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So normally (at least what's normal at my school) on an academic service medicine service as a third year the hierarchy looks like this:
Attending Physician
Supervising Resident (at most places, you can't supervise until the second half of your second year)
Intern #1 (taking half the patients) Intern #2 (taking the other half)
3rd year medical student x2 each taking 2-4 patients (depending on the expectations of the residents and attending)
At my school, third years basically are playing doctor, there are no real consequences, and the expectations vary throughout the year - early on it's enough to just get a thorough history and physical, but as the year progresses, you need to develop your ability to create a reasonable differential, then come up with appropriate labs/tests to run, and finally appropriate, but general, treatment plans, followed by more specific plans. Certainly the development of these skills are concurrent, but happen at various rates. Any first year student can order shotgun lab tests, the key is limiting it to appropriate ones. And there are certain drugs that I picked up on dosing regiments very early on, while others, I'm still whipping out my pda and looking up on epocrates. But with so many levels in between the third year, and actual treatment decisions, I really felt like I was simply playing a game.
A sub-intern falls on the "intern level" - functions the same, but takes fewer patients than the interns will. So if there is 15 patients on a service, the sub might get 3, and the interns will each take 6. The sub-i is a chance to work like an intern, but with the expectation that you won't be as efficient, and that you'll need a little bit more help from the supervising resident (ie, like in having all your orders signed. There's a little less oversight, the expectations are higher, but the oversight is there to make sure nothing slips through the cracks.
What I'm unsure of is how this service I've been assigned to is organized. I'm 90% sure the docs on it are community based, volunteer faculty. I have no idea if they have residents. I think it's a real possibility that it might just be me on service, with 2 or 3 attendings. There are definitely some benefits that could exist - a lot more responsibility, a chance for more one on one teaching, taking on a bigger patient load, fewer zebras/more bread and butter work. But on the other hand, it could also mean a lot more work, varying levels of expectations, the lack of that extra layer of insulation in the safety net, less really interesting cases, and so on.
Of course on the other hand, it could be just like a normal service on the University side and I'm making too big of deal about it being on the community side.
As for August...I won't be looking to go elsewhere. It was a pain enough as it was to get just the one application out, and the only reason I was going there was because my buddy is starting his residency program out there and it made for a great situation - one of my best friends, a cheap place to stay, a chance to go someplace else. If I had to try to figure out housing on top of everything else...uggh...no thank you. If it falls through, I'll see what other peds openings are available at my home school, and go from there.
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