Sub-I vs away rotation

There may be some technical difference, but at the programs I am familiar with the terms were used interchangeably.

Some places call it a sub-I, but it's clearly not...only one of my 3 EM rotations was an actual sub-I.

I did three EM rotations. One was considered an acting internship and the other two were just considered aways. All three were identical in terms of responsibility.

Desk_Jockey said:

Is there really much of a difference in responsibility when signing up for an away rotation in EM vs a sub-I away rotation?

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The answer to this question is very program-dependent. I did three EM aways with two of them being labeled as "clerkship" while the other was labeled as a "Sub-Internship". The level of responsibility and expectations at my second EM clerkship rotation was greater than during my Sub-I at a different program. For instance, I had to write notes, place orders and call consults on my second EM clerkship, but at my "Sub-I" I didn't have access to the EMR beyond just viewing privileges, so no note or order-writing there.

I hope you are not trying to "stay away" from more demanding rotations, because those were honestly the most formative and fulfilling ones. And regarding the "different EMR" portion of your post: I think every other MS4 I interacted with had to become familiar with at least one EMR that was different from the one used at their home institution, and everyone of them did just fine. This really should be the least of your concerns in terms of responsibilities.

Bottom line is that clerkship v. away v. sub-I signifies nothing in terms of the responsibility bestowed upon you

I did 3 EM rotations. I think one was a clerkship and the other two were acting internships.

At the first, I staffed with an R4 or attending. I wrote the note and did all orders, calls, consults. Also could order labs and imaging without being cosigned.
I was encouraged to take sick patients (just get help early obvs if they're super sick) and was titrating a MAP on nitro which was amazing and scary. Did get some procedures.

At the 2nd, staffed pretty much only with their senior R3 but was also pulled to the resuscitations to record vital signs and meds etc. Aka to do the job of the recording RN or tech at many other places. Was told by my seniors to not put in orders (but then on my eval said I should have?!?). I'd see like 2 patients a shift given they were a very busy center with tons of resuscitations going on in the summer. I staffed like twice with an attending and most had no interest in the M4s even if they were all nice enough. The R3s were insanely competent and good, and most were able to handle running the pod and teaching m4s (unfortunately not all). I saw no sick patients here. Handful of procedures (did get to attempt an LP though).

At my third, I was the intern for my patients similar to the first except all orders got cosigned. I staffed 50/50 time wise with R3s and attendings which I think was the best because I got 1 on 1 attending time which was so helpful and I learned a lot as well as being able to get meaningful feedback and evals. Plus I got to see how competent the R3s were. They actually were on paper charting with electronic orders which I ended up loving (notes were short!). I did write notes, call consults, call to admit, write all orders. I was pushed to see 8 to even 12 patients in an 8hr shift and was taking sign out on patients from off going m4s which was amazing because I had no practice with that. Any sick patient of mine I got to follow from low acuity to high acuity which was great. Lots of procedures.

Tldr; labels don't matter much but responsibilities do vary. I'd recommend a place where you get to staff with attendings as well as residents.

Long story short...they are both the same **** lol

I think they are both identical. Obviously the vast majority do their away AFTER doing their home rotation to avoid looking incompetent (remember, many of these people you only work 1 shift with - so if you look clueless even for good reasons, they'll remember you as clueless even if you're stellar). My first few days at my away were most difficult not because of the EMR but more the overall flow and where things were. I.e. if the resident would be starting a procedure they might ask me to grab them sterile gloves or other instrument, etc - then I'd wander around the ED trying to find these things and then finally find the cart but not know the passwords, etc. to get access. I found it helpful to (politely) tell people it was my first or second day when it wasn't awkward to do so for damage control. The rest of the away should proceed like your home institution. Work hard, be helpful, show that you studied/prepared hard, and you will be set.

gutonc said:

Po-tay-to, Po-tah-to.

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Or if you prefer fruit... To-may-to, To-mah-to

HoosierdaddyO said:

Or if you prefer fruit... To-may-to, To-mah-to

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love bae tho, lovato

HumerusBaker said:

At my third, I was the intern for my patients similar to the first except all orders got cosigned. I staffed 50/50 time wise with R3s and attendings which I think was the best because I got 1 on 1 attending time which was so helpful and I learned a lot as well as being able to get meaningful feedback and evals. Plus I got to see how competent the R3s were. They actually were on paper charting with electronic orders which I ended up loving (notes were short!). I did write notes, call consults, call to admit, write all orders. I was pushed to see 8 to even 12 patients in an 8hr shift and was taking sign out on patients from off going m4s which was amazing because I had no practice with that. Any sick patient of mine I got to follow from low acuity to high acuity which was great. Lots of procedures.

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Where was this rotation at?