chicamedica

1K Member
15+ Year Member
Jul 31, 2003
1,797
43
USA
Status
Attending Physician
I am having a hard time deciding the order of my 4th year rotations, mostly wrt Step 2.

The major concern I have is, I will be coming off of a research year during which I has clinical exposure only about once a week in an outpatient clinic.

My advisor recommended that I start with a consult service or two (namely pulm and cards) prior to even doing the anesthesiology sub-I, just to get back into the swing of things and review these two major organ systems that are most important for anes. I think this is a great idea.

In addition to pulm and cards i'd also like to take an ID consult month (won't really be that useful for anes sub-i though). In fact, i'd think ID would be more high yield than a pulm month otherwise. I could be wrong.

Since I have been out of the loop for a while in terms of inpatient patient care, I'm thinking i should take Step 2 after doing my medicine sub-I.

There is also this amazing CCM elective at my school that everyone raves about with minimal scut and loads of teaching. People have said a lot of step 2 questions deal with ICU cases, so I'm thinking this elective would be a good one to take prior to step 2.

I am required to take Step 2 prior to the end of November by my school. But I'd also like to take it early enough so that if I do really well, it could help boost my chances at top programs.

right now, the plan looks like:

June-- consult (pulm or cards)
July-- consult (pulm or cards)
Aug-- anesthesiology sub-i
Sept--CCM or med sub-I
Oct--med sub-I or CCM
Nov--step 2 study month, take step 2 @ end of the month

I am just concerned that taking step 2 at the end of november will be a tad late to do me any good in terms of boosting my chances at a top tier school (2 of which are my 1st choices currently) AND this schedule leaves no room for a pre-match away elective.

What my question is, if I'll get more learning about cards or pulm physiology in CCM, maybe I can postpone one of the consult months until later, instead of risking ending up on a consult service where there might not be much teaching at all?

Or, if the med sub-I won't help significantly for step 2, I can definitely take the sub-I later.

I appreciate any and all advice.

My stats to put this in context:

223 on Step I
3rd year grades: 1 honors (fam med), mostly HP's (emed, outpatient med, peds, surgery, neuro, psych), and 2 P's (medicine--was very 1st rotation--and ob/gyn)
1 non-1st author pub from med sch summer research
uncertain about yield of pubs from current research (will have a few poster presentations soon, though)
 
OP
C

chicamedica

1K Member
15+ Year Member
Jul 31, 2003
1,797
43
USA
Status
Attending Physician
Ok i think my questions got lost in the above rambling. . .sorry.

1) Which of these rotations would be helpful/unhelpful for Step 2?

2) Which of the consult services would be most helpful to take prior to anesthesiology elective (cards, pulm, or id?)

3) is step 2 @ end of Nov a bit late to do me any good in the residency app process? If not, i'll just quit stressing. . .


Thanks!
 

xampower

Member
10+ Year Member
5+ Year Member
Oct 4, 2004
97
0
Status
chicamedica said:
Ok i think my questions got lost in the above rambling. . .sorry.

1) Which of these rotations would be helpful/unhelpful for Step 2?

2) Which of the consult services would be most helpful to take prior to anesthesiology elective (cards, pulm, or id?)

3) is step 2 @ end of Nov a bit late to do me any good in the residency app process? If not, i'll just quit stressing. . .


Thanks!
First take a deep breath. Congrats on making the decision to pursue anesthesia. I will first say that I think you are a good applicant and have a good shot at the top programs based on the info above. As far as step 2, I think Nov. is a little late if you are hoping to use those scores for your application. It takes 4 weeks to get results so you won't be able to have them in until Dec. It seemed to me that I had heard from most programs by late November early december. I think your scores are competitive but if you feel you can increase your step 2 score then I would take it much earlier.
It is my opinion that what is learned on rotations and preparation for boards are two different beasts. If I had to pick one of the rotations above to help with boards I would probably go with cards. However, I don't think rotations are much help for the boards. Granted you must have them as a foundation but I found that boards are simply a matter of reading and doing questions. Repetition, Repetition, Repetition. I would advise you to do a rotation which you know will be a light the month before boards and study as much as possible during this month. Doing a month in cards, ID, etc will help you out for about 10% of the exam. Boards are about details and associations that we forget.
As far as rotations before anesthesia...as a student doing a rotation most of your participation will be with intubation and induction. Therefore you will be dealing mostly with airway management. Again, if I had to pick one I would say pulmonary. I think you would be just as well prepared if you picked up Baby Miller and read some of the basics. This will prepare you just as much if not more than a pulmonary rotation. I hope this helps.
 

MAC10

A Pimp Named Slickback
10+ Year Member
5+ Year Member
Dec 28, 2004
156
0
Status
IMHO

Seeing that youve done well in all the basic roatations of 3rd year....

The most important month will be the month off to study.

June- I would take the first month memorize crush the boards and do all of q-bank for 3.5 weeks straight. Then take step 3 at the end of the month.

July-Then do ICU-get some procedures, lntubations, learn about ventilators, geat a letter, read up on Anesthesia and gear up for next month.

Aug-Sept do your Anesthesia month perferably two, get your letters and then concentrate on working on your application.

Oct on-whatever..relax on the beach somewhere hell you earned it

You can do all the those subI and speciality rotations and learn practical stuff but when you study for the boards you need to study the answers they want. Im studying for StepIII myself and while doing practice questions, at first, I would go for the answer that was what I would do in real practice, but sometimes thats not the answer the board wants. Anyway, all that to say..youve got the base with your 3rd year rotations, you still had clinic all this time, now its time to study what they want you to know.

If its not required..dont waste time with all the SubI's, right now you want to put yourself in the best position on match day. This means good step II score+good LORs+good personal statement+well thoughtout application+ well rehersed interview.
 
OP
C

chicamedica

1K Member
15+ Year Member
Jul 31, 2003
1,797
43
USA
Status
Attending Physician
Thanks so much for the helpful advice!

I'd want to have the option of not sharing the step 2 score if it's not as good as expected, so I'll prob plan on taking it in Sept or Oct. (I'll use up one of my vac months for studying).

About the medicine sub-i--

I am actually required to take it for graduating. Question is. . .when?

I'm concerned that my "Pass" in my 3rd yr medicine clerkship may be received lukewarmly by prelim/transitional programs, so I feel I should try and redeem myself in the med sub-i in time for residency application too, otherwise i may end up in trouble matching for intern year. Am i unnecessarily worried about this?
 

MAC10

A Pimp Named Slickback
10+ Year Member
5+ Year Member
Dec 28, 2004
156
0
Status
Even if you take Step II in Sept or Oct you will still have the results by the time you interview in Dec/Jan and you may be asked. Anyway programs dont know when you take the exam.. you can take it in June and say otherwise (not condoning this ;) ). You dont ever have to release the results if you dont want to. And in no interview was I asked to account for my 4th year month by month. I think that Medicine pass will be overshadowed by the year of research that happened after it. BUT If you must do Med Sub I you can do it in Oct, okay Honor it..you can update your application, and you can mention it at your interviews if it comes up. I was never asked about medicine but I did discuss my ICU experience alot on interviews. Also I would get two Anesthesia rotations in...just to show you are really interested..and letters. Prioritize. A strong stepII and strong letters will go farther than a Medicine "high pass" etc.

PS: Relax
 

xampower

Member
10+ Year Member
5+ Year Member
Oct 4, 2004
97
0
Status
chicamedica said:
Thanks so much for the helpful advice!

I'd want to have the option of not sharing the step 2 score if it's not as good as expected, so I'll prob plan on taking it in Sept or Oct. (I'll use up one of my vac months for studying).

About the medicine sub-i--

I am actually required to take it for graduating. Question is. . .when?

I'm concerned that my "Pass" in my 3rd yr medicine clerkship may be received lukewarmly by prelim/transitional programs, so I feel I should try and redeem myself in the med sub-i in time for residency application too, otherwise i may end up in trouble matching for intern year. Am i unnecessarily worried about this?
I agree with MAC10, take the boards early. After just recently going through the interview process I walked away with the assumption that programs look primarily at three things when granting interviews. Board scores, letters of rec (esp your gas letter), and the overall appearance of your application ( ie are your grades, extracurriculars and research consistent with your letters and score). I can't reiterate how important I think board scores are. And I don't think either (step 1 or step 2) is weighed more heavily. Actually, I am A DO student and only took USMLE step 2. Many of the programs blatantly stated to me that they prefer step 2 scores because it tests clinical knowledge, but most students are afraid to take it during interview season.
I think your focus should be on boards and your anesthesia month (s). Like I previously said programs look at board scores and letters. Set yourself up to get a letter from a known faculty member in the field and do well on Step 2. It sounds like you are a little weary to take it but if you take the time to study and properly prepare it will pay off. If there was one single thing you could do to carry your application I think it is doing well on step 2.
 
OP
C

chicamedica

1K Member
15+ Year Member
Jul 31, 2003
1,797
43
USA
Status
Attending Physician
I just want to thank you all again SO MUCH for the advice. You have no idea how much less stressed about this I am now.

I think i will end up doing the med sub-i around march (which will prob be more useful to me towards the end of the year in preparing me for intern year)

instead i'm hoping to fit in an extra anes or ICU rotation (away, perhaps).

I've heard some mixed opinions on doing away rotations, at least for anesthesia. Some people say it's unhelpful especially in this field, others say it's good at least to get a feel for a program I might be interested in, and still others say that it really helps as far as matching goes.

What do you guys think about away electives?
 

fejack

Junior Member
10+ Year Member
5+ Year Member
Feb 10, 2005
12
0
Status
For a different perspective, I did not decide on Anesthesiolology until October and still have not taken Step 2 yet.

I wanted to decide what I'm going into (after multiple electives), apply, interview, rank, match, and I'm taking Step 2 in April, along with many friends.

Not one interview asked me about step 2, or why I haven't taken it. I never even thought it was an issue, b/c my understanding was we can take it literally whenever we want.

Just a different perspective. Good luck!

chicamedica said:
I just want to thank you all again SO MUCH for the advice. You have no idea how much less stressed about this I am now.

I think i will end up doing the med sub-i around march (which will prob be more useful to me towards the end of the year in preparing me for intern year)

instead i'm hoping to fit in an extra anes or ICU rotation (away, perhaps).

I've heard some mixed opinions on doing away rotations, at least for anesthesia. Some people say it's unhelpful especially in this field, others say it's good at least to get a feel for a program I might be interested in, and still others say that it really helps as far as matching goes.

What do you guys think about away electives?