Shortened preclinicals, Step 1, and rotation order

[NYCMS2]

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I know this business about rotation order been asked before about traditional curriculum schools (2 year preclinicals -> Step 1 -> 3rd year rotations), but what about those of us in the 1.5 year preclinical programs that go straight into a year of rotations, followed by Step 1?

At my school, as an MS2 I begin rotations in January; 12 months of that, then we take Step 1. Trying to figure out how much the order of rotations matter as far as taking Step 1 is concerned.

Otherwise, I am leaning towards IM, care not too much about surgery, OB, or peds, but I am concerned about the effect of being a year removed from preclinical classes and taking Step 1, wondering if that should influence my rotation order or not? You know, like scheduling medicine last...right before Step 1?

Thoughts?

 

[Jolie South]

Same advice applies. It really doesn't matter because you're assuming that:

a.) your registrar will comply with your request.
b.) you know 100% what you want to do and what you don't want to do.

For most students, one or both of the above are false.

 

[NYCMS2]

Same advice applies. It really doesn't matter because you're assuming that:
a.) your registrar will comply with your request.
b.) you know 100% what you want to do and what you don't want to do.

For most students, one or both of the above are false.

As for your point a., it is a lottery system, so I have a chance of getting my request; just trying to figure out what to put down.

As for your other point, I had some exposure to surgery through a summer fellowship - came out of it less keen than when I went in - otherwise I am as open minded as anybody, nothing written in stone. I did say "leaning" IM...

Would the medicine rotation taken right before Step 1 be more beneficial than others, or would it not matter? I have read comments that taking medicine right before Step 2 can be beneficial, just wonder if there is any similar benefit for Step 1.

 

[Jolie South]

As for your point a., it is a lottery system, so I have a chance of getting my request; just trying to figure out what to put down.

As for your other point, I had some exposure to surgery through a summer fellowship - came out of it less keen than when I went in - otherwise I am as open minded as anybody, nothing written in stone. I did say "leaning" IM...

Would the medicine rotation taken right before Step 1 be more beneficial than others, or would it not matter? I have read comments that taking medicine right before Step 2 can be beneficial, just wonder if there is any similar benefit for Step 1.

I don't think it matters that much.

 

[NYCMS2]

I don't think it matters that much.

I think you are right, but I am getting pretty nervous about all of this, and worrying about the taking of Step 1 after a year of rotations isn't helping matters much.

I would be curious to hear any comments from people who have done a 1.5 year preclinical program with Step 1 after a year of rotations. Sounded so great and logical when I selected med school, but now I am starting to wonder what I got myself into.

 

[Jolie South]

I think you are right, but I am getting pretty nervous about all of this, and worrying about the taking of Step 1 after a year of rotations isn't helping matters much.

I would be curious to hear any comments from people who have done a 1.5 year preclinical program with Step 1 after a year of rotations. Sounded so great and logical when I selected med school, but now I am starting to wonder what I got myself into.

That's how my school's curriculum is and I still don't really think it matters much. I took Step 1 in January of 3rd year.

 

[shantster]

I think you are right, but I am getting pretty nervous about all of this, and worrying about the taking of Step 1 after a year of rotations isn't helping matters much.

I would be curious to hear any comments from people who have done a 1.5 year preclinical program with Step 1 after a year of rotations. Sounded so great and logical when I selected med school, but now I am starting to wonder what I got myself into.

Upperclassmen at your school would be the best source of advice. What have they recommended?

As for clinical rotations, I found that having Medicine first was the most useful thing for all the rest of the rotations. For the most part the shelf exams in other disciplines are very heavy on the Medicine so it was good for that first. If you do outpatient rotations (family medicine, outpatient medicine/pediatrics), I found that it was much more useful to take that at the end of the rotations, especially after having inpatient Medicine and Pediatrics. In inpatient services things go much slower. You only get a patient or two new each admit day and have a good amount of down time to be able to learn about that patient in particular. In outpatient rotations you only get a few minutes to think about each patient and so you need to have the medical knowledge to be able to think through it quickly and come up with an assessment, differential, and plan and present that without being able to sit and think about the patient or read about him/her. The quicker you can do it, the more patients you'll be able to see and the more helpful you'll be to the attending that has a full outpatient schedule and is just adding your educational time in with his/her minimal free moments between patients.

 

[Jolie South]

Upperclassmen at your school would be the best source of advice. What have they recommended?

As for clinical rotations, I found that having Medicine first was the most useful thing for all the rest of the rotations. For the most part the shelf exams in other disciplines are very heavy on the Medicine so it was good for that first. If you do outpatient rotations (family medicine, outpatient medicine/pediatrics), I found that it was much more useful to take that at the end of the rotations, especially after having inpatient Medicine and Pediatrics. In inpatient services things go much slower. You only get a patient or two new each admit day and have a good amount of down time to be able to learn about that patient in particular. In outpatient rotations you only get a few minutes to think about each patient and so you need to have the medical knowledge to be able to think through it quickly and come up with an assessment, differential, and plan and present that without being able to sit and think about the patient or read about him/her. The quicker you can do it, the more patients you'll be able to see and the more helpful you'll be to the attending that has a full outpatient schedule and is just adding your educational time in with his/her minimal free moments between patients.

I definitely agree with the inpatient vs outpatient thing. At my school, that means taking Family Medicine after all your other cores.

 

[NYCMS2]

Upperclassmen at your school would be the best source of advice. What have they recommended?

That's the problem - my class is the guinea pig - we are the first class with the shortened preclinical.

 

[gpac123]

Are you at Columbia? A good friend of mine is in your class.

 

[mmmcdowe]

Are you at Columbia? A good friend of mine is in your class.

If he/she is, then technically my class was the guinea pig class. They have their rotations mixed around a bit more than us, but the same format applies in terms of taking the step 1 after MCY. Regardless, OP I also am a big believer in doing medicine first. Since we don't have the step 1, it is the closest thing to a general review of material that we can get. I genuinely feel that I have learned more in my other rotations and done better because of my basis in medicine. As for as the step 1, I recommend shooting for one of the rotations that ends in vacation and/or an lower time commitment rotation (psych, family med, or subs for columbia if that is where you are). This gives you more time to study for the step 1 if you feel under-prepared, but also gives you more time to work on your applications for whatever you are doing next year.