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How to Survive an Away Rotation

NewannaAnna Burkhead -- At my medical school, students in their clinical years do their rotations at hospitals all over the state and beyond. Of course, the most popular site to rotate is our “home” hospital at UNC-Chapel Hill. All the students put in site requests before the year starts, but if you don’t have a spouse or children anchoring you in the city, you’re pretty much guaranteed to get shipped out to another part of the state for at least one rotation during the year.

Not having a spouse or children, I knew that my chances of getting placed in Chapel Hill were slim to none, so I purposely requested to be sent to my hometown for most of my rotations. I figured that if I specified my hometown as an “away” site, I’d probably get placed there, instead of some more remote city I wasn’t familiar with. I played my cards right, and have done several rotations at home.

This month, I am assigned to a city near the coast, at a hospital I’d never seen, in an apartment provided by the hospital, with a roommate I’d barely met. It’s been a few weeks now, and although things started off a little rough, I’m adjusting to the setting. Too bad the rotation’s almost over!

To help other medical students adjust to “away” rotations, here are some tips and some vital pieces of information that will help you become more comfortable in a “foreign” city, hospital, or living situation.

1. The day before your rotation starts, take a walk through the hospital. Find the Emergency Department, Cath Lab, Radiology, Physician’s Lounge, and coffee shop.

2. On your first day, ask your intern to walk you through the hospital’s computer system and charting. Find out where to get patients’ vitals and up-to-date medication lists.

3. Bring your own bed sheets. They usually don’t provide them in student housing. (Would you want to sleep on them anyway?)

4. Ask for important phone numbers, and write them (as well as all the pager numbers of your team members) on a notecard. Numbers to know include the hospital operator, the Radiology listening line, long distance dialing code, telemetry monitoring room.

5. Cereal. Always a great meal in an unfamiliar living situation.

6. Ask a medical student who has spent time at the site to give you the details on call scheduling, pimp questions, and helpful things medical students can do during rounds at the site.

7. The day you get your ID badge, make sure it works at the entrances and badge-access locations. It’s a pain to get it fixed later.

8. Carry a little cash in your white coat and scope out the cafeteria. You never know when the department will have a “residents only” meeting, or when lunchtime conference will be cancelled and you’ll be on your own.

Although it’s difficult being uprooted and sent to unfamiliar hospitals, I feel fortunate to have the opportunity to do my rotations at several sites. This way, I get to learn different charting systems, experience different call schedules, and see different patient populations. If your school allows you to schedule rotations at away sites, I highly recommend doing at least one month in a new setting. Take these “Tips for Survival” along with you!

December 13, 2007 in Anna Burkhead | Permalink

Comments

Anna, being a native North Carolinian I do recognize Chapel Hill as "God's Country," but there is a huge world of medicine out there with many cultural nuiances.
I might add to your very valuable list something I found valuable during my rotation in Miami, find a translator, maybe that nurse or tech showing you the technical aspects of being a doctor.

Posted by: Gabriel | Dec 14, 2007 6:16:23 AM

Hey Anna.. Thanks for sharing these useful tips with us. I will be a foreign visiting student at UNC Hospitals next month and I am counting on these tips to help me out:) Being a foreign student makes it even more difficult because things could hardly differ more between your college and mine. But thankfully, everyone I have talked to in CH has been really helpful! I would love to know more about the charting system at UNC Hospitals, if you wouldnt mind helping me out, could you mail me at the above address? It would ease my apprehension a lot! Thanks for the tips again... I am looking forward to having a great time in Chapel Hill.

Posted by: Anuja | Dec 15, 2007 11:35:13 PM

Here's a helpful tip from a Nursing Student ! Please remember to tell the RNs when you've entered STAT medications and/or changed the care to be given to your patient. Love ya !

Posted by: Nancy Chardt | Dec 18, 2007 4:39:08 PM

You might also want to visit the visitors and convention bureau websites for local things to do while on rotation. I recently finished a rotation in Tyler, TX. I had never been to Tyler before, but found many cheap or free things to do in my spare time which made my stay more enjoyable.

Posted by: Emily | Dec 18, 2007 5:09:09 PM

There is a lot of true to what the commentary is saying. The other thing to consider when looking to clinical years is that by trying to limit yourself to one geographical area (ie the parent institution) you limit yourself to the pathology in the area. I understand that people have families, spouses, and obligations around there medical school. I did my third year in Portland, OR and had a great time about 1000 miles from my medical school. My fourth year, I am the traveling medical student, I have been to Cook county in Chicago, Banner Good Sam in Phoenix, St. Joe's in Denver, and soon back to Washington State. I have seen a variety of pathology, met amazing people and furthered myself in general. It also helps with the residency process. It is okay to be nervous about being in an unfamilar setting, but think how cool it is to say to classmates that you actually say a pheochromocytoma in the flesh (well, actually the CT, but still). Remember, life is like a box of chocolates, you never know what you're gonna get. Think of your clinical years the same and best wishes to everyone.

Posted by: bryon dorgan | Dec 18, 2007 6:10:30 PM

Hi Anna thanks for your useful advice I will change my city next year.Best wishes in ur new rotation

Posted by: Hager Hussein | Dec 19, 2007 3:45:03 PM

At my school in Monterrey, Mexico we have a whole year of away rotations in our fourth year. Most of us go to the US and other countries. If there is any advice you could get from me it would be to go to a foreign country for your away rotations, it's really important to learn from the practice of medicine in a country other than your own.

Posted by: Raquel | Dec 19, 2007 7:15:55 PM

...i recommend going to a country where you can do rotation in public or government hospitals, that's where the action is and you get a lot more hands-on training than anywhere here in the U.S. For my clerkship, i rotated outside the U.S., all of them government hospitals. I was able to do, on my own, 40 deliveries in OB, mostly NSDs, countless episiotomies and a good number of abdominal deliveries, some un-guided and some as first assist. In surgery, I was able to do un-assisted, appendectomy, cystectomy, thoracentesis, ungiectomy, 300 or so circumcisions, first assist in craniotomy, herniorraphy, corneal transplant, cholecystectomy, explore laparatomy, TAHBSO, modified radical mastectomy, thyroidectomy to name a few and to take full charge of the ER on duty nights. You'd be feeling like a doctor already after clerkship and internship was basically used for preparing for the boards. I don't think you can get this kind of training if you rotate here in the U.S. You get here one month's work to what we do outside for one day's work.

Posted by: | Dec 19, 2007 8:18:19 PM

what countries did you do all tht in?it sounds like amazing surgical experience

Posted by: | Dec 19, 2007 11:13:08 PM

hi...that's an very good tips for clinical rotations...thank u so much

Posted by: dr.athishaya | Dec 19, 2007 11:34:43 PM

Raquel my dear where did you do all of these surgeries?
Let me guess...In ur dreams
No country allows a med student to do any of your described procedures unassisted except for SVD

Posted by: dan | Dec 20, 2007 9:21:19 AM

firstful ... thanks Anna for those advices ..I agree with you to take ur rotation out of ur city.
I will agreat experince to us even if we face many diffeculties .
thanks alot

Posted by: Ibrahim | Dec 20, 2007 8:14:26 PM

Hey I didn't post that comment about the surgeries! I went to the states for my away rotations so obviously I didn't get to do those surgeries!

Posted by: Raquel | Dec 21, 2007 8:46:21 AM

Dan, you can certainly do many of those procedures when you are rotating in public hospitals in many countries in south america.You shoul find out, because it is true.

Posted by: | Dec 24, 2007 4:31:41 PM

Thank you for all your advises, they all are so important to me.
I study in Guatemala city, and in my university we have the oportunity to go two month were ever we want, particulary USA and Europe, we have an interchange program with Harvard medical school and we´re allowed to do our rotation there, that´s my plan actually, however I don´t know anyone there, and despite my temporary stay I would like to make it a great experience.

It would be very nice if anyone can help me get in touch with someone over there, I´ll be happy to return somehow the favor, like if they´re interested in come a couple of months to central america (particulary Guatemala) or somehow else.
Thank you
Sandra

Posted by: Sandra Contreras | Dec 28, 2007 9:22:11 AM

Anna:

All good advice, I would also advise anyone doing rotations, no matter where this may be, to learn who your nurses within the various areas. By learning who my nurses are, I can usually depend on help with questions when seeking additional information which may be unfamiliar to me. Remember these individuals spend more time with your patients and know them more intimately than we ever could.

Posted by: TrayMilburn | Dec 28, 2007 8:07:13 PM

In may away rotation I learn that a good partener is most importan that the cientificts knwoledge. Because we foun information in everywere, but we obtain security in ourself when we conquer the afraid to hurt our patiens

Posted by: Marianela | Jan 5, 2008 8:29:55 PM

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