Best sequence for 3rd and 4th year rotations

[falabra]

Hi guys,

It's time to choose the sequence for our required 3rd year rotations and I was wondering if anyone has any tips regarding the order in which I should take them. (FM, Ped, Sx, Psych/Neuro, Ob/Gyn, Med Selective are the required ones for 3rd year).

Some have mentioned that you don't want to take Ped right off the bat if that's what you're planning on doing since you may get low marks just for the fact that you don't have experience on the floors.

Any advice is greatly appreciated! Thanks!

---

Members don't see this ad.

 

[helvetica]

I've been told to do the specialty you want sort of in the middle/third quarter of your third year. So if I were you and planning, I would probably do:

Fam, Surg, OB/GYN, Medicine, Peds, Psych/Neuro

I did IM first for my rotations and I'm glad I did, because it was a solid foundation for everything else. However, it would have been nice to have it towards the end of M3 year too because I feel like you are better prepared for Step 2. I would try to have either medicine or surgery before peds, because they are both heavily medicine based and get you in the habit of rotations.

Honestly though, I'm not sure how much your schedule REALLY matters. I would say as long as you don't have peds first, you'll probably adapt pretty quickly and be a stellar student after the first two weeks or so. Even though I had IM first, I did really well in it (after a bumpy first week)!

 

[Siverhideo1985]

Rest assured that no matter what your track comes out to be...in the end it won't matter that much. 2nd year everyone is freaking out about it and there are good arguments to make for every permutation of rotation orders. Sure, put peds in the middle somewhere, but beware that getting the 'good site' (if there are multiple for these rotations) can be much more important than when you take it.

From my own experience and those of my friends I can tell you that order of rotation schedule probably had the least to do with how well we did, followed by getting the "good/nice" rotation spots. About 75% of all this is the sheer luck of ending up with residents/attendings that you click with and that will give you a good clinical grade & letters. Then it won't matter if you take it in July of 3rd year or March.

 

[oldbearprofessor]

There are as many opinions on this as there are people in the business....

My view is that those interested in pedi should do medicine (or surgery, if they can't get medicine) first to get the best "background" into how the system of MS3 works, etc.

Then, if possible do OB/Gyn, and then pediatrics. Don't wait too long for pedi as some places will not let you schedule pedi electives or outside rotations until you've completed the core.

Also, doing the core pedi rotation relatively early (but not first), is a good way to be sure that you really want to do this as well as starting to meet faculty who can serve as mentors.

Of course, as I said, everyone has a different view on this and it does depend to some degree on how the med school and its rotations are set up.

 

[GoSpursGo]

I would echo what OBP is saying. Personally, I had both surgery and IM before peds; my IM shelf score went up my surgery score, and then my peds shelf went even more. In a lot of ways, I feel like those three shelves cover a lot of the same material with different emphases, so I felt better prepared when it came time to study for the peds shelf because a lot of it was stuff that I'd already studied for on other rotations. If possible, I would definitely try and get at least one of those rotations before peds.

Regarding "saving" IM for later to do better on Step 2... honestly, I took Step 2 about a year after I finished IM and still improved from my Step 1 score. I don't think it's THAT big of a deal because, again, several of your other shelves throughout the year will reinforce a lot of what you learned on IM anyways.

That said, at the end of the day you're at the mercy of your registrar; plenty of my classmates wound up with peds first, and they still did fine. So don't stress if you don't get exactly what you want

 

[nogolfinsnow]

I was debating IM vs. Peds, ended up with IM first and peds 4th as rotations. I think IM early does a nice job of getting you ready for the rest of 3rd year, so by the time peds rolled around I had a little bit of clinical knowledge plus a good idea of how being a 3rd year worked. Don't worry about having IM far before step II; every rotation will have a large medicine component. I had surgery last, and actually found that to be a great review (in terms of studying for the shelf) of the entire year because the surgery shelf doesn't care at all about surgery itself, but about how to manage surgical patients, who span all age groups and are sometimes pregnant!

 

[justdoit31]

I would agree with OBP- I had IM first and while it was a lil tough on wards the first days I felt like it was a good place to dive in especially since I knew I hated IM (was 99% on Peds and contemplated FM briefly). I felt that ending with FM was also a great choice as I could study widely for my shelf which also was solid prep for Step 2 CK.

I think the scheduling for 4th year is easier. Try to schedule your Sub-I and ICU months (if required) earlier but not during Nov-Jan (interview season- this is when easy things or cool faculty are best). Also if you want to do aways most do them in the fall. I did aways and had to do my Sub-I and NICU months in spring since my school required them to be at home for those credit categories- not having them did not affect my interviews and I went on 12 interviews without being asked about any specific 4th year rotations.

 

[Slade]

I did Peds 3 months into my 3rd year. It was way too early for one reason: letters. At my school, peds is very popular and you get assigned a month for your AI without much chance to change it. I couldn't ask for letters from my attendings in peds since it was so long ago and my AI was in September... pretty late for letters!!
In the end I managed to get letters from other non-peds rotations, with a late one after my AI, and it all worked out but it was a lot of stress! I would recommend doing peds much later into your third year (as late as you can while still in time to schedule peds electives if you want). Note that this depends on how sure you are that you want to do peds. If there are doubts, definitely take the time to explore specialties.
Anyways, my 2 cents. Good luck with scheduling

 

[GoSpursGo]

I wouldn't necessarily sweat it if you have your core "early." I had peds in Nov-Dec of 3rd year, and at the end of the rotation I just asked one of my attendings if they would be willing to write me a letter. They said yes and to just remind them in June. I know some in my class who had it even earlier and did the same thing. So I think you CAN get letters from your peds core even if it's early, just be proactive about asking for the letter; if you ask 6-8 months after the fact, then yes, you'll probably run into a problem with them remembering who you are.

 

[falabra]

Thanks so much for all your replies. That helps me a lot. I appreciate it!

 

[physicsnerd42]

Peds was my second rotation of third year and two attendings agreed to write me letters from that rotation (one inpatient, one outpatient). Just ask for the letters reasonably close to when you do the rotation so that they remember you and you'll be fine.

Doing peds early also helped me decide on peds early, which has helped me with planning my sub-I and fourth year rotations.