picking tracks/surgery electives

[juicyprunes]

Hi there,

 

I'm interested in surgery and I was wondering if it's better to do your surgery rotation earlier on or later? Also, is it better to have your surgery electives right after the surgery rotation or after an "easier" rotaion, when you're less likely to be burnt out?

 

Thanks!!

[tuss]

Do your surgery rotations late (but not beyond the CaRMS deadline because you'll want to be able to get reference letters)

 

As for the elective timing - it really shouldn't matter. If you're burned out after your clerkship rotation you'll never survive 5 years in a row of surgery residency.

[JewelLeigh]

I disagree. If you're talking about when to do your mandatory clerkship surgery rotation, I suggest doing it early in the clerkship year, but not to do it as your first rotation.

 

This has several advantages in my opinion:

1. The clerkship year is one heck of a long and exhausting year. I know by the last few rotations in my 3rd year, I was pretty unmotivated - not the best situation for impressing preceptors and earning references.

 

2. By having it in the early to mid-year, you can confirm your interest in surgery BEFORE you need to worry about applying for electives. Ideally elective applications should be submitted early in the spring for fall electives (which is when most med schools set aside elective time for graduating students). Thus, what happens if you leave your surgical rotations until the summer and you don't like it? Now you're stuck figuring out what you want to do instead AND scrambling to change electives last minute. Costly & stressful. Yikes.

 

Along the same lines...even if you know you want surgery, you still have to pick a surgical specialty...again, something that is ideally done before you apply for electives.

 

3. By not scheduling your most desired field as your first clerkship rotation, you can build up confidence and skill in the clerk's clinical duties while doing a few other rotations first.

 

So, in my opinion, if your school is structured like most are (mandatory rotations throughout 3rd year, CaRMS electives in fall of 4th year), I recommend doing the specialty you are most interested in around mid-winter of your 3rd year.

 

Good luck!

[Kirsteen]

Hi there,

 

I completely agree with JL's post, above. I asked the advice of a number of different folks re: the timing of electives and decided to opt for the rota that scheduled all 10 weeks of elective time up front. I also chose to complete all 10 weeks in Gen Surg. Many of the arguments presented above certainly seemed to apply to my scenario and I doubt I'd change that strategy if I was to do it all again.

 

Cheers,

Kirsteen

[ally06]

Hello,

 

I've heard the advice of doing the rotation that you are considering applying for on CaRMS early in order to make contacts and possibly start a research project with them throughout the clerkship year.

 

Any thoughts/comments about this approach?? Is there even such a thing as "extra time" to get involved in research during clerkship?

 

thank you!

[tuss]

I still disagree about doing it early; having sat on the CaRMS committee for several years there were so many interviewees that apparently rotated with me, but i had no memory becuase it was more than a year before. The last rotation is probably a bit late but you want it closer to the end to make a good impression. Also, there is a steep learning curve during the clerkship years and the clerks that come thru on their first rotation are so stunned having never been on the wards before that it is really tough for them to make a good impression.

 

Also, avoid doing any rotation in the summer - especially surgery. In the summer many surgery departments are on a "slow down" and not doing any elective procedures, staff are on vacation, rounds and teachign don't happen as regularly and overall you just won't have as good of a rotation.

[Kirsteen]

Hello,

 

I've heard the advice of doing the rotation that you are considering applying for on CaRMS early in order to make contacts and possibly start a research project with them throughout the clerkship year.

 

Any thoughts/comments about this approach?? Is there even such a thing as "extra time" to get involved in research during clerkship?

 

thank you!

Hi there,

 

Yes, it is possible to do a research project with your elective preceptor(s). I did this (and managed to get one paper published). In order to get things kicked off I contacted them a few months in advance to establish the project. Often there's ethics boards to deal with and the design of the project can be tackled in advance, i.e., prior to your arrival.

 

Another point re: scheduling electives early: my surgery mentor noted that the atmosphere on the teams and wards later in the year, i.e., closer to CaRMS time, is quite different from that earlier in the year. He noted that earlier in the year you'll often have clerks who aren't so gung-ho about that rotation, so they won't necessarily be trying to impress everyone as much as those later in the year who might be gunning for a spot. He said that he's noticed this distinct difference. Relatedly, during my 10 weeks of surgery electives (which began in the month of March), for the first 5 weeks I was on with clerks who didn't give a hoot about Gen Surg. The next 2-week elective was the same--in fact, there were no clerks around at all for that elective in Toronto. It wasn't until my last, 3 week elective in Vancouver (which spanned May and June) when I actually worked on a team with a clerk who was keen on Gen Surg.

 

In terms of being green, i.e., scheduling your electives early in clerkship, this was a big concern of mine which I also raised with my surgery mentor. Although you may be less experienced than other clerks, you learn quickly. Also, almost all of my initial preceptors knew that these were my first rotations and they tempered my evaluations as such. To wit, I ended up with great letters from each of them.

 

Lastly, with respect to surgery interviews, it's a valid comment, above, that residents may not recall you, however, my interview panels were composed of residents with whom I'd never worked and most of whom I didn't know, anyway.

 

Cheers,

Kirsteen

[juicyprunes]

So, I got my track! It has electives (6 weeks) then surgery, then the other rotations, and internal med last. Pretty much my last choice - oh well!

 

I'm at a stage where even though I know I'm interested in surgery, I'm not 100% what surgical specialty and I'm also still open to the idea of something else (E.g. family medicine). Can anyone recommend some electives??

[bludshot]

i got the same one

[juicyprunes]

Any advice for those who are unlucky enough to have electives first??

[Lactic Folly]

Do electives during the summer between 2nd and 3rd year (pick ones that allow you to gain hands-on experience in patient care - seeing patients, writing notes, scrubbing in - instead of just shadowing). Spending 6 weeks out of your 3 month vacation in this way would be almost as if you had completed an entire rotation prior to beginning your electives/surgery block. I had a good experience with rural family medicine in the summer before 3rd year - got to spend time in the ER, delivery room, and OR in addition to clinics and they are flexible if you are interested in a specific area.