My question on rotations - and a great thread I found

[theWUbear]

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I didn't know much about rotations, but I used the search function, and this thread was very helpful

http://forums.studentdoctor.net/showthread.php?t=540311

I still have a couple questions. First, what is sub-Is?

The thread talks a lot about "away" rotations. I deduce from this, that "home" rotations are those with which your medical school has an affiliation. Correct?

If that is the case, do medical schools keep a list on their websites showing where their students can rotate?

Is there competition amongst MS2's to get the best rotations within a school's "home" rotations?

 

[tremulousNeedle]

I didn't know much about rotations, but I used the search function, and this thread was very helpful

http://forums.studentdoctor.net/showthread.php?t=540311

I still have a couple questions. First, what is sub-Is?

The thread talks a lot about "away" rotations. I deduce from this, that "home" rotations are those with which your medical school has an affiliation. Correct?

If that is the case, do medical schools keep a list on their websites showing where their students can rotate?

Is there competition amongst MS2's to get the best rotations within a school's "home" rotations?

SubI = Sub-Internship = Acting Internship: This is a course during your senior year where you function just like one of the interns on your service. You have your own patients and report directly to the senior resident, fellow, or attending, instead of working with an intern (which is fairly common during third year rotations). The specific responsibilities of these rotations vary by school and specialty.

Away rotations are courses as hospitals not directly affiliated with your school.

On their websites, schools will usually offer details regarding where their students rotate, i.e. affiliated hospitals. Most schools don't advertise where their students do away electives because this is completely random and based on the individual student's preference.

Competition over the best rotations is school dependent. However, many schools utilize a lottery system to assign clinical rotations, so this eliminates competition there.

-senior medical student / admissions committee interviewer

 

[BlueElmo]

SubI = Sub-Internship = Acting Internship: This is a course during your senior year where you function just like one of the interns on your service. You have your own patients and report directly to the senior resident, fellow, or attending, instead of working with an intern (which is fairly common during third year rotations). The specific responsibilities of these rotations vary by school and specialty.

Away rotations are courses as hospitals not directly affiliated with your school.

On their websites, schools will usually offer details regarding where their students rotate, i.e. affiliated hospitals. Most schools don't advertise where their students do away electives because this is completely random and based on the individual student's preference.

Competition over the best rotations is school dependent. However, many schools utilize a lottery system to assign clinical rotations, so this eliminates competition there.

-senior medical student / admissions committee interviewer

Cool, thanks for the info. I used to be curious about this as well.

 

[mvenus929]

I didn't know much about rotations, but I used the search function, and this thread was very helpful

http://forums.studentdoctor.net/showthread.php?t=540311

I still have a couple questions. First, what is sub-Is?

The thread talks a lot about "away" rotations. I deduce from this, that "home" rotations are those with which your medical school has an affiliation. Correct?

If that is the case, do medical schools keep a list on their websites showing where their students can rotate?

Is there competition amongst MS2's to get the best rotations within a school's "home" rotations?

A lot of away rotations are available on websites for the student to apply to. For instance, St. Jude's has a rotation for med students that you can arrange with your school's coordinator.

 

[FloatOn]

...
Is there competition amongst MS2's to get the best rotations within a school's "home" rotations?

...
Competition over the best rotations is school dependent. However, many schools utilize a lottery system to assign clinical rotations, so this eliminates competition there.

-senior medical student / admissions committee interviewer

I don't understand the OP's above question in regards to "best" rotations. I thought all MS3's eventually do the same core rotations (Ob/gyn, medicine, neurosurgery, etc.) sometime during 3rd year, and only the elective slots are limited during 3rd and 4th year.

Edit: Neurology, not neurosurgery.

 

[BlueElmo]

Pretty sure neurosurg is not a core rotation in 3rd year.

 

[FloatOn]

Pretty sure neurosurg is not a core rotation in 3rd year.

You are correct. It's part of surgery, I think like 2 out of the 8-10 weeks. I was thinking neurology, which is separate.

Edit: I think surgery is only 8 weeks.

 

[BlueElmo]

You are correct. It's part of surgery, I think like 2 out of the 8-10 weeks. I was thinking neurology, which is separate.

Ah gotcha.

 

[muhali3]

I don't understand the OP's above question in regards to "best" rotations. I thought all MS3's eventually do the same core rotations (Ob/gyn, medicine, neurosurgery, etc.) sometime during 3rd year, and only the elective slots are limited during 3rd and 4th year.

He probably means best in terms of the hospital you rotate at, which might be where you want to get a residency.

 

[theWUbear]

He probably means best in terms of the hospital you rotate at, which might be where you want to get a residency.

That happens to be exactly what I meant, sorry to not be clear. IMO, if your med school has ten hospitals at which students can do mandatory rotation A, then there will happen to be a hospital with a great residency in A, so people would want to do their rotation there instead of at another hosptial. For instance, I would like to do an internal medicine rotation at a hospital more known for infectious disease than one known for cardiology.

A poster mentioned that some schools do a lottery system. That answers my question in the case of those schools.

 

[45408]

That happens to be exactly what I meant, sorry to not be clear. IMO, if your med school has ten hospitals at which students can do mandatory rotation A, then there will happen to be a hospital with a great residency in A, so people would want to do their rotation there instead of at another hosptial. For instance, I would like to do an internal medicine rotation at a hospital more known for infectious disease than one known for cardiology.

A poster mentioned that some schools do a lottery system. That answers my question in the case of those schools.

There's often a lottery, but that still means you're competing for some rotations. It's fairly unavoidable, and not necessarily a bad thing. If people weren't competing for some rotations, it might mean that none of them are worth competing for.

 

[searun]

My med school has 150 students. Third year, you are divided into 10 teams, 15 students each. We have a primary hospital and then a group of other hospitals that we rotate through, depending on the medical specialty that is the focus of the rotation. Do not whine about the hospital where you do a given rotation. That is the kiss of death. 4th year, you can do clerkships in the specialty that you want to enter. Do not cry and complain during 3rd year about where you do your rotations. Show up and do your job at the low end of the totem pole. Otherwise, take that gun out of your desk when you get home, and shoot yourself in the foot, and apply a bandaid.

 

[tremulousNeedle]

I don't understand the OP's above question in regards to "best" rotations. I thought all MS3's eventually do the same core rotations (Ob/gyn, medicine, neurosurgery, etc.) sometime during 3rd year, and only the elective slots are limited during 3rd and 4th year.

Edit: Neurology, not neurosurgery.

"Best" can mean a lot of things. You are correct that most third curriculum is the same, but there are details to consider. First, the order in which a student takes rotations may be important. A theory popular amongst medical students is that if you are interested in a specific specialty that you do not take that specialty's rotations first or last during the third year. Second, a medical school may be affiliated with several hospitals and distribute its students amongst them for their third year courses. Of these different hospitals, some may be more desirable than others.

Many schools that have to address these two issues do so by using a lottery system that is completely random.

There's often a lottery, but that still means you're competing for some rotations. It's fairly unavoidable, and not necessarily a bad thing. If people weren't competing for some rotations, it might mean that none of them are worth competing for.

I don't think competition is occurring here; a student's performance relative to another student will not affect the outcome. If I buy a lottery ticket, I don't consider myself competing with other buyers of lottery tickets, the numbers drawn are independent of what numbers any individual selects.

 

[FloatOn]

"Best" can mean a lot of things. You are correct that most third curriculum is the same, but there are details to consider. First, the order in which a student takes rotations may be important. A theory popular amongst medical students is that if you are interested in a specific specialty that you do not take that specialty's rotations first or last during the third year. Second, a medical school may be affiliated with several hospitals and distribute its students amongst them for their third year courses. Of these different hospitals, some may be more desirable than others.

Many schools that have to address these two issues do so by using a lottery system that is completely random.
...

Good to know. Thanks!

Are the lengths of rotations uniform at all schools, ie. surgery is 8 weeks, medicine is 12 weeks, etc.?

 

[tremulousNeedle]

Good to know. Thanks!

Are the lengths of rotations uniform at all schools, ie. surgery is 8 weeks, medicine is 12 weeks, etc.?

No. Medicine, Pediatrics, and Surgery are usually longer than other rotations, but many schools vary in the length of their 3rd year clerkships.

 

[Raryn]

No. Medicine, Pediatrics, and Surgery are usually longer than other rotations, but many schools vary in the length of their 3rd year clerkships.

This.

My school has 8 "core" rotations that all the 3rd years do (medicine, surgery, pediatrics, ob-gyn, psych, neuro, family med, and what basically amounts to anesthesiology). Their lengths range from 2 weeks for neurology to 2 months for medicine/surgery/pediatrics.

Other schools I know of have more, or less (the lowest I know of is 6, subtracting neurology and our resuscitation+perioperative medicine rotation).

For fourth year, theres a mix of vacation/electives/sub-i's that varies hugely from school to school. Not 100% sure how it even works here.

 

[Law2Doc]

Good to know. Thanks!

Are the lengths of rotations uniform at all schools, ie. surgery is 8 weeks, medicine is 12 weeks, etc.?

Most often you see something like surgery 12 weeks, medicine 12 weeks, OBGYN 6 weeks, Peds 6 weeks, psych 4 weeks, and then maybe family med or neuro 4 weeks, etc. Most electives thereafter are 4 weeks.

Sub-I's, as mentioned are rotations which seek to mimic life as an intern, where med students will take admissions, take call, work up patients, write orders, and discharge patients, all under the supervision of residents and attendings. A strong sub-I helps make the learning curve of internship not quite as steep by giving you a taste of what's to come. Many residency programs smile on places that are known to have more rigorous sub-Is because the graduates tend to be more ready to hit the wards right out of the box.

Away rotations should not be confused with affiliated hospital rotations. An away rotation, also known as an "audition rotation" is where you arrange, usually on your own, to do a month at another med school in order to try to impress the attendings there prior to the match. In some fields this is more critical than others. Don't confuse this with something your med school arranges in lieu of providing its own rotations, or with rotating at another hospital affiliate of your med school -- it's not the same at all. Your job in an away rotation has very little to do with the subject matter and everything to do with impressing folks. So you usually will do an away rotation in something you are planning to go into and have already taken an elective in at your home institution.

Hope this helps.

 

[BlueElmo]

Most often you see something like surgery 12 weeks, medicine 12 weeks, OBGYN 6 weeks, Peds 6 weeks, psych 4 weeks, and then maybe family med or neuro 4 weeks, etc. Most electives thereafter are 4 weeks.

Sub-I's, as mentioned are rotations which seek to mimic life as an intern, where med students will take admissions, take call, work up patients, write orders, and discharge patients, all under the supervision of residents and attendings. A strong sub-I helps make the learning curve of internship not quite as steep by giving you a taste of what's to come. Many residency programs smile on places that are known to have more rigorous sub-Is because the graduates tend to be more ready to hit the wards right out of the box.

Away rotations should not be confused with affiliated hospital rotations. An away rotation, also known as an "audition rotation" is where you arrange, usually on your own, to do a month at another med school in order to try to impress the attendings there prior to the match. In some fields this is more critical than others. Don't confuse this with something your med school arranges in lieu of providing its own rotations, or with rotating at another hospital affiliate of your med school -- it's not the same at all. Your job in an away rotation has very little to do with the subject matter and everything to do with impressing folks. So you usually will do an away rotation in something you are planning to go into and have already taken an elective in at your home institution.

Hope this helps.

Cool, that did help. Thanks.

 

[FloatOn]

Most often you see something like surgery 12 weeks, medicine 12 weeks, OBGYN 6 weeks, Peds 6 weeks, psych 4 weeks, and then maybe family med or neuro 4 weeks, etc. Most electives thereafter are 4 weeks.

Sub-I's, as mentioned are rotations which seek to mimic life as an intern, where med students will take admissions, take call, work up patients, write orders, and discharge patients, all under the supervision of residents and attendings. A strong sub-I helps make the learning curve of internship not quite as steep by giving you a taste of what's to come. Many residency programs smile on places that are known to have more rigorous sub-Is because the graduates tend to be more ready to hit the wards right out of the box.

Away rotations should not be confused with affiliated hospital rotations. An away rotation, also known as an "audition rotation" is where you arrange, usually on your own, to do a month at another med school in order to try to impress the attendings there prior to the match. In some fields this is more critical than others. Don't confuse this with something your med school arranges in lieu of providing its own rotations, or with rotating at another hospital affiliate of your med school -- it's not the same at all. Your job in an away rotation has very little to do with the subject matter and everything to do with impressing folks. So you usually will do an away rotation in something you are planning to go into and have already taken an elective in at your home institution.

Hope this helps.

Yes, it did. Thank you! I hope the OP reads your extra details as well.

 

[tremulousNeedle]

Most often you see something like surgery 12 weeks, medicine 12 weeks, OBGYN 6 weeks, Peds 6 weeks, psych 4 weeks, and then maybe family med or neuro 4 weeks, etc. Most electives thereafter are 4 weeks.

Sub-I's, as mentioned are rotations which seek to mimic life as an intern, where med students will take admissions, take call, work up patients, write orders, and discharge patients, all under the supervision of residents and attendings. A strong sub-I helps make the learning curve of internship not quite as steep by giving you a taste of what's to come. Many residency programs smile on places that are known to have more rigorous sub-Is because the graduates tend to be more ready to hit the wards right out of the box.

Away rotations should not be confused with affiliated hospital rotations. An away rotation, also known as an "audition rotation" is where you arrange, usually on your own, to do a month at another med school in order to try to impress the attendings there prior to the match. In some fields this is more critical than others. Don't confuse this with something your med school arranges in lieu of providing its own rotations, or with rotating at another hospital affiliate of your med school -- it's not the same at all. Your job in an away rotation has very little to do with the subject matter and everything to do with impressing folks. So you usually will do an away rotation in something you are planning to go into and have already taken an elective in at your home institution.

Hope this helps.

Good response, but one thing to add. All away electives are not necessarily 'audition' electives. It all depends on your reason for doing the away rotations. If it is to impress a program other than your home institution and obtain a letter of recommendation, then by all means Law2Doc is correct. However, there are other reasons to do away rotations, in which case you can focus on the clinical experience and worry less about impressing someone. Probably the most common other reason is to get international experience; in this setting you’re in it for the experience and most likely are not looking for a letter or recommendation from the experience (at my schools, international electives were almost just a common as ‘audition’ electives). Another common reason is to do a rotation at a hospital closer to home, so students can have a month to visit instead of the usual weekend. Obviously for this to work you need to pick a relatively light rotation. Sometimes the going home idea overlaps with the audition idea, but not always.

I hope this adds a little more insight.

 

[Morsetlis]

I would say that some great experiences can be had in countries where lab tests and MRIs/CTs aren't so readily ordered. However, for those residency-minded people, I suppose the audition rotations would be more keen in their minds.

 

[tremulousNeedle]

I would say that some great experiences can be had in countries where lab tests and MRIs/CTs aren't so readily ordered. However, for those residency-minded people, I suppose the audition rotations would be more keen in their minds.

Your response sounds like it is implying that you have to choose one or the other. I have several friends who did audition away electives early in the 4th year, so they could be used for the residency application process. Then, later in the 4th year, after the residency application process concluded, many of the same students went on away electives abroad to experience international medicine. You can be residency-minded and still have an international experience.

 

[45408]

I don't think competition is occurring here; a student's performance relative to another student will not affect the outcome. If I buy a lottery ticket, I don't consider myself competing with other buyers of lottery tickets, the numbers drawn are independent of what numbers any individual selects.

It's not merit-based, but the lottery systems (at least at my school) are never random. They try to give you your first choice, and only if the demand outstrips the supply will they randomize it. If there's one good hospital and two mediocre hospitals, people will all request the good one. It also depends on your goals - the surgery-minded M3s often request the tough surgery rotations, and the medicine-minded M3s will ask for the easier surgery rotations.

 

[tremulousNeedle]

It's not merit-based, but the lottery systems (at least at my school) are never random. They try to give you your first choice, and only if the demand outstrips the supply will they randomize it. If there's one good hospital and two mediocre hospitals, people will all request the good one. It also depends on your goals - the surgery-minded M3s often request the tough surgery rotations, and the medicine-minded M3s will ask for the easier surgery rotations.

Agreed. This goes to show variation: At my school the process is completely random for most rotations and for the entire third year schedule as a whole.

 

[Raryn]

Agreed. This goes to show variation: At my school the process is completely random for most rotations and for the entire third year schedule as a whole.

Versus (as I understand it at least) at my school students rank various "tracks" in the order they would prefer them, and theres a lottery if more students want a track than it can accommodate.