I am in the midst of figuring out my 3rd year schedule. I am fairly sure I want to go into surgery and have the following two options regarding first semester:
o Surgery - Family Med - Medicine
o Medicine - Family Med - Surgery
I know EVERYONE warns to never schedule your desired field first, but I wondered the following things:
1. Wouldn't it be nice to be the ONE person in a group who is interested in surgery. Maybe I would get to be more active if everyone else is disinterested.
2. I realized the shelves involve a lot of Medicine... but isn't everyone in the same boat? And isn't it curved?
3. If it turns out I hate surgery, I think it'd rather find that out as early in the year as possible.
Any thoughts would be great. I need to decide by tomorrow morning. Thanks!
I would keep in mind that most attendings (or residents for that matter)don't really follow the academic calender very closely, nor do they care. If your presentations aren't good (they won't be if it's your first rotation), they won't be lenient just because it's your first rotation. Ditto for your knowledge base...most won't know or care what rotation it is for you. Some surgeons don't even know if you're a third year or a fourth year, so don't expect to get a free pass in terms of your evaluations just because it's your first rotation. Third year is really unfair in terms of the subjectiveness of the grading, and you'll find this out quickly.
In terms of being the only one on your rotation being intersted in surgery, you can't guarantee that, and most students tend to be really hard working on their first few rotations. Peds was my first rotation, and I knew that I had zero interest in Peds, but I definitely put in the most work on that rotation in terms of hours, just because I was still learning the system. On your first rotation, you'll be too busy learning basic stuff for the first week - how to write notes, how to present, even simple stuff like using the phone is actually more daunting than you realize.
In terms of the shelf, yes it's curved, but it's my understanding that the curve isn't based on rotation order or when you take it during the third year. I think it's graded like other standardized exams (ie Step 1). My first shelf was definitely my worst....I wasn't use to working the long hours, and then coming home and studying. Plus, I wasn't used to the time crunch during the actual exam, either. I'm a pretty fast reader, and I've never run out of time on a test until I took my first third year shelf. People will tell warn you that time is an issue, but you honestly just can't guage it until you take your first exam.
I would DEFINITELY do medicine before surgery. That is an absolute no-brainer. Not only will it help you for the shelf (yes, a lot of the surgery shelf is medicine related), but I thought my medicine rotation really tied everything together and made me a better medical student. My shelf exam scores went up quite a bit after medicine, and I learned a ton on that rotation. Plus, you have to keep in mind that even if you take surgery third, half of your class still won't have taken medicine yet, so you'll still be ahead in terms of knowledge.
Finally, in terms of finding out whether or not you want to do surgery, I think it would benefit you more to do it later. When I told surgeons that I wanted to go into surgery, they would usually ask me "why?" I wouldn't have been able to answer that question at the beginning of my third year, but by the time I reached my surgery rotation, I had a few things under my belt that I could mention. Also, if you really are thinking about going into surgery, you're going to need letters of recommendation. There's a better chance of them remembering you, as well as them taking you more seriously if you do it later in the year. If you decide surgery isn't for you, either way you have to do the rotation, so I don't see the benefit of doing it first.
If I were in your position, I would go Family Practice, Medicine, Surgery. I know going medicine to surgery back to back is extremely grueling, but you'll have the benefit of having just finisheding medicine, so studying for that surgery shelf won't be as bad.
Going back, if I could do my ideal schedule, I would go in this order -
1.Peds - similar to IM, but for kids. Good rotation to learn how things. Was good for me because I had zero interest and there was no way I would have studied enough to honor anyway.
2. Ob-gyn - you actually get some surgical experience here. I would try to do a gyn-onc rotation if possible, because a lot of what they do is surgical. If you have cool residents you can learn to suture and tie, which will make your surgery rotation a lot more fun.
3. Medicine - this is where I got the big picture and things kind of clicked. I really started to understand how doctors are supposed to think. This rotation is extremely resident dependent, in my opinion. I learned a lot, and thought about medicine, but I can't handle rounding for 3-4 hours.
4. Surgery - personally, if you want to go into surgery, I think this is the best place to schedule it. By this time, you'll have an idea of what's going on, and you can accurately figure out whether you like it or not because you'll have things to compare it to. Plus you won't be too burned out at this time of year, and you'll have gotten the hang of how to study for the shelf exams by this time.
Thats my 2 cents.
