Scheduling clinical rotations?

Hello all,
I’m procrastinating (2 exams down, 2 to go!). I started wondering what order I’m going to choose for my clinical rotations. We start this January, so I know they’re going to ask for our preferences before too much longer. Not that I’ll get the order I choose, but I have to put something down anyway.
Pertinent info: If I had to choose my specialty today, I’d probably say Pediatrics (or more likely a pedi subspecialty like cardiology). I’m planning to take Step 1 in November - and take off Oct/Nov. I have two little kids. I will NOT be choosing OB/GYN, although I anticipate that I will enjoy it.
So, does the order matter? I’ve heard that it doesn’t. But, I trust advice from this site more than the rumors floating around my class.
If we get some good answers to this, maybe we can start a FAQ thread.

As I’ve discussed elsewhere, I’m doing an experimental third year, so this wasn’t a choice for me. But before that, I was going to do this:





1. A one-month course in clinical anatomy offered here (often taken by future surgeons, which I’m definitely not)


2. A one-month course in radiology


3. Surgery


4. Psychiatry.


5. Medicine, peds, or ob/gyn in no particular order.


The logic being that I so don’t want to be a surgeon and my anatomy knowledge is so sucky that I really wanted to get my anatomy and understanding of the physical landscape of the body nailed down. Psych right after to regain my soul. Then the rest.





Varies, of course, depending on your school’s requirements and offerings. (Ours requires radiology, for instance.)





For what it’s worth, I’ll shock myself if I don’t become an internist.





Good luck!





cheers


joe

We had no say in the order of our rotations. Our Dean of Student Affairs believes that the order you take rotations in does not matter. Personally, I think it’s because it would be actual work for them…but that’s another issue.
That said, I was wishing not to have the rotations I am considering for my future first (neurology, medical oncology and anesthesia). I wanted either surgery or OB/GYN first because I knew I definitely did not want to do those so I figured I would get my growing pains out of the way. I also wanted to have medicine in the middle of the year (Jan, Feb, Mar). Well, half of my hopes came true. I started with surgery but have medicine last. We are allowed to trade full semester schedules with our classmates, but no one wanted to trade medicine in the “good” slot (Jan, Feb, Mar) for the last slot.
The order of my rotations is:
Surgery- Jul-Sep (12 weeks)
Psych- Oct (4 weeks)
Neurology- Nov (4 weeks)
Family Medicine- Dec (4 weeks)
Peds- Jan-Feb (6 weeks)
OB/GYN- Feb-Mar (6 weeks)
Medicine- Apr-Jun (12 weeks)
So for me this means that since I early match with the Air Force, I have to schedule my two audition rotations (which will take place in Jul, Aug, or Sep) well before I even see my medicine rotation. One of my friends who is a fourth year this year said that I will see plenty of medicine before I reach my medicine clerkship, so I will know whether or not it’s what I want to do. The good thing about having medicine last is that, according to Natalie (whose advice I trust), Step 2 is a lot of medicine, so I should be well prepared to take it next summer.
So the point of this long post is to say that I would do something I did not want to do first, then I would do what I did want to do in the middle of year before burn-out sets in. Just my humble two cents. Hope it helps.
Tara

Quote:

I would do something I did not want to do first, then I would do what I did want to do in the middle of year before burn-out sets in. Just my humble two cents. Hope it helps.
Tara


This is pretty good advice, and I wouldn’t try to psychoanalyze or game the system further than this - the effort is just not worth it. It is definitely better to put least desired rotations at the end because man, are you sick of rotations by the time you conclude that stretch. But if it doesn’t work out you will find a way to compensate - the truth is that there are good and bad things about every possible schedule permutation and pretty much everyone does OK.
Mary

Hi there,
I had no choice in the order of my clinical rotations during third year. I started with Peds and ended with Internal Medicine. It worked out great for USMLE Step II which I could take with practically no studying. It was great to have nothing between me and graduation. All of my most competitive interviews asked about Step II and it was a relief to tell them that I had already taken the test.
Other than prep for Step II, I don’t believe that it made any difference. As a resident who grades the third year medical students, I always took into consideration the experience of the medical student. The students who did General Surgery last were graded with a much more stringent standard than those who did the rotation first. It actually turned out that the students who were at the top of their class at UVa were in the group who rotates through surgery first. They like to get this rotation out of the way first so that it’s not hanging over them when they are getting their ERAS application materials together. Sounds like a good strategy to me.
Natalie

Our rotation blocks were determined by lottery. Draw your number from the hat and pick the rotation schedule you like from those that are left. I started with Psych, and had Medicine and Surgery in the middle. I recommend this if you have any say. That way you get a little clinical experience under your belt before you begin these two, which were for us the toughest. Then toward the end you can coast a little and maybe do a bit of board review before MLE2?
steve

Thanks for the input. It’s very helpful! I’m thinking about surgery first (get it over with - and I’m only going to remember anatomy less as time goes on!), and medicine right before the boards if I can manage it. That radiology elective that Joe mentioned sounds great. I wonder if we have something like that. I’ll have to look into it.
Of course, rumor has it that our requests have little to do with what we actually get. Also, there’s some debate over whether they start at the top of the pile or the bottom. So there’s traditionally a big rush to be first, but a bigger anti-rush to be last!
Off to bed. Starting my LAST block of preclinicals tomorrow!
Pam