'll learn more) if you call the cardiology consult yourself and find out what they said and get any questions you might have answered. Going down to radiology to see the images with the radiologist is a nice break from the hustle bustle of the wards, and no one can fault you for it (in fact, any but a complete a$$ of a resident will think better of you for it). The radiologist often likes having you there because they get to hear the clinical story, which improves their ability to read the scan. Hearing from a patient how they found out they had cancer, or learning that the patient still hasn't told their children, will connect you to the therapeutic experience in a way no amound of reading about the various chemo regimens ever could. Last piece of advice -- master the mechanics (a.k.a. scut). It'll leave you free to do the stuff you came here to do.

In short -- the best of times and the worst of times. Some rotations are just painful, others hard but exhillerating, and others like a vacation. Try not to get discouraged by the initial disorientation you'll probably feel -- these are very rewarding years ahead.

Best,
Anka
 

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bigneonglitter said:
I am starting MSIII tomorrow and have no clue what to expect. How much free time will I have? How does it compare to MSII? Will I have any down time on the weekends? I've heard from a lot of people that MSII was the most difficult year, and that MSIII is much better. Can anyone give me some perspective? Thanks!
  • It's a job. Don't let yourself be fooled by the negative salary; it's a job. And you must act professionally, or you will suffer, in a whole variety of ways. That means being on time, dressing professionally, knowing how to complain constructively (no whining!), and getting along with everyone (even with those who seem to delight in crapping on you).
  • You have to make yourself a doctor. The only person who's there for your whole education is you, and you have the ultimate responsibility for it. You have to exert yourself to get involved in what's going on, and you have to make yourself read; no one will be checking on you, really (until the exam at the end). Believe me, you can sit on your butt for a whole rotation and come out of it having no experience and knowing nothing.
  • Patients come first. Almost everything in the hospital is about taking care of patients, and that's what the residents and attendings will be focused on. You have to demonstrate that attitude, too. That means that you do your best to help take care of the patients (and you can do a lot more than you think), and you don't carp about doing scut if it's to help a patient.
  • It's exhausting. It's stressful, because it's like you're always performing for everyone (patients, residents, attendings), and you have to also be studying for the exams at the end. I actually found internship a little easier than 3rd year of medical school for that reason. And you're probably not used to the long hours, and not having control of your time to such a huge extent.
But it's actually a lot of fun. Most of the people you get to work with are awesome, and actually practicing medicine is just really damn cool. You just have to internally commit yourself to making yourself a good doctor.
 

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woowoo said:
4 weeks into 3rd year, and so far i love it. i am on peds, which is not my calling in life, however, there is much more free time during 3rd year. usually most of the people who have a hard time adjusting to 3rd year are ones who are straight from college into medical school, and haven't worked a "real" job. by real i mean, they haven't had an 8-5 job for a year, in which you only get a day or 2 for christmas, and there is no such thing as spring break.
You may find that you have more time in 3rd year than 2nd on a number of your rotations, but don't be fooled into thinking they will all be like that. Internal medicine you will be at work for 12 hours a day and then have to go home and study before finding enough time to sleep to be functional the next day. You will be there either overnight or by dawn 6 or 7 days a week depending on your days off. Surgery is the same way but with even more hours. I don't know anyone who doesn't think its hard or that isn't totally exhausted at the end of everyday, even those who held jobs before med school.
 

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erin682 said:
You may find that you have more time in 3rd year than 2nd on a number of your rotations, but don't be fooled into thinking they will all be like that. Internal medicine you will be at work for 12 hours a day and then have to go home and study before finding enough time to sleep to be functional the next day. You will be there either overnight or by dawn 6 or 7 days a week depending on your days off. Surgery is the same way but with even more hours. I don't know anyone who doesn't think its hard or that isn't totally exhausted at the end of everyday, even those who held jobs before med school.
agreed. i certainly didn't intend to imply that 3rd year is a breeze, but it is no different than a real job. sure it is hard, and you are exhausted at the end of the day, but you don't study during third year like you do during second year. the reason that most people like 3rd year better, is b/c when you are home, you are actually there and don't feel like your head needs to be in some basic science book learning some useless facts. so far 3rd year is actually easier than a real job. you don't actually have any real responsibilities and are learning what you actually came to school for.

i would suggest not going home after a 14 hour day and trying to "study." most of us are too tired and don't even bother trying. those that do try to study, can be described using one word, and i think most can figure out what that adjective is.
 

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Then you've got people who, like in my current surgery rotation, somehow find time to go into the hospital on their own "for fun" to follow around the night float on a Sunday night. Before a full 15 hour day tomorrow.

HOW is anyone else supposed to get a positive evaluation when we've got people like this in our group? It's positively manic. Or maybe I'm just WEAK! ;)
 

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woowoo said:
agreed. i certainly didn't intend to imply that 3rd year is a breeze, but it is no different than a real job. sure it is hard, and you are exhausted at the end of the day, but you don't study during third year like you do during second year. the reason that most people like 3rd year better, is b/c when you are home, you are actually there and don't feel like your head needs to be in some basic science book learning some useless facts. so far 3rd year is actually easier than a real job. you don't actually have any real responsibilities and are learning what you actually came to school for.

i would suggest not going home after a 14 hour day and trying to "study." most of us are too tired and don't even bother trying. those that do try to study, can be described using one word, and i think most can figure out what that adjective is.
3rd year can be like that, i.e. getting home and being home. But, I suggest that if you are considering a competitive field that you go the extra mile 3rd year. Clinical rotation grades (which at my school are fairly heavily influenced by shelf scores) are a very valuable to the match process. Even if your school does not release your numeric scores, I gurantee superior shelf scores find their way into your Dean's Letter, which also is a very important part of your residency application.
Its all up to you what you make of third year. If you want to R and R, nobody should give you grief about it. You work plenty hard at work without studying hard afterwards. However, realize that you are still in medical school, and the studying paradigm is still true... that is the people that study harder/longer/more often are the ones that get better results in the match. Not trying to be a gunner here, just don't want to have anybody to miss out on an oppurtunity to help their career aspirations. Also, you will learn alot more at work if you study outside of it, and you will be much better prepared for Step II (and thus have alot less stress of trying to learn a whole years worth of material in a few weeks) if you study hard. 3rd is great, but it can be alot of work.
 

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woowoo said:
agreed. i certainly didn't intend to imply that 3rd year is a breeze, but it is no different than a real job. sure it is hard, and you are exhausted at the end of the day, but you don't study during third year like you do during second year. the reason that most people like 3rd year better, is b/c when you are home, you are actually there and don't feel like your head needs to be in some basic science book learning some useless facts. so far 3rd year is actually easier than a real job. you don't actually have any real responsibilities and are learning what you actually came to school for.

i would suggest not going home after a 14 hour day and trying to "study." most of us are too tired and don't even bother trying. those that do try to study, can be described using one word, and i think most can figure out what that adjective is.
You may want to refrain from giving advice till you...lets say, pass your first clerkship. I think you're hearts in the right place but to be honest if you want to honor then you're gonna have to go home and read...nightly. You'll be in a better position to offer advice after you see how well your system is working.
 

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woowoo said:
agreed. i certainly didn't intend to imply that 3rd year is a breeze, but it is no different than a real job. sure it is hard, and you are exhausted at the end of the day, but you don't study during third year like you do during second year. the reason that most people like 3rd year better, is b/c when you are home, you are actually there and don't feel like your head needs to be in some basic science book learning some useless facts. so far 3rd year is actually easier than a real job. you don't actually have any real responsibilities and are learning what you actually came to school for.

i would suggest not going home after a 14 hour day and trying to "study." most of us are too tired and don't even bother trying. those that do try to study, can be described using one word, and i think most can figure out what that adjective is.
I would actually suggest going home to study. That is, unless, you do not desire to have choices when it comes to applying for residency.
 
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You have to study at some point, but it might be a waste of time to try to study when you are exhausted and/or sleep deprived. I think sometimes I did a lot more effective study on weekends (when I got them) or even an hour in the hospital library during a down point in the day than I did trying to focus when I was exhausted at the end of the day.

If you must study when you are really tired and out of it, do things that don't take a lot of brain power. Look at charts, Boards and Wards, First Aid. Tell yourself you have to memorize or review ten things before your sleep, something like that.

I also found my best shelf study came toward the end of the rotation when I had more experience and was starting to synthesize information better.

If you just started your rotations a couple of weeks ago, you might still be getting used to everything. Don't stress about it.

Not studying every now and then when you come home exhausted will NOT prevent your from having choices when you apply for residency! Not studying at all might...but I don't think that was implied.
 

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Several MDs have told me that the second year of medical school is a killer. Would anyone tell me what makes it so difficult? Is it the course workload? Thanks.
 

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drbee said:
Several MDs have told me that the second year of medical school is a killer. Would anyone tell me what makes it so difficult? Is it the course workload? Thanks.
Second year is mainly difficult because the first step of the USMLE is looming over you like the sword of Damocles. It is probably the most important test you will take as far as determing what field you are going into, as a good score will keep all your options open, while getting a 190 or something probably means dermatology and radiation oncology aren't happening for you.

Very important piece of advice I would give for new third years. Whenever you start a rotation, one of the FIRST things you need to find out is exactly how and by who/what you're being evaluated. At my school there is variation between rotations on how much the shelf exam affects your grade, psych was like 10 percent shelf, surgery 25, medicine 33 percent. Is there any oral exam? Are you evaluated by interns or not? Do you get to hand evals to certain people or are your evaluators predetermined? You can waste a ton of effort staying late and doing tons of floor work for a rotation that has your grade determined primarily by the shelf exam, or by trying to impress someone who's opinion doesn't affect your grade as much as your attending, etc.

Usually the best people to advise for particular rotations are the 4th years above you who have played the game already at your home school.
 

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woowoo said:
agreed. i certainly didn't intend to imply that 3rd year is a breeze, but it is no different than a real job. sure it is hard, and you are exhausted at the end of the day, but you don't study during third year like you do during second year. the reason that most people like 3rd year better, is b/c when you are home, you are actually there and don't feel like your head needs to be in some basic science book learning some useless facts. so far 3rd year is actually easier than a real job. you don't actually have any real responsibilities and are learning what you actually came to school for.

i would suggest not going home after a 14 hour day and trying to "study." most of us are too tired and don't even bother trying. those that do try to study, can be described using one word, and i think most can figure out what that adjective is.
Whoa! This is the worst advice I have seen in a long time. During my third year there really wasn't one rotation when I felt like it was a job and when I was home there was nothing more to do. That's an awful attitude to take, unless you're looking to barely pass. Save that perspective for 4th year. For now, I would study hard. Sure, when you get home from a day on surgery at 8pm and have to preround the next morning at 5, by all means, eat and go to bed. But study hard on your days off. It will help you in terms of the shelf exam and for the rest of your career. Good luck! :D
 

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I just finished my 1st wk of 3rd year in Neurology and I can't tell you how exhausted I am right now. The first few days I had no idea what the heck I was supposed to be doing with my time, my patients that were assigned to me and what was I supposed to be learning from my day at the clinic. I feel like I have learned very little besides the required lectures and grand rounds I attended. Whoever said its just like a job I would disagree.. In any job your work is predetermined and you will do the same thing everyday. MS3 is just frustrating since in each new rotation you r part of a new team, new people, different hours and you make the call when to refrain from clinical business so you can sit down and actually study for shelf. No job requires you to do that much homework when u get home and weekend or night calls. I just hope I don't get burned out so soon.
 

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I'm a pre-med and at the hospital I'm volunteering at, a few of the nurses said they like to make the third year med students change bed pans and stuff to make them more humble. Is that for real?
 

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MedStudentWanna said:
I'm a pre-med and at the hospital I'm volunteering at, a few of the nurses said they like to make the third year med students change bed pans and stuff to make them more humble. Is that for real?
Not that I've ever heard of, unless they're confusing a medical student with a student nurse (which occurs more often than you'd think, if you're female).

The type of work/scut you can expect to do as an MS3 is usually drawing bloods (or making sure they're drawn if you have a phlebotomy team that usually does it), getting ABGs, changing dressings, having data together for rounds, examining your patients, following up on any tests, filling out discharge paperwork, dipping urine if it needs to be done sooner rather than later, getting together everything your resident needs for a procedure, preoping and postoping patients on surgery, writing a brief op note, arranging social work, calling consults, and the occasional coffee run for your team. Don't get me wrong, you'll be 'owned', but by your resident, not the nurses.

That said, the nurses can hurt you if they want, especially at the beginning. At first you're not going to know where anything is, so you'll need a nurses help to find stuff. You're also not going to know what all the tubes going into and out of your patient are, so you're going to ask the nurses that. The nurse also may simply fail to pass information on to you about overnight events, which will make you look like a dork on rounds. However, you will find most nurses aren't like this if you're respectful and help them out occasionally. But you'll going to know the difference between that, and someone "making you change a bed pan to make you more humble".

The nurses you're talking to may just be trying to impress you with their infinite power or something. :cool:

Best,
Anka
 

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chocomorsel said:
I'm only on my third week of IM and hating it. On call days post call days, hours of just sitting around doing nothing, waiting to be paged, pretending to study and wanting to go home. Interns giving you a hard time and stupid little errands just cuz they are hating life right about now. Rounds that take 3-4hours. I know what I DON'T want to do. INTERNAL!!! Actually, I already knew that. Anyway, hope your other responses are more positive.

I second your resentment towards medicine. I just sit around and pretend to be interested in whatever they have to say about various "cool cases." It's funny how talking about internal medicine can give these guys, especially my attending, mental orgasms.........and I am not surprised if he actually got the real orgasms either.

What I hate about medicine is their utter ineffciency. At my hospital, when my residents get paged about a patient being in the ER, all the residents begin to salivate. And instead of seeing the patient first, they spend the first hour reading about the patient's past hospital visits. Correct me if I am wrong, but shouldnt the medical history be obtained from the patient first?

I came to realize that medicine doctors are completely unnecessary. They just sit around, talk about "cool cases," and do paperwork. Go through 4 years college, 4 years med school, and 3 years of residency just to do that? Must be very rewarding to realize that after 11 years of education, the same task can be accomplished by a PA.

Also, 90% of the patients that we admit do not even need to be admitted.
-HIV patient with dysphagia/anorexia due to oral/pharyngeal ulcers (tx: PO antiviral/antifungal)
-Asymptomatic bradycardia from verapamil overdose (tx: wait for verapamil to clear the system)
-Metastatic bone pain (tx: all we did was give PO pain meds)

The list just goes on and on......

I'm just venting.......so if I have offended any medicine docs, then my apologies.
 

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Doggie said:
I came to realize that medicine doctors are completely unnecessary.

...

I'm just venting.......so if I have offended any medicine docs, then my apologies.
I appreciate that you're just venting; this is a good forum for it (rather than to people in the hospital). And I couldn't be an internist myself; I just don't have the temperment for it.

But I have tremendous respect for the good internists I've known, most of whom have a very strong knowledge base and analytic capacity. And they're incredible professionals; they put forth the full effort for their patients, even the most difficult and painful to handle.

Besides which, our whole health care system falls down without the primary care internists who manage most patients over the long-term. How many times have you heard someone say, "We'll let that be dealt with as an outpatient?" Well, that usually means "We're going to dump this on some internist somewhere."

And it's not as if the system rewards them, either. In addition to not being compensated very well (for physicians), they have to deal with the most incredible crap patients and payers and ignorant/arrogant physicians. I honestly don't know how they keep going, and why they don't just dump the whole mess back in all of our laps.

It's OK if you don't want to be an internist---it's obviously not for everybody, and there are lots of important roles to play in medicine. But let's not look down on such dedicated, talented, put-upon colleagues.

Internists---tonight I raise my glass to you.
 

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ears said:
It's OK if you don't want to be an internist---it's obviously not for everybody, and there are lots of important roles to play in medicine. But let's not look down on such dedicated, talented, put-upon colleagues.

Internists---tonight I raise my glass to you.
Agreed. Internists are vital to medicine and I'm so glad that there are people who want to do it so I don't need to.
 
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