Clerkship vs. Sub-I

[Perfect Hair Day]

What is the difference between an EM clerkship and an EM Sub-I? In terms of SLOE, does it matter if the rotation is a clerkship or a Sub-I?

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[surely]

What is the difference between an EM clerkship and an EM Sub-I? In terms of SLOE, does it matter if the rotation is a clerkship or a Sub-I?

I saw at least one place on VSAS that offered separate EM clerkships and Sub-Internships in the course catalog, but never managed to figure out much of a difference. I don't think it matters, and I've never heard anyone say it matters on SDN or Reddit.

 

[racerwad]

What is the difference between an EM clerkship and an EM Sub-I? In terms of SLOE, does it matter if the rotation is a clerkship or a Sub-I?

I don't think anyone actually cares, but my understanding is that a clerkship is a rotation like any other while a sub-i is one where you are expected to act as an intern (or as close as you can get) vs "just" a medical student.

 

[alpinism]

Clerkships are usually for people not going into EM and as a result your hours and expectations are typically lower.

 

[gro2001]

What is the difference between an EM clerkship and an EM Sub-I? In terms of SLOE, does it matter if the rotation is a clerkship or a Sub-I?

I am a director of a clerkship, and a faculty sponsor on an elective and a sub-I. There is no universal nomenclature for this, so what is meant by clerkship, elective, and sub-I is going to vary widely by institution. Typically:

• Clerkship: mandatory rotation for third (or sometimes fourth) year medical students. At my institution there are clerkships for IM, surgery, peds, Ob/Gyn, Neurology, Anesthesia and Critical Care, Psychiatry, and Primary Care. There is no EM clerkship.
• Sub-I: a one month long mandatory clinical experience, similar to a clerkship but with a higher level of responsibility. At my institution this can be in IM, Surgery, Peds, or EM.
• Elective: an optional rotation for fourth year medical students in almost any subject, including ones for which there is already a clerkship or Sub-I available. Sometimes there are multiple tiers to electives, ie a regular elective and an advanced elective.

From a medical education best practices point of view, when there is a sub-I and an elective in the same subject, there should be some differences between the two syllabi. The Sub-I should be in some way a more advanced experience than the clerkship. This could be a more rigorous schedule, higher expectations of performance, more clearly defined roles and responsibilities, some additional mode of assessment, etc. However, I know at many institutions, this is not actually the case.

The take away from this for the EM applicant is that different institutions will name things differently. Enroll in the most rigorous EM clinical experience on offer, which will typically be called a sub-I or an elective. Make sure you are enrolled in the right one by asking the registrar, the faculty at the institution you are doing your elective at, and EM applicants from your school in the last couple of years. But don't worry about what that experience is called. Just do it, do well, and get a good SLOE.