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Dia dhuit From Baile Átha Cliath (or How To Succeed In An Audition Rotation)

Colinson72x721Colin Son -- I’m writing this post from over in Ireland, which explains the Gaelic-English hybrid title.

I've got approximately two weeks free from my last third year rotation until my first rotation of fourth year, and I'm incredibly lucky to be getting to spend it in Europe. As much as I'm enjoying myself, it is difficult not to let my mind slip back to medical school on occasion. That little 'type A' that is a part of even the chillest of medical students' personalities is showing. I can almost promise I was the only sap in the pub with a neurosurgery review book open as the Spain-Russia Euro 2008 semifinal played out.

Excuse me for missing Guiza's beautiful second half goal but you see, I want to match into something pretty competitive. Towards matching in any residency you've got a number of measurements which are applied to you. Everyone is familiar on what you're judged -- your board scores, your GPA, your letters. In some of the more competitive specialties, especially the surgical ones, I think you can add another measurement -- your performance in audition rotations. I know that some don't but I actually like the title 'audition rotation'. Maybe you're auditioning for a better letter or for an actual interview at the program, but these rotations often do serve as weeks-long auditions.

I spend three of my first four months of fourth year doing neurosurgery sub-internships. That includes my first rotation, which starts in a week. Not to let any semblance of anxiety show (not me, ever, as a future surgeon) but that is a whole lot of neurosurgeons I'm hoping to impress. Such helps explain why I packed some review books in my backpack before I hopped on a plane.

I obviously haven't done a fourth year sub-i yet. Even so, I think I've gotten some good advice and a general idea of what I'll be facing. I thought it worth sharing as fourth year starts for so many medical students. Here are three (perhaps obvious) things I think fourth years should strive for during a sub-i:

First, and foremost, the distinction between your sub-internships and your third year rotations should be in you demonstrating more initiative and spontaneously taking on more responsibility. If the rotation is a specialty you're interested in, then you should take the name 'sub-internship' to heart and, without prompting, try to pick up the work load similar to what an intern would have on the service. To the extent that is possible of course without an M.D. after your name.

Second, use the time to learn to teach. This is a sometimes forgotten role of being a resident. Every third year medical student feels it when they've walked off a service with a resident with such a gift and when they've walked off a service with a resident who couldn't have cared less if they were there. Especially early in the year, fourth years can really be a guide to the incoming third years. I know I had an awesome fourth year doing an inpatient medicine sub-i early in my third year, and she made the rotation immensely better. Something as simple as going over hints for doing well on the rotation or over how to gown up in the operating room or over the intricacies of physical exam findings can help a lot.

Third, become more technically proficient. Whether you're going into a surgical specialty or not, there are technical skills it helps to be adapt at for the practice of medicine. I stumbled across interns during my third year who weren't sure they could draw blood or had never even seen a lumbar puncture done. True, this may not be required of them, depending on the ancillary services and their specialty, but isn't it at least a little embarrassing to be called Doctor and not possess some basic skills? With a surgical or procedure based specialty the demand to be able to demonstrate technical skills, even as a medical student, is even greater.

These goals are not exclusive of course, but hopefully they will provide a good foundation as I head off into fourth year.

I promise I'll keep you updated.

June 30, 2008 in Colin Son | Permalink


Nice hints, btw Spain and russia played in the FINAL of Euro 2008 so it must have been a great neuro book

Posted by: Lewis | Jul 3, 2008 2:41:16 AM

Hi Jackie Colins!! ..so ya started to pick new languages....your atrophied parts got regenerated in ireland...:)....hmm..plus you write good things!

Posted by: Mini | Jul 5, 2008 5:57:27 AM

Hi Colin,
As an Irish med student I find it kind of surprising that you came from the States to Dublin! Were there any particular reasons why you chose to do a rotation here? Furthermore, how would you compare the different educational systems (ie Irish undergrad V American postgrad med degree) and did you find it a worthwhile experience?

PS Hope you tossed the neurosurg book in the end and at least got to see a GAA match!;)

Posted by: Piney | Jul 9, 2008 8:55:02 AM

i'm currently doing my internship in dublin for 2 weeks now and i still cannot draw blood from most patients yet. so what? would someone die because of that? i have this whole 12 months to practice every day. being a doctor doesn't mean i have to show the whole world that i'm good in some basic skills. sorry colin, i read this article and i can't help but feel that being a medical student can turn someone into an arrogant monster. i was just like u when i was a med student, i looked down on my intern who seemed to be clueless and incompetent. now i know how she must have felt.

Posted by: reina sofia | Jul 10, 2008 1:30:32 PM

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