4th year scheduling/timing

Most of the applications are due by early Nov at the latest. With that schedule (assuming you start in July), you won't do any ortho rotations in time to get a letter from the attendings.

1) Family med should be done as late as possible in my mind. This will do nothing for you early on. (Probably try to do home ortho here or block 2)

2) Radiology is a great "end-of-the-year" rotation. Save it.

3)Trauma is a good elective here I think. Get a good letter in a surgical discipline outside of ortho

4) Away ortho here would work

5) Another sub-I like general surgery or SICU would be a great way to round out the first half of the year.

6) Do Family Med here so if you have interviews you can miss some days and its no big deal. Nothing like auditioning and having to leave every Thurs. for an interview. Probably wouldn't look good.

I would take off block 7 (if that's January) as that is where the bulk of the interviews are.

Good luck

Well, I don't have much of a choice with Family Med ... have to do it within the first 5 rotations ... ridiculous school rules ... boooo.

From what you say, it sounds like all the ortho rotations (2 or 3) should be done by block 4. My thought was to do something that would prepare me to shine in ortho, considering I feel pretty shaky and stupid thus far in 3rd year (haven't done surgery yet though). I guess you're saying no, just dive in.

Looks like I'll have to do something like:

1: trauma surg
2: ortho away
3: ortho home
4: ortho away
5: fam. med
6: something light
7: something light

Is it naive to think that I'll use the 1st 2 orthos (and trauma) for letters, and the 3rd will just be audition, so I can do it as my 5th rotation and not worry about it being too late for letters?

Thanks!
b

I think doing the 1st 2 ortho rotations for letters and the last as just an audition is a great idea, at least that's what I did. I'll let you know if worked next week. I did my ortho in Aug, Sept, and Nov. The last one worked nice because I was able to do my interview during my rotation. Good Luck.

Crackbone

Take a deep breath and just chill. You are worrying too much about small things. Just do your away rotations during late summer/early fall and work hard. You are over thinking your away rotations. You'll learn tons of stuff during your rotation. Just relax and enjoy. Good luck.

J

Thanks (-: I'm fine, probably just procrastinating and thinking about 4th year electives instead of studying for my less interesting current rotation. But anyway, I'm just trying to get half a clue about it ... dunno if you remember how clueless/blind you were about the process halfway through 3rd year. Even the simplest advice here helps.

Anyone else have other experiences to share? Thanks!

b

regulations, regulations...

the planning your 4th year schedule depends on several factors. if you think you have a pretty secure shot at matching, then not to worry.

if you have some concerns about not matching, then i think it would be worthwhile to do as many visiting ortho rotations as possible. spend the first month studying "ortho" during the required FP rotation, then do ortho rotations until the interviews. remember though, you are going to be asked ANATOMY questions, not the fine details of operative orthopaedics. know your anatomy INSIDE AND OUT.

if you haven't done the 3rd year surgery rotation yet, i recommend that you rock that rotation and get a good letter. this will free up your 4th year schedule for another ortho month.

in selecting 4th year rotations, keep in mind many programs select heavily from their visiting student pool (for example: UTSW, temple, mt sinai NYC, san francisco program... look up previous posts). there is a strong regional bias in the selection process as well. also, some programs will let you rotate for 1-3 weeks. in all honesty, there is no difference between a 3 wk vs 4 wk rotation, and you could squeeze in an extra rotation here and there if you play it smart.

This is the first time where I feel I can contribute and not just blow smoke. So my two cents...

My first rotation 4th year was a MSK radiology rotation. It was awesome. The whole rotation I read ortho. It let me brush up on my anatomy and become familiar with fracture classifications as well as what the ortho trauma team did to fix it. MRI started to come to light, though not the physics behind it. By the end of the rotation I felt comfortable that I would do well on my ortho sub-I, and I was sick and tired of sitting on my duff just reading films. So come August I had a good knowledge base and a ton of energy to bust it.

You'll have time to get your letters August through October. I think a great letter in August or October is better than a average one in July.

I got nothing for your family medicine issue. Sorry.

Again, my two cents...

Gunga galunga

Whoever feels that this refers to them, email me, I'd like to meet up and give you a good beating with a leg bone (-]My first rotation 4th year was a MSK radiology rotation. It was awesome. The whole rotation I read ortho. It let me brush up on my anatomy and become familiar with fracture classifications as well as what the ortho trauma team did to fix it.

... You'll have time to get your letters August through October. I think a great letter in August or October is better than a average one in July.[/quote]

At the risk of just hearing what I want to hear ... that's what I was thinking. I was thinking it would make more sense to take the first block at least to chill and read up on ortho (anatomy esp., as moneyB said) ... the question then is which chill rotation would be most beneficial for acing an ortho rotation. I take it radiology is one ... any other ones that would be helpful?

The other approach I was getting at was to do something intense but non-ortho to get me ready, like a boot camp ... hence, trauma surg.

Thanks, great advice all around ...

b

I would have to agree with some of the above posts that 2 rotations should be for letters, and a third just to increase your chances at a program you're very interested in. The 3rd, therefore, could be in october if that is what suits your schedule best.

Another consideration is that 3 ortho months in a row is pretty rough as a 4th year. I know there will be people on this site that will say that I'm being ridiculous because residents do it all year-round. However, as a medical student, if you are working as hard as you should on away rotations, then you should be exhausted at the end of 2 months. Keep in mind that many places expect ortho sub-I's to stay in house post-call (so that attendings/staff can get to know you better) = >>100 hrs/wk. Some of this is an endurance contest too, so save up your energy between your 2nd and 3rd months, so that you can look like a genius with the work ethic of a machine for your 3rd rotation instead of a kid who's just tired of it at that point.

my 2 thoughts:
1) I would strongly recommend against doing a trauma surg month before ortho. hopefully, you already know how to work hard. if you haven't learned by the end of M3 year, you probably never will. also, the month will just tire you out needlessly prior to your ortho rotations. if you don't do ortho first, do something easy (rads or family) where you can read ortho.

2)this may be a little more debatable, but if you do your first ortho rotation in Aug and it is an away, the vast majority of the other students will already have done an ortho rotation in July so you may be a little behind initially.

my plan: home ortho in July, 2 aways in Aug & Sept. I had 2 weeks between M3 & M4 year that I used to read ortho. re LOR: got two from home, one from each away. probably won't match at any of these though as I didn't rank any of them high for varied reasons.

Hmm, a different perspective. I suppose it could make sense if "what it takes to impress during 4th year" is a lot less than what I'm imagining. I'm thinking I'll do trauma first to prepare for ortho, like boot camp, but maybe all one really needs is just some time to read up on anatomy and general surgical principles, plus a healthy attitude & work ethic ... none of which is really obtainable from a month on trauma or any other hard core rotation.

Is that accurate?

Secondly, assuming I will end up having to take something else before ortho (depending on the school lottery), and assuming it should be easy and laid-back yet useful ... what would be as good as musculoskeletal radiology to take?

Thanks,
b

I have to agree with IronDoc.

Dont take a trauma surgery rotation at the beginning of the year. I personally took radiology for a month for my first rotation and was very pleased with that choice. The rads rotation at my school was very easy so I studied for step II in the week I had off between 3rd & 4th year and took the exam in my first week of rads. I then took the rest of the month to read about ortho and also get my app and personal statement up to speed. I found the PS to be a big pain and was glad that I did not have to worry about it when I was on my ortho rotations. You will be working hard enough on your ortho aways so start your year with something easy. Plus, I have taken a trauma surgery rotation as a fourth year and although it was a great rotation, I can not imagine how it could have possibly helped me in my ortho rotations.

I did three ortho aways (no home program) in the months of Aug, Sept, and October. Three months in a row is definitely very difficult, but if you are at programs that are relatively non-malignant you can still work your butt off and maintain your sanity. As far as LORs go, it will be very difficult if not impossible to get a letter from the Oct rotation so in that spot I would place a program you are interested in attending but dont care about getting a LOR. As far as doing an away before doing your home rotation, I think it is not as big a deal as it may seem at first glance. For one, everyone has to have their first ortho rotation at some point and you should not look any worse then their own students did right out of the gate. Second, at my aways I thought the expectations for a medical student's ortho knowledge were pretty reasonable. The residents were medical students at one time and know that we get almost no ortho education. I found that as long as I was prepared for the scheduled cases, fund of knowledge did not seem to be much of an issue. However, if I had the option to do a home rotation first, I probably would.