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CLERKSHIP ROTATION Q&A
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Internal Medicine
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INTERNAL MEDICINE 12 weeks 5 weeks St. Clare’s (1 in 4 call) 4 weeks Health Science (1 in 4 call) 2 weeks Cardiology (3 call – in house) Neurology (3 call – home) Oncology (no call) 1 week Clinics (no call)
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EVALUATION ITER – 60% 5% per week NBME – 35% Resident clinic cards – 5%
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TEACHING & ROUNDS Teaching 8:00 – daily Rounds 12:00 – daily Half day Wednesday 8:00-11:30
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STUDYING USMLE Questions Text Book – First Aid, TO Notes, Blue Prints
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TYPICAL DAY Round on patients on own Talk to patient/nurses Look up bloodwork, etc Clear the boards Write progress note D/W residents Round with staff
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HOW TO SUCCEED Know your patients (hx/PE, latest labs, etc) Paperwork Write notes Orders D/C summaries Offer to help
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CLERKSHIP ROTATION OBSTETRICS AND GYNECOLOGY
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SARAH’S CLERKSHIP TIPS For each rotation, read 1 book + Q-bank Always have a granola bar close by Drink lots of water Eat, pee, and sleep when you can Read around your patients Work hard! Try not to complain Girls – buy shoes from Naturalizer Keep a notebook in your pocket Buy the “Clerkship Survival Manual” from UGME
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NEW OBS/GYNE STRUCTURE 2 weeks - Junior Obs 1 week – Junior Gyne 1 week – Gyne Onc 1 week – Clinics 1 week – Case Room
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CALL Call Schedule is made up by a volunteer from your template 1 in 4 (ish) Weekends – 5 shifts: Fri – 5p.m. – 9a.m. Sat – 9a.m. – 9p.m. Sat – 9p.m. – 9a.m. Sun – 9a.m. – 9p.m. Sun – 9p.m. – 9a.m.
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EVALUATION Staff ITER - 25% Resident ITER – 10% Midterm Exam – 5% Oral Exam – 30% NBME – 30%
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RESOURCES 1. Toronto Notes ** 2. Case Files 3. USMLE World Questions ** 4. Pretest
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OBS/GYN SURVIVAL TIPS Granola bars Hair Elastics Extra socks Buy Crocs or Birkenstocks! Make friends with the nurses
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FAMILY MEDICINE
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PREPARATION IS KEY
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SIMPLE THINGS FIRST You’re in a rural area for 8 weeks, so get prepared! I.e.: If you’re able to drive, bring your: groceries, outdoor gear, comfort things (a good pillow, coffee maker.. A scattered book?) If you’re headed out in the winter: bring your storm gear (my power was out for 3 days)
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MAKE IT YOUR OWN!
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This rotation allows you to explore any area of medicine that you have an interest in. Discuss early on with your preceptor what you have a particular interest in, and most will try very hard to incorporate those things into your rotation. Also, always take a peek at your clinic list the day before to allow you to read around cases or a particular population (ie: Obs or Peds)
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Most staff will call you if something interesting comes into the office/ER; it’s up to you how much extra you do. Let nursing staff know if need practice with IVs, and let lab staff know if you need practice with phlebotomy or ABGs. In most locations, they’ll page you when those skills need to be done.
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EXAM Unlike the NBME examinations, this exam is clinically relevant (Sorry, NBME!) You’ll find that just reading around cases will enable you to do well The Academic half days are great for exam prep; and the more interactive you are with them, the more quickly those 2 hours online will fly.
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MORE PEARLS… Get to know the community! There are always things on the go, and for some odd reason people just love medical students. Most people use their family medicine rotation as a great way to get a reference (since you’re with the same attending in various settings and scenarios). Keep this in mind from the beginning.
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PSYCHIATRY CLERKSHIP ROTATION
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DETAILS 6 weeks long Split between HSC and the Waterford Clinics throughout
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CALL Home call About 1 in 4 Two clerks on each day On call until 12
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EXPECTATIONS Part of an inter-professional team Dependent on team dynamics Don’t have to do anything you are not comfortable with
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EVALUATIONS Clinic and weekly cards Half-way interview Inter-professional workshop Final interview NBME ITERs
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PEDIATRICS CLERKSHIP ROTATION
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ROTATION LAYOUT Two weeks – Janeway Emergency Common illness presentations (e.g. otitis media, URTIs) Procedures! Eight 8 hour shifts Opportunity to do witnessed H & P
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ROTATION LAYOUT Two Weeks – Neonates (5NB) Newborn Exams 4 call shifts – NICU Lots of teaching!
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ROTATION LAYOUT Four Weeks Wards (J4A) and Clinics One or two weeks of Blue (General Medicine) or Green (Subspecialty) Teams One clinic week Seven call shifts over 4 weeks Meet at 8 AM; Rounding on inpatients; Coming up with a plan of care with team Emerg consults
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ROTATION LAYOUT NBME Enough said…
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DOING WELL IN PEDIATRICS Be on time Be respectful Be curious
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Surgery Clerkship 8 Weeks 5 of General Surgery, 3 of Orthopedics 8 General Surgery call shifts – in-house until midnight 3 Orthopedic Call shifts – home call until midnight Evaluations NBME – 60 %* ITER 2x10% Witnessed History and Physical 2x 10%
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Surgery starts early: anywhere from 6:00 to 7:00 am First you usually meet as a team Review patients who were admitted or had issues Round on patients +/- teaching Sleep is important, to be healthy you will go to bed at times you haven’t gone to bed at since you were a child.
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After teaching your team will decide who is covering what: OR’s Clinic Small Procedures Scopes* Team Rounds Consults Share the joy’s and the burdens with your team Make sure you see it all Go where you’re needed Get involved
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ORs & Procedures Scrub in Assist as needed Clinics See patient first: focused H&P Review with staff Wards Help your resident Call – Consults & Cases Not all of us are intelligent, not all of us talented, not all of us have experience… but we all have it in us to be helpful and that will take you far.
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Show up on time Be interested Be dependable
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The single greatest resource to survive …
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PsychiatryFamily PediatricsObstetrics Surgery Internal
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