Postclerkship Period
• What are the requirements?
• What is a sub-internship?
• How do I find and sign up for rotations?
• How can I optimize my GME application?
• What does a typical schedule look like for: – A wanna-be surgeon?
– A wanna-be internist?
– What if I am interested in ANE, EM or neurology?
FAQ’s
• What if I have to make up a core clerkship?
• GME applications….I know they include letters of reference…how should I go about these?
Minimum of 5 Rounds for rotations of your choosing
*Neurosurgery for the Neuroscience requirement (scheduled by and graded by
neurology) does NOT meet the Surgery SI OR Surgery ELECTIVE requirement.
Done by Lottery
Other Considerations
• An ICU rotation encouraged
• A rotation in behavioral health encouraged
• CAPSTONE Research – Dr Ottolini
• International rotations
• Operational rotations - MEM
Postclerkship Period
• What are the requirements?
• What is a sub-internship?
• How do I find and sign up for rotations?
• How can I maximize my GME application preparation?
• What does a typical schedule look like for – A wanna-be surgeon?
– A wanna-be internist?
– What if I am interested in EM or neurology?
Sub-Internships
• Also commonly called acting internships
• One in surgery, one in primary care (IM, FM, Peds)
• Increased independence---you work directly for the resident/attending
• Your schedule should look very similar to the other interns on the service
Subinternship Goals
• Gain advanced clinical skills and knowledge
• Develop competency in practical skills at house officer level
– Inpatient care
– Evaluate and Admit patients
– Call coverage
Sub-Internships
• Surgery – General surgery – Surgical subspecialties (orthopedics, CT, plastics,
pediatric, vascular, etc) – SICU, Burn unit, Trauma ICU – GYN-Oncology, Uro-GYN, some general GYN
• not OB, maternal fetal, reproductive • Under purview of OB/GYN department
– Sports Medicine • if ortho sponsored and inpatient – USMA
– Case log
Sub-Internships
• Primary Care – Internal medicine wards, heme-onc ward, CCU,
MICU
– Pediatric wards, PICU, NICU
– Family medicine inpatient service
• What are the requirements?
• What is a sub-internship?
• How do I find and sign up for rotations?
• How can I maximize my early GME application preparation?
• What does a typical schedule look like for – A wanna-be surgeon?
– A wanna-be internist?
– What if I am interested in EM or neurology?
*** 1304 – obsolete ***
* 114 – still in use for NEW dod or civilian rotations, including research!!!
https://drive.google.com/file/d/0B7yt0ja4gtrHT2RlLVpVMHk1aEE/view?usp=sharing
*** This is the best resource for contact information! ***
• How do I schedule? – Schedule with the GME office or USU department (varies) – Enter your schedule in the Lottery Site – If a rotation is not listed as a SI, contact the USU
Department in advance to be sure it will count as such!
• If it is a new rotation: – USUHS Form 114 – approved by department at USU and
completed copy to OSA • Scheduling rotations not listed in the catalog, such as civilian,
humanitarian, research, federal sites not routinely used
– Enter request for MOA online at • https://docs.google.com/a/usuhs.edu/forms/d/1CAlfDzk2C4mhkFHSfsxFmDMwoav0bJTPu-
NW9Lg1GQE/viewform
– ***NO MOA, NO ROTATION, START EARLY, VERIFY
FORM 114 lower half – Registrar no longer collects
Completed copy emailed to OSA, keep for your record
Exact Steps
• Select a rotation
• Contact the POC (either in the GME office or the USU department)
• Verbal/Email confirmation of the rotation
• Add the rotations to your schedule on the lottery website
• If you make changes: – Not less than 30 days advance
– Contact BOTH sites promptly
– Enter change in Lottery website
• What are the requirements?
• What is a sub-internship?
• How do I find and sign up for rotations?
• How can I optimize my GME application preparation?
• What does a typical schedule look like for – A wanna-be surgeon?
– A wanna-be internist?
– What if I am interested in EM or neurology?
Rounds 1-3 - Sorting
• Try a new specialty
• Repeat specialties you are interested in
• Early interview at a residency site
• Required rotations
– For some, this may include officer basic training
• Can consider flight medicine training
Rounds 4-6
• Prime Rounds for GME interviews
– first choice site and location
– warm-up for your first choice site
– Allow Step 2CK/CS study – keep one light
• What are the requirements?
• What is a sub-internship?
• How do I find and sign up for rotations?
• How can I maximize my GME application preparation?
• What does a typical schedule look like for – A wanna-be surgeon?
– A wanna-be internist?
– What if I am interested in EM or neurology?
Wanna Be Surgeon
• General surgery SI at top choice site
• Two other general surgery or surgical subspecialty rotations at 2/3 choice sites
• Primary care SI: MICU, CCU
• Primary care clerkships: Cardiology, ID, GI, Pulmonary
• ATL TA
• Surgical clerkship in Philippines, Germany, Guam
I want to be a Navy Orthopedic Surgeon and train at San Diego;
Bethesda would be my second choice
Rads Sports
Med Ortho
NMCP
Ortho
WRB Ortho
SI SD
GS
SD
I can’t decide between ENT and Orthopedics, but I would like
to train at Madigan
ENT
WRB
Ortho
WRB
Allergy
WRB
ENT
MAMC
SICU
MAMC
ENT
TAMC
Wanna Be Internist
• IM, MICU, CCU or Heme/Onc SI at top choice site
• 2-3 medical subspecialty rotations at 2/3 choice sites
• Surgical SI: SICU, Burn Unit, Cardiothoracic SI
• Surgical electives: ophthalmology, ENT
• Electives: radiology, anesthesia, complicated OB
I want to be an Army Internist, and train at WRB, but MAMC
would also be great!
MICU
WRB
SICU
WRB GM
MAMC
Neuro Pulm
WRB
Rads
WRB
Interested in ANE, EM or Neurology?
• You can select audition rounds in the lottery and work with the Departments to set up 1-3 rotations in that specialty – typically during Rounds 4-6
• EM, Neuro and ANE will facilitate schedule prior to running the lottery to ensure that interviewing students are scheduled appropriately
• If you change your mind – they will usually move you to a different block
I want to be a Pediatrician….
• Can’t I do a PICU for my medicine SI, and Peds Surg for my surgery SI, and peds neuro…..
– Balance! You need to pass Step 3, and you need to be deployable!
– Mix in some adult medicine
• Great surgery SI is ENT
• adult ID or pulm - significant overlap
Operational? Humanitarian?
• One operational rotation is allowed IF…
– You are in good academic standing
– Selected through an OML which includes physical fitness and military rankings
– Flight medicine requires will often overlap several rounds
• You cannot take time from a required rotation for operational/humanitarian rotations
• MEM – COL Chen
Other FAQs
• Can I do a medical history rotation? – Only if you already have a project which can be completed
in 4 weeks
• Can I rotate near my family or significant other? – In general, yes… elective rotations can be done at outside
institutions
FAQs
• What if I have to make up a core clerkship?
• GME applications….I know they include letters of reference…?
Make up Clerkship
– Except in rare instances, core clerkships should be completed at the beginning of the post-clerkship period
– This allows you to complete all required rotations before Step 2Ck/CS and the GME selection board
– Coordinate with OSA - must align with the 2018 clerkship schedule
FAQs
• What if I have to make up a core clerkship?
• GME applications….I know they include letters of reference…how should I go about these?
LOR’s
• GME application process begins in July of 2016 • MODS/ERAS and service specific forms • Three LOR’s
– 1 departmental (USU chair letter), 2 personal
• Personal letters – From someone who knows you well and will write you a strong letter--
-varies by specialty, ask PDs what they prefer – Ask after you finish working with them – Let them know what you intend to apply for, where, and things you
would like them to emphasize – Give them a copy of your cv and photo
• All letters are addressed to “Dear Program Director” • Have all LORs sent to OSA, Ms Mcauliffe [email protected]
Postclerkship Planning
• 4th Year Lottery – early fall • Plan for R1-3 by the end of February • Complete R 4-6 by the end of April • Complete schedules by the end of September
2016 • Stay in contact---phone and email are fine if you
are out of town on rotations • Have fun, use the time to prepare yourselves well
for internship and Step 3! • CALL OSA if emergency, concerns arise!
Neurology/EM/Anesthesia Lottery
• Plan to run virtually
• Three iterations, each on a separate day
– Will coordinate these dates well in advance with your class leadership
– During Round 7 to avoid proximity to any exams or OSCEs
• Process similar to core clerkship lottery
30 points available for three iterations of choosing: Anesthesia, Neurology, ER may be chosen during any of the three iterations.
If assigned a rotation without being assigned in the lottery, for instance an interview rotation, average number of points used
during third year will be subtracted from total points available.
Like third year choosing, with addition of selecting round. OSA controls slots available, and choosing will be based off these
slots.
Point mitigation will be the same as third year: 25% decrement for each subsequent choice, staying in same location as prior
round (only available if prior round is assigned) decrements by 10%, choosing rotation only will decrement by 20%.
Additionally, choosing round only will decrement by 20% and choosing rotation and round will decrement by 10%.