Most demanding rotation?

[Guest windymountain2003]

Of all the mandatory rotations, which would you say is the most demanding/difficult?

 

I am saying surgery because you have really long hours and a lot of call. I am also thinking that Internal medicine could be tough in terms of the time required both on the wards and studying.

 

Psych is supposed to be easier, I am not entirely sure why. Maybe because you start later in the day. Also, I think it will involve more sitting and listening to the patient, rather than standing for hours holding retractors and trying to answer random and unexpected anatomy questions posed by the surgeons!

 

WM

[Guest AC]

I've heard Surgery and Medicine are the hardest. Family and Psych are the easiet. And everything else falls in between.

[Guest Kirsteen]

Hi,

 

I shared my Hepatobiliary (Gen Surg) rotation with a few students from the home schools. I thought HPB was a challenging rotation and so did they. Likewise, the residents who rotated through were looking forward to the light at the end of that notorious tunnel. In one centre, we started at 5:45am every day and it wasn't uncommon to be done at anywhere between 7-9pm at night. Thereafter you'd go home, eat, sleep and repeat. It was pretty bleak. Surgical Oncology hours were much easier. I was often home by 5pm. So, overall it probably depends on the team on which you're working which will help to determine how tough your surgery rotation will be.

 

In terms of easy rotations, I've got one week of Family Med left. I initially felt some guilt due to the hours: 9-4pm (M-Th), 9-3pm (Fridays) with 2 half-days off per week. It's been refreshing to have a bit of a life after 10 weeks of surgery. By far, it has been the easiest rotation. I also hear that the hours on Psych are pretty scant. Some of my classmates reported regularly getting out of the hospital at 11am on some days. (...and that isn't post-call.)

 

Cheers,

Kirsteen

[Guest kosmo14]

I found surgery to be the worst they definately have the sickest of the patients on the ward. Next was obstetrics (darned babies like to come at night).

[Guest UWOMED2005]

In one regard, I found psychiatry to be my hardest rotation in clerkship.

 

Obs was usually joyful - rarely do things go bad enough that a clerk has to deal with real tragedy. Family Med was a mixed bag. Peds could be absolutely awful when things didn't go well. . . particularly when I was in the PICU.

 

Most of my truly sick cases on surgery or medicine were older patients whose ill health was a result of diseases which were a result of old age. Often not happy outcomes, but at least you could note the patients had most often had years of quality of life before their current predicament. Some of the surgery patients even got better!

 

I spend my first 3 weeks on psychiatry working in the (first episode) psychotic disorders unit. Most of the patients were my age or younger, and just being diagnosed with an illness which would irrevocably change their life plans.

 

Some to many of the patients were university students just about to embark on life when the underlying pathology was revealed. Worse still, I saw just enough older patients to get a glimpse of what the future was for the younger: often little improvement*, huge effect on their psycho-socio-spirituo-economic well being, high risk of suicide, and very bad drug side effects. Not to mention the stigma of having a mental illness. . . in particular, a psychotic spectrum mental illness.

 

Clerkship is one year. If you find the long hours on surgery or medicine hellacious, you can always seek comfort from the fact the rotation will be over in a few weeks and you can conceivably never do it again! The outcomes of the patients you see can never be changed.

 

 

* I saw ONE pt with a serious psychotic diagnosis who had attained some degree of normalcy in her life. And she had a fair degree of weight gain, elevated lipids, and diabetes from the meds. I know there are success stories with psychotic disorders, but there also many pts who struggle for years with this category of diagnosis.

[Notepad]

are you required to do a minimum number of deliveries (of babies) ?

what if during your rotation, there is none ?

[Kirsteen]

are you required to do a minimum number of deliveries (of babies) ?

what if during your rotation, there is none ?

Hi there,

 

During our Obs/Gyn rotation, we complete a logbook that contains check boxes for deliveries (vaginal, C-section, vacuum and forceps) as well as about 35 other procedures and patient presentations. We have to complete the date on which we experiences these procedures/presentations, the number experienced as well as the preceptor with whom we were working. This sheet is then reviewed by the Evaluation Coordinator at the end of the rotation, presumably to ensure that we have each completed an adequate number of experiences. (The completed logbook counts as part of our clinical evaluation.) Presumably, if there are insufficient deliveries experienced, then we would be required to do some extra time within the field to increase our experience. Chances are, however, that if you spend enough time on the Obs ward over a standard rotation time, you'll be able to be involved in numerous deliveries.

 

Cheers,

Kirsteen

[Kiel]

Hi there,

 

During our Obs/Gyn rotation, we complete a logbook that contains check boxes for deliveries (vaginal, C-section, vacuum and forceps) as well as about 35 other procedures and patient presentations. We have to complete the date on which we experiences these procedures/presentations, the number experienced as well as the preceptor with whom we were working. This sheet is then reviewed by the Evaluation Coordinator at the end of the rotation, presumably to ensure that we have each completed an adequate number of experiences. (The completed logbook counts as part of our clinical evaluation.) Presumably, if there are insufficient deliveries experienced, then we would be required to do some extra time within the field to increase our experience. Chances are, however, that if you spend enough time on the Obs ward over a standard rotation time, you'll be able to be involved in numerous deliveries.

 

Cheers,

Kirsteen

Is this for other rotations too?(ie surgery)

[crackers]

It might be a good idea to keep track of your procedures in rotations like internal medicine, obstetrics and surgery. Not so much for the others...

 

my two cents on this general thread: the hardest rotation is one with a mix of long hours and material you don't find interesting. That is a real grind; best ways to get through it are to find the things that interesting about it and focus on those, and find activities to do outside the time you're in the hospital and focus on those.

[TimmyMax]

Hey,

 

I would agree with the part about the long hours and boring material making a rotation difficult. Sums up my disdain for IM quite nicely!

[Kirsteen]

Is this for other rotations too?(ie surgery)

 

Hi there,

 

It's clearly school-dependent. At UofC we had similar procedural/presentation logbooks for Surgery, Family Medicine and Internal.

 

Cheers,

Kirsteen

[Kirsteen]

my two cents on this general thread: the hardest rotation is one with a mix of long hours and material you don't find interesting. That is a real grind; best ways to get through it are to find the things that interesting about it and focus on those, and find activities to do outside the time you're in the hospital and focus on those.

 

Woah, I couldn't agree more. I recently finished a rotation which was a grand slog for me. I've loved everything up to now except this specialty. I clung to the hours that I spent in the specialty clinics and dreaded most else.

 

Hear, hear crackers.

 

Kirsteen

[Kiel]

Woah, I couldn't agree more. I recently finished a rotation which was a grand slog for me. I've loved everything up to now except this specialty. I clung to the hours that I spent in the specialty clinics and dreaded most else.

 

Hear, hear crackers.

 

Kirsteen

Was this Obstetrics?

[Blake]

Hey,

 

I would agree with the part about the long hours and boring material making a rotation difficult. Sums up my disdain for IM quite nicely!

Haha. I'm surrounded by IM lovers at my school, and I was wondering if I was the only medical student on earth who found it not so exciting.

[TimmyMax]

Hey,

 

Yeah, I was definitely in the minority during my time at UWO and wondered if I was weird or something. Now that I'm a resident, I can safely say that I definitely am not- it's definitely the rest of the herd that's gone crazy! Not liking IM does not make you insane. IM haters of the world, unite!

So with that in mind, let's steal a chant from the USask supporters after last year's Vanier Cup semi-final versus Laval with respect to IM- Ov-er-rated! (clap, clap, clap-clap-clap!) Ov-er-rated! (clap, clap, clap-clap-clap!)

[CutieYellow]

Can't believe Laval lost After winning two Vanier Cups in a row, you'd expect a nice third one to top it all !

[noncestvrai]

This year they will.

 

noncestvrai

[TimmyMax]

Hey,

 

Can't believe Laval lost! After winning two Vanier Cups in a row, you'd expect a nice third one to top it all !

Yeah, although I would rather have liked to have seen my alma mater, Laurier, lay the smack down on Laval last year in the Vanier Cup to avenge our loss the previous year, but I'll definitely take the results of last year- easily the greatest Canadian university football game I have ever seen! It was really too bad that somebody had to lose although Laurier should have won that game handily, I thought. Nonetheless, at the end of the day, the cup was finally ours- I went and saw it when they finally brought it home and it was very cool indeed!

Ah well, we should all celebrate now because it doesn't look like a repeat is in the cards for us and maybe not even another Yates Cup, but you never know. I'd watch out for Manitoba, though- they seem to have the team this year!

[crackers]

Timmy Max --- two things cannot be left without discussion.

 

1) As an IM resident, I am APPALLED at the way you perceive my specialty, and your public denouncement of it as OVER-RATED. I am retroactively revoking the use of my notes from years ago for anything

 

2) Did you make it through the wind and the rain for the 1st round game of this year's Vanier Cup playoffs yesterday? Yuck, what an ugly day...

[TimmyMax]

Hey,

 

Now, now, no need to get our Palm Pilots and multidisciplinary progress notes in a knot! I was simply pointing out that it's okay for current medical students to not like Internal Medicine- it doesn't make you any better or worse than your classmates that eat, sleep and dream Internal Medicine, but it can make you feel like the only kid on the block without a Christmas in December. This is perfectly okay and there's nothing to feel ashamed about. There are other specialties out there that aren't Internal Medicine and believe it or not, Internal Medicine does not make up the majority of CaRMS residency spots. I was just trying to say (in as non-offensive a way as possible) that it's okay to not like Internal Medicine in the new millenium. That's all.

See you all at Cardex rounds tomorrow afternoon! Oh wait, I'll be in the OR, catching some Z's, I mean, reading up on current medical journals. Somebody be sure to mention that Mr. Y's urine output was up by 0.7% from two days ago for me!

[noncestvrai]

Bro gas must be the chillest job in medicine after psychiatry. Funny, the shrink gets like what 7 bucks for an ECT while the gas dude gets what a 100$?

 

I don't know the actual numbers. I'm looking forward to book my gas elective.

 

I'm actually also looking forward to my next rotation, internal. =)

 

noncestvrai

[Kirsteen]

Bro gas must be the chillest job in medicine after psychiatry. Funny, the shrink gets like what 7 bucks for an ECT while the gas dude gets what a 100$?

 

I don't know the actual numbers. I'm looking forward to book my gas elective.

 

I'm actually also looking forward to my next rotation, internal. =)

 

noncestvrai

Hey ncv,

 

I'm in Internal now and quite enjoying it, with all its problem solving and management regimes. Reminds me of many a House episode.

 

Cheers,

Kirsteen

[Kiel]

Hey ncv,

 

I'm in Internal now and quite enjoying it, with all its problem solving and management regimes. Reminds me of many a House episode.

 

Cheers,

Kirsteen

House is great! Did anybody catch last nights episode??

[Kirsteen]

House is great! Did anybody catch last nights episode??

No, but I did catch Hugh Laurie on SNL this past weekend. Quite a talented chap.

 

Cheers,

Kirsteen

[noncestvrai]

No, but I did catch Hugh Laurie on SNL this past weekend. Quite a talented chap.

 

Cheers,

Kirsteen

 

I did too, a fine actor.

 

As for internal, I'll be for one month in the ER internal consults team, one less month in the ward sounds awesome to me.

 

noncestvrai