Our system changed about half way through my residency... the med school adopted a policy that the students had to follow the hour restrictions of interns, so no more 24 hour call. So now, they would generally do 1 late call a week while on day hours (6A - 10P) and have a full week of night float at some point (6P-6A). Personally thought this system was miserable -- I'd much rather do the occasional 24hr call and get a postcall day as a student.
That being said -- I thought overnight call was important on GS. You definitely saw some pathology you didn't see during the day. There also was a lot less oversight -- attendings not around the hospital and ready to go, senior residents not available, etc. Those were the times I could let our students do quite a bit. In the OR, I could also let the student take their time closing and such, since we weren't rushing to get to the next case.
GS is an important rotation, even for a FM doc. You need to learn to "talk the talk." Just like psych was important for me so I now know what are appropriate consults and what to expect from them. I'd much rather get a consult from a medicine doc saying "the patient has had 24 hours of RLQ pain, with rebound tenderness. I'm concerned about appendicitis, ordering a CT and sending over to you" rather than "The patient has belly pain, can you check it out?" (I know, lame example, but you get my point)
Do the students need to be as exhausted as me all the time? Of course not. It's our responsibility to understand what each student's needs are. I always made sure my students had eaten and were well hydrated, even if it involved them being a little late for a case. If someone who had been clearly working hard all month said they were exhausted and needed a break, I'd have no problem giving them an afternoon to go relax. If they had a legitimate "life event" that needed to be taken care of, of course they could have the day off. (had one student who needed to file some paperwork or she was gonna get deported. I was actually a little shocked she was worried about asking me....) In exchange, my expectation is that they are enthusiastic about being on surgery, regardless of career goals.
There are plenty of students that try to take advantage. A shocking number actually. I accept a vague, non-specific reason for time off once. After that, I need details or documentation that it was legitimate.
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On a different note -- we had PA students rotate on our service as well. Yes, there were lazy students and hard working students on both the med and PA sides. The PA students though were routinely more pleasant to be around, more enthusiastic, came to cases better prepared, complained less. Med students usually had a stronger knowledge base, but that was less important to me. Not trying to start a war, but anyone else have this experience? Always wondered why.