No idea which rotation order is best for my interests.

[croissant10947]

Advertisement - Members don't see this ad

• Specialty interests from most to least interested: Neuro > Ophtho > IM
  • Planning to do neuro elective in between rotations
• Specialties I am not interested in: FM, OB, Peds, Psych, Surgery
• Rotation grading: ranked & graded, score is 100% based on Shelf - this has made me try to prioritize tracks where Peds and/or OB come before FM
• Boards: taking Step 1 & 2 after rotations end during my dedicated period

I have figured out my top 3 rotation tracks. From most to least desired:

1. Psych, IM, Surgery, Peds, OB, FM
2. OB, FM, IM, Psych, Surgery, Peds
3. Peds, Surg, OB, FM, IM, Psych [note: kind of conflicted between #2 and #3. I feel like having FM after Peds and OB is gonna be very helpful for the FM Shelf, but I also am hesitant to have IM scheduled as my second to last rotation. Also, I've heard Surgery before IM is not ideal]

Now for the tracks I know I don't want. This is unranked though - I am not sure which track is less horrible than the others.

• IM, Peds, Psych, Surgery, FM, OB
  • Pros: IM before Surgery & FM after Peds
  • Cons: IM first, ending OB
• Surgery, Psych, FM, OB, Peds, IM
  • Pros: Starting on Surgery (I guess it's a good thing because I won't be as burnt out)
  • Cons: Ending on IM, FM before OB and Peds
• FM, OB, Peds, IM, Psych, Surgery
  • Pros: IM then Surgery
  • Cons: FM before OB and Peds, ending on Surgery

Would appreciate any and all insights.

 

[FalconSlice]

Short answer is does not matter. But if you want to do the rotations you’re interested in during the middle, you may feel more comfortable.

 

[Dragonite7]

I would prefer #2 over #3 - it will make the surgery shelf easier. I don't think doing IM first is particularly worrying. You generally want to put what you're interested in during the middle. Having something easy like psych at the end is helpful for grinding step studying. I wouldn't worry too much about the relative timing of OB, Peds, FM - it's better to compromise on what you're not interested in, and some stuff will always be out of order. OB and Peds are easier ones to study for so just start studying them earlier. The order of clerkships matters less than I thought it did before I went through them. It's more important to work hard so attendings see you are improving.

 

[MatchVault]

With grading being 100% shelf-based, I'd think about this in terms of which shelf helps which other shelf, since the knowledge compounds across the year:

- IM before surgery is the classic move. A large portion of the surgery shelf is really medicine (infection, fluids/electrolytes, perioperative management), so doing IM first makes the surgery shelf noticeably easier. The same logic applies to doing IM before FM.
- OB and peds shelves are more self-contained, so they can slot in wherever they fit without much downside.
- Since you're taking Step 2 right after rotations in dedicated, consider ending on a lighter or high-yield block rather than your hardest one. Going into dedicated burned out is real, and a psych or FM block right before dedicated doubles as Step 2 review.
- With neuro as your top interest, try to get your neuro elective after IM and reasonably close to ERAS season, so your letter writers see your most seasoned self.

Of your three tracks, #1 (Psych, IM, Surgery, Peds, OB, FM) lines up best with the IM-before-surgery principle, and ending on FM before dedicated is gentler than ending on surgery or OB.

 

[croissant10947]

@MatchVault @Dragonite7 : Thank you for your insights. I ended up getting placed in this track -

• OB, FM, IM, Psych, Surgery, Peds

Currently, my friend is looking to switch their track (Peds, Surg, OB, FM, IM, Psych). I ranked this specific track as my #1 because FM comes after Peds & OB, and IM is the 5th rotation (but AFTER surgery)- I really want to try my best in IM.

Would it be worth switching since I currently have IM as my 3rd rotation?
My concern is that having Surgery 2nd to last is a disadvantage for me because the attendings will expect more (as opposed to me having Surgery as my 2nd rotation).

IM being my 2nd rotation was also my concern for Track #1 (which I ranked #3 on my list - Psych, IM, Surgery, Peds, OB, FM) - but having FM at the end is really appealing.

 

[Dragonite7]

Personally I think switching gives you a worse track. You can ask students at your school, but I don't think the expectations on surgery will shift that drastically - it's always unfamiliar as an M3. I did surgery second to last and I felt being better prepared did more for me than any curve on expectations. You know your own weaknesses so if you feel strongly it's not unreasonable, just my two cents.