Forgive me for asking a stupid pre- med question, but there is something I don't understand (and its been eating at me). When during your 4th year do you apply for a residency position? The reason I don't understand is many people seem to decide surgery vs. medicine during 3rd year, but what if they haven't gotten a taste of all the different types to know what they want. For example, if someone wants neurosurgery, but didn't get a taste of it during 3rd year, they would have to take an elective in it 4th year. However, what if they have to apply to a residency before they get a chance? So, can someone clarify that for me? Thanks!
Your exposure to many different medical specialties can start at early as your first year of medical school. You do not need to do an elective in a specialty to gain insight or information about that particular specialty. As a first-year medical student, you can join a specialty interest group where you are exposed to residents and attendings in a particular specialty. You can also request to set-up a shadowing experience with any specialist of your choosing.
During second year if you are on a classical curriculum, you will be exposed to a variety of disease processes in your pathology class. If there is a specific system or set of disease entities, you may identify a specialty that treats that particular disease entity set e.g rheumatology and the treatment of arthritis and autoimmune diseases. In addition, you may also discover that you are more interested in the surgical treatment of disease rather than the medical treatment of disease.
During third year, you have a series of required rotations such as pediatrics, family medicine, psychiatry, surgery, internal medicine/neurology and ob-gyn. It is usually during third year that many students crystallize their interests in a particular specialty. Nothing prevents you from making contact with other specialties outside of your required rotations. It is probably a good idea to make contact with other specialties such as emergency medicine, dermatology, anesthesiology, ENT, opthalmology or neurosurgery if you desire to do good fourth-year electives in those specialties.
Other factors that will greatly limit specialty choice for many medical students are grades, board exam scores and performance in the core rotations of surgery and medicine. You are not likely to be competitive for a residency in dermatology, ophthalmology, anesthesia, emergency medicine, orthopedic surgery or neurosurgery if you haven't performed well in your pre-clinical coursework, on step 1 of your boards or in the core rotatations of third year.
Getting a good medical education is not about waiting for your medical school to present you with options for specialty for your choosing or even waiting until fourth year to decide what your future specialty will be. Making sure that you and your specialty are a good match is largely in your hands. The process starts with you gathering as much information, as early as possible, about what you need for your future career and making sure that you obtain it including a strong academic record and information/experiences that allow you to be competitive for your career choice.
The residency application process actually begins at the end of your first clinical rotation first year when you request a letter of recommendation from your first clinical preceptor. The experience that you need to make an informed choice in terms of specialty can begin as soon as the first day of medical school orientation when you meet some of the pre-clinical and clinical faculty or join a specialty interest group. In short, being proactive and getting as much information as possible about a decision that will affect your future is largely up to you.
There are websites
San Francisco Match and
Electronic Residency Application Service that will give you information on specific time-lines and on the specific specialties that are covered by each particular application service. It's not a bad idea to check these out at the beginning of second year to be sure that as you move through third-year, you are getting the experiences and requirements for the specialty that interests you.
