Internal Med- sub internship

[medlyfe19]

Hi everyone, I am a fourth year medical student. I am planning to apply to internal medicine. Unfortunately my medical school did not have a good inpatient internal medicine rotation for third year, therefore I feel very unprepared on my sub internship, this internship is in a big university hospital on the east coast. As far as pimping and medical knowledge I feel confident, but when it comes to charting (like progress notes/discharge/ consults, etc) I am having a very difficult time. Does anyone have any pointers?

Also, I have heard some people say that it is not necessary to do a sub-internship experience and many have encouraged me to enjoy my fourth year by setting easier rotations, but I was wondering by not having the sub-i experience will this cause intern year to be more difficult? Any thoughts on this would be very appreciated.

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[Crayola227]

I think it's a mistake not to have 1 solid sub-I in acute hospital care under your belt starting intern year. I think it's a mistake not to have any real ICU experience.

It depends on who you talk to regarding what to do with your 4th yr. You just have to ask yourself if you will really be relieved to find that that you made things too hard on yourself after scheduling a more rigorous 4th yr than your friends after you start intern year, vs how likely are you to struggle and regret you didn't do more.

You may not be the best person to determine if you've had enough experience. You should be the best one to tell if you really do need more.

SDN frequently likes to tell people not to give in to "typical" student fears, like not being prepared for MS1 or intern year, and tell you not to study over the summer and to take it easy 4th yr.

That's great if you're the typical student and these are typical fears. Do you have reason to be worried?

It's OK if you do. Contrary to common wisdom, I'll tell people that didn't get nearly enough biochem to look it over if anything before MS1, and I'll tell someone that really thinks they didn't get enough quality clinical experience to do a few more challenging rotations.

Unless you fail, you have very little to lose after interview season in doing more rotations.

I know people who feel they did too much 4th yr. And those that didn't do enough.

One in my intern class did like 4 sub-Is back to back to back. Still dumb as a stick but at least they were as prepared as one could be. Smart and unprepared might catch up to that, sure. It seemed like a waste of 4th yr to the rest of us interns, except that person left us in the frakking dust. Efficiency, speed, success, getting home early intern year - that might be worth the investment of a few med student months. Or not, if you can get there without it, great. If you struggle you might otherwise wonder if you had worked harder 4th year.

 

[Crayola227]

TLDR:
For IM I recommend one good solid hospital sub-I and one solid ICU rotation at least. Some do fine without them going in, I guess.

 

[MedicineZ0Z]

Agree with poster above. And for those going into other fields, do stuff that helps you develop certain skills! If you're doing EM, make sure you do at least one anesthesia elective, and stuff like opth/ent. Peds? Do a couple subspecialties where you get less exposure to in residency.

You want to develop important skills both in what you need intern year and what your residency may lack in.

 

[Shigaliketoxin]

Your school will let you graduate without a sub-I??

 

[medlyfe19]

Thanks everyone for your help! Yes they do let you graduate without sub-I in medicine, I do have two upcoming sub-i’s but I keep hearing mixed opinions about doing less sub-i’s vs doing more so I wanted to ask on here. Thanks again !

 

[IMreshopeful]

Agree that a sub I will help prepare you for intern year by giving you more responsibility and workload. It’s a more accurate representation than third year, though not perfect.

 

[MSTP18]

Your school will let you graduate without a sub-I??

My thought exactly. Feel like OP can't be an AMG with that thought process.

 

[MedicineZ0Z]

My thought exactly. Feel like OP can't be an AMG with that thought process.

A lot of subIs are over rated. It's not the biggest deal really.. You just need some autonomy exp at someee point in ms3-4 and that's luck of the draw.

You also need to be efficient at doing notes and misc tasks/resident scut work prior to intern year, ideally. That leaves you more room and mental energy to improve at actual medicine.

 

[MSTP18]

A lot of subIs are over rated. It's not the biggest deal really.. You just need some autonomy exp at someee point in ms3-4 and that's luck of the draw.

You also need to be efficient at doing notes and misc tasks/resident scut work prior to intern year, ideally. That leaves you more room and mental energy to improve at actual medicine.

I wasn't really commenting at all on the merits of a sub-i. I was under the impression that the vast majority (all?) LCME accredited schools require at least 1 in something as a requirement for graduation. Is that not the case? In my mind (which maybe is wrong?) it was akin to saying someone is probably a DO student if they come on here saying they've heard maybe it's not worth taking Step 2 as an MS4 and are considering not taking it.

 

[Crayola227]

Your school will let you graduate without a sub-I??

A subI in one field might not be as helpful in another. If you do a peds subI for whatever reason, and go into ob/gyn, it might not be as good of prep.

That's why regardless of a school's subI requirement, ie that they have you do one, it's worth asking what rotations should one do to prepare for their intern year.

I did 2 subIs, and the second subI meant I didn't have to do an ICU rotation as a med student. Mistake. If I had done one subI and an ICU month, I would have been lacking a subI for the fields I was considering. So that's why it's a legit question for someone to ask that is going into IM if they need to do one or more IM subIs.

 

[deleted898021]

I wasn't really commenting at all on the merits of a sub-i. I was under the impression that the vast majority (all?) LCME accredited schools require at least 1 in something as a requirement for graduation. Is that not the case? In my mind (which maybe is wrong?) it was akin to saying someone is probably a DO student if they come on here saying they've heard maybe it's not worth taking Step 2 as an MS4 and are considering not taking it.

Never heard of a subI being a requirement to graduate at most medical schools. I know plenty of people in both MD and DO schools who were going for stuff like FM or IM who never did a “subI” it’s just “highly recommended “ at my school and many schools though..

 

[Matthew9Thirtyfive]

Please check the dates before you resurrect threads. Let the dead rest.