What's a good sequence for 3rd year rotations?

[spicedmanna]

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Hi, guys,

A classmate of mine has the opportunity to choose the sequence for his third year rotations. He doesn't want to just randomly arrange it. The required rotations are 2 mo. of FP, 2 mo. of IM, 2 mo. of Surgery, 1 mo. of OB/GYN, 1 mo. of Psyc, 1 mo. of Peds, and 1 mo. elective. What do you think is the best possible order, knowing that his interest in Surgery and to maximize board study time?

 

[Rogue Synapse]

To your "classmate":

You can get a great education and be prepared for your field of choice no matter what the order of the rotations you/he chooses. There are still some schools out there that don't have a choice in their schedule, and they get along fine. That said, there are a few things that you might find help you out when making your schedule:

1. Try to plan the specialty you think you want to do towards the middle of the year. That way, you have enough experience with your hospital and clinical medicine to really shine.
2. I picked Peds as my first rotation and it worked out great because it's a good introduction to managing patients and following labs, etc. in a setting that tends to be pretty benign and forgiving (as opposed to e.g. OB-GYN or Surg).
3. Some people say to do the rotations with the longest hours (again, OB-GYN and Surgery) in the fall or spring as opposed to winter, so at least you can see SOME sunlight. Obviously a minor point in picking out your rotation order.
4. Worry about board study time after third year is over. Fourth year is so much more relaxed, with more opportunities to plan for studying (at least initially, before you have to start dealing with interviews). I am taking my Step 2 CK at the end of my first rotation in fourth year.

Hope this helps.

 

[45408]

Do medicine first. Excellent foundation for everything else. I did medicine first, then surgery. The surgery shelf has a LOT of medicine on it, so having taken the medicine shelf before the surgery shelf was a big boost.

 

[penguin24]

Whatever you think you might do (ex: Peds), don't do it first, b/c the first rotation will be your worst, going from classroom to wards is a big transition. It also takes one shelf exam to get used to the difference from M1/M2 tests, which are generally shorter. I agree to take Surgery after Medicine b/c of all the medicine that is tested on the surgery shelf.

 

[SouthernSurgeon]

Whatever you think you might do (ex: Peds), don't do it first, b/c the first rotation will be your worst, going from classroom to wards is a big transition. It also takes one shelf exam to get used to the difference from M1/M2 tests, which are generally shorter. I agree to take Surgery after Medicine b/c of all the medicine that is tested on the surgery shelf.

Alternatively, the first rotation can be the best, because the residents/attendings know that you are clueless, and all they really expect from you at that point is a willingness to work hard and learn. I did a hard rotation first (OB) and it was actually my best grade thus far, just because I had a good attitude (def not b/c of my shelf score...)

Ultimately, I think it tends not to matter that much (certainly not as much as we tend to worry over it at my school) - if you are trying to decide between a few things, I wouldn't save them for last b/c then you may have a lot of anxiety towards the end of third year.

Also, if you are interested in something surgical, I would not do that first or second - if you do a surgery rotation early in the year, you will probably have 4th years and visiting students doing sub-I's - the result being that you may not get as many good cases or the climate could get kind of gunner-ific.

 

[asmallchild]

What you'll find is everyone offers different advice and there's no surefire way to approach this.

What I recommend is starting off with something workload-intensive. OBGYN is nice because it often offers exposure to a variety of settings (clinic, OR, floors, etc...) and it will prepare you for the rest of the year. Nothing else seems quite as miserable after OBGYN 🙂

I also liked the idea of putting medicine and surgery in the middle of the year. They are typically looked upon as the "more important" clinical rotations and it's nice to go into those rotations with some experience. Of course, doing them first will provide you with a nice support for the rest of the year and attendings/residents will expect less from you.

Finally, I would try to end the year on a cushy rotation (outpatient medicine, elective time, surgical subspecialties which are notorious for sending students home early, radiology, neurology, sometimes even ER) I spent the end of my 3rd year manically trying to arrange away rotations and the rest of my 4th year schedule. It helps to be on campus with plenty of free time during working hours (9-5) to accommodate these arrangements.

 

[asmallchild]

What you'll find is everyone offers different advice and there's no surefire way to approach this.

What I recommend is starting off with something workload-intensive. OBGYN is nice because it often offers exposure to a variety of settings (clinic, OR, floors, etc...) and it will prepare you for the rest of the year. Nothing else seems quite as miserable after OBGYN 🙂

I also liked the idea of putting medicine and surgery in the middle of the year. They are typically looked upon as the "more important" clinical rotations and it's nice to go into those rotations with some experience. Of course, doing them first will provide you with a nice support for the rest of the year and attendings/residents will expect less from you.

Finally, I would try to end the year on a cushy rotation (outpatient medicine, elective time, surgical subspecialties which are notorious for sending students home early, radiology, neurology, sometimes even ER) I spent the end of my 3rd year manically trying to arrange away rotations and the rest of my 4th year schedule. It helps to be on campus with plenty of free time during working hours (9-5) to accommodate these arrangements.

 

[DrWBD]

Like everyone here is saying, you'll get a million different opinions about this issue. I have yet to hear anyone say "I would have gotten ___ residency in ___ hospital if I did ___ rotation earlier/later". Not to say this absolutely never happens, but FWIW I've never seen it.

Because I knew I didn't want to to Psych, Surgery, or Ob/Gyn I arranged those rotations earlier in the academic year. It worked out well because you spend a good portion of your first rotation just getting used to how things work in a hospital without caring about impressing people.

 

[thedrjojo]

At my school there are 12 block schedules to choose from, each with the predefined order, so the options aren't as great, but here is my advice:

I started with Psych as my first rotation. This got me used to the hospital and patient interaction setting, but only focused on the interview portion (no physical exam in psych). Plus there was no call! An alternative for your friend could be Family Medicine as well, since that is also very chill experience.
Surgery was what I want to go into, so I did surgery as my 3rd rotation in October/November. This worked out great because I was not burned out / jaded from 3rd year, and I knew more than when I just started
Medicine ended up being my final rotation. While having it earlier would have helped for surgery (if before surgery) it wasn't needed and now I am going to be in top shape for my 4th year Sub-I's etc. Plus, if I wanted to take step 2 early, Medicine = ubber high yield for step 2, so I can just follow that studying I just finished into step 2.

The important thing at my school is that we schedule our SubI and our electives during Jan/Feb. That means that if you have something after that (which was FM and IM for me) you don't know if thats what you want to do for your life (I was already sold on Surgery though). Now, if I feel in love with something later, I could have changed my schedule, but I have my SubI on the chairman's team in August for surgery, and I don't think I would have been able to switch into that had I not gotten that in my lottery in January (and I was lucky to get that in the first place). Just something to think about.

 

[RussianJoo]

I liked my schedule. i had surgery first and it was great to get that monster out of the way, plus after 3 months of getting to the hospital by 5am, it made everyother rotation seem like sleeping in. And I had medicine last which is great too because it's still going to be fresh in my head when i take step2. I am not interesed in surgery, i am interested in anesthesia which i had a few weeks exposer to as well but i don't think being fresh out of basic science hurt me at all, at least it didn't show that way on my evals and grades.

Starting with the hardest rotation i feel like is the best way to go, then it's all down hill from there.

 

[Doctor Bagel]

I liked my schedule. i had surgery first and it was great to get that monster out of the way, plus after 3 months of getting to the hospital by 5am, it made everyother rotation seem like sleeping in. And I had medicine last which is great too because it's still going to be fresh in my head when i take step2. I am not interesed in surgery, i am interested in anesthesia which i had a few weeks exposer to as well but i don't think being fresh out of basic science hurt me at all, at least it didn't show that way on my evals and grades.

Starting with the hardest rotation i feel like is the best way to go, then it's all down hill from there.

I really, really wanted to start with surgery first but couldn't because I got a crappy random number for rotation selectives. Now I'm ending with it, which I think might maybe have some perks. One, I'm not horribly burned out right now, and two, I don't really care. I think I'd be a lot more nervous if it were earlier in the year, and now I'm just eh about the whole thing. Of course, I don't want to do surgery or anything surgery related so that helps.

My general plan was similar to those mentioned above. I wanted something hard to start out with, and I wanted to put the things I was considering around the middle of the year. So I wound up starting with ob/gyn, which worked out nicely I think -- I definitely felt up for most anything after getting through that rotation. At the start of this year, I thought I would go into either IM or psych, so I put both of those in the middle, which was also a good choice because I discovered I really like psych and that IM is probably not for me. I was also able to do well on both rotations, but you really can do well on your first rotation, too.