What to do about Not-In-Person Core-Surgery rotation

[MAS91]

Hi! I am a third-year, I am very interested in surgery but I found out that I may not have the opportunity to experience surgery in-person. Nothing is for sure but I have a strong feeling I may end up losing the opportunity to experience surgery. I was wondering if anyone knows of a strategy to overcome this? I, unfortunately, lost my research opportunity as well. Definitely a crappy situation but I am sure there's a solution just need to figure it out!

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[samac]

If you’re interested in surgery you have to figure out a way to get into the OR. Applying surgery without ever actually experiencing it terrifies me for you.

 

[ritts]

Hi! I am a third-year, I am very interested in surgery but I found out that I may not have the opportunity to experience surgery in-person. Nothing is for sure but I have a strong feeling I may end up losing the opportunity to experience surgery. I was wondering if anyone knows of a strategy to overcome this? I, unfortunately, lost my research opportunity as well. Definitely a crappy situation but I am sure there's a solution just need to figure it out!

can you try doing surgery for an elective?

 

[Osteosaur]

So sorry you're in this situation. Besides trying for an elective, I think your student body needs to put some actual pressure on administration so you can get all the necessary exposures. Its ridiculous otherwise.

 

[jurassicpark]

If you’re interested in surgery you have to figure out a way to get into the OR. Applying surgery without ever actually experiencing it terrifies me for you.

^ this

Actually, practically ALL of the cores should be done in person. That is the only way you learn to interact with hospital staff, personnel and most importantly patients. You get the tempo of what is going on, and how to respond and stay cool under pressure. It is where you start learning the art of the trade.

The more I hear about students losing their core rotations to online modules compounded by the lack of electives is extremely terrifying and frustrating for me, I can't imagine what you students are going through and honestly I can't think of solution that is painless or easy.

 

[AnatomyGrey12]

By COCA requirements at least 2 weeks of your core surgery rotation must be done in person.

 

[Neopolymath]

By COCA requirements at least 2 weeks of your core surgery rotation must be done in person.

My school has not said anything about this and made no mention of making things up. So it will be interesting to see how they react later.

 

[AnatomyGrey12]

My school has not said anything about this and made no mention of making things up. So it will be interesting to see how they react later.

I would seriously press your admins. One of our very high ups sits on the COCA board, and they straight up said that any school that isn't doing at least 2 weeks of core rotations face to face must make that time up later or they can't graduate the students. Even if it's you guys doing a bunch of 2 week online stuff now and then 2 week in person rotations next spring would be ok, but from what they said if that doesn't happen the schools will be in direct contradiction to COCA mandate and COCA will not allow them to graduate those students.

I'm kind of curious why COCA hasn't made on official statement about it, just to clarify the matter.

 

[Neopolymath]

I would seriously press your admins. One of our very high ups sits on the COCA board, and they straight up said that any school that isn't doing at least 2 weeks of core rotations face to face must make that time up later or they can't graduate the students. Even if it's you guys doing a bunch of 2 week online stuff now and then 2 week in person rotations next spring would be ok, but from what they said if that doesn't happen the schools will be in direct contradiction to COCA mandate and COCA will not allow them to graduate those students.

I'm kind of curious why COCA hasn't made on official statement about it, just to clarify the matter.

I agree. Do you happen to have any supporting doc I can use to share?

 

[AnatomyGrey12]

I agree. Do you happen to have any supporting doc I can use to share?

No, just the response that was sent to us when a student asked if we were moving to fully online rotations indefinitely.

Edit. I guess I could have been told incorrectly as I can't find any definitive proof from COCA that is their policy from a quick google search

 

[Neopolymath]

No, just the response that was sent to us when a student asked if we were moving to fully online rotations indefinitely.

Edit. I guess I could have been told incorrectly as I can't find any definitive proof from COCA that is their policy from a quick google search

I can't find anything in the policies either. Perhaps someone else has been told one way or the other.

 

[PsychHopeful2021]

I would seriously press your admins. One of our very high ups sits on the COCA board, and they straight up said that any school that isn't doing at least 2 weeks of core rotations face to face must make that time up later or they can't graduate the students. Even if it's you guys doing a bunch of 2 week online stuff now and then 2 week in person rotations next spring would be ok, but from what they said if that doesn't happen the schools will be in direct contradiction to COCA mandate and COCA will not allow them to graduate those students.

I'm kind of curious why COCA hasn't made on official statement about it, just to clarify the matter.

This is interesting; I know my school changed their rotations to abide by this. I've also heard of another DO school apparently okaying all online rotations for their students.

 

[NotAProgDirector]

N=1 but I can't imagine I'd seriously consider any application, MD or DO, where cores are online. All the current apps will have a hole from March to May/June, which is fine. But beyond that? You can't teach clinical medicine online.

Maybe I'm old fashioned? Are these just "online modules" or have they strapped GoPro's to doc's heads and you actually get to interact with patients?

 

[jurassicpark]

or have they strapped GoPro's to doc's heads and you actually get to interact with patients?

..that is actually.. that is actually a great idea! :-D

 

[AnatomyGrey12]

This is interesting; I know my school changed their rotations to abide by this. I've also heard of another DO school apparently okaying all online rotations for their students.

Well from my understanding it isn't just "no all online rotations." It's no all online CORE rotations, as COCA defines them. So stuff like Surgery, IM, Peds, FM, OB, etc. Electives and other graduation requirements can be done fully online.

 

[Isoval]

N=1 but I can't imagine I'd seriously consider any application, MD or DO, where cores are online. All the current apps will have a hole from March to May/June, which is fine. But beyond that? You can't teach clinical medicine online.

Maybe I'm old fashioned? Are these just "online modules" or have they strapped GoPro's to doc's heads and you actually get to interact with patients?

Our hospitals aren't accepting students until the end of August.

We're contracting rotations; your first two longs are cut in half with half in person and half online if you have longs and your first four shorts are cut in half if you have shorts.

e.g. my original schedule was Surgery, FM, IM. Now, I have 4 weeks online Surgery with simulations on campus, 4 weeks FM online, 4 weeks FM in person, 8 weeks IM in person, and 4 weeks Surgery in person.

 

[MAS91]

N=1 but I can't imagine I'd seriously consider any application, MD or DO, where cores are online. All the current apps will have a hole from March to May/June, which is fine. But beyond that? You can't teach clinical medicine online.

Maybe I'm old fashioned? Are these just "online modules" or have they strapped GoPro's to doc's heads and you actually get to interact with patients?

I am still in the dark as to what is going on. But I've made it very clear to my advisors that I will not be ok with taking surgery online. My goal is to make sure surgery truly is something I can see myself doing for years to come. I was told the schedule will be very fluid esp with covid numbers starting to inc again.

Do you have any suggestions for possible solution? I appreciate your time and am interested to learn a feasible solution.

 

[cookiegrub]

I would seriously press your admins. One of our very high ups sits on the COCA board, and they straight up said that any school that isn't doing at least 2 weeks of core rotations face to face must make that time up later or they can't graduate the students. Even if it's you guys doing a bunch of 2 week online stuff now and then 2 week in person rotations next spring would be ok, but from what they said if that doesn't happen the schools will be in direct contradiction to COCA mandate and COCA will not allow them to graduate those students.

I'm kind of curious why COCA hasn't made on official statement about it, just to clarify the matter.

I don't know what's worse...redoing core rotations in person because they didn't meet COCA guidelines or having that mandate retracted after weeks of sdn blowing up over yet another last moment announcement. All the while, covid-19 is sipping tea and saying YOLO. If my grandkids ever decide to go into medicine, I will make it a point to narrate this year to them

 

[Lanhaines Elsetion]

Is there any chance you can do an elective rotation in surgery later on during 3rd year? Another option if it isn't breaking any rules (some schools don't allow 3rd-4th years to shadow) is to contact surgeons later in the year and shadow them for a few weekends.

 

[NotAProgDirector]

I am still in the dark as to what is going on. But I've made it very clear to my advisors that I will not be ok with taking surgery online. My goal is to make sure surgery truly is something I can see myself doing for years to come. I was told the schedule will be very fluid esp with covid numbers starting to inc again.

Do you have any suggestions for possible solution? I appreciate your time and am interested to learn a feasible solution.

Even if COVID cases are increasing, why can't medical students be part of clinical care? Most sites seem to have solved their PPE issues. I'm fine with having students not see the COVID patients.

 

[MAS91]

Even if COVID cases are increasing, why can't medical students be part of clinical care? Most sites seem to have solved their PPE issues. I'm fine with having students not see the COVID patients.

I asked this question and I was told it is a liability issue and that most schools are not willing to assume the risk that comes with students being around COVID patients. Especially since there are still many unknowns regarding the disease. The other reason I was told is preceptors may not be able to deliver the best teaching while focusing on COVID related cases. The assumption is most physicians aren't in the same practicing environment as they were before COVID hit. From what I was told it seems physicians were pulled from different specialties to cover ICU or into other departments. Now that COVID is increasing it may happen again. I guess they believe students should be in a safer environment and we will have a better chance of learning from an online format.

If it was up to me I would attend all in-person rotations.

 

[Ho0v-man]

I would seriously press your admins. One of our very high ups sits on the COCA board, and they straight up said that any school that isn't doing at least 2 weeks of core rotations face to face must make that time up later or they can't graduate the students. Even if it's you guys doing a bunch of 2 week online stuff now and then 2 week in person rotations next spring would be ok, but from what they said if that doesn't happen the schools will be in direct contradiction to COCA mandate and COCA will not allow them to graduate those students.

I'm kind of curious why COCA hasn't made on official statement about it, just to clarify the matter.

I was told the exact same at my school and I have a hard time believing they’d tell identical lies.

 

[You shall know the Truth]

N=1 but I can't imagine I'd seriously consider any application, MD or DO, where cores are online. All the current apps will have a hole from March to May/June, which is fine. But beyond that? You can't teach clinical medicine online.

Maybe I'm old fashioned? Are these just "online modules" or have they strapped GoPro's to doc's heads and you actually get to interact with patients?

Neither, we had 5 cases on aquifer and some ome videos and the self thats about it.

 

[You shall know the Truth]

Even if COVID cases are increasing, why can't medical students be part of clinical care? Most sites seem to have solved their PPE issues. I'm fine with having students not see the COVID patients.

It’s because many students are complaining that they are being put in harms way. They refuse to help pt. because they might get COVID. There are many residents that are saying the same thing.

 

[samac]

It’s because many students are complaining that they are being put in harms way. They refuse to help pt. because they might get COVID. There are many residents that are saying the same thing.

Quite frankly from my understanding I feel there’s very little learning with them and they’re pretty formulaic. For no pay and nothing to show for putting their life on the line/their family’s it’s totally understandable to keep them off

 

[You shall know the Truth]

Quite frankly from my understanding I feel there’s very little learning with them and they’re pretty formulaic. For no pay and nothing to show for putting their life on the line/their family’s it’s totally understandable to keep them off

I respectfully disagree, we went into medicine to help not to run away when things seem bad. First responders run toward trouble and we should to. the Learning aspect is tremendous, can you tell me how COVID works with ckd or diabetes, how about pregnancy or cancer, maybe hiv or Parkinson’s? We know none of theses answers and to see these pt would offer great learning opportunities. Not to mention the decision making that goes on at all levels.

what happens when med students who don’t want to see COVID go into residency or practice and something Like this happens again? At least if they were seeing pt, now they Could make informed decisions later.

 

[samac]

I respectfully disagree, we went into medicine to help not to run away when things seem bad. First responders run toward trouble and we should to. the Learning aspect is tremendous, can you tell me how COVID works with ckd or diabetes, how about pregnancy or cancer, maybe hiv or Parkinson’s? We know none of theses answers and to see these pt would offer great learning opportunities. Not to mention the decision making that goes on at all levels.

what happens when med students who don’t want to see COVID go into residency or practice and something Like this happens again? At least if they were seeing pt, now they Could make informed decisions later.

First responders are paid. Residents are paid.
once you’re an attending/resident you are the doctor.
To volunteer their lives for minimal learning benefit and no actual helpfulness to patient care is selfish.

edited to say: theres plenty to learn about COVID from reading. If something like this happens again I hope we will minimize the number of people exposed in the hospital for best practices to protect the most people.

 

[cookiegrub]

I asked this question and I was told it is a liability issue and that most schools are not willing to assume the risk that comes with students being around COVID patients. Especially since there are still many unknowns regarding the disease. The other reason I was told is preceptors may not be able to deliver the best teaching while focusing on COVID related cases. The assumption is most physicians aren't in the same practicing environment as they were before COVID hit. From what I was told it seems physicians were pulled from different specialties to cover ICU or into other departments. Now that COVID is increasing it may happen again. I guess they believe students should be in a safer environment and we will have a better chance of learning from an online format.

If it was up to me I would attend all in-person rotations.

in terms of liability, I feel like every document my education throws at me is basically asking me to sign my life away lol. Is this situation any exception? I think there is more to it than that as there have been plenty of other liability-ridden aspects of our education that have been taken care of by our required signatures. Unlike my good samaritan friends on this forum, I do concur with the opposing side that says it is better to limit exposure by denying clinical experience. The saying "too many chefs in the kitchen can ruin the dish" may very well apply to this scenario. I believe people may not get that message until someone falls ill and courses through the symptoms while a vaccine is several months away from the making. Yes, you continue to visit stores, get your yearly required tests for medical school, but that is limited as you aren't stepping out of your house daily. If you are doing these activities everyday then perhaps doing a clinical rotation isn't out of the realm of possibilities but that simply isn't the pattern as many have been only stepping out of their home for necessities.

 

[BorntobeDO?]

I respectfully disagree, we went into medicine to help not to run away when things seem bad. First responders run toward trouble and we should to. the Learning aspect is tremendous, can you tell me how COVID works with ckd or diabetes, how about pregnancy or cancer, maybe hiv or Parkinson’s? We know none of theses answers and to see these pt would offer great learning opportunities. Not to mention the decision making that goes on at all levels.

what happens when med students who don’t want to see COVID go into residency or practice and something Like this happens again? At least if they were seeing pt, now they Could make informed decisions later.

My residency will not let students interact with a known COVID patient. That patient automatically goes to attending service, although we do have some night coverage with residents where we are expected to cover codes so it is possible for us (residents) to interact. However my hospital has excellent PPE, so we are as good off as anyone if we have to jump in the fire. It’s night and day how my DO school was handling COVID compared to how my residency is.