Ques about Third-Year Clerkships

[Feinberg2012]

I'm an M2 currently about to apply to the lottery for 3rd year clerkships. Do certain grades matter more to Rad Onc residency programs? Or is it just important to do well in them? I'm asking because I don't want to try to do something first that might be especially important.

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[Onc99]

As in many specialties, medicine and surgery are probably looked at slightly more closely than other clerkships. That being said, doing well throughout your third year is much more important than any individual clerkship grade (some schools have no grades at all).

My personal bias would be to do something like inpatient peds first- the residents tend to be fairly nice and helpful in teaching you how to function in a hospital setting (a generalization obviously), as opposed to medicine or surgery residents.

However, I think the impact of how you schedule your 3rd year rotations on your success as a residency applicant is approximately nil in the big picture, so don't stress over it.

 

[StanleyCup7]

Having just went through the interview circuit and about to enter the match, I can offer my thoughts on things that I felt to be important.

I firmly believe that the combination of 3rd year grades and the comments from attending physicians on the Dean's Letter are just as important as your Step 1 score. Why? For two reasons:

1. Just about everyone applying into RadOnc is going to have a great Step 1 score. Therefore, the third year grades, IMHO, are more likely to show the combination of character and work ethic that residency program directors seek. A lot of people can bust a** for five weeks and rock Step 1. It takes a whole lot more effort to bust a** for 48 weeks and Honor all of your clerkships.

2. While grades are important, the comments from the attendings are just as important because they can ascribe to you certain characteristics: enthusiam, great work ethic, compassion, empathy, affability. If you really shine on the wards, some attendings may make comments like, "Stanley is one of the best medical students that I have ever worked with and is at the top percentile in all areas." Remember, these programs have to ask themselves, "Do I want to work with this individual in clinic, side by side, for three months at a time?" Personality means a lot in this field because it is inherently assumed that all applicants are intelligent.

As far as scheduling advice:
1. Schedule Internal Medicine last: Step 2 is ~50-60% medicine and so if you finish with medicine you can then take ~3 weeks to study all of the other subjects. Provided that you have studied hard all year long and scored >75% percentile on all of your shelf exams, this should enable you to do extremely well on Step 2. A strong Step 2 score will only re-inforce a strong Step 1 score.

2. Schedule Surgery first: I knew that I didn't want to do surgery, so to get the most difficult/grueling clerkship done first was a great feeling.

3. If you are at all unsure about whether or not you love RadOnc, schedule an elective in the second half of 3rd year. I realize that some schools don't let you do this, but if your school does take advantage of it. You may like the IDEA and LIFESTYLE of RadOnc, but not really like the underlying medicine/principles/day-to-day/planning, etc. It's much better to find out if you like/dislike something in 3rd year as it will make scheduling 4th year infinitely easier.

Assuming that I match (with 10 interviews, I sure hope I do!) I fell like I am about to win the lottery and am incredibly blessed to be entering what I feel is the best field in all of medicine.
Best of luck,
Stanley

 

[TIMTIM]

For the most parts, I agree with Stan...(great post!)

I do think that doing Medicine first, and then Surgery can help...Surgery's shelf is pretty much like a Medicine-shelf: a lot, a lot of medicine on it...

Doing Peds first can help medicine - the progress note style and ward routines are about the same for both specialties, and reasoning and ddx skills are interexchangable.

Definitely DON'T do Surgery nor Medicine first...if you could avoid it.

Psych, neuro and ob/gyn are relatively easier...

I think collectively 3rd year grades help, but I still hoped to use another 20 points or so for Step 1 though (that's still most deciding factor IMO). I think cultivating good characters and team work help, those are really the lifelong skills no matter where we go...if you do well enough on Step 1 (240 or above? Others may tell you differently), you don't even have to worry Step 2...

Finally, taking a solid year off between year 3 and 4 (NOT after year 4...because the timing can make publishing difficult), with HHMI or Doris Duke, can help A LOT for an otherwise average MD candidate...remember there's so many wonderful MD/PhD guys out there these days...1 or 2 first-author pubs in that year probably beats honoring surgery and medicine combined...

Nobody cares about Sub-I...I am doing it now and it's never raised an eyebrow...

AOA? Might help...some schools don't even have AOA...

 

[NFKB]

Feinberg 2012, I sent you a PM.

-NFKB (Feinberg 201)

 

[bragmt]

To echo shogun's statement one of the residents that matched at a top of the top program in 2009 had a 226 step I. If you have an average step score that's fine, but you better bring the heat with publications and LOR's. I am not talking about abstracts either, I am talking first author papers. Actually I would say that having papers on your CV is stronger than having record breaking step I's. Derm and Plastic's love those 265's, Rad Onc likes them, but what really gets the program directors salivating is MD/PhD's and publications.

 

[TIMTIM]

Hey Shogun, I agree with you. I misspoke, should clarify more - some schools don't even have grades for 3rd year (another friend from an Ivy League school said a lot of people could obtain honors, so effectively there's no cutoff...), and I thought Step 1 would be one of the more important things PDs use...somehow I think there's different yardsticks for MDs and MD/PhD's...

Having known people that FAILED step 1 and got into the field, I would disagree with that statement.

 

[ECGcali]

When would be good times to do away rotations during 4th year?


Better to do it in the late summer early fall or closer to interview season in hopes that the good impression you left is fresh in their mind?

Not quite sure about this, maybe I'm just over-thinking the process.