4th Year Away Electives vs. Sub-Is

Hi all,

Some of the places I am looking to away rotations only have elective opportunities in IM sub-specialities versus an acting internship/Sub-I. What are your thoughts on doing a rotation in sub-speciality in a hospital?

Thanks 🙂

Depends on if you are interested on applying for residency in that program or not. If you are applying for residency then I would do the Sub-I. It will more likely give you exposure to the PD/Residents/People who will help get you in. Also, it is what all the other applicants are likely doing so you will be prepared apples to apples. I would opt for the subspecialties if A) You can't get a Sub-I and are really interested in the program or B) You are just trying to fill a required rotation.

Survivor DO

It's not uncommon to only offer sub-specialty experiences to visiting students, since the sub-I is often filled during application season with students from the actual school; visiting students generally get whatever electives are left over.

I think the answer to this question depends on why you're doing the away. If you're really interested in a specific program for whatever reason, I'd try and get a sub-I if possible, but if they only have subspecialties available it's no big deal--take as close to an intern's workload as possible and find a way to impress them anyway 🙂 If you're trying to get a perspective from a hospital in a different environment than your home school (ie academic vs community, big city vs rural), I'd try and find a program that specifically lets you do a sub-I. If you're trying to get a letter (not that I would recommend doing an away to get one for IM since it's not considered a requirement, but whatever), I'd also lean towards doing a sub-I.

In the same boat. I'm looking to do a few aways/auditions both to get a feel for big academic programs (I'm mainly in a smaller community hospital for my rotations now) and to hopefully get a foot in the door and make some connections for residency. If the program has a Sub-I that's immediately what I applied for. If they don't offer it and I still want to rotate there, I'm looking for a subspecialty (pulm, cards, ID, etc.).

survivordo said:

Depends on if you are interested on applying for residency in that program or not. If you are applying for residency then I would do the Sub-I. It will more likely give you exposure to the PD/Residents/People who will help get you in. Also, it is what all the other applicants are likely doing so you will be prepared apples to apples. I would opt for the subspecialties if A) You can't get a Sub-I and are really interested in the program or B) You are just trying to fill a required rotation.

Survivor DO

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+1, although I did a subspecialty away at the institution I matched to, so it's not an absolute necessity to do a sub-I. I got an excellent letter out of it as well.

Since the OP is applying for IM, I would advise that conventional wisdom will probably suggest that he NOT do a sub-I unless he's very confident in his abilities; if you're not up to scratch with your numbers I don't think it'll help you net an interview at a program that would otherwise wouldn't interview you. If it's at a program within your reach academically and also one that you're confident you can do well in, by all means certainly do a sub-I.

A subspecialty rotation isn't a bad idea, but I would go out of your way to meet/work with the program director (if they're in the department you're doing the away in). If the PD isn't in that department, make an appointment to talk with them and bring your CV.

Doing a sub-I can have pitfalls as well if it s at an away institution. You won't know the computer system or where anything is and that alone can make you slow and look like a ******* if you are doing the rotation with students who rotate there normally.

That said you get minimal exposure on specialty services to impt faculty and the pd. where I did residency rotating students never met the IM faculty and were always stuck with either the hospitalists or on a consult service.