Best 4th year elective for peds?

[docbee18]

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MS4 here! I was recently offered an elective at a program I'm interested in, and was given the choice between peds endocrine, pulm, and GI.

I'd honestly be interested in doing any of those...Can anyone recommend one in particular that would be most useful for someone going into peds?

 

[mvenus929]

Depends on your goals. In Pulm, you'll see CF, asthma, and BPD, the latter two of which you will see plenty of during residency and in a general peds practice. In GI, you'll see lots and lots of constipation, plus some inflammatory bowel disease and short gut, plus some intermittent biliary atresia, fatty liver, etc. In Endo, you'll see a lot of diabetes, but will also see short stature, hypo- and hyper-thyroidism, septo-optic dysplasia, Turner's syndrome, precocious and delayed puberty, etc. You'll likely see more variety of pathology in Endo, but how much you see will depend on how big your center is.

I'm biased, but I think you'll get more out of an endo rotation than anything else if you are going into gen peds, just because growth is such a huge thing in pediatrics, and endo gets a good number of growth problems referred. Also, some adolescent medicine, not only with the kids with diabetes, but also all the puberty problems. But whether you'll get more out of it as an MS4 or as a resident, it's hard to say.

 

[Staphylococcus Aureus]

I'd like to expand the question, what are the best 4th year electives for peds in general? And, if you have a cap of electives in one specialty, what are some good non-peds electives that would be most helpful for peds?

 

[mvenus929]

I'd like to expand the question, what are the best 4th year electives for peds in general? And, if you have a cap of electives in one specialty, what are some good non-peds electives that would be most helpful for peds?

You will get a lot of exposure to electives and specialties in residency, so it's difficult to say what you should take in Med school vs waiting. If you have a particular interest now, take that elective so you can start to figure out if you really like it. If your clerkship didn't have a good nursery rotation where you had to run numbers of how much intake and calories level 2 babies took in, then level 2 or NICU is a good rotation to get your feet wet, so it's not so terrifying in intern year.

Helpful non-Peds electives for the budding pediatrician include dermatology, radiology, and anesthesia if you get the opportunity to do procedures. Then look to see what you might not be able to do again. My school has a non-operative Peds Ortho rotation, which was very useful. We also had a camp elective. Doing a global health rotation is good if you can fit it into your schedule and can get funding help with it. Refugee medicine is also useful, if your school offers something of that variety.

 

[zafonte86]

Endo is the worst. Do a rotation where you will get the opportunity to do procedures and have a little action. Things that come to mind are peds EM, Nicu, newborn nursery, Picu. At my home institution students are given a lot of opportunities in the ER and Nicu. If you have to choose between Endo, pulm and GI I would choose between pulm and GI. Asthma and abdominal pain are two common complaint ever pediatrician sees. Endo for me was all diabetes and growth hormone deficiency with a few zebras (all dka go to the picu). Definitely do a rotation at a place you are interested. Getting face time can really help your application. Best of luck!

 

[Mountaineer12]

I'd like to expand the question, what are the best 4th year electives for peds in general? And, if you have a cap of electives in one specialty, what are some good non-peds electives that would be most helpful for peds?

I haven't started intern year yet, but I think Sports Medicine will have been helpful. It was pediatric specific, but I saw plenty of kids and having a better feel for the MSK exam (usually a weak point, especially for MDs) and concussion guidelines was a good use of time.

I also second a global rotation as someone else mentioned. If offered at your school and feasible financially, definitely do it! I went to Guatemala this past winter and it was amazing. Very high volume, focused on basic physical exam and history taking skills, and really rewarding (and fun!) experience!

Otherwise, radiology seems to be popular if it's good at your school. I've heard of people doing peds surgery or ENT to get around the peds limit.

For peds, I found peds GI and peds ED to be awesome rotations. Especially ED, lots of learning how to properly assess patients and determine who needs what treatments versus someone with the same CC. Some procedures, too. Peds ID was okay, but nothing earth shattering. I did a two week outpatient peds rotation and loved it. I think it will help a lot when clinic starts. Peds cards was pretty good as well. I wish I had done NICU. I did PICU instead since residents said I wouldn't get to do anything in NICU, but now I'm terrified for intern year. I also may have tried to squeeze in peds Heme/Onc, but otherwise just pick what interests you and you can't go wrong!


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[oldbearprofessor]

As the wide range of previous answers suggests, there is no one clear answer to any of this as it really depends 1) what your interests lean towards and 2) how hard you want to work in MS4. Classically, good electives are ID and GI as these services do consults everywhere in a pedi hospital so you see a lot. NICU/PICU/cards are great if you have a real possible interest in these. If you're interested in a bit of an easier time during interview season then derm, rads or anesthesia may be the answer depending on how they are set up.

 

[NurWollen]

What about for an incoming PGY-1/PL-1? My program allows a few electives first year and has asked me to pick them. I'm not sure if I want to do a fellowship or not and if I do I'm not sure what it would be. Should I approach 1st year electives with an eye towards helpful skills for general peds? If so, do you have suggestions? Or shoulf I choose thwm with an eye towards exploring subspecialties I might be interested in?

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[Ismet]

What about for an incoming PGY-1/PL-1? My program allows a few electives first year and has asked me to pick them. I'm not sure if I want to do a fellowship or not and if I do I'm not sure what it would be. Should I approach 1st year electives with an eye towards helpful skills for general peds? If so, do you have suggestions? Or shoulf I choose thwm with an eye towards exploring subspecialties I might be interested in?

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I specifically picked 1 of my intern electives for a sub-specialty I was interested in, so I could get a better idea if I actually wanted to pursue it. The other one I left up to the chiefs and it turned out well. I'd save the lighter electives like derm, sports med, etc until 2nd or 3rd year. Nephrology is a good elective to do, if you have good attendings who like to teach, you'll learn a ton. ID and GI are also great for an intern.

 

[Perrotfish]

I'd like to expand the question, what are the best 4th year electives for peds in general? And, if you have a cap of electives in one specialty, what are some good non-peds electives that would be most helpful for peds?

I strongly recommend both a NICU and a non-NICU sub-I. If you know the basics of both wards and NICU odds are you won't end up under the microscope during Intern year. Other than that I think a 'good' elective is whatever is good at your school. Odds are there is a service or two at your hospital well known for great teaching. Whichever service that is, do that.

 

[Dr. Immune]

I'd like to expand the question, what are the best 4th year electives for peds in general? And, if you have a cap of electives in one specialty, what are some good non-peds electives that would be most helpful for peds?

I did several peds electives during my 4th year. I think PICU was a great option and one of my favorites. As a peds resident, you don't spend time in the PICU until 2nd and 3rd year, so it's a great way to get some exposure to that area and may help during your application. I also really enjoyed Heme/Onc and ID. All very different areas of pediatrics

 

[Dr. Immune]

I strongly recommend both a NICU and a non-NICU sub-I. If you know the basics of both wards and NICU odds are you won't end up under the microscope during Intern year. Other than that I think a 'good' elective is whatever is good at your school. Odds are there is a service or two at your hospital well known for great teaching. Whichever service that is, do that.

I second this! Great advice

 

[dextor2003]

Also a 4th year student here. I had an empty slot and chose Allergy/Immunology cause I've always been interested in it and because I plan to pursue peds ID. But I could've chosen NICU. I'll be doing PICU later in the year also. Should I switch from Allergy/Immuno to NICU if it'll help me come intern year?

 

[Dr. Immune]

Also a 4th year student here. I had an empty slot and chose Allergy/Immunology cause I've always been interested in it and because I plan to pursue peds ID. But I could've chosen NICU. I'll be doing PICU later in the year also. Should I switch from Allergy/Immuno to NICU if it'll help me come intern year?

Personally, I would go with an elective that I was interested in over one that may help in the future. NICU is a great choice as a 4th year, however, if you're not interested in it, you'll get more than enough exposure during residency. Places generally like to see that you've done an ICU rotation and you have one of those set up, so that's great

 

[dextor2003]

Personally, I would go with an elective that I was interested in over one that may help in the future. NICU is a great choice as a 4th year, however, if you're not interested in it, you'll get more than enough exposure during residency. Places generally like to see that you've done an ICU rotation and you have one of those set up, so that's great

Sounds good, I'll stick with Allergy then. Thank you so much for the input!

 

[zafonte86]

Nothing will prepare a resident for NICU. Do a fun elective. Responsibility gets real after 4th year!

 

[oldbearprofessor]

Nothing will prepare a resident for NICU. Do a fun elective. Responsibility gets real after 4th year!

Why do you say that? In a good NICU sub-I/elective, the 4th year student has 2-3 patients that represent the NICU population, does all the calculations on them and gets to assist in the procedures if possible. How would that not be preparation for what an intern does in the NICU? It's not as many patients, don't stay all night (do this year's?), but an elective is to teach the skills needed such as fluid calculations and the disease processes. Do interns have that much more responsibility without supervision in most teaching hospitals which have a fellow and/or attending in house 24/7?

 

[zafonte86]

Why do you say that? In a good NICU sub-I/elective, the 4th year student has 2-3 patients that represent the NICU population, does all the calculations on them and gets to assist in the procedures if possible. How would that not be preparation for what an intern does in the NICU? It's not as many patients, don't stay all night (do this year's?), but an elective is to teach the skills needed such as fluid calculations and the disease processes. Do interns have that much more responsibility without supervision in most teaching hospitals which have a fellow and/or attending in house 24/7?

I wasn't making the statement to argue however more as a joke. However NICU is an odd field. The research and literature is always changing. Some things you do in the NICU Is based more off experience and where you trained verses a book. My real point was that a month of NICU as a student isn't going to be a game changer in you doing it as a resident. I did NICU as a student at my current location and after the month I was still confused on how to calculate TPNs and although I did get some cool procedures you aren't given the same responsibilities or opportunities as a resident. You should do NICU rotation because you want to work with newborns. No need to get a leg up on residency. They expect interns to come In July knowing nothing.