Elective choices?

[PhoenixFlare500]

I believe at one point I described the difficulty as "can you go an hour without soiling yourself or punching the interviewer in the face? Then you'll match to psych somewhere".

Well I guess I'm screwed, on both accounts.

[Lactic Folly]

But you may match elsewhere in a program where punching is considered a sign of strength. Just wear your protective undergarments.

[rogerroger]

I'm assuming there must be some planning/strategy to electives as well with regards to doing certain ones too soon when you may be inexperienced in a certain topic area and therefore not stand out as much, and also doing them too far in advanced where you are just a distant memory by the time CaRMS roles around?

 

 

Yes, not to stress you out but if you are going for something even moderately competitive your elective choices and when you time them will be one of the most important decisions you will make during medical school.

 

I was at UofT where we are lucky enough to do all electives post-core rotations. You have an advantage if your school does this. You will be more knowledgeable come your electives. I can't comment much on other clerkship curriculums in this regard. I would assume you would try to maximize your most important electives in your summer prior to starting CC4 or in the fall as a newly minted CC4.

 

For more competitive programs I suggest the following:

 

You want to ask current residents in the specialty of interest which programs are the best. Do electives there. Also ask residents which supervisors are good to work with. Try to schedule electives with these people. Try to do one elective out of province. This shows you are willing to leave the province and opens doors to more programs. Also the sweet spot for maximizing your time and experience is about 2 weeks. Don't go less than 2 or more than 3. Doing so is not a good use of your precious elective time. On elective go to journal clubs, go to academic half days. If you can pick up extra work days do it. Picking up extra shifts is key in emerg electives. Try to live the life of a resident in the program as much as possible. It will help you rank come CaRMS and also shows those who matter in the program that you are interested.

 

Look on the CaRMS schedule when reference letters are due. Any electives 2 weeks prior to this date are much less useful. You can't get a reference out of it very easily. Electives after this date are still good for getting your face out there and learning about the programs. But your first choices really should be prior to this date.

 

Lastly, inquire and book early. I discovered my desired specialty late in my 3rd year. It happens. But I really had to scramble come elective planning. As soon as you think you are ready to go for a particular specialty start considering the things above. I wish someone told me everything above when I started CC3. It is somewhat common sense, but it's uber important and I think worth mentioning.

[Renin]

RE: Psychiatry

 

I did all my electives in psychiatry except for 4 weeks (2 wks in palliative care and 2 weeks in radiation oncology). I tried to do a range of different things within psychiatry (child, consult liaison, eating disorders, emergency, etc.)

 

I only interviewed at two schools and ranked only two schools - because I only wanted to go to those two schools for psychiatry. It was VERY nervewracking, but I managed to match to what I wanted! I'd advise you should probably apply for a few more psych programs, but you probably don't need to back up in another area - unless there is some particular reason you think you may not match psychiatry.

 

That being said, there are places in the country where psychiatry is very popular, and there is competition for those spots (ie: Toronto, Calgary, Edmonton, McGill). But if you were to back up with somewhere where psych is less popular (Saskatchewan, Memorial, Queens), then you'll probably get it!

 

If you have any specific psych questions; feel free to PM me

[Med0123]

Yes, not to stress you out but if you are going for something even moderately competitive your elective choices and when you time them will be one of the most important decisions you will make during medical school.

 

I was at UofT where we are lucky enough to do all electives post-core rotations. You have an advantage if your school does this. You will be more knowledgeable come your electives. I can't comment much on other clerkship curriculums in this regard. I would assume you would try to maximize your most important electives in your summer prior to starting CC4 or in the fall as a newly minted CC4.

 

For more competitive programs I suggest the following:

 

You want to ask current residents in the specialty of interest which programs are the best. Do electives there. Also ask residents which supervisors are good to work with. Try to schedule electives with these people. Try to do one elective out of province. This shows you are willing to leave the province and opens doors to more programs. Also the sweet spot for maximizing your time and experience is about 2 weeks. Don't go less than 2 or more than 3. Doing so is not a good use of your precious elective time. On elective go to journal clubs, go to academic half days. If you can pick up extra work days do it. Picking up extra shifts is key in emerg electives. Try to live the life of a resident in the program as much as possible. It will help you rank come CaRMS and also shows those who matter in the program that you are interested.

 

Look on the CaRMS schedule when reference letters are due. Any electives 2 weeks prior to this date are much less useful. You can't get a reference out of it very easily. Electives after this date are still good for getting your face out there and learning about the programs. But your first choices really should be prior to this date.

 

Lastly, inquire and book early. I discovered my desired specialty late in my 3rd year. It happens. But I really had to scramble come elective planning. As soon as you think you are ready to go for a particular specialty start considering the things above. I wish someone told me everything above when I started CC3. It is somewhat common sense, but it's uber important and I think worth mentioning.

 

This. Is truth.

 

I'll say that your electives between June and October before CaRMS are absolutely key. Keep also in mind that if you are gunning for a surgical specialty, OR time is DOWN during the summer and you may considerate to do these electives in fall or spring (fall being the best because it is then easier to ask for a good letter of recommendation).

 

I'd add that if your school was like mine and makes you start your clerkship with electives, I can't stress you enough to shadow a maximum of different specialties in the summer between MS1-MS2 and between MS2-MS3.

[Lactic Folly]

Obviously this depends on your school's clerkship schedule, but it's not always a bad thing to have elective time earlier in 3rd year before finishing all core rotations, especially if you're rotating in a field that isn't one of those core rotations and where less clerkship experience can be compensated for by more preclerkship knowledge and enthusiasm.

 

It can be easier to schedule away electives outside of the August to November crush, less difficult to stand out against the multiple other keen hopefuls, and gives you more time to change around your 4th year electives should your early 3rd year electives shed more light on your career choices.

[rmorelan]

Obviously this depends on your school's clerkship schedule, but it's not always a bad thing to have elective time earlier in 3rd year before finishing all core rotations, especially if you're rotating in a field that isn't one of those core rotations and where less clerkship experience can be compensated for by more preclerkship knowledge and enthusiasm.

 

It can be easier to schedule away electives outside of the August to November crush, less difficult to stand out against the multiple other keen hopefuls, and gives you more time to change around your 4th year electives should your early 3rd year electives shed more light on your career choices.

 

Part of the problem now is that the fall is overloaded - everyone thought hey it is to the advantage of the call if all the electives are in the fall. True - if you are the only one doing it - but now we have such an overloaded fall that it is becoming quite difficult to actually get electives where you want to go in many fields.

 

As an example TO this simply stopped taking anyone intereted in Derm in the fall not from their own school. THey don't have the space. Now you can say that is just one school but 1/2 of the spots in english speaking schools are at that school and only 2/14 of the people they accepted last year didn't do an elective there. So if your school also only does fall electives (say like Western) - you are basically all other things being equal to the other candidates at a 50% disadvantage over either TO derm or non fall only elective students that can do one at TO. Let's just say the hopefully derm people in our class are not assumed

 

Now that is an extreme example but it is similar in other areas to a lessor degree. We cannot all have solely fall electives with our current enrollment levels. The system is straining under the load.

[rogerroger]

Just a few comments.

 

Those posting here raise good points. I agree that the fall being overloaded is problematic. Yet the benefits of the post-core rotation elective schedule is enormous. I would have been toast if I didn't have this system last year. I changed my speciality of choice a few weeks prior to CC4 into a more competitive option. This fall elective schedule literally saved my butt. Career exploration is key and in some ways it can't easily be rushed. Striking that balance between maximum career exploration and maximum oppurtunity for demonstrating commitment to a speciality is so important in hind sight.

 

But you still raise a good point. It is not ideal. What you say speaks volumes as to why the system should be centralized. No one time should be blocked out. Maybe limmited spots reserved, but a pure blackout period is not fair I agree. I wanted to do a competitive elective at UBC and was locked out last year. I also know how frustrating the "fall rush" can be...

 

One other point in response to some other posters... Try to shadow to get career exploration. Elective time is so precious. If you are career exploring via electives you are potentially really making things hard for yourself when you actually "discover" your speciality and have few electives left. If your 1st choice ends up being somthing mildly competitive this could be a game changer come CaRMS.

[rogerroger]

One more thing. As someone who had to scramble and change all my electives at the last miniute I discovered somthing interesting.

 

If the "central elective office" refuses you then always contact the department directly. Explain your situation and your interest. I secured 2 electives which were originally not approved this way. The programs want to attract applicants and it is in their interest to have elective students from different schools visit. It is clear that at many schools the departments have a degree of flexibility about approving elective students beyond what the MedEd office is approving.

[greengrassgrows]

One more thing. As someone who had to scramble and change all my electives at the last miniute I discovered somthing interesting.

 

If the "central elective office" refuses you then always contact the department directly. Explain your situation and your interest. I secured 2 electives which were originally not approved this way. The programs want to attract applicants and it is in their interest to have elective students from different schools visit. It is clear that at many schools the departments have a degree of flexibility about approving elective students beyond what the MedEd office is approving.

 

Excellent tip!

 

Out of curiosity, for those who are at schools where all of your core is done before the fall of 4th year, what exactly do you do other than electives for the rest of fourth year? Surely you don't have a full year of electives?! If you do, I'm supremely jealous

[ellorie]

We have ICE where we go back to the classroom and take lecture-based classes while studying for the MCCQE.

[greengrassgrows]

We have ICE where we go back to the classroom and take lecture-based classes while studying for the MCCQE.

 

ICE. Sounds cool.

 

[rmorelan]

One more thing. As someone who had to scramble and change all my electives at the last miniute I discovered somthing interesting.

 

If the "central elective office" refuses you then always contact the department directly. Explain your situation and your interest. I secured 2 electives which were originally not approved this way. The programs want to attract applicants and it is in their interest to have elective students from different schools visit. It is clear that at many schools the departments have a degree of flexibility about approving elective students beyond what the MedEd office is approving.

 

Oh we did that - Our dean of education even spoke directly with the departement - it was the derm department itself that raised the barrier. The fact that the departments have flexibility actually swings both ways. They have the flexibility to simply say no despite any higher up restrictions

[rmorelan]

ICE. Sounds cool.

 

 

Sort of - After you have been "doing things" for 1.5 years suddenly to be completely back in the classroom is a drag for many (or so I have been told). Plus it means you are in class for about 7-8 weeks post carms results - so you know what speciality you want and yet still you can be in a classroom perhaps covering something unrelated. With the prospect of setting up your "new life" and the big exam you can imagine attention in the classroom could falter a bit

[ellorie]

I'm not thrilled with the whole ICE thing, but what can you do really? I guess every curriculum has its lows.

[greengrassgrows]

I'm not thrilled with the whole ICE thing, but what can you do really? I guess every curriculum has its lows.

 

Sort of - After you have been "doing things" for 1.5 years suddenly to be completely back in the classroom is a drag for many (or so I have been told). Plus it means you are in class for about 7-8 weeks post carms results - so you know what speciality you want and yet still you can be in a classroom perhaps covering something unrelated. With the prospect of setting up your "new life" and the big exam you can imagine attention in the classroom could falter a bit

 

Heh, I was just making a pun. I didn't actually think it sounded overly exciting. Sorry that that wasn't clear:o

[rogerroger]

We have ICE where we go back to the classroom and take lecture-based classes while studying for the MCCQE.

 

That's rough. After you do the MCCQE and see what this exam is like you will want a refund on that years tuition.

 

If you showed up to your rotations and study a week you will be maximally prepared. It's a "feel" exam not much more.

[greengrassgrows]

That's rough. After you do the MCCQE and see what this exam is like you will want a refund on that years tuition.

 

Meaning it's not so bad?

[rmorelan]

Meaning it's not so bad?

 

rather high pass rate for CMG. Still it is a good test to generally reinforce everything I guess.

[Med0123]

Meaning it's not so bad?

 

Supremely passable if you studied at least a bit during your clerkship.

 

I took 2 weeks to "study" in a house located on the US eastern coast we rented me and 3 of my pals just before the MCCQE, 2 minutes walk from the beach... it shows just how much I was not worried about this exam and I was right not to be.

[rogerroger]

The MCCQE is scaled so if you do better on one section you get a harder section next. The opposite is true if you do poorly. The end result is the exam where you are always on the threshold of your knowledge. This is not a feel good exam.

 

Yet everyone who is a CMG passes pretty much. The pass rate is in the high 90s. You don't need to study more than 1-2 weeks for this exam.

[ontariomed0002]

Would you say then that it is sort of pointless to arrange some of your hopeful residency school electives early on - well not pointless but not as good?

 

For example, Mac already has 7 weeks of electives starting in July after first year meaning it's still almost 1.5 yrs before CaRMS - so could it be a bad decision to quote on quote 'waste' some of your electives that early on at the schools you want to go for residency? Or is it just a matter of how much you think you'd be able to stand out at that point in time?

 

This. Is truth.

 

I'll say that your electives between June and October before CaRMS are absolutely key. Keep also in mind that if you are gunning for a surgical specialty, OR time is DOWN during the summer and you may considerate to do these electives in fall or spring (fall being the best because it is then easier to ask for a good letter of recommendation).

 

I'd add that if your school was like mine and makes you start your clerkship with electives, I can't stress you enough to shadow a maximum of different specialties in the summer between MS1-MS2 and between MS2-MS3.

[Med0123]

Would you say then that it is sort of pointless to arrange some of your hopeful residency school electives early on - well not pointless but not as good?

 

For example, Mac already has 7 weeks of electives starting in July after first year meaning it's still almost 1.5 yrs before CaRMS - so could it be a bad decision to quote on quote 'waste' some of your electives that early on at the schools you want to go for residency? Or is it just a matter of how much you think you'd be able to stand out at that point in time?

 

Exactly what's in bold.

 

I started my own clerkship with 8 weeks of electives and we could only do 4-weeks blocks electives. The first rotation I've ever done (which was therefore an elective) was the specialty I ultimately matched in. I won't lie to you: you add the stress of a completely new schedule (waking up early, no afternoon nap and calls) and a completely new way of functioning in the hospital-world with consults/evolution notes/prescriptions/admissions to the stress of performance if this is a specialty you see yourself in the future.

 

It was hard, but your attendings KNOW it is your first ever rotation so you can ultimately have a great evaluation because they basically have no expectations about your performance hahaha. If you keep a great attitude it will work out just fine.

 

So definitely NOT a waste of time. But to be honest with you, if it was to be done again, this elective would have been my 2nd rotation and not my 1st just because of the painful transition between summer laziness and the surgical wards reality.

[ontariomed0002]

That's great advice... thanks - and something I didn't think about either about the adjusting to life outside of the class and in the hospital. But it is good to hear that the supervisors will still have a hopefully good evaluation they can look back on when they see your application come across their desk too.

[Lactic Folly]

Early electives are not a waste as important attributes such as work ethic, personality, preclerkship knowledge can still be assessed.

 

Consider a summer elective to hit the ground running on your clerkship rotations. Most people in my class did one.