Would you do a medicine or pediatric heme onc elective?

[Mrbojangles]

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I'm thinking my endocrine elective at the end of the year will be pretty low yield. But then again at the end of the year after the match you'd want to do electives like radiology 😉.

 

[b&ierstiefel]

Neither. It's like me trying to pull off my last month of med school by doing a rotation called, "Pharmacology-Independent Study." Of course, if you have an extra vacation month left, replace that elective with more vacation time.

Radiology is good. You come in at 8-9 am, leave by noon. Another good choice is an Anesthesiology elective. My average days during that rotation lasted ~2.5 hours.

Seriously, in residency we're gonna be working our butts off. Take advantage of this year, that's what I say.

 

[yaah]

I did an adult heme-onc in march and enjoyed it. I had a pretty mild schedule though. Generally didn't have to show up until 9 or so, then would page the fellow and he would give me a consult if there was one pending at the time (maybe every other day). If no consult, hung around and read or did something else until 1pm when we would go on rounds. If consults came up later in the day (which they almost always did) we would see them all together.

I found adult heme-onc much more interesting than Pedi, because Pedi is almost all children hospitalized for chemo treatments or leukemia patients with low ANCs. The more interesting stuff from a pathology standpoint (like, if you want to see how all these cancers you will be diagnosing present) comes in adult. I got to see some interesting cases - sarcoid confused with lymphoma, new diagnoses of HCC, Gastric Cancer, metastatic pancreatic cancer, plus patients with past treatment now presenting with difficult diagnoses that required biopsies and further tests.

 

[Doctor B.]

I agree with Yaah, adult heme onc would likely be more interesting. Also, peds heme onc is very depressing, more so than adult for me.

 

[Mrbojangles]

Yeah normally I do take the path with the least resistance. I'm feeling a bit guilty right now about the quality of my non-pathology electives because I'm doing a plastics elective which is almost a complete waste of time. I get to see some skin cancers and lesions but my intent on doing this elective was getting some hands on surgical experience which just isn't the case. I threw in peds just because the peds attendings are nicer here. I know I'd get more from a medicine heme/onc service than a pediatric heme/onc service and I don't have a particular interest in pediatric tumors. We don't have a heme/onc consultative service and I think the only electives are one associated with the heme/onc inpatient services (no way I did that already in third year of internal medicine) and heme/onc oupatient with the risk of working with an impossible attending. I geuss I'll see how my motivation is after I finish neurology/neurosurgery in February.

 

[yaah]

after I finish neurology/neurosurgery in February.

Combining neurology and neurosurgery in one rotation is like mixing beer and wine in the same glass.

 

[b&ierstiefel]

Yeah normally I do take the path with the least resistance. I'm feeling a bit guilty right now about the quality of my non-pathology electives because I'm doing a plastics elective which is almost a complete waste of time. I get to see some skin cancers and lesions but my intent on doing this elective was getting some hands on surgical experience which just isn't the case. I threw in peds just because the peds attendings are nicer here. I know I'd get more from a medicine heme/onc service than a pediatric heme/onc service and I don't have a particular interest in pediatric tumors. We don't have a heme/onc consultative service and I think the only electives are one associated with the heme/onc inpatient services (no way I did that already in third year of internal medicine) and heme/onc oupatient with the risk of working with an impossible attending. I geuss I'll see how my motivation is after I finish neurology/neurosurgery in February.

I think when I encourage the path of least resistance, it really is a biased opinion that is fostered by the highly malignant nature of the clinical rotations here (especially medicine and peds--surgery wasn't as bad though). My buddies and future pathologists-to-be, after the horrific experience of M3 year here, have vowed to take this heroic path of staying the @&#% away from clinical electives during M4 year. I remember one of the advisers here suggesting that I spend my 5th and last month of 4th year (which can be used as a vacation month) doing another clinical elective in ID or Heme/Onc. Inside, I couldn't stop laughing while saying, "@&#% that!" Seriously, I don't wanna spend one more frickin' month here at Michigan partaking in long-ass-hell rounds, getting pimped endlessly, and having the notion of being a stupid sh1t driven further into my skull. I already know I'm stupid and I don't need other ppl to frickin' tell me that.

Mr.Bojangles, if you're at a malignant institution, I encourage you to take the path of least resistance. We don't need to take more sh1t from people during our final, most chill year of med school. If your institution is benign on the other hand, then feel free to do clinical electives and learn stuff.

 

[Mrbojangles]

Combining neurology and neurosurgery in one rotation is like mixing beer and wine in the same glass.

At my school the neurology clerkship is combined with neurosurgery. Actually they are three weeks each which is kind of weird. I would have thought neurology would have more precedence but that's the way it is.

 

[Mrbojangles]

I think when I encourage the path of least resistance, it really is a biased opinion that is fostered by the highly malignant nature of the clinical rotations here (especially medicine and peds--surgery wasn't as bad though). My buddies and future pathologists-to-be, after the horrific experience of M3 year here, have vowed to take this heroic path of staying the @&#% away from clinical electives during M4 year. I remember one of the advisers here suggesting that I spend my 5th and last month of 4th year (which can be used as a vacation month) doing another clinical elective in ID or Heme/Onc. Inside, I couldn't stop laughing while saying, "@&#% that!" Seriously, I don't wanna spend one more frickin' month here at Michigan partaking in long-ass-hell rounds, getting pimped endlessly, and having the notion of being a stupid sh1t driven further into my skull. I already know I'm stupid and I don't need other ppl to frickin' tell me that.

Mr.Bojangles, if you're at a malignant institution, I encourage you to take the path of least resistance. We don't need to take more sh1t from people during our final, most chill year of med school. If your institution is benign on the other hand, then feel free to do clinical electives and learn stuff.

I understand where you're coming from Andy. I'm pretty reluctant to do either of the medicine heme onc electives because one is in-patient (no more 60-70
hour weeks for me) and the other is outpatient but there is a really hard core attending who will find fault even if there is none. She'll make medical students stay on duty till 10pm on days they aren't even on call and she'll make the student see patients repeatedly before seeing the patient herself if she thinks the student is missing something from their presentation. I don't know maybe I'll choose the peds heme onc elective. No point in driving myself into a neurotic frenzy in fourth year 😀.

 

[b&ierstiefel]

I understand where you're coming from Andy. I'm pretty reluctant to do either of the medicine heme onc electives because one is in-patient (no more 60-70
hour weeks for me) and the other is outpatient but there is a really hard core attending who will find fault even if there is none. She'll make medical students stay on duty till 10pm on days they aren't even on call and she'll make the student see patients repeatedly before seeing the patient herself if she thinks the student is missing something from their presentation. I don't know maybe I'll choose the peds heme onc elective. No point in driving myself into a neurotic frenzy in fourth year 😀.

Geezus. Why would any 4th year student elect to do more inpatient months than what's already required?!?

 

[jeff2005]

I'm actually wresting with these questions myself. Do I do the super intense heme-onc elective or do I do something sweet? I leaning towards the "something sweet." It's not that I'm lazy - I just can't put myself through the torture of clinical medicine any longer.

 

[jeff2005]

Forgot to mention that Radiology electives are in the "sweet" category. Radiology is actually pretty cool - I loved it! If Path didn't exist I'd be heading to Radiology. 😍

 

[yaah]

I'm actually wresting with these questions myself. Do I do the super intense heme-onc elective or do I do something sweet? I leaning towards the "something sweet." It's not that I'm lazy - I just can't put myself through the torture of clinical medicine any longer.

Surprisingly, I found some of the 4th year electives not very painful. It was very freeing knowing that my future career would have very little of this, and I could just keep telling this to the residents. I learned a lot my 4th year - there is something to be said for nice easy electives, but you will also never have the chance again to do electives like heme-onc. I did cardiology, heme-onc, ID, and derm in addition to my required Neurology and IM. All except for the derm (and the IM) I would do again because they were actually very interesting. However, they were interesting because I was only doing them for a month. Any more time I would have been much less interested.

I wanted to do radiology too, but at my school radiology counted as a type "C" elective (aka minimal to no patient contact) and since I was going one away path rotation and one local hemepath rotation I couldn't do any more type C electives unless I gave up a month of vacation, which I was NOT about to do!

 

[b&ierstiefel]

Surprisingly, I found some of the 4th year electives not very painful. It was very freeing knowing that my future career would have very little of this, and I could just keep telling this to the residents.

Yeah but having to do anything 4th year sucks....sucks llama balls.

I learned a lot my 4th year - there is something to be said for nice easy electives, but you will also never have the chance again to do electives like heme-onc. I did cardiology, heme-onc, ID, and derm in addition to my required Neurology and IM.

You either have a high pain threshhold or are a masochist .

I wanted to do radiology too, but at my school radiology counted as a type "C" elective (aka minimal to no patient contact) and since I was going one away path rotation and one local hemepath rotation I couldn't do any more type C electives unless I gave up a month of vacation, which I was NOT about to do!

These kind of rules are stupid. I tried to make my last month of med school "Pharmacology Independent Study". And I was totally psyched about this. But then at the last minute they told me, "you don't see patients, you can't take this." So at the last minute, I find a path research mentor and do a path research month. Which was totally allowed because I saw SOOO many patients that month. In fact, I got to remove their thyroids all by myself and then cut them, fix 'em, embed 'em, and perform IHC. 🙄 What a load of crock!

 

[yaah]

Yeah but having to do anything 4th year sucks....sucks llama balls.

True enough. But at that point I was resigned to the fact that nothing was going to get me out of doing 6 weeks of clinical electives, so I had best make the most of it and do things that might be actually interesting. So you perhaps agree with me that 4th year should be eliminated or at least shortened?

 

[b&ierstiefel]

So you perhaps agree with me that 4th year should be eliminated or at least shortened?

You're preaching to the choir dude 🙂
Remember, my fourth year was abbreviated. I think there should be an abbreviated 4th year allowing for a few electives. SubI's should be eliminated. 3 electives should comprise 4th year. Not 2. 4 is too many. Hence, 5 (actually, three) electives during 4th year would be money.

Gawd I'm so frickin' glad med school is over. Now only Step 2 CS this Monday stands in Andy's way! Then when I pass step 2 CK in feb or march, it's GG NO RE K THX med school! Kiss my A$$ med school!