Medical Education US

With the clinical years coming up -- (not right away, but on the horizon) -- I am increasingly wondering what to do with my elective rotations.

Some of my classmates, such as the hard-core surgery wonks, are already planning out when they want to "showcase" in surgery at XYZ Hospital, so that they can impress the pants off of the attendings there and suture up their surgical residency futures at XYZ.

I, on the other hand, am very interested in completing a combined residency (IM/PSY or FM/PSY), but I am starting to wonder if this type of "showcase" stuff should have any bearing in what I want to do...

Would trying to match with a combined residency require the completion of a showcase rotation, or is that something more exclusive to the really-really competitive and Type-A specialties?

Would I do just as well to focus on areas of medicine that are of interest to me, things that I might not get to see as much in residency?

Any insights from combined residents or physicians on the other side of this mountain would be greatly appreciated!

Thanks...

The showcase rotations aren't always the best move - it not only gives you a chance to prove yourself, but it also gives you a chance to keep yourself from getting accepted if you happen to say the wrong thing at the wrong time to the wrong person - over the course of a month long rotation, it is very possible that someone you run into won't think you are awesome enough to go to their program.

The main reason to do an externship rotation should be for you to see if you really like the particular program - the people, the place, the location, etc. In general, I don't think doing the externship gives you much advantage in the match - it mainly shows the program that you have enough interest to spend a month with them. Even for the supercompetitive residencies, I'd think it would only help those applicants that are on the border of being able to match - and then the applicant would have to be someone who is truly awesome enough to impress everyone - which is rare at a competitive program.

As for elective rotations, there are a few theories as to what to do. From another post I made here a while ago:

"I'd say the most important thing is to do some rotations in the summer time where you can get good evaluations. I know some of my classmates felt it was necessary to get letters from well known people within the department - in the end, I think they wound up getting letters that were not as good as if they had gotten them written by someone most other places probably haven't heard of."

My other suggestion - aside from doing the "letter of recommendation" rotations in the summer is to select rotations that are of interest to you that you won't get exposure to during your residency. You will learn your specialty well at your residency program - but you won't have the opportunity to do some cool electives in other fields.

[ Edited by Admin on 2005/4/20 18:08 ]

Thanks, Dr. Admin! Once again, you ride to the rescue.

Now, could you possibly tell me what sub-internships are? I am rather confused... would they be considered showcase-type rotations, or are they something else entirely, or does that all depend on where you are completing them?

Thanks again for your time, doc.

Sub-internship is a rotation where you are expected to function "almost" like an intern. You can't fully function as an intern because you can't write your own medication orders without having them co-signed. Also, typically the sub-i's are given a slightly lighter work load than the regular interns.

Some medical schools require you to do a sub-I in your 4th year, but not all schools. At my school, they were optional, and I opted to not do one, mainly because I didn't see the use in doing such an intense rotation when I know that I'd get to do plenty of the work when I do my residency. Some people felt that it would make you "more prepared" for residency, and that may be true.

Some externships may be "sub-I" rotations, but they are not necessarily so. If you do this as an externship, then I suppose it fits in your category of "showcase" rotations - which is a term I've never heard before.

For me, sub-I's were mainly the rotations done at my medical school, but I think a few people did do sub-I's as an externship (rotation at another program).

Thanks for the insights, Dr. Admin, as usual. It seems, then, that just about any externship could be viewed as a chance to win friends and influence people for The Match... sub-internship, or no. (Or, as you pointed out, step on toes and piss people off for The Match, as the case may be...)

Aye, it is an odd term, "Showcase." I just heard one of my classmates use it in conversation about an hour ago. It somehow reminds me of Bob Barker's Showcase Showdown on "The Price is Right." But with doctors and patients. And substantially fewer fabulous prizes. Although I imagine that a great residency makes a pretty fabulous prize.