Most helpful MS-4 electives?

[Leukocyte]

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I will be a MS-4 soon, and have to decide on 4th year electives. I am planning on going for General Surgery in 2006.

What 4th year electives best prepares you for the intern year in General Surgery?

My list thus far (I have to do 9 months of electives, 2 have to be in Medicine):

1) Medicine Sub-I ?????????????
2) Critical Care Medicine ???????
3) Neurology (a required elective)
4) General Surgery Sub-I
5) Surgical Critical Care
6) A Surgical sub-specialty ????????
7) A Surgical sub-speciality ????????
8) Radialogy ??????????????????????
9) Anesthesiology ?????????????????

So, as you can see, I have a lot of question marks. What 2 Medicine electives should I do? What Surgical electives? Is doing an Anesthesia elective helpfull? Is doing a radiology elective worth it? 😕

Any input will be greatly appreciated.

Thanks in advance.

 

[dr.evil]

Radiholiday, Anesthesia, ONE surgical sub-I (ok, at most two), vacation, cruise to the bahamas, "research", "advanced anatomy", more radiology, physical education, etc

If you REEEAAALLYY feel like doing something constructive...

Medicine sub-I's I would do = Cardiology, Nephrology, or Infectious Disease

Surgery sub-I's = General Surgery, Maybe Vascular or even Critical Care (I only did one month of general surgery and it worked out great)

Anesthesia = definitely. You get to intubate a ton and you're home by noon (at least 4th years were at my med school)

Radiology = This is helpful two-fold. One, it's easy and you go home early. Two, you will really learn how to read your own films which is absolutely priceless. I actually did a month of Diagnostic Radiology and a month of nothing but Computed Tomography. I can't tell you how helpful that has been.

Really though, take it as easy as humanly possible. 4th year is the time for ALL GUNNERS to relax. Learn a little, lounge a lot.

Just writing about this makes me miss 4th year bad.

 

[Leukocyte]

Thanks Dr. Evil. You are Dr. Angel in my eyes. 👍

 

[njbmd]

Hi there,
My fourth year electives were: Gastroenterology, Geriatric medicine, Radiology, Neurology, Cardio-Thoracic/Critical Care Anesthesia (you get critical care and intubation with vent management). I also did Trauma/Burns and Endocrine Surgery (you can do lots of procedures and operating). These worked out best for me and made me a better PGY-1.

njbmd 🙂

 

[Leukocyte]

Thank you Dr. njbmd 🙂 It a real pleasure (and a great asset) to have you in this forum.

 

[Blade28]

For medicine, I did nephrology (for fluids/electrolytes/ARF), and will do cardiology later in fourth year. I just finished a Cardiothoracic Surgery sub-I (away elective), and will do General Surgery next month. I've also added the ubiquitous SICU rotation, as well as some interests...Reproductive Endocrinology and Infertility, Plastic Surgery, Anesthesia and Radiology.

 

[Slave#8801011]

Try some away electives just so that you will get to see how other medical school surgery departments think (or even non-surgical).

Burn surgery is something that they do differently at different places.
Radiology is very good.
Derm is very good for general knowledge.
SICU is helpful.
If you don't mind thinking and working, Nephrology is a good medicine choice.
Consider ER.

At my school, rheumatology was a waste of time.

 

[fourthyear]

Radiology is extremely helpful. You will often be looking at films without a radiologist immediately available and will need some skills to work from in helping make your diagnosis.

ER is also a good one. You'll see medical, surgical, and gyn problems, both acutely ill people and primary care stuff. It's a good way to learn to sort out a differential diagnosis and triage who is the sickest and needs most immediate attention, which is what you'll often be doing as a surgical consultant. You'll get called with a consult that will turn out to be a whole different diagnosis than what you were initally called with, and learning how to figure out a complicated patient at first glance is a good skill to work on developing, and the ER is a great place to do it.

Any ICU experience will be helpful, but try to find the ones that give you at least some procedure experience, not just "talking rounds" for the students. If they don't let students put in central lines or anything, at least stick around to pull lines out, pull chest tubes out, debride wounds or help with dressing changes - all these are simple skills you'll be expected to do on your own when you start intership and you'll be much more useful to the team if you at least have good experience with the basic surgical skills.

 

[Celiac Plexus]

2 surgery blocks right at the beginning of 4th year... the chairman's service, and another rotation that you're curious about.

ICU... it's neat. Doesn't matter if you do any "procedures" there or not. ICU medicine is pretty interesting. Don't think it matters at all for prepping for intern year though because most interns don't manage icu patients. the best thing you can learn on an icu rotation is VENT MGMT.

radiology is theoretically useful... focus on chest and pelvic plain films, and chest/abd/pelvis CT. You're gonna have to know how to read these puppies. Angios are important too for vascular, and to a lesser degree plastics.

anesthesia is pretty useless... you'll learn how to put in a-lines (whoopee), and you might get to tube a patient or two...

er... totally useless. you won't get to work up any complicated patients... first of all, most of the patients are slugs, and the ones that do require emergent care will be handled by er or surgery residents. you can always learn by osmosis though. for me, i learned more on my first er call as an intern than i did on my whole freakin er rotation as a student.

cardiology is neat... you need to be able to read ekgs... a lot of residents don't know how to do this surprisingly. it's a lot easier to read ekgs yourself, and make decisions in the middle of the night than have to call cards or the senior resident because you don't feel comfortable calling the ekg yourself.

gi medicine was cool... learn a lot of GI non-op mgmt, and it's useful to get some exposure to scopes.

the best thing about 4th year though is just chilling out.

good luck.

 

[maxheadroom]

Plastics -- learn how to sew, make it look good, and do it quickly.

Trauma is a waste of time -- lots of time rounding

Burns -- good to learn come critical care, do lines, learn vents, learn skin grafts

SICU -- lines, vents, bedside procedures

A short Uro rotation -- learn how to ram any catheter up any penis at 0200 (Urojet and Couday, please)

Bahamas, Vail, Appalachian Trail . . .

 

[surg]

I agree with the relax mode, but if you really want an education, here is my list:

Radiology: if you have to choose, focus on GI (all modalities) rads or CTs (all areas). Make sure you ask for a day or two though, reading CXRs. You often have to read your own films, and you sometimes have to disagree with the radiologist, so you better know what you are talking about.

Anesthesia: only if you get to intubate. As a surgeon, you will have to manage lots of airways.

ICU: preferably a strong SICU experience in my book since those are the pts you will be taking care of, but a strong MICU experience is better than a weak SICU experience. Goals should be a passing familiarity with pressors, vent mgmt, and minor procedures (lines, tracheostomy changes, etc.)

In medicine: cardiology would be my choice. Best bang for the buck of things that make you uncomfortable at night (Pts with Chest Pain or arrhythmias); second choices: GI and Nephrology: both are good for learning to deal with acute on chronic problems.

Other specialties/subspecialties:
Plastics: you often get to do a lot of sewing and wound closures. Also knowing how to apply a vac dressing properly and debride wounds appropriately is useful as an intern.

ANYTHING easy for the months that you need to interview: every school has a rotation that you barely need to be there for. Take it for the month you are interviewing.