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Careers in Medicine: Developing a 3rd Year Schedule BUSM II Class Meeting Friday, February 6, 2015 Angela Jackson, M.D. Associate Dean, Office of Student Affairs
Careers in Medicine:
Developing a 3rd Year Schedule
BUSM II Class Meeting
Friday, February 6, 2015
Angela Jackson, M.D. Associate Dean, Office of Student Affairs
Plan Your Future
Lifestyle decisions Professional needs Personal needs At the end of a great day, ask yourself- Why was it great? What did I do that I really enjoyed?
Success in the clinical years….
• Clear expectations • Ongoing feedback • Set your own learning goals
• Don’t underestimate your
contributions to your patients and to your team
Letters of Recommendation
Work early with those who will write your letters of recommendation Seek input about who to ask Field specific vs. other Academic rank, national recognition of letter
writers can be important, but does not trump personal knowledge
You do not want a generic or lukewarm letter
MSPE (Dean’s Letter):
Summary Evaluation of your work to date (“just the facts”)
Student characteristics Research Extracurricular/Leadership activities Relevant Life Experiences
Clerkship and Rotation Narratives
BUSM-1/BUSM-2 “Book” learning, studying, storing information, recalling information
BUSM-3 Clinical skills, diagnostic acumen, professionalism
Hints for success in third year Be proactive Follow instructions Be on time – actually, be early Be inquisitive- but not intrusive Be helpful - but not obsequious Know tomorrow what you didn’t know today Know why the patient is being seen Speak using only medical terminology- but
don’t use medical jargon with patients
Hints for success in third year
Don’t be afraid to commit to a dx or plan- better to be wrong and learn something
Keep in mind that faculty rely on residents and fellows to help them assess performance of medical students
Do not hesitate to seek advice from the Office of Student Affairs
Student Wellness
John Polk, MD, EdM Office of Student Affairs
WELL-BEING
VS
Physician Burnout Burnout is defined as loss of enthusiasm for work, feelings of
cynicism, and a low sense of personal accomplishment.
Slightly under 40% responded that they were burned out.
Medscape's Physician Lifestyle Report 2013
Resident Burnout Twenty-eight (28%) percent of residents
reported burnout
The role of concrete behaviors, such as reading outside the field of medicine, regular exercise, and taking time for
family, did not demonstrate a protective effect
Doolittle BR, Windish DM, Seelig CB. Burnout, coping, and spirituality among internal medicine resident physicians. J Grad Med Educ. 2013;5:257-261. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3693690/
Medical Student Burnout
Burnout was reported by 49.6% (95% CI, 47.5% to 51.8%) of
students, and 11.2% (CI, 9.9% to 12.6%) reported suicidal ideation within the past year
Dyrbye LN, et al. Burnout and suicidal Ideation among U.S. Medical Students. Ann Intern Med. 2008;149:334-341.
Student Wellness
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Education Training Job
Debt Lifestyle Investments
Relationships: Significant other Family Friends
Mental Spiritual Physical
Engagement: Social Professional
Wellness = Equanimity
What If? Wellness is not the "golden mean," a desirable middle between two extremes, one of excess and the other of
deficiency. Aristotle (Nicomachean Ethics)
"Wellness (Winning) is not a sometime thing; it's an all time thing. You don't win once in a while, you don't do things right once in a while, you do them right all time.
Wellness (Winning) is habit."- Vince Lombardi
"Happiness (Success) is not a matter of intensity but of balance, order, rhythm and harmony." - Thomas
Merlton
Boston University School of Medicine Time Off Policy
http://www.bumc.bu.edu/mec/files/2008/04/clinical-student-time-off-policy-APPROVED.pdf
Proposed Policy for Medical Student Time off during Clinical rotations of the 3rd and 4th years Purpose: The purpose of this policy is to formalize guidelines for time off for planned or unexpected absences during the clinical years. Clear communication of the expectations between students and clerkship directors will permit flexibility within reasonable limits in a way that does not impact either clinical education or reflect on a student’s professionalism. Professionalism in patient care requires reliable attendance. The medical school will centrally track the number of days off for each student. Any student with more than 5 days (per academic year) of time off (not made up) will be referred to the promotions committee. It is the responsibility of the student to not finish the year with >5 days absent. The time off policy for the 3rd and 4th years includes: Approved time off: • Conferences (only if the student is presenting, is an officer in an organization, or other situations
by special permission) • Residency interviews • Religious observances • Jury Duty • Unanticipated Family/Personal Emergency • Exception: Step 2 CS – days off are considered working days and are not subject to this policy Other time off: • Personal medical illness • Step 2 CK • Missed clerkship time because of travel complications
Proposed Policy for Medical Student Time off during Clinical rotations of the 3rd and 4th years Notification policy: For all anticipated time off the student will need to notify the Registrar’s Office and the clerkship director as far in advance as possible: In the case of religious holidays notification should occur before the start of the academic year (and at least 8 weeks before the start of the first rotation). For conferences, requests should be made at least 8 weeks before the start of the clerkship. For other time off: In the case of illness, the student must contact the clerkship director and/or clerkship coordinator. If a student will miss more than 2 days, the student will need to obtain a note from their personal physician. The student must maintain communication between him/herself and the medical school, before traveling to family/etc, and while there. This communication can include contact with the clerkship director, administrator, site director, registrar and staff in the office of student affairs. Time off for residency interviews: Students requiring time away from clerkships for interviewing may take up to twelve days off during interview season, which extends from October-February 15th. 1) Students are encouraged to take a four week block of vacation during interview season. Also, students may request to split a four week rotation over eight weeks if enrollment and the structure of the clerkship permit. Clerkship directors should allow this if possible. 2) Students may request no more than 5 days off for interviewing during any four week rotation, and no more than four days over any two week rotation. This includes partial day absences of greater than four hours. Students will be required to make up time missed at the clerkship director’s discretion. 3) All requests for time off must include written verification of the interview location and date, provided to the clerkship director. 4) Students who require more days off than stated above must arrange with the clerkship director to make up the missed days, with Spring Break a possible time. Missed days cannot be made up by taking time from other rotations. Make Up Time: The student will be expected to be available to make up any time off at the discretion of the clerkship director. If the student's absence will involve missing an examination, the student will need to retake the exam at the discretion of the clerkship director.
Developing a 3rd Year Schedule Ellen DiFiore, Registrar
Selecting 3rd Year Clerkships
February 6 – February 20 : enter sequence selections on Registrar’s web site
March 27: Final schedules appear on Registrar’s web site & in E*Value
A Brief overview for BUSM 2 students Rachel Thompson, MD Pediatric Clerkship director Assistant professor of pediatrics Division of pediatric emergency medicine
Pediatrics Clerkship 2015-2016
Clerkship Basics
Patient Care Inpatient/ward Outpatient
Primary care clinics Subspecialty clinics
Emergency Department
Newborn nursery
Learning Objectives Growth &
Development Disease prevention Newborn health Adolescent health Acute illnesses of
childhood Oral presentation &
other clinical skills: communication, differential diagnosis, A/P, labs/imaging professionalism,
Pediatric Sites for 2015-2016
* Site is not available every block
• Schedules vary by site • Inpatient days typically 7am to 5:30pm, (+ pre-round) • Outpatient clinics 8am-12pm and 1pm-5pm. Evening clinics 5pm-8:30pm • No clinical responsibilities Tuesday am for off-site students • Tuesday pm mandatory didactics for all students
Hospital Location # Spots Transportation
Boston Medical Center (SSH)
Boston, MA 15 May require car!!
MGH for Children at North Shore Medical Center
Salem, MA 4 car
Winchester Hospital
Winchester, MA 2* car (train + cab)
Beverly Hospital Beverly, MA 2* car (train + cab)
Boston Children’s Hospital/BMC
Boston, MA 2* Car or MBTA
Kaiser Santa Clara Santa Clara, CA 2* N/A
Student Financial Services presented by
Dennis Murphy • 2015-2016 FAFSA Application / www.FAFSA.ed.gov
• Continuing Student Application for Financial Assistance Form to be posted to the SFS website soon
• Rotation Cost of Attendance Increase Form / www.bumc.bu.edu/osfs/webforms
• Financial Literacy Sessions held on campus during upcoming Spring
• More scheduling information to come
Questions: [email protected]
Surgery Clerkship Goal and Objectives
• GOAL: • To increase your knowledge of surgical disease, and advance
your skills as an effective caring physician
• OBJECTIVES: • Students will develop skills in teamwork, individual
responsibility for patient care, and a systems-based approach to patients safety. (B, U, A, S)
• Students will demonstrate understanding of tumor biology, and the diagnostic workup and multidisciplinary treatment of cancer. (C, U, A, R, E)
• Students will demonstrate knowledge of diagnosis and surgical treatment of diseases of the gastrointestinal tract, liver and biliary system, endocrine organs, vascular system, muscle and soft tissue, and the management of traumatic injury. (U, R, E)
SURGERY CLERKSHIP Sites Location #
Slots Transportation Lodging
Boston, MA 8 Walk, run N/A
West Roxbury, MA Jamaica Plain, MA
5 Need a car 25-40 minutes
N/A
Hyannis, MA 2 Need a car 1.5 hours
Housing will be provided in close proximity to the hospital
Providence, RI 2 Need a car 1.5 hours
Housing will be provided in close proximity to the hospital
Framingham, MA
2 Need a car 45 min-1 hour
N/A
Santa Clara, CA 2 Need a pilot license
N/A
Once assigned to a block a ranking form will be sent via email
SURGERY CLERKSHIP Sites Location #
Slots Transportation Lodging
Boston, MA 8 Walk, run N/A
West Roxbury, MA Jamaica Plain, MA
5 Need a car 25-40 minutes
N/A
Hyannis, MA 2 Need a car 1.5 hours
Housing will be provided in close proximity to the hospital
Providence, RI 2 Need a car 1.5 hours
Housing will be provided in close proximity to the hospital
Framingham, MA
2 Need a car 45 min-1 hour
N/A
Santa Clara, CA 2 Need a pilot license
N/A
Once assigned to a block a ranking form will be sent via email
Family Medicine Clerkship Sites Site Notes Housing #’s
(per yr) Community Health Center / Underserved Variety of types of practices,
most require a car N 40
Greater Boston Private Practice Variety of types of practices, most require a car
N 115
Central Maine Medical Center - Family Medicine Residency Program
No car needed and food provided
Y 7
Cape Cod Family Medicine Centers Car typically needed Y 20
Valley Medical Group, Greenfield, MA
Car needed
Y/N
1
Rehoboth/Seekonk Medical Center Car typically needed Y 4
Trailside Health, Shelburne Falls, MA Car typically needed Y 5
*Kaiser Permanente San Jose, CA N 16
Other sites available throughout MA without housing available- please contact FM Dept. ASAP
See website for details of all sites http://www.bu.edu/familymed/medical-student-ed/third-year/
*Kaiser is done outside the registrars lottery
How to choose
1. Select sequence through the registrar 2. Rank the 7 site categories 3. Complete the online Family Medicine Site Preference Form
Do this after you get your site category from the registrar’s lottery Remember: All of our sites provide excellent learning experiences You will do a lot, learn a lot, and have a great time! See handout/website for more detailed information about
the clerkship and site selection process Plan to have a car
Psychiatry Clerkship • As providers, you will see many people with
mental health conditions • These conditions will impact your ability to
provide effective care • In order for you to be great physicians you need
to know what to do if you encounter someone who needs help
Important: If you have been in therapy with any of our staff psychiatrists or residents (now or in past) then do not rank a BMC site and let the Registrar know that you can not be placed at any BMC site.
The psychiatry clerkship, as mandated by the LCME, AAMC and school policy, will not allow your therapist to be involved in evaluating and/or grading your performance in this clerkship.
1
2
6
4
3
5
7
1. BMC ED and ENC - 0 miles
2. Bay Ridge - 13 miles
3. Bournewood – 6 milesBournewood - 6 miles
4. Mount Auburn Hospital - 6 miles
5. Westwood Lodge - 23 miles
6. VA Bedford - 25 miles
7. VA Brockton - 23 miles
Clerkship Sites
8
10
9
8. VA West Roxbury – 8 miles
9. St Elizabeth’s – 7 miles
10. Roger Williams – 50 miles
11. Kaiser – 3,140 miles
SITE TRAVEL Shuttle RESIDENTS POS SETTING
1 BMC ENC No --- Yes 4 C&L
2 BMC ED No --- Yes 2 Emergency
3 Bay Ridge (p) 13 Miles No No 2 Inpatient
4 Bournewood (p) 6 Miles No Yes 4 Inpatient
5 Mount Auburn 6 Miles No No 2 Combination
6 Roger Williams 50 Miles No No 2 Combination
7 Westwood Lodge (p) 23 Miles No No 2 Inpatient (adol)
8 St. Elizabeth’s 7 miles No No 3 Combination
9 VA Brockton 23 Miles No No 2 Combination
10 VA Bedford 25 Miles No Yes 4 Combination
11 VA West Roxbury 8 Miles From JP Yes 3 C&L
12 Kaiser Permanente 3,140 Miles No No 2 Combination
12 Clerkship Sites
Obstetrics and Gynecology Clerkship 2015-2016
Ob/Gyn Clerkship Sites 2015-2016 Site Mi
away Volume % Students
Deliver a Baby Car? Residents
BMC only 0 Good 4/20 No Yes
BMC Lahey
0/18 Good/High 4/20 Yes Yes
Mt. Auburn 5 Superb 2/2 No No
Beverly 26 Great 2/2 Yes No
Metrowest 20 Good 50% Yes Yes
Plymouth* 40 Amazing All Yes No
St. Elizabeth’s
7 Good ?? No Yes
Our goal is to provide you with the fundamentals of neurology, expertise with the examination, and proficiency with patient management.
During this four week block you will see patients in the inpatient and outpatient settings. You will learn how to perform a lumbar puncture, read a Head CT and MRI, and understand when EEGs and EMGs are used.
All students participate in teaching sessions on Tuesdays at BMC.
Neurology Clerkship
Sites Description Slots Transportation
BMC: ICU, General, Stroke, PEDS, Neurosurgery
Inpatient>Outpatient 12 None
VA: General, ICU, Neurosurg clinic
Inpatient=Outpatient 6 Shuttle/Car
Mt. Auburn: Outpatient general neurology, MS clinic, Botox, EMG
Outpatient>Inpatient 1 Bus/Car
Braintree Rehab for Stroke, TBI, MS, and PD
Inpatient> Outpatient 1 Car
Radiology Clerkship Our goal is to expose students to all
common imaging modalities, their uses and limitations, and to develop a systematic approach to image interpretation.
During this four week block, students will see radiology in action, watch patients undergo exams, participate in consultation between clinicians and radiologists, and gain an appreciation of the contribution of imaging to clinical care.
Site Description # Students Transportation BMC Inpatient and
Outpatient – all age groups
All None
Medicine 1
Purpose Experience
Inpatient team Enrichment
Focus Sites- Be ready to travel
BMC WRVA MetroWest- Framingham Jordan- Plymouth Roger Williams- Providence
Medicine 1
Time commitment 6 days a week ~ 12 hours in hospital/week
Grading Clinical Shelf exam Formal Evaluation of the Write-up and Oral Pt.
Presentation Preparation
Resources: Careers in Medicine:
https://www.aamc.org/students/medstudents/cim/
