Intership electives.

[minstral]

What do people recommend?
SHould I keep an eye towards my potential fellowship aspirations?
Do a month of neuro at the very end?
Several neurologists told me Rheum would be useful.
Im thinking of taking PMR or sports med since I have interest in pain and NeuroMusc..

good idea? bad idea?

Any advice based on experience or opinions based on nothing are welcome.

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[typhoonegator]

I remember deliberating a lot about this myself when I was in your position. I think, in the end, it doesn't really matter. However, a lot of the decision will depend on the program in which you do your prelim year. In many places, intern year "electives" are pretty lame. During my prelim year, interns could only rotate on a subset of the subspecialty services -- they saved rheum, GI, and transplant for the older kids.

Rotating on rheum or ID for a few weeks sounds like you would be learning all this subspecialty knowledge, but in reality you mostly just learn about being an intern on a subspecialty service. Sure, you'll pick up some pearls here and there, but I wouldn't expect anything earth-shattering. Also, don't forget that intern year is a real grind, and you're going to end up looking forward to those elective blocks as a point of decompression from all those ward blocks.

Finally, I would think a lot about your future neurology program when deciding on electives. Some neurology services are consult-driven, meaning they have small, low-acuity inpatient services but see lots of patients as consults for other services. Other neurology services are big inpatient units with lots of ancillary medical problems in addition to neurology, even ICU-level care. If you're going to be walking into one of the latter two, some extra time on cardiology or pulmonary can actually pay more dividends during your neurology training than time spent on a more seemingly relevant specialty.

 

[buckley]

My prelim asked me for my preferences as well. I put Cardio > Endo > Rheuma. We do have the option to go to Neuro, but I figured I would have 3 years to train in Neurology whereas I only get a year of formal training in IM. So those are my thoughts. Good luck

 

[bjolly]

I get 2 1/2 electives. I'm planning to split the difference by requesting 2 electives that will hopefully be useful to me and help me be a better neurologist (cardiology and rehab) and one that just sounds nonstressful and fun to me. (haven't decided what yet).

 

[danielmd06]

I think you have plenty of choices. I also think you should tailor your months for potential areas of interest or weak points in your previous education.

I personally took Neuroradiology and Ophthamology rotations my intern year of IM. As a fourth year medical student, I did two months of Neurosurgery, one month of Neurology, one month of Neuroradiology, one month of Neuroscience Review/Neuroanatomy - and this influenced my choice to add the Ophtho experience.

My intern prelim year included two months of critical care medicine - for which I am grateful for now. I picked up plenty of Cardiology and Pulmonary medicine on the floors and in those two ICU months.

Your PGY-3 and PGY-4 years of Neurology should include plenty of elective time for you to add additional training as you deem fit.

If you are personally interested in Pain Medicine, you might consider Anesthesiology rotations that would include exposure to Pain Clinics. Good luck.