Best Sub-I and Ward Rotation for EM

[strongboy2005]

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At my school for 4th year we are required to do a 4 week sub-I and 4 week ICU rotation. These are our choices:

Sub-I: Medicine, Pediatrics, Family, or Surgery
ICU: Medicine, Pediatrics, or Surgery

Which of these would prepare me the best for an EM residency? I must choose one sub-I and one ICU experience from the list above.

I made the poll multiple choice in case you think more than one answer would work. Feel free to make several picks if you think there is more than one good choice.

Also, as a side question, these are the electives I have planned: EM (1 home, 1 away, total 8 wks), Pediatric EM (2 wks), Anesthesiology (4 wks), IM-ECG/Cardiology (2 wks), Radiology-Neuroradiology (2 wks), Radiology-Body CT (2 wks). Any suggestions for other electives and, if so, which of the above would you replace?

 

[pseudoknot]

Whatever gives you the most autonomy and best teaching. I don't know anything about these things at your school, so I'm not voting in the poll.

Your electives would all be useful for EM, although I'd be concerned that the radiology rotations may involve mostly shadowing.

Ophtho and derm are two things you'll see frequently in the ED, but probably won't rotate through in residency. I kind of wish I'd done those as an M4, but don't stress over specific choices too much.

 

[gro2001]

As above, too much depends on how good a learning experience these services are at your medical school.

All else being equal I think high yield learning will be:

1) medicine sub i = surg sub i = peds sub i > family med sub i

2) icus probably all equal, with surg and medicine being slightly higher yild.

Although, most people are relatively weak in peds, so maybe making this a strength by doing sub i and/or icu month in peds could be worth it (if you like peds).

Electives (with same disclaimer as above) I found high yield were:
1) Anesthesia. Try to learn to bag really well and start IVs.
2) Radiology.
3) Ortho
4) Ultrasound
5) Trauma

But really electives should be chosen with the goal of making 4th year the sweetest experience possible.

 

[turkeyjerky]

I would avoid the surgery sub-I, since there might be some expectation that you go (or at least want/try to go) to the OR. Peds sub-I and PICU, I would also avoid since there's such a high proportion of weird peds people. Thus, medicine sub-I is probably your best bet. I don't know what's involved with a family med sub-I, so I can't comment on it, but I would assume it's not as useful as medicine, and I doubt you'd get as good teaching as on medicine.

For ICU, I would go medicine or surgery. Talk to people to see which is better, priority being on not crazy hours, procedures and good teaching. I also would favor a closed unit over open.

Your electives sound pretty good, although I wouldn't take so much radiology. Ideally, rads would be 1-2 weeks of plain films. Avoid CT, MRI and neurorads (head CT is good, but not useful sitting through a bunch of crap for). Also make sure that rads is cush at your school, at my rotation we were expected to be there from 7:30 to 4 every day (the coordinator would check up on us--crazy I know). I think ortho or sports med would be useful too, but again avoid a rotation where your in the OR (or on floors) all the time. I've also heard optho rotations are useful, but I haven't taken mine yet and can't speak to that.