Fourth Year Medical School Electives

[ru4real1666]

I'm posting in the general surgery forum because I'd like more information on what people think are the most important electives/subinternships for a to-be surgeon. I will be applying on orthopedics, but I would like to have a strong foundation in managing complicated patients, especially surgical patients.

Half of my fourth year will be spent doing orthopedics aways, but the other half is open. I was thinking of doing the following

(1) IM sub-internship
(2) Medicine ICU sub-internship (can't do this without #1)
(3) Surgery ICU sub-internship
(4) maybe a trauma surgery rotation

Other things I was thinking about were possibly
(1) General Surgery sub-internship
(2) Plastic surgery sub-internship

Obviously I won't have time to do all of the above, but if anyone can recommend a game plan or chime in as to what they think, I would really appreciate it! Thanks so much. You guys are the best!

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[Pir8DeacDoc]

So you want to be an orthopod and want to manage complicated surgical patients...Have you rotated on ortho?

 

[TraumaLlamaMD]

I'd pick SICU over MICU. Trauma will be nice in terms of seeing the initial presentation of sick patients who often have ortho (and other surgical) issues - and following them as they recover is enlightening too. You might even consider a sports medicine (non-operative) or an anesthesia rotation, since I think it's really helpful to know a bit about the jobs of people who you'll work closely with, in order to communicate more easily.

 

[ru4real1666]

So you want to be an orthopod and want to manage complicated surgical patients...Have you rotated on ortho?

Ha. Yes. I know. It's...contradictory to say the least. But at least while I'm a resident, I want to be deal with whatever is thrown at me. And most of that is learned during residency, but I'd like to get an exposure while I'm in medical school.

 

[WinslowPringle]

Ha. Yes. I know. It's...contradictory to say the least. But at least while I'm a resident, I want to be deal with whatever is thrown at me. And most of that is learned during residency, but I'd like to get an exposure while I'm in medical school.

I think that's admirable and a good idea.

Practically, though, is it going to work? Your attending and seniors will probably dictate a lot of the critical patient management. In some places ICUs are closed, so ortho wouldn't be primary then. And where I am now, ortho isn't primary on most of their patients - typically medicine is.

Personally, I wouldn't do that many sub-i's. Do your required sub-i (ortho if it counts, general surgery otherwise). The trauma rotation would be good - lots of ortho issues and critical care exposure. Maybe a single ICU rotation. You'll be working hard enough with the ortho aways - enjoy the rest of your year. Oh, and radiology would probably be pretty helpful (and decent hours), too, if you get a chance.

 

[DoctwoB]

I agree with much of the above. I would avoid additional SubIs, you're going to have rough hours the next several years, enjoy the end of fourth year. In terms of potentially useful electives:
-I agree with radiology, usually good hours, and can be a very good experience as long as its not just shadowing people in reading rooms
-You're going to be dealing with a lot of post-op surgical issues that come up, meaning DVTs, MIs, PEs, strokes, etc so doing things like cards, heme, stroke etc. certainly wouldn't go amiss. Orthopods will consult out a lot of those issues, but getting the initialy workup right and early recognition can be key
-If you haven't had any ICU exposure, then a ICU rotation is just a good general learning experience.