4th year switch advice

[beyondbethany]

I will try to keep this brief - I had a strong interest in Neurology for my first two years but did not enjoy my Neuro clerkship. I essentially ignored this experience and scheduled my 4th year with the intention of going into Neuro (thinking I should go through with it because of my early interest). Here I am after a Neuro sub-I making the change I should have made as a third year. I am switching to IM, but I have a few issues I need to work out and I was hoping for advice.

1. Medicine Sub-I: with the way my schedule works out, I can't do a ward month until Oct-Nov. Would I be at a disadvantage if I couldn't go on interviews during early Nov? Does it look bad to have a late sub-I (not that I have a choice at this point)?
2. ICU Month: I plan to do it in April (which some people say is better because the experience is fresh for intern year). Good idea?
3. Letters: Would I be good with one each from the chair of medicine, my 3rd year med attending, and the attending from my Neuro sub-I?

I appreciate any help.

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[gutonc]

I will try to keep this brief - I had a strong interest in Neurology for my first two years but did not enjoy my Neuro clerkship. I essentially ignored this experience and scheduled my 4th year with the intention of going into Neuro (thinking I should go through with it because of my early interest). Here I am after a Neuro sub-I making the change I should have made as a third year. I am switching to IM, but I have a few issues I need to work out and I was hoping for advice.

Since Neuro's differentiation from IM is still fairly recent (in the geologic time scale that medicine functions within), I don't think too many people in IM will fault you for wanting to bail out of Neuro (or vice versa if you were asking the converse question).

1. Medicine Sub-I: with the way my schedule works out, I can't do a ward month until Oct-Nov. Would I be at a disadvantage if I couldn't go on interviews during early Nov? Does it look bad to have a late sub-I (not that I have a choice at this point)?

You don't have a choice at this point, so don't worry about it. As for the timing question, the changes in the schedule this year (later initial app date, earlier MSPE date) make the interview timing thing a bit of a crapshoot, but I anticipate that it will hew largely to the prior timeline, which is to say that the vast majority of interviews will fall in the post-Thanksgiving -- pre-MLK day period (with some outliers on both ends). So as long as you're free the last week of Nov through mid-late January, you should be fine.

2. ICU Month: I plan to do it in April (which some people say is better because the experience is fresh for intern year). Good idea?

Do you have to do an ICU month? It's not a bad idea per se, but your experience as a matched MS4 will border on irrelevant for your future practice. You'll be so checked out at that point that, at best, you won't forget anything and you'll pass. At worst, you'll stop bothering to show up and you'll fail the rotation. IMHO there's a significant upside to being scared sh**less of the ICU in July of your intern year. I certainly was, and I think I learned more in that month than I did the rest of residency.

3. Letters: Would I be good with one each from the chair of medicine, my 3rd year med attending, and the attending from my Neuro sub-I?

Yes, those will be fine.

 

[beyondbethany]

Do you have to do an ICU month? It's not a bad idea per se, but your experience as a matched MS4 will border on irrelevant for your future practice. You'll be so checked out at that point that, at best, you won't forget anything and you'll pass. At worst, you'll stop bothering to show up and you'll fail the rotation. IMHO there's a significant upside to being scared sh**less of the ICU in July of your intern year. I certainly was, and I think I learned more in that month than I did the rest of residency.

I didn't really consider it from that perspective. Thanks for the input, I appreciate it.