Long Term Planning for Pre-MS1 students

[molecular_medic]

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So, as many med students do, I enjoy long term planning and preparation. In order to facilitate the best possible chances for myself, and anyone else who stumbles onto this thread, I have a few questions regarding planning for MS1 matriculation.

Would it be possible to summarize the process of moving through medical school and into the professional world? I know the bare basics of two years didactic, exams, two years rotation, internship, residency, specialty training (beyond residency?). Can anyone provide information beyond basic timeline. For instance, are rotations provided by the school or are they competitive entry? Do COMLEX/USMLE scores matter beyond becoming licensed? What part does a fellowship play? How does one become competitive among outstanding peers?

Thanks! Sorry if these questions are "newb-ish" (to use gamer lingo). I am desperately trying to tame my anxiety and anticipation through preparation and path planning.

 

[kbeitz]

Buy a copy of med school confidential and read.

 

[IslandStyle808]

I am having a hard time believing you are a gamer sir. We gamers use the term "noob." I kid. 😉

Can't answer too much of the specifics. For rotations, most will either use a ranking list or lottery system to determine where students go for their core rotations. I think you are matriculating into LECOM, if I am not mistaken, so I think it is a "do it yourself" set up. For the boards, you need to do extremely well and this will sever as a launching pad to competitive residency programs. However, Step III/Level III doesn't matter too much when matching to a fellowship (YMMV). Fellowships play the role of you training to be an expert in a certain type of medicine. However, the longer one trains in fellowship the more confined one is to it. For instance, a cardiologist does heart stuff, but cannot do the general internal med stuff as well as some who has only done an IM residency and is currently an attending (there are exceptions of course). This is because of spending 3 years focusing on the heart/cardiovascular issues mainly. However, if one does a fellowship like pain (1 year) after a anesthesia residency, they can practice both fairly well. As for the whole competitive thing, it is 1. strong board scores, 2. strong grades during clinical rotations, 3. research, 4. networking. Of course needing research may vary depending on what field your after, but those four seem like the most important things necessary.

 

[AlteredScale]

are rotations provided by the school or are they competitive entry?

Variable. Some schools like LECOM are little more lax on where rotations occur. That doesn't mean they are "bad" but sometimes people prefer knowing exactly where they will be for one year (third year). Many MD schools with university hospitals will allow students to do all rotations at that hospitals. Some MD schools require rotations at multiple hospitals to get both a community, academic, VA experience if those affiliations are there.

Do COMLEX/USMLE scores matter beyond becoming licensed?

Board licensing and the ability to become board certified has nothing to do with your COMLEX/USMLE scores. You are board eligible by completing an accredited residency program by the ACGME or the AOA. Now obviously if you screw up your COMLEX and/or your USMLE you won't get a residency, hence will not be board eligible.

What part does a fellowship play?

A fellowship is utilized as a way to increase your clinical acumen within a specialty (this is why a fellowship is considered a subspeciality). In many cases, it is utilized as a stepping-off for those at university medical centers to enter faculty positions (adjunct/associate/assistant professor). Many of these fellowships have protected research time (a lot of GI fellowships give 6 months - 1 year of protected research time) to work with a strong mentor and potentially obtain a pathway to independence grant (this is a K99/R00 NIH grant award) however the competition to get to this point is absolutely fierce and in many ways, one must get lucky to find the right mentor/PI to do research with at the right time that happens to be the hot topic (these trending topics can change year to year).

How does one become competitive among outstanding peers?

Being "competitive" is such a subjective term in medical school. Are you wanting to do a surgical residency like ENT? Neurosurgery? Are you trying to enter IM to enter academic medicine? Each of these have a different "plan" so to speak in terms of how one becomes competitive. Overall I guess you can say: do well in your preclinicals, kill your boards, kill your rotation grades, get some productive research (posters, presentations, publications - publish or perish!), get outstanding letters from department chairs and stay on the good side of your school. It's quite a feat and you'll have to push yourself much farther than you've ever pushed yourself. Be prepared for bags under the eyes.

 

[molecular_medic]

Variable. Some schools like LECOM are little more lax on where rotations occur. That doesn't mean they are "bad" but sometimes people prefer knowing exactly where they will be for one year (third year). Many MD schools with university hospitals will allow students to do all rotations at that hospitals. Some MD schools require rotations at multiple hospitals to get both a community, academic, VA experience if those affiliations are there.



Board licensing and the ability to become board certified has nothing to do with your COMLEX/USMLE scores. You are board eligible by completing an accredited residency program by the ACGME or the AOA. Now obviously if you screw up your COMLEX and/or your USMLE you won't get a residency, hence will not be board eligible.



A fellowship is utilized as a way to increase your clinical acumen within a specialty (this is why a fellowship is considered a subspeciality). In many cases, it is utilized as a stepping-off for those at university medical centers to enter faculty positions (adjunct/associate/assistant professor). Many of these fellowships have protected research time (a lot of GI fellowships give 6 months - 1 year of protected research time) to work with a strong mentor and potentially obtain a pathway to independence grant (this is a K99/R00 NIH grant award) however the competition to get to this point is absolutely fierce and in many ways, one must get lucky to find the right mentor/PI to do research with at the right time that happens to be the hot topic (these trending topics can change year to year).



Being "competitive" is such a subjective term in medical school. Are you wanting to do a surgical residency like ENT? Neurosurgery? Are you trying to enter IM to enter academic medicine? Each of these have a different "plan" so to speak in terms of how one becomes competitive. Overall I guess you can say: do well in your preclinicals, kill your boards, kill your rotation grades, get some productive research (posters, presentations, publications - publish or perish!), get outstanding letters from department chairs and stay on the good side of your school. It's quite a feat and you'll have to push yourself much farther than you've ever pushed yourself. Be prepared for bags under the eyes.

This has been incredibly informative. Thanks!