Fort Gordon

[Betsy]

This was posted by Madonna from the Class of 2006 Forum.

This rotation really changed my view on family medicine (I enjoyed it!). It's basically split up into 3-3.5 weeks of clinic, 1 week of procedures and 1/2 day clinics, and 1 week of inpatient (generall 4-5 total inpatients!). You get all weekends off except one Sunday call which falls on the Sunday starting your inpatient week. You work with a different attending each clinic (2 per day usually), and you do repeat some. Each attending gives a full evaluation form for each clinic (some forget to, and yes, usually the nicer ones forget to fill it out). Grading is done by making a large composite evaluation form and taking the best comments (supposedly) from the individual ones.

Pros: CHEAP FOOD! Pretty good schedule, Take call once a week (2x inpatient week - Sun and one weekday) but get out generally before 9PM, friendly residents, nice staff, generally more compliant/appreciative patients, lots of cool procedures, not as much clinic thanks to inpatient week, procedures week, and Thurs morning lectures (which last till noon). Also, you get a mandatory feedback session 3 weeks into the rotation in which you can see all your evaluations.

Cons: Harder to fill your 120 patients (especially since the military has more holidays), it's hard to get AWESOME evaluations except for inpatient week since they get more time with you. A big con is that you will be required to more stuff than the military students rotating (logbook, sign off procedures, more detailed home visit), which will seem laaaammmeeee. Also, they often "forget" to give you computer access, so you will not be able to look up labs or vital if the nurse doesn't wite them on the cover slip for you.

Tips: Get notes done early but thoroughly on inpatient and make sure your presentations are systematic (read the note if need be) and have a DIFFERENTIAL and well-outlined A/P. They are really big on this. For clinic, make sure after you go over the exam, you say "i think her issues to be dealt with are..." and list each issue and a differential. I'm not sure about other family med rotations, but on this one, they REALLY love you for that. HAVE A PLAN! Also, many of the military students will be lazy and be late for clinic, etc. Don't do this- its' amazing how impressed the faculty is if you just show up on time!

[Betsy]

Hmmmm, what to say about Fort Gordon. I think it is an interesting rotation for people not familiar with the military, like myself. Be prepared to be referred to as “civilians” and anywhere outside of the base to be referred to as “the real world” or “the outside”. One of the military students was telling me how she is pimped by attendings, “God you don’t know the answer??? Even a civilian would know that!” Niiiiice.

When you get to the Fort, give yourself an additional 10 minutes or so to get through the gate. And that is if you have your temporary pass. Give yourself 15-20 minutes if you need to get searched, which you will without a pass (the first few days). The line at the gate looks long, but it really moves. On the first day, you will get the orientation about the site and have to go through in-processing. GO TO THE 11th FLOOR TO THE GME (Graduate Medical Education) Office to do your in-processing. Citabria and I made the mistake of following the signs and doing the employee in-processing. So we spent our entire first morning going through the employee in-processing, which requires everything but body cavity checks. Don’t make that mistake like we did.

The good thing about the military is that things are very timely. You will start every day at 7:30 am with morning report, and end every day by 5pm. From 4:30 to 5 is ACC aka After Clinic Conference where you go over cool stuff you saw throughout the day. The weekly schedule is on the student room door at the beginning of each week. There is a student room with 3 brand new computers in it, and lockers for your stuff. There are 2 MCG students there, and 2 USHUS students there (military med school). We also had a 4th year from USHUS doing a sub-I.

You spend 4 weeks doing clinic, 1 week with procedures, 1 week on the inpatient team. I also did 1 day doing OB call at MCG where I saw one delivery. Good times.

Clinic: You spend half a day with one attending, the afternoon with another. There are like 20 attendings, so you probably don’t spend more than 1 day with the same person the entire time. That is very frustrating because you are constantly getting used to a new person, and how they do things. Not only that, but you give an evaluation to each person at the end of clinic. So they give you a grade based on 3 hours with you. Be ready to have your game face on 24/7. As far as patients, lots of variety. At the Fort, they do it all……Peds, OB, and medicine. You will get a large variety of stuff.

Procedures: You get to shadow the resident doing procedures for 1 week. Each procedure day is half a day, so the other half you do clinic. You get to do: Flex Sigs, Colposcopy, Minor Surgery (mole removal, incision and drainage, toenails, etc), Stress Testing, and Vasectomies. I didn’t really get to do much but stand there and watch. OK, well I did get to be a human booty retractor the flex sigs.

Inpatient: You will feel like a 3rd wheel at the beginning of the week, which starts on Sunday. But by the end, it will be cool. I enjoyed it more than clinic. During this week you have to pre-round on your patients before morning report, so I got there at 6:30 to have my notes written before 7:30. They gave me 2 patients to follow. After morning report, you round on the patients, and basically follow the residents around and do scut work. So if your patient has a procedure, they will let you watch. I got to see an endoscopy. You work with the same resident and attending all week, which is very nice. So hopefully your evals will be better here.

Staff: Most are pretty nice. There are a few really good teachers. A few could care less if you were abducted by aliens. Overall, friendly and helpful. 2 people to avoid: 1. Social work lady for outpatients. Not too fond of med students to put it nicely. She wasnt happy until she saw tears or blood. 2. One nurse on 9E. The other student asked for a pediatric nasal cannula. The nurse sebsequently told her how much money she and the resident were wasting by using them (they cut the prongs off because they child didnt like them). "Please ma'am, a child is suffering and cant breath. Its for a good cause."

Grades: As I mentioned before, you give an eval to each attending for each ½ day you spend with them. Dr. Johnson (the student coordinator who compiles it all) takes the evals and averages them for a numerical grade. This sucks because every day is weighed the same. (Personally, I sucked the first week because I didn’t know what the hell was going on). Even the one eval from the inpatient team is weighed the same as a clinic eval. And as mentioned in the other posters comment, the good people NEVER turn in your evals. Don’t feel bad to go around and bug them.

Dr. Johnson gives you a mid term eval, which is nice. She goes over all of your evals so far with you. So, if there is one attending that gave you a crappy grade, I would maybe “forget” to give them an eval the next time you worked with them.

As far as the logbooks go, shouldn’t be a problem reaching the magic 120. I logged way more than that. Just make sure you write them in your book as you go, so you don’t forget. You can even write in morning report patients, and ACC case presentations.

The midterm and final is given by Dr. Johnson, and make sure to do the home visit too. My advice is to find a patient early in the rotation, because it’s a pain to try and find one at the last minute.

Overall: Lots of variety. MAKE SURE TO GIVE YOUR ASSESSMENT AND PLAN ON EVERY PATIENT. Even if you are wrong. They will kill you on the eval if you don’t (I learned this the hard way). Be a “manager”, not a “reporter”. Usually done by 5pm. Take call once a week, where you follow the resident on call around from 5pm-9pm. I never left later than 10pm. Hard to get an awesome eval, and an awesome grade for that matter. Be ready to impress everyday, which gets old FAST. Try and have fun with it. Good thing is, the food at the cafeteria is cheap. Bad news is it sucks. GREAT NEWS: Starbucks is located next to the pharmacy, always a good thing to cheer yourself up. Good Luck!!

[J]

What was said is true. You get eval'ed every 1/2 day by an attending, those get weighted 1x. Then you have 1 week of inpatient medicine, which is weighted 2x attending, 2x resident, 2x intern, for a total of 6 evals. Thursday mornings are always lecture/academic day. MTWF starts at 7:30 with morning report, R starts with 8:00 lecture. You are on call 1x, during your inpatient week.

Dr. Carlisle is the new director of the students. If you have a few outlying grades on your 1/2 days, those will find their way into the round filing cabinet, more than likely. There are a ton of attendings. Best: Earwood, Noble, Seeheusen. Most of them are fun to work with, you will occassionally have those that you can't imagine getting along with though. You also get one week where you'll do about 6 1/2 days of procedures, that's pretty nice, those grades don't count either.

There is a lot of peds/OB/gyn out here. There was hardly any diabetes/HTN management stuff. If there were older people, it was a lot of preventative, medication refills, referral appointments.

All that being said, loved the site, think everybody will enjoy it. You get plenty of variety, you're not stuck with the same person every day, and it's just a happier patient population, in general.

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