Going into EM - Need help with 4th year schedule

omgwtfbbq? · Jan 16, 2010

Hi Everybody, I'm going to be applying for EM residencies next year, but first, i need to come up with a 4th year schedule. I have NO IDEA what to do. We have to turn our forms in in a week. Much of the time is elective, except for 2 weeks of subi surgery, 4 week EM/critical care mash up of some sort, and 4 week sub-i in whatever they allow (There is no EM subi here). So I'm trying to figure out what the best thing to do with the rest of my time is!

Suggestions for surgery sub-i and other rotations I should form my year around would be great.

Also, when should I try to do my away? Near interview season so i don't have to fly again? (jeez, i hate flying)

On one hand I really want to get some EM experience in at the two local residencies (i'd like to stay local if i can) on the other hand the school says not to spend our whole 4th year doing what we're g oing to be going into residency for. I'm basically just about to explode...

Any and all suggestions would be great! I also want to take step 2 a little early, as i only got a 220 on step 1. I also have no clinical research or previous EM experience I made my decision a little late 🙂 So i'm thinking about doing a research block with the toxocologists.

Any advice appreciated! I'm overwhelmed!

RxnMan · Jan 16, 2010

Here's SAEM's advice on how to plan fourth year. Here's their advice on application timeline. You can find all of this on the SAEM student resource page. Also try this page detailing the student session at the 2009 SAEM meeting.

Using their advice and by talking to the EM faculty at my school, I came up with the following (my school year starts in Aug):

Aug - Step II study
Sept - EM (home)
Oct - EM (away)
Nov - Teaching course (Required), some interviews
Dec - vaca for interviews
Jan - March - Neuro, MICU, IM Sub-I
Apr - DONE

omgwtfbbq? · Jan 16, 2010

rxn, thanks for the links, i'll go check 'em out. I'll share my sample schedule once i figure it out. now to pick where i want to do my away (ack)

RxnMan · Jan 16, 2010

omgwtfbbq? said:
rxn, thanks for the links, i'll go check 'em out. I'll share my sample schedule once i figure it out. now to pick where i want to do my away (ack)

I've been told two thoughts on this. One, pick a place you're interested in, but unsure of (e.g. in a different part of the country), and you use your month to 'test it out.' The second thought is go to a place you'd really like to end up at (becomes a month-long interview, what I plan to do).

omgwtfbbq? · Jan 16, 2010

i think i have a place that qualifies for both. Where are you going to go for yours?

opb · Jan 16, 2010

I'll share what I did for my 4th year schedule. Just as a preface, my institution does not have a home EM program so I did all away rotations (3 of them... long story). My goal was to finish my EM electives in time to have letters of recommendation submitted by some time in October.

Jul - EM rotation #1
Aug - EM rotation #2
Sept - EM rotation #3, submitted my ERAS by Sept. 10
Oct - required IM sub-i, got all of my required LORs in by mid-October
Nov - Step 2 CK and CS, a few local interviews
Dec to Jan - Interviews and online electives through my school
Feb to early May - teaching electives, anesthesia, filler electives to graduate

In retrospect, I probably would have done Step 2 CK and CS earlier... after Sept. 1 so it wouldn't automatically go onto ERAS but before November, and I probably would have done away with one of my EM rotations.

As far as where I rotated, I picked places where I was interested in ending up at. This serves two purposes in my opinion. It allows you to see first-hand the program you're considering, and it gives you the chance to rock your rotation and thus help your chances at getting in. The only caveat being you need to do well.

You can PM me if you have more questions or want to know where I went and what I thought about the rotations.

strongboy2005 · Jan 17, 2010

What if you choose to do your away rotation in something like Emergency Ultrasound? Does a rotation like that still give you the benefit of the "month long interview"? I think it would be cool to do an EM rotation at my home institution, and then an away rotation in Emergency Ultrasound. Would this be a good route or would it be better to just do two rotations of standard EM, one home and one away?

strongboy2005 · Feb 2, 2010

Anyone have any opinions on the usefulness of an away emergency ultrasound course? Thanks.

RxnMan · Feb 2, 2010

strongboy2005 said:
Anyone have any opinions on the usefulness of an away emergency ultrasound course? Thanks.

I'd do a month of EM ultrasound is if I wanted to have some experience at a program, like an away, but I had already maxed out my school's limit on specific specialty rotations (my school does not allow more than 3 months in any specialty in 4th year). You're not going to be getting a full experience in ultrasound and your interaction with the faculty would be limited compared to an away.

Assuming you were under your school's limit, and barring a real compelling reason to do ultrasound over an away, I'd just do another away.

DocVirk · Feb 2, 2010

I'm a big fan of a MICU month. Sure it's hard work, but you should get to put in a few lines, maybe intubate someone. It's really good experience, if you can survive talking about potassium endlessly.

I also did a basic medicine AI and a basic peds AI. I think you're much more likely to see something like croup or a heart failure exacerbation than you are a Whipple during your intern year. Again, these are not the easiest fourth year rotations but I think they are incredibly instructive in the basics.

strongboy2005 · Feb 3, 2010

RxnMan said:
Assuming you were under your school's limit, and barring a real compelling reason to do ultrasound over an away, I'd just do another away.

Limits aside, how many EM away rotations would you recommend? I thought having a rotation in ultrasound would be seen more favorably than just doing another EM rotation.

RxnMan · Feb 3, 2010

strongboy2005 said:
Limits aside, how many EM away rotations would you recommend? I thought having a rotation in ultrasound would be seen more favorably than just doing another EM rotation.

The FAQ (top of this forum) and the SAEM student resource page (link in my sig) both say doing something between 1-3 rotations in 4th year.

I'd say doing one home EM rotation + 1 EM away rotation >>>>> home EM + US rotation. But check out the links.

Going into EM - Need help with 4th year schedule

omgwtfbbq?

yes, really, I'm a girl

RxnMan

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omgwtfbbq?

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omgwtfbbq?

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