6 Tips For Disappearing on Rotations
As I progressed into my third year and especially my fourth, I would often brainstorm creative ways to disappear or otherwise leave rotations early. Here are some of the best strategies and tips for being the “absent” medical student while still achieving a passing grade.
- Set The Bar Low
The best thing you can do if you’re shooting for a month-long vacation is to never really make yourself visible that much from day one. Your first few days on a rotation can really set a precedence as to how much your residents expect to have you around. If you spend the first week of the rotation fully visible at all times and then mysteriously disappear, a few red flags will be raised. You do need to “feel out” the rotation to see just how much you can get away with, but don’t sit around the resident’s room in your downtime as this will increase your visibility. - Learn The Schedule
Find out when the attending or your chief resident likes to round, since you’ll likely have to base your disappearances around these times. It may take a few days to learn the schedule, but often the attending will just come out and state that he or she wants to round at a specific time. If you’re taken by surprise, remember you’re just a page away. - Build Inconsistency
Starting early on, you’ll need to build inconsistency with your team. What this means is that they will really never know what to expect out of you. To do this, you’ll want to disappear unannounced for half an hour or so during the first day or two of the rotation. Get lost at completely random times and random intervals, and then miraculously return. As the first week of the rotation progresses, increase the duration of your disappearance. Before you know it, you’ll be gone 2-3 hours at a time and no one will expect anything any different. - Study In The Library
If you like to study in your downtime, always let it be known that you prefer to study in the library for minimal distractions. This gets you away from rotations and you’ll be less likely to be called on for scut. If the residents or attendings object, reinforce the fact that you’ll be available via page and that you are on campus. No argument against you studying in the library can hold much water, so you’ve just got to do it. - Map Your Exit Strategy
Always know your route of escape for each rotation. A good rule of thumb is to never, ever take the elevator on your way out. You’ll inevitably run into an attending or someone that’s going to squeal. Even if you’re on the 11th floor, the stairs are your best friend. Once you’re in the stairwell you are generally home free. - Never Carry A Backpack
Having your backpack on while walking down the hall is a sure-fire sign that you’re leaving. You should always carry just what you need in your white coat. By doing this, you never look like you’re leaving. While you want to create inconsistency with your presence, you’ll want to maintain a consistent appearance. If you plan to study in the library, simply leave everything in your car and then swing by and pick it up.
All Joking Aside
Even though this post is partly in fun, I did actually put these tips to use while on some of my rotations. Obviously, you’re going to have to use some common sense and feel out the residents to see if ducking out for any length of time is feasible. There were certain rotations where I would be absent 3-4 hours out of every day and left early without permission, while others would check up on the students so often that it just wasn’t possible to slip away.
Also, you guys are smart enough to know that if you employ these stealth tactics, you most likely won’t be honoring these rotations. If you get nailed or somebody has a sit-down with you, it’s best just to play the game and ride out the rest of the rotation without being gone too much.
The idea is to achieve the maximum amount of time away from the rotation while still receiving a passing score. In order to do this, sometimes you’ll need to balance a fine line.
Volunteering is Overrated
My previous post on needle sticks and exposures was awarded a shiny new post over at SDN. Some questions for me were posed in the discussion, and I wanted to expand on the topic a bit more than simply posting a reply to the thread. Before I go much further, I wanna give bronx43 props for watching my back.
Druggernaught states:
I’m curious how much clinical exposure the guy who runs MedSchoolHell had before he applied to medical school. I’m guessing not nearly enough. Do any of his regular readers know, or is he willing to share that with us here? It doesn’t take long to realize that you’ll be dealing with people who aren’t willing to put in the time for a little common sense preventative care for themselves, who will simultaneously hate you for doing your job and yet demand that you give them the care they need, and that you’re going to have to put yourself at some risk from time to time.
It’s a bit off topic, but looking over that website and some of the posts here, I really wish that medical schools posted some sort of requirements as far as real clinical exposure to avoid the 4.0, 40 MCAT applicant who very quickly realizes he’s made a mistake but is too far in debt and has committed too much time to turn around now.
I had roughly 8 months of volunteer experience, ranging from shadowing in the ER during college to volunteering in private pediatric and family medicine practices in my hometown. This was across three years of college, so roughly 2.5 months out of those college years I was volunteering somewhere. I loaded my volunteer experiences during the last three years of college, and didn’t do much of anything other than school-related stuff during my freshman year. These gigs were the typical “volunteer” positions, so they were probably 1-2 days per week at 3-4 hours each day. Nothing excessive, by a long shot.
I never fully enjoyed any of my volunteer positions. I saw them as a necessary evil in order to boost my chances of getting into medical school. Everybody else was doing it, so I should too. I should have listened to my heart way back then, but I brushed it off as “not liking specialty X.” I thought I’d surely like something in medicine, just not whatever I was volunteering in at the time. Since I didn’t volunteer in every conceivable medical specialty, I rationalized that I would find something that would fit my personality.
The Volunteering Conundrum
The problem with volunteering is that you’re not really going to see what it’s all about short of becoming a full-fledged employee where you actually get to do stuff. You follow some doc around for a few hours and then go home — rinse and repeat while your pre-med mind thinks it’s going to be cool to be like that doc one day. Most volunteer gigs won’t let you do anything remotely close to what you’re going to be doing as a medical student on the wards due to insurance and litigation issues.
What volunteering won’t show you are the long hours, after-hours calls, sleeping in some crappy call room overnight, unruly patients, staying after “office hours” to complete paperwork, aggravated family members, social work involved with “patient care”, and the terrible insurance crisis and low reimbursement to physicians. The only way you’re going to learn about this stuff is to pull a regular job in a clinical setting, and even then experiencing some of these things might be iffy at best. Some of my pre-med buddies were doing stuff like phlebotomy, full-time ER nursing, or even full-time EMTs. Were these people more prepared going into medical school as far as knowing more about what they were getting themselves into? I think that without a doubt they were.
That being said, most students (myself included) have no idea what the practice of medicine is really going to be like prior to medical school matriculation. That’s the nature of the beast, especially when you do the standard volunteer gigs. By the time you get on the wards and decide that it really sucks, you’ve already thrown away two years so you might as well finish it.
That’s what I did, anyway. By the time I decided I really hated medicine, I had already taken and passed Step 1 and thrown away two years worth of tuition and time studying. I still believe this was the best decision for me, as talked about in my post about when to get out of medicine if you’re unhappy. Your mileage will vary, but had I not had student-loan debt incurred during the first two years of medical school, I would’ve probably cut my losses a lot earlier.
UberVolunteer (or Work) More
If I had one piece of advice to give, it would be that you need to really dig down and come as close as possible to finding out what medicine is really going to be like before you waste your energy applying. If this means getting a full-time job working 12-hour shifts doing blood draws, you need to do it. If you can shadow a 1st or 2nd year OB/GYN resident and work every hour that they are at the hospital including calls, that experience will give you a much better idea of what this whole medicine thing is going to be like than pushing patients to their car or bringing down food trays to the emergency room. This isn’t volunteering, this is being an UberVolunteer. I’ll be the first to admit that I didn’t really know what I was getting myself into, but I at least partly chalk that up to the fucked up volunteering system in place. If I had to work 12 hour shifts doing blood draws or follow some poor OB/GYN resident around the hospital while he or she got their asses burned, I would’ve given medicine the finger long before I even matriculated.
Paramediclizard states that I should “learn something from a real physician and student of life.”
Being compassionate, being concerned for your fellow man, doing everything you can to help people—that’s the kind of religion I have, and it’s a comforting religion.
Sorry DeBakey, that stuff just doesn’t float my boat. For me, medicine was just a job prospect. For you, it was a lifestyle and religion. I’m really not that concerned for the welfare of sick people I don’t know. Sorry.
Plus, I like more than 4-5 hours of sleep every night and retirement before my 90th birthday. Hey, that counts for something, right?