- Joined
- Oct 31, 2007
- Messages
- 121
- Reaction score
- 0
I apologize if this thread has already been created but I wasn't able to find anything. Does anyone have suggestions on what sub-I to do 4th year, or does it really even matter? Thanks.
Suggestions for sub-I?
- Thread starter arb011
- Start date
- Joined
- Jan 1, 2004
- Messages
- 2,923
- Reaction score
- 9
I'm not sure what you mean by what sub-I. Do you mean which elective that your school calls a sub internship to do? In that case, I'd say it doesn't matter for apps, but your best bet is whatever will give you the most possible autonomy in learning to manage patients (often this will be medicine). Do you mean what emergency medicine away rotation to do, out of the 150+ available? You'd need to ask a more specific question. Do you mean what fourth year electives should you do in general?
- Joined
- Oct 31, 2007
- Messages
- 121
- Reaction score
- 0
Sorry, I guess I incorrectly assumed that all schools have the same requirements as mine. I have to do a sub-internship but there is no sub-I in emergency medicine. I could do it in almost any other field; IM, surgery, family med, etc. I'm just wondering if students going into EM lean one way or another. Sounds like medicine. Thanks for your response.
- Joined
- Jul 4, 2006
- Messages
- 1,229
- Reaction score
- 1,103
My school had a requirement for IM or peds sub-i. Anyone going into anything except peds did IM. I did IM.
The choice of which sub-i probably depends largely on the specifics of your school. All else being equal, I'd choose either an IM or surgery sub-i. Is the FM sub-i inpatient or outpatient? As mentioned by pseudoknot, you want something that will give you the most autonomy. Basically, you are looking for:
1) Autonomy, both for LORs and, more importantly, for the quality of your education. The sub-i is a unique opportunity to grow as a physician.
2) LOR opportunities. Your most important LORs will be SLORs from EM rotations, but many people include 1 or 2 letters from other specialties. a sub-i letter is a good choice for this. Also, not sure how universal this is, but my school includes the sub-i evaluation on the dean's letter as a separate component. So you want to go to a service that is known to evaluate students fairly.
3) Good teaching. This is potentially the most educational month of your fourth year.
4) Sicker patients. If there is one service in particular that has a tendency to have sicker patients (maybe GI or renal), try to do the sub-i with them.
Good luck!
- Joined
- Feb 25, 2011
- Messages
- 16
- Reaction score
- 0
I did mine in our Trauma ICU. I had to make special arrangements with the surgery people but it wasn't hard. It was an awesome month. Lots of procedures and it's a rotation you'll do in an EM residency anyhow so it's great experience. I'd recommend seeing if you could arrange something similar. If not I'd recommend doing any ICU month if you haven't done one yet.
I did my Sub-I in Family Medicine because I wanted something cake knowing that I would be going to residency soon. Unfortunately for me I was placed at a county hospital where the family docs manage their own ICU patients so I was subsequently working 15 hour days.
- Joined
- Dec 18, 2005
- Messages
- 949
- Reaction score
- 16
I had a good experience on IM for my Sub I, but you have to find out what kind of responsibility you get. At my school they take an intern off the team and replace them with 2 Sub-Is. So I carried half an intern load. I had up to 5 of my own patients during the day, plus 5 of the interns when she was post call, plus 10 from the other team during call nights. So I could have up to 20 patients. I was the one the nurses called at 3am when the patient had chest pain, and I would eval the patient and start a work up before calling the resident. We had 30 hour Q 4 call, felt like it really helped prepare me for residency.
So an IM experience like that is great. If you are just going to be following around your residents during endless rounds, not having your own patient's maybe do something else.
I also did an anesthesia sub-I. I got some great skills, like lots of intubation practice, art lines, IVs etc. Also learned a lot about vents and critical care. But didn't really have responisbility or learn much about taking care of multiple patients.
Part of it depends on what kind of residency you want. If you think you are going to go to one of those 4 year EM programs where you do 6 months of non ICU floor time (peds, gen surg, IM etc) you should think about getting that Sub-I experience of taking call, getting sign out, managing people overnight you don't know that well.
So an IM experience like that is great. If you are just going to be following around your residents during endless rounds, not having your own patient's maybe do something else.
I also did an anesthesia sub-I. I got some great skills, like lots of intubation practice, art lines, IVs etc. Also learned a lot about vents and critical care. But didn't really have responisbility or learn much about taking care of multiple patients.
Part of it depends on what kind of residency you want. If you think you are going to go to one of those 4 year EM programs where you do 6 months of non ICU floor time (peds, gen surg, IM etc) you should think about getting that Sub-I experience of taking call, getting sign out, managing people overnight you don't know that well.
