When to schedule 3rd year home derm elective?

[Pinkus]

I'm now finishing up my second year, and the time has come to choose my M3 schedule. I am 100% committed to dermatology at this point, so I'm trying to plan accordingly.

We are given 6 weeks of "elective time" to use in M3. My school offers a 4-week derm elective with the main derm faculty as well as a 2-week elective with a private practice dermatologist/adjunct clinical professor. Obviously I am going to take the 4-week rotation, which is my chance to "audition" for my home program and get a LoR. My first question is when should I take it? I was thinking I could take it sometime in the second half of M3, ideally right after winter break, which would give me some time to brush up on my derm knowledge. This brings me to my second question: Should I also take the 2-week private practice rotation? I was thinking it might be nice to do them back-to-back, with the 2-week rotation first as a "warm-up" for the big one.

Here's the twist: these same derm rotations are also offered in 4th year. Is there any reason to save them for 4th year? We are required to start our 4th year off with a "sub-I" of our choice, but then we have 2 blocks of time before ERAS in which I could potentially fit the home electives. However, I was also hoping to do an away rotation at some point (and gain another LoR from that). Is early 4th year before ERAS the right time to do that? Also, I know this may differ from school to school, but generally speaking, can a derm away rotation count as a "sub-I" ? It would be nice if I could kill two birds with one stone.

Any advice would be really appreciated. Thank you!

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[asmallchild]

I'm now finishing up my second year, and the time has come to choose my M3 schedule. I am 100% committed to dermatology at this point, so I'm trying to plan accordingly.

We are given 6 weeks of "elective time" to use in M3. My school offers a 4-week derm elective with the main derm faculty as well as a 2-week elective with a private practice dermatologist/adjunct clinical professor. Obviously I am going to take the 4-week rotation, which is my chance to "audition" for my home program and get a LoR. My first question is when should I take it? I was thinking I could take it sometime in the second half of M3, ideally right after winter break, which would give me some time to brush up on my derm knowledge. This brings me to my second question: Should I also take the 2-week private practice rotation? I was thinking it might be nice to do them back-to-back, with the 2-week rotation first as a "warm-up" for the big one.

Here's the twist: these same derm rotations are also offered in 4th year. Is there any reason to save them for 4th year? We are required to start our 4th year off with a "sub-I" of our choice, but then we have 2 blocks of time before ERAS in which I could potentially fit the home electives. However, I was also hoping to do an away rotation at some point (and gain another LoR from that). Is early 4th year before ERAS the right time to do that? Also, I know this may differ from school to school, but generally speaking, can a derm away rotation count as a "sub-I" ? It would be nice if I could kill two birds with one stone.

Any advice would be really appreciated. Thank you!

A couple of factors/questions:

1) Is it common for interested M3s to do these derm electives? And to get letters from such a brief rotation? Many programs only write letters for M4s

2) How good are you clinically? This is a tough question to answer as an M2. I myself went from being an all honors student to an all high pass student making the transition from pre-clinical to clinicals (and it did not feel good). In general, my recommendation is to take all the facetime you can get with derm faculty. But if you aren't the strongest clinically or have a personality that rubs people the wrong way, you can sink your chances before you even get started. In short, my recommendation has always been clouded by my own experiences but if you aren't the strongest student clinically and it is not required or strongly recommended for M3s to take these derm electives, it may be worth deferring until M4. (The other example I'll give is that I did my 4th year derm rotation with a student who was better than me in every way on paper. Except for his interactions with derm attendings, residents, and somehow even volunteer faculty. I would later find out that he ticked off so many people he was ultimately ranked in the 30s on the final rank order list. Although I guess that's still better than being left off entirely. Some people are really better off on paper than in person)

3) If you are going to do the rotation, I agree with trying to do this after an internal medicine and surgery rotation. Most M4 rotations are a shadowing experience so I would expect more of the same for an M3 rotation. But I think having those 2 core M3 rotations under your belt and a chance to brush up on some derm is going to be wise in the event you get asked to suture / present a patient / etc

4) If you are interested in the 2 week private practice rotation, I agree that is a smart idea to do it first so you can warm up for the real rotation.

5) If you are confident you'll make a good impression, the more facetime the better. Do rotations as an M3 and M4. If you are unsure, I would save it for M4 (I also have horror stories of students really making a negative impression as an M3 and needing to dig themselves out of that hole as M4s). The time before ERAS submission is a good time to get in home rotations, away rotations, research rotations, etc

6) This will depend from school to school but my school only accepted medicine/surgery/pediatrics as a sub-I