No Clue What I Want to do!! Help

[mynamewastaken]

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Hello,

I'm about to make my 3rd year schedule and I'm really having difficulty with an important decision. As of now, my 3 interests are: Anesthesiology, Urology, and Internal Medicine.

I have obviously prioritized Anesthesia and Urology higher than IM and planned on doing a rotation in both uro and anesth. 3rd year....the problem is I have only 1 elective.

I do have a surgery rotation in addition to gen surg where I can be put on the urology OR anesthesia service. The huge problem is, I will not be able to do this at a place that has either residency program. I realize this isn't a huge deal and 3rd year is mostly for the experience but I'm torn about which one to do an elective in at the program of my choice. I really want to do both to help decide what I will ultimately apply for, but I also have heard from BOTH fields that doing a 3rd year elective at a place I am interested in is highly advantageous. I would love some advice!! Thanks

 

[Smurfette]

I'm a bit confused but it sounds like you are considering doing an elective away rotation at another institution as a third year?

Actually, doing a fourth year elective at a place you are interested for residency is possibly advantageous. Third year...not so much. You want experience and exposure to the field to see if you like it, obviously, but as a third year, to go to an outside institution, when the majority of people who do this (away rotation) are fourth years with a bit more experience will make you look less favorable due to less experience. You don't want your first experience with a specialty to be under this circumstance if you think you may want to go there for residency---you want to already have a baseline knowledge of the field so you have an advantage and can present yourself in the best possible way. Most people would assume you're a fourth year if doing an away rotation so would judge your performance by a different standard than they would a third year.

Can you do your surgery elective in anesthesia and then an elective with your institution (or affiliated hospital) in GU? OR vice versa. If not, schedule whichever rotation you don't get for very early in your fourth year. Realistically, use your first two rotations of fourth year to be the two fields you are most interested in. That way, you'll know before the match process and ERAS starts which field you want to apply for. And as a fourth year, you can get your LORs from the rotation as well. Also, if you want, schedule an away rotation in your chosen field in fall of fourth year and use it to your advantage to make them want you and rank you highly.

It's not bad as a student to rotate at hospitals without residents....you may get to do more as a result (i.e. you don't have to compete with a resident). It may be good to get your feet wet there, and then you may be able to wow them later on at a different institution (with a residency programs) with how much you know.

Also, away rotations are not necessary or helpful in certain fields. Not sure how helpful an anesthesia away rotation REALLY is (probably less helpful than an GU away, as GU is more competitive and it can give you an edge over other candidates for the one or two spots there; anesthesia programs are bigger and the majority of their residents likely did NOT rotate there as a student), as you may find on the interview trail you like other places better anyhow.

 

[McGillGrad]

Your best bet is to get the most out of your cores by doing something besides surgery or IM first to get you warmed up. Once you know what you're doing, you can honor your IM and surgery rotations.

 

[mynamewastaken]

I'm a bit confused but it sounds like you are considering doing an elective away rotation at another institution as a third year?

Actually, doing a fourth year elective at a place you are interested for residency is possibly advantageous. Third year...not so much. You want experience and exposure to the field to see if you like it, obviously, but as a third year, to go to an outside institution, when the majority of people who do this (away rotation) are fourth years with a bit more experience will make you look less favorable due to less experience. You don't want your first experience with a specialty to be under this circumstance if you think you may want to go there for residency---you want to already have a baseline knowledge of the field so you have an advantage and can present yourself in the best possible way. Most people would assume you're a fourth year if doing an away rotation so would judge your performance by a different standard than they would a third year.

Can you do your surgery elective in anesthesia and then an elective with your institution (or affiliated hospital) in GU? OR vice versa. If not, schedule whichever rotation you don't get for very early in your fourth year. Realistically, use your first two rotations of fourth year to be the two fields you are most interested in. That way, you'll know before the match process and ERAS starts which field you want to apply for. And as a fourth year, you can get your LORs from the rotation as well. Also, if you want, schedule an away rotation in your chosen field in fall of fourth year and use it to your advantage to make them want you and rank you highly.

It's not bad as a student to rotate at hospitals without residents....you may get to do more as a result (i.e. you don't have to compete with a resident). It may be good to get your feet wet there, and then you may be able to wow them later on at a different institution (with a residency programs) with how much you know.

Also, away rotations are not necessary or helpful in certain fields. Not sure how helpful an anesthesia away rotation REALLY is (probably less helpful than an GU away, as GU is more competitive and it can give you an edge over other candidates for the one or two spots there; anesthesia programs are bigger and the majority of their residents likely did NOT rotate there as a student), as you may find on the interview trail you like other places better anyhow.

Thank you very much for the advice. You did understand my question correctly. I completely understand how doing a 4th year away (audition) rotation is advantageous and I plan on doing them. However, I was also told showing your face at a preferred institution 3rd year is a good idea as well. My plan, if this is possible, is to return to one of these institutions as a 4th year for a second time....I guess I should ask the follow-up question: is this possible?! Thanks

 

[DrBowtie]

Do the elective in Urology. Set yourself up for the hardest to match into in case that's what you want to do. If you are competitive for uro you'll easily be competite for anesthesia even with only a 4th year rotation.

 

[Smurfette]

Thank you very much for the advice. You did understand my question correctly. I completely understand how doing a 4th year away (audition) rotation is advantageous and I plan on doing them. However, I was also told showing your face at a preferred institution 3rd year is a good idea as well. My plan, if this is possible, is to return to one of these institutions as a 4th year for a second time....I guess I should ask the follow-up question: is this possible?! Thanks

Not sure here...it will vary by institution, of course. I also realize I am assuming you would be doing an away rotation that is truly away (i.e. not the hospital 2 blocks away from your own) and takes a bit more time and effort to coordinate.

Assume several people are trying to do a fourth year elective in the months before rank lists are due. People that they don't know will (in most cases) get preference over you; you've had your time there already. Like I said, you are better off going elsewhere only after having the most experience possible already under your belt. It's VERY hard to impress them as a third year, and memories of you (as a third year) compared to others (as fourth years) could give you a big disadvantage. Also, it depends on how the institution works the rotation if you do an away as a MS3....are you mixed into a rotation with other MS3s from their own institution? Are you considered a sub-i (which implies MS4 status, and thus gives you a disadvantage compared to other sub-i's.)? Will the person coordinating this rotation know you are an MS3 or assume that you are an MS4 since most who do an away are MS4's? Would you as an MS3 be paired with an MS4 who is also doing an away rotation? How about the residents and attendings? Often residents/attendings have no idea what year you are unless expressly told, but you may assume that the person(s) you told informed everyone else OR that they remember that you mentioned it once on rounds your first day. I can tell you that I had a few students rotate on my service that I had NO IDEA were the year of school they were...

Some institutions are bigger 'melting pots' for med student away rotations than others, so some institutions have less assumptions about your background than others will.

Besides, if you can afford to do multiple away rotations, why not go to another institution the second time around? It would allow another place to get to know you.

 

[CardiacIntensivist]

A general rule I got from every single surgeon I've ever met. If you can see yourself happy doing anything else but surgery, do that instead. Good luck!

 

[jdh71]

I think the FIRST step here is an honest evaluation of your CV as it stands right now. If your step 1 and class rank wasn't outrageous, you have no research and/or contacts in Urology, I'd say scrap the urology and go with the gas passing. Someone can correct me if I'm wrong here but I'm pretty sure there are only about 160-180 urology spots accross the country, so not as bad as derm or plastics, but pretty damn close. If you're not a superstar, then I wouldn't suggest trying . . . I know we were all told as kids that "if you can dream it, you can be it" and then real life showed up and laughed at such a notion . . . I may want to play pro ball, I could practice my free-throw and three point shots every waking moment, run line drills all day long, but it just aint happening . . .