ICU vs. Sub-I away rotation?

[DoctorWannaBe]

I applied for an away rotation recently and just found out that the only electives available that I'm interested in are either PICU in August or a Peds Sub-I in mid-October to mid-November. The Sub-I seems kind of late in the year for me to show off to the program and hopefully get an interview. However, I'm worried about doing PICU as an away rotation in case it is so difficult that I don't impress the program. I don't have any experience managing ICU patients, so I'll have to learn all about vent settings, etc. Which would be the best choice?

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[colbgw02]

Are you sure you won't get an interview anyway?

There's no reason why a good performance mid-Fall rotation wouldn't help your chances to get into a program, but if you're that worried that you won't get invited for an interview then it's an easy decision.

 

[DoctorWannaBe]

Are you sure you won't get an interview anyway?

There's no reason why a good performance mid-Fall rotation wouldn't help your chances to get into a program, but if you're that worried that you won't get invited for an interview then it's an easy decision.

Thanks for the advice. I'm an average applicant and the program isn't one of the top programs, so I think I would get an interview based on my application alone. What I'm more concerned about is whether it is harder to do well on an ICU rotation or a Sub-I rotation. I've always gotten good clinical evaluations, but I don't want to blow it by doing an ICU rotation when I might do better on a Sub-I.

 

[pillowhead]

I'm going into Anesthesiology, not Peds, but my first rotation of 4th year was an Cardiovascular/thoracic Surgical ICU rotation. Of course, I was in way over my head and had little idea what was going on, but I still made a good impression because no one in a NICU or advanced SICU can possibly expect a new M4 to come into that situation knowing anything useful. What you can impress people with is your enthusiasm and ability to ask questions which should be very easy for you to convey given that it's such a novel and interesting place to be for an M4. You may suck at ventilator settings and have no idea what to do for a daily progress note and presentations, but you have so much room to move up in your knowledge base that you can really impress your team with the new information you learn. Learn to be flexible and adaptable, really read up on what you see every day, and GET BETTER. Volunteer for all the procedures you can (may be tough in the NICU but perhaps you can still get a handle on IVs on the little guys) and just be enthusiastic. You should improve dramatically over the course of a month and that should be duly noted.

A sub-I is also useful but the expectations will be higher in the sense that you should pretty much have a handle on 95% of what a gen peds intern does already. I think the NICU would be more interesting and a better learning experience. I personally didn't learn a whole lot on my 4th year sub-Is. I just got better at learning to do discharge paperwork and fill out radiology forms. The actual medical knowledge you need isn't that different to 3rd year.

Thanks for the advice. I'm an average applicant and the program isn't one of the top programs, so I think I would get an interview based on my application alone. What I'm more concerned about is whether it is harder to do well on an ICU rotation or a Sub-I rotation. I've always gotten good clinical evaluations, but I don't want to blow it by doing an ICU rotation when I might do better on a Sub-I.