Med student electives to prepare for IM

[medstudent7860]

I'm a 3rd year med student currently on my IM rotation, and I am pretty sure that this is what I want to do. I am hoping to do some out-of-town IM rotations at some competitive places next summer, but before that, I have room in my schedule for 1 in-town elective. I want to take something that will help prepare me for the out-of-town IM rotations so that by then I hopefully really know what I am doing and look good. I am currently signed up for an EM rotation (which is not one of the 3rd year cores at my school) during this elective month. Is this a good rotation for me to take, considering my goals? I know EM won't directly prepare me for IM, but would it still give me some sort of knowledge base that would help? I could always try to switch to a Cardiology or Neurology elective too. My other option is doing a research month (since I haven't done any research). Which one of these 4 options would be most beneficial to succeed in my out-of-towns and for a competitive match? Thank you!

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[gutonc]

Cards, MICU, Renal, Pulm.

 

[jdh71]

I'll second the above.

And don't do away sub-I's.

 

[gutonc]

And don't do away sub-I's.

...unless you like getting your ass handed to you.

FTFY

 

[jdh71]

Real talk in this thread so far.

 

[disorder]

I'll second what was mentioned about, especially MICU (you'll get a good dose of renal and pulm here as well).

I did an away sub-I. Mistake. Worked like a dog.

 

[medstudent7860]

The out-of-town rotations I'm doing next summer may include sub-Is. I know I'll have to work a lot, but won't it help if I'm applying to that place?

 

[lymphohystiocytosis]

The out-of-town rotations I'm doing next summer may include sub-Is. I know I'll have to work a lot, but won't it help if I'm applying to that place?

You're an early third year, eh? Haven't seen to many visiting students on any of your rotations? The problem with aways, in my opinion, is that no matter how good you are you're still a med student. Very few attendings are really going to be impressed by anything you do, no matter how good your presentations are or how well you answer their questions. And you always have to toe the line of being annoying- the guy who hands out a new paper every morning about his patient is overdoing it. Add that to the fact that you're often on a team with 2-3 other students doing aways, who are also trying to suck up and look awesome. The environment can get pretty poor, depending on the team, which doesn't make anybody look good. Plus, for really competitive places, they know you really want to go there and they have hundreds of students on aways rotating through. How do you plan to stand out?

 

[gutonc]

The out-of-town rotations I'm doing next summer may include sub-Is. I know I'll have to work a lot, but won't it help if I'm applying to that place?

It might help if you completely dominate the rotation. Which you won't. Because for the first 2 weeks you'll still be trying to find your ass with both hands being in a new city/hospital/culture/EMR/etc.

Away rotations should be done for you to determine if you like the place, not to try to impress the faculty and move your way up the rank list. Note that this is not necessarily true if you're talking about DO programs, but for ACGME IM programs, most away rotations are a waste of your time.

 

[jdh71]

It might help if you completely dominate the rotation. Which you won't. Because for the first 2 weeks you'll still be trying to find your ass with both hands being in a new city/hospital/culture/EMR/etc.

Away rotations should be done for you to determine if you like the place, not to try to impress the faculty and move your way up the rank list. Note that this is not necessarily true if you're talking about DO programs, but for ACGME IM programs, most away rotations are a waste of your time.

qft

 

[jdh71]

The out-of-town rotations I'm doing next summer may include sub-Is. I know I'll have to work a lot, but won't it help if I'm applying to that place?

Medicine is not like it's prettier and more glamorous surgical sub-specialty cousins where you need to do a lot of audition rotations. You'll have classmates going for these and you'll see them scrambling to get these sought after rotations and you naturally think you should do the same in IM. Nope.

There is TOO much going on in medicine at any given time for you to be able to show up and make any kind of difference. Plus, at least for now, if you're an AMG with a pulse and no red flags on an application (and this includes *gasp* . . . "average" board scores) you will get more interview invites than you can go on.

We all are in agreement here that sub-specialty rotations are the way to go so that YOU can see if you actually like the place. It also narrows the focus of what you're trying to so (in much the same way doing a rotation on a surgical sub-specialty gets "narrowed" in focus) and gives you more of a chance not only to learn some stuff but perhaps shine.

 

[drfunktacular]

Not to dissent too much from the MICU/cards/pulmonary/general misery suggestions here, but might I suggest a rotation in rheum?

A) It's much easier than MICU, giving you time to study, and rheumatologists generally are pretty nice and have time to teach
B) You learn about rare-ish diseases that rheumatologists see a lot of but most others don't know much about, so you will look like a genius when you pull out a diagnosis of anti-synthetase syndrome in a patient with weakness and dyspnea, or chronic polyarticular CPPD arthropathy in a seronegative old lady with MCP synovitis
C) you might actually develop a decent set of musculoskeletal physical exam skills, which 90% of your IM co-residents will lack, which is funny since musculoskeletal pain is one of the most common reasons to visit a doctor
D) Rheumatology actually involves a great deal of general internal medicine; to diagnose something rare you have to be pretty comfortable ruling out things that are common
E) Who knows, you might actually like it?

 

[IM2GI]

I always recommend an easier consult rotation for aways: rheum, ID, endo. You will have enough time to see and read about your patients, write good notes, and do a good job presenting them.

I do not recommend high volume services like Cards/GI, and especially not a sub-I. You will most likely get your ass kicked, and not have enough time to get a sense for the city/program. Lose/lose.

 

[Raryn]

To be honest, if the purpose is to "prepare" for IM residency, I recommend electives like radiology, urology, anesthesia. Even ortho would probably be a good choice if you have access to one where they wouldn't mind you being primarily in clinic. Services you may never rotate on as a resident but have stuff that is relevant to the rest of your practice. You'll have plenty of time for the IM subspecialties as an IM resident.

 

[gutonc]

Rads - Depends on the elective. My school had a very generalist, mostly lec/dem first Rads elective that you had to take before they'd let you sit down next to a radiologist. It was basically 3 weeks of plain films and 1 week of everything else.

Gas - Really useful for tubes and lines/IVs but not much else for the internist. I did my required 2w of gas and learned about 10 times as much that has stuck with me from a 2w pain elective (through anesthesia).

Ortho - anything an internist needs to know about ortho can be learned from Rheum as drfunktacular pointed out above, or a Sports Med rotation.

While you can always learn something from every rotation, I don't think there's much of regular use to an internist to be gained from most surgical subspecialty rotations. Obviously if you're planning for GI a couple of weeks spent with a colorectal or HPB surgeon is a good idea, same for somebody headed to Cards hanging with a CT surgeon.