any suggestions as to what electives I should take during my fourth year? peds cardiology? peds radiology?
I already have done peds ER and peds Pulm as part of my 3rd year... thanks!!!
(I guess really my question is: which electives will be most helpful to my future as a peds intern/resident?)
My top 5 would be newborn nursery, NICU, endocrine, sports medicine, and something spanish language.
newborn nursery. Learn to give advice concerning normal newborn care. Read a baby book and learn to regurgitate it. Trivia questions about babies has definitely been one of biggiest knowledge gaps coming into residency. When can babies start drinking water? When do you introduce solid foods? How does a Mom trouble shoot breast feeding? When will I know baby's permanent eye color? I had to leave the room to ask someone almost any well baby question for the first month or two or residency. I feel like two weeks learning that would have been worth the monotony
sports medicine: Learn how to do an accurate physicial exam on a patient with ankle pain, knee pain, hip pain, and shoulder pain. What needs a bone scan? What needs an ortho referal? How do you treat the stuff that doesn't need any of that stuff? If you have the drive read through 'orthopaedics made ridiculously simple' or something similar. This stuff is common in adolescent clinic and there's just not a lot of time devoted to teaching it.
Endocrine: Learn how to manage diabetes, panhypopit, and DI patients. Read through the pink panther book on diabetes.
Spanish: Translators are a myth made up by the liberal media. If you're planning to do a residency anywhere south of washington state a course in even the most basic conversational spanish will make your life way easier. If you have the money you could do a proper 4th year elective and spend a couple of months abroad learning the language, either at a
formal language school or a program at a south american hospital.
NICU: this is the debatable rotation. The issue is that some residencies are still very NICU heavy, and some have almost eliminated NICU from their cirriculum. If you end up at a residency that expects you to do 5 and 1/2 months of NICU (the maximum allowed), to carry half a dozen complicated patients as an Intern, to run to deliveries with distant supervision, and in general to act like a neonatologists in training then a month as a medical student is a fantastic running start for what will be your most stresstful months as an Intern. On the other hand there are now programs that have only a couple of months which are basically tourisim since the neos and NNPs to all the work, in which case do you really want to stress yourself by piling a hard rotation onto fourth year?. If you're going to do this do it early, its basically another sub-I and your motivation will flag later in the year.
Rotations I did in fourth year that sucked:
Peds anesthesia. Learn to tube and place IVs. Great idea, except that it turns out the residents do that and they view you as an inconvenience. Remember standing in the OR during your surgery rotation, waiting for someone to talk to you or dismiss you? Welcome back
Peds rads: How to turn two days worth of reading into two weeks of monotony. If you want to learn rads go to learningradiology.com and spend a weekend going through the cases. If you want to learn it even better when you finish that buy a copy of
pediatric imaging from amazon and spend two days reading through that. The nice thing about a profession that you do on a computer screen is that there's no reason you need to be seeing real films to get the full learning experience.
MORE SUB-Is!: I admit, I did two of them (three, counting NICU). It was exhausing and not particularly educational compared to my subspecialty electives. This is a good example of why you shouldn't psych yourself out.
Derm: The problem with most derm clinics is that academic dermatologists genearlly treat people who, if you saw them in outpatient clinic, you would treat by shuddering and refering them to an academic dermatologist. What do you do with crippling, refractory psoriatic arthritis? How about someone whose skin is covered in oozing bullae? SJS? With any luck you know you're out of your league and pick up the phone. I would however recomend reading through
Lookingbill and Mark's principles of dermatology, if you get the chance, it takes no more than weekend to read and taught me most of what I needed to know as an Intern about dermatology. If you find a derm rotation that's more primary care oriented try using it as your textbook.
