Filling electives

[IntheClouds4ever]

Current 3rd year med student, here. Good grades, great board score, and honoring all of my clinical grades, so far without any red flags/deficiencies. I have to start filling in electives for fourth year rotations. I used 3rd year to get core requirements and COMAT exams out of the way so 4th year was more about what I wanted to learn before intern year. I wanted to get some input from y'all on here to see if there were any specific specialties or electives that gave you a good base foundation for FM residency?

Im considering Derm, Rheum, Endocrine because I would never have any true experience with them otherwise outside of residency. Derm for some procedures, Rheum because everyone has RA, and Endo because I would like to have a deeper knowledge for treatment and maintenance. Im wondering if I am overthinking these choices as clinical exposure during residency will been enough to adequately collaborate with specialist and care for patients on a maintenance regimen?

I am going back to rural America and plan to use electives in residency for inpatient medicine, so I have the option of hospitalist work if I so desire. Instead of the heavy subspecialty exposure, should I be using the contacts that I have in my desired area of practice and residency to get more exposure to inpatient medicine, EM, and maybe one or two of the specialists in the area?

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[Ironheme]

Do what you'd like. Your residency will help prep you. The best ones on your list there would be derm and endo. I'd also think about an IM sub-I if you wanted hospitalist work. And if you wanted to strengthen your app for FM, or rural FM, then I would definitely include a rural FM rotation in there to demonstrate your interest in the field (and ideally get a very strong letter of rec). I wouldn't worry about getting subspecialist connections to the area. You'll have electives and specialty rotations in residency and you'll be able to get a sense of who to refer patients to anyways.

 

[LeroyJenkinsMD]

Do as many electives as you can that will get you procedures so that when you’re a resident and everyone asks if you’ve done something before, you can say yes and reinforce that experience rather than getting pushed aside.

 

[nwciowa]

It's awesome that you are aware enough to be looking this far ahead. I would include things that you can see a specific benefit from. Radiology - reading your own images on the fly in rural areas. ENT - honing physical diagnosis skills. Emergency - acute presentation/treatment. Peds inpatient could be great for you too. Otherwise what you listed are great as well. Good luck!

 

[cabinbuilder]

From someone who worked rural medicine this is what I would stress: Radiology (films, CT, and MRI), derm, ophtho(what is an emergency and what can wait), Ortho clinic (what can you splint and wait, what is emergent), As much ER as possible, Neuro, GI management w/ hepatitis (doubt you will do scopes) but know what work-up to have the patient do before they see GI.

 

[Ironheme]

From somewho worked rural medicine this is what I would stress: Radiology (films, CT, and MRI), derm, ophtho(what is an emergency and what can wait), Ortho clinic (what can you splint and wait, what is emergent), As much ER as possible, Neuro, GI management w/ hepatitis (doubt you will do scopes) but know what work-up to have the patient do before they see GI.

One thing I found helpful @cabinbuilder was sending messages or calling the specialist directly and asking them what labs/imaging they would like ordered prior to the patient arriving at their clinic. I imagine you already know most of it, but for starting out, that was helpful for me.

 

[Atlas Shrugged]

Anesthesia. Super chill and useful procedural skills. Not much exposure during residency.

 

[cabinbuilder]

One thing I found helpful @cabinbuilder was sending messages or calling the specialist directly and asking them what labs/imaging they would like ordered prior to the patient arriving at their clinic. I imagine you already know most of it, but for starting out, that was helpful for me.

Most places I have worked did not have specialists close. While this is true in a family practice office, generally not practical in urgent care.

 

[FamilymedMD]

If you're headed to a rural area, consider what skills are high value to patients. That gives you more options down the road (and are a fun break from the daily grind). Office ortho, office surgeries, derm, colposcopy, point of care ultrasound, office xray (with online rereading by rads), occ. med, FAA or diving exams depending are all useful so would pick based on what you enjoy.
Don't get stuck in a job where you need to hand out referrals for things you might enjoy managing in the office yourself.