SubI for 4th year?

[Dr1216]

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Hi everyone!

So I'm trying to round out my electives/ SubIs for this year and I'm getting mixed suggestions.

Some people recommend not doing SubIs per se, with the claim that they don't actually help much unless you're excellent on the floors and can actually do more harm than good if you're average. Others say that subIs should be done to guarantee you an interview.

I'm confused about the whole thing and I was hoping that you all could help since most of you have gone through this already. So please bare with the million and one questions😕.

Are subIs for psych (which I assume to only be adult inpatient?) recommended? And if so, how many? I've also heard people say do a practice one at a place which is not highly ranked on your list before doing one at your top choice. And if not, is it ok if I just do random psychiatry electives (ie: Eating disorders, Sex & mental health, women's psychiatry, etc)? Would those still be considered helpful? What about doing a medicine subI? Necessary(please say no to this )?

I guess what I'm really wondering is if you believe doing or not doing a SubI's in psychiatry helped you in matching at your residency program?

Whew😱.....any insight would be helpful. Thanks in advance!!

 

[Bartelby]

Fellow fourth year student here. I have asked several Psych faculty members about away rotations and they seem to think they give you an edge because they show the program how serious you are about going there. I think if you are set on a given program, do an away there and make every possible effort to impress.

If your question is whether doing a sub-I for your away rotation is better than doing whatever rotation interests you, I don't really know. My guess is what matters is working with someone who will be active in the admissions committee, and if you do something you are really interested in and good at maybe that would paint a better picture of you than just doing a generic sub-I month.

I would like to hear the resident/fellow/attending opinions on this though, especially in response to this: I don't have my heart set on a single place, but I would like to end up somewhere with faculty doing field-defining research like Harvard, Columbia, etc. I would rather not do a sub-I just to impress program directors, in my opinion that month would be better spent taking dermatology, emergency medicine, research, a neuro sub-I, basically things that are meant to help me grow as a clinician. Will taking this no-aways approach really hurt my chances assuming I am an otherwise good candidate?

 

[notdeadyet]

Some people recommend not doing SubIs per se, with the claim that they don't actually help much unless you're excellent on the floors and can actually do more harm than good if you're average. Others say that subIs should be done to guarantee you an interview.

Sort of.

Away Sub-I's are also commonly called "audition rotations" and they are just that. So if you're a strong candidate for an interview at a particular site, there is a great opportunity for an audition to hurt you. All it takes is a personality friction with someone running a particular site to sink your chances at a place you were otherwise a great candidate for. This is why conventional wisdom is that audition rotations have the potential to do more harm than good for a strong applicant.

That said, for weaker candidates, or average candidates for top programs, doing a stellar job on an audition rotation can give you the extra edge that you'd need to secure an interview at a competitive location.

Another reason to do an away rotation is to get a good feel for an institution and how you'd fit there. Many folks audition at their dream program and walk away a month later with that program much lower on their list.

You just need to look at yourself and judge how strong your application is and compare that with how competitive the programs you're hoping to interview are. No interest in the tired MD vs. DO debate, but if you are applying as a DO, audition rotations at more competitive programs might make more sense as they may traditionally have fewer osteopaths matching there, so increased exposure to you might be a boost.

Best of luck...

 

[atsai3]

If you search the SDN archives you will find several (extended) threads where contributors have discussed this question in great detail. In short,

1. If your application looks fantastic on paper (i.e., great scores, great letters, publications, etc), then don't do the away rotation. There is a higher probability that it will hurt you rather than help you. During an away rotation, if you give them anything short of a walk-on-water performance, you will be a disappointment to your observers. In addition, the residency selection process is as much about "fit" as it is about other factors -- and if you do anything during the rotation to annoy the residents, then you will get dinged. (And unfortunately you can't win here. If it's not "he was a little too eager", then it will be "he didn't seem eager enough". If it's not "he was too aggressive", then it will be "he wasn't aggressive enough".)

2. If your application looks terrible on paper, then you really have nothing to lose. Putting in a stellar performance on an away rotation can only help you.

3. If your application is middle-of-the-road in terms of quality, then the correct course of action is unclear. Basically, "it depends".

 

[Dr1216]

Thanks to those who responded. I guess I'll do 1 or 2 based on tbe criteria listed here. My only issue now is deciding which programs to do one at since I don't have a top program. The one that was doesn't take DOs.

 

[zac16125]

I really can't see how doing an audition rotation can be a bad thing, unless you 1) Have absolutely terrible people skills and don't get along with peers or 2) You suck at what you.

Getting a chance to experience a month at a program which you are interested, getting a chance to to meet and interact with a people already involved in that program, and showing your legitimate interest in a program all at the same time. Seems like everyone wins.

 

[billypilgrim37]

I really can't see how doing an audition rotation can be a bad thing, unless you 1) Have absolutely terrible people skills and don't get along with peers or 2) You suck at what you.

or 3) just happen to wind up on a service with that one attending and/or resident with a personality disorder that lurks around every program everywhere.

Your audition rotation depends WAY too much on the particular individuals you are assigned to work with, and even at very good programs this is a risk. If you really want to check the place out, that's not a big enough concern that it should dissuade you.

But if it's a place that otherwise on paper you'd be well qualified for and you feel comfortable with the place already, the audition can probably only hurt you. It's not likely to hurt you, but it's even less likely to help you.

 

[atsai3]

or 3) just happen to wind up on a service with that one attending and/or resident with a personality disorder that lurks around every program everywhere.

Your audition rotation depends WAY too much on the particular individuals you are assigned to work with, and even at very good programs this is a risk. If you really want to check the place out, that's not a big enough concern that it should dissuade you.

But if it's a place that otherwise on paper you'd be well qualified for and you feel comfortable with the place already, the audition can probably only hurt you. It's not likely to hurt you, but it's even less likely to help you.

And in addition to this, residents expect more of MS4's than of MS3's. You will be expected to be a functioning member of the team, not just a productivity sinkhole. If you do an away rotation at an institution with a completely different system, if it is complicated you can expect to spend the first few days trying to figure things out. And since first impressions matter...

 

[Manicsleep]

I would still do it although there are obviously potential drawbacks. However the potential gain is much better. Schedule 2 or 3 and your chances of failure are almost entirely based on your performance.

However, it is prudent to get there early if possible and introduce yourself. Get to know the system as atsai mentions. If you can find out things like what EMR they use and if you go to a system that has an EMR you are familiar with it may give you a big advantage. First impresssions are very important and you need to work very hard the first few days to week that your are there to establish yourself/learn the system. Things should naturally flow after that.