4th yr away electives...SUB-I or not

[whoknows2012]

So I tried to do a search, as I'm sure this question has been asked before, but unfortunately I have not come up with anything helpful. So this is my situation; I am planning on applying for an IM residency in the NYC metro area. I am middle of the pack (60th percentile?) as of right now in my class (awaiting the grade from my last rotation and the one im currently on). Board score 240+. Most of my clinical grades are either HP or Honors, with Honors in medicine. My question is whether or not it'd be worth it to do a Sub-I in IM as opposed to doing sub-speciality electives that might be less work. I have a required Sub-I through my school, but I need to fill 16 wks of electives and as of right now all of have is 8. I got a Sub-I offered to me from Columbia for July but I'm not sure what the general consensus is on whether or not it will help/look good to do a Sub-I instead of just of sub-specialty elective. I also need a solid letter from one of my aways as well. If anyone has any advice/suggestions please help me out! Thanks in advance

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[whoknows2012]

So I tried to do a search, as I'm sure this question has been asked before, but unfortunately I have not come up with anything helpful. So this is my situation; I am planning on applying for an IM residency in the NYC metro area. I am middle of the pack (60th percentile?) as of right now in my class (awaiting the grade from my last rotation and the one im currently on). Board score 240+. Most of my clinical grades are either HP or Honors, with Honors in medicine. My question is whether or not it'd be worth it to do a Sub-I in IM as opposed to doing sub-speciality electives that might be less work. I have a required Sub-I through my school, but I need to fill 16 wks of electives and as of right now all of have is 8. I got a Sub-I offered to me from Columbia for July but I'm not sure what the general consensus is on whether or not it will help/look good to do a Sub-I instead of just of sub-specialty elective. I also need a solid letter from one of my aways as well. If anyone has any advice/suggestions please help me out! Thanks in advance

bump...anyone?

 

[medstud161]

Sounds a lot like my situation, although I did elect to do a sub-I but at my home institution. For the top academic programs a sub-I on the app demonstrates your work ethic and knowledge base as a functioning intern, things you want the program to know about you. I was told that a medicine sub-I on the app by the time you apply is a definite plus and is even expected at some programs.

If your intent is IM, away electives of course aren't required especially since you are already strong on paper. However if you were to do an away, from what I've gleaned the consensus is to do it in a sub-specialty that you are already familiar with. Doing an away as a sub-I sounds to me like a high risk/low reward proposition when compared to doing a sub-specialty that you've had some experience with, and I think you would get a better letter from the latter. Why not do a sub-I at your home program?

 

[Valadi]

If you think you might be anything short of stellar I wouldn't recommend it. Doing poorly will be worse than them not knowing you. That being said, the kids I know who wanted to end up at "top brand-name" institutions for IM all did away sub-is somewhere prestigious to get their name out there. If you're shooting for any program in the NY metroplex, then you're probably fine.

 

[Oxer45]

Sub-I or "showcasing sub-I" are double edged swords. They are basically a month long interview where everyone gets a say on your future. Anyone can ask you any question and you better know the answer; you can be paired with someone who just doesnt like you (or with someone who does). To make things worse, the first week or two, you wont have EMR access. Try presenting a pt without knowing lab values, vitals etc. Just for a simple blood draw, you'll run around for 20 min finding the stock room, getting someone to give you Pyxis access etc. Your ID access wont work at first as well, so you'll have a hard time going to pre-op, post-op, icu, OR. And to top it off, housing is a pain.

The students who "shine" in sub-I are those who have worked at that hospital before (even if it was another dept). Also remember interview day is structured and they all ask 3 questions: why this field, why you, do you get along? Preparing for interview is easy, not so much for sub-i. Also think of it in terms of numbers. For surgery, they usually take 5 residents, but have about 25 sub-I (5 students x5 mo). Just because you do a sub-i doesn't guarantee anything. Also about 1/2 of the residents typically never rotate at the program.

 

[XRanger]

With good board scores and clinical grade, I would even say don't do an away at all. IM isn't that competitive and aways aren't that important for IM. There are a lot of hospitals in the NYC area. I think you have more to lose and to gain.