12-26-2016, 06:41 PM
Sub-I at Vanderbilt. The hospital is a nice facility and is a private hospital, and the children's hospital is beautiful. Nashville is a fun town to be in, but you had better have an appreciation for country music if you want to rotate there (seriously, it was played in virtually every OR).
During the rotation, there were way too many medical students - 4 away rotators and 4 Vanderbilt students (although the Vanderbilt students were third and second years, due to their new curriculum). It made the rotation challenging in terms of having enough work to do and deciding who got to scrub in to cases, etc., which really took away the ability of sub-i's to shine. There also wasn't a lot of direction for what was expected of you as a sub-I, and there were very mixed signals from the residents about what they wanted you to do or not do in terms of patient care. As a student rotator, you get to do very little in the OR. In fact, most of the time, sub-i's served as pseudo-scrub techs, and even then, some attendings asked that you not touch the instruments. On one or two occasions, you might get to suture or put on a Raney clip, if you were lucky.
The attendings were friendly for the most part but generally didn't interact much with students. There generally wasn't much of an emphasis on teaching, as compared to my other rotations, from the attendings and from the residents. You only go to clinic once, and it's with Dr. Thompson. Dr. Lola Chambless was great though and met with students to provide guidance on ERAS, which was extremely helpful. The residents were okay - other than the current group of third year residents who were great, there were some that were just hard to get along with as a medical student and didn't seem to get along with the rest of the residents either.
Also, to comment on a couple other topics brought up in this forum... First, regarding locations that favor sub-i's, Vanderbilt is certainly not one of them. In fact, they don't interview many, if not most, of the sub-i's. Second, the letter from Dr. Thompson took over a month to receive and was only a few sentences long.
Sub-i at Vanderbilt - I disagree with some of the above, so thought I'd toss in my two cents below for those considering a rotation.
General: You have to earn your respect and place on the team as a sub-i at Vanderbilt. I found that there is a lot for sub-i's to do but you need to be proactive without asking the time old question "how can I help" all the time - figure it out. They let you function as the intern and will ask you to run the list with them at the end of the day rather than the intern or NPs if you demonstrate your abilities. If you are taught how to do something, then know it the next time - gather all the supplies for an EVD (ie make a list of what they use at Vanderbilt the first time you help with the procedure) and you'll get to do the EVD next time, pulling drains, closing cases quickly, how a certain resident/attending likes something, etc. Basically, show you pay attention to details and you'll do more. Ask the younger medical students about how to run their EMR - they can definitely be helpful. Vanderbilt has their own. It is different and takes some getting used to.
People - Strongest selling point in my opinion. The entire program is very friendly and down to earth - faculty and residents. Faculty really go to bat for the residents. Most faculty love having students around in the OR- some less so. Just read the room. If you have earned the resident's respect, they will include you. Chambless' application prep session is very helpful if you rotate before ERAS is due.
Research - Lots going on, especially in sports concussions, peds, and spinal/tumor outcomes. If you want a clinical project while you are rotating to demonstrate further interest in the program, ask around. Plenty to do.
Talk - I think it was like 7 or 8 mins long plus a few mins for questions; don't really remember exactly. Pretty benign, but you will be asked some questions. The questions seemed to be more to gauge your reaction and how you handled yourself than really caring about the specifics of your answer.
Call - q4. You're busy but not exhausted. Essentially one sub-i on every night and you rotate one week on each of the different services. Had a couple of days off to explore Nashville over the course of the month. Some awesome food/live music. Go to Hattie B's Hot Chicken - walking distance from campus.
Typical day - come in around 4:30/4:45 - List ready by 4:45/5:00 (by the way for those new to sub-i's, if they say list ready by 5, they mean 4:55. Don't be late.). Round with the junior resident. Some days you'll see a couple of ED/floor patients if they trust your exam and census is bigger than usual. Run the list as individual teams. Quick and efficient. Go meet your patient before the case. Breakfast with all the residents around 7:15 before OR starts at 7:30. Cases all day. PM rounds once done for the day. Update the resident about the patients on your census (sometimes they'll ask you and sometimes they won't). Go home around 8.
Interviews - For what it's worth, they said at interviews that they didn't want to waste people's time. The sub-i functioned as the interview in their eyes and coming back for interview day was more of a formality.
During the rotation, there were way too many medical students - 4 away rotators and 4 Vanderbilt students (although the Vanderbilt students were third and second years, due to their new curriculum). It made the rotation challenging in terms of having enough work to do and deciding who got to scrub in to cases, etc., which really took away the ability of sub-i's to shine. There also wasn't a lot of direction for what was expected of you as a sub-I, and there were very mixed signals from the residents about what they wanted you to do or not do in terms of patient care. As a student rotator, you get to do very little in the OR. In fact, most of the time, sub-i's served as pseudo-scrub techs, and even then, some attendings asked that you not touch the instruments. On one or two occasions, you might get to suture or put on a Raney clip, if you were lucky.
The attendings were friendly for the most part but generally didn't interact much with students. There generally wasn't much of an emphasis on teaching, as compared to my other rotations, from the attendings and from the residents. You only go to clinic once, and it's with Dr. Thompson. Dr. Lola Chambless was great though and met with students to provide guidance on ERAS, which was extremely helpful. The residents were okay - other than the current group of third year residents who were great, there were some that were just hard to get along with as a medical student and didn't seem to get along with the rest of the residents either.
Also, to comment on a couple other topics brought up in this forum... First, regarding locations that favor sub-i's, Vanderbilt is certainly not one of them. In fact, they don't interview many, if not most, of the sub-i's. Second, the letter from Dr. Thompson took over a month to receive and was only a few sentences long.
Sub-i at Vanderbilt - I disagree with some of the above, so thought I'd toss in my two cents below for those considering a rotation.
General: You have to earn your respect and place on the team as a sub-i at Vanderbilt. I found that there is a lot for sub-i's to do but you need to be proactive without asking the time old question "how can I help" all the time - figure it out. They let you function as the intern and will ask you to run the list with them at the end of the day rather than the intern or NPs if you demonstrate your abilities. If you are taught how to do something, then know it the next time - gather all the supplies for an EVD (ie make a list of what they use at Vanderbilt the first time you help with the procedure) and you'll get to do the EVD next time, pulling drains, closing cases quickly, how a certain resident/attending likes something, etc. Basically, show you pay attention to details and you'll do more. Ask the younger medical students about how to run their EMR - they can definitely be helpful. Vanderbilt has their own. It is different and takes some getting used to.
People - Strongest selling point in my opinion. The entire program is very friendly and down to earth - faculty and residents. Faculty really go to bat for the residents. Most faculty love having students around in the OR- some less so. Just read the room. If you have earned the resident's respect, they will include you. Chambless' application prep session is very helpful if you rotate before ERAS is due.
Research - Lots going on, especially in sports concussions, peds, and spinal/tumor outcomes. If you want a clinical project while you are rotating to demonstrate further interest in the program, ask around. Plenty to do.
Talk - I think it was like 7 or 8 mins long plus a few mins for questions; don't really remember exactly. Pretty benign, but you will be asked some questions. The questions seemed to be more to gauge your reaction and how you handled yourself than really caring about the specifics of your answer.
Call - q4. You're busy but not exhausted. Essentially one sub-i on every night and you rotate one week on each of the different services. Had a couple of days off to explore Nashville over the course of the month. Some awesome food/live music. Go to Hattie B's Hot Chicken - walking distance from campus.
Typical day - come in around 4:30/4:45 - List ready by 4:45/5:00 (by the way for those new to sub-i's, if they say list ready by 5, they mean 4:55. Don't be late.). Round with the junior resident. Some days you'll see a couple of ED/floor patients if they trust your exam and census is bigger than usual. Run the list as individual teams. Quick and efficient. Go meet your patient before the case. Breakfast with all the residents around 7:15 before OR starts at 7:30. Cases all day. PM rounds once done for the day. Update the resident about the patients on your census (sometimes they'll ask you and sometimes they won't). Go home around 8.
Interviews - For what it's worth, they said at interviews that they didn't want to waste people's time. The sub-i functioned as the interview in their eyes and coming back for interview day was more of a formality.
