Help! confused about 4th year schedule

[wsingh]

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Hi all:

I'm currently a 3rd year but as 4th year draws near I find myself confused about the sequence and nature of electives to choose. I just finished reading Iserson's Getting into a residency and it was helpful but questions remain.

My interest is EM and I was planning on taking Step II in late July so that my results would be available in time for residency app. I was planning on taking the month of July off to study for step II. But after reading Iserson's I got confused b/c it suggested NOT to take a break immediately after 3rd year and actually suggested doing a SubI in IM followed by EM rotation.

So here lies my dilemma, if I do a Sub I. in the beginning of my 4th year then I'm afraid I may not have enough time to study for step II. Any suggestions would be appreciated.

wsingh

 

[GCS:3]

Well, I STILL haven't taken step II, and my step I was only average. Don't feel rushed to take it, but don't wait too long, either (I'm starting to feel rusty).

An EM month is actually a good way to prep for step II, since a lot of the questions (from what I've heard) are "what to do next?" and "A patient comes to the ED with..."

I think the perfect time for me would have been at the end of my EM rotations, had interview season not bitten me on the ass. Now I'm stuck trying to re-prep, but since the match is so close, I just have to pass. *phew*

Don't feel pressured by what Iserson said. It's always good to have more prep for "audition" rotations, but hey, it's just one guy's opinion. Take the boards when you're ready, and have fun on your EM month.

 

[iwakuni_doc]

I took my first month off from 4th year to "study" for the boards...in reality all I did was work as a bouncer & party, hence my mediocre step II scores following an excellent step I (dropped 40 points).

While I had a blast & the time off really rejuvinated me for the rest of the year, I'd say taking a solid sub-I or EM elective early on would be much more beneficial for your scores.

 

[greatdane]

one thing to keep in mind is the importance of letters of rec from you EM rotations...that being said, the earlier you do your rotations (like july/aug) the better chance you will have of having your letters in by the first day you can submit to ERAS.

also, if you did well on step I, you can always put off step II. I did okay on I and got all the interviews I wanted. I took step II in dec and was able to send my scores to PDs the first of Jan.

Hope this helps a little

 

[roja]

I concur. Step 2 scores aren't that crucial but strong letters from the ED or from a subI (particularly an ICU type rotation) are very important. Your step 2 scores can be transmitted whenever you take it and thus aren't really crucial to the initial application process. (I took mine *after* interview season). I have no idea where my step 1 score fell in terms of EM competitiveness.

But letters are definately teh most important.

 

[frog4brooke]

Hey- I think that my 4th year has gone pretty darn well-Here's what I did in the summer & Fall

July-Trauma/ICU AI
Aug-Personal time/ Step 2
Sept-Home EM
Oct-Away EM
Nov-Req. Geratrics and Plastics
Dec-Anes.
Jan-Interview time off
Feb-ortho
Mar-Review of Anatomy
April-Peds EM
May-Personal travel/Grad

This was pretty good. I had a pretty light schedule in Dec and Nov, so I did all of my local interveiws then. The ones I had to fly to I did in Jan. I got cheaper flights this way and did not get quite so burnt out doing them all back to back. The other thing is you really do get lazy during your 4th year. I don't think that I would have even studied for Step 2 if I would have put it off. The only thing that I maybe would change is moving up the EM months and taking step 2 in Oct.

Other good electives that I wish I had gotten in are:
Cards, and maybe Medicine
Derm (just cause I like that stuff)
Optho (not a great elective at our school though)

Hope that it helps-
B

 

[DrQuinn]

Originally posted by roja
I concur. Step 2 scores aren't that crucial but strong letters from the ED or from a subI (particularly an ICU type rotation) are very important. Your step 2 scores can be transmitted whenever you take it and thus aren't really crucial to the initial application process. (I took mine *after* interview season). I have no idea where my step 1 score fell in terms of EM competitiveness.

But letters are definately teh most important.

Completely agree with roja.

I ended up doing an FP month during my Step 2 (DOs can only take Step 2 in either August or January). My attending let me leave after lunch every day, and it was only M-Th. So I had plenty of time. I probably only had about 2 weeks total (of maybe 4-6 hours a day) of hard core studying. I ended up doing very well, though, 99%ile, but those scores were never submitted to the residencies anyways (got my scores in March).

I would look at your Step 1 score and see if you feel you need to improve it or not. I know that at our program, Step 2 scores carry much less weight than Step 1. If you did well on Step 1, hold off until later to take it (like GCS3).

Q, DO

 

[beyond all hope]

I did a medicine SubI and hated it. The only good thing about that subI was that I learned I wanted to do EM.

I don't know about other people, but I think that most EM faculty want two letters from EM rotations, and the other two should be from your third year rotations such as IM, Surg, etc.

I don't think that SubI letters help unless that person is a really outstanding member of their field, someone that the EM directors know.

The only recommendation I would add is to have at least one EM letter from a 'name' program. Anyone can get a glowing letter from Bumf*ck Mississippi, but if you get a glowing letter from Bellevue, Denver, etc that goes a long way. I got a lot of interviews simple from a strong letter from Jacobi.

Ask for your letters EARLY and OFTEN. The worst thing is to have programs rejecting you while you're still waiting on your LORs.

And use the SLOR form. SLOR is key.

 

[Dr. Zorders]

No shortage of advice on this thread.

Mine-- DO NOT use a vacation mo to study step 2...that is far too much free time. As mentioned by others, do a general month in FP or medicine or EM or elective even. Attendings are almost always understanding. Along the same lines I know many who did not take time off for interviews! Thats bold b/c your showing up <10 times/mo. Doing a rotation will keep you disciplined, while taking a mo off will keep you intoxicated...

 

[roja]

The point of having a good subI (if its an ICU) is that it shows that you can manage patients well. Critically ill patients are kind of important to be familiar with, so a strong LOR from a MICU/CCU rotation can help. but you should also definately have 2 recs from the ED, from different locations. I didn't have any from a 'name' program.