Order of 3rd Year Rotations

[Future Doc B]

I've been debating what order to do my 3rd year rotations. I'm looking for some pros/cons to taking the rotations in specialties you're considering for residency first vs. later in the year.

My question is: Is it better to do the rotations that you are considering as specialties first or later on in the year? How does that impact setting up 4th year elective rotations?

Thanks...

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[QuinnB]

it's my 2 cents that it matters only where and with who not when...I don't buy all of that take what you're interested in somewhere in the middle but never at the end or beginning...I also don't buy into the thought of "do IM before everything else to build a strong foundation"...when I started 3rd year, I had just finished step 1 a week before and now 8 months into 3rd year and having just finished IM, I don't think it matters...

 

[efex101]

It truly has no relevance....do what works best for you.

 

[Anka]

I had a good experience doing what I was interested in first (surgery). I was very excited to be there, and knew a bit more about it walking in than I would have about, say, peds or ob/gyn. It confirmed my interest, and meant that even on the most miserable rotations I could tell myself, "Look, this is only for six weeks; you already know what you're going to do, so just get as much out of this as you can and don't stress!" I agree with avoiding your planned future as fourth rotation, because you're going to be so sick of clerkships and all the BS that surrounds them, that you won't be able to muster as much interest/enthusiasm as earlier in the year.

Best,
Anka

 

[Dr JPH]

It truly has no relevance....do what works best for you.

Im not so sure about that.

Here are a few different ways to look at it:

For the person UNSURE about what they want:
Start with an area that will gradually get you involved in your clinical rotations. Maybe avoid surgery or OB/GYN so that you arent "shell shocked" and avoid these fields in the future. Start with something like Medicine or Family Practice to introduce you to patient skills and (hopefully) some hospital duties.

For the person who KNOWS what they want:
Start with your intended specialty, or at least do it early. Make connections right off the bat and plan electives as soon as possible. Use your inexperience to your advantage by showing the attendings/residents how fast you learn and how much you have improved when you return there for future elective rotations.

For the person who THINKS they know what they want:
Put your intended specialty in the middle of the 3rd year. Gain some experience with some other rotations so that when you get to the field where you are "pretty sure" you will end up you have something under your belt so that you can impress. This schedule allows you to see a few other things first to possibly peak your interest and when you do get to that specialty you think you want you have something to compare it to DURING the month. (as opposed to looking back later and trying to compare).

Just my $0.02

 

[Dunce]

The post right above this is absolutely perfect. I'm glad someone else already typed it.

 

[lord_jeebus]

Stick your psych rotation in where you would like to catch up on sleep

 

[dynx]

Stick your psych rotation in where you would like to catch up on sleep

I was told it doesn't matter at all.
Thats a lie. The only thing I know for sure matters is make sure that you dont have the specialty you want scheduled dead last. We have a random system and i got it last...everyone said it doesnt matter when I tried to change it (probably because they were to lazy to go through switching the schedule)...end of the year I had trouble applying to away AIs since my grade from that rotation wasnt back yet and many programs want it. Thats the extent to which I think if matters.

 

[QuinnB]

Stick your psych rotation in where you would like to catch up on sleep

I put psych first and this worked out well...ours is 6 wks and coming off boards it was nice to have relatively short days (8 or 9 to 4 or 5) w/o weekend responsiblities; it was also a great way to learn the computer systems, learn to write better notes and just make my way around the hospitals...I pretty much took the first 4 weeks off and did very little reading beyond pts I saw in clinic and also the shelf is pretty manageable no matter when you take it. If your school's psych is anything like mine and I highly recommend trying this out.

 

[efex101]

I said it is irrevelant because there are so many opinions about when to do what. I have heard "oh do what you like first to make connections" then I have heard "oh do what you like last so you shine" so there are many many opinions out there. The bottom line is that regardless if you do what you like first or last you still need to do well. Connections can easily be made during subI's/electives/etc early during fourth year. So IMHO busting your head open trying to figure out which rotation to do first is pointless. The best advice I did receive was to space out the harder rotations. So try not doing surgery/ob/gyn back to back or whatnot.

 

[njbmd]

The order in which you go through third year is meaningless. During any rotation that you do first, you are not going to be as familiar with Junior Medical Student duties as on the last clerkship that you go through. Interns, residents and attendings know this and take this into consideration when grading you. If you are a jerk on your first rotation, odds are that you are going to be a bigger jerk on your last rotation.

Things that I did find pretty helpful in terms of third year rotations were, it is a good idea to take USMLE Step II as soon as you can after you have completed your Internal Medicine rotation. Most of Step II is medicine so taking this exam as early as possible gets this hurdle out of your way and makes fourth year very nice.

Pediatrics in July and August will give you plenty of practice doing physical exams on children and adolescents as school physicals are generally done at that time. General Surgery rotation during June, July and August are good for plenty of Trauma experience. You get more ID experience on Internal Medicine during December, January and February since it is cold and flu season. Also, IM during the summer months will usually net you more geriatric experience as heat and humidity take their toll on this population.

In the end, you have to do all of the required clerkships and the order actually doesn't matter. Plenty of my classmates who did IM first, went into IM and plenty of my classmates who did surgery first, went into surgery.

 

[Bubb Rubb]

i've been pretty happy with the order of my rotations so far, as i feel like i've been introduced to the OR and the clinic in a friendly way. of course, my ob/gyn rotation wasn't as hellish as many that i've heard of.

ob/gyn
family med
electives: time off! + 2 surgical subspecialties x 2 wks for kicks
peds
(winter break, 2 weeks!)
surgery, in the dead of winter -- might as well grin and bear it
psych (ah, relaxation)
IM, once i'm all prepared for it, with any luck
(another 2 week break)