doing all electives in one area a good idea?

[monkey799]

I guess many of us will have come to one specialty of choice by 3rd and 4th year, and would not want to settle for anything less.

 

Is it a good idea to put all 3rd/4th year pre-CaRMS electives in one specialty to maximize the chance of getting in? And then after CaRMS do electives in your 2nd choice specialty in case you do not match and have to apply again next year to two specialties.

 

What is concerning is that on CaRMS website some programs state that they are looking for students with diverse electives. Yet, if you diversify your elective, there are at least two disadvantages:

 

(1) you are missing out the chance to show interest and visit another school that you may be interested in going.

 

(2) program may 2nd guess your intention in choosing specialty. I've heard that IM residents do not like applicants who have done Derm electives thinking that they are using IM as a back up.

[Ollie]

There is now a requirement passed by the AFMC (applying to classes of 2008 and onwards) that you must complete electives in at least 3 different disciplines (defined as different CaRMS programs, ie pediatric surgery and vascular surgery would be the same discipline). I can't find a link for this, but here's what our associate dean said in his email:

"Electives in the clinical clerkship must be organized so that by the time of graduation, each student has had an elective experience in a minimum of three different disciplines, each of which shall take place for a minimum of two weeks."

[Blake]

Never heard of this, and I really can't see it happening at my school, considering we have a whooping total of 2 electives, both taken as our first clinical rotations of 3rd year. Yea, it's a mess alright, but that's the way it works (Sherbrooke). I doubt this rule affects us, but stranger things have happened.

[Kirsteen]

Never heard of this, and I really can't see it happening at my school, considering we have a whooping total of 2 electives, both taken as our first clinical rotations of 3rd year. Yea, it's a mess alright, but that's the way it works (Sherbrooke). I doubt this rule affects us, but stranger things have happened.

Hi there,

 

Take heart: earlier this year I worked with a PGY-1 who graduated from Sherbrooke last year. When I worked with him he was an off-service resident but had snagged a spot in a very competitive program without having completed one elective in it.

 

Cheers,

Kirsteen

[007]

Yes, that is the move for future years. However, our school sent us information saying it wouldn't go forward until all schools were on board (whether that's from a med school elective perspective or residency perspective I don't know) to ensure a fair policy across the country.

[Blake]

Hi there,

 

Take heart: earlier this year I worked with a PGY-1 who graduated from Sherbrooke last year. When I worked with him he was an off-service resident but had snagged a spot in a very competitive program without having completed one elective in it.

 

Cheers,

Kirsteen

I wish I had his GPA then, haha.

[Kirsteen]

I wish I had his GPA then, haha.

...or his hockey skills! (He was offered a spot in the NHL and turned it down to begin medical school.)

 

Kirsteen

[TheresaS3D]

The way I look at it, do electives related to what you like....so for example, if you want to do surgery, theres 2 corresponding distinct electives that would be helpful: anaesthesiology or radiology, and whats listed below

 

General surgery: gastroenterology

Urology: Nephrology

Cardiac Surgery: Cardiology

Orthopedic Surgery: Rheumatology

Plastic Surgery or Dermatology: Infectious Disease (if you get burned you're more susceptible to getting infectious diseases)

 

Also, I'd advise you to pick what you love and go for it...if you work hard you'll excel. If you're genuinely interested in derm, then go for it. But also be realistic...if you're a 'pass' student (if there's an honors/pass/fail system), you have no extracurricular, then you may want to focus on something less competitive.

 

Another point to consider is finding two things you'd be happy with in a related field and going for both. For example, there's lots of different surgical subspecialties....apply for both general surgery and plastics, if that's what your interested in.

[Kirsteen]

Another point to consider is finding two things you'd be happy with in a related field and going for both. For example, there's lots of different surgical subspecialties....apply for both general surgery and plastics, if that's what your interested in.

Hi there,

 

In principle, I absolutely agree, however, be aware that some programs and their Directors are on the lookout for this having been burned in the past. In fact, I was speaking with one General Surgery PD last year who noted that, the year prior, they had a number of unmatched spots because they had ranked a number of individuals highly. Turns out that all of these individuals were gunning for Plastics and had used Gen Surg as a back-up, so some programs, such as this one, have become gun-shy and are taking measures to avoid being bitten twice. One such measure, for example, is that which has been used by the UofT Gen Surg program where they have inaugurally requested, of all applicants, a list of their Gen Surg rotations and electives. (I presume this is for comparison with those lists of other applicants.) Another program closely scrutinizes the career-related extracurricular activities and research productivity within the medical school years to determine who they feel is truly interested in Gen Surg in order to make the first cut re: who receives an interview and who does not. (After all, many programs interview only one half of those who apply.)

 

Another set of programs which seem to be more careful in the selection of candidates who are ranking that discipline first is Family Medicine. I've seen a few places within CaRMS and elsewhere where Family Med programs have stipulated that they're taking steps to try to identify those who have a true and primary interest in Family.

 

Again, I think it's a good idea for some folks to apply broadly and possibly to more disciplines than one, but just a heads up as to what the programs are doing to find the most committed candidates.

 

Cheers,

Kirsteen

[coastalslacker]

Further to Kirsteen's post, we had a session with a resident today in preparation for clerkship in January (we're a bit slow at Queens...) and he also mentioned being careful about what other specialities you do electives in besides whichever is your primary interest. More specifically, he said if you want Ortho (he was an Ortho resident) don't do plastics electives because Ortho is frequently used as a backup for plastics gunners. Paeds/Family was also mentioned. Obviously, you're still going to match to Family, but if you've done a bunch of paeds electives many Family programs will assume you're just backing up with them and you may have trouble matching to the particular program you wanted. There was another Surg related example he gave but I can't remember it.

[Kirsteen]

There was another Surg related example he gave but I can't remember it.

Hey there,

 

Any set of surgical electives with Gen Surg as a complement doesn't look mighty snazzy if you're applying for Gen Surg.

 

Cheers,

Kirsteen

[noncestvrai]

I find this "programs will feel as a backup" thing completely stupid, how the heck are you going to find out really about a field without doing an elective in it, in general.

 

Let's say you like surgery, you do an elective in ENT, you decide to venture electives in gen surg, you fall in love with hepatobiliary sx, well I don't think it's fair not to pick someone with genuine interest for the field...even if they picked "snazzy" fields, what is this an inferiority complex, some kind of immature defense mecanism?

 

noncestvrai

[EMD]

In principle, I absolutely agree, however, be aware that some programs and their Directors are on the lookout for this having been burned in the past. In fact, I was speaking with one General Surgery PD last year who noted that, the year prior, they had a number of unmatched spots because they had ranked a number of individuals highly. Turns out that all of these individuals were gunning for Plastics and had used Gen Surg as a back-up, so some programs, such as this one, have become gun-shy and are taking measures to avoid being bitten twice. One such measure, for example, is that which has been used by the UofT Gen Surg program where they have inaugurally requested, of all applicants, a list of their Gen Surg rotations and electives. (I presume this is for comparison with those lists of other applicants.) Another program closely scrutinizes the career-related extracurricular activities and research productivity within the medical school years to determine who they feel is truly interested in Gen Surg in order to make the first cut re: who receives an interview and who does not. (After all, many programs interview only one half of those who apply.)

I think it is interesting that some programs don't rank by who they think is best... but by who they think is most blindly commited and narrowly focused.

 

Interestingly, the internal medicine program at U of T has the opposite approach. The PD said a few years ago he doesn't really care how much the people are commited at the beginning 'cause he has found people switch in and out regardless of how commited they are at the beginning. It seems the policy gen surg programs are creating relate more to the fact that people don't switch into gen surg... only out.

[EMD]

Recently, I remember reading somewhere else on the board that there was discussion about forcing med student to spread the elective time they have over different disciplines. In some ways... I imagine this would be a nightmare for many programs--if they sort by what other electives you've done.

[flying kumquat]

If I'm reading our school's elective page properly, Queen's has enacted what EMD is talking about starting with the class above mine. We're required to do electives in 3 different disciplines (where discipline = Family Medicine or a particular Royal College Specialty training program). In a way, this sucks for us because we have 12 weeks of electives right after our first core block, potentially giving us even less of an advantage in a particular speciality. In another way, it might not be so bad for us. Considering we only have the one core block before electives, if we just do electives focused on one discipline, we might miss out on something else that we'd enjoy more. I've heard others say that it's OK to have our third discipline elective fulfilled in the time we have off for CaRMS, when we have to do 10 days of electives anyway. In this case, one would only have to have two different disciplines of electives in the main elective blocks. I imagine this is what a number of people do anyway.

 

Here's the link: http://meds.queensu.ca/courses/phaseiii/home/electives

[Kirsteen]

...what is this an inferiority complex, some kind of immature defense mecanism?

 

noncestvrai

Pretty much sounded like it to me, sprinkled with a bit of gun-shy-ness.

 

However, there are Gen Surg keeners out there but given the number of folks who apply to Gen Surg as a back-up, it's a tough job for the programs to ferret out the former from the latter. Hence, I suppose, these recent application measures.

 

Cheers,

Kirsteen

[TimmyMax]

Hey,

 

some kind of immature defense mechanism?

Oh man, welcome to the world of residency! If you don't understand it now, you soon will...

[studentz]

UofT has the policy in place as well and I believe it starts with the class of 2009. Looks like that post-carms block will be used to satisfy distribution requirements!

[Kirsteen]

UofT has the policy in place as well and I believe it starts with the class of 2009. Looks like that post-carms block will be used to satisfy distribution requirements!

Hi there,

 

That sounds like a plan as long as the schools don't go along with the mandate and even the playing field by stipulating that all candidates must use pre-CaRMS elective time to satisfy the requirements.

 

Cheers,

Kirsteen

[TheresaS3D]

I get what your saying, but my problem is that I'm genuinely interested in both general and plastics...I was actually leaning towards general, but then I also found plastics and ortho interesting. Its going to be tough to decide unless I do electives though. So will it be looked on as bad if I do 3 electives, one in each, then do more in whichever I like best? Plus, there;s the two unrealated discipline provisions...I was thinking 2 weeks gastro and 2 weeks of an international elective? Opinions?

 

 

T

[TimmyMax]

Hey,

 

Personally, I'd say save the international elective for when you're actually in the program. Unless you're planning on hooking up with a world authority on whatever or doing your elective in the U.S., I'd say save your money. It'd be much more worthwhile (and informative) to do your elective at a Canadian school that you are interested in matching to (or a U.S. one, if you're thinking of going south) and getting to know the program and the big players involved there that will ultimately be playing some role in deciding your eventual fate. It never hurts to grease the wheels a bit. Once you're in, feel free to do electives wherever with whomever, but at this point in time, I can't really see how a short, 2-week international elective would help your chances, especially for something that is pretty competitive, like plastics.

[Kirsteen]

I get what your saying, but my problem is that I'm genuinely interested in both general and plastics...I was actually leaning towards general, but then I also found plastics and ortho interesting. Its going to be tough to decide unless I do electives though. So will it be looked on as bad if I do 3 electives, one in each, then do more in whichever I like best? Plus, there;s the two unrealated discipline provisions...I was thinking 2 weeks gastro and 2 weeks of an international elective? Opinions?T

Hey there,

 

I asked a similar question re: international electives (in world-class centres) of one of my mentors last year. She noted that, in terms of matching, it's much better for you to take electives in centres where you think you'd like to eventually match. By doing so you'll get to know them and the centre and more importantly, they're going to get to know you as well.

 

Cheers,

Kirsteen

[studentz]

Hi there,

 

That sounds like a plan as long as the schools don't go along with the mandate and even the playing field by stipulating that all candidates must use pre-CaRMS elective time to satisfy the requirements.

 

Cheers,

Kirsteen

 

I don't see how this could possibly be passed. There is too much inconsistency with the amount of elective time schools offer before CaRMS to force people to complete distribution requirements before the application. At UofT we only get 12 weeks before the application is due and, at minimum, 6 of those would be used to fill these requirements if this policy was in place. It would greatly impact the ability of students to visit multiple centres in their program of choice. I also think the distribution idea is related more to a desire for students to have educational breadth than for CaRMS purposes, but I may be wrong.