Help with away programs

[The wise one]

Greetings,

I am MSIII interested in GS/ 236 Step I. I had surgery first and HP'ed it. I ended up honoring every rotation since. I am mostly interested in clinical programs. Any idea?

Thank You,

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Edit:
- I am looking for an unopposed GS program or a community program with a solid reputation. I have had little success finding them online.

Edit 2:
- My understanding of an away = learn about the program.

Edit 3:
- But clinical medicine, I meant to say surgical medicine. From personal experience, top programs tend to focus on research and less on skills. Surgery is an art. Some programs try to balance both. Others have so much hierarchy (resident, fellow) that residents don't get much clinical experience.

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[AnatomyGrey12]

Very sparse on the details here. What exactly are you looking for?

 

[The wise one]

As much clinic experience as possible. I go to a mid tier, and they don't let operate as often as I wanted. Holding a retractor or closing the fascia get boring after a while.
I interned at an Ivy last year and I noticed the same trend.

 

[LucidSplash]

I don’t think you understand the purpose of an AI.

 

[FalconSlice]

Also confused:

1. What’s your specific question regarding away rotations as a third year student?

2. You already “interned” as in you’re finished with your PGY1? Or you mean away rotation/subI? (Also how since aways were only done for a select few this cycle?)

3. My extrapolation from what you asked was: what are some good programs for me to do an away rotation in GS? I am interested in “clinical medicine.” (I don’t understand the last part)

4. You talk about clinical medicine and then not wanting to retract all day in the OR... these aren’t the same thing?

Harder to crack than the latest Zodiac cipher

 

[The wise one]

@FalconSlice My apologies. I will edit my post once I get home.

@LucidSplash Do you mind sharing?

 

[LucidSplash]

@FalconSlice My apologies. I will edit my post once I get home.

@LucidSplash Do you mind sharing?

My takeaway from your post is that you want to be in the OR constantly and aren’t interested in the peri-operative care. Perhaps I am wrong and you meant something else when you said you wanted “clinical programs”. And you want people to “let you operate more” which at the level of an MS3/4 you think should be much more than closing fascia/skin and holding a learning stick?

First of all, an acting intern on any service gets into the OR yes. Any budding surgeons wants that. But at that level you are still learning basic periop care and should be focusing on a lot of what goes on outside the operating room.

If someone let you close fascia as an MS3, that is something because it is one of the most critical parts of a case where a bad stitch can go to hell - usually several days later.

I’m not sure what you expect people to be letting you do at the MS3/4 level. Like the whole Whipple? If you are bored with closing fascia, I’m not sure surgery is right for you.

 

[The wise one]

My takeaway from your post is that you want to be in the OR constantly and aren’t interested in the peri-operative care. Perhaps I am wrong and you meant something else when you said you wanted “clinical programs”. And you want people to “let you operate more” which at the level of an MS3/4 you think should be much more than closing fascia/skin and holding a learning stick?

First of all, an acting intern on any service gets into the OR yes. Any budding surgeons wants that. But at that level you are still learning basic periop care and should be focusing on a lot of what goes on outside the operating room.

If someone let you close fascia as an MS3, that is something because it is one of the most critical parts of a case where a bad stitch can go to hell - usually several days later.

I’m not sure what you expect people to be letting you do at the MS3/4 level. Like the whole Whipple? If you are bored with closing fascia, I’m not sure surgery is right for you.

True, but I have also had some cases where I was the assist (PGYIII). I want more of those cases, and I also don't want to end up in the middle of nowhere. Thus, the question.

I have edited the OP.

 

[FalconSlice]

True, but I have also had some cases where I was the assist (PGYIII). I want more of those cases, and I also don't want to end up in the middle of nowhere. Thus, the question.

I have edited the OP.

@LucidSplash is correct, as a third-year medical student, you should be thankful that they even let you suture. As a medical student, and even as an intern, you will not be assisting all the time (or even the majority of the time). Sure you can try to find whatever programs are right for you. Surgery is inherently a hierarchical field... you start at the bottom and a medical student is pretty far at the bottom... Your job is to learn as much as possible--especially the nonsurgical management of patients and floorwork

You are correct different programs have different operative experiences for the trainees. This is dependent on so many different things: number of available staff, volume, attending/program culture, your willingness to showcase your knowledge/enthusiasm, number of fellows, etc.

Also, away rotations are mainly for two additional reasons that the one you mentioned (i.e. learning about the program): it is a month long interview... and you better be f***ing ON the entire time which segues into 2.) if you're doing an away rotation there, it is understood that you are seriously "courting" that program. If you "just want to learn" there are plenty of opportunities throughout third and fourth year at your home institution.

 

[dpmd]

My takeaway from your post is that you want to be in the OR constantly and aren’t interested in the peri-operative care. Perhaps I am wrong and you meant something else when you said you wanted “clinical programs”. And you want people to “let you operate more” which at the level of an MS3/4 you think should be much more than closing fascia/skin and holding a learning stick?

First of all, an acting intern on any service gets into the OR yes. Any budding surgeons wants that. But at that level you are still learning basic periop care and should be focusing on a lot of what goes on outside the operating room.

If someone let you close fascia as an MS3, that is something because it is one of the most critical parts of a case where a bad stitch can go to hell - usually several days later.

I’m not sure what you expect people to be letting you do at the MS3/4 level. Like the whole Whipple? If you are bored with closing fascia, I’m not sure surgery is right for you.

I get the impression they go to school at a place where the fellow is getting walked through opening the abdomen and everyone lower than that is on retractor duty. I rotated at a place like that as a third year resident and it was painful that the most I was allowed to do beside a few lines under the supervision of the fellow (when I had gotten enough lines to be signed off to teach others by the end of my intern year) was closing half the abdomen (with the attending showing me how he likes it done for the other half) on a dead person (post harvest). So I assumed they are looking for a place that isn't like that. But I could be reading too much into it.

 

[dienekes88]

Greetings,

I am MSIII interested in GS/ 236 Step I. I had surgery first and HP'ed it. I ended up honoring every rotation since. I am mostly interested in clinical programs. Any idea?

Thank You,

---------
Edit:
- I am looking for an unopposed GS program or a community program with a solid reputation. I have had little success finding them online.

Edit 2:
- My understanding of an away = learn about the program.

Away is also your way of showing that you fit in with the culture of the program.

Edit 3:
- But clinical medicine, I meant to say surgical medicine. From personal experience, top programs tend to focus on research and less on skills. Surgery is an art. Some programs try to balance both. Others have so much hierarchy (resident, fellow) that residents don't get much clinical experience.

"Top programs" vary greatly with respect to the amount of operating. But that is the case in community programs too. Case mix may be less broad in a community program.

True, but I have also had some cases where I was the assist (PGYIII). I want more of those cases, and I also don't want to end up in the middle of nowhere. Thus, the question.

I have edited the OP.

OK. So this is where things are getting unclear. Did you like that because you got to assist? Or did you like the fact that there was a pgy-3 doing a case with the student as an assistant.

Same with the fascia comment. It is my opinion that a medical student should not close fascia, so are you saying that you didn't like the fact that there was a resident whose only role was opening and closing? Or that you only got to do fascia as the student.

I get the impression they go to school at a place where the fellow is getting walked through opening the abdomen and everyone lower than that is on retractor duty. I rotated at a place like that as a third year resident and it was painful that the most I was allowed to do beside a few lines under the supervision of the fellow (when I had gotten enough lines to be signed off to teach others by the end of my intern year) was closing half the abdomen (with the attending showing me how he likes it done for the other half) on a dead person (post harvest). So I assumed they are looking for a place that isn't like that. But I could be reading too much into it.

Thats what I thought until the above comments.

Always interesting to hear how students choose a program.