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What if my med school does not offer a sub-I in my desired specialty?

ee1025

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Feb 22, 2016
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Hello, I am a rising MS1 so apologies if this a silly question given I still have years to go before clinicals--still have a lot of questions about the structure of med school despite lurking on SDN and my school's website:shy:

I know that a sub-I is required at one's home institution and you can do additional sub-I's as away rotations. My school requires a sub-I in either medicine, FM, peds, OBGYN, or psych, or ENT, but do not to my knowledge offer sub-I's in other specialties such as ophtho, neuro, surgery, etc. Is it a disadvantage if I do not have a home sub-I in my desired speciality (just regular elective rotations) or is it no big deal as long as I do an away sub-I in that speciality?

Thanks!
 

the negative 1

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If you have an interest in a specialty that isn't offered as a sub-I, I would start by looking at the list of folks who matched into that specialty at your school and get in touch with them. Ask them about how they planned their rotations and what made them competitive in the match.

See if your school has an interest group for your particular specialty of interest. These groups can be a good resource to start networking and help you plan your time in medical school. If there isn't one? Then be the first to start one and look for faculty/resident support.

Lastly, even if there isn't a specific sub-I, you may be able to create your own sub-I. There's always required rotations in your last year, but you should inquire if there's flexibility in the schedule. The main advantage of doing a sub-I at your institution is that the faculty already know and you know the system you're working in. In turn, you'll be able to get a more thoughtful and personal letter of recommendation, as well as have folks that can go to bat for you to get an edge in a competitive specialty.

Best of luck!
 
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longhaul3

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Yes, it will be a disadvantage, but if you're a very strong student you can overcome it.

The standard for many surgical subspecialties is to do one home sub-i and 2-3 aways. By the time you apply I would say you'll want to do 4 aways, assuming things don't permanently change due to covid.

Edit: in response to the above, creating your own home sub-i is not going to count towards the "requirement" in ortho, neurosurgery, etc. It may help by showing you how things work and introducing you to some faculty, but you need to do 3-4 rotations at institutions with ACGME-accredited residency programs, whether or not your school has one of its own. What do you mean when you say your school has rotations but not sub-is? Do they have residency programs in those specialties?
 
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ee1025

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Feb 22, 2016
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Yes, it will be a disadvantage, but if you're a very strong student you can overcome it.

The standard for many surgical subspecialties is to do one home sub-i and 2-3 aways. By the time you apply I would say you'll want to do 4 aways, assuming things don't permanently change due to covid.

Edit: in response to the above, creating your own home sub-i is not going to count towards the "requirement" in ortho, neurosurgery, etc. It may help by showing you how things work and introducing you to some faculty, but you need to do 3-4 rotations at institutions with ACGME-accredited residency programs, whether or not your school has one of its own. What do you mean when you say your school has rotations but not sub-is? Do they have residency programs in those specialties?

they have residency programs for most specialties, and you can do a 4 week elective rotation your fourth year in any of those more niche fields like ophtho or urology, but I don’t know if those count as an official sub-I. It seems like you have to do a required home sub-I in IM, peds, etc and then fill the rest of 4th year with electives and away rotations
 

longhaul3

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they have residency programs for most specialties, and you can do a 4 week elective rotation your fourth year in any of those more niche fields like ophtho or urology, but I don’t know if those count as an official sub-I. It seems like you have to do a required home sub-I in IM, peds, etc and then fill the rest of 4th year with electives and away rotations
Got it, this sounds like they are all actually what everyone would call "sub-i's" for the purposes of applying in each of those specialties. Some schools only designate some rotations as actual sub-internships for the purposes of graduation requirements, my med school included. So you would have to do one of those for your graduation requirements, then your home "elective" in your chosen specialty, then 2-3 aways in that specialty if it's ortho, neuro, urology, etc.

If you know any of the rising 4th years or recent graduates, just email them and ask to clarify. I'm 99% sure that the electives you're talking about are what most of us would call sub-i's.
 
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