Ideal Subspecialty Electives?

[Mental Gymnast]

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I was curious if any fourth year students or residents had input on the following. I am in between third and fourth year and am starting to think about planning electives for fourth year. I will likely be going into medicine and was wondering what subspecialties are good to do away electives in or that would be easy to "shine" on (and ideally get a good letter)?

For example, it seems to me like cardiology would be difficult to bring your A-game on since no med students are natural-born experts at reading EKG's, echos, balancing CVD meds, etc? Something like endocrinology, however, seems to be a lot more straightforward and can be reviewed to a pretty good extent the weekend before (thyroid pathways, insulin time scales, etc). Am I wrong about this? Any feedback is much appreciated.

Thanks! 🙂

 

[153445]

Kids who came to my home institution for away rotations tended to choose the cardiology service, but I have a sneaking suspicion that they all will be gunning for cards. If there is a particular subspecialty you are interested in, choose that one. Your genuine interest would prompt you to do what you need to do to shine. The fellows and attendings know that students don't match a (competent) R2 in terms of skills and fund of knowledge. Your main competition will be the students who have home-court advantage ...

 

[bof]

The approach I would take towards my 4 year electives is to think of them as a supplementation to my intern year. Your intern year is going to be very busy and you may not be able to do too many electives, so use this opportunity to broaden your knowledge and get a head start on intern year. I would choose electives based on my personal interest.

Now too answer your specific question. If you want to do an "audition rotation" and shine in it I would recommend a few possible strategies.

1. Do a sub internship or unit rotation. If you do well, this is going to help you a lot, in terms of getting in the program that you are interested in. On the flip side, if you do not do so well, it can really hurt you. High risk, high reward proposal. Also note that you are going to be disadvantaged by not knowing the system compared to the home students.

2. Do a elective in a sub-speciality that you have an interest in. I say this because if you have a genuine interest in the subject you will be more likely be better perceived and get your good letter. I can not agree with your statement that some electives are always better. If a subject is straightforward, then most students will have a higher baseline knowledge and thus the standard will be raised. It may in fact be easier to stand out in a "tough" subspecialty, as most students are weak in the area. So, don't play those games and just do what you are interested in.

Remember that these rotation as as much as you getting a feel about the program and seeing if it is right for you are it is an audition rotation for them.

boF

 

[Mental Gymnast]

Thanks for the feedback Bof and wenkebach! I already completed my sub-I at a high-powered research institution and did very well. So I think I will go for a sub-specialty elective in something that I will enjoy. Thanks again!

 

[dragonfly99]

Agree with above comments, although I don't totally disagree with the student's comment that it might be easier to shine in an easy elective like endocrine (rheum is another one that comes to mind). Attendings SHOULD know that a PGY 3/4 student is going to know a lot less than an intern or resident, but sometimes they forget...

Also, if you do an elective on a less busy service, you likely won't have to work as hard so will have perhaps more time to interact with other students there and house staff, get to know the hospital, etc. However, as long as you are the type of person who can suck it up, I would just pick whatever specialty interests you, even if it happens to be cards.

 

[souljah1]

A subinternship in medicine and a subinternship in the unit...spend the rest of your fourth year being lazy...

 

[Gastrapathy]

Do GI. Its the most fun, the fellows are usually happy and you'll need to publish to get it so you might as well find a case report or something. Just stay away from any Liver Transplant service (no matter what they say).

 

[elwademd]

if you know that you want to do medicine residency, do something that you're not going to do in residency training. broaden your horizons.

opthamology. you're going to be referring your diabetic patients to them. it might interest you to know what they do, and how they do it.

dermatolgy. some medicine residencies do a month in it. some don't. but given this thread: http://forums.studentdoctor.net/showthread.php?t=595976 , it's something you may want to think of.

sure, you could do endocrine, gi, and cards, but you're likely to do them in residency.

you're not likely to have much choice of what you do and exactly when you do it in residency. cherish this time, and do rotations because you have genuine interest, as you may not have another chance.