Advice Choosing 4th Year Electives

[socaltrojan]

I am in the process of planning my 4th year schedule and could use some advice.

I am interested in Internal Medicine followed by a Heme-Onc fellowship.

Any advice about what electives I should take.
So far I have a Medicine SubI, MICU, Heme Onc Clinic, and Radiation Oncology electives picked out.

I was also thinking about doing an ER elective to get used to formulating differentials and know how to evaluate patients quickly.

What other electives do you think would be helpful for a career in Internal Medicine?

I wanted to do a Peds Heme Onc rotation too but I didnt know if it would look bad to have only done a bunch of Heme Onc Electives and not anything else.

How did you all choose your 4th year electives?

Thanks for your advice!

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[FutureCTDoc]

Have you contemplated derm or palliative care? In derm oftentimes you can find a program with Moh's and palliative care is often, although certainly not always, cancer related. I would do some surg subspecialties as well.

 

[socaltrojan]

No one else has any thoughts on fourth year schedules?

 

[alwaysaangel]

I've been told by numerous advisors you shouldn't do a ton of stuff that you'll be taught in your residency anyway. You should do things you will never get if you don't do it now

Like traveling abroad for an elective
Research (not really as much time to do it in the future)
Peripherally related fields that you won't get much training in during residency (for example, I'm doing EM and he recommended optho, derm and peds since those are things you need in EM but don't get extensive training in)

 

[GoBuckeyes913]

Forensic Path. Hands down the coolest rotation I ever did, and I'm not even a pathologist. You actually get a visual of everything you've read about and it was a great learning rotation. . . . not to mention NO call and weekends off.

 

[ropeadope1983]

I second the suggestion about taking a dermatology elective. I would also add radiology as a rotation that should really help prepare you for a residency in internal medicine.

I also agree with another post that you should try to see some things that sound like a lot of fun that you might not get to see ever again. I also am planning on doing a forensic pathology elective because it sounds cool, even if it doesn't have as much practical cross-over with my specialty of interest. At least it will give me a really good perspective on anatomy and will be a really good exercise in problem-solving.

Lastly, I would consider taking electives that don't involve a lot of hours or a lot of stress. You will have plenty of chances to learn on the job in residency and there will be a lot less time to learn by reading. 4th year is a great opportunity to beef up your clinical knowledge by reading the clinical literature, and that will really come in handy for residency if you simply know a lot. I plan to take a lot of radiology and derm, forensic pathology, an independent study in pathology, and of course flex time. None of these rotations involve a lot of hours. I still need to do an acting internship, which will probably be a lot of hours (oh well...gotta do it). I'm planning on taking a special cardiology elective that is very light on hours and is really just designed to help improve your ECG reading skills. I'm also planning on doing about 8 weeks of basic science research in my chosen field (4 weeks will overlap my independent study, and 4 weeks will be during flex time). So my 4th year is really designed to both give me a lot of experience doing things I can't really master just by reading (radiology and dermatology), plus a lot of experience doing things that just interest me (forensic pathology, other pathology rotations, research, and certainly radiology and dermatology), and almost all of my rotations will give me plenty of time to beef up my clinical knowledge through independent reading at home. I plan to buy a student subscription to UpToDate for $195 (since I can't access it from home, which is a constant pain) and really hit it hard studying a few topics per day plus a few drugs per day.

I'm really looking forward to 4th year because the rotations will be a lot of fun, there will be no shelf exams, and because of that I can study what I want to get ready for residency and future practice.

 

[Davey Havok]

I'm going to concur with most people here, in that you should diversify to things you will use in a medicine residency but not have that much training in prior. Here's my advice:

1. Even if you're thinking "Heme-onc" right now, you have 3 years of IM ahead of you, where you will have time to do electives in that and other specialties, so I would think doing a month of it in 4th year is of only moderate utility at best, unless you plan to stay at your home institution for residency and are building relationships with the heme-onc attendings already.

2. I second the recommendation to do some research. Again, exposure to attendings, and also, you will have to do some as a fellow, and in some programs your time to graduate fellowship is related to how well you can get through the research years. I don't know your depth of research experience but as an MD/PhD trust me when I say research is almost never easy and rarely works out like an attending or PI tells you it will.

3. I also recommend path or maybe forensic path, because it's good form to have follow-up on your patients as a resident (even if that follow-up is a post), and it's been awhile since your basic anatomy and histology, not to mention all the clinical tests you'll be ordering and should have at least a basic understanding of.

4. If you're going for the other branches of medicine you'll interact with as a heme-onc doc, don't forget surgery. You could consider a month of surgical oncology if it's offered, in addition to radiation oncology. Dermatology is also a good suggestion to round out your skillset with some useful information.

My $0.02, good luck!

 

[IM Substance P]

I'm going to concur with most people here, in that you should diversify to things you will use in a medicine residency but not have that much training in prior. Here's my advice:

1. Even if you're thinking "Heme-onc" right now, you have 3 years of IM ahead of you, where you will have time to do electives in that and other specialties, so I would think doing a month of it in 4th year is of only moderate utility at best, unless you plan to stay at your home institution for residency and are building relationships with the heme-onc attendings already.

2. I second the recommendation to do some research. Again, exposure to attendings, and also, you will have to do some as a fellow, and in some programs your time to graduate fellowship is related to how well you can get through the research years. I don't know your depth of research experience but as an MD/PhD trust me when I say research is almost never easy and rarely works out like an attending or PI tells you it will.

3. I also recommend path or maybe forensic path, because it's good form to have follow-up on your patients as a resident (even if that follow-up is a post), and it's been awhile since your basic anatomy and histology, not to mention all the clinical tests you'll be ordering and should have at least a basic understanding of.

4. If you're going for the other branches of medicine you'll interact with as a heme-onc doc, don't forget surgery. You could consider a month of surgical oncology if it's offered, in addition to radiation oncology. Dermatology is also a good suggestion to round out your skillset with some useful information.

My $0.02, good luck!

Great advice. I would recommend doing the easiest rotations possible that will diversify your education.

Some examples include a pathology rotation, dermatology, radiology, outpatient gynecology, outpatient pediatrics specialties, and an easy surgery rotation.

Most of these will have no weekends, no call, and normal office hours.