welcome to the fourth year of medical
school lecture series in this video
we're gonna discuss the goals of being a
fourth year medical student we'll
discuss what is a sub internship
we'll discuss the differences between
the expectations of third-year medical
school now being a fourth year medical
student and will also discuss away
rotations now the goal of the fourth
year of medical school what's the
difference how is it any different than
third year well the fourth year of
medical school is the home stretch this
is where all your hard work
culminates into taking us Emily step 2
you perform sub internships and during
your fourth year you apply to residency
and you hopefully match these are the
goals of the fourth year of medical
school do well in step two rock your sub
internships match into the program of
your choice go on and have a great life
but the expectations for a fourth-year
medical student
are greater substantially than that of a
third-year medical student in life as
you progress every year through your
academic training a little bit more was
probably expected of you each year you
can think of that in college in the
beginning of medical school
however the transition from the third
year of school to the fourth is actually
quite a significant jump you are
expected to make the largest leap as a
student from the third year of medical
school to a somewhat fairly functioning
sub intern as a fourth year of medical
school so on that topic what is a sub
internship the fourth year of medical
school contains core rotations that are
similar to the third year of medical
school
however certain rotations during the
fourth year of medical school are called
sub internships this means the fourth
year medical student will be on a
rotation and they will be auditioning
essentially or attempting to perform or
work at the level of an intern and so we
call this a sub internship or a sub
intern and the purpose of this sub
internship is multifold
the first is applying to residency
that's the first reason we do sub
internships
you want to go to residency now part of
the residency application process
requires letters of recommendation
students will traditionally perform sub
internships during their fourth year in
the specialty interests of their choice
for example if you wish to apply to
neurology residency then you will
perform a neurology sub internship at an
institution during this rotation you
will work really hard you'll try to work
at the level of an intern try to impress
the residents and your attending and in
that process or in a very strong letter
of recommendation from an attending in
the specialty of your interest and then
you will use that letter to apply to
residency programs of your choice this
is the key reason of what we do sub
internships the second reason is for
graduation requirements most medical
schools require that students complete
sub internships and various core
rotations for graduation for example if
you were applying to neurology residency
you will perform a neurology sub
internship like we previously stated
however your school may also require you
to perform an internal medicine
sub-internship just as a graduation
requirement an important note if you are
performing a sub internship in a
specialty outside of the specialty you
are applying for don't slack off for
example if you're applying to neurology
and your program says you know what you
got to do in medicine or a surgery sub
internship as a graduation requirement
don't say to yourself oh well I'm not
going into the I'll to slack off
no all right that that's a big mistake
don't do that
it is absolutely imperative that you
work as hard as you can on any sub
internship that you're on slacking off
during a sub internship will be notice
and your program director or some other
program director they all talk to each
other and they may speak of you and it
this could inadvertently hurt your
chances of getting into a residency of
your choice never ever ever slack off
during a sub intern you're always
expected to perform your best
irrespective of specialty interest
choice and let me tell you why when
I was on my internal medicine rotation
and I was on the sub internship at that
point I had to do the sub-internship
even though I was going into neurology
for a simple graduation requirement now
that sub intern you're on the service
the attending who comes in and says okay
who's on the team today this is what
they always ask on the first day here's
our third year here's our fourth year
sub I and then here's the residents and
here's our whole team the moment you're
categorized as a sub internship the
attending has eyes on you they want to
see how you perform they're interested
in evaluating you so just being the sub
intern on a service you immediately get
the spotlight whether you like it or not
and if you don't perform well that
attending will notice because the
spotlights on you with the big label of
sub intern and they could go talk to
their program director and they say the
internal medicine program director could
go speak to the neurology program
director and say hey that kid I think
wants to do neuro but he was on my
service and you know I didn't go too
well so we could all come around so
never slack off on a sub internship
you're on the spotlight now what are the
expectations for a sub intern or a
fourth-year medical student
given the FET the fourth year medical
students are expected to function at the
level of a sub intern it raises the
question of what does it really mean and
how is it different than being a
third-year medical student
during the third year of medical school
you were pretty much let's be polite
about it a large liability to the team
okay you weren't an SME you try to be
the best asset that you could but you
weren't you know and it you weren't a
resident the third year medical students
are new to the hospital environment
they're still learning the ropes they're
still trying to know how the hospital
works so they're continuously taught by
residents on how to do things now as a
fourth-year student the expectation is
that you've learned the basics you know
how to interview patients you know how
to perform exams you know the basics of
medical management how to get that
started you don't have to come up with a
complete and a full assessment and plan
but you should know what's going on
which questions to ask during the
history what to do on a physical and
have a focused thought process you
should always have basic plan
recommendations at this point now there
is the
increased expectation for fourth-year
medical students and this may seem
daunting you may say to yourself after I
just said all that hey I don't know if I
know all the right questions to ask
during a history I don't know if I know
all the maneuvers what if I'm not very
good at performing a plan Omo you're
stressing me out why am i watching this
video it's okay it can seem daunting and
it's supposed to remember we said the
third year - the fourth year is the
biggest leap you have to make it's when
you become the biggest kid of all you
know you suddenly got to grow up so how
do you go from being a kid a third-year
student to a big kid fourth year medical
student and really it's a you have to
become more in control and you have to
ask more thoughtful questions and in
fact there is a secret to this and you
will need the strategic help of your
interns and your residents they will
help you grow and they will make you
into a star sub intern and we'll talk
about this shortly a topic we need to
discuss our away rotations now
performing sub internships is a vital
component to the fourth year of medical
school as we discussed earlier a
question that's often raised is is there
a benefit of doing your sub internships
at your local home institution versus
doing them at away outside rotations
away rotations as the phrase goes are
simply sub internships that you perform
at a medical school other than your own
for example let's say you're a medical
student at Stanford medical student
school and you want to do an away
rotation at Harvard Medical School in
order to do this you need to apply for
an away rotation at the end of your
third year or maybe even in the middle
of your third year or possibly at the
beginning of your fourth year aka
we'll start looking early so you know
when the application deadline is open
you are responsible and you are
absolutely solely responsible for
setting up all the details of the
rotation knowing when to apply knowing
where you want to apply to and managing
the travel and the housing for these
away rotations thus setting up an irwe
rotation is not easy it takes effort so
you may be asking yourself well why do I
want to do it who wants to do all this
extra work is there a purpose and really
the purposes of doing in a way rote
are multifold if you are very interested
in matching into a specific residency
program then it's extremely valuable to
do an away rotation there
the program director the faculty the
residents will get to meet you they'll
work with you in person in the hospital
and if you work hard and shine as a
great fourth-year sub intern performing
in a way rotation they're really
highlights your dedication to the
program and allows you to personally
meet and influence people from the
program and really increase your chances
of matching their color core concept
here for these is essentially networking
get yourself exposed to the people who
can get you in and make them like you
through your hard work also another
reason for seeing how are doing in a way
rotation is you want to see how other
hospitals in other parts of the nation
or world practice medicine you can
expand your understanding help of how
medicine is practice even within your
own specific specialty and broaden your
worldview for example there were some
students in my class who were going into
Neurology with me but some people did
rotations on the other side of the coast
or some Didem internationally just
because they wanted to see how is
neurology practice somewhere else and
how does it differ from how we do it
neurology is not the same anywhere and
medicine is not the same anywhere so you
really have the opportunity to expose
yourself to more ways in which we
practice medicine another reason why
some students new wave rotations is
simply for fun you can do an away
rotation at a great vocation a vacation
spot I've had friends do away rotations
in Hawaii sounds pretty nice they were
surfing or you can do an away rotation
near family so you can visit them right
this third reason of doing a wave
rotations is more personal enjoyment and
organized but just so you know this is a
thing that people do as well now let's
go over what we've talked about the goal
of the fourth year of medical school is
to match into a residency program the
sub internships are core rotations that
utilize and you can shine as a student
build a networking basis for matching in
to your residency program of choice as a
fourth year medical student and as a sub
intern you have high expectations and
you're expected to
function at the level of an intern away
rotations are great ways for you to
express your interest in a specific
program or see how medicine is practiced
at other institutions thank you
you