How depressed are you supposed to get on MS3 surgery?

[Kahreek]

There's no point in dwelling on it. Unless you went to an Ivy, MIT, Stanford, or maybe a few other schools, it's unlikely that you ever had a shot at investment banking.

since the lemon brothers fall and subsequent cushioning by the us state. I don't even consider IB a true job anymore. Quant trading is black magic as far as I know, you either are an expert at trading and can read the markets well and make decisions based on odds, have good position in some good firm which goes to war only when it knows it can win or you hedge all your investments and arrange some entity to take your collateral.

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[Psai]

Surgery training with a baby must be ridiculous. Those people need some kind of medal.

I've heard of a resident who kept working until her water broke. That's when I knew I didn't have what it takes to be a surgeon

 

[KnuxNole]

I've heard of a resident who kept working until her water broke. That's when I knew I didn't have what it takes to be a surgeon

I would be using my sick days to a T if I had someone cooking in my belly....after all, they ARE there for a reason, no point in putting them all to waste.

 

[SouthernSurgeon]

I would be using my sick days to a T if I had someone cooking in my belly....after all, they ARE there for a reason, no point in putting them all to waste.

Most surgery residencies do not have sick days.

 

[Winged Scapula]

I've heard of a resident who kept working until her water broke. That's when I knew I didn't have what it takes to be a surgeon

I would be using my sick days to a T if I had someone cooking in my belly....after all, they ARE there for a reason, no point in putting them all to waste.

Most surgery residencies do not have sick days.

Yep, we were made to "sell back" our sick/personal days given by the GME office. I've talked to other friends who said they didn't have any built-in sick/personal days and vacation time had to be used.

 

[sakata8242]

Gen surg is your FIRST clerkship? Jesus, your school is administered by sadists.

IMO it should be after IM, so that you've been through those UW qs before you have to take the surg. shelf.

Unless your med school class is like, 30 per year, there will be people who HAVE to start on surgery in order for everyone to rotate through all the clerkships.

 

[SouthernSurgeon]

Yep, we were made to "sell back" our sick/personal days given by the GME office. I've talked to other friends who said they didn't have any built-in sick/personal days and vacation time had to be used.

It's actually really complicated for a pregnant woman - since the ABS mandates 48 weeks/yr of clinical training, taking any kind of sick days/maternity leave likely requires extending your training

 

[Winged Scapula]

It's actually really complicated for a pregnant woman - since the ABS mandates 48 weeks/yr of clinical training, taking any kind of sick days/maternity leave likely requires extending your training

Agreed.

The only ones I had/have experience with planned their pregnancy during lab years, so not as much of an issue. I cannot imagine doing it during clinical years or using all my yearly vacation time for postpartum reasons.

 

[Winged Scapula]

Yeah, sorry it was a bit out of line to post that and I apologize. I just remember seeing that video a while ago and thinking it was a bit pretentious. Sometimes I feel the premed advising here gets a bit self-important, as if people think they're minor celebrities here. Whatevs, it was out of line. Overall you're a good dude, Nick.

I'll remove my post

Unfortunately some of the bad rap SDN gets is from the fact that very few medical students and residents actually take the time to try and help the pre-meds, so it ends up being the blind leading the blind, with an incredible amount of misinformation.

@NickNaylor and his colleagues willingly gave up their time and anonymity to help applicants without being asked and I, for one, am incredibly grateful to them.

 

[LostinLift]

Have any former college athletes here finished their surgery rotation? ? I.E. in undergrad you had to wake up at 4-5am for workouts, go to class/lab all day, then go to afternoon practice.

If so, how did you feel about your surgery rotation?

 

[mimelim]

Your experience is hardly the norm of actually getting to do a lot of procedures or anything of significance. http://theunderweardrawer.homestead.com/obgyn1.html

I never understood this. At my medical school... On OB, it was unusual for an MS3 to not do 3-4 deliveries. I know several that did 10+. I had next to zero interest in the deliveries themselves and while I didn't run from them, certainly turfed them to others if they wanted to do them and still did 4. On the other hand I had 5 c-sections in a 6 week block. Don't get me wrong, I know that that stuff happens. There are definitely clinical sites that just aren't appropriate for residents, much less students. But, from my experience (4 institutions), those situations are vastly out numbered. I've heard a dozen complaints about "not getting to do anything" from students on services that are gold mines for procedures and active student participation. They tend to be the same people who complain about longer hours. It usually boils down to people being passive learners and not proactive about their learning.

 

[Kahreek]

Have any former college athletes here finished their surgery rotation? ? I.E. in undergrad you had to wake up at 4-5am for workouts, go to class/lab all day, then go to afternoon practice.

If so, how did you feel about your surgery rotation?

it is not about the hours trust me. Many people exercise before their morning job, or some even take their sweet time to shower, read the newspaper, eat, etc, effectively waking up at 4am, and they only bless it, making their whole work day better. Getting there at 4am is completely different animal.

 

[DermViser]

I never understood this. At my medical school... On OB, it was unusual for an MS3 to not do 3-4 deliveries. I know several that did 10+. I had next to zero interest in the deliveries themselves and while I didn't run from them, certainly turfed them to others if they wanted to do them and still did 4. On the other hand I had 5 c-sections in a 6 week block. Don't get me wrong, I know that that stuff happens. There are definitely clinical sites that just aren't appropriate for residents, much less students. But, from my experience (4 institutions), those situations are vastly out numbered. I've heard a dozen complaints about "not getting to do anything" from students on services that are gold mines for procedures and active student participation. They tend to be the same people who complain about longer hours. It usually boils down to people being passive learners and not proactive about their learning.

There are cases in which "I'm not getting to do anything" = "I'm not wanting do do anything" (but bc I'm nice, can you give me Honors, anyways?)

I think a lot of it has to with the earth-shattering transition from MS-2 to MS-3, in which the expectations and culture vary wildly among rotations and among residents, to which you are put on the spot a lot, and your grade is an overall gestalt of you, and not your ability to fill in multiple choice bubbles. I think it's difficult for many in the transition from sitting in a classroom to being on the wards. That being said, I think a medical student can only be proactive for so long before getting the label of "aggressive" or "gunner". Hence why clerkship books that tell you the underlying way that things work are crucial (First Aid for the Wards, 250 Mistakes..., etc. etc.)

That being said, I also think OB-Gyn (as noted in Michelle Au's comic) is known for not having medical students front and center doing deliveries, or doing cervical checks every so often, etc. I understand due to malpractice concerns, but then you can't complain when students become frustrated and feel like they can't do anything. Maybe this changes if you take it later in the year when the OB-Gyn interns have delivered more than their share of babies. I wonder if at top-tier institutions are different from the rest with respect to medical students on rotations.

 

[tco]

I never understood this. At my medical school... On OB, it was unusual for an MS3 to not do 3-4 deliveries. I know several that did 10+. I had next to zero interest in the deliveries themselves and while I didn't run from them, certainly turfed them to others if they wanted to do them and still did 4. On the other hand I had 5 c-sections in a 6 week block. Don't get me wrong, I know that that stuff happens. There are definitely clinical sites that just aren't appropriate for residents, much less students. But, from my experience (4 institutions), those situations are vastly out numbered. I've heard a dozen complaints about "not getting to do anything" from students on services that are gold mines for procedures and active student participation. They tend to be the same people who complain about longer hours. It usually boils down to people being passive learners and not proactive about their learning.

I thought that this might apply to me until I did an away rotation. That made me realize the people at my med school institution were simply jerks.

 

[KnuxNole]

I never understood this. At my medical school... On OB, it was unusual for an MS3 to not do 3-4 deliveries. I know several that did 10+. I had next to zero interest in the deliveries themselves and while I didn't run from them, certainly turfed them to others if they wanted to do them and still did 4. On the other hand I had 5 c-sections in a 6 week block. Don't get me wrong, I know that that stuff happens. There are definitely clinical sites that just aren't appropriate for residents, much less students. But, from my experience (4 institutions), those situations are vastly out numbered. I've heard a dozen complaints about "not getting to do anything" from students on services that are gold mines for procedures and active student participation. They tend to be the same people who complain about longer hours. It usually boils down to people being passive learners and not proactive about their learning.

I know several people who only delivered placentas in med school, and more who never touched a vagina in OB/GYN. I "delivered" a baby in terms of reaching med school requirement, but when happened behind closed doors is the residents didn't allow me as a male to do it, so I had to catch the placenta and that counted towards the requirement. And tons of people who were told by OB residents to not even THINK about touching the mother during a delicate delivery. I was shocked that at some schools, med students did more than 2-3 deliveries! So, it's not unheard of by a longshot, especially as you know, the state of teaching hospitals and medical student involvement.

 

[KnuxNole]

Most surgery residencies do not have sick days.

I guess I should be grateful that we have built in sick days in our speciality. Then again, it's not as insanely intense compared to gen surg/surg sub specialities.

Which is one of the many reason why I wouldn't ever be fit to be a surgeon.

 

[DermViser]

I would be using my sick days to a T if I had someone cooking in my belly....after all, they ARE there for a reason, no point in putting them all to waste.

Um, surgery residencies don't have "sick" days.

 

[SouthernSurgeon]

I know several people who only delivered placentas in med school, and more who never touched a vagina in OB/GYN. I "delivered" a baby in terms of reaching med school requirement, but when happened behind closed doors is the residents didn't allow me as a male to do it, so I had to catch the placenta and that counted towards the requirement. And tons of people who were told by OB residents to not even THINK about touching the mother during a delicate delivery. I was shocked that at some schools, med students did more than 2-3 deliveries! So, it's not unheard of by a longshot, especially as you know, the state of teaching hospitals and medical student involvement.

That's unfortunate.

We got assigned to mothers when they came through triage same as the interns did (although we "carried" fewer patients than they did). We followed them, under the supervision of the senior resident, until they delivered or our shift was over. That meant we did every cervical check, the delivery (unless something crazy happened or there were complications during labor), or if they had to go for a c-section we scrubbed in. I delivered probably 6? Or so, with a bunch more c-sections. I also got to do one vacuum delivery with the chief resident.

 

[DermViser]

That's unfortunate.

We got assigned to mothers when they came through triage same as the interns did (although we "carried" fewer patients than they did). We followed them, under the supervision of the senior resident, until they delivered or our shift was over. That meant we did every cervical check, the delivery (unless something crazy happened or there were complications during labor), or if they had to go for a c-section we scrubbed in. I delivered probably 6? Or so, with a bunch more c-sections. I also got to do one vacuum delivery with the chief resident.

Yes, at our institution, medical students definitely didn't get to do cervical checks. @KnuxNole's experience is more common of getting to "deliver" the placenta.

 

[VisionaryTics]

That's unfortunate.

We got assigned to mothers when they came through triage same as the interns did (although we "carried" fewer patients than they did). We followed them, under the supervision of the senior resident, until they delivered or our shift was over. That meant we did every cervical check, the delivery (unless something crazy happened or there were complications during labor), or if they had to go for a c-section we scrubbed in. I delivered probably 6? Or so, with a bunch more c-sections. I also got to do one vacuum delivery with the chief resident.

Not too different from me. I would follow patients I admitted from triage, and I would usually pick up a few that were ready to pop when I came on. I only did like two cervical checks (with the infectious risk), but delivered about 10 babies vaginally and scrubbed on many more c-sections. I was only thrown out of the way once (when a shoulder dystocia occurred). I saw patients in triage, ultrasounded them, talked things over with the CNM, presented the patient, and wrote the notes.

You CAN get some involvement during third year. By contrast, a lot of my fellow med students on the same rotation/same location for OB did much less than I did. The difference? I stayed up on the L&D floor and did not sleep in the call room overnight. And I asked to do stuff.

 

[LostinLift]

it is not about the hours trust me. Many people exercise before their morning job, or some even take their sweet time to shower, read the newspaper, eat, etc, effectively waking up at 4am, and they only bless it, making their whole work day better. Getting there at 4am is completely different animal.

My question was less about the hours and more about people who've had to endure days filled with strenuous mental and physical exertion at the college level and how drained they felt comparatively. 2-a-days of football practice at the college level while taking a rigorous course load cannot be understood unless you have done it. Similar to how clinical rotations, residency, etc. really cannot be understood until you've gone through it. I was hoping to find someone that has been through both experiences to share their thoughts.

 

[KnuxNole]

Not too different from me. I would follow patients I admitted from triage, and I would usually pick up a few that were ready to pop when I came on. I only did like two cervical checks (with the infectious risk), but delivered about 10 babies vaginally and scrubbed on many more c-sections. I was only thrown out of the way once (when a shoulder dystocia occurred). I saw patients in triage, ultrasounded them, talked things over with the CNM, presented the patient, and wrote the notes.

You CAN get some involvement during third year. By contrast, a lot of my fellow med students on the same rotation/same location for OB did much less than I did. The difference? I stayed up on the L&D floor and did not sleep in the call room overnight. And I asked to do stuff.

Damn, that sounds like an awesome OB rotation. I got to do all of that as an intern in L+D, and that made me think differently about obstrectics as a med student. I didn't have near that involvement(didn't get to do ultrasounds, we saw people in triage but that was it w/ no following). They did love having med students in C-sections so I scrubbed in a ton of those haha.

 

[Apoplexy__]

Since this thread bumped up again, I'll just update and say that this week has been infinitely better. Understanding the flow, EMR, hospital layout etc. has helped me find useful tasks to do during the day. I'm only spending a little time in the OR and I've been keeping myself better caffeinated/sandwichized. So for posterity: suck it up, it gets better!

Something else to back what you're saying up: I felt pretty worn out during my 35 hrs/week + weekends off Psych rotation during the first week. I was convinced that anything would be easy after studying all day every day in pre-clinical years, but something about having to move my body again after 2 years of profound sedentariness will do that to you. That, combined with having to pack food and plan access to caffeine...I'm sure it's just the transition effect like you're already thinking.

I'm slowly stopping being a big baby after adjusting to the change last week.

 

[DermViser]

Something else to back what you're saying up: I felt pretty worn out during my 35 hrs/week + weekends off Psych rotation during the first week. I was convinced that anything would be easy after studying all day every day in pre-clinical years, but something about having to move my body again after 2 years of profound sedentariness will do that to you. That, combined with having to pack food and plan access to caffeine...I'm sure it's just the transition effect like you're already thinking. I'm slowly stopping being a big baby after adjusting to the change last week.

No, that just means you're very lazy.

 

[Psai]

Something else to back what you're saying up: I felt pretty worn out during my 35 hrs/week + weekends off Psych rotation during the first week. I was convinced that anything would be easy after studying all day every day in pre-clinical years, but something about having to move my body again after 2 years of profound sedentariness will do that to you. That, combined with having to pack food and plan access to caffeine...I'm sure it's just the transition effect like you're already thinking.

I'm slowly stopping being a big baby after adjusting to the change last week.

I don't think I've walked more than a mile altogether these past few weeks

 

[Apoplexy__]

No, that just means you're very lazy.

Thanks for that valuable contribution. If I didn't already recognize how absurd that sounded, I wouldn't have made that post, or the point to be made within it.

 

[DermViser]

Thanks for that valuable contribution. If I didn't already recognize how absurd that sounded, I wouldn't have made that post, or the point to be made within it.

My point is if you're exhausted on what is essentially a 9 to 5 rotation (35 hrs/week) and get your weekends off as your first rotation, then don't know what to tell you when you go into OB-Gyn or Surgery.

 

[Serous Demilune]

My point is if you're exhausted on what is essentially a 9 to 5 rotation (35 hrs/week) and get your weekends off as your first rotation, then don't know what to tell you when you go into OB-Gyn or Surgery.

He was kidding

 

[DermViser]

He was kidding

He wasn't. He realize how absurd he sounded and manned up.

 

[Kaustikos]

First off - the hours complaints. Maybe it was me but I worked as long, if not longer, hours during inpatient peds/IM. Sure, I wasn't up at 4am for rounding, but I was there till 7pm sometimes. Weekends are WAY easier for a med student in surgery vs im/peds. All my surgery weekends were 1-2 hours tops in the morning. (Yes, I know it's different for actual surgeons). So, believe me when I say this - you need to know that it's not just surgery that's long hours. The thing I liked best about that, though, was that there was no bull****; if I was done with OR cases/rounding, they had NO problem with me leaving to study no matter what time. IM/Peds did the classic "Well, you can leave if you want to..." ****. Passive aggressive. OB/GYN was worse because not only did I not do ****, but they didn't let me leave or study. "Why are you studying? Why don't you check on X patient... she could deliver at ANY MINUTE!"... "She's in the room right there where I can see the monitors and the nurse told me she'd let me know if anything happened" "Well, why don't you check on this other patient for me downstairs"

Second - Be a team player. That's the one thing I've learned from Surgery. They just wanted me to actually help the team out (I don't mean the ******ed scut work that some do). But when you become competent enough to be their eyes/ears, they do appreciate it. I've generally had good success with being level-headed, helpful, candid and knowing my role. They see thousands of you in a short amount of time and most med students generally make their disdain/lack of interest obvious. Don't make it obvious you don't enjoy retracting. No one does. But it's the role they gave you.

Also - there's a lot to take from Surgery that's underappreciated. I'd really ask/inquire about learning to do consults with them because once you learn how a surgeon wants to be consulted - consulting anyone else is WAY easier. How medicine taught me does NOT work in any other specialty. Ask about intensive care. Learn how SOAPs are done by them; despite what some people think - the quicker you are, the better has worked substantially better. And believe it or not - asking questions during cases is generally not a bad idea. Yeah, they pimp you, but that's equal opportunity to ask about things. Don't take pimping personally - they do it to piss you off/berate you, but not in a bad way. I actually love that kind of teaching.

Surgery also taught me a lot about how to do a quick 5 minute interview/exam on a patient that's thorough enough to give the gist while not being openly ******ed.

Lastly - and I can't say this enough - be friends with OR nurses. I'm not saying buy 'em coffee - I'm saying you need to approach them and humbly admit to being a medical student but that you don't want to be that med student and would appreciate any help in not screwing up. I've heard the stories about scrub nurses, but I've never had one bad interaction by doing this. These nurses deal/interact with Surgeons day in/day out and they don't want anything ****ing up the groove because although the surgeon might be disappointed with you, he/she might take it out on the nurse instead.

But seriously - Surgery is what you make it. And having a negative attitude doesn't help... because the reality is that programs talk with each other. And if you upset the wrong Surgeon with that attitude, he can make it hell for you in other rotations.

 

[Kahreek]

damn someone has a crush

 

[Kaustikos]

damn someone has a crush

It's my unofficial SDN crush that I disclose to everyone. I'm getting a giant decal on my car that says "I LOVE SURGEONS!" in red with some ****ing sutures and ****. lol

 

[DermViser]

damn someone has a crush

Well he is going into Surgery, not that his soul doesn't need any more crushing.

 

[Wordead]

I thought surgery was way better than medicine (had medicine first). And the hours were way better for me (q8 call vs q4, though surgery was 24 hr call and medicine only 16). And I didn't have a million demented patients that kept dying.

 

[DermViser]

I thought surgery was way better than medicine (had medicine first). And the hours were way better for me (q8 call vs q4, though surgery was 24 hr call and medicine only 16). And I didn't have a million demented patients that kept dying.

 

[LostinLift]

I've found most people say the order of rotations don't matter so much, just don't take what you want first or last. If I'm interested in a surgical specialty would doing IM first be a good idea IF I've had some decent hospital and patient experience already? Or perhaps OB? (IK I won't be in rotations for 2 more years and I'll obviously ask older students/residents in my field of interest at my actual school as well.)

 

[Kaustikos]

I've found most people say the order of rotations don't matter so much, just don't take what you want first or last. If I'm interested in a surgical specialty would doing IM first be a good idea IF I've had some decent hospital and patient experience already? Or perhaps OB? (IK I won't be in rotations for 2 more years and I'll obviously ask older students/residents in my field of interest at my actual school as well.)

So, here's the thing - some schools let you "select" your preference but then you don't get it. The best thing you can do - keep an open mind and figure out what you NEED to learn first. You learn SOAPs/Presenting/etc fast, then you're good. Which is funny because they don't teach you that in first two years really. Or not me.

Anywho - I wanted Medicine and never once thought Surgery. I got Medicine last (hurray) but that didn't matter because I had my life turned around when I had Family Medicine which I loved/learned a lot and then Medicine which I hated. Surgery - yes I love it. I don't think it makes much difference except that having Surgery in winter can be a tad depressing since you get in when it's dark and leave when it's dark. lol

 

[Psai]

So, here's the thing - some schools let you "select" your preference but then you don't get it. The best thing you can do - keep an open mind and figure out what you NEED to learn first. You learn SOAPs/Presenting/etc fast, then you're good. Which is funny because they don't teach you that in first two years really. Or not me.

Anywho - I wanted Medicine and never once thought Surgery. I got Medicine last (hurray) but that didn't matter because I had my life turned around when I had Family Medicine which I loved/learned a lot and then Medicine which I hated. Surgery - yes I love it. I don't think it makes much difference except that having Surgery in winter can be a tad depressing since you get in when it's dark and leave when it's dark. lol

I figured it would be like that for surgery no matter what season it is.

 

[tco]

I've found most people say the order of rotations don't matter so much, just don't take what you want first or last. If I'm interested in a surgical specialty would doing IM first be a good idea IF I've had some decent hospital and patient experience already? Or perhaps OB? (IK I won't be in rotations for 2 more years and I'll obviously ask older students/residents in my field of interest at my actual school as well.)

The order does not matter. Our registration was literally a free for all. At 5 PM, they opened up the website and it was first come, first serve. I had a set of criteria that I wanted fulfilled, but didn't care about a strict order. I wanted IM before surgery and something easy after winter break (because I knew I'd still be lazy).

I ended up having FM, IM, Surgery, Psych/Neuro, OB/GYN, Peds. Looking back at it, if I could design *my* perfect rotation schedule, it would have been OB/GYN, IM, Surgery, Psych/Neuro, Peds, FM. The logic is that you learn about how to act in the OR during your first OR rotation, you learn to suture and be useful in that rotation as well. You also learn how to act towards the scrub nurses and techs, which is tremendously important. IM is a great foundation rotation. No matter if someone wants to do it for a career or not, I suggest having it fairly early (definitely before surgery). Surgery third because I was interested in it at the time. The shelf is probably 50/50 with surgical/medical management of surgical patients, so having it after IM is essential. The others I just didn't particularly have an interest in. Family medicine's shelf is basically a "baby" shelf of the other rotations. Everyone who took it last did fantastic on it.

 

[Kaustikos]

I figured it would be like that for surgery no matter what season it is.

You keep that attitude, then yes. But I actually think it'd be more depressing doing Surgery in the summer if you had no interest in Surgery.

 

[Psai]

I meant the being dark outside when you come in and leave thing

 

[Elisabeth Kate]

How about that psych rotation. not only do ugly people have kids. but you have these people barely 30yo already on social security, effectively retired. and they sometimes bring their kids from different baby daddies to the shrink. what are you talking?? why would i have to cook if my woman cooks?? I see all too often how guys settle for ugly useless women. When I want to feel good about myself I go to mcdonalds and observe how a nonfat guy is there with a fat woman who not only does not cook (or why else would they eat at mcdonalds?) but is also fat. You need that for "free" sex? You know taking step2 in 2weeks i realize how useless i am as a person. successful people my age go to wall street and shake hands with other successful people. I am studying for some stupid test that requires very little intelligence. And most likely I'll never own a bentley

Yeah u can tell how some 40 yo drs are frustrated that they're not part of that world. Some of them wish their wife would've left them for an I banker. But get real. Their wife could never be hot enough to pique a bankers interest

It's a shame you didn't learn more about psych while on the rotation. Definite pathology there.

I never understood this. At my medical school... On OB, it was unusual for an MS3 to not do 3-4 deliveries. I know several that did 10+. I had next to zero interest in the deliveries themselves and while I didn't run from them, certainly turfed them to others if they wanted to do them and still did 4. On the other hand I had 5 c-sections in a 6 week block. Don't get me wrong, I know that that stuff happens. There are definitely clinical sites that just aren't appropriate for residents, much less students. But, from my experience (4 institutions), those situations are vastly out numbered. I've heard a dozen complaints about "not getting to do anything" from students on services that are gold mines for procedures and active student participation. They tend to be the same people who complain about longer hours. It usually boils down to people being passive learners and not proactive about their learning.

This was my experience as well. I did several deliveries, C-sections, and outpatient OB follow-ups as well. However, there were rotations where the residents just didn't trust students or didn't want students (for whatever reason) to do procedures. One of my IM months was like that. I did H&P's, progress notes, and basic exams, but when it came to anything the least bit invasive, it was the residents who did those, even when my fellow med student and I would ask.

I guess I should be grateful that we have built in sick days in our speciality. Then again, it's not as insanely intense compared to gen surg/surg sub specialities.

Which is one of the many reason why I wouldn't ever be fit to be a surgeon.

DITTO! My program gives us 20 sick days.

My point is if you're exhausted on what is essentially a 9 to 5 rotation (35 hrs/week) and get your weekends off as your first rotation, then don't know what to tell you when you go into OB-Gyn or Surgery.

His point was that psych was his first rotation and after two years of doing nothing physical, even that was too much for him. He's lucky they didn't start him off on surgery, IM, peds, OB, or neuro wards.

 

[SouthernSurgeon]

However, there were rotations where the residents just didn't trust students or didn't want students (for whatever reason) to do procedures. One of my IM months was like that. I did H&P's, progress notes, and basic exams, but when it came to anything the least bit invasive, it was the residents who did those, even when my fellow med student and I would ask.

That is usually because the medicine residents don't get enough experience with those procedures themselves.

 

[mimelim]

That is usually because the medicine residents don't get enough experience with those procedures themselves.

And not to be overly blunt, but don't usually receive the best instruction on how to do them. It is hard to supervise people when you aren't very good at the procedure yourself.

 

[SouthernSurgeon]

And not to be overly blunt, but don't usually receive the best instruction on how to do them. It is hard to supervise people when you aren't very good at the procedure yourself.

Yeah that's what I was trying to tiptoe around...

 

[mimelim]

Yeah that's what I was trying to tiptoe around...

Last night I took a triple lumen out of a carotid (PGY3 IM). I'm currently waiting to inject a pseudoaneurysm with thrombin (Cards attending). Last week I had to stop an IM PGY2/intensivist after they shredded a wire putting in a quinton. I'm done tiptoeing about these avoidable complications. I'm a PGY2 (couple weeks from PGY3). I'm at the beginning of my training. From my position it has less to do with lack of experience and more to do with lack of good instruction and foundation. Nobody teaches good basics . In my infinite free time I'm trying to put together a course for non-surgical residents for basic bedside procedures.

 

[SouthernSurgeon]

Last night I took a triple lumen out of a carotid (PGY3 IM). I'm currently waiting to inject a pseudoaneurysm with thrombin (Cards attending). Last week I had to stop an IM PGY2/intensivist after they shredded a wire putting in a quinton. I'm done tiptoeing about these avoidable complications. I'm a PGY2 (couple weeks from PGY3). I'm at the beginning of my training. From my position it has less to do with lack of experience and more to do with lack of good instruction and foundation. Nobody teaches good basics .

Triple lumen in the carotid ain't that bad...

The Cordis in the subclavian artery that our Pulm/CC fellows were running a special on a while ago (3 in a month)...now that's a little rougher...

In my infinite free time I'm trying to put together a course for non-surgical residents for basic bedside procedures

We've discussed this multiple times. It doesn't go over well politically with the medicine department at my institution.

 

[DermViser]

We've discussed this multiple times. It doesn't go over well politically with the medicine department at my institution.

Uh, why? Only IM doctors should teach other IM doctors how to do procedures?

 

[SouthernSurgeon]

Uh, why? Only IM doctors should teach other IM doctors how to do procedures?

It's just defensiveness. They don't like someone else telling them how to do procedures that they believe they are competent to perform. Especially since surgeons tend to approach it from a perspective of "you're bad at this, let me show you how it is really done"

 

[DermViser]

It's just defensiveness. They don't like someone else telling them how to do procedures that they believe they are competent to perform. Especially since surgeons tend to approach it from a perspective of "you're bad at this, let me show you how it is really done"

Obviously, they're not competent if they have to keep paging Surgery to help them with their screwups. My understanding is now the ACGME no longer has procedure # requirements for IM like they used to.