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cpb80

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Hello-
I am trying schedule my M4 year, and I was wondering if you guys could give me feedback on what electives would be most useful for ER residency. Here's my tentative M4 schedule.

This is what's required that I have left:
-4 wk ER elective x 2
-4 wk Medicine Sub-I (required)
-2wk Rads (required)
-2wk Anaesthesia (required)
-2wk Derm (required)
-2wk Optho (required)
-2wk Neuro (required)

These are the elecives I am considering scheduling in addition to the above required courses:
-Critical Care Medicine (ie MICU) vs SICU --> Any thought vs one or the other??
-Cardiology
-Toxicology
-Primary Care Sports Med
-Infectious Disease
-International ER elective


Any advice is welcomed and greatly appreciated.
Gracias
 

dmitrinyr

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I think the electives that you have already is more than enough and probably more than most 4th years take. I did 3 EM electives, 1 month of both neuro and cardio (both just because I needed to choose medicine electives and not for the reason of preparing for EM). If you want you can do an ICU month (be it MICU, SICU; in both you will see very sick pts and in both you will learn about critical care medicine). Anything more than that could just be a bit overkill as you will have some of these as electives during your EM residency (ex. tox). I think you should take electives that you think are interesting or ones that you think you might not do ever again. I wish I could have done an international EM elective just for the experience during my 4th year. I did a peds clinic month (my school requires a peds specialty month in 4th year) and I liked it. Lots of kids at my school do peds ER for a month and that will be good exposure to child pts and might help you in your future in EM. Good luck.
 

AmoryBlaine

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One thing that was suggested to me (too late) was to try to do a PICU month. The rationale was that "you can never see too many sick kids."

Oh well, I'll get it next time.
 
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WallowaWanderer

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Make sure that you have at least one really chill elective or a vacation month post-match. You will have a ton of things to do to get ready for the move, graduation, house buying, etc, and if you're anything like me you'll be a little burnt by that time.

Another nice time to have a chill rotation is after interviews. I was pretty tired then too and had a lot of stuff to catch up on after so much travelling, even though I took a month off for interviews. Of course, I did 21 interviews and that was too many. Maybe if you did a more sane amount, you would be ready to jump into a call month.

I didn't do a unit month. I would have liked to do one but I was really focused on visiting rotations at the places I was really interested in. I did 3 EM auditions plus my home EM rotation . . . too many in hindsight, but hey - it landed me where I wanted to be, which was #3 of the 4 rotations. Then after a month of vacation for interviews and 2 x 2 week blocks between auditions for Step 2 study/recovery I had time for 2x4 week electives plus one 2 week elective. I did 2 weeks of anesthesia (awesome, hands on, very chill, low time commitment), 4 weeks of optho (bored out of my mind, low time commitment, very chill, would have wanted it to be 2 weeks), and will be doing 4 weeks of electrophysiology with a focus on EKG reading (super chill, high yield). So, as you can see, I tried to pick things where I would learn things but would also be living the good life.

I was really glad I did a total of 5 weeks of anesthesia, 3 as a 3rd year and 2 as a fourth. These were freaking awesome weeks. I did on a average 6-7 intubations per week, so I come out of med school with 30-35 tubes. By no means an expert, but really nice to have that experience behind me.

Sounds like your school has a much more intelligent curriculum than mine. Having derm, optho, and rads built in is super-nice.

On your list, I think Critical Care, Cards, and sports med would be high yield. Ortho if you like being in the OR for protracted periods of time. Of course, mostly it depends on the quality of teaching on each rotation.
 

nymbarra

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I know that most of this is common sense info:

I agree with WallowaWanderer that you need to make sure you have time for interviews as well as to chill out, especially right before residency starts. Also, even a week or two between hard rotations may be good.

The electives you choose should also depend on the curriculum and what others who have taken them say. For example, there is an ER Ortho rotation at my home institution which supposedly is great for fracture and joint reductions (w/ no required OR time), but the downside was that you had to take overnight call. This was the killer for me.

I also did Step2CK early to consolidate my 3rd year clerkships. I think they made me strong for my ED rotations (x2).

Hello-
These are the elecives I am considering scheduling in addition to the above required courses:
-Critical Care Medicine (ie MICU) vs SICU --> Any thought vs one or the other??
-Cardiology
-Toxicology
-Primary Care Sports Med
-Infectious Disease
-International ER elective


Any advice is welcomed and greatly appreciated.
Gracias

Cardio: I did a consult rotation x 2 weeks first (for various reasons that I can explain if you PM me), but that really helped when I was on MICU and in the ED.

MICU vs. SICU: depends on the institution, but seems like you may be expected to carry more pts on the SICU. I got to do several central lines, but I don't think I did one in the ED. I originally planned to do MICU at the end of 4th year to prepare for residency but decided I would rather spend time w/ friends and family.

EM ultrasound: might be good, might help you hit the ground running, and if you are interested in it as a subspecialty. Whether or not it will help in residency may depend on how strong U/S is in the ED.

Tox: I would've loved to fit in tox. Once saw a girl with serotonin syndrome in the ED, and that got me hooked.

Peds urgent care: that might be chill, and ease you into acute peds care...I am a little anxious about seeing kids in the ED, considering I haven't done any peds since the beginning of 3rd year!

Plastics: a few of my classmates took this to get better at good suturing practice in sensitive areas.

Anyways, have fun and it will fly by like nothing!
 

theCamel

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my two cents...

i'm finishing up an ED ultrasound month right now post match, and i'm really glad i did it. not only have i learned a lot (saw retinal detachment today, pyloric stenosis yesterday, etc) but it's fairly chill, and in the down time i've done some suturing, dental work, intubations, etc for the medical residents who are more than happy not to deal with that sort of stuff.

so, i'd suggest doing something you're interested in or feel weak at. i'd also suggest setting up an ortho consult elective month (no need to be in the OR, at all) and/or an ophthalmology month as well. again, fairly chill but high yield. cards can be good too, if set up properly.

oh, and do them somewhere fun like nyc, hawaii, colorado, socal, wherever floats your boat. life is short.
 

DrQuinn

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Just do a month of anesthesia and a month of radiology. That will be all you'll need.

You'll get all you need to know in residency. promise!

Q
 
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