Best sugue from MSIV to internship?


1K Member
15+ Year Member
Nov 7, 2000
Avon, Ohio
  1. Attending Physician
It seems, at least at my school, there's a tremendous amount of leeway in how we spend the latter half of our 4th year. In fact, I have almost 6 months of uninterrupted elective time prior to graduation.

Now, it seems to me that the best way to prepare to be a new intern would be to schedule nothing but hospital-based IM rotations during those last few months. However, I see a lot of 4th-years taking a ton of cushy electives, most of which seem to impart very little carry-over value to the role of being a house officer, e.g. I don't see how outpatient derm, rheum, pain mgmt, etc. rotations is going to help prepare you for your first month as an intern (at least not nearly as much as doing more medicine rotations would).

Is my thinking here flawed? At first, my thinking was that your MSIV elective time should be spent getting exposure to different specialties, but now I'm questioning that thinking. I'm curious to hear the thoughts of some of the residents on this forum. Thanks.

Winged Scapula

Staff member
Volunteer Staff
Apr 9, 2000
  1. Attending Physician
Have to agree with C above. While you may learn something during your 4th year rotations, even as an AI your role and expectations are so different as an intern that I'm not sure it will make a significant difference. What will is showing up well rested with a good attitude after a few weeks/months of easier rotations and vacations.

That being said, I wish I had taken Derm after seeing so many rashes and not being really comfortable with them.
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Jul 21, 2003
Our school also pushes you very hard to do IM rotations and subspecialties outside of cores, even if you have little or no interest in these areas. They say it makes you a more well-rounded candidate, but I disagree, and plan to fight it when the time comes.
Hi there,
I am going to agree with Dr. Cox and C. Take the rest of your fourth year and enjoy every scrap of vacation time that you can muster. Your learning curve is going to be so steep during your first couple of months of intership that you don't need to attempt to supersaturate yourself at the end of fourth year.

Elective time is just for electives. You can take things that you want to know more about and will never do or you can take cushy things that give you the max time off. (Radiology fills both of these characteristics unless you are going in to Rads).

To those who have matched, have a good time and start looking at finding a good place to live in your new locations. The time goes by so fast.


beyond all hope

Senior Member
7+ Year Member
15+ Year Member
Dec 18, 2003
Residency is a long haul. Give yourself a well-deserved break. Do easy rotations in fun locations, take up hobbies, spend time with your significant other.

You have THE REST OF YOUR LIFE to learn medicine, but very few chances in the near future to really kick back.
There are generally 3 categories of rotations you can take in fourth year (or so I'm told):

(1) Rotations that you need for your chosen field
(2) Rotations to improve your weaknesses
(3) Rotations to give you exposure to fields you'll never see again (e.g., for me, derm, rads, etc.)


Full Member
10+ Year Member
15+ Year Member
Jan 9, 2003
Kansas City, MO
  1. Attending Physician
I agree with the above. Do anything you want 4th year it is your time off. I took a couple specialty electives, some to improve my weaknesses, and plenty just because I wanted to. I also did an elective in Costa rica, great stories, great people, great beer what more can you say. Those are the experiences that have gotten me through intern year relatively happy. Right now I'm in Thailand for my 2 week vacation, the beer here is very cheap as well and the whiskey is even better.

my 2 cents
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