Core-Elective-Audition || Family Medicine Rotation
My Family Medicine rotation was scheduled for my 3rd year but was canceled due to staffing issues. SGU gave me the choice of SGU finding an alternative or I could schedule it as a 4th year elective for 4 weeks (compared to the 6 weeks required in 3rd year). Since I’m applying to Family Medicine, well that wasn’t a problem. I planned for 3 audition rotations anyway. Currently, I’m writing in the middle of my second audition rotation. The first one was Family Medicine Inpatient and this one is Family Medicine Outpatient. Personally, I’m an outpatient gal though I do enjoy some inpatient. The thing is the hours as a student and resident are demanding.
Reflecting on the journey
In 2012, I started pursuing a career in medicine. I remember interviewing for my first medical volunteer experience in college. It was so…extreme now that I think about it. There were applications, personal statements, panel interviews, and individual interviews. Nevertheless, I was beaming to get an ugly ill-fitting green polo and badge. I remember stepping into the hospital. I felt like I was finally starting something. In reality, I just helped nurses grab water and blankets and walked in a circle around the floor. In fact, I watched so much Grey’s Anatomy I believed I wanted to be a surgeon. Then I shadowed a surgeon. It’s really not the same haha. Nothing happens in elevators and there’s way more paperwork involved.
New hobbies
Tennis
Here’s to trying new old things in your late 20’s! I played tennis in high school. The major appeal was it was similar to badminton and they gave free “sports” jelly beans every practice. Though I didn’t love it as I do now. It’s fun to be competitive again, even though I’m pretty poor at everything I start. I just didn’t pick up “Natural Talent” as a character perk.
Sourdough
I’m in absolute love with making sourdough. I love to tinker with the recipe, but also learning how the dough speaks. Then after a long two-day process and an agonizing 2 hours waiting for it to cool, I finally get to see the outcome. It’s like my labor of love and my meditation. Currently, I’m experimenting with mini cinnamon raisin loves.
My Family Medicine Rotation
The family medicine rotation at SGU is either 6 weeks or 4 weeks long. It’s not considered a core rotation, but it is required. I had both an entirely inpatient rotation and an entirely outpatient rotation. Though SGU states in their syllabus you should have both, both my rotations were at SGU-affiliated hospitals. In both my rotations, my teams consisted of 1 attending, 2-3 residents, and 1-2 other students. The inpatient rotation honestly felt like just a internal medicine rotation with occasional pregnant patients. However, the pregnant patients would be transferred to OBGYN and Pediatric service after delivery. In the outpatient rotation, I’d see anywhere from 1 to 9 patients. Then I’d chief to the attending and see the patient together.
An average rotation day
Inpatient: Most of the attendings like to round around 9-10 am. Since it was my audition rotation, I took on 4-5 patients. I’d arrive around 7 am to preround. Then before rounds, I’d usually touch bases with the residents and brief them on the plan I wanted to present and what questions I had. My team had 2 residents and I followed the schedule of one of the residents.
Outpatient: I worked 8 am- 5 pm Monday to Friday. I got an hour lunch which was amazing. It was great to see the variety of cases.
SGU requirements
Weekly Requirements
This section is pretty much the same as the core blogs, but just in case you came here first here’s the deal. I’ve underlined the unique requirements for Family Medicine.
Firecracker
SGU requires you to sign-up for this website. It attempts to pace out the topics you need to learn. You’re supposed to mark 10 topics a day and review topics through their flashcards and questions. Participation counts towards professionalism. It is required to fo 10-20 questions a day. Though other students have told me they don’t do this and haven’t been docked points so it’s a requirement (?)
Quizzes: The quizzes are done online through Firecracker. They are released on Fridays and are due on Mondays. They are usually 20-25 questions.
Midcore Exam: I didn’t have to take it during my rotation, but it was shortly introduced after I finished. If it’s like the IM midcore, then it was ungraded and just a gauge of where you’re at.
Patient Encounter Log (PEL) & Social Determinant Assignment: You can find this google form-esque log on the SGU clinical site. Before the end of the rotation, you need to submit all 22 required encounters. It’s optional to submit a SOAP note in the comment, but the school mentions you can print this log and show it to your preceptor for the final rotation evaluation. My advice, submit a couple of encounters every week so it’s not a rush at the end but I still did it all at the end.
2 Observed Encounters: You can print the rubric from the Surgery Sakai site. Multiple residents/attendings can sign off competencies. My advice, it all depends on who you ask. Play smarter, not harder.
Preventative & Wellness Assignment. So far, I haven’t been docked points for this but I’ve written about 1-2 pages which include HPO, PE, lab, and imaging findings with the assessment and plan. The SOAP note takes up most of page. The instructions say it should include supplementary reading.
3 Communications courses
Geriatric Sakai Course
Family Medicine Shelf Exam
Signing up
Since my rotation was 4 weeks long, I got an email with the scheduling permit to schedule my Shelf exam the first week. I have to drive around 40 minutes to the nearest testing center. In SGU’s current policy we get the day of the exam and the day before off. However, some attendings have different policies allowing you to have more time to study.
Grading
Grading for Family Medicine is pass or fail. Currently in June 2023, to pass you need 65 or above.
How I Studied for The Family Medicine Shelf Exam
The Family Medicine Shelf has a reputation (at least around SGU students) for being a tougher exam. In my opinion, it was more challenging because it’s very general but not as hard as IM or surgery. The high-yield concepts (IMO)
USPTF screening guidelines: guaranteed questions about this
Vaccinations, especially for seniors
Pneumonia treatment
Asthma treatment
MSK things: Osgood schattler, patellofemoral, hip dysplasia, Ottowa guidelines
How I studied For The Family Medicine Shelf Exam
My Shelf studying is pretty routine at this point. I try to listen to a comprehensive review earlier in the rotation to know the layout. In this case, there is only Dr. High-yield’s review. I aim to finish Uworld a week before the exam. So I usually take the total number of questions and divide by the number of study days. I take Sundays off. About 2-3 weeks before the Shelf exam, I try a NBME as a baseline. I will take them weekly to see if I’m staying on track and see where my weak points are. About 2 weeks before the exam, I listen to the comprehensive reviews again. And that’s it! Keep it simple, keep it routine especially since it’s pass or fail!
For cumulative review, I loved these video series:
I watched or listened to them in my car starting about a month away from my Shelf Exam.
Divine Intervention: There isn’t a cumulative video but he has a playlist. I would especially listen to the risk factors and screening one
Dr. High Yield: This one is about 1 hour and 17 minutes long
No Emma Holiday for this one
Case Files Family Medicine: I haven’t used it, but heard great things about it!
Qbanks:
Uworld: 499 questions for Family Medicine
Amboss: 321 questions for Family Medicine
Times are tough! There is an Amboss Scholarship Program you can apply for. At the very least, they usually give you 1-2 weeks free if they don’t give you a scholarship.
4 NBME practice tests are available for purchase or floating around the internet
Audition Rotations & being introverted
A note on audition rotations. It is my understanding that audition rotations and Sub-i’s are interchangeable. Audition is like the colloquial word, indicating you are interested in the program. Sub-i seems to be a school/program word especially for graduation purposes. With both you’re expected to try and function at a similar level to an intern. I told my residents right away that I was on audition rotation. In my opinion, it helped because they would bring it up the attendings to try to help me out.
My first audition rotation was tough because it was a new hospital, a new EHR, a new field and it felt like higher expectations. I tend to ease into rotations and it can take me a bit to read the room per say. That was fine for 6-12 week rotations, but in 4 week rotations I had to be much more extroverted. So this is my personal advice for those who are introverted (i’m rooting for you!) and maybe also deal with anxiety.
It’s okay to take breaks away from people on long shifts. I saw one medical student say to his group that he’s just going to take a moment for himself and where he is if they need him. It was really graceful!
Create specific goals of what you want from the rotation. For me, it was often creating better plans, being able to know the diagnosis and treatment of a condition like DKA, or even speak up more often. These are measurable things that you can say you’re working on in a discussion with your resident or attending. If they’re willing of course.
Know your audience, but it was helpful for me to tell my residents exactly what I was working on which included being shy. They tried to help facilitate conversations and gave me great insider knowledge.
Talk to your attending early. Especially if you’re looking to earn a letter of recommendation. I approached them mid-way through our time together and asked them for feedback and told them my goals. It created an opportunity for them to let me know if there’s anything I need to fix and just a heads-up that I’ll request a letter. Plus I tend to do better one-one.
Warmly, Rainee
Alright! 2 auditions down! Now a 2 rotation intermission in ENT and my required SUBi in IM. Talk to you soon!