Rotation order advice for returning MD/PhD

[gstrub]

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Hello,

I am going to be returning to M3 this summer after 4 years in the lab. I have the benefit of selecting whichever rotation group I want. Most likely, I will be pursuing a surgical subspecialty. Out of the 12 groups, 6 have medicine before surgery, and out of those, 3 have what I am considering "easier" starting rotations considering I haven't taken a HPI in 4 years. One of those has surgery last, which I don't think will be the best choice. The remaining 2 are:

1. Psy-OB-IM-(Christmas)-IM-Surg-FM-Workshop week-Neur-Peds
2. OB-Psy-IM-(Christmas)-Peds-Surg-Workshop week-Surg-FM-Neuro

Note that the 1st group has IM immediately before surgery, and that the 2nd has both IM and peds before surgery as well as a break during the actual surgery rotation, which I hear is very beneficial. Any thoughts on these two options? Also keep in mind I can choose any group so if you have other advice that these 2 groups don't address I would greatly appreciate it.
Thanks in advance,
G

 

[pmpkn219]

I like #2 better. let me try to get through my rationale (because part of it is gut, I apologize for that!)

I started on Ob... I assume you guys take a Shelf exam at the end of your clerkships? The Ob shelf, I thought, was a good starter to clinical medicine. Why? Because there's really only like 6 disease processes (no offense at all to future Obs!) There's pregnant versus not, too much/wrongly timed bleeding, and a few cancers (whose exact staging you do Not need to know).

Starting from the end, I like having Family as a sort of "wrap up" rotation. It's different than Medicine, more than I expected... but if you've already taken everything else (except Neuro), it should be kinda like a review. We don't take the FM shelf, we have an in-house test (which I've heard isn't uncommon), and so there'll definitely be more variability, but I think it's a sound strategy. Family could also make a good #1 rotation, as it's a little of everything and very laid-back (here anyway) so it's a good starting point to relearn your H&P skills, etc.

Having the break in Surg is probably nice, and having Xmas right after Medicine is also nice (I had this). I thought Medicine was just as/if not more exhausting as Surgery (unexpected), and probably some of that had to do with the way our IM clerkship is, and how much I dislike adult medicine 😉.

So having a break right after or in the middle of arguably the 2 most tiring rotations, seems like a nice set-up. I didn't have Surgery until the end of my third year, so it had been 5 full months since the End of IM... I didn't feel terribly affected in terms of Shelf performance (which as you may have heard, there's a lot of Medicine on the surg shelf), so I wouldn't put Too much weight into having those two back-to-back.

For what it's worth I skipped block 1 then did Ob-IM-Xmas-Peds-Psych/Neuro (we only do 2w Neuro/6 Psych)-Surgery-Family. I really liked my schedule overall. I also liked having Ob before Peds, because I liked the continuity aspect... like I could remember the TORCH infections because of checking moms' titers at the first prenatal visit, etc...

 

[gstrub]

Yes, I am leaning towards that group. Also I didn't notice but that group breaks IM up as well, the 1st 8 weeks are before Christmas, then the last 2 are after. This group will likely be full of people interested in Surgery, so getting some of the smaller sub-specialty rotations may be more competitive, but who cares. I think I'd rather end with FM and neuro more-so than Peds. Thanks for the input.

 

[smq123]

I haven't taken a HPI in 4 years.

I'd also go with option #2.

Psych is a fairly easy rotation, generally, but it won't help you transition back into 3rd year. You haven't taken an HPI in 4 years....and you still won't be comfortable taking an HPI after psych. Most of your patients will have severe dementia, be delirious, or severely schizophrenic, and can't give you a coherent sentence, much less remember what meds they're on.

Starting with OB is, I think, better. The problems that arise in OB tend to be fairly focused, but you still have chances to practice basic physical exam, rounding, SOAP notes, H&Ps, etc.

What are you interested in going into, by the way?

 

[HouseHead]

Did you do Step 1 yet? If not, I'd try to do IM first. If you're fresh off board studying, you'll be fresh for IM. I'd recommend surgery last- that way you'll have as much experience under your belt as possible.