4th year schedule

[eilis721]

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I'm a 3rd year applying for general surgery next year and I was hoping to get some input about planning for 4th year. Specifically, is it best to jump right in and take a surgery elective early in 4th year (i.e first month)? A surgery attending at my school suggested that I take a medicine elective like cardio or ID. She said that in July, I won't know anymore than a 3rd year student, and that if I really wanted to shine in surgery I should wait and get more experience. Honestly the thought of spending another month on a medicine service makes me puke, but if it will truly help then I'm game. What are your thoughts on this?

 

[klubguts]

I took my two surgery rotations in july and august of my 4th year. While i can understand your attendings rationale, i'm sure you are more knowledgable than incoming, brand new MS3s who will be rotating with you. In addition, you need to secure LORs early in the year for your residency applications. I'm sure there is benefit to doing medicine rotations such as ID, gastro, etc, but i would put those off in favor of doing my surgery rotations early. Best of luck to you.

 

[Ergo]

My advisors (first two authors of a major surgery text) suggested a very different strategy:
First, do a SICU month and brush up on physiology and patient management.
Then, do a home surgery elective AI (like burns or trauma with someone well known at your school who will write a letter). Read up on cases ahead of time, be early, stay late, be available and affable = great LOR.
They dont expect you to be much better than 3rd years, but you should be more efficient and probably will understand the medicine behind the diseases better than the newbies.
Also, you can look really good by doing some teaching - show the third years the ropes a little, it makes you look like a good team player.
Then do at least one away AI at another program with big name faculty where you might want to go for residency. Set up a meeting in advance with the faculty of interest, and let him/her know you are a visiting AI and will as them for a LOR at the end of the month. Try hard to work with their team and scrub in with them when possible. Volunteer (!) to take extra call with various residents on the faculty's team, and also on nights when that faculty is on service. This will get your name out there in the 4 weeks you're there.
Later in the year, do an easy radiology elective. Between SICU, radiology, trauma/burn and a general elective you will have plenty of surgery to make you a good candidate for internship. The rest of 4th year, do whatever the hell you want, the minimum to graduate if that suits you.

 

[eilis721]

klubguts and ergo: thanks so much for your reply. that was really great advice. i really appreciate it. best of luck to you!

 

[jmattwilson]

"A surgery attending at my school suggested that I take a medicine elective like cardio or ID."

DO cards that is always useful

"She said that in July, I won't know anymore than a 3rd year student, and that if I really wanted to shine in surgery I should wait and get more experience."

That doesnt make much sense as all the third years will be complete newbies totally clueless on how to get things done on the wards. I would think that as a fourth year you would be able to get a lot of stuff done and know a good bit about surgery and surgical patients. Infact I believe we are at our apex as students when we complete third year. Fourth year is a major brain drain, unless you are hypomanic, so relax before intern year.

 

[jmattwilson]

My advisors (first two authors of a major surgery text) suggested a very different strategy:
First, do a SICU month and brush up on physiology and patient management.
Then, do a home surgery elective AI (like burns or trauma with someone well known at your school who will write a letter). Read up on cases ahead of time, be early, stay late, be available and affable = great LOR.
They dont expect you to be much better than 3rd years, but you should be more efficient and probably will understand the medicine behind the diseases better than the newbies.
Also, you can look really good by doing some teaching - show the third years the ropes a little, it makes you look like a good team player.
Then do at least one away AI at another program with big name faculty where you might want to go for residency. Set up a meeting in advance with the faculty of interest, and let him/her know you are a visiting AI and will as them for a LOR at the end of the month. Try hard to work with their team and scrub in with them when possible. Volunteer (!) to take extra call with various residents on the faculty's team, and also on nights when that faculty is on service. This will get your name out there in the 4 weeks you're there.
Later in the year, do an easy radiology elective. Between SICU, radiology, trauma/burn and a general elective you will have plenty of surgery to make you a good candidate for internship. The rest of 4th year, do whatever the hell you want, the minimum to graduate if that suits you.

Excellent advice. But be carful on away rotations one slip and you can hurt your chances at that institution majorly.

 

[SocialistMD]

The only thing I would add is to choose your electives such that they will make you a better internist. My electives were all internal medicine subspecializations that allowed me to see disease processes more such that I will be able to recognize them in my patients.

 

[Blade28]

Agreed...remember, the best internists are surgeons (supposedly). 🙂

 

[Winged Scapula]

The only thing I would add is to choose your electives such that they will make you a better internist. My electives were all internal medicine subspecializations that allowed me to see disease processes more such that I will be able to recognize them in my patients.

A good IM subspecialty of interest and help to surgeons is Gastroenterology. You'll work a lot with these guys as a surgeon and it helps to know some detail about their work.

 

[blue2000]

I recommend GI (as above) and if you can take a straight, didactic EKG interpretation class, I think that is incredibly helpful. Many interns have told me that being comfortable with EKGs is worth it's weight in gold intern year.