Saturday, July 30, 2011

The Fourth Year begins

I just completed the  first week of my fourth year of medical school.  I can honestly say that this past week has been one of my favorites since starting medical school!  This month, I am doing  a Sub-Internship at a Family Medicine residency program.   I think it is important for every fourth year student to spend some time away from your home institution. The theory is that this will help you to make a more informed decision later.  My biggest advice is to start the process early.  I began working on setting up this Sub-I last February. I did not get absolute confirmation until June.  I don’t think this reflects the average experience, but it’s better to be safe than sorry.
Meeting the residents that you will be spending the greater part of your life with for the next three years is helpful.  It gives you a pretty good look into how a residency program works. You get insight into resident satisfaction, the patients that they care for, and their procedural experience.     For this rotation, I applied online directly with the program.   Some programs require you to use VSAS which I’m not as familiar with. 
The Fourth year is fantastic! You get more responsibility in patient care.  It’s your time to start sticking your neck out--they actually want you to write down your plans and recommendations.  I have been having a great time. In four days (just off the top of my head) I’ve delivered six babies, scrubbed in on five cesarean sections, and performed three circumcisions.  I even repaired a second degree perineal laceration under  the close supervision of the attending.  This program seems to put its 4th year Sub-I students near the front of the line when it comes to procedures.  I was worried that scheduling this in July could be a mistake since all of the new interns are just starting and just as eager for experience, but I haven’t had any trouble getting procedures. 
It is important to try to identify early on what you would like to incorporate in your future practice.  Family medicine is wonderful in its flexibility.  I plan to practice in a rural town and I would like to do OB and procedures, which makes it very important for me to find a program that can provide adequate experiences  for these things.   Every program has a different emphasis, so if you can narrow down your likes and dislikes it helps. 
When Matt and I first started looking at residency programs, I really didn’t have a good idea of what I wanted to do in the future.  We began by narrowing it down by places we would actually want to live….that got us down to 80 programs!  Since I started this Sub-Internship,  I have been able to talk to a lot of residents and feel I’m getting a much clearer picture of what I want my practice to look like.  I now have my choices narrowed down even further.  I will be attending the AAFP National Conference for Family Medicine Residents and Students from July 28 to 30th. This will give me an opportunity to talk to residents from lots of different programs and hopefully get a better idea of the ones would be a good fit for me.  Matt is coming  along so he can get a feel for each of the programs.  It is important to me that he likes the location just as much as I do. And we have to have job opportunities there for him too. 
I will continue to blog about this process as I go along.

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