Got last choice intern year electives: does it matter?

[Seaunicorn]

My program just told me my electives for intern year and unfortunately, I got none of the ones I had actually chosen. I'm interested in IM fellowships so I had chosen electives that would give me experience in pretty much any of those areas but instead I got derm and PMR.

Does this really matter? I know I'll have time for electives my 2nd year. I just wasn't sure if residents really needed to get exposed to their desired fields in PGY1. I'm sure it's a mess having to scheduling us all in the first place so I don't want to make a fuss about it. Just trying to figure out if I'm going to need to hustle more as a result.

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[DrBowtie]

My program just told me my electives for intern year and unfortunately, I got none of the ones I had actually chosen. I'm interested in IM fellowships so I had chosen electives that would give me experience in pretty much any of those areas but instead I got derm and PMR.

Does this really matter? I know I'll have time for electives my 2nd year. I just wasn't sure if residents really needed to get exposed to their desired fields in PGY1. I'm sure it's a mess having to scheduling us all in the first place so I don't want to make a fuss about it. Just trying to figure out if I'm going to need to hustle more as a result.

I think you'll see these cushy rotations as a blessing after getting crushed on ICU and impatient wards.

 

[mvenus929]

1. Interns probably get last pick of electives. Meaning if there are 2 slots for cards that month, and third years want them, they go to the third years, not the intern.
2. You'll likely be doing some work in whatever fields you requested on inpatient services. You'll get some exposure during intern year.
3. You have plenty of time to catch up with electives prior to applications for fellowship.

 

[IM2GI]

My program just told me my electives for intern year and unfortunately, I got none of the ones I had actually chosen. I'm interested in IM fellowships so I had chosen electives that would give me experience in pretty much any of those areas but instead I got derm and PMR.

Does this really matter? I know I'll have time for electives my 2nd year. I just wasn't sure if residents really needed to get exposed to their desired fields in PGY1. I'm sure it's a mess having to scheduling us all in the first place so I don't want to make a fuss about it. Just trying to figure out if I'm going to need to hustle more as a result.

Yes it is kind of annoying. Not sure why PMR is even an elective.

You should at least get some sort of a core internal medicine elective IMO. Save the derm and PMR electives for the third years. Probably not a ton you can do about it.

Do you have your heart set on a particular field? I assume you are categorical IM?

 

[Ismet]

I'm not IM so I can't speak to the importance of the electives re: fellowships, but in line with an above post, those "cushier" electives would be nice breaks. Are they spread out or later in the year by any chance? I'm on an extremely light rotation now and it's very welcome at the end of intern year and before jumping in to 5 straight inpatient months.

 

[Gastrapathy]

See if you can split your PMR elective into 2 weeks PMR and 2 weeks of "research". Use those two weeks to hang in your dept of interest and get started on a simple project (case series or something). I'd wait until you show up to do this. This is why they pushed back fellowship applications.

 

[NotAProgDirector]

This seems somewhat crazy. We let interns pick their electives, and then make it work. If several people pick GI, we split them so some stay at the mother ship, and some to the VA. Plus, we can put some in the outpatient GI clinics, or in the endo suite, or on the inpatient consult service. Rarely there's a specific rotation that has a limit to the number of learners at a time. But the usual core electives for fellowships, there's almost always room. I guess it might depend on the size of the program (although bigger hospitals tend to have more interns)

 

[RangerBob]

It's PM&R, not PMR. It's just a pet peeve of mine, but a number of people have made this mistake here. Our specialty is a small one, and isn't that well known or understood. We're like the small little brother no one remembers. Particularly on our consult rotations, one of our biggest duties is to educate people on what PM&R does. Often that means explaining what PM&R even means (physical medicine & rehabilitation).

I disagree with the others about PM&R not being a good elective, though I'm clearly biased (I do agree for an intern that other rotations would probably make more sense).

Many services don't know what we do--medical sub-specialties in particular. Neurosurg/ortho/neuro, etc., all know what we do fairly well because they send so many patients to use for rehab, but I find the medical services often don't understand what we do. This leads to more inappropriate consults (consult to bring someone to inpatient rehab that clearly can't tolerate more than 30 minutes of therapy), or not being consulted on patients who would clearly benefit from rehab (fairly common--typically we find out if that patient is denied from all subacutes and we're consulted as a last resort, only for us to see the patient and decide they'd do great on inpatient rehab).

We've been holding more lectures to other services to explain what we can offer them and their patients, but rotating through PM&R so you can actually see that decision process (as well as understand what else we have to offer--we can do a lot more than just decide if a patient is appropriate for inpatient rehab) could still be very beneficial.

 

[IM2GI]

It's PM&R, not PMR

Get over yourself. We know it is PM&R and are just too lazy to type the & sign.

 

[RangerBob]

Get over yourself. We know it is PM&R and are just too lazy to type the & sign.

Whether all three of you were too lazy or some didn't know the true spelling, our specialty is often ignored/overlooked/misunderstood. When others write our initials (which is a vast abbreviation!) to PMR or PMNR, it suggests a lack of respect. You may not mean it that way, but that's how it is often viewed in our specialty.

I know it may seem silly and arbitrary to you, but it shows respect for your physician colleagues in PM&R.

 

[IM2GI]

Whether all three of you were too lazy or some didn't know the true spelling, our specialty is often ignored/overlooked/misunderstood. When others write our initials (which is a vast abbreviation!) to PMR or PMNR, it suggests a lack of respect. You may not mean it that way, but that's how it is often viewed in our specialty.

I know it may seem silly and arbitrary to you, but it shows respect for your physician colleagues in PM&R.

To me it suggests a baseline level of insecurity and inferiority if you get offended by such trivial slights. Everything is offensive these days, it is suffocating. I promise you no one is trying to take a dig at your specialty by leaving out the & sign.

Call me gastro, GI, scope monkey, whatever you want. I like my job.

 

[RangerBob]

To me it suggests a baseline level of insecurity and inferiority if you get offended by such trivial slights. Everything is offensive these days, it is suffocating. I promise you no one is trying to take a dig at your specialty by leaving out the & sign.

Call me gastro, GI, scope monkey, whatever you want. I like my job.

I already suggested we're a bit more sensitive of a specialty. Lots out there don't know we exist. You asked why PM&R was even an elective.

Many people in my field do interpret it as a slight when you leave out the "&" or write "PMNR." It's just a little thing, but little things are easy to change.

I just wanted to help the OP and let them know PM&R could still be a very beneficial rotation, even if there might be better alternatives for an intern planning to pursue a fellowship. Since I also saw three people forget the "&" symbol, I threw in a PSA for my field as well. Quite a lot of people out there don't know there's an "&" or even what P, M, or R stand for.

Either way it seems our dialogue is getting more personal and doesn't help the OP.

 

[IM2GI]

I already suggested we're a bit more sensitive of a specialty. Lots out there don't know we exist. You asked why PM&R was even an elective.
.

For a categorical IM resident, it does seem like an odd elective to be forced to take. As an undifferentiated med student, of course go for it.

Interesting on your perspective that your entire specialty is sensitive to that term. I will ask our PM&R guys.

 

[RangerBob]

For a categorical IM resident, it does seem like an odd elective to be forced to take. As an undifferentiated med student, of course go for it.

Interesting on your perspective that your entire specialty is sensitive to that term. I will ask our PM&R guys.

Think of us like psychiatry--we can be a bit more sensitive (not all of us, but in general more than other specialties) because a lot of other physicians don't see us as "real physicians."

I see what you mean by the elective statement--I misinterpreted that. Yes, it's a very weird elective for a any resident to be forced to take. But if the OP isn't able to change it, hopefully they will find it beneficial and enjoyable.

 

[IM2GI]

Think of us like psychiatry--we can be a bit more sensitive (not all of us, but in general more than other specialties) because a lot of other physicians don't see us as "real physicians."

I see what you mean by the elective statement--I misinterpreted that. Yes, it's a very weird elective for a any resident to be forced to take. But if the OP isn't able to change it, hopefully they will find it beneficial and enjoyable.

Im a little jaded in that every referral I have made to PM&R in my ivory tower world for abdominal wall pain/trigger point injections were either blocked or never scheduled

 

[Seaunicorn]

This seems somewhat crazy.

Apparently I will be assigned a mentor somewhat based on my specialty interest when I arrive at my program. Would it be fair to mention my elective concerns to them (or anyone else in my program)? Namely, that I'm interested in hemetology-oncology and allergy and I'm wondering if I need to try to find some time intern year to reach out to mentors in these areas on my own, since I didn't get electives in these fields? I'm unsure of proper etiquette and I am just wary of coming off as complaining about my schedule.


Regarding PM&R, that was actually typo RangerBob but I do apologize for any offense! I have nothing against your field. I just happen to have more interest in other things and I already have limited time to explore those interests.

 

[IM2GI]

Apparently I will be assigned a mentor somewhat based on my specialty interest when I arrive at my program. Would it be fair to mention my elective concerns to them (or anyone else in my program)? Namely, that I'm interested in hemetology-oncology and allergy and I'm wondering if I need to try to find some time intern year to reach out to mentors in these areas on my own, since I didn't get electives in these fields? I'm unsure of proper etiquette and I am just wary of coming off as complaining about my schedule.


Regarding PM&R, that was actually typo RangerBob but I do apologize for any offense! I have nothing against your field. I just happen to have more interest in other things and I already have limited time to explore those interests.

Allergy is sort of the PM&R of internal medicine. I sure if you really want to do that you could ask and they could accommodate you. Does your program have an in house allergy fellowship?

 

[RangerBob]

Im a little jaded in that every referral I have made to PM&R in my ivory tower world for abdominal wall pain/trigger point injections were either blocked or never scheduled

How weird. Those are some of the more interesting pain consults for us, and we can do a lot for them--trigger point injections, as well as all the interventional stuff the pain team (PM&R/anesthesia) does.

When we pick and chose the patients we accept, that does give our field a bad name. And I don't think it's that uncommon from some of the other programs I've rotated through. Still, that's bad if the referrals you place aren't going through. Unless the consult is grossly inappropriate, it's bad form for a service to turn down a consult request.

 

[Psai]

Whether all three of you were too lazy or some didn't know the true spelling, our specialty is often ignored/overlooked/misunderstood. When others write our initials (which is a vast abbreviation!) to PMR or PMNR, it suggests a lack of respect. You may not mean it that way, but that's how it is often viewed in our specialty.

I know it may seem silly and arbitrary to you, but it shows respect for your physician colleagues in PM&R.

oh my god lol get over it pmr resident
it's an abbreviation that so few med students care about that they let the field fill with DOs

 

[RangerBob]

oh my god lol get over it pmr resident
it's an abbreviation that so few med students care about that they let the field fill with DOs

DO's are a great fit for the field, and I both greatly admire and respect all my DO colleagues. I notice zero difference between them and my MD collegues.

 

[RangerBob]

Apparently I will be assigned a mentor somewhat based on my specialty interest when I arrive at my program. Would it be fair to mention my elective concerns to them (or anyone else in my program)? Namely, that I'm interested in hemetology-oncology and allergy and I'm wondering if I need to try to find some time intern year to reach out to mentors in these areas on my own, since I didn't get electives in these fields? I'm unsure of proper etiquette and I am just wary of coming off as complaining about my schedule.


Regarding PM&R, that was actually typo RangerBob but I do apologize for any offense! I have nothing against your field. I just happen to have more interest in other things and I already have limited time to explore those interests.

No worries!

I don't blame you for being a little disappointed in being assigned an elective. It'd be like assigning me to ID for one of my three PM&R electives. Sure, it'd be a really good learning experience, just like PM&R would be for you, but I would want the freedom to chose what elective I wanted to do (ideally one in an area I want to apply for fellowship in, or one I feel I need a little more experience in). As an intern, I think that's even more critical.

If you haven't spoken with your program director, that would be a good start. It's highly unlikely that PM&R service depends on a resident. If there are PM&R residents at the program, then sure, they would rely on them to keep the service running, but we would never rely on a non-PM&R resident to keep the service running. The few times we had outside residents rotate through with us, they were just an extra resident, and mostly there to just learn what PM&R was and how they could utilize our services in the future (or in the case of neuro residents, see what happens to all the stroke patients they send to rehab).

While there's a lot of what I would call "medicine-light" on rehab, it's a whole new experience learning about rehab, so the odds of the PM&R unit relying on you to be there are slim (some rehab units even have their own hospitalist, in which case the rehab physician doesn't do any medicine, which I find a little sad to not even be practicing the basics).

I would think if there's another rotation you could be assigned to, that the PD could place you there. I think it'd be worthwhile to sit down with them (or you can try the chiefs first) and say "hey, I'm really excited about heme-onc or allergy/immunology--is there any way I can swap my PM&R rotation for one of them?)