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Clerkship ???

Discussion in 'Clinical Rotations' started by Mohd, Dec 28, 2008.

  1. Mohd

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    This might be a stupid question . . . . please be kind :)

    What does "clerkship" exactly mean, is it the same as an elective ???

    Thanks!
     
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  3. socmob

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    Clerkship is synonymous w/ rotation. An elective is a type of rotation/clerkship. The main other kind are mandatory clerkships (i.e. 3rd yr rotations).
     
  4. Law2Doc

    Law2Doc 5K+ Member
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    I don't think this is exactly right. Generally (at least at most schools) "clerkship" means a CORE rotation (So you have medicine, surgery, OBGYN, Peds, Psych clerkships). So it is not really synonymous with elective. An elective is a course you have a choice in (eg you "elect" to take it). So in 3d year, you usually do your clerkships, in which you have no real choices, but in 4th year, you may have the ability to choose various electives.
     
  5. BigRedBeta

    BigRedBeta Why am I in a handbasket?
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    Agreed; and it seems that any clinical rotation that's required in 4th year is labeled a Sub-Internship...though that's just something I've picked up from SDN, since my school doesn't have any required clinical months in the 4th year.
     
  6. Mohd

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    Thanks for the replies!!

    So if I want to contact some one in order to inquire about an elective course; is the "clerkship director" the right person???
     
  7. socmob

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    Well, a month ago I'd be inclined to agree with y'all but I've been looking into doing away rotations around the country recently and the most common term I've come across for these away/elective/sub-i rotations is "clerkship" Google "visiting clerkship" and see for yourself. Here's Mayo's page: http://www.mayo.edu/mms/visiting-clerkships.html which is a good example just b/c it clearly uses clerkship, elective, elective clerkship synonymously.

    So yeah, contact the clerkship director.
     
  8. Law2Doc

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    Well, a sub-internship is a bit different than a rotation -- they generally have you carry your own patients and function as if you were an intern (but with a bit more supervision); you don't help the other interns with their scut as you might have as a 3rd year -- you have your own patients with their own paperwork and scut to keep you busy. It's a lot more autonomy, and you feel like you are doing something closer to useful. So no, I wouldn't equate the two (rotation vs sub-I). A serious sub-I probably makes the transition to resident a bit easier, whereas a rotation is much more of a spectator sport.
     
  9. Law2Doc

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    Um no. Again an elective is not a clerkship. Hence the clerkship director isn't going to be the right person. And there is going to be a clerkship director for each core clerkship anyhow.
     
    #8 Law2Doc, Dec 29, 2008
    Last edited: Dec 29, 2008
  10. Law2Doc

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    Well, they seem to call it an "elective clerkship" so they clearly aren't using it synonymously. If it were a synonym they would use one term or the other. They are, in fact, talking about an away rotation. But at any rate, putting aside away rotations, at your own school there are generally clerkships and electives and they aren't the same.
     
  11. socmob

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    Yes, "elective clerkship" isn't synonymous w/ "elective" (I mis-wrote) but the point is that they were using "visiting clerkship" and "elective clerkship" and "clerkship" interchangeably. And while at your own school, there may be a difference, the OP's question was about the general use/meaning of the word and clearly away rotations/electives/clerkships are used synonymously by many schools. To be fair, maybe in my response I should have said: it may depend on whether you're looking at rotations at your home program vs. away rotations. At your home program, clerkships often (but not always) refer just to the mandatory 3rd yr rotations. For away rotations, clerkships = electives.

    As such, at some schools, you do contact a "clerkship director" or clerkship office for electives. At my school, scheduling's run through the registrar and we don't use the term "clerkship" at all, it just depends. At the very least, the clerkship director you're contacting should be able to point you to whomever you're supposed to talk to.

    Also, I assumed that BigRedBeta wasn't requiring an explanation of electives vs. sub-is but rather that often it seems like all 4th year rotations are actually sub-is rather than electives. I know I've felt that way...for example, at my school, you can't do an elective in surgery or peds or medicine. Only sub-i's. And many away rotations I've looked at refer to the rotation as a sub-i/acting internship.
     
    #10 socmob, Dec 29, 2008
    Last edited: Dec 29, 2008
  12. Law2Doc

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    Your school is not really the norm on this, based on what I have experienced/heard. At most schools at which I have contacts, there are sub-I's and there are electives during fourth year, and they are NOT equivalents by any stretch of the imagination. Most schools require you to do 1-2 sub-Is. These are where you function as the equivalent of an intern (but with greater supervision). They tend to be valuable opportunities to get good LORs for residency applications, because the attendings can give residency programs a better sense of how you will manage an actual internship, and they give the students a window into what to expect after graduation. Then there are the electives, which are much more chill, and where your responsibility is often quite limited -- these tend to be in things you didn't have third year rotations in, or where your exposure during third year was more limited (things like derm, rads, anethesia, path, ortho, optho, etc.). Lots of people try these to get a flavor of those fields, or because they want to go into them, or because some are light enough schedules to allow folks to interview or study for Step 2. So they are very different than a Sub-I as that term tends to be used. I would encourage you to talk to folks at more schools because much of what you describe is very different than what most of the schools have in place.

    And I would limit your focus on terminology for "away rotations" because, as you have already demonstrated, the terminology for an away rotation tends to be confused and different than what people experience at their home school. An away rotation is an opportunity to "audition" to a program you may want to apply to. In some away rotations you will, in fact be applying to do a Sub-I at a particular school, at others it may be an elective -- it depends on the offerings of the school. For instance most of the IM or surgery offerings in 4th year may be Sub-Is, while more specific subspecialties like cardiology or nephrology may be electives, and things like derm or optho may only be electives. But in an application for an away rotation, it's a pain to talk about "sub-I or elective" away rotation so for convenience, they may call it things like an "elective clerkship", a "sub-I" and so on. But that is a catalog convenience, not a definitional term. For the most part, at most schools a Sub-I and an elective are different things. Which is why if you go to the ERAS discussion board, you will see talk of saving one LOR space on ERAS for a recommendation from your sub-I rather than using it up with electives. A sub-I is just different, and adds more value because it tends to be more like what you will experience in residency than in third year. An elective, by contrast may be even less stringent than a third year rotation.

    At any rate this is all a matter of semantics. If you are really interested in how the terms are used at other schools, talk to people at other schools. Ignore the away rotation catalogs/applications/websites because those terms tend to be mashed together so they don't need separate language depending on whether you are applying to do a sub-I or an elective specialty there.
     
  13. socmob

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    I fully understand the differences between sub-is and electives. I was just noting that while I expected to have the choice of either sub-is or electives in every specialty (given how different the two are), I have been surprised to note that often specialties are offered as one or the other. And most away rotations are advertised as sub-is, regardless of whether it's just for convenience, it gives the impression that the offerings are overwhelmingly sub-is rather than electives. *shrug* I think the confusion between us is that you're defining what the terms *actually* mean, whereas I was trying to explain how the terms are commonly used. Anyways, clearly this has gone on far enough, the OP understands now, I'm sure =)
     
  14. BigRedBeta

    BigRedBeta Why am I in a handbasket?
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    If you're trying to set up an away rotation, your best bet initially is to contact the school's education office or registrar. They're likely the one who is going to be able to get you enrolled. On my away rotation, when I called the department 10 days before I was scheduled to start to ask where to report to on the first day, they didn't even know I was coming (I've seen the same thing happened at my school, where it was a "surprise" there was a visiting student). If they tell you to contact the clerkship director, then obviously that's who you'd talk to.

    Thank you so much for that in-depth explanation...I wouldn't have ever known what a sub-I was...were it not for the two I completed myself in July and August.

    For the record, I was speaking about clinical (as opposed to non-clinical rotations because I know that many schools have required ethics courses or "how to be a good intern" type courses which tend to be classroom based) rotations (I don't know what else to call a block of time spent being part of a health care team), that were required for graduation. I suppose that some places to do have required 4th year "rotations" as opposed to Sub-I's without the autonomy, but that hasn't seemed to be what I've seen discussed on these forums or with my friends at other schools. But since you seem to want to be the great end all and be all answer guru of SDN, feel free to correct my misguided statements. I'm sure you'll be able to find something I've misstated.
     
  15. BigRedBeta

    BigRedBeta Why am I in a handbasket?
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    double post
     
    #14 BigRedBeta, Dec 30, 2008
    Last edited: Dec 30, 2008
  16. Law2Doc

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    Chill out -- your statement "that any clinical rotation that's required in 4th year is labeled a Sub-Internship" was not correct in my experience and so I addressed that. Didn't mean any offense by it. A sub-I has a very specific definition at most places, other than merely being a required rotation, as you obviously already must know from the two you completed. My comment was more for the folks reading this thread who haven't done sub-I's already because statements suggesting that they are the same as any other rotations/electives create confusion and sometimes unrealistic expectations. Again not trying to say you are misguided as much as clearing up confusion for those others not as far along the path.
     

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