What type of internship?

[rugtrousers]

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I'm applying to prelim medicine and transitional years. Residents tell me to do transitional with lots of electives and minimal surgery. Attendings tell me to do a "rigorous" intern year. The few categorical programs I've seen have several months of medicine and surgery in the CBY, with some ICU thrown in. What gives? Should I do a transitional year and schedule myself for extra ward months (aiya!)? Extra ICU? I don't want to die intern year but I don't want to be a ******ed CA-1 either.

 

[Skrubz]

given the choice, i'd say medicine over surgery, ICU over wards. the benefit of doing a prelim medicine year is that you should know your medicine very well by the end, which will help during your anesthesia years.

granted, i did a prelim medicine year myself, so i'm probably a little biased. but i have had some attendings tell me that i know more medicine than some of the CA-2s. of course, i'll probably forget most of that by the time i'm a CA-2. 😛

 

[supahfresh]

i did surgery and it was incredibly helpful in the or. but don't run off and do a prelim surgery year unless you do your homework. some programs crush the prelims. i got lucky.

 

[me454555]

The advice given to me by an MDA that I respect a lot was "know you medicine real well" Do a medicine year of a surgery year b/c its much more important to understand medicine than perfect your lines. She also recommended doing at least 1 month peds and 1 ICU.

 

[Noyac]

I like the idea of doing a medicine tear mostly. You are going to spend a large portion of your time in practice determining if a pt has been optimized for surgery or whethter there is more to be done b/4 taking the pt to the OR.

I like the idea of doing a few ICU (SICU, MICU, PICU) months along with cards, pulm, peds, and then some gen. medicine months.

Surgery is simple (to learn that is) and you will know all that you need to know about every case you are going to do after you have done a few of them.

 

[WalterSobchak]

I did a year of surgery, and I would recommend it to anyone who asked. Everybody has their opinion, and that's just mine.

 

[maximuum]

I too am curious about categorical positions versus transitional years. Do people who have done categorical years have any opinions? I have noticed on the interview trail that a lot of the chief residents did categorical years, and they claim that they get to know the hospital and their colleagues better. I am not sure if the clinical training is actually better though.

 

[Crash cart]

Do a year in medicine. You will pick up the technical skills that an intern year in surgery will teach you. You need a good understanding of organ systems and physiology. I would strongly recommend to stear clear of transitional years... Several fellowships I've looked at REQUIRE a year in medicine (not surgery and NOT a transition year -- some have been explicit on this point).

 

[aredoubleyou]

Several fellowships I've looked at REQUIRE a year in medicine (not surgery and NOT a transition year -- some have been explicit on this point).

Serious? Not saying your making it up, but this seems so random. Perhaps ICU fellowships? Care to share a bit more...

 

[zeusdoc]

So how does the categorical year fit in with the alleged requirement of doing a medicine year prior to doing one of these fellowships?

Several programs, following recommendations from the RCC and ASA, are going to an all inclusive 4 year programs with the intern year spread out over the 4 years.

 

[zeusdoc]

So how does the first categorical year fit in with the alleged requirement of doing a medicine year prior to doing one of these fellowships?

Several programs, following recommendations from the RCC and ASA, are going to an all inclusive 4 year programs with the intern year spread out over the 4 years.

 

[jc237]

Do a year in medicine. You will pick up the technical skills that an intern year in surgery will teach you. You need a good understanding of organ systems and physiology. I would strongly recommend to stear clear of transitional years... Several fellowships I've looked at REQUIRE a year in medicine (not surgery and NOT a transition year -- some have been explicit on this point).

yeah, why don't you tell us which fellowships... huh? I'm very curious as well. Even though I'm still a 4th year student, I don't think fellowships are so competitive that they could demand what you do for your PGY-1 year. Please clarify, dude.

 

[Crash cart]

Sorry to keep you hanging...

Check out this link:

http://www.bidmc.harvard.edu/display.asp?node_id=1226

It is to beth Israel's critical care fellowship. The explicitly state applicants must have completed a year in either surgery or medicine (NOT a transitional year). So, I guess surgery is in, but transitional years should be entered into with the utmost caution.

 

[BraveSirRobin]

Sorry to keep you hanging...

Check out this link:

http://www.bidmc.harvard.edu/display.asp?node_id=1226

It is to beth Israel's critical care fellowship. The explicitly state applicants must have completed a year in either surgery or medicine (NOT a transitional year). So, I guess surgery is in, but transitional years should be entered into with the utmost caution.

i think this is just slightly out of date and only saying that you need to have finished your four years. for instance, many programs offer a categorical four-year program, and i'm sure BID would take any of these seeing how they're usually academic places sponsoring such programs (duke, pitt, penn, etc...). i'm in a transitional year and have yet to hear anything bad from anyone i've talked to. i did take two months of icu, though. we'll see if that hurst me later - but i tend to doubt it.

internship should be enjoyed. knowing how to work up hepatitis or how to adjust oral hypoglycemics doesn't help all that much, so why waist time working on such months. a TY program gives you all the important stuff should as EMED, floor months, etc..., and allows you to swap out unexciting endocrine months to things that interest you. unless you like diabetes.

can't imagine anyone would.

 

[Sugar72]

i think this is just slightly out of date and only saying that you need to have finished your four years. for instance, many programs offer a categorical four-year program, and i'm sure BID would take any of these seeing how they're usually academic places sponsoring such programs (duke, pitt, penn, etc...). i'm in a transitional year and have yet to hear anything bad from anyone i've talked to. i did take two months of icu, though. we'll see if that hurst me later - but i tend to doubt it.

internship should be enjoyed. knowing how to work up hepatitis or how to adjust oral hypoglycemics doesn't help all that much, so why waist time working on such months. a TY program gives you all the important stuff should as EMED, floor months, etc..., and allows you to swap out unexciting endocrine months to things that interest you. unless you like diabetes.

can't imagine anyone would.

I'm only an MS4, but I agree with you. From what I have been led to believe out interviewing - fellowships are mostly about who you know and who the faculty in your department know.

 

[Crash cart]

I agree completely... a four year program is fine. If people are only applying to advanced programs, I would recommend medicine or surgery over a transitional year. But I totally agree that a four year program would almost certainly be acceptable. Thanks for clarifying that.

 

[iron]

One program (Pitt, I think) compared in-training exam scores of residents who did medicine internship, transitional and surgery. The transitional internship residents had the highest scores at least for their clinical base year. This could be a pre-existing difference as T.Y is more competitive. TY program can widely vary. I did 2 months med. ICu, 1 peds ICU, 1 neonatal ICU, consult cardiology, etc. And I had fun. I enjoyed my internship. I don't think I would worry to much about the differences -- go to a place with a good reputation.

 

[rugtrousers]

The explicitly state applicants must have completed a year in either surgery or medicine (NOT a transitional year). So, I guess surgery is in, but transitional years should be entered into with the utmost caution.

I emailed the PD of the BID fellowship - he said it doesn't matter what kind of internship you do as long as you are board eligible in anesthesia. So do what makes you happy, I guess.