Recommended Electives for MSIV

[docbrown76]

I am in-process of planning my 4th year electives and plan on going into pediatrics. What rotations did you find most useful preparing for internship year? Regarding away/audition rotations, do you recommend 1 or 2 sub-Is?Any advantage to doing an away in a non-Sub-I capacity (i.e. cards, GI, heme/onc)?

Thank you in advance for your responses.

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[CrazyPeds527]

First of all...yay for more friendly Peds people!

Now thats out of the way...a caveat, i am a current 4th year, so what i will say is stuff i have done this year and i dont know for sure how well it has prepared me for next year, but i think i have had a well balanced year:

I did 1 Sub-I on the inpatient team where i was the acting intern and this was one of the best months i had all year in terms of learning and accelerating my skills.

I did my away in cardiology and only know one classmate who did an away as a true Sub-I, all of my other friends did aways as elective months (ID, PICU, Cards, Heme-Onc, Clinic). the advantage to this is you are not q4 in a new city and it gives you time to explore and see if you like the area. The only downside is that you dont see what call is truly like.

I also thought it would be helpful to do one ICU month (PICU or NICU, i did PICU) in order to get familiar with vents and stuff.

One thing i am happy about for this year is that i didnt do 6 or 7 different peds electives, i did stuff i might not get to do again (Anesthesia, Radiology) and round out my medical education.

Good luck!

 

[andyh]

Congrats on choosing peds. Like CrazyPeds527, I'm a 4th year as well so here are my 2 cents.

Re: sub-I selection & #s
Ever med school is different so you may have different requirements. For me, my PICU counted towards my sub-I and I had a great time doing this (and I only did 1 sub-I). I had friends who did the NICU, the wards etc... so go with the flow. We have a lottery system and so I got the PICU. I had hoped for the wards but in the end I'm really gald to have worked on the PICU. Granted, I didn't have as much autonomy, but I learned quite a bit and managed the easy questions when I was on call (deferred to the 2nd year and fellows for the rest).

Re: away rotations
I think I wrote about this before in another post but I would recommend doing an away rotation (and more specifically an away elective) more for the sake of figuring out if a place is a right fit for you. I did an away in Peds Oncology and had a blast. Not only did I get to see the hospital from other aspects other than floor work, but I got to meet lots of faculty, fellows, and to a certain degree, residents (the residents mostly in the mornings or at conferences). In anycase, I got a unique perspective which helped me figure out what I wanted to see on the interview trail.

Re: scheduling the rest of the year
CrazyPeds said it best, do what you are most interested in. If you want to get a broader exposure to medicine in general, do other things than peds electives. If you want to see specific aspects of peds that you may not see as a resident, do that (e.g. I'm doing a peds BMT elective and palliative care elective since not every program has this.). Outside of that, I'm spending the rest of the year finishing up my requirements, continuing my research, TA'ing, hopefully traveling a bit, and taking some classes (e.g. ICU physiology to "how to be an intern cross covering" to "being a resident teacher" to procedure service).

Also, you can do some searches on SDN to find what others have said in the past since I think some aspects of your questions have been asked before.

 

[TheFriedert]

Do not do any more sub-i's than are necessary, they are good for education but you have plenty of time to work 80 hour weeks.

As far as away rotations, i would say they are not necessary. Two times when they are helpful 1) Just to see another children's hospital and give you an idea of what you do and do not like about different places. 2) if you really have your heart sent on one place. As far as what to do, dont do a sub-i. Do a sub-speciality with a lot of exposure to the whole hospital ie renal, pulm, ID. You will get to see everything and meet a lot of people. Plus your hours will be reasonable so you can read at night and groom yourself to impress in the mornings.

 

[kristing]

When I did my Sub-I, the peds director in Austin gave me the BEST advice -

Don't do rotations now that you will do again. Do rotations you will never do again. Now is the time to see things broadly.

That said, I still did mostly peds, I just didn't kill myself with the sub-I's. I did a NICu month (which I guess is really a sub-I, but I didn't know that). I don't know if I would recommend that. I learned a ton and was able to use it in my residency, but you will have 3 NICU rotations, so that may be too much. But I liked it, and I'm glad I did it.

I did peds endo for a whole month, and as such, looked like a freaking superstar around the endocrinologists from day one. Because you will take care of a LOT of diabetes in Peds, and this will help you tremendously.

I don't know how much exposure you will have to the "important" people by doing away rotations in the subspecialties (residents, PD, faculty that will decide your fate.) So don't do an away rotation for that reason. I did an away in Peds ER, which was awesome. I am glad I did it because my program doesn't have a freestanding peds ER, and I learned so much on that rotation. Plus, I got, by far, the best LOR from anyone on that rotation (and who would've known the peds emergency physician would do that? Who knew?)

I also did peds ophtho and ENT (mostly peds - 2 weeks each) and man, am I glad I did. I won't be doing those in residency, but I feel I saw so much, that at least I have a fair idea of what happens to my patients when I send them to those subspecialties.

Good luck!

 

[Marigold]

I did a month of Pedi Rheum and a month of Pedi Derm....I just finished Derm so I have yet to see how helpful it will be in my general practice (but I predict it will be very helpful!). But I am very appreciative of the knowledge I gained on Pedi Rheum! It de-mystified a lot of stuff for me, and I can now do a pretty great musculoskeletal/joint exam.

I agree it's best to flesh out your education with some of the stuff you won't ever do much of again. These electives are a great chance to broaden your knowledge base, which will benefit you in whatever pediatric field you end up practicing.

 

[165808]

I recommend doing something along the lines of a Child Abuse and Neglect/Child Protective Services rotation. If your school offers it, of course.

I would hope that most residencies would incorporate this into their curriculum, but, as I saw while interviewing, some programs are a bit heavier on it than others. It's an absolutely crucial field to know, though, and I'm happy I'm going to have experience in it going into residency. There's things I never would have thought about if I hadn't done this elective....

I also did Peds EM and Peds ID as away rotations and will be doing an outpatient peds elective in April/May to help myself brush up before starting residency. I say don't kill yourself with peds electives you're going to do as a resident, too. Do fun stuff that you'll never get to do again!! I did Addiction Medicine, and I'm starting Forensic Psychiatry after my Child Abuse elective. (I'm a clost psychiatry fiend!!)

That's my 2 cents, for what it's worth.

 

[165808]

Oh, and I did my Peds Inpatient Sub-I, as required by my school.

Almost forgot that one!!