Saturday, January 3, 2015

Clinicals

So it’s official, I scheduled my clinicals!! I will be going to Trinity Hospital in Augusta, GA for OBGYN and Family Medicine as well as an elective in Perinatology. I will then move to Decatur, GA (Atlanta) for Internal Medicine and Pediatrics rotations. I then will travel up to Connecticut to complete my Surgery and Psychiatry rotations. I’m super excited to start the next stage of this fabulous journey I call life.

While waiting for my clinicals to start I went on a mini vacation to Florida to relax and enjoy the sun. I felt like I deserved it after studying day and night for the last two years. Give yourself a break!

As my last post detailed, there are a lot of items that need to be completed before you are able to schedule your clinicals. If you complete all of this prior to receiving your Step 1 score then you will be ready to go once it does arrive. The day after I received my score, I called the clinical department. They had been very helpful leading up to this point too because I had called them on multiple occasions asking a variety of questions. The day after my exam, I was told someone would call me. If you know anything about me, I usually don’t wait for someone else to call me so I called the department every morning instead J I had done a lot of research on our clinical sites, what was offered where, where were the best programs, are they accredited, etc. A lot of the student doctor forums had students from other Caribbean schools that rotated in the same places. 

What is required?
We are required to do 48 weeks in core rotations and 30 weeks of elective rotations. Cores include Family Medicine (6 wks), OBGYN (6 wks), Internal Medicine (12 wks), Pediatrics (6 wks), Surgery (12 wks) and Psychiatry (6 wks). Electives can be done at any time but you must have completed your core rotation before doing a sub-specialty. For example, you must complete internal medicine core before doing an elective in cardiology.

Greenbook, Bluebook, what?!
A not so little note on accreditation: As I was going through school, I heard the words Greenbook and Bluebook rotations tossed around all the time but never truly understood what it meant. So I’ll try to clarify for you all.  A greenbook rotation is a rotation, which occurs in a teaching hospital and is accredited by the Accreditation Council for Graduate Medical Education (ACGME) for that residency program. These hospitals can be directly accredited as they have residents through their hospital or accredited via another hospital/school where residents from other programs rotate at that hospital for part of their program thus making it accredited. For example: Family Medicine rotation at Dekalb Medical Center. Dekalb itself does not have a residency program in family medicine but they are still a teaching hospital and receive residents through the Medical College of Georgia resulting it Dekalb being accredited for family. Important to note: Just because a hospital is accredited for one rotation it does not mean it is accredited for all. Bluebook are rotations that are not accredited. Accreditation is important for residency and future employement depending on the state.

**To research if programs are accredited search via ACGME’s website: https://apps.acgme.org/ads/Public/Programs/Search Be aware that program may not show up directly under the hospital and may be under another program. It took some digging but I did a majority of the legwork for you.

Family Medicine Umbrella
A family medicine umbrella term is used when a hospital has an accredited family medicine residency program thus resulting in the other rotations being accredited under this umbrella even though they aren’t accredited individually. One excellent example of this is Adventist Hospital in Hinsdale, Illinois. When is this important? Well, a family medicine umbrella is accepted by California standards and most other states but there is an issue with Texas. You can still obtain a residency there but to obtain licensure you must be board certified first then it doesn’t matter where your rotations were.

I don’t necessarily see myself practicing in Texas but I really don’t know where I’ll be so I chose another program that eliminated the family medicine umbrella altogether. In the long run, I don’t think it will be an issue either way but be sure to check what states require. Especially the ones you’re interested in potentially practicing in someday.

Where can we do our rotations?

The following list I am including is by no means everything but it is a majority. I may have missed a few here or there as I was attempting to type as I was on the phone with someone from the clinical department. There is a short summary table at the end of accredited programs by specialty. 

ACGME Accredited Programs
·      Arizona
o   Maricopa Integrated Health Care, Phoenix
§  Psych
·      Directly
·      Need Application, fee of $100 
·      Connecticut – need >210 on Step 1
o   Griffin Hospital, Derby
§  Internal Med
·      Directly Accredited
o   St. Mary’s Hospital, Waterbury
§  Surgery
·      Directly Accredited
o   St Vincent’s Hospital, Bridgeport
§  Internal Medicine
·      Directly Accredited
o   Danbury Hospital
§  Psychiatry
·      Accredited through the University of Vermont
·      Georgia
o   DeKalb Medical Center, Decatur
§  Family Medicine
·      Accredited through Medical College of Georgia
§  Pediatrics
·      Accredited through Morehouse School of Medicine
§  OBGYN
·      Accredited through Morehouse School of Medicine
§  Internal Medicine
·      Accredited through Morehouse School of Medicine
§  Surgery
·      Accredited through Morehouse School of Medicine
o   Doctor’s of Augusta
§  Surgery
·       Accredited through Dwight D Eisenhower Army Medical Center
o   Laurel Heights Hospital, Atlanta
§  Psychiatry
·      Accredited through Morehouse School of Medicine
o   Trinity Hospital of Augusta
§  Family Medicine
·      Accredited through Dwight D. Eisenhower Army Medical Center
§  OBGYN
·      Accredited through Medical College of Georgia
·      Illinois
o   Adventist, Hinsdale
§  Family Medicine
·      Directly accredited
§  All others are “Family Medicine Umbrella”
o   Jackson Park, Chicago
§  Nothing accredited
o   Louis Weiss Memorial, Chicago
§  Internal Medicine
·      Directly Accredited
§  Surgery
·      Not Accredited

·      Maryland – need >220 on Step 1
o   Sinai Hospital Baltimore
§  Surgery
·      Directly accredited
§  Internal Med
·      Directly accredited
§  Pediatrics
·      Directly accredited
·      Michigan
o   Just getting rotations in Michigan, contact department for more info

·      New York
o   Montefiore New Rochelle
§  Surgery
·      Accredited through other programs
o   Southampton
§  Internal Medicine
·      DO Residency so not accredited the same
o   Ellis Hospital, Schenectady
·      Family Medicine
·       Directly accredited

·      Puerto Rico
o   Ponce School of Medicine/ Hospital Episcopal San Lucas
§  Internal Med
·      Directly accredited
§  OBGYN
·      Directly accredited
§  Pediatrics
·      Directly accredited
§  Psych
·      Directly accredited
§  Family Medicine
·      Not quite sure if/how it’s accredited
§  Must speak Spanish but do offer a medical Spanish elective

·      Wisconsin
o   Aspirus Wausau Hospital
§  Only students from Wisconsin

Chart of Accredited Programs
Pediatrics
OBGYN
Family Med
Intern Med
Surgery
Psych
Decatur, GA
Decatur, GA
Decatur, GA
Decatur, GA
Decatur, GA
Atlanta, GA
Baltimore, MD
Augusta, GA
Augusta, GA
Baltimore, MD
Augusta, GA
Danbury, CT
Puerto Rico
Puerto Rico
Puerto Rico
Puerto Rico
Baltimore, MD
Puerto Rico


Hinsdale, IL
Derby, CT
New Rochelle, NY
Phoeniz, AZ


Schenectady, NY
Bridgeport, CT
Waterbury, CT




Weiss, Chicago, IL



















Update: I heard we are losing Adventist Hospital in Hinsdale, IL but possibly gaining more at Weiss in Chicago. We also lost Psych at Laurel Heights in Atlanta, GA but are working on gaining DeKalb for psych. We gained McLaren Hospital in Michigan for most cores but they fall under the Family Medicine Umbrella as of right now. 


How do they schedule you?
I stated what I was interested in and then we worked to see how we can fit it together. I really wanted Surgery in Connecticut so we planned that and then fit everything else around that (I really enjoy surgery and had read that this was a good rotation but difficult so I made it a priority). I was willing to move around so that gave me a little more flexibility as well. This is your future, so if you want to do something suggest it and see how it all fits. The first schedule that I was given, I didn’t feel 100% confident about it so I asked for another option and the clinical department gladly came up with an alternative schedule that I am much happier with. **Update: they just sent out an email about how they are starting a new process. They will email you and you have to agree or disagree with the schedule they create for you or something like that. 

Stay in tune for my future rotation updates such as the dreaded search for housing...