What is the importance of clinical rotations?

[Postictal Raiden]

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Aside from getting letters, what role do clinical rotations play in medical education? Do 3rd and 4th year get to learn skills that will help them in their residency? Or do they spend the majority of their time shadowing and reading about diseases?

 

[koan]

You'll be seeing patients, managing medication, filling out paperwork, assisting in surgery, discussing lifestyle modifications, filling out more paperwork, and yes, reading about diseases in your spare moments. A rotation where you are shadowing is a bad rotation, but it happens sometimes. Usually you're following residents around and learning exactly what they do and helping them do that stuff.

 

[Postictal Raiden]

You'll be seeing patients, managing medication, filling out paperwork, assisting in surgery, discussing lifestyle modifications, filling out more paperwork, and yes, reading about diseases in your spare moments. A rotation where you are shadowing is a bad rotation, but it happens sometimes. Usually you're following residents around and learning exactly what they do and helping them do that stuff.

Thank you for your response.

I'm glad to see that I will have the opportunity to get my hands dirty. What do you mean by assisting in surgery? Holding the lamp for the surgeon or making incisions and practicing stitching?

 

[cabinbuilder]

It's to figure out what you like and what you don't so you have an informed decision as to what residency you choose. Sometimes what you envision your life's dream to be does not turn out how you expected. You may think you will love being a pediatrician, then you got on rotations and realize that dealing with dirty, screaming children every day with bad parents really sucks. Or something you thought would be gross, like pathology, you fall in love with. Never know.

Assisting in surgery can be holding the camera during a gall bladder, holding a retractor, helping with sutures, etc.

 

[Postictal Raiden]

It's to figure out what you like and what you don't so you have an informed decision as to what residency you choose. Sometimes what you envision your life's dream to be does not turn out how you expected. You may think you will love being a pediatrician, then you got on rotations and realize that dealing with dirty, screaming children every day with bad parents really sucks. Or something you thought would be gross, like pathology, you fall in love with. Never know.

Assisting in surgery can be holding the camera during a gall bladder, holding a retractor, helping with sutures, etc.

I see. However, I'm wondering whether you actually benefited from your rotations. Did you learn skills that helped in residency? I think what I'm trying to figure out if one would be at a great disadvantage if he/she didn't get to do things in their rotations. As Koan has implied, some rotations are better and more involving than others, so my question is, will those who do "bad" rotations end up being worse residents and eventually less competent physicians?

 

[cabinbuilder]

I see. However, I'm wondering whether you actually benefited from your rotations. Did you learn skills that helped in residency? I think what I'm trying to figure out if one would be at a great disadvantage if he/she didn't get to do things in their rotations. As Koan has implied, some rotations are better and more involving than others, so my question is, will those who do "bad" rotations end up being worse residents and eventually less competent physicians?

Not really. Most rotations are generally good since no one forces doctors to take students so those who do generally like to teach, etc. Of course there are bad rotations (I've had my share) it just taught me how not to be. Everyone has to do the same core rotations to get experience in all aspects of general medicine. Depending on what residency you choose, you may never do that again. Like being on OB/GYN delivering a baby knowing in your heart you will in the lab as a pathologist. Does it matter if you never did a delivery or just watched during a C-section? NOPE. On the flip side of that, if you are on a rotation and see yourself needing those skills then by all means let your attending know that you would like to try to intubate or learn suturing, or reading x-rays, or learning the different splints and casting techniques, etc.

 

[Postictal Raiden]

Not really. Most rotations are generally good since no one forces doctors to take students so those who do generally like to teach, etc. Of course there are bad rotations (I've had my share) it just taught me how not to be. Everyone has to do the same core rotations to get experience in all aspects of general medicine. Depending on what residency you choose, you may never do that again. Like being on OB/GYN delivering a baby knowing in your heart you will in the lab as a pathologist. Does it matter if you never did a delivery or just watched during a C-section? NOPE. On the flip side of that, if you are on a rotation and see yourself needing those skills then by all means let your attending know that you would like to try to intubate or learn suturing, or reading x-rays, or learning the different splints and casting techniques, etc.

Thank you.

One last question, can DO students sign up for audition rotations at MD academic hospitals? Or are they only limited to hospitals that are affiliated with their schools?

 

[cabinbuilder]

Thank you.

One last question, can DO students sign up for audition rotations at MD academic hospitals? Or are they only limited to hospitals that are affiliated with their schools?

Yes, just depends on the rotation site. Generally it tells you on their web site. I rotated on surgery in Albuquerque as a DO, at UMC in Las Vegas, and in Fairbanks, AK. You are only limited by the rules of your school. You should have elective months and those are yours to do with how you want. Just remember that if you "go outside" the school affiliated sites, your school is not obligated to help you and it will be up to you to file to paperwork, get permission, get yourself there, and find your own housing.

 

[Elisabeth Kate]

It's to figure out what you like and what you don't so you have an informed decision as to what residency you choose. Sometimes what you envision your life's dream to be does not turn out how you expected. You may think you will love being a pediatrician, then you got on rotations and realize that dealing with dirty, screaming children every day with bad parents really sucks. Or something you thought would be gross, like pathology, you fall in love with. Never know.

That's definitely part of it, but a bigger part of third year is learning medicine. The first two years is book knowledge. Third year is where you learn medicine and I'd argue that third-year rotations are important, regardless of specialty. You may never deliver a baby if you go into IM or neurology, but you will always have pregnant patients and your OB rotation will teach you how to care for them. If you go into third year thinking of it only as a way to find out what you want to do, you'll write off rotations you know you're not interested when, in all honesty, they have a lot to teach you.

 

[cliquesh]

That's definitely part of it, but a bigger part of third year is learning medicine. The first two years is book knowledge.

This. What you learn during your preclinical years and what you study for boards does not translate into the everyday practice of medicine. During 3rd and 4th year rotations is when you actually start to learn how to care for patients; how to act like a doctor. Consequently, your clinical years are arguably the most important aspect of your medical school education. You will, at the very least, learn how to gather a history, perform an appropriate physical exam, and come up with a plan, which are the fundamental skills you need as an intern.

You will also learn some procedures on your rotations, but it is somewhat of a hit or miss process depending on the attending/residents you are working with and what rotations you choose to do. I'd recommend doing a month of ICU, a month of surgical ICU, and a month of anesthesia before you graduate. Not only will you feel comfortable treating very ill patients but you will also learn a lot of useful skills, such as mask ventilating, intubating, and central line placement, which are skills many interns, residents, and, even attendings, are deficient in.

As a 3rd year, you pretty much can only do electives at your school's affiliated programs. As a 4th year, you can do electives anywhere that will take you. Most, but not all, hospitals take DOs. You can visit the hospital's webpage and click "visiting medical students," or something similar, to see what their requirements are for visiting rotators. Also, many hospitals use VSAS, which is an online application service for visiting students. I used this service to set up my elective rotations at university hospitals. You could make a log in and see which electives are open to DOs.
https://www.aamc.org/students/medstudents/vsas/

 

[Postictal Raiden]

This. What you learn during your preclinical years and what you study for boards does not translate into the everyday practice of medicine. During 3rd and 4th year rotations is when you actually start to learn how to care for patients; how to act like a doctor. You basically learn how to gather a history, perform an appropriate physical exam, and come up with a plan, which are the fundamental skills you need as an intern. Your clinical years are arguably the most important aspect of your medical education.

You also learn some procedures on your rotations, but it is somewhat of a hit or miss process depending on the attending/residents you are working with and what rotations you choose to do. I'd recommend doing a month of ICU, a month of surgical ICU, and a month of anesthesia before you graduate. Not only will you feel comfortable treating very ill patients but you will also learn a lot of useful skills, such as mask ventilating, intubating, and central line placement, which are skills many interns, residents, and, even attendings, are deficient in.

As a 3rd year, you pretty much can only do electives at your school's affiliated programs. As a 4th year, you can do electives anywhere that will take you. Most, but not all, hospitals take DOs. You can visit the hospital's webpage and click "visiting medical students," or something similar, to see what their requirements are for visiting rotators. Also, many hospitals use VSAS, which is an online application service for visiting students. I used this service to set up my elective rotations at university hospitals. You could make a log in and see which electives are open to DOs.
https://www.aamc.org/students/medstudents/vsas/

Since I will be attending a DO school that is within 100 miles of top-tier MD schools, would it be wise to try to do my elective rotations at their university hospitals, or is it better to do audition rotations at hospitals that are known to have taken DO's in the past?

 

[FrkyBgStok]

Since I will be attending a DO school that is within 100 miles of top-tier MD schools, would it be wise to try to do my elective rotations at their university hospitals, or is it better to do audition rotations at hospitals that are known to have taken DO's in the past?

you are jumping way ahead of the gun. you haven't started and are worried about elective rotations. you have time.

 

[cliquesh]

Since I will be attending a DO school that is within 100 miles of top-tier MD schools, would it be wise to try to do my elective rotations at their university hospitals, or is it better to do audition rotations at hospitals that are known to have taken DO's in the past?

It depends on the field you're interested in, I suppose. If you want to do a surgical subspeciality, you should just stick with AOa programs. If you want to do something really DO friendly, like anesthesia, PM&R or EM, for instance, it might be worth rotating at that program if you REALLY want to go there and they have a history of taking a few DOs in the past. If they've never taken a DO its probably not worth it.

Keep in mind that MD programs do not expect you to do auditions, except for maybe EM. Moreover, the educational experience will probably be no better than any other university program. So its really not necessary to do auditions if your application is strong. Doing well on your rotation at a top hospital will not make up for average board scores.

Also, you should plan to take the usmle if you want to do your residency at a decent university program.

 

[Nymphicus]

Clinical rotations are where you learn to be a doctor and how to care for real!!! patients.

 

[Highway61]

Clinical rotations are where you learn to be a doctor and how to care for real!!! patients.

My thoughts exactly.
Regarding this thread:

 

[Postictal Raiden]

My thoughts exactly.
Regarding this thread:
View attachment 178125

Excellent contribution!

 

[Dr. Zombie]

What are some tips n tricks to ensure you honor as many rotations as possible?

 

[Mr Kenobi]

What are some tips n tricks to ensure you honor as many rotations as possible?

 

[sonofva]

i also tried to approach each preceptor as if i was trying to write a biography about them... i would ask what their life was like in and out of practice. why they got into the field. how to manage a successful practice, etc.... the joy of 3/4th years is that that noone expects you to know jack or do much... haha

 

[Dr. USMLE]

I would do the same...it helps your evaluation if your preceptor thinks you are showing interest in them and their field/career.

They do have expectations and will definitely compare you to others at your training level, but that's an opportunity to shine.

 

[NontradCA]

Purpose of rotations is to hone RN pickup skills. Amirite.

 

[Goro]

Jeeze, ibn, if you have to ask...

OK, Dr goro has composed himself now.

Think of the 3rd and 4th years as learning the real doing of Medicine, as opposed to learning the knowing of Medicine, which you get in your first two years.

 

[tripl3s3v3n]

Purpose of rotations is to hone RN pickup skills. Amirite.

Am I the only one that read that post in the voice of Turk from scrubs? LOL.