Choosing order of rotations+class rank?

[didimao]

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Hi everyone, I tried doing a search on this but could not find any information on this. Does anyone know if choosing the order of clinical rotations will affect grades/class ranking?? For example, Internal Med and Surgery at my school are worth a lot more credits than other rotations. Wouldn't it be safe to assume that those who take Internal Med later throughout the year will perform better? Also would class ranking be determined based on a raw score or national percentile on the shelf exams?

I most likely will go into internal med/surgery and my main concern is that I definitely don't want to jeopardize my grades for these rotations just because I took them earlier. Thanks for all the help!

 

[redpanda]

Hi everyone, I tried doing a search on this but could not find any information on this. Does anyone know if choosing the order of clinical rotations will affect grades/class ranking?? For example, Internal Med and Surgery at my school are worth a lot more credits than other rotations. Wouldn't it be safe to assume that those who take Internal Med later throughout the year will perform better? Also would class ranking be determined based on a raw score or national percentile on the shelf exams?

I most likely will go into internal med/surgery and my main concern is that I definitely don't want to jeopardize my grades for these rotations just because I took them earlier. Thanks for all the help!

It might, but not everyone can take medicine or surgery early. Don't worry too hard about the order of rotations.

 

[didimao]

Ah ok, so with a good lottery number, would you suggest against choosing medicine and surgery early?

 

[Jabbed]

Family medicine as late as possible is the only pearl that's been passed down to me with regards to the order of your third year rotations.

 

[operaman]

I seriously doubt it would affect your class rank either way. I'm almost positive they will use scaled scores since the NBME does not report raw scores to the school unless they have made some kind of special arrangement (per their website).

I did surgery and medicine first, in that order, and had no problem with either. If I had to do it again, I would probably flip them and do IM first, but I don't think it made that much difference. If you do the big ones first, the rest of the year is cake.

 

[Ismet]

Ah ok, so with a good lottery number, would you suggest against choosing medicine and surgery early?

There are pros and cons to both early and later. I'm doing medicine now and surgery next, so I've already had ~6 months to "learn the ropes" of 3rd year. Also the interns at this point are pretty comfortable and knowledgeable with how things are run. I'm not going into IM or surgery so the order didn't really matter to me, but knowing now how I was functioning at the beginning of 3rd year, I would have been doing a lot worse in IM had I started with it. I guess a "con" is that the resident/attending knows that you are halfway through 3rd year and thus have higher expectations of you, but if you continue to learn and improve throughout 3rd year, you should rise to the expectation. But also it's winter and cold and dark all the time. Bleh.

Some of the pros of starting with med and/or surg is that you're fresh off Step 1 with all that knowledge in your head and you're raring to go. If you start 3rd year in May/June like my school does, your interns are at the very end of their intern year and thus are quite comfortable and you'll learn a lot. If you start in July, you're starting with brand new interns who are learning the ropes and might not have as much time for you or you won't get as much experience (like in surgery). Also the rest of the year is usually easier compared to med/surg.

Everyone says to do medicine before surgery, because the surgery shelf is pretty much all medicine. So there's that. I won't have my own opinion on that until April.

The IM shelf is its own beast. I think having other rotations before it can help you with your evals, but you're going to have to put in the time to study for the shelf whether you do it first or last.

Absolutely agree with @Jabbed and taking FM near the end of everything. FM shelf = IM, Peds, and Ob/gyn plus a smattering peri-operative and psych things, and the shelf is ridiculous if you haven't had some/all of those rotations. Darn thing cost me honors.

 

[Psai]

The only thing that matters is not having inpatient last. Which has happened to me almost every time, barely missed honors in im

 

[notbobtrustme]

it doesn't matter. First rotation has lowered expectations. Every rotation has increased expectations even if they aren't related. If you had OB, then psych, then IM, you would have higher expectations on IM despite not learning much medicine on OB/Psych.

Just do w/e you want and don't stress it. Put your best foot forward, get lots of feedback and sweat the stuff that matters (eg sites that are easy graders, sites that let you study for the shelf).

 

[JJMrK]

it doesn't matter. First rotation has lowered expectations. Every rotation has increased expectations even if they aren't related. If you had OB, then psych, then IM, you would have higher expectations on IM despite not learning much medicine on OB/Psych.

Just do w/e you want and don't stress it. Put your best foot forward, get lots of feedback and sweat the stuff that matters (eg sites that are easy graders, sites that let you study for the shelf).

I agree. Have said many times that it doesn't really matter. Sub-I's 4th year are the time to impress. For now, just learn as much as you can about everything, and study whenever you can for the shelf exam. At least at my school, the shelf was often the main reason people missed honoring a rotation.

 

[qw098]

Family medicine as late as possible is the only pearl that's been passed down to me with regards to the order of your third year rotations.

why?

 

[Jabbed]

why?

FM shelf = IM, Peds, and Ob/gyn plus a smattering peri-operative and psych things, and the shelf is ridiculous if you haven't had some/all of those rotations. Darn thing cost me honors.

 

[ChEMD]

Hi everyone, I tried doing a search on this but could not find any information on this. Does anyone know if choosing the order of clinical rotations will affect grades/class ranking?? For example, Internal Med and Surgery at my school are worth a lot more credits than other rotations. Wouldn't it be safe to assume that those who take Internal Med later throughout the year will perform better? Also would class ranking be determined based on a raw score or national percentile on the shelf exams?

I most likely will go into internal med/surgery and my main concern is that I definitely don't want to jeopardize my grades for these rotations just because I took them earlier. Thanks for all the help!

Aren't the number of credits dependent on the length of the rotation? If that's the case, it shouldn't mathematically make any difference.

 

[Serous Demilune]

The only thing that matters is not having inpatient last. Which has happened to me almost every time, barely missed honors in im

Can you expand on this?

 

[FIREitUP]

I agree. Have said many times that it doesn't really matter. Sub-I's 4th year are the time to impress. For now, just learn as much as you can about everything, and study whenever you can for the shelf exam. At least at my school, the shelf was often the main reason people missed honoring a rotation.

I'm going to have to disagree. I think if you take IM and then surgery as your first rotations you accomplish a few things. First, your residual knowledge from Step 1 helps you destroy the IM shelf. Second, IM is where you learn how to properly interview patients and present them to attendings, this is crucial for the other rotations. Third, the surgery shelf is basically IM, so after preparing for your IM shelf you really don't have to study much for your surgery shelf.

 

[Rocher]

I had peds/IM/surg as my last three rotations, and thought that set me up well for Step 2. I didn't really have a choice, but if I could've chosen I would've put peds/IM/surg/easy specialty so that studying for Step 2 didn't feel so crammed. The order probably doesn't matter that much in the end, though.

 

[Psai]

Can you expand on this?

You get the most effective studying done closer to the exam date. Inpatient has the worst hours. Get up early, leave late, have more to do. In general. Not very conducive to studying

 

[Ismet]

You get the most effective studying done closer to the exam date. Inpatient has the worst hours. Get up early, leave late, have more to do. In general. Not very conducive to studying

Our inpatient rotations are completely inpatient. Agreed that 12 hour days 6 days a week is not conducive to studying. Currently feeling that pain.