Cass Posted January 29, 2014 Report Share Posted January 29, 2014 Hey All! I'm in the process of figuring out my clerkship rotation schedule and while I'm aware that every school has a different schedule, I wanted to get some input from the clerks and residents on this forum on a particular dilemma I'm having. Essentially, I'm undecided as to whether or not I want to start off clerkship with Internal Medicine/Surgery which are both 8 week blocks and run from September to December OR have these two blocks towards the end of 3rd year (March-August). The thing is that I haven't ruled any of these two out yet in regards to interest (I know - this is like the first decision most medical students should make!) and so I can see pros and cons to having either rotation schedule. I would love to hear the thoughts of those who've gone through both rotations and whether or not they would repeat the schedule they've had or preferred a different arrangement. Link to comment Share on other sites More sharing options...
Lactic Folly Posted January 29, 2014 Report Share Posted January 29, 2014 If you are potentially interested in IM or surgery (which are basically *the* core rotations of clerkship), I would prefer to start with them, so that you can better plan your electives in fourth year. There will be a steep learning curve if you haven't done much clinical work before, but the experience gained will help you during your other rotations for the remainder of the year, which may not be as true for the converse scenario had you started with the other rotations. Link to comment Share on other sites More sharing options...
thebouque Posted January 29, 2014 Report Share Posted January 29, 2014 the order doesn't matter Link to comment Share on other sites More sharing options...
rmorelan Posted January 29, 2014 Report Share Posted January 29, 2014 If you are potentially interested in IM or surgery (which are basically *the* core rotations of clerkship), I would prefer to start with them, so that you can better plan your electives in fourth year. There will be a steep learning curve if you haven't done much clinical work before, but the experience gained will help you during your other rotations for the remainder of the year, which may not be as true for the converse scenario had you started with the other rotations. I would agree with this - order isn't critical but if you find out in the middle of the summer you want internal medicine as an example and have to go and rearrange electives and set stuff up rapidly you are going to have a hard time. You simply won't be able to get electives everywhere you want to go. Same with surgery. It really is tough arranging things for things where letters of reference are more critical as the field may be more competitive. It isn't that you cannot change your mind it is just more work, more stress..... Also if you do those first and then decide you want family or psych later it is pretty easy to then get electives you need etc for this less competitive fields. That leaves things like peds and oby/gen left which in theory if they were your third block you would still be pretty set to line yourself up for those. Of course there are a lot of school specific variations for some other fields If you can rule in or out what you want early you have an advantage of finally having a plan. This isn't a bit deal but having lighter blocks in the summer - particularly in things your truly don't care about or don't take as much work to actually to pretty well in - let you rest up for fall electives, study, prepare, even start on that CARMS doc etc. Of course all this being said you can make any elective schedule work for you - there is not damning consequence of another order etc Link to comment Share on other sites More sharing options...
rogerroger Posted January 29, 2014 Report Share Posted January 29, 2014 Don't start with something you are interested in matching into. This will put you at a disadvantage. You are going to look pretty armature and weak during your first rotation compared to your later. As a resident you can tell a fresh clerk from a seasoned clerk from a mile away... Link to comment Share on other sites More sharing options...
BigM Posted January 29, 2014 Report Share Posted January 29, 2014 I am someone who is interested in psychiatry and I started on psychiatry. The reason that I did this was I was doing 10 weeks of psychiatry clinical in the summer between 2nd and 3rd year so I wanted to do it all in a row to keep it fresh. I regret this decision. In retrospect I would start with medicine or surgery (likely medicine). It is going to be a though first rotation because of the learning curve but you need to get thrown into the hospital at some point. When I was on psychiatry I had very little exposure to hospital procedure so it was like starting at square one when I finished that rotation and started on surgery. Link to comment Share on other sites More sharing options...
ellorie Posted January 29, 2014 Report Share Posted January 29, 2014 I chose to start on ob/gyn and paediatrics and have psychiatry in the early spring, because I am interested in psych, but I wanted to rule out ob/gyn and paeds. I think it's reasonable to start with things that you need to rule in/rule out, just so you don't get caught in the electives crunch. Especially if you still need to decide between surgery v. non-surgery. So far, I like my track and I would pick it again. Maybe I won't be so amused when I'm stuck on surgery all summer, but for the most part I'm glad that I got to experience ob/gyn and paeds before I started planning electives. Link to comment Share on other sites More sharing options...
rmorelan Posted January 29, 2014 Report Share Posted January 29, 2014 I chose to start on ob/gyn and paediatrics and have psychiatry in the early spring, because I am interested in psych, but I wanted to rule out ob/gyn and paeds. I think it's reasonable to start with things that you need to rule in/rule out, just so you don't get caught in the electives crunch. Especially if you still need to decide between surgery v. non-surgery. So far, I like my track and I would pick it again. Maybe I won't be so amused when I'm stuck on surgery all summer, but for the most part I'm glad that I got to experience ob/gyn and paeds before I started planning electives. ha - if you have no interest in surgery at Western then the summer is a good time to do it. Many of the surgeons reduce their workflow during that time so it is supposed to be a bit lighter. Plus you still get to see sunlight, which you won't if you do it in the winter like I did Nothing like weeks of no sunlight Link to comment Share on other sites More sharing options...
chickenfingers91 Posted January 29, 2014 Report Share Posted January 29, 2014 Any advice for what streams are advisable for the three year programs like Calgary where we start with 6-8 weeks of electives and then start our core rotations? (*Think* I'm interested in peds, psyc or family med, but how can anyone be sure when planning electives pre core?) Link to comment Share on other sites More sharing options...
Cass Posted January 29, 2014 Author Report Share Posted January 29, 2014 Thanks everyone for the input so far! Many of the reasoning for and against having IM/surgery in the beginning or later were the some of the ones I was contemplating. If I have my IM/Surgery blocks later on in the year, I would start off with psych, paeds, ob/gyn, family and from those 4, ob/gyn + family are the only ones I can potentially see myself doing. I guess what's holding me back from doing IM/Surgery first is because I know that since these are the core and most intensive blocks, I would rather get more accustomed to clerkship by doing the more "non-intensive" rotations first such as family, psych etc (kind of get my feet wet if you will). Furthermore, as someone mentioned, if I am leaning towards these two areas, would it be better to accumulate more knowledge and clinical skills through the year and be a rockstar clerk in these fields towards the end? Also, if I do these two areas towards the end of my 3rd year, I was reasoning that I would remember more of my material and also my attendings would remember me more? Lastly, can I still book electives in IM/Surgery and if in the summer I decide I don't want to do that, just cancel these electives? I was trying to look at both sides of the situation so let me know if any of my reasoning makes sense or there's something I'm not considering. Thanks again for all your input! Link to comment Share on other sites More sharing options...
Lactic Folly Posted January 30, 2014 Report Share Posted January 30, 2014 As BigM said, psychiatry and family medicine don't really prepare you that well for the core hospital rotations. If you want to be better prepared, I would suggest doing clinical electives in IM/surgery during the summer between 2nd and 3rd year. There is more to doing well on rotations than just experience.. for one, preceptors will adjust their expectations based on your level of training.. so people at the start of clerkship can still stand out if they have a superior base of knowledge from preclerkship, for example. Second, if you are at the end of third year and have more experience, well, so do your classmates on the same rotation, so you won't necessarily stand out on that basis alone. Third, you are evaluated in no small part on personal qualities like work ethic and interpersonal skills, not just clinical knowledge/skills. Not sure what you mean by "remember more of my material" - to what purpose? It's hard to predict, but there is some worry about burnout at the end of 3rd year (as there are no real breaks). As for attendings remembering you, if you are looking for a letter of reference, it's usually best to ask them at the end of the rotation anyway, so that they can jot down some notes if they wish while their memory is still recent. Yes, you can book electives early and then cancel (main cost is $). That is not the main concern, however - it's more of not being able to get the fall electives you want if you change your mind in the summer. Link to comment Share on other sites More sharing options...
rogerroger Posted January 30, 2014 Report Share Posted January 30, 2014 You want to start on IM/Surgery if you are NOT interested in these specialties. These rotations generally suck and your life becomes horrible. But, you will learn a lot and be a better clerk on rotations which you care about. IM/Surgery are high yield learning. They are rotations which define your senior med school years. Putting these rotations at the end is only advantageous if you need to look good, eg. you want to match to surgery or IM. If you are interested in IM/Surgery put these rotations in the middle. This gives you some experience first for you are not useless on an important rotation while also giving you enough time to plan electives etc. Sure, preceptors will pretty much expect nothing from a newly minted clerk. But ideally you want to show them how you will be as a resident if you are looking at applying to a given program. Early clerkship will not provide you this opportunity even with "adjusted" expectations. I didn't do this. I started with stuff I couldn't care less about, psych, family, etc. I ended with IM. Things worked out for me, but this was a big mistake in hindsight. Life would have been much easier if I organized things differently. Plus, I would have been in deep water if I actually enjoyed IM and wanted to do it. IM encompasses a lot of specialties, it's best to rule it in or out definitively by doing that rotation early to mid clerkship. Link to comment Share on other sites More sharing options...
burrb Posted January 30, 2014 Report Share Posted January 30, 2014 You want to start on IM/Surgery if you are NOT interested in these specialties. These rotations generally suck and your life becomes horrible. But, you will learn a lot and be a better clerk on rotations which you care about. IM/Surgery are high yield learning. They are rotations which define your senior med school years. Putting these rotations at the end is only advantageous if you need to look good, eg. you want to match to surgery or IM. If you are interested in IM/Surgery put these rotations in the middle. This gives you some experience first for you are not useless on an important rotation while also giving you enough time to plan electives etc. Sure, preceptors will pretty much expect nothing from a newly minted clerk. But ideally you want to show them how you will be as a resident if you are looking at applying to a given program. Early clerkship will not provide you this opportunity even with "adjusted" expectations. This is school dependent. If you go to UofT and do all your core rotations prior to any electives, do what you're interested in (IM/surgery) in the early-middle part of clerkship. You have time to "get your feet wet" with family or peds or what have you. However, if you go to Mac or Queen's, electives are VERY early in the game, and doing IM/surgery electives without having done your core will reflect poorly on you because everyone else will know more than you and you will not stand out in any good way. So in that case do IM/surgery rotations FIRST. So plan to finish IM/surgery BEFORE you do electives, whenever they are. Other than that, it doesn't matter how your rotations are set up. Link to comment Share on other sites More sharing options...
BK47 Posted January 30, 2014 Report Share Posted January 30, 2014 This is school dependent. If you go to UofT and do all your core rotations prior to any electives, do what you're interested in (IM/surgery) in the early-middle part of clerkship. You have time to "get your feet wet" with family or peds or what have you. However, if you go to Mac or Queen's, electives are VERY early in the game, and doing IM/surgery electives without having done your core will reflect poorly on you because everyone else will know more than you and you will not stand out in any good way. So in that case do IM/surgery rotations FIRST. So plan to finish IM/surgery BEFORE you do electives, whenever they are. Other than that, it doesn't matter how your rotations are set up. Excellent advice Link to comment Share on other sites More sharing options...
Recommended Posts
Archived
This topic is now archived and is closed to further replies.