Tuesday 7 February 2017

One Down, Seven to Go!

My first elective rotation is in the books! Electives are a wonderful thing, but choosing the right ones definitely has its' challenges. When doing your cores, you are told exactly what you have to do and then suddenly you are finished and you get to choose any electives that you want. The choices are endless it seems, and it can be difficult to know where to start with it all. 

I decided on radiology for my first elective. No, I definitely am not an aspiring radiologist. I chose it because I actually feel quite weak in reading images - I felt that throughout the core rotations I didn't have adequate exposure to X-rays, CT scans, MRIs, mammograms, and cardiac stress tests. Coming from a Caribbean medical school, most of our rotations tend to be in the clinical outpatient setting. Yes, I have had a fair amount of time in the hospital as well, but when compared to students from US medical schools we tend to get less hospital (and therefore imaging) exposure. I have the USMLE Step 2 CK exam coming up (it's actually a week from now....eeeek), and I thought that taking this elective immediately prior to taking the exam would be an excellent review. I was definitely right! We went into the hospital for 4 hours each morning and discussed scan after scan after scan. The doctor I was with was amazing, incredibly knowledgeable, and surprisingly enthusiastic! I feel so much more confident when it comes to reading images now, and I know that it is a skill I will use throughout my lifetime in my practice!

Last Day of radiology rotation - this was an awesome group of students to work with!!


Electives are shorter than the core rotations. Core rotations all run for either 6 or 12 weeks, where elective rotations are anywhere between 2 and 4 weeks in length. They are meant to allow you to try out some different specialties that you are considering, to get more experience in the specialty (or specialities) that you are going to apply to, to expand your knowledge base, and to get acquainted with different hospitals.

Here are some general tips that I came up with when it comes to deciding on and scheduling elective rotations:

1. Have a plan! By the time you are finished with your core rotations, you should definitely have a plan, or at least an idea, of where you think you are headed. I say this because you should be able to justify every elective rotation that you do. When interviews come around, you want to be able to explain why you chose the electives you did, and how they have helped you grow as a future physician. Do NOT choose electives because you have heard they are "easy" or because you thought that specialty "might" be fun. There should be a reason you choose each elective you do.

2. Smart scheduling - The year (yes, the whole year) before you apply for residency should be very strategically planned out. There are a lot of things that must be done in order to apply to programs. Several of these things are time sensitive, and students often get into sticky situations where timing doesn't work out for whatever reason, and they miss deadlines and have to push their applications back by an entire year. The match happens only once a year, so you need to ensure you are booking things and planning things effectively. Make sure to consider time you will need to study for exams, and time you might need to take off for interviews and such.

3. Choose 4 week electives - There are several electives that you can opt to spend just two weeks in rather than four. This is definitely my own personal opinion, but I would argue that two weeks is just not enough time to get a feel for and to become comfortable in a rotation. I think 4 weeks is the perfect amount of time to spend in a rotation because it will allow you to grow and obtain some skill in the area. Additionally, you will get to know the preceptor better which can result in better chances at good letters of recommendation.

4. Show commitment to your specialty - by the end of your cores, try to have a good idea of what you want to do. If you don't know for sure, you should at least try to narrow it down to a couple of options. Do lots of work in that area (or those areas) to show that you are genuinely interested in that specialty and that you are actively trying to increase your knowledge and experience in that field. This will also open doors to get letters of recommendation from doctors in the specialty as well.

5. Research which hospitals in your area has residency programs you may apply to and try to get electives at that hospital. Sometimes you might not be able to get a core rotation in those hospitals, but if you go on the hospital websites many of them allow IMGs to complete elective rotations there. Trust me, it is worth the extra work to get these rotations! Email department heads and be persistent, no one is going to find these opportunities for you! Planning ahead also comes into play here - many of these rotations must be booked several months in advance! One of the electives that I got had to be scheduled 8 MONTHS ahead of time - they had nothing sooner and if I wasn't planning ahead I wouldn't have been able to get it.

6. Make the most of it! Think of every elective (and every rotation, for that matter) as an audition rotation. You never know what connections you might be able to make and who is watching you. Always strive to be the best and to give every rotation your all, even if it doesn't seem so important at the time. People remember students who stand out and you never know when a seemingly average experience could open doors for you.

All in all, electives should be a breath of fresh air and a great experience. Having the freedom to do what you want to do is a great thing, just always make sure to choose wisely and always be looking ahead into the future.

As always, thanks for reading! I am going to be publishing a post in the near future dedicated to the most frequently asked questions I get about attending a Caribbean medical school and things to consider before making the move! If anyone has questions that they'd like to be included, please email me at drnicolefox@gmail.com

XOXOX