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  1. #1
    iwanabmd is offline Member 516 points
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    The 5th Semester

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    I saw some opinions being posted under the doubles topic for 5th semester. I was hoping an actual threar could be started with people in 5th and all the pros and cons of their sites
    STEP 1 [X] STEP 2 [X] STEP 3[X] PGY - 1 [X] PGY-2 [*]

  2. #2
    rahulb is offline Senior Member 695 points
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    Baltimore:

    Rotations are Mon-Thurs and breakdown is as follows:
    4 weeks hospital. Hours are 8-1 and you're free to study in the hospital library from 9-12. You only attending morning report and noon conference. You also are on night float in the ER once a week from 9pm-7am but you can go sleep in the staff lounge around 2am unless there are lots of admissions.

    1 week ER. Your shift is either 7am-3pm or 3pm-11pm. This rotation is amazing and you get to see a lot of different acute cases. I had brain bleeds, COPD exacerbations, chest pain, gastroenteritis, seizures, schizo patients, drug overdoses, etc.

    1 week writeup: I drove home and used this week as a vacation. Only thing you're obligated to do is write a 5-6 page comprehensive patient write-up.

    3 weeks primary care: You work outpatient in a primary care office from 9pm-3pm. You see around 20 patients a day for various colds, prescription refills, fevers, flu, etc.

    1 week ob/gyn: Haven't had this yet but I've heard good things. Get to see surgeries and various procedures.

    1 week EMR: You work in the 5th semester director's office and see patients. You learn the basics of electronic medical records and get to do some procedures.

    1 week pediatrics: See a ton of snot-nosed crying kids.

    Rotations are pretty solid. I've learned a ton and am a pro as seeing patients now. I can take a good history and rarely miss anything anymore. I've also become really good at listening to heart/lungs, checking the retina on fundoscope, palpating, etc. I've also seen and helped do a bunch of different procedures.

    Fridays are reserved for lectures at the hospital and the hours are usually 8-4pm. You attend grand rounds which is an amazing lecture by a MD/PhD from Hopkins. We usually have a quiz on the previous week's material too.

    We have Saturday classes about 2 times a month from 9-3. The only reason for this is so we can finish 5th semester by April instead of May and get a free month to self study. The only thing we're responsible for in April is the ICM shelf. I plan on moving back to NJ beginning of April and just driving to Baltimore for the shelf.

    The hospital and primary care offices are in the good part of Baltimore. I haven't had to go into the ghetto yet and live in a real nice neighborhood. The bar scene is really hip and there's a ton to do in the surrounding vicinity. I give it a solid A.
    [X] Attending Physician

  3. #3
    Fornis J. Plebney is offline Senior Member 525 points
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    Atlanta:

    Overall, Iíve been pleased with Atlanta so far. The course proper covers 12 weeks. We alternate weeks in the clinic and doing board prep didactics. The class is divided in half and one group is in the clinic while the other is in didactics.

    The didactic portion is focused around board review with First Aid as the guideline. We cover ~ 2 systems a week. We have lecture from 9AM-1PM Mon-Fri. We have case studies 2PM-4PM Mon-Thur where we cover an applicable disease related to the lectures (Cardio lectures = MI case study). We have a quiz each didactic week that is drawn from a list of q-bank type questions we get earlier in the week. Friday afternoons are free. Didactics are done at the Atlanta Medical Center downtown.

    Clinic locations are spread all over ATL. Your clinic hours depend on how much your attending wants you there. Worst case, you can probably expect 8AM-5PM Mon-Fri. During our first rotation, we did 9AM-2PM MWF and 9AM-1PM on Sat. The clinic we are starting at this week does either half or full days depending on what the student wants to do and the schedule is Mon-Thur. Talking to fellow students, the quality of the attendings varies quite a bit. Some are very good when it comes to teaching, some act like they are bothered if you dare to ask a question and expect you to have a third year resident knowledge base. The MD we had was very laid back and went out of his way to explain things. The clinic was primarily a pain management clinic, so we didnít get to see alot of family practice type patients. Most were there for med refills for chronic lower back pain. We did the intakes and then turned them over to the MD for their scripts while we went on to see another patient. If you wanted to hang around and wait for the MD to see your patient and go in with him, that was cool tooÖyou just limited yourself on the other patients you could see by limiting yourself to a single patient. If it was an interesting case or had something out of the ordinary, I would make sure I went with the MD into the room. Once or twice a week he would sit down with all the students and go over some medical topic (EKGs, etc) for about an hour. These were laid back sessions and I learned more cardiology in one hour from him than I learned in a semester of Physiology. We were allowed to draw blood, administer 12-lead EKGs, do drug screens, etc. The only drawback to that clinic was the lack of H&P practice due to the nature of their clientele. There was another AUA student there with me and several other students from other Caribbean schools doing clerkships there. Overall, it was a good non-stressful intro into the clinical environment.

    UPDATE: I just finished week one of my second (and last) clinical rotation. We work 3 days a week 8:30AM-5:45PM. This one is at an up-scale family practice clinic. We saw more patients in two days than I saw in three weeks during the first rotation. We see typical family practice disease ranging from diabetes and hyperlipidemia to sprained ankles and strep throat. The learning format is quite different here. The attending first asks the patient if they mind if students come in to hear their case. Most agree and then all of the students (5-6) follow the attending in and he first discusses the case and then goes around the room asking questions about the disease, related anatomy, related pharm, etc. After a few rounds of that, he finishes up with the patient and we all leave. We don't do any H&P. If there is something worth seeing on the patient (i.e, strep throat), he will show us what it looks like. The rotation is good in that his questions make you think as you try to dredge up topics that you last read about two years ago. You get used to saying "I don't know" alot...but it is incentive to look things up. Again, like the first rotation, it is bad in that there is no H&P training whatsoever.

    Regarding our portfolio, we have to keep a list of all patients we see along with our primary diagnosis (25WM Ė Sinusitis). We have to do 20 SOAP notes. We have to do 10 write-ups on case studies we covered during afternoon didactics. We use the 5MCC format (http://www.5mcc.com/5mcc/ub/view/5-Minute-Clinical-Consult/116030/all/Angina ). The format basically covers the disease from start to finish. We also have to do 2 full H&Ps + write-ups of the patientsí diseases (using 5MCC) and then present two of the 5MCC subcategories to the clinical director / class. There is also some type of physical exam practical we have to do. They have yet to tell us what the practical entails. In addition to the weekly quizzes, there is a midterm in a few weeks. They have yet to tell us what it is over and what it covers. Then there is the ICM Shelf towards the end of the semester. And you have to take/pass the Comp if you havenít already done so.

    One of the biggest problems here is ATL is the lack of focus on honing our H&P skills. We had an attending(s) call in after the first clinical week griping that the students werenít proficient in H&Ps. Well, no duh! That is what the semester is for. For some reason, some of the attendings think we should be masters at it. This led to us taking two afternoon didactic sessions to review cardio and respiratory physical exams. But that has pretty much been it other than a overview of history taking that we did on day one before didactics started. So, depending on the clinic, you may or may not get adequate H&P training. So to date, I really donít know any more about taking a good H&P than I did when I left the island (which isn't much). We were under the impression the focus of this semester would be to hone our H&P skills. That has not been the case for alot of us here in ATL so far.

    It would be beneficial if they would scrap the afternoon case study sessions and focus on small group H&P sessions. Whereas it is nice to review diabetes, it would be more beneficial to master the H&P skills weíll need next semester. It would also be beneficial if they would do away with the written 10 case studies and let us use that time to focus on USMLE World questions. Again, learning more about diabetes is nice, but the time would be much better spent doing questions in preparation for the board.

    Everyone gets a copy of ExamMaster shortly after they get to 5th. Iíve never heard of the q-bank and neither has anyone else I know. Why the school spends our tuition dollars on it, I donít know. I know of nobody that uses it. Everyone uses the gold standard USMLE World. The school should get us a subscription to USMLE World and stop wasting our money on a product that nobody wants or uses.

    ATL is a great city and there is a ton to do here. I hope AUA can close the deal and get cores here this Fall. I like the program here and the clinical director and staff seem to be really organized and look out for the students. They just need to bolster their H&P training and cut down on some of the make work. This is a good place to do 5th semester if you can get it.
    Last edited by Fornis J. Plebney; 03-05-2009 at 10:51 AM.

  4. #4
    Arkie, M.D.'s Avatar
    Arkie, M.D. is offline Elite Member 6139 points
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    thanks for the great reviews so far guys...

    please keep 'em coming
    Step 1 [x] Step 2 CK [x] Step 2 CS [x] Prematch [x] M.D. [x] Step 3 [x] PGY-1 [x] PGY-2 [x] PGY-3 [x] ED Attending [2015-]
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  5. #5
    mrpark01 is offline Member 520 points
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    Quote Originally Posted by rahulb View Post

    The hospital and primary care offices are in the good part of Baltimore. I haven't had to go into the ghetto yet and live in a real nice neighborhood. The bar scene is really hip and there's a ton to do in the surrounding vicinity. I give it a solid A.
    ..dude said hip. hahaha =)

    o and mods..
    could we make this a stickey?

  6. #6
    Fornis J. Plebney is offline Senior Member 525 points
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    Quote Originally Posted by mrpark01 View Post
    ..dude said hip. hahaha =)

    Baltimore might be hip, but Atlanta is groovy!!!!!

  7. #7
    rahulb is offline Senior Member 695 points
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    As for the workload in Baltimore, you're responsible for 18 short 2 minute write-ups and 1 detailed write-up. There are a total of 12 or 13 quizzes, 1 exam, the comp shelf and the ICM shelf. It's really not that bad and I spend maybe 30 minutes a week prepping, leaving a lot of time for USMLE self-study.
    [X] Attending Physician

  8. #8
    Bmoregirl is offline Member 516 points
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    Rahul, I live in baltimore and would love to go there for 5th for the reason of saving money to pay for Falcon. I've heard so many horror stories about baltimore though. I live about 10 miles from Harbor Hospital so it would be perfect as far as location. After reading your posts, it seems baltimore is not as bad as everyone makes it seem. Do you think its worth going to baltimore over Miami considering the almost 5000 i'll save? Thanks!

  9. #9
    iwanabmd is offline Member 516 points
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    Is there anyone out there who can post about NY
    STEP 1 [X] STEP 2 [X] STEP 3[X] PGY - 1 [X] PGY-2 [*]

  10. #10
    islandthrift is offline Moderator 675 points
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    Do a search. I posted about NY a few times!


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