Dilemna with fourth year schedule and applying to Med/Peds programs

[mochamuffins]

Well I am having trouble with setting up my fourth year rotations. I have finally decided to apply to med/peds and not pursue FP as I feel I want the more in depth training especially in pediatrics. My dilemna is that I am an osteopathic student and there is only one osteopathic approved residency in med/peds. My top choices are in allopathic programs. To make a long story short, I have to fill one month with either a subI in medicine at my top choice program or with consider doing a med/peds outpatient elective at this osteopathic approved site. My dilemna is that since my top choices are all allopathic sites, I am thinking I will not apply through the osteopathic match. My reason for doing the medicine subI was to get to know the program better if I was accepted. However, I would have already done a pediatric subI and a consult service at this hospital. Am I putting too many eggs in one basket? Should I do as many med-peds outpatient experiences as possible to get a flavor for the programs? Should I not do the medicine subI?
Any help or clairty of how to approach the situation is much appreciated!!!!!

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[ChildNeuro]

Well I am having trouble with setting up my fourth year rotations. I have finally decided to apply to med/peds and not pursue FP as I feel I want the more in depth training especially in pediatrics. My dilemna is that I am an osteopathic student and there is only one osteopathic approved residency in med/peds. My top choices are in allopathic programs. To make a long story short, I have to fill one month with either a subI in medicine at my top choice program or with consider doing a med/peds outpatient elective at this osteopathic approved site. My dilemna is that since my top choices are all allopathic sites, I am thinking I will not apply through the osteopathic match. My reason for doing the medicine subI was to get to know the program better if I was accepted. However, I would have already done a pediatric subI and a consult service at this hospital. Am I putting too many eggs in one basket? Should I do as many med-peds outpatient experiences as possible to get a flavor for the programs? Should I not do the medicine subI?
Any help or clairty of how to approach the situation is much appreciated!!!!!

I think that a medicine subI would add more to your application for residency, as well as give you more "enhanced" work experience which will benefit you as a resident, assuming that you have not done a subI yet. Not to knock ambulatory healthcare, but performing excellently on a subI is something that program directors look for and can greatly enhance an application. An outpatient clinic is more linear, i.e. seeing one patient after another. A subI is viewed as an in-depth experience where you have to keep track of several things at once, have more responsibiity and it is viewed as more intense. I don't believe that PDs are overly concerned with your performance/experience in a clinic, which is pretty easy to get a hang of, my specialty clinic fourth year experience were very easy in terms of the history, physical and next step, and attendings never to my recollection made a change in what I was doing. PDs are concerned about how you will be able to manage the inpatients, i.e. are you good at multi-tasking, working with complex medical problems in an acute situation, know when a patient is very sick and needs further evaluation. More difficult for some residents is carrying >8 patients on an inpatient service with a high-turner over, keeping excellent track of what needs to be done, and becoming very familiar with your patients in a short amount of time. I have personally seen residents who have had difficulty managing or getting the big picture of their inpatients, where as clinic is very routine for them. Inpatient medicine, IMHO, is more complex and challenging, and hence more fun, than outpatient medicine, although outpatient medicine can be very rewarding as well in terms of helping patients to maintain their health, which in the overall picture of healthcare may save more lives than acute care.

 

[mochamuffins]

Thank you so much for your advice Childneuro. Are you a med-peds resident?

You are so right about outpatient being more of a one dimensional situation and subIs being about handling a bunch of complex patients. I figure that if I really want to apply to med-peds that has much more inpatient training, I should do the subIs. Unfortunately, I could only find a medSubI in December and apply to that one. As I am still waiting for a response, I think I have a very challenging fourth year but I figure that is what I need to do to make sure I feel settled about applying for med-peds and not FP. If I end up hating the subIs and see that outpatient is more my thing, I can always try to apply FP.

well thanks again for all your advice on different questions I have posted on different forums. If you have any advice/tidbits, please pm me

 

[megsMS]

BTW, although you will do quite a bit more inpatient during your med-peds residency as compared to FP, you are still an excellent outpatient clinician. The preceptors I work with in my own clinic (med-peds) are awesome and can spit out treatment guidelines as though they have photographic memories. All that stuff drilled into your head during your inpatient months really carries over to outpatient.

 

[sdeel]

Hey I am a DO at a competitive allopathic program. At my school we had 3 ppl do m/p allopathically, so it can be done. I was in the same position as you, and chose to do a outpt M/P elective at my #1 choice. It gave me a chance to meet the residents and get to know the attendings, which is why the PD said they chose me. PM me if you want to know more.

sam

 

[ekydrd]

Hey Sam,

How's residency going so far? Good to see you looking so well .

 

[The Med-Peds Dude]

Most people have never done a Med-Peds elective of any sort, though many have 'accidently' worked with a Med-Peds physician. I don't have data to support my position on audition rotations, but I doubt more than half actually match at the same program. Basically, you need to interview at, and rank, a several programs. This might help - http://www.nrmp.org/data/chartingoutcomes2007.pdf

 

[RuralMedicine]

Most people have never done a Med-Peds elective of any sort, though many have 'accidently' worked with a Med-Peds physician. I don't have data to support my position on audition rotations, but I doubt more than half actually match at the same program. Basically, you need to interview at, and rank, a several programs. This might help - http://www.nrmp.org/data/chartingoutcomes2007.pdf

I think if you're interested in doing audition rotations for Med-Peds they can be in either Peds or IM. I'd agree that I'm not sure they actually help you or not doing them hurts you. I actually did an EM rotation at what ended up being my first choice and where I matched but I couldn't have told you that when I signed up for the rotation. Rotations also in a few situations showed me I didn't want to apply to or rank a particular program.

 

[Evil X]

We offer an outpatient rotation and have a DO in our program.