Am I screwed that my 3rd year surgery site doesn't offer elective in specialty I'm interested in?

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cybermed2424

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Basically the site I will be doing surgery at doesn't offer a neurosurg elective, and is not able to set one up for me. Will I be at a significant disadvantage going into fourth year without any experience essentially?
 
Yes I plan to. My concern is looking bad compared to my peers who have already completed a rotation and getting poor reviews as a result.

You should be fine as long as you do well on the aways and get good letters.
 
Are you saying your home school doesn't have a neurosurgery department/sub-i? Or just that you won't have any exposure to it before then?

Either way you will probably be fine (unless DO), but not having a home department in small, competitive specialties is a significant disadvantage.
 
I do have a home program and am MD. My school has us rotate at several different hospitals, and for my surgery rotation I am a hospital that doesn't have a neurosurgery as an elective unfortunately.
 
It is a disadvantage because you are trying to base your career for the rest of your life on something you have no real exposure to. Specialty choice is a decision you don’t want to take lightly.

If your school has a 1.5 year preclinical curriculum, you will have time to do neurosurgery aways and change your mind if you don’t like it. Otherwise, it’s a blind leap of faith.

People overcome the disadvantage of not having a home program by doing extra aways, but you need to make sure you make an informed decision about your specialty choice

I agree, this is what is so concerning to me.
 
It is a disadvantage because you are trying to base your career for the rest of your life on something you have no real exposure to. Specialty choice is a decision you don’t want to take lightly.

If your school has a 1.5 year preclinical curriculum, you will have time to do neurosurgery aways and change your mind if you don’t like it. Otherwise, it’s a blind leap of faith.

People overcome the disadvantage of not having a home program by doing extra aways, but you need to make sure you make an informed decision about your specialty choice

OP has a home program, they just won't be able to do an elective in it during third year. They can do their home sub-i + aways and be fine.
 
I do have a home program and am MD. My school has us rotate at several different hospitals, and for my surgery rotation I am a hospital that doesn't have a neurosurgery as an elective unfortunately.
This is not a problem, just schedule your home sub-i as early as possible in your 4th year and figure out whether you like it. If you're applying this year I suspect the away rotation landscape will be completely blown up by coronavirus but you need to at least start the process as if everything will proceed as normal.
 
Currently just a 2nd year so hopefully that will be blown over by then. Thanks for the advice everyone.
 
Currently just a 2nd year so hopefully that will be blown over by then. Thanks for the advice everyone.
I imagine you will be fine. Now is the time to shadow, get involved in research, and meet people in the department. Things will happen quickly once you get into your clinical year.
 
Do not go gentle into this good night...

I would raise a moderate stink about this if it happened to me. It's not the end of the world, but it's pretty significantly sub-optimal. You need exposure to see if you even like the specialty, it's good to build relationships early with the nsurg department at your home program so they can write letters and go to bat for you, and having that experience will be helpful so you don't suck on your sub-i and away rotations.

Talk to other students and see if anyone is willing to switch sites/rotations with you. Contact the rotation director with these concerns. Talk to whoever is in charge of the NSurg rotation at the hospital to see if they can squeeze you in. Talk to the head of the department if you already have a relationship and see if they can pull some strings for you. If you've been doing NSurg research, reach out to an attending you've worked with.

If you yourself just ask some random administration troll for help they will likely say sorry, sucks to be you. But it often turns out that there is wiggle room with these things if you get the right people involved.
 
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Do not go gentle into this good night...

I would raise a moderate stink about this if it happened to me. It's not the end of the world, but it's pretty significantly sub-optimal. You need exposure to see if you even like the specialty, it's good to build relationships early with the nsurg department at your home program so they can write letters and go to bat for you, and having that experience will be helpful so you don't suck on your sub-i and away rotations.

Talk to other students and see if anyone is willing to switch sites/rotations with you. Contact the rotation director with these concerns. Talk to whoever is in charge of the NSurg rotation at the hospital to see if they can squeeze you in. Talk to the head of the department if you already have a relationship and see if they can pull some strings for you. If you've been doing NSurg research, reach out to an attending you've worked with.

If you yourself just ask some random administration troll for help they will likely say sorry, sucks to be you. But it often turns out that there is wiggle room with these things if you get the right people involved.


This is something I'm working on. I've already gotten the initial "no we can't help you" from admin. So I'm going to try to circumvent them now.

I'm not entirely familiar with how 4th year works, but would it be possible to set up a sort of throw away elective rotation at a site I'm not interested in to gain experience before rotating at my home site and other programs I may be interested in?
 
Its going to be fine. You should reach out to the program to see if you can get on some research now. You should be doing research, trying to go to their didactics if you are still an m2.
It literally will not matter, because if your clinical rotations would not let you rotate with them during your surgery rotation, its not like you would be able to build relationships with the department anyway.

You should have some electives during Y3 rotate with them during that time.


Somethings and skills you can pick up on even without rotating there

-single handed ties- this is the tie of choice for neurosurgeons at the institutions i have rotated with . Have this down, comitted to muscle memory, most of this work will happen outside the rotation anyway.

-Anatomy
-Neurorads
-Neuroexam


In reality you will have no skills that will wow them either way, You are an m3/m4 you will be expected to show interest, put in long hours, know somethign about the procedures/anatomy, and basically be a person they would want to be around for 7 years. No amount of extra exposure will give you that information other than doing well on all your cores and genuinely being a reasonable human being.

If you are still gung ho you should try to shadow during your time off in m3.


And most of all ACE YOUR STEP ONE.
 
Its going to be fine. You should reach out to the program to see if you can get on some research now. You should be doing research, trying to go to their didactics if you are still an m2.
It literally will not matter, because if your clinical rotations would not let you rotate with them during your surgery rotation, its not like you would be able to build relationships with the department anyway.

You should have some electives during Y3 rotate with them during that time.


Somethings and skills you can pick up on even without rotating there

-single handed ties- this is the tie of choice for neurosurgeons at the institutions i have rotated with . Have this down, comitted to muscle memory, most of this work will happen outside the rotation anyway.

-Anatomy
-Neurorads
-Neuroexam


In reality you will have no skills that will wow them either way, You are an m3/m4 you will be expected to show interest, put in long hours, know somethign about the procedures/anatomy, and basically be a person they would want to be around for 7 years. No amount of extra exposure will give you that information other than doing well on all your cores and genuinely being a reasonable human being.

If you are still gung ho you should try to shadow during your time off in m3.


And most of all ACE YOUR STEP ONE.
This is all solid advice. It's a field that people are taught exactly nothing about in med school, so the expectations of a fresh sub-i are minimal. It's not like medicine or obgyn where you would be expected to have a pretty strong fund of specialty-specific knowledge on day 1. You should know the names of the cranial nerves and what each one does (really, what happens when each one goes down). You should know that the right side of the brain controls the left side of the body and vice versa. You should have some idea of how the cerebral vasculature is arranged and ideally be able to name the different parts of a vertebra. That's about it—anything else is gravy. Most places are very supportive of their home students and try to teach them something so they look good on their aways.
 
All great advice, thanks guys. I have a great research mentor at a neighboring institution (albeit, realistically, out of my league) who is really preparing me well on the academic end of things.
 
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