Is there such thing as "too many" electives in a non-competitive specialty?

[jlkhhylyiluh6]

Lets say I want to do psych, is it fine if I do 6 elective blocks in psych and 2 in something else? Or should I do 4/5 in psych and several other specialities to be more balanced? Thanks!

[goleafsgochris]

It wont hurt you for psych to do more.  Your school may not let you do that many electives in one thing though.  You can "balance it out" by doing a variety of different settings and subspecialties in psych.  Or doing electives that are "almost psych"--neuropsych, brain injury, addiction medicine, etc.

[ellorie]

I did 6 in psych, one in family, and one in emerg. Never came up in interviews, totally normal. 

[goleafsgochris]

56 minutes ago, ellorie said:

I did 6 in psych, one in family, and one in emerg. Never came up in interviews, totally normal. 

For sure.  Ive said this before, but the "programs want to see balance" is in my experience a total myth.  I helped with the file reviews for neuro when I was a resident and they literally considered you a more serious applicant the more neuro you did, and too much elective variety made them worried you weren't that committed and may be a risk of switching programs lol.  People hate hearing this but it was definitely true.

[Lactic Folly]

Yes, unfortunately it's one of the few "objective" indicators of interest that are available.

[FailureToThrive]

How do you guys have so many elective blocks?

We only have 10 weeks of electives..

[jlkhhylyiluh6]

1 hour ago, MD_2021 said:

How do you guys have so many elective blocks?

We only have 10 weeks of electives..

we have 16 weeks (8 blocks), do you go to a 3 year school?

 

Quote

It wont hurt you for psych to do more.  Your school may not let you do that many electives in one thing though.  You can "balance it out" by doing a variety of different settings and subspecialties in psych.  Or doing electives that are "almost psych"--neuropsych, brain injury, addiction medicine, etc.

we have to do at least 3 specialities, but max 12 weeks (= 6 blocks) in one so i should be good with 6 psych + 1 family + 1 something else

[ralk]

About the only specialty where having some variety in electives is beneficial is Family Medicine. I generally tell FM gunners to aim for about 3 straight FM electives (I only did 2), then do the rest in any FM-related fields that hold their interest. As long as you're not clearly gunning for another specialty, FM programs tend to like that variety.

For all other specialties, variety means little - you want as much exposure to as many programs in that field as possible. Psych is no exception here.

[FailureToThrive]

2 hours ago, beeboop said:

we have 16 weeks (8 blocks), do you go to a 3 year school?

No I just go to a school that likes to set us up for failure

 

[yup]

7 minutes ago, MD_2021 said:

No I just go to a school that likes to set us up for failure

 

Do you mind sharing which school?

[SunAndMoon]

42 minutes ago, yup said:

Do you mind sharing which school?

my guess is on sherbrooke

[Snowmen]

1 hour ago, SunAndMoon said:

my guess is on sherbrooke

That would be a classic "Class of 2021 whiner" but I'm pretty sure they get 12 weeks of pre-carms electives like the previous classes.

[Peasant Sirwallis]

Your electives should help you become comfortable and confident in your choice of specialty. That can mean challenging yourself with another specialty that could also hold your interest. Who knows, maybe you'll fall in love all over again. And that's thing: it's difficult to switch specialties once you're in residency so your best strategy is to avoid making a decision you'll regret.

[ralk]

8 hours ago, Peasant Sirwallis said:

Your electives should help you become comfortable and confident in your choice of specialty. That can mean challenging yourself with another specialty that could also hold your interest. Who knows, maybe you'll fall in love all over again. And that's thing: it's difficult to switch specialties once you're in residency so your best strategy is to avoid making a decision you'll regret.

Firmly disagree here. Electives should be about exploring specialties and ensuring you're making the right choice, but it has been a long time since that was the case. Now using your electives to explore is just a way to increase your chances of going unmatched.

[goleafsgochris]

1 hour ago, ralk said:

Firmly disagree here. Electives should be about exploring specialties and ensuring you're making the right choice, but it has been a long time since that was the case. Now using your electives to explore is just a way to increase your chances of going unmatched.

Totally agree.  This is what I was talking about above.  "Exploring specialties" is the official line your med school will give you, but everyone knows that's not realistic at all anymore.  You should be exploring specialties in your 1st year or 2 (prior to your electives starting), by doing informal shadowing etc.  In no way should you be spending your formal electives doing this if you want to maximize your chance at a specialty.  

TBH the people that use electives to "explore specialties" all end up in family medicine (often by choice).

[Edict]

It isn't as black and white as people are saying. I know plenty of people who did not do electives all in one specialty that matched to their first choice location and specialty, even in surgical specialties (non plastics or ent though). At the same time, I know people who went all out on one specialty and didn't match. 

With that being said, if you know you want psych, do as much psych as you can. It demonstrates interest, lets you get the best letters and by your later electives you will be more competent and will be able to impress better. The only specialty i've heard where they may prefer some more diversity is family medicine, but otherwise all of the RC specialties don't seem to have a limit where you are "too focused on our specialty".

The point I would be trying to make here (and this is for those who are reading rather than the OP) is that it is not the end of the world if you do switch your mind, or you can't decide. You can still match, even to competitive locations and specialties (although i won't lie, i haven't seen anyone match to the ultracompetitive specialties without dedication i.e. plastics, derm, emerg, ent, ophtho), without a strong elective profile. 

Programs want really capable people as well, a top candidate who is likeable in one specialty is often also likeable in another and at the same time, you can be 100% dedicated to one specialty but if people in that specialty don't think you are suited for it, you still may not match or match to your top choices.   

If you are someone who is undecided, the best "solution", is to really gun for both. It does mean you will have less free time, but you can sell 2 electives in a specialty + shadowing residents/faculty in your free time + research in said specialty + awards in said specialty as enough interest better than if you just did 2 electives in a specialty and nothing else. 

 

 

[NeuroD]

On my anesthesia core & Neuro elective I got to work with a seasoned veterans. Back in his day there was so much flexibility, even after graduating. One was FP for years, went back for anesthesia training, came out an ran an ER, then ICU, then switched to typical OR anesthesia full time. Another one was a FP for 5 years, went back for a Neuro residency, did that for 4 years, then went for a pain fellowship.

Nowadays you've got to be committed to a career from like the 2/3rd year of medicine. There's always a couple people who some how match to something unexpected, but that's not the norm. Its silly, how are you supposed to know that you're "passionate” about a field and commit decades to it before you really have a clue what its about. Obviously you can’t, given the job satisfaction rate of most specialities. I wonder if the satisfaction rate would be any worse if people were randomly assigned to a specialty.

[sangria]

12 hours ago, goleafsgochris said:

Totally agree.  This is what I was talking about above.  "Exploring specialties" is the official line your med school will give you, but everyone knows that's not realistic at all anymore.  You should be exploring specialties in your 1st year or 2 (prior to your electives starting), by doing informal shadowing etc.  In no way should you be spending your formal electives doing this if you want to maximize your chance at a specialty.  

TBH the people that use electives to "explore specialties" all end up in family medicine (often by choice).

There is increasing pressure from UGME to get its students to "parallel plan". And they blame it on the unmatched student for not doing said parallel planning. 

If the point of undergraduate medical education is to produce undifferentiated doctors, fourth years should not be running around the country having basically auditions. 

[FailureToThrive]

18 hours ago, sangria said:

There is increasing pressure from UGME to get its students to "parallel plan". And they blame it on the unmatched student for not doing said parallel planning. 

If the point of undergraduate medical education is to produce undifferentiated doctors, fourth years should not be running around the country having basically auditions. 

Who even has time for "parallel planning" though? You would probably risk going unmatched from not being "competitive enough" for either.

[Leon]

I am a PGY1 and I had 14 weeks of electives, 10 of which were pre carms and I spent all 14 on various psychiatry electives. 10 were at my home school and 4 away as I applied too late through the portal to land more non home school ones. Based on my experience, I can say that the commitment was well received. I know of someone who split their electives between psych and something else half half and didn't match to either but it's hard to say if that split was the deciding factor in this person not matching. I think carms is becoming increasingly competitive and even for former safe specialities like psychiatry, commitment is helpful. I did meet a Pgy 4 who matched despite having done nothing in psych but they are Pgy 4 so I'm not sure if that would work now. My electives gave me lots to talk about as I did General psych, child, emerg psych, forensics etc 

[Hanmari]

On 4/16/2018 at 6:46 PM, Leon said:

I am a PGY1 and I had 14 weeks of electives, 10 of which were pre carms and I spent all 14 on various psychiatry electives. 10 were at my home school and 4 away as I applied too late through the portal to land more non home school ones. Based on my experience, I can say that the commitment was well received. I know of someone who split their electives between psych and something else half half and didn't match to either but it's hard to say if that split was the deciding factor in this person not matching. I think carms is becoming increasingly competitive and even for former safe specialities like psychiatry, commitment is helpful. I did meet a Pgy 4 who matched despite having done nothing in psych but they are Pgy 4 so I'm not sure if that would work now. My electives gave me lots to talk about as I did General psych, child, emerg psych, forensics etc 

Minor clarification that we had 15 weeks total in our year hahah we were allocated 13 weeks of electives and 2 weeks of vacation, although many people decided to just use those 2 weeks as more elective time. I take it that Leon probably used 1 of the vacation weeks as part of an elective.

I did 10 weeks in my specialty of which 8 were pre-CaRMS, and I did 3 weeks in another related specialty, and took the full 2 weeks off. I ended up matching comfortably to my top choice specialty and location although I am in a relatively non-competitive specialty so buyer beware when it comes to taking vacation weeks. I did feel also that it was well received that the majority of my electives were in the specialty of choice.

[Leon]

Yup I took one week off and spent 14 of 15 weeks total in electives though in retrospect I would have taken the couple weeks off that we're allowed to.