Do I need to take a Medicine Sub-I?

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SoulinNeed

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I'm planning on taking a Psych Sub-I, of course, but some at my school have recommended that I take a Med Sub-I before I apply, as well. My Step 1 score isn't great by any stretch, 208, and I'm not sure if people are recommending this based on my score. Not doing a Med Sub-I this fall would really open up my schedule for a lot of other things, like away rotations, but I'm wondering, what do you guys think? Thanks!
 
some programs require a medicine subi (Cambridge and Stanford come to mind) so you'd be limiting yourself somewhat if you don't do a medicine subi. I don't think you need a psych subi if you do a medicine one. (I didn't do a psych subi, step in the 210s, got interviewed by many excellent programs)
 
Yes you should do it irrespective of whether it's required. You will have at least four months of medicine as an intern, and while most of learning how to be an intern is on the job, the more you know (in terms of medical knowledge) the better you will be. And while as a med student (even as a sub I) you contribute nothing to patient care and still don't have legitimate responsibilities just being in an environment where you are seeing medically sick people with lots of problems and reading about it increases your medical knowledge and comfort as a physician significantly.
 
Yes, you should do a medicine sub-internship. The current trend has psychiatrists seeing increasingly complicated medical patients while training programs are decreasing the stringency of medicine rotations- many favoring outpatient months in lieu of inpatient wards. Any additional exposure you can get to the management of the physically sick in a protected learning environment will be an invaluable asset in your career going forward.
 
I didn't do a medicine Sub-I and it didn't come up for me.

I get the point of the posters above, but would probably disagree. Having sat on the admissions committee, I don't remember any comments ever happening about "wow, no sub-i in medicine." It might happen someplace, but it's far from universal.

But you DO want to have a sub-i that gives you experience managing inpatient medical cases. I just disagree that it has to be medicine. Inpatient Neurology or Inpatient Family would fit the bill.

Aside from it being good to get the experience, if you have a sub-standard application, I wouldn't recommend coming in with just a psych sub-I. The fact is, your only real chance to redeem yourself clinically in fourth year is through sub-I's. Any other rotations are pretty much assumed to be Honors for everyone.
 
I didn't do a medicine sub-I either, but my school has a required critical care month for everyone.
 
I did not do a medicine sub-I and was invited to interview at 90% of the places o applied to. I did, however, do a neurology sub-I that was mostly spent on a high volume stroke service and an epilepsy unit, so will second the previous post suggesting an inpatient non-psych experience.
 
You asked if you need it. The answer depends on need it to ____. Do you need it to match to psych period? That depends. Did you honor medicine? Are you at HMS? Are you at a no-name DO school? Do you want to maximize your choice of residency or do you literally not care where you end up?

Of course I, like the others recommend a non-psych medical service (peds/neuro/on) sub I, but, like everything else, the value is probably differential depending on what the whole picture is. If your ms3 is at a reputable place and has lots of honors, it probably won't make a difference. If you stand out in no ways, and I was reading applications (which I don't), and I had to pick between two people who were otherwise indistinguishable... I'd interview the person who did a non-psych sub I over one who didn't. But you probably know this.
 
Just to be clear, I would do a Med Sub-I. I'm just wondering if I need to do it before I apply.
 
We're required to do a medicine sub-I, but I did mine so late that it wouldn't have mattered for interviews etc. It was really cool, because that service is the "Sub-I service" with two attendings, four residents, and eight sub-I's, and 40ish patients. Sub-I's were treated every bit as regular interns except for the smaller census and our orders had to be cosigned, but we were the primary clinicians for all of our patients (first paged for any issue.) I thought it was a really rewarding experience.

I don't believe I interviewed at any residencies that require a sub-I (including Stanford), although I do know that some programs prefer that you have done a sub-I (Longwood.)
 
We have to do either a medicine/surgery/peds sub-I. I did an IM sub-I in July of MS4 and it was a great opportunity for me to get a letter from someone who could see me in more of an experienced, leadership capacity - and this was remarked on during a number of my interviews. Speaking just for my interests, I was deciding between Psych, IM, and Med-Psych at the time, so the experience came early enough to afford me a strong letter, more insight into what I wanted out of my career, and flexibility with what my application would look like. I learned a lot, and it was one of the first times I really felt somewhat competent - one of my favorite rotations in medical school.

Speaking to your situation, my question for you is do you think you have a strong non-Psych letter in the bag? With your Step 1 score, I'm not sure whether an away Psych rotation or a strong IM letter would help more in demonstrating to programs you'll be a capable resident. Re: aways, this was not something anybody at my program has done in recent years for Psych, maybe that just speaks to the number of rotations we have available and the strength of our program, but on my interview trail I saw it was quite common for applicants from programs that have smaller Psychiatry programs and I think if you fall in this boat doing an away would serve you quite well. This isn't necessarily like Ortho or EM where you need to go to several places, even one away could be fine if it's at a place you think you really want to go to but may be overlooked at because of your numbers. How many were you thinking of doing? I'm in the match right now so this is all n=1, I'd put more value into the opinions of your advisors and folks on here who have some experience in evaluating applicants.
 
I agree that you don't need to do it before applying, but at my school we also had to do one in either medicine, pediatrics, or surgery, and I was glad I did, because it prepared me well for my medicine months intern year. My one regret is that I scheduled it later in MS4 hoping that medicine would be "fresh in my mind" for intern year, only to have all my inpatient medicine in the 2nd half of intern year.
 
It doesn't matter when you do it- just do it. And no, peds/inpat family/neuro are not substitutes (though it is a good idea to do electives in some/all these as well). And I think it's hugely beneficial to have a month of rigorous medicine with sick, complicated patients. The more exposure you get, the more focused your reading becomes, the more knowledge you'll gain, and you will be better prepared for intern year.
 
J DUB said:
I would recommend doing it near the end of 4th year so it is more fresh going intern year.
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Lol thats cruel, second half of MS4 should be spent at the pool/beach/bars with family and friends, not miserable on a medicine Sub I.

I didn't do any medicine sub I's and I did just as well or better than the medicine interns on medicine in July. Really all you need to do to be a good intern is show up to work early, don't complain and always ask for help when you need it. If you do those things you'll be fine.

If your confident and think you know enough to manage sick patients July 1, you will at best piss off your upper level and at worst kill someone.
 
J DUB said:
Yeah, it is not necessary but for me I took the first part of 4th year off because I wanted a break. Now, I have 4 months of "real" rotations. Then, a couple of months off before July 1st. That is plenty of time off for me. To each their own.
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What's a "month off"?

(For that matter, what's a DAY off?)🙁
 
Ah, that totally makes sense then! I hope you're able to squeeze one in, as it sounds like being in Chicago is very important to you. I'd honestly prioritize it over the sub-I in that case.
 
So you guys get that psych is still not that competitive, right? You don't need to be stellar in any sort of way to have a good shot at matching at a pretty decent program in psychiatry, and you certainly don't need to do a medicine sub-i if you don't want to. As noted earlier, I've never, ever heard that commented on when talking about applicants. I guess there are 2 programs that require it (although I bet they really don't and would still interview you and rank if they like you), but that's nowhere near the norm. Regardless, you should ideally get enough experience in internal medicine in residency that a medicine sub i shouldn't affect your competency as a psychiatrist. You might maybe do better on your medicine months, but again, it shouldn't be a huge deal. Do what makes your 4th year work well for you.
 
SoulinNeed said:
I attend a top med school, with a very well known Psych department. I'm just determined to do my residency in Chicago, and want to do one rotation there (probably Rush), to show them that I'm serious.
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You also don't need to do this. Search the forum to see discussions about aways. Entirely non necessary. If you really go to a top school, you've got good odds everywhere unless you've got some other serious deficiencies. Again, psych is really not that competitive. I've never heard of Rush as being listed as a competitive program either.
 
Doctor Bagel said:
You also don't need to do this. Search the forum to see discussions about aways. Entirely non necessary. If you really go to a top school, you've got good odds everywhere unless you've got some other serious deficiencies. Again, psych is really not that competitive. I've never heard of Rush as being listed as a competitive program either.
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Well, my issue is that I have a low Step 1 score (208), and almost no one from my school (not located in IL) goes to Rush (or any Psych programs in Chicago not named Northwestern). My fear is that Rush (or other Chicago programs) won't take my application seriously, as a result, and will just overlook me, so I want to show them that I'm serious about going to their programs by doing an away rotation.
 
poiuytre said:
Cambridge and Stanford come to mind) so you'd be limiting yourself somewhat if you don't do a medicine subi.
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I interviewed at Stanford with a medicine sub-I, also without a neurology sub-i.

SoulinNeed said:
My fear is that Rush (or other Chicago programs) won't take my application seriously, as a result, and will just overlook me, so I want to show them that I'm serious about going to their programs by doing an away rotation.
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So then do a psych away there, a medicine sub-I at the program will not let the psych department know that you're interested in it. They might even think you're dual applying to IM and Psych of you do that.

Just my $0.02
 
DuskPhilosophy said:
I interviewed at Stanford with a medicine sub-I, also without a neurology sub-i.



So then do a psych away there, a medicine sub-I at the program will not let the psych department know that you're interested in it. They might even think you're dual applying to IM and Psych of you do that.

Just my $0.02
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That's my plan. Do a Medicine Sub-I at my home institution, while doing an away Psych in Chicago. My question is whether or not I need to do the Medicine Sub-I before I apply.
 
SoulinNeed said:
Well, it's not so clear. My advisor here is telling me to do so.
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And my advisor told me I should go on 20 interviews to match, which has very little support in data or anyone's lived experience. The advisor has every incentive to recommend unnecessary but maybe marginally helpful things.

You do however have a thread of people from this last application cycle saying "I got competitive interviews aplenty without a documented medicine sub-I." Also, actual residents saying they did fine without one. What special information do you reckon your advisor has access to?
 
poiuytre said:
some programs require a medicine subi (Cambridge and Stanford come to mind) so you'd be limiting yourself somewhat if you don't do a medicine subi. I don't think you need a psych subi if you do a medicine one. (I didn't do a psych subi, step in the 210s, got interviewed by many excellent programs)
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so just wanted to correct some misinformation (made an account just for this): stanford does not require a medicine sub-i (ref: i interviewed there and i haven't done a med sub-i; n=1 tho...)

but i would recommend it for reasons others have mentioned
 
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