MD Help with deciding rotation order?

[narla_hotep]

At my school we rank our preferred rotation choices, but I'm stuck on what to do for my first 6 months of rotations. My top 5 are as follows but I have no idea what order to rank them... I know I want to do Step first, but have no idea beyond that. In addition, I will be taking a couple years off from med school after these first 6 months so idk if I should get the hardest clerkships out of the way, or start off with stuff I don't care about, etc.

Questions:
How hard is it to do surgery as your first "real" rotation? I'm tempted to get it out of the way, but also very intimidated by starting with surgery.
Do you think I should save internal medicine for after the gap bc it's something I'm actually interested in?
Would you prefer starting off with OB and ambulatory, or psych and peds?

Let me know what you would rank these and why, so I can see if any of your reasons would apply to me

Step prep, 2 wk elective, surgery, medicine
Step prep, 6 wk elective, OB, ambulatory
Step prep, 6 wk elective, psych, peds
Step prep, 2 wk elective, neuro, Family med
OB, ambulatory, test prep, 6 wk elective

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[mehc012]

It's kind of hard to rank these since they don't even have the same rotations in them. It'd be more useful if you clarified a bit more about when the rest of the rotations would be and what your rotation requirements ARE.

Also, doing IM before step prep was the best thing that happened to me.

My personal biggest preferences were:
- Have IM before surgery, because surgery covers a bunch of IM stuff, plus surgery specific stuff, with less time to study.
- Do not have surgery first or last

I ended up doing IM before Step, even, and when I got to dedicated it felt as if I'd just finished learning all of that stuff.

 

[mvenus929]

In the end, it won’t really matter.

However, if you are taking time off, I recommend doing less elective time up front, since you may need it later on to explore other specialties that aren’t in the core group and your preferences may change in the next year or two. Surgery is easiest to do after IM, since a lot of the shelf is medicine based, but beyond that. I had OB before surgery and liked it because I got to practice suturing in a relatively low stakes environment.

 

[DocWinter]

It doesn’t matter

 

[narla_hotep]

It's kind of hard to rank these since they don't even have the same rotations in them. It'd be more useful if you clarified a bit more about when the rest of the rotations would be and what your rotation requirements ARE.

I have a 1.5 year condensed preclinical curriculum so rotations start in January. We have to do a 6 wk test prep block, psychiatry, peds, neuro, family med, IM, surgery, OB-gyn, ambulatory medicine, and a 3 month research block which I dont have to do bc im MD/PhD. Also some electives to fill in the time before residency interviews and sub-I's start. So I'm trying to figure out what to do for 6 months before I leave to do research. The only requirement is we have to take step before leaving in June.

I noticed a lot of people are saying to do IM before surgery. However, that might mean IM is my first rotation. Is that recommended? I've heard the IM shelf is really hard :/ That's why I'm tempted to do ambulatory first, because it doesn't have a shelf. Or am I doing myself a disservice by just doing "easy" things first and leaving the hard things for later, when I'm out of it and haven't done medicine in a while? I know a lot of that comes down to personal decision, just trying to figure out my life right now lol.

 

[mehc012]

I have a 1.5 year condensed preclinical curriculum so rotations start in January. We have to do a 6 wk test prep block, psychiatry, peds, neuro, family med, IM, surgery, OB-gyn, ambulatory medicine, and a 3 month research block which I dont have to do bc im MD/PhD. Also some electives to fill in the time before residency interviews and sub-I's start. So I'm trying to figure out what to do for 6 months before I leave to do research. The only requirement is we have to take step before leaving in June.

I noticed a lot of people are saying to do IM before surgery. However, that might mean IM is my first rotation. Is that recommended? I've heard the IM shelf is really hard :/ That's why I'm tempted to do ambulatory first, because it doesn't have a shelf. Or am I doing myself a disservice by just doing "easy" things first and leaving the hard things for later, when I'm out of it and haven't done medicine in a while? I know a lot of that comes down to personal decision, just trying to figure out my life right now lol.

Personally, I found it easier to get the big picture first. Yes, IM is 'hard', but it's also fairly complete, in its own way. So by taking it first, I felt that I had a longer rotation when I was able/motivated to sit down and get the clinical/Step 2 overview of, well...most things. Going forward, it's more about adding to that foundation. For example, surgery has a LOT of IM on its shelf, but it also has a lot of stuff that's specific to surgery itself. I didn't want to do just GI in isolation, and then the surgery-specific UW questions, and then kind of flail about half-assedly trying to pack in the IM subjects that seemed most relevant to me while I was working a ton of hours in a short amount of time. Having done IM first, now I can just do the surgery questions and maybe redo the GI ones, while already having the basic IM framework. Same with my other rotations, really.

If I were you, I'd probably do IM and surgery now, while you still know things and are in the game, then come back with ambulatory to give myself time to get back into it. But that's just me...I prefer to frontload and coast later.

 

[mvenus929]

IM is most similar to the content you’ll be studying to take Step 1. So having it first is not necessarily a bad thing, because presumably you’ll remember much of the pathology that you had to study for Step 1. You’ll be focusing on slightly different things, but you’ll have a stronger base.

 

[mehc012]

IM is most similar to the content you’ll be studying to take Step 1. So having it first is not necessarily a bad thing, because presumably you’ll remember much of the pathology that you had to study for Step 1. You’ll be focusing on slightly different things, but you’ll have a stronger base.

Exactly! All of the 4th years I've talked to had 3 main conclusions about shelf exams: FM was the hardest, IM felt way more like Step 1 than they'd expected (and more so than the others), and surgery was basically IM plus some surgery-specific topics.

I ended up taking my IM shelf after finishing 2nd year but before taking Step 1. No joke, my step 1 UW scores increased far more over the course of that rotation than they did throughout my entire dedicated Step 1 review period (and I only did Step 2 UW during the rotation).

 

[Iz_FtB]

Any advice for people yet undecided about their specialty going into clerkships? Better to place potential specialties earlier in the process or later?

My bias is earlier given that if a clear decision can be made regarding a specialty, it allows for more time to do field specific research. Not sure if this idea jives with reality, though.

 

[mehc012]

Any advice for people yet undecided about their specialty going into clerkships? Better to place potential specialties earlier in the process or later?

My bias is earlier given that if a clear decision can be made regarding a specialty, it allows for more time to do field specific research. Not sure if this idea jives with reality, though.

I kinda figured 'middle'. Start and end with my "helllll no" specialties to account for the learning curve (first) and time crunch (last), put the rest in that sweet spot in the middle.

 

[takeurmeds02]

At my school we rank our preferred rotation choices, but I'm stuck on what to do for my first 6 months of rotations. My top 5 are as follows but I have no idea what order to rank them... I know I want to do Step first, but have no idea beyond that. In addition, I will be taking a couple years off from med school after these first 6 months so idk if I should get the hardest clerkships out of the way, or start off with stuff I don't care about, etc.

Questions:
How hard is it to do surgery as your first "real" rotation? I'm tempted to get it out of the way, but also very intimidated by starting with surgery.
Do you think I should save internal medicine for after the gap bc it's something I'm actually interested in?
Would you prefer starting off with OB and ambulatory, or psych and peds?

Let me know what you would rank these and why, so I can see if any of your reasons would apply to me

Step prep, 2 wk elective, surgery, medicine
Step prep, 6 wk elective, OB, ambulatory
Step prep, 6 wk elective, psych, peds
Step prep, 2 wk elective, neuro, Family med
OB, ambulatory, test prep, 6 wk elective

You're taking Step 2 before your time off, right? I'd do step prep as close to that time as possible. Doesn't make much sense to do it first, how can you prep when you don't have a foundation?

I would save Medicine for when you come back but not let it be the first thing you do. Probably put that somewhere towards the middle when you come back (if you can) since that's what you're interested in.

If you absolutely hate surgery, then I'd do it now. It does make it a bit more difficult if you don't have medicine first but if you have no interest whatsoever, then so be it.

That sucks that you have to split your 3rd year up.

Any advice for people yet undecided about their specialty going into clerkships? Better to place potential specialties earlier in the process or later?

My bias is earlier given that if a clear decision can be made regarding a specialty, it allows for more time to do field specific research. Not sure if this idea jives with reality, though.

I've heard it's best to put your interest in the middle so that you have some time to become comfortable with clinical work and if you don't like it after all, you still have half a year to figure it out.

You could also do it last but then you have to keep your eyes open for secondary interests in case you finally get to your primary and you don't like it. This also means that you have to bust your butt on every rotation in case you end up not liking your interest at the end and want to switch. Keep in mind, there's less room for recovery if you haven't done as strongly throughout the year and, on top of that, don't like your initial interested specialty.