“And say: My Lord! Cause me to come in with a firm incoming and to go out with a firm outgoing. And give me from your presence a sustaining power” -the Holy Quran, chapter 17, verse 80
Now that I’m a fourth year who can sit on the “elite” table at our school clinic and pass off patient charts to the third years, I have the privilege of bestowing knowledge from my experiences “abroad”. Although I didn’t rotate through hospitals outside of PA and NJ, it really does feel as though I was traveling and school feels like home. Although as students we always complained and couldn’t wait to experience the outside world, you can’t help but form an attachment to your home base for the past 4 years. On the other hand, externships are great opportunities to view how different hospitals and attendings treat their patients, meeting new residents and students, and the overall academic focus. Some programs are clinic heavy, and cover several private practices, while others have the bare minimum. Some attendings let students participate in the surgical procedure, while others don’t let the residents touch the knife until their second year. I’ve been to places where journal club is an impromptu, “whenever we have time kind of thing”, and places where there were presentations and radiology rounds twice a week. It really varies from place to place, and as I tell the lower classmen, you don’t really know what you want until you experience it. Personally, I at first wanted a “country club” residency, where I had a decent 7-5 shift, barely on call, mix of clinic and surgery, and not a lot of trauma. However, Alhamdulillah I had a change of heart and ended up choosing programs that had a decent amount of trauma, some with more clinic than others, and enough on call time without being excessive. No regrets there, as I found out that I absolutely loved trauma and ranked my top choices as trauma heavy programs.
Another consideration that some students don’t realize is rotating at a teaching hospital vs a non-teaching hospital. I am personally a fan of teaching hospitals, all 5 of my externships were of those sort. I enjoy academics and having patient encounters transformed into lessons, so that is what I chose (sounds absolutely nerdy right now, I know). However, that isn’t the environment for everyone, as some people have had enough of school and want something a bit different. There is also a lot of teaching other residents and students involved (hence the name, “teaching hospital”), so that is something to take into consideration.
A pearl of advice that I’ll share is to be honest with yourself, yet at the same time, don’t put yourself down. Am I speaking in riddles or contradicting myself? Not really. So some programs are big names, famous hospitals which big time physicians trained at. These programs have a reputation of only matching potential residents who were at the top of their class, or only want brilliant individuals. There are people who may think that they are it good enough, and won’t take the chance, even if they are sincerely interested in the program. My advice is to give it a shot. We are all brilliant individuals to have made it this far, and for you not to think that aren’t good enough is a lack of confidence that a future physician should not have. At the same time, if you are ranked pretty low of your class, it isn’t the smartest idea to waste an opportunity at a program that specifically requires for you to be in the top 10%. I almost didn’t extern at a certain program, thinking that I didn’t have a good chance. I almost let it go by, but I’m glad I took the opportunity and alhamdulillah, now it’s my top ranked program 🙂
In short, be honest with yourself about what you want to get out of a program. Be a little aggressive, but keep a sound head on your shoulders. Hang tight, there’s more to come InshaAllah!