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PLEASE advise. Serious audition rotation question from 4th year.

Discussion in 'General Residency Issues' started by Disimpact22, Aug 1, 2015.

  1. Disimpact22

    5+ Year Member

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    Hey all.

    So when I started making my audition rotations way back in third year I was still undecided between FM and IM. I have since decided on FM. However, I made an audition rotation for IM at a hospital I'm really interested that has residencies in both FM and IM.

    Should I still go, kick ass in IM and see if I can meet the FM PD? Or would I be shooting myself in the foot by going on an IM audition rotation even though I only applied to the FM residency there? Also, what do I say to the IM residents and attending a I'm working with if they ask where I applied? This is actually causing me a good deal of angst so ANY advice would be truly, deeply, profoundly appreciated.

    I was told that it's extremely risky and very poor form to apply to more than one program at a hospital. Is that true? It makes sense--shows and lack of dedication to your field.

    Thanks guys. Seriously.
     
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  3. Disimpact22

    5+ Year Member

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    So would I be better off canceling the rotation? I spoke to the residency coordinator and told her that I have decided to apply only to FM. Did I screw the pooch at this location? I can't be the only person who was still undecided between internal medicine and family medicine early third year when we were making our audition rotation schedules.
     
  4. dpmd

    dpmd Relaxing
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    Can't you change the rotation?
     
  5. Winged Scapula

    Winged Scapula Cougariffic!
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    I think you're blowing this out of proportion.

    Cancel the IM audition rotation, schedule an FM one and apply to FM. Don't apply to IM at same hospital.
     
    Doctor4Life1769 likes this.
  6. WonderBoy

    Physician 10+ Year Member

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    I would second this advice. Let someone else who is actually interested in applying to IM at that program take your spot.
     
  7. Crayola227

    Crayola227 The Oncoming Storm
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    If schedule - wise you are locked into this IM away rotation, then do it, and do it well. If you are there for IM though, don't try to do some ass-kissy thing with the FM PD. This will be seen as disrespectful to the IM rotation that understandably doesn't want you to show up for them to give you 4 wks of teaching when all you wanted was 5 min with the FM PD, and I don't think this will curry enough favor with the FM PD to justify trying it, in fact, he may see it as sort of a slimey thing
    if you have to do IM there, sing the praises of the institution in general without too much brown sh8t on your nose,
    if you literally had some reason why you were interacting with the FM PD, like they invited you to lunch (yeah right) you could say that you came to do IM, love the institution, but while having a good experience there on IM you are now convinced FM is the way for you (if this is a true statement, don't bull****)

    next, I talk about ERAS, after this I have some advice about doing rotations in fields not your own, and dealing with the FM vs IM rivalry
    If when you submit ERAS you apply to this hospital for FM, they may scratch their heads why you did IM there, but any rotation you do well at an insitution helps you somewhat because you are showing you can function in their hospital in some capacity although different from their own niche
    so hard to say what this does for you on paper to the FM PD should you be stuck doing the IM rotation there
    just know that no matter where you are in that hospital, you need to leave a positive impression because any negative one can hurt you lots, your IM rotation there will matter regardless

    If this were your absolute number 1 place you want to match, you could put in your PS how you wanted to be in a primary care field, and carefully considered IM vs FM and what soul-searching and experience led you to your decision, in which case none of the above seems schizophrenic to this institution that you did an IM rotation there
    (or this may be a dumb idea, it'd be great for those above me to chime in on that)
    it's not unusual however in general for your PS to show some thought and insight on your part for why you and the specialty are a good fit
    if there's someone at your med school who is a mentor for FM application you should talk to them about this

    keep in mind that the IM vs FM internal debate for students is VERY common and not unexpected, so doing that as a subI is not odd and understandably may in fact be what tipped you to FM
    and regardless of how you structure your 4th yr sched, PS, ERAS, you can almost always count on the question on interviews "why this specialty?" at some point
    so having done both as rotations but applying to one specialty via ERAS is not necessarily damaging, in fact, it gives weight to the idea that this is a well-considered decision on your part

    one of the greatest fears of a program is that you match there and decide at some point it was the wrong specialty for you and want to bail

    actually if you apply in ERAS to this institution to both the separate IM and FM programs they can't see this in the computer
    no one but you sees what other programs you have applied to
    that being said, 1) yes programs may ask you where else you applied, and no, that's against the rules but they do it anyway
    and you will have to think about how you want to handle these kind of questions ahead of time even if they're inappropriate you don't want to be caught by surprise and 2) Program directors talk to each other within the field, and who knows what the FM PD has to chat with the IM PD there
    so 3) be careful about this, I would only apply for one specialty at that insitution
    4) that doesn't have to be a solid rule in that people will apply to more than one specialty, but you should think long and hard on that, talk to advisors, read on here, and decide what is strategic, if you liked neurosurgery and IM, it might behoove you to apply both if you would rather match to your second choice specialty than not at all (as can happen with competitive specialties), and some people play a lottery of "the fates will decide rads vs neuro" but in general unless you're playing the game of back-up specialty, you should just apply to one specialty

    This next piece of advice will serve you well for all of the awkwardness of 4th yr, namely that *everyone* knows that YOU know what specialty you've applied to after Sept, yet you will still likely be doing rotations that are NOT that, you can't do the 3rd year vague "I'm considering ___ specialty that just so happens to be the rotation I'm on now with you Dr. Awesome!!" or the "I'm not sure yet."

    For example, if you were going for IM yet having to do your required 4th year Peds, they could think you don't give a f8ck about Peds
    what you should do is show respect to their field in some way, like you could point out that you appreciate seeing kids who are really gorked and how they're dealt with as Peds because you know one day as an IM doc you will be taking over their care, like kids with cerebral palsy etc, and you think IM docs should have more experience with Peds for this reason, you can also point out that since IM scope of practice includes 12 and up, you appreciate any exposure to adolescent medicine because you have interest in that, and many IM docs don't get enough of that experience, so you're glad to soak that up now with them, or you can say that you have kids of your own, and while you're going to do IM for career (because you're a little intimidated by the responsibilies of caring for children medically, because it's such an overwhelming responsibility kissy kissy) on a personal level you appreciate what the peds knowledge means for you. None of this applied to you as you considering FM, but Get the game? It's not even game, it's a mature and appreciate way to think about the collaborative nature of medicine. There really is a point of rotations not in your field, you need to know what other people's jobs are to do your own

    You're lucky because going for Family Med you can tell every specialty how very important they are to your education
    IM might be the only ones feeling snubbed, you can just chalk this up to how difficult and challenging the patients and rounds are, and how it really takes a special kind of I don't know make something up to do their job, and my favorite, is "I really like how much internists are able to care for inpatients and the acuity, and the challenge of the cases, something hard for FM docs to do these days, I really had a hard time deciding, but the one thing I just couldn't give up is treating those kiddos and maybe catching those babies"
    They either 1) had little interest in kids/preggos medically which is why they chose their field, so naturally your odd need to be involved in birthing means you should go to FM, this is not a slight to what they do
    or 2) this was the hard thing for them to give up as well, so they will understand why you went for FM

    The reality is that docs don't care so much if you want to grow up to be their mini-me doctor, they just want to know you appreciate them, their field, what they do, what they are teaching you, no one wants to feel they are wasting their breath. There can be assumptions made towards you about this, but saying something thoughtful like above or below tends to help a lot. In fact, since you are not going into their field any appreciation you show seems less ass kissy I would argue

    the other way to show respect is to say, "As someone going into FM or ___ specialty, what do you wish for those docs, for me to know, about your specialty? What advice do you have? What would you like us to do/not do? When should we refer? What's the biggest mistake we make? What drives you nuts that you wish we did differently?" That's a favorite for them! Because it's not only educating you, but they get to vent about a specialty in the name of education. You're essentially saying you want to direct your practice around them! The chance to change the world to benefit ____ specilaty.. A lot of docs are really appreciate interest from outside their field for what they do.

    Anyway, I hope this helps you with the applying and politics of 4th year, and if you get stuck doing the IM subI that's OK, you will learn things that are valuable for FM too. Play the game smart. Good luck in the match!!
     

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