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MansionMD

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MansionMD said:
How did you guys choose the order of your rotations in clerkship?

We have 6 core rotations:
Pediatrics
Obs/Gyn
Surgery
Family Medicine
Internal Medicine
Psychiatry

Which rotations did you find would have been better after finishing something else? Any tips on choosing a rotation order much appreciated :)
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Don't do what you want first. You're going to suck coming out of 2nd year. Fam med is a good gradual intro if you're one of those people that doesn't want to jump straight into the pool. If you'd rather just dive in, then go for IM.
 
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MansionMD said:
Can you explain? Lets say I want to do surgery, and I'm really weak at internal medicine, how would you choose the order?
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If you want to do Surgery, you should plan to do your Surgery clerkship in December/January. First, you will have several rotations before surgery, so your fund of knowledge will be reasonable for the wards. Second, you will have taken a couple of shelves already, so you will know what they are all about. It is ideal to have IM before Surgery. For the obvious shelf reasons at a minimum, but also basic patient management and care. You don't want to do Surgery too late for a couple of reasons. You want to know by mid-year if you are still interested in Surgery, or if you need to start looking for something else to go into, last thing you want is June to roll around and you still are undecided. Also, you want to be able to get a feel for your surgery department, meet faculty etc. before setting up your fourth year schedule.
 
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I'm not interested in Surgery, but I was told the following about Surgery.

Surgery after christmas, OB/GYN immediately before christmas. OB/GYN gives you some experience in an OR and you won't be a complete noob.

I am not interested in surgery (but still ended up with essentially that schedule). I have IM first (which is likely one of the things I would consider going into) and am partially worried about how I'm going to do on the shelf.

However, it is nice to have IM first because you get a pretty wide knowledge base that subsequent shelves (incl. surg and fam med + step 2) will be primarily based off of.
 
evilbooyaa said:
I'm not interested in Surgery, but I was told the following about Surgery.

Surgery after christmas, OB/GYN immediately before christmas. OB/GYN gives you some experience in an OR and you won't be a complete noob.

I am not interested in surgery (but still ended up with essentially that schedule). I have IM first (which is likely one of the things I would consider going into) and am partially worried about how I'm going to do on the shelf.

However, it is nice to have IM first because you get a pretty wide knowledge base that subsequent shelves (incl. surg and fam med + step 2) will be primarily based off of.
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Is your school already picking rotations for M3 year? (are you an M2?)
 
normtheniner said:
Is your school already picking rotations for M3 year? (are you an M2?)
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No, currently an M3 in the middle/end of my first rotation, IM.

We had a lottery system through the middle-ish of M2 that involved a few steps to first pick what rotation order you wanted, followed by a separate lottery for which sites you ended up at a, followed by a separate family med lottery.

I got to skip most of it because I decided to do all my M3 rotations at one hospital that wasn't our school's "home" hospital. Just had to do the first lottery to see what my rotation order would be.
 
I did surgery first, got it out of the way. Was a new third year, so I had that cloud hanging over my head. Had no interest in surgery and the expectations were low.

IM was next. IM is fundamental in setting the groundwork for third and fourth year. It teaches you how to write a note, come up with a differential, etc.

I would not begin with a heavily outpatient rotation first. It will be a rude awakening when you get to surg, OB or IM.
 
I took surgery first thinking I'd be much more bright eyed for it than if i took it last when i just wanted to gtfo of there.

That worked well for me, but for anyone interested in surgery I would say do IM first since most of the surgery shelf is medicine more than "how exactly do you remove a gallbladder".
IM is a nice ground work for everything else.
 
I picked whatever I hate the most first, thinking that the earlier in the year the dumber I would be. So by the time I got to what I liked I would at least be a little sharper than I would have been if I did the rotation first and get honors in that rotation. So I did Peds, OB, Psych, and Neuro first then Medicine and Surgery after that.

In terms of which ones complement each other, I think Psych and Neuro would be good to do back to back, with Psych first b/c it's pretty easy, there is some overlap, and it can help you a little during neuro. I think doing everything before surgery helped me too.
 
I saw a study saying that there was no statistical difference in up the order of your clerkships and your overall performance.

I started on outpatient family med. this was perfect - I saw everything and read a little about everything. This gave me a good head start on all other clerkships.

If I didn't do that, I'd like to start on something you are interested in. It would 1) give you a long time to build a relationship with the attendings for LORs and potentially conduct research 2) have low expectations, being the first clerkship and all 3) give you a better shot at doing well on the shelf - they're scaled to the people in the same time of the year 4) let you know if you like it - you may think you love something then think its hell on earth during the rotation. This will allow you too look better at other rotations.

Just my $0.02.

Good luck.
 
Best order IMO:

Medicine (being immediately after step 1 is useful and sets the foundation for other rotations with EMR, etc.
Surgery (shelf is heavily medicine)
After that, it doesn't matter.
 
drizzt3117 said:
Best order IMO:

Medicine (being immediately after step 1 is useful and sets the foundation for other rotations with EMR, etc.
Surgery (shelf is heavily medicine)
After that, it doesn't matter.
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I agree with this.

I am in the home stretch of MS3, and I look back and see now that I was way too concerned with the order. Anyway, my school does a lottery, and I had a bad num...and yet I still have found it really doesn't matter at all.
 
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NYCMS2 said:
I agree with this.

I am in the home stretch of MS3, and I look back and see now that I was way too concerned with the order. Anyway, my school does a lottery, and I had a bad num...and yet I still have found it really doesn't matter at all.
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How in the world are you "in the home stretch" of ms3. Our ms3s just finished their first rotation a couple weeks ago. I just finished my third month of fourth year....


Color me confused.
 
FSU2013 said:
How in the world are you "in the home stretch" of ms3. Our ms3s just finished their first rotation a couple weeks ago. I just finished my third month of fourth year....


Color me confused.
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Some people defer core clerkships into 4th year for various reasons (needing time off, retaking a failed step 1, etc.). My school's 4th year started July 1st, so anyone deferring our 10 week medicine clerkship to the beginning of 4th year would still have 2 weeks left of 3rd year clerkships. This also leads to the awkward situation of being a subI for your own classmate's 3rd year rotation.
 
DrSnips said:
Some people defer core clerkships into 4th year for various reasons (needing time off, retaking a failed step 1, etc.). My school's 4th year started July 1st, so anyone deferring our 10 week medicine clerkship to the beginning of 4th year would still have 2 weeks left of 3rd year clerkships. This also leads to the awkward situation of being a subI for your own classmate's 3rd year rotation.
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There is another answer: med school with a 1.5 year preclinical; core rotations from Jan to Dec.
 
drizzt3117 said:
Best order IMO:

Medicine (being immediately after step 1 is useful and sets the foundation for other rotations with EMR, etc.
Surgery (shelf is heavily medicine)
After that, it doesn't matter.
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I couldn't take medicine until the 2nd to last rotation which I initially was pretty disappointed about. In retrospect, I don't think it mattered much and taking it towards the end of the year makes studying for Step 2 a lot easier. Medicine does set the foundation for other clerkships but you're going to learn to write a note, give presentations, etc no matter what rotation you do first.
 
Would strongly recommend taking IM earlier in the year, but NOT as your first inpatient rotation if you plan to go into IM.

I don't think I really learned how to be a 'good' medical student until my IM rotation and it does lay the groundwork for all your other rotations. Would strongly recommend IM before surgery, since you'll be managing surgical patients who also have medical problems but the team likely won't have time to teach you about the medical issue in detail.
 
Cali2 said:
Would strongly recommend taking IM earlier in the year, but NOT as your first inpatient rotation if you plan to go into IM.

I don't think I really learned how to be a 'good' medical student until my IM rotation and it does lay the groundwork for all your other rotations. Would strongly recommend IM before surgery, since you'll be managing surgical patients who also have medical problems but the team likely won't have time to teach you about the medical issue in detail.
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^This. I'm going into IM, so I did peds before IM, but IM before surgery. Peds inpatient really helped me get my presenting style down for medicine, and then studying for the medicine shelf helped me with the surgery shelf more than the other way around would have.
 
If I had to do it all over again, IM first fo shizzle.
 
Early MS3: weak, least favorite specific rotations (obgyn, psych, neuro) - adjust and get the worst out of the way. Better than blowing an important grade or learning opportunity due to being a newb.

Early/mid MS3: general stuff where you can learn/practice a lot (IM, peds, family). Build up some skills and approaches.

Late/mid: Anything you do want to go into. Gives you the best chance at a good grade.
 
I'm still only on my 2nd clerkship, but I'll actually cast a surprising vote -- I got OB first and thought it was a really good intro. I learned my way around the OR and got comfortable carrying a high inpatient census (on gyn-onc I averaged 4-6 patients to see and write notes on / present each am). I didn't want to do OB, but the novelty kept me interested and I ended up doing well.

Other than that, I agree with the consensus that a) it doesn't really matter and b) IM before surgery.
 
Agree with this. If you are interested in surgery, I'd do OB/Gyn first, so that you start out knowing OR etiquette, how to tie knots, how to do a *brief* surgery rounds presentation, etc.
 
This thread's really interesting. It looks like my school splits the class in two and half of us do the 8 week blocks (IM, Surg and 4 weeks of Neuro + 4 weeks of elective) first, then the 6 week blocks (FM, Psych, Peds, Ob/Gyn), and the other group is the opposite. I REALLY hope I'm in the group that does the 8 week blocks first. I'm mostly interested in Ob/Gyn or Peds so I'd like to do them later.

I think my ideal schedule would be: IM --> Surg --> Neuro/Elective (which would also be during a very birthday-heavy time of year for my family, including the baby) --> Ob/Gyn --> Psych or FM (These are supposed to be not as hectic, right? Good during Christmas time, but I'm sure I won't be the only person thinking that.) --> Peds (I figure winter might be a good time for this. More sick visits and hospital stays) --> Psych or FM.

We run on a lottery, I know that, but I don't know if that's how they assign people to the two groups or just how they let people order rotations. I know that as a parent, I'm allowed more control over at least the locations I'm sent to, but beyond that I don't know.
 
I'd say doing surgery first is good. You're fresh out of studying your genitals off for Step 1, so the work hours won't be much of a system shock. It's true that you'll probably take a bit of a hit on the shelf due to how much medicine is on it, but you can combat that by doing the GI UW questions. Also, nobody else in the nation taking the shelf at the same time will have had medicine, either, so your score won't suffer.
 
Several people mentioned above not to schedule a rotation first if you want to go into that field. Unfortunately, my first M3 clerkship is IM, and it's something I'm thinking about going into (based on my limited pre-clinical experience). Is it possible to still do well/get an honor despite IM being the first rotation?
 
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