DrMike24 said:
Hey Dr. Mike
I am just finishing up my second year here at USF. I will do my best to recount my clinical experiences so far. I know that one of the students from Miami previously said that he/she felt that the clinical stuff early on is a waste of time and that more time to focus on the boards would be better. Let me offer a contrary perspective if you will bear through my long writing. Like REL said you will work formally with 3 docs during the 1st 2 years. At least one will be primary care (family, peds, IM) and one will be a specialty (GI, neurosurgery, ortho, derm etc...), the last can be either. In this process you have no say about your 1st pairing. During 1st year I was paired up with a Family Practice doc for about 6 months. She was in Clearwater and the drive sucked, but the experience was great. I was only a shadowing experience for the 1st day, after that I was seeing patients and getting to misdiagnose stuff all over the place. The benefit if this experience is that I could practice my interviewing skills and fumble my way through the physical exam. I would see 3-5 patients a day on my own, and present them to her, and then she would have me write a one of the notes before I left. During that LCE (that's Longitudinal Clinical Experience) I got to see everything from your typical old guy with hyper everything, kids for sports physicals, a young guy with bizarrely uncontrollable HTN (...mental note not to do cocaine before getting blood chemistry/toxscreen drawn) to a rather nice gentleman who had a fungal infection on his penis for 9 months(please don't ask). Overall, this was a great experience. She was a very knowledgable doc, really good with her patients, the residents were very good to me, I learned a lot, and realized that I probably don't want to do family medicine.
The point of these early experiences is not so much to get you to be a rock star at diagnosing stuff, but to #1: put some context to what you are learning in the classroom, #2: give you a freakin break from the classroom, #3: to let the students begin to understand how all of the "nuts and bolts" of patient care work such as interacting with attendings, presenting, writing notes etc and, #4: most importantly in my opinion the LCE lets you begin to understand and become part of the complexities of the doctor -patient relationship. Because this is not graded you really just get to use this as a learning tool to best fit your needs.
For the sake of space and time I will hurry here.
Between 1st and 2nd year during my summer I did research with a foot and ankle orthopod. I needed to work that summer and because I am smarter than I am good looking I choose paid research over exotic dancing. Research is not required, but if you want to do it you can and they will throw ~ 2500 bones your way. Aside form doing the clinical research (not really that time consuming) I got to go into clinic with her and see patients and go into the OR. In her clinic I would see new patients 1st and then present them to her, I would rebandage dressings, take out staples and sutures, and try very poorly to read Xrays (no radiology for me). Clinic days were crazy and way over booked, but she was a great teacher and very patient. Friday was OR day. I got to scrub in on every case (at present we have no ortho residency so it was just her and I). I got to do some suturing, take screws, lots of bovieing (sp?), and I got to be there when we amputated the toe of one of our faculty
. Overall, a very good experience. I will likely get a paper out of the research and realized that I like surgery, but not bones. During 2nd year I had 2 docs that I worked with. For the 1st part of the year I was with a pediatric pulmonologist. He was a good guy, very caring. I found the experience a bit boring and somewhat depressing though. Lots of asthma over and over (boring after a couple of weeks, at least for me) and a good amount of cystic fibrosis kids (kinda depressing). He had a very busy practice and and I saw tons of patients, but they were generally from one of the previous 2 groups. Not a thrilling experience, but not bad overall. I can rule out pulmonology as a field and probably peds too.
My second LCE of the 2nd year was with a general surgeon. This was my favorite so far. The drive was the worst by far, but well worth it I thought. Each week I would alternate between clinic days and OR days. It was at the VA in St. Pete so I got to see a lot of the traditional bread and butter GS stuff. Lots of hernias, carotid endarterectomies, generally lots of gut surgeries. In the clinic I saw patients and presented them to the attending just as the MSIIIs were doing, although not quite as good. Again I got to scrub in on almost every case, but here there were residents and MSIIIs so the 1on1 was less, but the cases I thought were more interesting than over the summer. The highlight was scrubbing in on a AAA repair (abdominal aortic aneurysm). Lots of holding retractors and stuff in the OR, but you understand anatomy so much better when you see it alive and beating.
Overall in the 1st 2 years I scrubbed in on a couple of dozen OR cases. I have done a good amount of focused H&Ps (you kinda lose count, but I'm guessing Ive done and written up 25-30). Probably a dozen full H&Ps and seen >100 pts with the docs (probably a couple of hundred). I think that many of my classmates have had similar experiences. My experiences overall were very good, because I think that I had really good preceptors. During the 2nd year you can have some i/p about the 3rd preceptor that you have, but the 1st two are assigned to you.
Ok, sorry Dr. Mike and all for the long windedness. I hope that at some point I actually addressed your question. Yes, seeing all those pesky sick people will distract you from studying for step 1 for a few hours as my colleague from Miami pointed out, but they will also be there when you study for step 2 and I think you will also need to see patients when you study for step 3 and .....judges ....yep you will be seeing patients when you are studying for your specialty boards. My sarcastic point is that the time away from the books is generally a good and welcomed experience. I think that is one of the highlights at USF.
Good luck my friend on having the enviable burden of deciding between medical schools.
Please let me know if I can answer any other questions.
Actually, I shouldn't crack on her so much....she really does have a totally awesome bachelorette pad. 
