What do I take in Fourth Year

[ladyj]

I am a third year interested in Peds Residency with the goal of Neonatalogy. I am totally lost and need to know what I should take for my fourth year electives to prepare me for a residency in Peds and that will appeal to residency programs?

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[Stone'sDad]

I am a third year interested in Peds Residency with the goal of Neonatalogy. I am totally lost and need to know what I should take for my fourth year electives to prepare me for a residency in Peds and that will appeal to residency programs?

In my experience, your 4th year schedule has virtually zero bearing on a residency's opinion of you. As long as you do at least 1 pediatrics sub-I and have that on your schedule you will be fine. Having a couple of other peds electives that are specifically interesting to you would be helpful in the sense that you could talk about your experiences in them during interviews.

In terms of choosing 4th year electives, do what interests you in Peds as well as in other fields that you may not get to experience anymore once residency starts. I have been told that it is not necessary to do 4th year electives in order to prepare for intern year, but I would assume that you would feel more comfortable with a subject the more you see it.

One thing you could consider is that certain peds fellowships have application dates very early in residency, sometimes before one has rotated through this specialty. Most residencies seem to have a bit of flexibility to allow you to take at least 1 elective in your first year/18 months. So, you could pick an elective your 4th year to see if it interests you as a future subspecialty. If after 4th year, you find one that interests you, you can try to schedule it early in residency.

That being said, I have not been in the hospital since September, took 2 peds electives total, and am enjoying a relaxed 4th year before the beginning of the intensity. So, you have to do what you feel works best for you.

 

[kas23]

Agreed. Don't worry about what the residencies think about your 4th year schedule - they don't really care, as long as you graduate. Just do a sub-I early on for a LOR and to confirm your choice for peds. Then take a peds elective you are interested in sometime during the year. In your case, do NICU. Fill in the rest of the months with requirements, time off, relaxing, sitting around, and taking the easiest classes your school has to offer - no matter if it has absolutely nothing to do with peds (you will be doing this for the rest of your life). You deserve the relaxation after 3rd year - don't worry, you'll get used to it very quickly.

And try to get your Step 2s done early on - it just makes things so much easier.

 

[jamie]

Agree with above. A guy in my class interested in neonatology did a month of maternal-fetal medicine (kind of the opposite of how those going into Ob/Gyn do some time in the NICU).

I've done peds radiology and derm, which I found helpful for peds, and not difficult at all.

 

[14022]

I have heard regardless of adult or pediatric medicine, you should do some time in adult/peds anesthesia...you will undoubtedly need to intubate somebody at some time and it is better to practice on little johnny who is asleep before his hernia operation than little susie who's heart rate is in the 40's

the piece of advice i have heard from almost everyone beyond my training is that you should try to enjoy your fourth year as much as possible...within reason of course...dont take 12 weeks doing some stupid reading electives....but dont spend all year doing sub-i's either

 

[GeneGoddess]

I don't think that a sub-I is necessary. I didn't do one, mostly because I had several "required" classses that I could only fit in in the Fall (Family Practice, Internal Med, Surgery, etc). I took Pedi Endocrine, which was GREAT, since it covered so many aspects of Pedi, and Pedi Urology, which was my "req'd surgery". The latter was fantastic, because I saw tons of circ consults (I'm now an expert on the normal newborn penis), enuresis, and reflux/UTIs. All things a general pediatrician will see.

 

[docmartin]

Hey ladyj,

Alot of this is subjective, but here goes. Some people do 1-2 peds electives their 4th year, others like myself did 5, in addition to 3 months in my 3rd year. I too was interested in Neonatology. Definitely should do a month of NICU, probably at the beginning of your 4th year. Food for thought: you may consider doing your peds residency at a place that has a Neonatology fellowship. They will have seen you during residency, and perhaps the director of the NICU can help. On the flip side of that, I have heard that sometimes it's better to go somewhere where there is no fellowship, b/c you'll have much more hands on during peds residency.

Aside from that, I think a Sub-I is helpful (I did 3), just b/c you see what it's like to be an intern, and pick up alot of pearls along the way. Of course, helpful to do Sub-I's at places you think you may want to go for residency. I also did Peds Nephro (just for kicks) and outpatient peds during 4th year. The one thing I had wish I had done during 4th year was a Peds ER or even PICU. But I did do all my peds stuff early on in my 4th year (to get LORs) and now am just cruising until Match day. I was also asked on many interviews what peds rotations I had done my 4th year and where, felt good to say 5!

Good luck!

 

[NYtoCA Peds]

Okay, I got a little different advice re: 4th year and I think it worked out pretty well. I was actually told that unless you're interested in NICU or PICU that it's not really necessary to do a rotation there during your 4th year. Don't feel like everyone else will have NICU experience coming into intern year, because it's just not true. As an intern they really don't expect you to have any NICU experience and if you're not planning on pursuing either one of those fellowships then I don't think one extra month in those units as a fourth year makes much of a difference in your education.

In terms of other electives, I would definitely recommend doing away electives at programs that you might be considering for residency. I did two electives and it gave me a lot to talk about during my interviews. Most interviewers wanted to know why I did each elective and if I had any interesting cases, etc. Just pick fields that are interesting to you, not fields that you think will give you a leg up during intern year because they're all going to be helpful. You'll probably be able to do well and be the most enthusiastic if it's obvious that you're enjoying what you're doing.

Hope that helps!

p.s. woops--i didn't realize that in your original post you said you were interested in neonatology!! i guess this is for all the people out there who aren't!!

 

[RySerr21]

anybody have any suggestions in terms of elective timing? At my school they require a sub-I in either medicine or peds (ill be doing peds) and then an ICU rotation (i can choose either NICU or PICU).

My concern is for my sub-I. Peds was my 2nd rotation, so it will have been over a year since ive had really any peds exposure (with the exception of WCC during family and a week of peds neuro). I wanna be sharp on my sub-I, so i was thinkin maybe doing an elective in peds before my sub-i would help refresh? Electives I wanna do at some point throughout the year are cards, ID, maybe ER...