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22 hours ago, MedZZZ said:

Just wondering if I should do ICU or an IM sub specialty elective if I am applying to IM?

Almost everyone applying to IM does some sub spec electives.

22 hours ago, MedZZZ said:

Is ICU a must do elective for applying to IM?

It is not. Personally I found my ICU rotation very enjoyable even though I did not apply to IM however, so if it's something you're interested in, go for it!

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As someone who applied to IM I was told not to do ICU if you are looking for a letter because your role on the team can substantially vary. You also have to remember these are sick complex patients and even the PGY1 sometimes find its difficult to manage so if you want to show the best version of yourself it might not be the easiest elective to get an outstanding letter. I didn't do an ICU elective (somehow ended up doing CCU), and even the PGY1s on CCU felt something were well over their head. I've heard its a great elective but just keep in mind if you are planning to get a letter from it, you may be better of doing another sub-specialty.

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2 hours ago, Sardaukar said:

As someone who applied to IM I was told not to do ICU if you are looking for a letter because your role on the team can substantially vary. You also have to remember these are sick complex patients and even the PGY1 sometimes find its difficult to manage so if you want to show the best version of yourself it might not be the easiest elective to get an outstanding letter. I didn't do an ICU elective (somehow ended up doing CCU), and even the PGY1s on CCU felt something were well over their head. I've heard its a great elective but just keep in mind if you are planning to get a letter from it, you may be better of doing another sub-specialty.

Always good to keep getting letters in the back of your mind. These opportunities can vary substantially between centres and staff, and if you ask around you may be able to find a rotation that is more conducive for one (although you don't necessarily need one from every rotation). I will say that I actually got one of my strongest letters from my ICU rotation and used it across the country despite not applying to IM. On ICU, often staff are on service for longer periods of time (like CTU), rather than a clinic-based subspec where you might be with someone different every day. I also find on ICU, you have lots of opportunity to show your knowledge/skills directly to the staff, as on my rotation, we rounded as a team for every patient so I had several chances to do a H/P in front of staff,  and even assisted with a couple of procedures. There were a few residents but I got to know them well and they told me that the staff asked for their input for my letter too so having residents can be a bonus if you fit well within the team.

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