Worried about quality of Rotations

[tealeafexplorer]

Hi everyone, I know it is still early in 3rd year, but COVID caused my first 2 rotations to be virtual, and my last rotation as well as current rotation are more or less shadowing.

I follow my preceptor and he teaches me some things, and I do some physical exams with him on patients, but I have not been able to write an official note, or do a presentation on a patient yet.

I have had ample time to study during my rotations, so i have been doing well on shelf exams and have been studying for step 2, but am scared that I will not have experience in working with residents in a teaching hospital before I apply for and go to residency.

I will try and set my electives at teaching hospitals, hopefully in IM as well as FM, and hopefully get some experience as to what its like to be a resident and intern, but I am just scared about how rotations have been going so far


Is this something I should be worrying about right now??? Or should I just focus on learning as much from my preceptors and doing well on my exams? I am hoping 4th year I can schedule rotations at teaching hospitals with residents

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[jurassicpark]

Well, no use in worrying about something you can't change. In regards to virtual rotation, a lot of your fellow peers are in the same boat with a lot of their core rotations being virtual. How this will pan out is anyone's guess, this is in uncharted water. But can definitely put you at a disadvantage when you're doing your elective and auditions where you can't even find the bathroom room, let alone know what you are supposed to be looking for in a chart. Doesn't help a lot of people's IM-ward and surgical rotations were all virtual since these rotations are usually the basis of understanding hospital life.

Preceptors are a highly variable lot. Some understand that preceptors are not the best way to teach students to become functional 4th years and residents and try to set up their rotations to give you a little taste and foundation. A lot more can't be bothered and is essentially shadowing.

Focus on what you can, study the beejsus out of everything you can. It's the best you can do

 

[tealeafexplorer]

Well, no use in worrying about something you can't change. In regards to virtual rotation, a lot of your fellow peers are in the same boat with a lot of their core rotations being virtual. How this will pan out is anyone's guess, this is in uncharted water. But can definitely put you at a disadvantage when you're doing your elective and auditions where you can't even find the bathroom room, let alone know what you are supposed to be looking for in a chart. Doesn't help a lot of people's IM-ward and surgical rotations were all virtual since these rotations are usually the basis of understanding hospital life.

Preceptors are a highly variable lot. Some understand that preceptors are not the best way to teach students to become functional 4th years and residents and try to set up their rotations to give you a little taste and foundation. A lot more can't be bothered and is essentially shadowing.

Focus on what you can, study the beejsus out of everything you can. It's the best you can do

Thanks for the kind and reassuring words. I will study and learn the most I can

 

[Noemata]

Regarding notes, just know the SOAP format. Give the patient's story first (Subjective), then the objective data. Then make a list of every problem you can think of for that patient. If it's a 50+ age patient who hasn't had a colonoscopy yet, well, that goes on your problem list (Assessment). And for each problem on your list in descending order of acuity and importance, plan what you're going to do (Plan). The plan can be as simple as "Observe" all the way to "Emergent surgery consult."

A good note often translates into a good presentation. For me, I usually just presented my SOAP note as my presentation.

Regarding physical exam, see if your school has a Physical Exam teaching handbook as part of the curriculum. If not, I would recommend the Bates Physical Exam textbook and the videos accompanying it (Bates Visual Guide to Physical Exams). The textbook is way too detailed, so just focus on the videos and you should be good.

Good luck!