4th year electives for FM

[superoxide]

I am starting my first core rotation next month, but I am already looking into what kind of electives I want to do. I am really interested in a FM residency. So, for all of you who are doing electives now, or are in a FM residency or post residency, can you chime in based on your experiences which electives are the best preparation? These are the ones I am looking into. Add/substract as you wish:

- FM
- FM subinternship (how is this looked upon by programs?)
- geriatrics
- orthopedics
- infectious diseases
- rural FM
- EM
- addiction medicine

Thanks

---

Members don't see this ad.

 

[flighterdoc]

Diag rads - you'll be reading a lot of films, especially rural
Anesthesiology - airway and if you're actually somewhere where you operate
ID? Planning on missionary work? If so, the people there will teach you in 10 minutes what you need to know.

 

[superoxide]

Diag rads - you'll be reading a lot of films, especially rural
Anesthesiology - airway and if you're actually somewhere where you operate
ID? Planning on missionary work? If so, the people there will teach you in 10 minutes what you need to know.

Thanks a lot!

Regarding ID, I was thinking more HIV/AIDS.

ooops, I just did a search on SDN and found a great thread regarding FM electives....but feel free to add to this one

 

[Red Beard]

Mind posting a link to the thread you found?

My search engine kung-fu is weak.

Thanks!

 

[superoxide]

Mind posting a link to the thread you found?

My search engine kung-fu is weak.

Thanks!

Here ya go: http://forums.studentdoctor.net/showthread.php?t=267127&highlight=subinternship

 

[deleted87716]

Thanks for finding that link. I was about to repeat myself.

 

[superoxide]

According to this article (http://www.stfm.org/fmhub/fm2004/February/William118.pdf), the highest priority 4th year rotation for FM is a subinternship in Internal Medicine. Internal Medicine?! Why not a Sub-I in Family Medicine? Is there any benefit in doing both?

 

[deleted87716]

the highest priority 4th year rotation for FM is a subinternship in Internal Medicine...Why not a Sub-I in Family Medicine?

At most medical schools, which have multiple competing residency programs, the family medicine inpatient service is primarily taking care of patients who are assigned to their clinic. They typically don't admit unassigned ("service medicine") patients; these usually go to IM. An academic FM service may not even do ICU, depending on the political environment at the school. They may or may not admit peds patients. In this situation, the FM inpatient service often has a lower census and lower acuity. For a medical student who's interested in maximizing his/her learning opportunities on a single rotation, they'll probably see more on the IM service. FM residents at opposed programs usually have to do some off-service rotations in order to get more inpatient exposure.

At unopposed residencies, this isn't the case...the FM residents typically do it all. However, even at my program, we had different inpatient teams and different rotations for family medicine and "service medicine." The service medicine months were definitely busier.

 

[sophiejane]

According to this article (http://www.stfm.org/fmhub/fm2004/February/William118.pdf), the highest priority 4th year rotation for FM is a subinternship in Internal Medicine. Internal Medicine?! Why not a Sub-I in Family Medicine? Is there any benefit in doing both?

They are very similar, actually. I've done both, and the only difference with Family Sub-I is that you have OB and peds (usually lots of newborns), depending on how the program is organized.

So far, I've done an academic month,medicine, OB, family, and ER. I have another 2 months of family (one required by my school, another to get a look at a program), and geriatrics. No derm, no rads, no anesthesia...those would have been nice, but it was more important to me to rotate at my top three choices, which is something I'm really glad I did.

The only thing I wasn't able to schedule that I regret was an ICU month. But I had a month of ICU as a 3rd year (which was like being a deer in the headlights, actually)...so I've at least spent some time in one.

 

[chibihamsta]

For those considering a radiology elective, I did a 4wk Radiology rotation for three reasons:
1. because I knew it was an easy rotation and I could take a lot of time off for interviews
2. I am studying for Step 2 and needed an easy rotation
3. I wanted to learn how to read my own CXR's, which tests were most appropriate to order for looking at X condition, and to learn radiology basics

If it weren't for reasons 1 and 2, 4wks of radiology is overkill for someone going into family medicine. I recommend only doing 2 wks of it, if at all.. or bring some of your own reading to do in between cases, because there is ALOT of down time.

The Fam Med Inpt Sub-I rotation is no different than doing a Medicine Sub-I because usually the PGY2 takes care of the mother-baby issues. Sub I's only took care of the regular floor pts where I was and we never rounded on the moms/babies as a whole team. It may be different elsewhere.

Other suggestions for electives: the Indian Health Services or a wilderness/rural rotation

 

[Faebinder]

I'm gonna say something that might tick some people off now.

In all honesty... if FM wants to become as respected as they SHOULD be.... the programs should make it such that an FM sub-I should be the most critical rotation of them all.... It will show true dedication to FM....

That rotation needs to be unique and the experience unacquired in any other specialty... The ambulatory procedures of FM that every FM needs to know should be stressed out.

 

[deleted87716]

if FM wants to become as respected as they SHOULD be.... the programs should make it such that an FM sub-I should be the most critical rotation of them all.... It will show true dedication to FM....

You used the "R" word...who are you trying to impress?

Personally, I think everyone interested in matching to a good FM residency should do an FM AI. My previous reply was intended to answer the question, "why do so many people do medicine AIs instead of FM AIs?"

During my fourth year in med school, I did AIs in FM and IM. I also did electives in EM and pulm/CC that were considered AIs. Oh, and trauma. Yeah, I was a glutton for punishment...but it was fun.

 

[superoxide]

You used the "R" word...who are you trying to impress?

Personally, I think everyone interested in matching to a good FM residency should do an FM AI. My previous reply was intended to answer the question, "why do so many people do medicine AIs instead of FM AIs?"

During my fourth year in med school, I did AIs in FM and IM. I also did electives in EM and pulm/CC that were considered AIs. Oh, and trauma. Yeah, I was a glutton for punishment...but it was fun.

Thank you all for your replies.

I agree. Anyone interested in FM must do a FM Sub-I. I found it really strange, that a FM Sub-I didn't even make the list of highest priority 4th year electives.

So looks like I'll be doing atleast an IM Sub-I, FM Sub-I, ER and ICU as electives. Here I was thinking 4th year was going to be chill

 

[deleted87716]

Here I was thinking 4th year was going to be chill

Do whatever you want. I had a great time on those electives, and still had plenty of opportunity to "chill." Fourth year is a breeze compared to the rest of medical school, no matter what rotations you choose.

 

[sophiejane]

Fourth year is a breeze compared to the rest of medical school, no matter what rotations you choose.

Truer words were never spoken. I've taken up KNITTING to stave off the boredom, for crying out loud.

 

[Faebinder]

You used the "R" word...who are you trying to impress?

As you posted links before to AAFP with articles showing recruitment of students to a specialty is affected by their respect of the specialty and the teaching faculty's opinion of the specialty. Unfortunately, no specialty is an island (Well maybe radiologists... I hear they are evil and secretly keep MRI machine altars in the hospital basements where they sacrifice patients to Dinaro, the god of money)

 

[deleted87716]

recruitment of students to a specialty is affected by their respect of the specialty and the teaching faculty's opinion of the specialty.

"Men are respectable only as they respect." - Ralph Waldo Emerson

 

[Marigold]

Truer words were never spoken. I've taken up KNITTING to stave off the boredom, for crying out loud.

Niiiiiiiiiice.

Ahh, only 6 more months till 4th year...*sigh*

 

[elizabeth5863]

Fourth year hasn't been chill at all. I only get 3 months of elective time at my school and everything else is required.

I did an inpt FM sub-I off campus (with an unopposed FM residency program a few hrs away from my university). I got to do more there and saw more variety than the sub-I that I worked with during my 3rd year IM rotation. (It was a busy service so I even carried more pts than the IM sub-I I knew). I HIGHLY recommend doing the FM sub-I off campus if you can.

Also, many residency programs require a LOR from a family medicine doctor in order to apply.
G'luck!

 

[EP to FP]

I would definitely recommend doing a SubI in FM at an unopposed program. That way you can see what it's like taking care of ICU patients, regular med/surg patients, newborns and obstetric patients all on the same service. It makes life really interesting. On our service right now we have 4 patients in the ICU, 3 newborns, a post-partum PE, 2 peds patients (one peds patient was recently transferred to Cincinnati (a 4 month old) for liver failure from autoimmune hepatitis + autoimmune hemolytic anemia, and a variety of floor medicine patients. This is why I love family medicine. Of course if I had all of these patients (with their acuity) in private practice I'd have to admit myself to the psych ward.

The best part of a sub I, as I'm sure you know, is getting to truly know the program and allowing them to get to know you. This can always backfire of course. But I can say that our sub I's are more memorable when it comes time to rank.