Should I do a medicine rotation close to the start of intern year?

[ratherbefishing]

Tried to find the answer to this using search but came up empty:

I front-loaded my 4th year schedule and in the second half of the year I will have a bunch of research and travel. In the 1-2 months before intern year I have the option to do a general Internal Medicine rotation or something fun like wilderness medicine/cush elective. If I do the latter, I'm worried that it would be almost 7 months without an in-patient medicine experience and that I would be too rusty at the start of intern year. No big deal or better to hit the ground running next July?

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[ThoracicGuy]

Tried to find the answer to this using search but came up empty:

I front-loaded my 4th year schedule and in the second half of the year I will have a bunch of research and travel. In the 1-2 months before intern year I have the option to do a general Internal Medicine rotation or something fun like wilderness medicine/cush elective. If I do the latter, I'm worried that it would be almost 7 months without an in-patient medicine experience and that I would be too rusty at the start of intern year. No big deal or better to hit the ground running next July?

Do whichever you want. Be ready to start learning day one of residency. Your final months of 4th year won't make much difference either way.

 

[gutonc]

So your options boil down to this:

1. Go into intern year fresh, rested, happy and unprepared for the reality of being an intern.
2. Go into intern year exhausted, burnt out, angry and uprepared for the reality of being an intern.

I'll let you guess which of your options correlates with which of the two above but I'm sure you can figure it out.

 

[RangerBob]

I did a medicine sub-I at the end of 4th year, and I actually thought it was pretty helpful--I thought it was really helpful considering my last "real" rotation during 4th year was EM in January. It jogged my memory, refreshed my patient skills/bedside manner, and helped me get back into the routine of not expecting to get home by noon everyday. Though, my attendings and residents still tried to get me home early everyday since I'd already matched, so I was still only working from around 7am-3pm. Plus it was the the VA, and census was low that month, so those are the other caveats.

I agree you don't want to be burnt out prior to internship. But, I think having vacation prior to internship is much more important for being rested and refreshed than having light rotations for all of the second half of 4th year. I took five weeks to drive/camp throughout the West--that was one of the best decisions of my life. Some of my classmates went to Europe. Very few did rotations past the end of April.

I do think one "real" rotation in the spring where you interact with patients and have more responsibility wouldn't be a bad idea. But I wouldn't do an elective in IM unless that's what interests you--I was required to do both a floor and unit sub-I and I intentionally scheduled the floor month for the spring. If the month your talking about is an elective month then do what excites you--wilderness medicine sounds pretty cool. Remember--it's your last chance to learn stuff you won't see again, and many other interns will be in the same shoes as you if you do go 7 months without any inpatient experience.

 

[ratherbefishing]

So your options boil down to this:

1. Go into intern year fresh, rested, happy and unprepared for the reality of being an intern.
2. Go into intern year exhausted, burnt out, angry and uprepared for the reality of being an intern.

I'll let you guess which of your options correlates with which of the two above but I'm sure you can figure it out.

Somehow, I knew if you were to answer it would be a response like this ;-)

 

[gutonc]

Somehow, I knew if you were to answer it would be a response like this ;-)

Well somebody had to tell you the truth instead of just blowing smoke up your ass.

 

[FutureInternist]

There will always be things that you are going to be unprepared for, regardless of whether you do an IM month near end of 4th year
The difference is in the type of things you are unprepared for
If you can do anything to make your day (and you team's day) easier by knowing how to adjust vents a little, replace elytes, call consults professionally etc then you should do it

 

[secants]

I did my 4th year SubI at the place I matched for my prelim since it was affiliated with my school anyway. I think just being orientated to how their system works and already knowing your future residents helped a great deal. I don't actually remember anything I learned though so hard to say if it's going to be as useful for you.

 

[deleted116380]

I did my medicine ai in February of my 4th year, but I was a rads prelim and didn't need LORs from my ai for my application early. I think it definitely helped me as my first rotation of intern year was medicine (followed by ICU, which I did as a 4th year rotation in Sept/Oct). Plus, the rotation where I did my ai had no MS3s on service in the medicine department. Only rarely any MS4s and I was the only MS4 there that month and the medicine service is run by PGY2 and 3s so I was truly treated as an intern and did all orders, social work stuff, d/c summaries, etc. More one on one teaching compared to a regular wards team with two interns, two MS3s, and then an MS4 ai.

 

[Houmd]

I'd have to agree with most fo the above who say not to do it at the end

 

[Anosh0101]

If you have time.. Looking over Washington Manual for DM, CHF, HTN

 

[DermViser]

So your options boil down to this:

1. Go into intern year fresh, rested, happy and unprepared for the reality of being an intern.
2. Go into intern year exhausted, burnt out, angry and uprepared for the reality of being an intern.

I'll let you guess which of your options correlates with which of the two above but I'm sure you can figure it out.

Maybe he's afraid of going into internship and possibly being so far behind, that he gets unnecessarily labeled? Not sure if that's the case, just a possibility.

 

[DermViser]

Tried to find the answer to this using search but came up empty:

I front-loaded my 4th year schedule and in the second half of the year I will have a bunch of research and travel. In the 1-2 months before intern year I have the option to do a general Internal Medicine rotation or something fun like wilderness medicine/cush elective. If I do the latter, I'm worried that it would be almost 7 months without an in-patient medicine experience and that I would be too rusty at the start of intern year. No big deal or better to hit the ground running next July?

Are you going for categorical IM/Surgery or prelim IM/Surgery?

 

[ratherbefishing]

Prelim IM

 

[iatros]

Tried to find the answer to this using search but came up empty:

I front-loaded my 4th year schedule and in the second half of the year I will have a bunch of research and travel. In the 1-2 months before intern year I have the option to do a general Internal Medicine rotation or something fun like wilderness medicine/cush elective. If I do the latter, I'm worried that it would be almost 7 months without an in-patient medicine experience and that I would be too rusty at the start of intern year. No big deal or better to hit the ground running next July?

I had a month of IM and a month of anes/cc in spring of ms4. I'd do it again too.

Sure, sometimes the days were long but I didn't mind the work. Had I not done that, it would have been >1 yr since my last inpatient IM rotation.

Now that I'm covering nights on the floor this month, I'm REALLY glad I had those rotations when I did.