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Arranging your Third Year and Fourth Year Schedule

Tino Mkorombindo is a third year MD/MBA candidate at the University of Louisville School of Medicine/College of Business. You can follow him on instagram, twitter, or linkedin.

Arranging your Third-year schedule:

The issue at hand is often deciding whether to take medicine/surgery/your desired specialty choice early or later. It will really depend on two factors

  1. Amount of clinical experience you have had by the time you start your third year:
    • If you have significant experience, it does not matter when to take them. You will be well-versed in the way things work in the clinic and can be of greater use to your team early.
    • If you do not have significant experience, consider taking less-intense clerkships before medicine, surgery, or your desired specialty choice.
  2. Do you want to go into a specialty offered in the third year?
    • If you think you are interested but are not sure, take the specialty early and decide whether you like it. If you do, you can then spend the remainder of the year with research projects, attending grand rounds and conferences, and shadowing attendings in the field to bolster your application.
    • If you are sure what you want to do, take it at a time when you can be confident that you will do well on the rotation. Going through other clinical areas first will improve your performance, efficiency, and impression, as well as your grade.

Arranging your Senior Schedule

This topic is worth the early consideration, as it will help you maximize the results of all your hard work and place you in the best position to land a residency position in your dream specialty. This section is broken down into three main categories:

Timing your specialty rotations (June/July-December)

If you are applying to one of the specialties (Neurology, Neurosurgery, Ophthalmology, Urology- ) that does not match early, you may not be so pressed for time and have room to breathe. However, it’s still important to note that the beginning of your fourth year is a critical time!

It is not the ideal time for vacations or extended time off — this can be done second semester, post-match, or prior to the July 1 intern start date! During this time, it is recommended that you do a sub-internship (Sub-I’s) in either internal medicine or your desired specialty (orthopaedics, surgery, etc.). This will give you the necessary experience you need and will provide you an opportunity to receive an excellent reference letter. 

It is a general rule of thumb that your Sub-I should be at least four weeks for optimal time to make a good impression and present your best self. Therefore, it should finish near mid-to-late August. This Sub-I can be in your desired specialty, but if your specialty choice does not require multiple away rotations (such as orthopaedics), it is recommended to do a Sub-I before your audition Sub-I in your desired specialty. Keep in mind that you have limited time between completing your third year of medical school and beginning interview season. Specialty rotations that are done during interview season (December to February) are generally not going to be of any help and may actually be a hindrance. 

One thing to note in deciding the location of your away rotations is not all programs that take visiting medical students will provide them an interview. As you apply, keep this in mind and be sure to reconfirm prior to arrival. 

Strategy is essential. Try your best to arrange your schedule so that you work with an attending physician who is well-known in the specialty, especially if you are pursuing a career in a competitive specialty. When you start the rotation, ask that individual if, based upon your performance, they would be willing to write you a letter of reference. Be sure to give them your Letter of Reference Letter ID EARLY; time is of the essence, and these letters need to go out fast. You also want to make sure they know early because you want to make sure the impression you made is still fresh on their minds. 

If time permits and you feel as though you may have areas of weakness in your desired specialty that you would like to enhance, you may want to do your earlier specialty rotations in an area that you do not intend to rank highly. You can then follow up with rotations at your higher choices where you can make a better impression

  • Caveat: many students who thought they might rank a program highly ended up ranking that program higher than expected. 
Interview season (December to February)

During this time, you want to make sure that you have enough time and flexibility in your schedule for interview travels and preparations. Either use your vacation time during this period or try your best to be on a flexible rotation during this period.

The remainder of the Year (February to Graduation)

Now is the time for you to balance your time between the rest of your vacation time, electives that you feel as though you may need more training in, and possible international medical electives. It is definitely NOT the time to take more electives in your chosen specialty. This is when you fill in gaps in your training and experience. You can also utilize this time to complete any recommended clinical requirements. Most important, HAVE FUN!

  • First half of the year is spent preparing to get into a residency
  • Second half of the year is spent training in your areas of clinical deficiency
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