Electives over the next 3 years.

[kushr88]

New intern and I plan to apply for Pulm/CC fellowship. I was wondering what you guys thought would be good electives to get ready. We have the ability to do electives at other hospitals if we arrange it. I have heard procedures here are hit-or miss so I wanted to make my electives focused on that for the most part.

What are your thoughts on:

Trauma Elective (Heard one at University of Maryland is very good for procedures)
Anesthesia Elective
Other ICU's (Neuro/SICU)

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[jdh71]

I think getting more sick head icu is good for any internist and especially anyone wanting to do pulmonary and critical care.

Neurology is mostly an out patient, day time consult only kind of practice outside out academic centers.

 

[aspergilloma]

electives just to get clinical experience?
electives just to get letters for when ERAS rolls around?
electives just to boost your CV?

you can approach this situation in multiple ways...

 

[kushr88]

Probably for clinical experience. I should be good with letters. I guess I'm just wondering what elective will give me the most procedural experience.

 

[aspergilloma]

(as an FYI, there is a dedicated Pulmonary-Critical Care subforum; this thread is currently in the Critical Care forum. You might get different responses if you post in the Pulm-CC forum over the next couple of years.)

Does your program have a dedicated procedures elective? We have one that includes all of the ambulatory paracenteses & thoracenteses + a decent smattering of floor paras/thoras that the hospitalists don't have time to perform. I loved it and learned a ton; learning ultrasonography from a radiology attending/fellow is awesome. Got more reps in four weeks than I could ever dream of getting during residency.

Doing a neuro crit care rotation is good not just for the sake of the medical learning, but those are also some of the easiest A-lines you'll ever place.

Two of the non-procedures electives I've gotten the most mileage out of were a Thoracic Surgery rotation and a radiography elective.

 

[AdmiralChz]

Yep, above poster hit exactly what I was going to suggest - procedure elective, if available.

I'm an anesthesiology resident now, and we have a limited number of rotators that come with us from time to time (none from IM) - unless you need intubations, most residents might be less than enthusiastic about having you take care of a-lines/CVL in the OR. Some of my friends in other programs feel the same (honestly, it's a space and time issue most times). So other than potentially nice hours, why do an anesthesiology elective?

I really try to get the medical students (and interns) more involved on my ICU rotations so I would focus there.

 

[G-Man82]

The non-anesthesia trained fellows at my current hospital all do an anesthesiology elective. Essentially they flit from room to room looking for airways. When they ask me, I usually have them focus on BMV and introduce them to various airway tools and adjuncts. Plus I've basically stopped taking them through direct laryngoscopy. Video laryngoscopy is where it's at now.

An Anesthesiology elective would be good for airways. It can be good for lines if and only if you have a place where there are no residents.

Oh. And because I do CCM, too, I'll take them through the common ICU scenarios and try to guide them on induction medications in those scenarios. "20 of etomidate and 100 of sux" is not always appropriate. I also like to talk about NMBDs and their use. I feel like people are too afraid of them, which is fine if the guy looks challenging and is predicted to be difficult and you're thinking of consulting out for the airway, but for emaciated granny from the nursing home? It's probably ok.

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