Order of MS3 Rotations

[C5toC9]

I'm not sure how most schools conduct their ordering of the core third year rotations for med students, but the process is coming up for us and we have to choose the order, locations, teams, etc. Some people say the order doesn't matter, while others say it depends what you want to do.

Just wondering if any MS3's and higher have any advice on this. It's almost like a rank list of the various core clerkships and I have no idea how to approach it. I am guessing other MS2's here have similar decisions coming up?

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[da8s0859q]

I'm not sure how most schools conduct their ordering of the core third year rotations for med students, but the process is coming up for us and we have to choose the order, locations, teams, etc. Some people say the order doesn't matter, while others say it depends what you want to do.

Just wondering if any MS3's and higher have any advice on this. It's almost like a rank list of the various core clerkships and I have no idea how to approach it. I am guessing other MS2's here have similar decisions coming up?

We just did ours.

Obviously I'm not an M3+, but "it doesn't matter as much as you think it does" we definitely one of the most common pieces of advice I received. And besides, you can argue for or against just about any set of rotations. IM first? Awesome, great backbone for third year, and you'll be fresh from Step 1 -- and you don't have to do it when you're already burnt out later in the year. IM last? Awesome, great capstone for third year, and it's a nice review for Step 2 also.

 

[Jolie South]

Don't stress. It really doesn't matter that much. I personally wouldn't do medicine first, but that's just me.

 

[da8s0859q]

Don't stress. It really doesn't matter that much. I personally wouldn't do medicine first, but that's just me.

Which is exactly what I'm doing first. Why wouldn't you?

 

[dude1344]

I know people say it doesn't matter THAT much, but since we get a choice, what things should I be thinking about when I choose my order?

 

[DrBowtie]

I know people say it doesn't matter THAT much, but since we get a choice, what things should I be thinking about when I choose my order?

What you are thinking about doing for residency.

I wouldn't put that first just because it takes time to get used to seeing patients all the time, finding where things are, who to talk to in order to get things done etc. Get your feet wet before you need to shine in front of attendings in your specialty of choice.

 

[Funky]

Don't stress. It really doesn't matter that much. I personally wouldn't do medicine first, but that's just me.

I've heard either do it first or get it done early because it helps for the rest of the rotations

 

[Dwindlin]

I've heard either do it first or get it done early because it helps for the rest of the rotations

This is what I have heard from all my friends and most likely what I'll end up doing me thinks.

 

[Jolie South]

Which is exactly what I'm doing first. Why wouldn't you?

I honestly found it to be the hardest and most demoralizing of all my rotations and I did it midway through rotations, after surgery, ob/gyn, and neuro.

I think it's best to have the system somewhat down before you start that rotation.

 

[Dwindlin]

I honestly found it to be the hardest and most demoralizing of all my rotations and I did it midway through rotations, after surgery, ob/gyn, and neuro.

I think it's best to have the system somewhat down before you start that rotation.

Think you would have a different opinion if you attended a community program?

 

[Jolie South]

Think you would have a different opinion if you attended a community program?

We do 3 months at 3 very different facilities with 3 very different populations, one of which was private. I don't think it has anything to do with where I was.

 

[xanthomondo]

Some students in your class will have it first, some will have it last. Everyone will survive.

Although wasn't there a JAMA article showing that students that have medicine first statistically have higher clinical grades for the rest of the year? Not by much, though.

 

[da8s0859q]

Some students in your class will have it first, some will have it last. Everyone will survive.

Although wasn't there a JAMA article showing that students that have medicine first statistically have higher clinical grades for the rest of the year? Not by much, though.

"Among students at four campuses of a US medical school, clerkship order was significantly associated with performance on clerkship subject examinations and overall grades, but not with clerkship clinical performance or USMLE Step 2 scores."

Very small difference, but interesting.

http://jama.ama-assn.org/content/304/11/1220.abstract

 

[Depakote]

For the most part you can do them in any order.

Personally, I don't think it hurts to do a rotation you know you're not interested in as a "practice" rotation to let yourself get used to the wards and shelf exams so by the time you get to the ones where the grades might be a little more important, you have your feet wet.

If you have a thought of what you might want to do, you might try to do that around the middle of the year. That makes it a little more convenient for setting up your fourth year schedule if you do make the decision and are trying to set up electives/aways/etc.

 

[turkeyjerky]

I did Ob-gyn as my first rotation and am glad I did so. I was still motivated at the time and the long hours or b!tchy residents didn't bother me so much. I can't imagine if I had to look forward to six weeks of that crap now that I'm tired and burnt out.

So that's what I would recommend: do the hardest rotations that you're least interested in early in the year. For most people that's gonna be OB or Surgery. I did them in that order and it's worked out pretty well for me (got 99 on both shelves too, so that doesn't need to be a worry).

 

[Jolie South]

I did Ob-gyn as my first rotation and am glad I did so. I was still motivated at the time and the long hours or b!tchy residents didn't bother me so much. I can't imagine if I had to look forward to six weeks of that crap now that I'm tired and burnt out.

So that's what I would recommend: do the hardest rotations that you're least interested in early in the year. For most people that's gonna be OB or Surgery. I did them in that order and it's worked out pretty well for me (got 99 on both shelves too, so that doesn't need to be a worry).

I agree with this. I scheduled all the crap that I thought I would hate the most and work the hardest at first. I think it was a good choice. I have a hard time pretending to care now.

 

[iwumd07]

I tend to think that if you know you are highly interested in a certain field (that is offered 3rd year), then do it in the middle of the year. My reasons:

1. You have at least 2 rotations under your belt already.
2. You are more comfortable with the hospital environment and nuances.
3. You hopefully have better written and oral presentation skills, such as to make a better impression during your rotation of interest.
4. It's not too late in the year...attendings will know you and it gives them more time to write LORs if asked, rather than waiting until the Spring/Summer months.
5. You are familiar with the shelf exam format and timing.
6. You are more prepared with how to study for the shelf exams and know what works best for you when learning on wards.
7. You're not burnt out yet (hopefully) since it's not the end of the 3rd year.

This was my schedule (my first choice as well):
Medicine 12 weeks
Family 4 weeks
Surgery 8 weeks
OB/GYN 8 weeks
Pediatrics 8 weeks
Psychiatry 8 weeks

I was interested in Surgery, Anesthesiology, and EM.
I knew that I didn't want to do anything involving the last 3 rotations, and I liked having Medicine right after Step 1. It would also make sense to have Medicine last, but I liked having Psych last because it gave me more time to study for Step 2 without having to take extra time off at the start of 4th year.

 

[coldweatherblue]

my schedule, and why I love it. 😉

1. Medicine - I did medicine first because I wanted a "hard" rotation to start off with. Out of the frying pan into the fire.. plus it was right after step 1 so some of the details were semi-fresh. Doing medicine first makes for a steep learning curve the first few months, but it sets you up well for the rest of MS3.

2. Neuro/Psych - psychcaaaaaation.. needed psych at this time because I could relax for the first time since starting boards studying in April. Plus it was prime football season so with weekends off I could watch the NCAA and NFL games..

3. Surgery - never a "good" time to do surgery, but our school gave us two weeks for christmas which gave me a nice vacation in the middle of g surg. Highly recommended.

4. Peds/Elective - have a good reiteration of a lot of medicine + learning pediatrics of course.. elective later in the year = easier to shine.

5. Family - family late will tie everything together. Having most of my rotations over with by the time I do family will hopefully make the rotation a "cap" on the whole year.

6. OB/Gyn - this is my last rotation, I don't have any reason to want to end with OB, I just liked the order of everything else so I'll end with OB. one last busy rotation before blessed fourth-year.

I don't think it matters so much the order in which you do your rotations. Choose whatever seems most appealing to you. I'm very happy with my schedule and would choose the same track over again.

 

[C5toC9]

What's the take on different rotations at main academic center vs VA vs community hosp/outpt?

 

[unsung]

"Among students at four campuses of a US medical school, clerkship order was significantly associated with performance on clerkship subject examinations and overall grades, but not with clerkship clinical performance or USMLE Step 2 scores."

Very small difference, but interesting.

http://jama.ama-assn.org/content/304/11/1220.abstract

This is weird. Why would taking internal med 1st help more so than taking family med 1st?

I would've thought the 2 would be ~ equivalent, since both are dealing with a wide variety of cases, both are primary care, etc.

Perhaps it's the hospital setting vs the outpatient setting? Or what?

 

[Jolie South]

This is weird. Why would taking internal med 1st help more so than taking family med 1st?

I would've thought the 2 would be ~ equivalent, since both are dealing with a wide variety of cases, both are primary care, etc.

Perhaps it's the hospital setting vs the outpatient setting? Or what?

Because family medicine is rapid fire patient encounters and covers medicine, ob/gyn, and pediatrics. If you don't have that knowledge base already, it's hard to learn as there isn't really time for teaching.

 

[ZagDoc]

When it comes down to it, doesn't really matter. You should be getting most of your letters during your fourth year sub-i, and effort goes a long ways towards honors.

That being said, in an "ideal world", I'd say try not to do your rotation in your "chosen" field as the first two (still getting your clinical feet under your) or last two (less time to network/become familiar to the dept before your sub-i).

 

[unsung]

Because family medicine is rapid fire patient encounters and covers medicine, ob/gyn, and pediatrics. If you don't have that knowledge base already, it's hard to learn as there isn't really time for teaching.

Not THAT rapid fire. From what I've seen of family med, there's a decent amount of time per patient & between patients. And see enough of the same sort of HTN, diabetes, etc. cases to learn a decent amount. (Of course it's always up to the person to read up about the encounters afterwards.) Guess this is site-specific, though.

Now outpatient peds is rapid fire! Oddly enough, I was busier during my outpatient peds experience than during my (community) ER experience. That's how busy it was!

Good grief... simultaneously boring and high volume.

But again, I guess it is all site-specific...

 

[2012mdc]

This is weird. Why would taking internal med 1st help more so than taking family med 1st?

I would've thought the 2 would be ~ equivalent, since both are dealing with a wide variety of cases, both are primary care, etc.

Perhaps it's the hospital setting vs the outpatient setting? Or what?

In my experience the inpatient setting, teaching rounds, morning report all contributed. FM was too broad and too fast and when they did have time to teach it was strictly outpatient issues

 

[Jolie South]

Not THAT rapid fire. From what I've seen of family med, there's a decent amount of time per patient & between patients. And see enough of the same sort of HTN, diabetes, etc. cases to learn a decent amount. (Of course it's always up to the person to read up about the encounters afterwards.) Guess this is site-specific, though.

Now outpatient peds is rapid fire! Oddly enough, I was busier during my outpatient peds experience than during my (community) ER experience. That's how busy it was!

Good grief... simultaneously boring and high volume.

But again, I guess it is all site-specific...

You must be doing academic FM. I worked in a busy private practice and we had like no time for long drawn out presentations or teaching. It wasn't uncommon to have back to back 15 minute appointments. I usually saved up my questions for the end of the day if we had time.

 

[2012mdc]

You must be doing academic FM. I worked in a busy private practice and we had like no time for long drawn out presentations or teaching. It wasn't uncommon to have back to back 15 minute appointments. I usually saved up my questions for the end of the day if we had time.

My rural experience was exactly like this.

Even on the academic part of my FM rotation there was significantly less teaching than IM

 

[ArcGurren]

I'm doing this order:

- FM first - easy-ish rotation with a lot of outpatient stuff, good transition

- Peds - hard ass rotation but a good followup from FM

- Medicine - hard rotation, but good foundation for the rest

- Surgery - not as hard per se after medicine but tiring with long hours

- Psych/Neuro - winds down after Surgery but still kinda tough

- OB/Gyn - ... eh.

 

[ButImLETired]

Hey guys, I need advice about this.

Ok, so our required rotations are OB/Peds (means the two always go together, each is 4 weeks, one follows the other no matter what), Medicine, Surgery, and Psych/Neuro (again, they go together). The only things I'm really considering right now are EM (which we don't do until 4th year), Anesthesiology (an elective you can do within Surgery) and Surgery. So, I asked a fourth year friend for advice and he recommended I not do surgery first or last since I may be somewhat interested in it, especially since anesthesia would be one of the electives I will (hopefully) take. He also recommended I do IM before surgery since it really helps with the shelf.

Another thing I wanted to take into account is the fact that I would like to do some research next year, which means that I would theoretically like to have a couple of the less time-intensive specialties next to one another so I can at least start a project in EM if that's what I'm going to end up doing. This isn't a huge deal, just something I'd like to do.

So my school does the whole third year rotation thing on a lottery system of sorts, in which you can list your preferences and express how important each rotation's specific spot in your schedule is. I decided that I wanted to do: Medicine first (good way to get to know the hospital, I know I won't like it but I'll probably be gung-ho for the first rotation, and it'll help with surgery), then Surgery, and then second semester just do OB/peds and psych/neuro (the last one in particular should allow me time to plan a research project, study for Step 2, do a lot of consults in the ER to get some face time, etc).

We got our results this week and we received our own schedules as well as those of our classmates. Sadly, I didn't get my first choice schedule. Instead I got OB/Peds first, then surgery, then medicine and then psych/neuro. We are allowed a couple of weeks within which to swap with classmates if other people are up for it, so my first instinct was to switch the ob/peds and medicine with someone else.

Ok, so here's my dilemma (sorry for the long intro...)

Judging from the schedule we were sent, most people who are doing IM first put that as their first priority, so it's very unlikely that any will be willing to switch. Moreover, though I love my classmates, we have a pretty large population of somewhat anal retentive type A folks and a large percentage of them is doing IM first (which makes sense, since thats the universally acknowledged "way to do well on the shelf"). On the other hand, because we're advised to do "what we like" second or third, by having IM third I'll likely encounter all the folks who really want to do IM like, for a living, so even though they're not as anal retentive in general as those who are doing it first, they might be really intense when taking it third since that's what they want to do.

SO SHOULD I TRY TO SWITCH?? I have zero interest in OB/Gyn and likely not much interest in peds, so I don't care about doing that first, although I do think it'll be the least applicable stuff to surgery. Also, I've been advised against doing OB at my home institution (since the people are mean and the hours are brutal) and Peds is done at our Children's Hospital, so I'll enter Surgery probably without having gotten to know the intricacies of the hospital, what the rules are, etc. Would I be at a disadvantage, going from peds/OB to surgery instead of IM to surgery? Or should I be glad to avoid the gunners for that one rotation?

Sorry for the ridiculously long post, I may be complicating my life needlessly but I really have no idea whether I should pursue the switch or not.

Thanks!

 

[sunset823]

I did Ob-gyn as my first rotation and am glad I did so. I was still motivated at the time and the long hours or b!tchy residents didn't bother me so much. I can't imagine if I had to look forward to six weeks of that crap now that I'm tired and burnt out.

So that's what I would recommend: do the hardest rotations that you're least interested in early in the year. For most people that's gonna be OB or Surgery. I did them in that order and it's worked out pretty well for me (got 99 on both shelves too, so that doesn't need to be a worry).

this is exactly what I'm planning on doing, starting with OB-GYN. I have 0 interest in it and want to frontload my schedule and get the hard stuff out of the way.

2. Neuro/Psych - psychcaaaaaation.. needed psych at this time because I could relax for the first time since starting boards studying in April. Plus it was prime football season so with weekends off I could watch the NCAA and NFL games..

good point...I'm a big NCAA football fan but the way our schedules are set up I'm either going to have medicine or surgery during prime football season, so I'm screwed either way.

We have a lottery system, and we're going to be getting our schedules in a few weeks, but my first choice is as follows:

1. OB-GYN
2. Family Medicine
3. Medicine
[two week winter break]
4. Surgery
5/6. Either peds or psych, don't care which order for those two.

I'm interested in anesthesia, IM, and EM (in that order) right now, so I feel medicine and surgery are the two most important for me and from what people have said above doing those in the middle seems like a good idea.

 

[MossPoh]

Man, I wish we had control over our schedules. We get a survey where we can put put what people we'd like to do rotations with and which ones we'd prefer not to do rotations with, as well as a surgical subspecialty to rotate with for 2 weeks. Other than that, they pretty much give us a schedule and tell us tough luck.

We do regional campuses and are with community physicians though, so I suspect part of the scheduling is based around their schedules and when they can take us.

 

[RySerr21]

Man, I wish we had control over our schedules. We get a survey where we can put put what people we'd like to do rotations with and which ones we'd prefer not to do rotations with, as well as a surgical subspecialty to rotate with for 2 weeks. Other than that, they pretty much give us a schedule and tell us tough luck.

We do regional campuses and are with community physicians though, so I suspect part of the scheduling is based around their schedules and when they can take us.

HA. We dont even get that. We are just given a schedule and told to deal. If you have special circumstances like a wedding or somethign where you'd like an easier rotation you can request, but thats about the only reason. If you don't like your schedule, you can swap schedules w/ another student (which is what I ended up doing). In terms of locations I think its first come first serve when they send out an email saying you can sign up for where you want to rotate.

Ive heard a lot of similar advice from other upperclassmen, but one of my classmates has a friend who's in her first year of residency, and she recommended that if you know you are interested in a specialty you should do it after August because if you do it before, the new residents will still be learning everything and they will have priority over learning and doing things, etc. So, less of a hands on learning experience for you where as if you do it later you might be able to participate in more as the residents will have a solid grip on what they are doing and be more willing to teach you.

 

[Depakote]

Hey guys, I need advice about this.

Ok, so our required rotations are OB/Peds (means the two always go together, each is 4 weeks, one follows the other no matter what), Medicine, Surgery, and Psych/Neuro (again, they go together). The only things I'm really considering right now are EM (which we don't do until 4th year), Anesthesiology (an elective you can do within Surgery) and Surgery. So, I asked a fourth year friend for advice and he recommended I not do surgery first or last since I may be somewhat interested in it, especially since anesthesia would be one of the electives I will (hopefully) take. He also recommended I do IM before surgery since it really helps with the shelf.

Another thing I wanted to take into account is the fact that I would like to do some research next year, which means that I would theoretically like to have a couple of the less time-intensive specialties next to one another so I can at least start a project in EM if that's what I'm going to end up doing. This isn't a huge deal, just something I'd like to do.

So my school does the whole third year rotation thing on a lottery system of sorts, in which you can list your preferences and express how important each rotation's specific spot in your schedule is. I decided that I wanted to do: Medicine first (good way to get to know the hospital, I know I won't like it but I'll probably be gung-ho for the first rotation, and it'll help with surgery), then Surgery, and then second semester just do OB/peds and psych/neuro (the last one in particular should allow me time to plan a research project, study for Step 2, do a lot of consults in the ER to get some face time, etc).

We got our results this week and we received our own schedules as well as those of our classmates. Sadly, I didn't get my first choice schedule. Instead I got OB/Peds first, then surgery, then medicine and then psych/neuro. We are allowed a couple of weeks within which to swap with classmates if other people are up for it, so my first instinct was to switch the ob/peds and medicine with someone else.

Ok, so here's my dilemma (sorry for the long intro...)

Judging from the schedule we were sent, most people who are doing IM first put that as their first priority, so it's very unlikely that any will be willing to switch. Moreover, though I love my classmates, we have a pretty large population of somewhat anal retentive type A folks and a large percentage of them is doing IM first (which makes sense, since thats the universally acknowledged "way to do well on the shelf"). On the other hand, because we're advised to do "what we like" second or third, by having IM third I'll likely encounter all the folks who really want to do IM like, for a living, so even though they're not as anal retentive in general as those who are doing it first, they might be really intense when taking it third since that's what they want to do.

SO SHOULD I TRY TO SWITCH?? I have zero interest in OB/Gyn and likely not much interest in peds, so I don't care about doing that first, although I do think it'll be the least applicable stuff to surgery. Also, I've been advised against doing OB at my home institution (since the people are mean and the hours are brutal) and Peds is done at our Children's Hospital, so I'll enter Surgery probably without having gotten to know the intricacies of the hospital, what the rules are, etc. Would I be at a disadvantage, going from peds/OB to surgery instead of IM to surgery? Or should I be glad to avoid the gunners for that one rotation?

Sorry for the ridiculously long post, I may be complicating my life needlessly but I really have no idea whether I should pursue the switch or not.

Thanks!

I think you're fine. You should have the hang of things by the time you get your first couple of rotations under your belt and getting OB out of the way would let you have at least one "surgical" specialty down before doing surgery.

Personally, think that as long as you have one shelf under your belt... the rest can be handled with appropriate study. While it occasionally makes things easier, you don't need X rotation to prepare for Y shelf.

 

[Jolie South]

I think you're fine. You should have the hang of things by the time you get your first couple of rotations under your belt and getting OB out of the way would let you have at least one "surgical" specialty down before doing surgery.

Personally, think that as long as you have one shelf under your belt... the rest can be handled with appropriate study. While it occasionally makes things easier, you don't need X rotation to prepare for Y shelf.

Agreed. UWorld Step 2 CK bank is the grand equalizer.

 

[lockjaw]

I think you're fine. You should have the hang of things by the time you get your first couple of rotations under your belt and getting OB out of the way would let you have at least one "surgical" specialty down before doing surgery.

Personally, think that as long as you have one shelf under your belt... the rest can be handled with appropriate study. While it occasionally makes things easier, you don't need X rotation to prepare for Y shelf.

Agreed. While certain rotation orders may be more desirable than others, you're not at a huge disadvantage if your order doesn't fall into place perfectly. You don't hear of people failing to get into residency or having to switch their specialty choice because they did surgery first vs. last. If you work hard and study hard, you'll do fine.

 

[agrarianmonk]

Getting to the end of third year now, and while I think its nice to have the order you want, it's not absolutely essential. At my school, the site of the rotation was IMO way more important than the order. This is esp. true if you grade depends more on the shelf: the sites with more flexibility (eg, more time to study) are better regardless of what time you do the rotation during the year.

 

[MilkmanAl]

Agreed. While certain rotation orders may be more desirable than others, you're not at a huge disadvantage if your order doesn't fall into place perfectly. You don't hear of people failing to get into residency or having to switch their specialty choice because they did surgery first vs. last. If you work hard and study hard, you'll do fine.

I agree with this in principle, but I share your worry that, at a school like yours, medicine may well turn into a huge nightmare if you're taking it with a bunch of people who want to do it professionally. In regards to everything else, though, you should be fine. The order of your rotations is not nearly as big of a deal as most people make it out to be.

 

[unsung]

Ok guys:

The way our lottery sys worked out, I'm taking medicine first period of FOURTH year. Is this going to screw me in some way?

Actually, I have the option of taking it as last rotation in 3rd yr, which is slightly more preferable. HOWEVER, I placed my intended specialty rotation in that spot. It is at my #1 preferred site, and there was only 1 slot, so I used my lottery pick on that.

Plus, it is at a "good" time for me to take it, after I've gained experience at the end of the year. But not too late so that I won't have time to do a sub-I.

Soo... my schedule is looking kind of ridiculous. I'm starting off with bunch of stuff like surgery, ER, neurosurg... peds in the winter time... and capping it w/ ob-gyn, right b4 my intended specialty rotation.

One thing that does haunt me is... is the lack of med going to hurt my shelf scores throughout the year? Is it going to detract from my performance in my intended specialty?

The flip side though, is that I'll probably do well in med when I do take it... and having a bunch of primary care stuff 4th yr after I already have some experience might be a good way to tie all that knowledge together. Or so I tell myself. 🙄

 

[xanthomondo]

Ok guys:

The way our lottery sys worked out, I'm taking medicine first period of FOURTH year. Is this going to screw me in some way?

Actually, I have the option of taking it as last rotation in 3rd yr, which is slightly more preferable. HOWEVER, I placed my intended specialty rotation in that spot. It is at my #1 preferred site, and there was only 1 slot, so I used my lottery pick on that.

Plus, it is at a "good" time for me to take it, after I've gained experience at the end of the year. But not too late so that I won't have time to do a sub-I.

Soo... my schedule is looking kind of ridiculous. I'm starting off with bunch of stuff like surgery, ER, neurosurg... peds in the winter time... and capping it w/ ob-gyn, right b4 my intended specialty rotation.

One thing that does haunt me is... is the lack of med going to hurt my shelf scores throughout the year? Is it going to detract from my performance in my intended specialty?

The flip side though, is that I'll probably do well in med when I do take it... and having a bunch of primary care stuff 4th yr after I already have some experience might be a good way to tie all that knowledge together. Or so I tell myself. 🙄

What's your intended specialty?

At least you'll have medicine fresh in your mind to ace step2

 

[Jolie South]

I agree with this in principle, but I share your worry that, at a school like yours, medicine may well turn into a huge nightmare if you're taking it with a bunch of people who want to do it professionally. In regards to everything else, though, you should be fine. The order of your rotations is not nearly as big of a deal as most people make it out to be.

For real. Beware.

 

[ButImLETired]

For real. Beware.

I agree, but unfortunately SOMETHING has to go third, and no matter what it is, the people in it will be gunning for it cause that's where we're told to put "what we're interested in". The surgery gunners for the most part put medicine either first or second and surgery either second or third. The medicine gunners are starting with surgery and putting medicine second or third. I have surgery second (with some of the surg gunners, some of the med gunners, some randoms), and medicine third (with medicine gunners, but at least no surgery gunners). I'm more scared of the surgery people than the medicine people so I'd rather have medicine third after surgery than have medicine second and then surgery third....does that make sense?

Sigh...this is so complicated.

 

[MilkmanAl]

Yeah, I guess if you have to choose between surgery gunners during surgery and medicine gunners during medicine, I'd choose the latter. Still, pretty much anything else would be better than those two.

 

[Jolie South]

I agree, but unfortunately SOMETHING has to go third, and no matter what it is, the people in it will be gunning for it cause that's where we're told to put "what we're interested in". The surgery gunners for the most part put medicine either first or second and surgery either second or third. The medicine gunners are starting with surgery and putting medicine second or third. I have surgery second (with some of the surg gunners, some of the med gunners, some randoms), and medicine third (with medicine gunners, but at least no surgery gunners). I'm more scared of the surgery people than the medicine people so I'd rather have medicine third after surgery than have medicine second and then surgery third....does that make sense?

Sigh...this is so complicated.

I know. You can't really win.

 

[mrhealth]

I'm not sure how most schools conduct their ordering of the core third year rotations for med students, but the process is coming up for us and we have to choose the order, locations, teams, etc. Some people say the order doesn't matter, while others say it depends what you want to do.

Just wondering if any MS3's and higher have any advice on this. It's almost like a rank list of the various core clerkships and I have no idea how to approach it. I am guessing other MS2's here have similar decisions coming up?

ultimately order really doesn't matter in my opinion. however, i didnt study as much for my first shelf as i should have which ultimately hurt me. those around me did fine, so that was more of an issue with me. i prefer to end with the 'easier' rotations... hitting surgery or medicine in the late spring is rough psychologically in my opinion.

 

[da8s0859q]

ultimately order really doesn't matter in my opinion. however, i didnt study as much for my first shelf as i should have which ultimately hurt me. those around me did fine, so that was more of an issue with me. i prefer to end with the 'easier' rotations... hitting surgery or medicine in the late spring is rough psychologically in my opinion.

That's part of why I opted for having them up front -- same thing. Going into medicine+surgery to round out the last several months of M3 sounds horrible.

 

[MossPoh]

HA. We dont even get that. We are just given a schedule and told to deal. If you have special circumstances like a wedding or somethign where you'd like an easier rotation you can request, but thats about the only reason. If you don't like your schedule, you can swap schedules w/ another student (which is what I ended up doing). In terms of locations I think its first come first serve when they send out an email saying you can sign up for where you want to rotate.

Ive heard a lot of similar advice from other upperclassmen, but one of my classmates has a friend who's in her first year of residency, and she recommended that if you know you are interested in a specialty you should do it after August because if you do it before, the new residents will still be learning everything and they will have priority over learning and doing things, etc. So, less of a hands on learning experience for you where as if you do it later you might be able to participate in more as the residents will have a solid grip on what they are doing and be more willing to teach you.

The who you like/don't like list is really more to make us feel special, because it really doesn't matter. We are paired up with private docs in the community, so the odds of even seeing one of our classmates is pretty rare at best. Also, nobody wants to put who they DON'T want to be with because they are terrified they will be outed for hating that person. I just don't know some people well enough to know whether I dislike them or not, but I usually get along with everyone in at least a professional manner for it to be a moot point.

We don't have to worry about residents. It is one student and one private physician for the month or however long the length of the rotation is. If we are interested in a specialty or want more exposure many of the attendings are cool enough to try to help you out. I'm sure there are a couple who are d-bags, but I've heard they will do their best to help you, especially in your off time. My attending for the summer practicum we have to do knew that surgery and emergency medicine are both high on my list, so he gave me every opportunity to go and hang in the ED or get into the OR when he had "boring" stuff to do, which usually entailed hospice meetings or 15 stress tests in a row. It wound up being a great experience because I got to do compressions on 2 codes in a 30 minute span, debride/suture/dermabond a big wound, staple a head, and do tons of H&Ps. By the end of summer, I was able to do a very very basic workup, which is still pretty exciting after 1 year of school.

 

[airplanes]

Relax guys, it's all gonna be JUST fine 🙂

There's pros and cons to every track, but I have faith they will even out in the end.

I'm starting with peds then surg.

 

[22031 Alum]

I built my entire third year schedule around my desire to do pediatrics, and got the exact rotation assignment I wanted. All that schedule stress was meaningless- I'm now an Ob/Gyn resident. Clerkship order really doesn't matter. Don't worry about it, and go into each one with an open mind.

 

[MossPoh]

I still can't help but think that my disdain of stethoscopes and white coats is going to skew me in a certain specialty direction.

 

[myhandsarecold]

If I could do it all over again:

1. Surgery
2. Medicine
3. OBGyn
4. Peds
5. Family Medicine
6. Psychiatry

would have liked to have done the hard stuff first when I still had the energy and motivation then do the easy stuff to kind of recharge until Step 2 and make time for sorting residency apps.

 

[kl323]

Which rotation has the hardest shelf exam?