Sub-I Question for 4th years

[hunniejl]

---

Members don't see this ad.

I'm starting my sub-i in Medicine and was wondering what the difference is in expectation for sub-i's vs. the 3rd year clerkship. What do the attendings/residents look for and how do you get an honors in your sub-i?

I'm in my first week of my sub-i and feel a bit overwhelmed, and the expectations seem to be different but can't quite figure out how to shine as a 4th year.

Thanks! 🙂

 

[HarryRosenMD]

Hi...

The main difference is that during a subI, you are given more responsibility... which varies based on your abilities. You work alongside the interns... without breaking off to go home to read. You, in a sense, live with them for the month. There is always a great deal of importance on knowledge. The problem comes when attendings lose sight of what a 4th year should actually know and understand. If you find one that does... then some knowledge, along with a great deal of work/scut will put you on top.

 

[Anka]

Probably depends a bit on the school. Where I am, when the team gets a subintern, they lose a real intern (i.e., complement becomes resident + intern + subintern rather than resident + 2 interns). So, the subintern has their own hemiservice overseen directly by the resident, and the caps are the same as the intern cap. Your number appears in the housestaff datafield which the interns call, and you crosscover like you would if you were an intern.

In contrast, the junior medical student role doesn't substitute an intern, usually carries 3-4 patients, doesn't appear as the primary contact for the RNs, and doesn't take overnight call.

Anka

 

[Dazeo]

I'm starting my sub-i in Medicine and was wondering what the difference is in expectation for sub-i's vs. the 3rd year clerkship. What do the attendings/residents look for and how do you get an honors in your sub-i?

I'm in my first week of my sub-i and feel a bit overwhelmed, and the expectations seem to be different but can't quite figure out how to shine as a 4th year.

Thanks! 🙂

I wouldn't worry about what is expected of you. You probably have developed some skills during the 3rd year, whether you realize it or not, and you will use them in your sub-I. If you work hard, read about your patients, show enthusiasm and have at least a rudimentary diagnosis and plan for the patients you admit, you will get honors.

Your residents/attendings probably expect you to feel overwhelmed if that is how you feel, so don't sweat it. Just try to be efficient, focus on the task at hand, and spend your energy learning as much as you can, not worrying about your grade.

 

[hunniejl]

Probably depends a bit on the school. Where I am, when the team gets a subintern, they lose a real intern (i.e., complement becomes resident + intern + subintern rather than resident + 2 interns). So, the subintern has their own hemiservice overseen directly by the resident, and the caps are the same as the intern cap. Your number appears in the housestaff datafield which the interns call, and you crosscover like you would if you were an intern.

In contrast, the junior medical student role doesn't substitute an intern, usually carries 3-4 patients, doesn't appear as the primary contact for the RNs, and doesn't take overnight call.

Anka

Anka, what school do you go to? Seems really intense! At my med school, 2 AI's pair up to replace an intern on the team, so we have half of the work a regular intern would have. However, we do cross-cover and get called by RN's all the time (particularly on night call 😛).

From my first week, it seems like a lot more emphasis is placed on getting your work done (as HarryRosenMD said, scut) but there's a lot less emphasis on acquisition of knowledge. Are you supposed to demonstrate what you know like you would during third year rotations, or try not to waste the team's time during rounds/work hours and get your work done as fast as possible?

Thanks!

 

[lankysudanese]

Anka, what school do you go to? Seems really intense! At my med school, 2 AI's pair up to replace an intern on the team, so we have half of the work a regular intern would have. However, we do cross-cover and get called by RN's all the time (particularly on night call 😛).

From my first week, it seems like a lot more emphasis is placed on getting your work done (as HarryRosenMD said, scut) but there's a lot less emphasis on acquisition of knowledge. Are you supposed to demonstrate what you know like you would during third year rotations, or try not to waste the team's time during rounds/work hours and get your work done as fast as possible?

Thanks!

the sub-I's responsibilities (at our school) are exactly the same as those of an intern.
regarding your last question: sub-I's are expected to do both (stick around to demonstrate superior knowledge, and get work done before rounds end), somehow!?!? meanwhile, each intern breaks off from the team when we're rounding on someone else's patient.

 

[Anka]

From my first week, it seems like a lot more emphasis is placed on getting your work done (as HarryRosenMD said, scut) but there's a lot less emphasis on acquisition of knowledge. Are you supposed to demonstrate what you know like you would during third year rotations, or try not to waste the team's time during rounds/work hours and get your work done as fast as possible?

Thanks!

I pm'd you my school. There is more emphasis on getting things done efficienty. Some of it is true scut, but for the most part it is about getting your patient the best possible medical care -- which is often mundane, true, but not something to be avoided.

You are supposed to demonstrate what you know by doing the right thing, having the right plan, etc. A lot less BS "I prepared a brief presentation on Topic X", no writing H&Ps for purely academic purposes, etc. However, if you don't know what you're doing it'll be pretty darn obvious. I usually tried to stick around for most of rounds so I knew what was going on with the other hemiteam's patients, but would cut out to call consults as it was decided they should be called, and if there was a computer nearby I'd enter orders as we went.

Anka