Sub-I or regular rotation in the specialty I want?

[ohmanwaddup]

So I've been submitting VSAS applications, with an emphasis on trying to get Sub-Is from July to October. I am planning on applying Med/Peds and the hospital that is my top residency choice offers a Sub-I in IM, but just a regular Med/Peds rotation. There is a decent chance I will only be able to pick one because I need to get a Peds-SubI and letter completed in that timeframe as well.

Would it be smarter to do the IM Sub-I and show I can function as a intern, or do the regular rotation in Med/Peds. Id lean towards Med/Peds since that's the specialty I want to apply to and specifically I want to be at this hospital for residency, but wonder if a good Sub-I will be valued more.

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[Redpancreas]

So I've been submitting VSAS applications, with an emphasis on trying to get Sub-Is from July to October. I am planning on applying Med/Peds and the hospital that is my top residency choice offers a Sub-I in IM, but just a regular Med/Peds rotation. There is a decent chance I will only be able to pick one because I need to get a Peds-SubI and letter completed in that timeframe as well.

Would it be smarter to do the IM Sub-I and show I can function as a intern, or do the regular rotation in Med/Peds. Id lean towards Med/Peds since that's the specialty I want to apply to and specifically I want to be at this hospital for residency, but wonder if a good Sub-I will be valued more.

1.) SubI > Regular rotation. The expectations are greater. When you say you're a subI the attending automatically sees you as a junior intern. I would do the Sub-I in IM since that's the only thing that your top choice offer. Before you sign up for the Sub-I make sure you know the ins-outs of the EMR and how things function at the hospital that is your top choice.

2.) Get the Peds Sub-I done, like you said, before October.

Good luck! You'll kill it.

 

[ohmanwaddup]

1.) SubI > Regular rotation. The expectations are greater. When you say you're a subI the attending automatically sees you as a junior intern. I would do the Sub-I in IM since that's the only thing that your top choice offer. Before you sign up for the Sub-I make sure you know the ins-outs of the EMR and how things function at the hospital that is your top choice.

2.) Get the Peds Sub-I done, like you said, before October.

Good luck! You'll kill it.

wont be able to know how things function, but they use EPIC and I've used epic all year so i should be fine in that regards

So put the Sub-I as priority over the Med/Peds got it. I guess my only other concern is I'll be applying with zero med/peds specific experience. I've heard this should not be an issue with a med/peds application, but idk, feels a little counterintuitive.

 

[Redpancreas]

wont be able to know how things function, but they use EPIC and I've used epic all year so i should be fine in that regards

So put the Sub-I as priority over the Med/Peds got it. I guess my only other concern is I'll be applying with zero med/peds specific experience. I've heard this should not be an issue with a med/peds application, but idk, feels a little counterintuitive.

So here's the thing...what is a med/peds rotation but just seeing a mix of adults (IM) and peds separately? It's not like you are ever going to have a case where you're seeing a kid and parent simultaneously in one billed office visit which would be a unique competency necessitating doing a separate med/peds rotation. Doing one month of both is equivalent to a med/peds month and IMO better especially if both are SubIs.

 

[ohmanwaddup]

So here's the thing...what is a med/peds rotation but just seeing a mix of adults (IM) and peds separately? It's not like you are ever going to have a case where you're seeing a kid and parent simultaneously in one billed office visit which would be a unique competency necessitating doing a separate med/peds rotation. Doing one month of both is equivalent to a med/peds month and IMO better especially if both are SubIs.

Makes sense. I'd assume since I want to match at this specific place I should do my IM Sub there I as opposed to one at another local hospital,

 

[Redpancreas]

Makes sense. I'd assume since I want to match at this specific place I should do my IM Sub there I as opposed to one at another local hospital,

I guess. That said, it could just as easily backfire if you do a bad job. I'd say do it if you need an in or feel confident in your ability.

 

[ohmanwaddup]

I guess. That said, it could just as easily backfire if you do a bad job. I'd say do it if you need an in or feel confident in your ability.

The million dollar question lol

 

[TelemarketingEnigma]

Can you check if there's overlap between IM faculty/leadership and Med/Peds? Unless you specifically need to meet certain requirements of multiple subIs, I think the value of doing this away rotation would be in meeting Med/Peds leadership at your institution of interest (assuming you do at least one Sub-I elsewhere). An IM Sub-I will still give you a chance to show your chops, but a Med/Peds rotation would demonstrate interest in that specific program

 

[Redpancreas]

Can you check if there's overlap between IM faculty/leadership and Med/Peds? Unless you specifically need to meet certain requirements of multiple subIs, I think the value of doing this away rotation would be in meeting Med/Peds leadership at your institution of interest (assuming you do at least one Sub-I elsewhere). An IM Sub-I will still give you a chance to show your chops, but a Med/Peds rotation would demonstrate interest in that specific program

Someone can correct me if I'm wrong but unlike surgical subspecialties, derm, rad-onc, etc. demonstrating interest in Med/Peds itself isn't a huge priority for the field. It's lengthier training without any financial benefit you're signing up for so I don't think people are applying to Med-Peds as a back-up for to anything. I also don't think Med-Peds in recent years has been competitive to the extent that you need to demonstrate interest in the field by doing a rotation in it as even at places with great IM or Peds programs, the Med/Peds program hasn't been too competitive. Additionally, not sure how doing a Med/Peds rotation demonstrates interest in it as opposed to a separate Meds and Separate Peds rotation. I think the best is to do the subIs to "show your chops" in both areas.

All that said, I do agree to do some faculty searching and try to see if you can work with a Med/Peds attendings. Having a letter from a Med/Peds attending, particularly the PD, may be nice boost to your application and would be one reason I would consider opting to do the Med/Peds rotation instead. You're going to have to use your judgment there.

 

[TelemarketingEnigma]

Someone can correct me if I'm wrong but unlike surgical subspecialties, derm, rad-onc, etc. demonstrating interest in Med/Peds itself isn't a huge priority for the field. It's lengthier training without any financial benefit you're signing up for so I don't think people are applying to Med-Peds as a back-up for to anything. I also don't think Med-Peds in recent years hasn't been competitive to the extent that you need to demonstrate interest in the field by doing a rotation in it. Additionally, not sure how doing a Med/Peds rotation demonstrates interest in it as opposed to a separate Meds and Separate Peds rotation.

All that said, I do agree to do some faculty searching and try to see if you can work with Med/Peds attendings. Having a letter from a Med/Peds attending, particularly the PD, may be nice boost to your application.

I'm planning to apply to Med/Peds this year, and you're right that (according to my discussions with my home PD) an away isn't necessary for demonstrating interest, but he does recommend doing the Med/Peds rotation we have (who knows maybe the one OP is talking about lol) for exposure to the field and faculty and culture. However, if you're going to do an away anyway, why not do it directly with the program you're interested in? This would also give you a better opportunity to learn about the environment at that program and whether you would want to be a resident there. I'm not sure what OP's school is like (maybe they need lots of aways to fill out their 4th year schedule, in which case sure go for IM + Peds) but Med/Peds rotation would kill both birds with one stone

 

[TelemarketingEnigma]

I also don't think Med-Peds in recent years hasn't been competitive to the extent that you need to demonstrate interest in the field by doing a rotation in it.

Also this is not totally true - every med peds spot filled in the match this year, zero soap spots. It's a small field and definitely self selects but it's not necessarily an uncompetitive specialty by any means

 

[Redpancreas]

I'm planning to apply to Med/Peds this year, and you're right that (according to my discussions with my home PD) an away isn't necessary for demonstrating interest, but he does recommend doing the Med/Peds rotation we have (who knows maybe the one OP is talking about lol) for exposure to the field and faculty and culture. However, if you're going to do an away anyway, why not do it directly with the program you're interested in? This would also give you a better opportunity to learn about the environment at that program and whether you would want to be a resident there. I'm not sure what OP's school is like (maybe they need lots of aways to fill out their 4th year schedule, in which case sure go for IM + Peds) but Med/Peds rotation would kill both birds with one stone

Up to OP ultimately. Maybe you're right. OP I'd trust TelemarkingEnigma more if he's applying to Med/Peds this year as he has a common interest. Perhaps you two can talk or already do via PM to network?

 

[ohmanwaddup]

I'm planning to apply to Med/Peds this year, and you're right that (according to my discussions with my home PD) an away isn't necessary for demonstrating interest, but he does recommend doing the Med/Peds rotation we have (who knows maybe the one OP is talking about lol) for exposure to the field and faculty and culture. However, if you're going to do an away anyway, why not do it directly with the program you're interested in? This would also give you a better opportunity to learn about the environment at that program and whether you would want to be a resident there. I'm not sure what OP's school is like (maybe they need lots of aways to fill out their 4th year schedule, in which case sure go for IM + Peds) but Med/Peds rotation would kill both birds with one stone

I'm a DO with no core site, every rotation next year will be an away. I also have a 3 sub-I graduation requirement.

 

[TelemarketingEnigma]

I'm a DO with no core site, every rotation next year will be an away. I also have a 3 sub-I graduation requirement.

Gotcha, yeah i think it will depend more then on if you can meet your requirements while still doing Med/Peds. If you need to do more sub Is to fill those requirements, I don't think you'll be hurt by picking the IM sub-I at all, but if you've got the room in your schedule might as well do Med/Peds!

 

[ohmanwaddup]

Gotcha, yeah i think it will depend more then on if you can meet your requirements while still doing Med/Peds. If you need to do more sub Is to fill those requirements, I don't think you'll be hurt by picking the IM sub-I at all, but if you've got the room in your schedule might as well do Med/Peds!

Makes sense. I Forgot to mention, but its program/city I am gunning hard for (have a house there, fiance lives there etc,). So in retrospect I Should probably prioritize the Med/Peds if I can get a Sub-I at another local hospital (applied to 3 Ped Sub-i and 2 IM sub-Is). The if I get a letter it might be super valuable.

 

[ohmanwaddup]

Well I went through the dates and the Sub-I is not even offered till November.

I'm thinking of doing it in December or January to try and get a letter to add to my application before rank lists are made, but idk maybe that is risky.

 

[Chads2]

Well I went through the dates and the Sub-I is not even offered till November.

I'm thinking of doing it in December or January to try and get a letter to add to my application before rank lists are made, but idk maybe that is risky.

We have a med/peds program at my institution. (I’m an internist). Our med/peds PD and APD are both very much in tune with the medicine and pediatrics faculty, and a strong letter from each would go a long way. If you have a peds sub-I and a medicine sub-I at your program of choice, you’ve set yourself up well.

 

[ohmanwaddup]

We have a med/peds program at my institution. (I’m an internist). Our med/peds PD and APD are both very much in tune with the medicine and pediatrics faculty, and a strong letter from each would go a long way. If you have a peds sub-I and a medicine sub-I at your program of choice, you’ve set yourself up well.

Unfortunately my top choice does not offer a Sub-I in peds. On their website they talk about a "advanced advanced Sub-I" that is 8 weeks long and includes one on one time with a physician. It's not listed on VSAS but I was going to reach out today and see if it is still offered.

What are you thoughts on doing a Sub-I where I want to match, but after interview season?

 

[fldoctorgirl]

I'm a DO with no core site, every rotation next year will be an away. I also have a 3 sub-I graduation requirement.

Not sure if you know this, but a rotation doesn't have to be technically called an audition or a sub-I for us to code it as that for graduation purposes. You can call any rotation a sub-I if you feel like you were functioning as an intern. So if you do the meds/peds elective, you can still call it a sub-I.

 

[ohmanwaddup]

Not sure if you know this, but a rotation doesn't have to be technically called an audition or a sub-I for us to code it as that for graduation purposes. You can call any rotation a sub-I if you feel like you were functioning as an intern. So if you do the meds/peds elective, you can still call it a sub-I.

True, but I'm not worried about getting the graduation requirements, its more about which LOR would hold more weight. I also think we need to get calling a "non official sub-I a Sub-I we have to get the preceptor to sign off.

 

[Chads2]

What are you thoughts on doing a Sub-I where I want to match, but after interview season?

I’m going to state the obvious and say that before interview season is always better. However, even afterward can still be to your benefit if your attending holds some weight with the admission committee. I once wrote a letter to our own PD about a student I wanted to rank highly, after interview season. He responded that the student was already going to be highly ranked but that my opinion was confirmatory.

 

[ohmanwaddup]

I’m going to state the obvious and say that before interview season is always better. However, even afterward can still be to your benefit if your attending holds some weight with the admission committee. I once wrote a letter to our own PD about a student I wanted to rank highly, after interview season. He responded that the student was already going to be highly ranked but that my opinion was confirmatory.

Makes sense. I suppose the only tricky part would be making sure there was enough time for them to write a LOR, but also late enough that I didn't have to take time off for interviews