What clinical rotations do you wish you did?

[amthrasher]

I'm a PA student, my clinical year is quickly approaching and I'm working to set up my rotations. Im currently most interested in eventually working in a ED after graduation, which motivates me to spend as much time in the ED as possible, but I'm also interested in ICU work, CT surgery, cardiology, the list goes on. I've heard it said that a nephrology rotation provides valuable experience for work in the ICU.

 

Experience in which areas of medicine do you feel would be the most benefit to your medical knowledge, career, marketability and earning power?

[jen0508]

I'd say i wish i did cardiology, I hate cards. It would have been a grueling 6 weeks but useful. I can manage chest pain decently in the ED, however beyond the basics, I admit I dont know as much as I would like to. However, I'm not sure if i would swap it for any of the electives i did. (Ortho- sports medicine, GI, EM). The extra EM rotation was golden, I had a great mentor. Without it I would have struggled on my first job. Ortho helped tons, saw alot of acute injuries, which was useful for EM. I see TONS of ortho complaints in EM, and it helps to be able to do more than just tell ppl "its not broken" and tell them to ice/elevate, esp when alot of my patient population doesnt have insurance and most likely wont have the luxury to followup with ortho. If something is broken, i already knew what splint to use, etc. I also can tell ppl what to expect when they see the orthopedist. Honestly if i wouldnt have done that clinical, i would have no clue. The other day I rongeured an amputated finger.

 

Anywho, I vote for cards, ortho, and whatever specialty you are going into. Its a huge plus to put on ur resume- "I did additional clinical training in (whatever specialty ur applying to)" It shows ur interest in the specialty, plus gives u a hair more experience than someone who didnt have any extra training.Oh, not to mention, it will allow you to make connections to get a J-O-B :)

[jmj11]

Internal Medicine was my best learning experience and I think it would be a great asset to any future practice. I also took a rotation in the middle of the desert between Abu Dhabi and Oman + Pakistan and that was my favorite.

[amthrasher]

Thanks for the responses.

 

jen0508, I think cardiology would be really helpful too, maybe Ill try to do that as an elective along w/ EM.

 

jmj11, doing rotations out of the country sounds great. Alas, my school doesn't allow that.

[OpSite]

Endocrinology is one I wish I could add, but I wouldn't want to have to give up anything else.

[chickitabanana]

How many elective rotations do you have? How do you know you want to work in ED? Are you an EMT already? I only ask because I was really looking forward to my ED rotation and signed up for an elective in trauma surgery as well. ED was not what I thought it would be and it ended up being one of my least favorite rotations. Subsequently I switched out of my trauma surgery elective and into something else. If you know you'll like ED then you could focus on rotations that will put you in a better position to get a job in the ED. I would advise against doing another elective in the ED, though. Your clinical rotations are the only opportunity where you can dabble in many different areas. If you already have 4-6 weeks in the ED for a core rotation then spending another 4-6 weeks doing a second ED elective might be a waste of valuable time you could've spent elsewhere learning other skills. CT surgery should give you ICU exposure as well as cardiology. You'll need to read telemetry strips and all of your patients will be on cardiac medications pre/post op. They're also some of the sickest patients in the hospital so in addition to the guaranteed cardiac problem management you'll also be dealing with pulmonary issues, renal failure, diabetes, etc.

 

When we were picking electives our program director told us the following. "Pick something you love/are interested in, something you hate, and something that scares you." (My PA program offered 4 elective options which is more than most places, though). She advised doing the "something you hate" and "something you're scared of" months because it gets you out of your comfort zone and forces you to learn things instead of shying away from/avoiding a particular area of medicine. If you're interested in medicine you could do a MICU rotation and if you're interested in surgery you can do a SICU rotation. I was offered a job in thoracic surgery without seeing any thoracic cases on my CT surgery elective, so, while it's a good idea to make yourself the most marketable as you can for a job, it's possible to get a job in an area that you've never been exposed to before. No rotation will be a waste and you'll learn something from each of them. If your program is flexible with changing electives the way mine was you can do a few core rotations and then try to change the electives once you're more sure of your interests. If you know you want to go into ED then I would agree with jen0508 about doing an ortho elective. I was scared/hated ortho and ended up having to do a rotation in it when my international elective fell through last minute. I learned a lot more than I did during our didactic ortho module and it really helped for the PANCE, too (ortho is 10% of the PANCE). I'm not interested in working in ortho, but I'm glad I did the rotation now because I was able to experience it and see what it's like first hand.

 

Regardless of your electives keep in mind that your clinical year is like a 12 month job interview. Not only will you need references when you start applying for jobs you'll also need letters of recommendation to get hospital credentials for whatever job you accept. Plus, making connections is KEY. One of the PAs I worked with on a rotation knew the chief PA where I ended up taking my first job because they worked together years before. I have no doubt that this connection helped me get the job over the other people who applied despite the fact that I had no experience as a new grad. Even if you're on a rotation that you hate continue to do your best because you never know who knows who in this profession! Good luck and let us know what you end up deciding :)

[pennpac]

Cardiology. I am regretting not having done it because ALOT of the PANCE questions are in cardio and it is a tough subject to master.

[EMEDPA]

critical care and anesthesiology.

I did trauma surg which was great but could have used more medical icu training too.

[amthrasher]

Thanks for the replies, EMEDPA I always value your input, I haven't heard of anyone in my program doing an anesthesiology rotation. I will look into the possibility of doing that.

[mjl1717]

Good q..

 

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