3rd year schedule. Need help!

To my knowledge the best starting schedule you can have is:

1. surgery
2. ob/gyn
3. Internal medicine

I've got

Peds
IM
Surgery
Neuro/Psych
Ob/Gyn
Family


I actually wanted ob/gyn first, since I have no desire to do it and it would give me a little practice in surgery and medicine, but we have a lottery on who gets to pick stuff first and when I came up ob/gyn was full. I am also getting married in november so I had to put psych during that month so I would be able to get a friday off before the week of thanksgiving (we get the entire week of thanksgiving off).

Here's how I did it (I'm going into a surgical sub-specialty)

Psych/neuro
OB/gyn
Family Med
ortho (aka elective)
Clinical Procedures Rotation (bunch of stuff including anesthesia)
Surgery -- Jan/Feb
Peds -- Mar/Apr
IM -- May/June

I wanted to get psych and ob/gyn out of the way because I figured I wouldn't like them (gyn wasn't as bad as I thought it'd be; I like the OR. OB was.). I wanted surgery in Jan/Feb because I figured there'd be no sun anyway, so I wouldn't miss it if it wasn't there, and I had no chance to see it.

On inpatient peds I got totally burnt out. Now I'm on my outpt peds month, and it's not too bad because I only have 6 half days of clinic and 2 afternoons of lecture => free time! I'm going to get burnt out way fast on inpatient medicine in May and June.

I can't wait 'til 4th year.

I would agree with doing Ob/gyn before surgery, and would also suggest doing medicine before surgery. A lot of surgery is medicine - you will be asked about the pathology of the diseases just as often as the anatomy, and a lot of the surgery shelf is medicine. If you did Ob/gyn --> medicine --> surgery, it would be tiring, but you'd also get the tougher ones out of the way. And even if you got burnt out, it's not like you'd NEED to honor peds, fam med, psych or neurology.

diosa428 said:

I would agree with doing Ob/gyn before surgery, and would also suggest doing medicine before surgery. A lot of surgery is medicine - you will be asked about the pathology of the diseases just as often as the anatomy, and a lot of the surgery shelf is medicine. If you did Ob/gyn --> medicine --> surgery, it would be tiring, but you'd also get the tougher ones out of the way. And even if you got burnt out, it's not like you'd NEED to honor peds, fam med, psych or neurology.

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Or you could do medicine --> ob/gyn --> surg; i doubt it matters. Having medicine first might be a rough start to the year, but it would definitely help with all the subsequent rotations. Plus, the expectations are generally lowest in whatever you have first, as someone already mentioned.

Also, I have friends who did surgery first and want to go into surgery, didn't know anything, still showed enthusiasm, and ended up doing well.

Overall goal: Medicine
General approach: find a way to do well in as many clerkships as possible.
General Ideas:
These were just a collection of ideas from other third years, SDN and our advising office. (don't think it's ground-breaking, new info, but still better than nothing)
- Medicine as early as you can, since everything else in some way will build on it
- Whatever you are interested in towards the middle, so you have your feet wet, but are still not burned out on being a 3rd year and have your eyes set on the green pastures of 4th year.
- OB before Surgery since lots of OB is based in the OR.
- Fill in whatever spots are left with relatively easier rotations: family, peds, psych
My final schedule:
1st half of year: OB-gyn -> Peds -> Medicine (Start off w/ two 'primary care' type fields to get me into gear for medicine. Ob/gyn first is tough, but it will make peds seem like cake. Peds second since I was told by one third year that peds is pretty much medicine for little people and it will be a nice break from the tougher clerkships of OB and Medicine).

2nd half of year: Surgery -> family -> psych/neuro (wanted surgery right after medicine. Then the rest of it is kind of smooth sailing until I hit my Sub-I's in the summer).

Hope this helps.

I'm interested in a surgical subspecialty and I'm doing it this way:

Ob/Gyn
Peds
Medicine
Surgery (also in Jan/Feb - might as well keep myself indoors during these months - )
Psych/Neuro
Surgical Subspecialty elective
Away
Family Med
Away

I think its all about peaking at the right time. I wouldn't do what your interested in too late. You might be burned out and it will show. Just my 0.02.

I started with family, and I thought that was a nice warmup. You get familiar with some of the same stuff as medicine, but at a slower pace. I wanted a bit of a break after studying for step one, and it was also nice to get out at reasonable hours during the summer.

My schedule was family, geriatrics, 2wk rads/2 wk vacation, psych, IM, surgery, OB/gyn, peds. Slow warmup to the harder stuff, which is a personal preference; a lot of people liked getting the hardest stuff out of the way early. Also, our surgery wasn't as intense as many, which is good or the surgery/OB back-to-back would've been tough. So knowing the details of a rotation at your school and your specific site may be helpful. Peds, for example, was stated by someone to be an easy rotation, but at my site it's actually a time-intensive one.

There seems to be a pretty strong consensus is that medicine before surgery seemed to work better for most people than surgery before medicine.

-Goose- said:

I'm interested in a surgical subspecialty and I'm doing it this way:

Ob/Gyn
Peds
Medicine
Surgery (also in Jan/Feb - might as well keep myself indoors during these months - )
Psych/Neuro
Surgical Subspecialty elective
Away
Family Med
Away

I think its all about peaking at the right time. I wouldn't do what your interested in too late. You might be burned out and it will show. Just my 0.02.

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Totally agree with you, especially about peaking at the right time. Just be really good on surgery. I had a resident tell me that I was going to get a good eval from one attending because she thinks that everyone who does surgery in Jan/Feb doesn't want to go into anything surgical. I really don't understand the reasoning behind that, but she wrote a straight, to the point, good comment on my eval. This winter was also the first winter that I didn't feel like I was starting to have SAD.

Hi, this is what I got for 3rd year and I think I want a medical subspecialty.

Peds
Radiology
Surgery
Ob/Gyn
Psych
IM
Family Med

Just in general...with only 9 weeks left in my third year (3 of inpatient psych, 6 of OB/GYN), I really feel that 3rd year schedule DOESN'T really matter in the grand scheme of things.

The only piece of advice I'd have is to not put something you really think you're going to do either first or last. Doing it anywhere from October to February is okay though. There's always that chance that you'll hate it and you may need time to take a step back and say "crap, now what". Too early and you don't have much experience and you can't really shine. Too late and the expectations can be crushing.

One other thought - depending on how your school sets up family med - doing it last if possible might be a really good lead into sub-i's as a fourth year. My school sends us out to rural towns throughout the state for 8 weeks of family med, and usually the docs are willing to let you take on as much as you can handle. Doing it after you've gotten through everything else could be a great chance to take on a lot of responsibility and get a lot of practice.

Favorite schedule around here:

Family Medicine
Ob/Gyn
Internal Medicine
Pediatrics
Surgery
Neurology
Psychiatry

The schedule in the previous post is my exact schedule for next year-that makes me excited. It was pretty much my first choice of schedule anyway.