In similar situation to another thread on this board.
Always thought I was going to do neurology, but am now 1/2 way through my neuro rotation and not exactly loving it. I really liked IM so am seriously considering going this route. My question is this, if I already honored my 3rd yr IM rotation and think I can get good LORs do I still need to do my IM AI early in the 4th yr? I currently have it scheduled in Feb w/ friends and would ideally like to keep it there. Also, I don't want to risk getting less then honors if I don't have to. Any help u guys can offer is greatly appreciated.

Background (if it matters): would like to go to top IM as want to do research and teach eventually, from mid tier medical school, step I 253/99, honored all 3rd year rotations except peds, will be borderline for AOA (don't know yet), 3 publications (2 1st author) lots of abstracts

I assume you mean "acting intern" and not "artificial intelligence" . . . most people call this a SubI, and I only point this so that you don't run into any breakdown in communication in the future . . .

You sound like a super-star and I can't imagine you doing poorly, I mean . . . how could you?! You don't inspire much confidence when you say you worry about not getting a good grade, especially in light of your super-star stats to date . . . doing your SubI early can only help you, but I don't see how doing it in February is going to hurt with your application as stated. I imagine you'll get interviews anywhere you send that app.

Agreed, it shouldn't matter much. Most IM applicants have their SubI done prior to interviews, but there is no requirement. My only concern is that you seem to be basing this change in career based upon a single rotation -- consider doing a medicine SubI earlier not because an application will require it but more so that you're more sure you'll be happy in IM.

Agreed, it shouldn't matter much. Most IM applicants have their SubI done prior to interviews, but there is no requirement. My only concern is that you seem to be basing this change in career based upon a single rotation -- consider doing a medicine SubI earlier not because an application will require it but more so that you're more sure you'll be happy in IM.

As a related question, I know there is no requirement but is it expected a medicine applicant would do a sub-i in medicine?

I'm have been planning on doing surgery sub-i, just because I won't have much chance to be in the OR in the future and I'd like to get better at suturing.

AProgDirector, do you guys commonly look for the grades on medicine Sub-I? Should I expect questions on the interview trail? Basically, is this completely unheard of to not do a medicine sub-i as as a medicine applicant?

Do you anticipate it affecting where I get interviews?

You should do a medicine Sub-I.

If you want to do a surgical Sub-I also, be my guest.

Will you get a spot without a medicine Sub I? Absolutely. Per your post, you'll be a very strong applicant to IM. A lack of a medicine sub I will stand out, and perhaps some of the top tier programs will notice.

I am only a prelim for medicine so take this for what it's worth I suppose. But I would do a month in an IM specialty you are interested in or an outpatient general medicine month IF you end up wanting to do a sub-I to decide if IM really is for you. A sub-I I feel would only tell you if you like IM RESIDENCY. Long grueling hours (at least for an intern which is what you would be as a sub-I), all inpatient care, the sickest of the sick (if you are at a tertiary center). Though it is still IM, I don't think it is the best way to judge if you will like the career as it would really be once you are done with training. Just my opinion. Good luck in your choice. As for whether you need a sub-I for those "top" IM programs, that is another story. I don't doubt that it would be a good idea to do one for that reason.

Thanks for your feedback.

Aprogdirector, I'm not the OP but have somewhat similar stats.

My problem is my home institution will only let us do 1 class in a particular subject, IE no repeats. You can't do two sub-i's in medicine. I basically had to choose whether or not to do a medicine sub-i at my home institution or at an away institution.

At this point, I do not want to stay at my home institution.

I chose to do medicine sub-i away and surgery sub-i at home (to fullfill my requirements). Only bad thing is my away institution doesn't give H's, so basically I'll end up with a pass for my medicine sub-i.

Enough rambling, too late to change anything. Looking forward to applying this fall. Thanks again for your feedback LCK and aProgdirector.

Thanks for your feedback.

Aprogdirector, I'm not the OP but have somewhat similar stats.

My problem is my home institution will only let us do 1 class in a particular subject, IE no repeats. You can't do two sub-i's in medicine. I basically had to choose whether or not to do a medicine sub-i at my home institution or at an away institution.

At this point, I do not want to stay at my home institution.

I chose to do medicine sub-i away and surgery sub-i at home (to fullfill my requirements). Only bad thing is my away institution doesn't give H's, so basically I'll end up with a pass for my medicine sub-i.

Enough rambling, too late to change anything. Looking forward to applying this fall. Thanks again for your feedback LCK and aProgdirector.

This will be fine. Assuming you have a nice LOR from your away rotation, you'll have no problem. Interesting that your medical school puts limits on Sub-I's

This will be fine. Assuming you have a nice LOR from your away rotation, you'll have no problem. Interesting that your medical school puts limits on Sub-I's

I have a question for aProgDirector, which sorta relates to the OP's question:
a common rumor spreading through the IM applicants in our class is that "it looks bad if you don't get a LOR from your sub-I". is that true? I’m particularly asking because my sub-I attending, who is as junior as they come, is already writing me a so-called "strong" LOR. The problem is that in the meantime I've manage to arrange for 2 other IM attendings (who are world-renowned in their respective fields) to write me "excellent" LORs. And 1 of our letters if already wasted on a "departmental chair" letter.

So would I be putting myself in some "suspicious applicants category" if i pick the hot-shot attendings over the junior attending (keeping in mind that I have had similar types/lengths of interactions with all 3 physicians)?

I don't think so, but would just like a confirmation. thanks

I have a question for aProgDirector, which sorta relates to the OP's question:
a common rumor spreading through the IM applicants in our class is that "it looks bad if you don't get a LOR from your sub-I". is that true? I’m particularly asking because my sub-I attending, who is as junior as they come, is already writing me a so-called "strong" LOR. The problem is that in the meantime I've manage to arrange for 2 other IM attendings (who are world-renowned in their respective fields) to write me "excellent" LORs. And 1 of our letters if already wasted on a "departmental chair" letter.

So would I be putting myself in some "suspicious applicants category" if i pick the hot-shot attendings over the junior attending (keeping in mind that I have had similar types/lengths of interactions with all 3 physicians)?

I don't think so, but would just like a confirmation. thanks


You can send 4 letters

You can send 4 letters

sorry for the confusion, but i'm saving one of my LORs as a research LOR to make up for 10wks of research elective that never produced any publications.

So would I be putting myself in some "suspicious applicants category" if i pick the hot-shot attendings over the junior attending (keeping in mind that I have had similar types/lengths of interactions with all 3 physicians

As long as you have a good grade for the Sub I, it's no big deal.

You could also ask that some of the content of your Sub-I letter be included in your dept letter.

Lankysudanese
use the famous people's letters of recommendation
keep the 4th letter/Jr. attending letter only for places he/she may have trained and/or knows people, or decide not to use your "research letter" and use this attendings as a 4th letter instead. Or do what aprogdirector said, and have some of Jr attendings stuff incorporated into your "departmental letter".

And stop worrying so much. Sounds like you will get a great residency.

As an aside, I find it weird and restrictive that someone's med school is limiting the number of sub-I's someone does. I did one medicine one, one EGS and one ortho.