Specialty Preparation Guide


Anesthesia

Suggested Electives for Preparation

Students interested in a career in anesthesia need to have a working knowledge of a wide variety of medical and surgical problems. Students should pursue fourth-year clinical rotations that give the student responsibility for the diagnosis and treatment of diverse patients.

Suggested Electives

  • Family medicine
  • Internal medicine and any subspecialties
  • Pediatrics
  • OB-GYN
  • Neurology
  • Surgery and any subspecialties

Additional Information
Critical care experiences encouraged; away rotations generally unnecessary.

Dermatology

Suggested Electives for Preparation

Students interested in a career in dermatology should understand that dermatologic disease is often tied to systemic issues. Electives in general medicine teach important components of comprehensive patient care.

Highly Recommended Electives

  • One-two dermatology electives
  • Involvement in dermatology project
  • Attendance at grand rounds and didactics is encouraged
  • Research strengthens an application. Research can be case reports or longitudinal studies (one-two publications is a good goal).

Suggested Electives

  • Allergy
  • Infectious disease
  • Rheumatology
  • Sub-internship in medicine or pediatrics
  • Student with an interest in research could take a dermatology research elective
  • Students with a pathology interest could take a dermatopathology elective

Additional Information
Surgery electives generally unnecessary. Away rotations are advisable at institutions that the student is seriously considering. One or two away rotations is reasonable.

Emergency Medicine

Suggested Electives for Preparation

Students interested in a career in emergency medicine should complete the emergency medicine Phase 3 clerkship on the Indianapolis campus in either the Methodist or Eskenazi emergent department.

Highly Recommended Electives

  • Two emergency medicine clinical rotations; one should be an away rotation (if possible)
  • Two standard letters of evaluation (SLOEs)

Suggested Electives
Elective rotations should focus on getting a wide variety of clinical experiences.

  • Adult intensive care unit
  • Cardiology
  • Dermatology
  • General orthopedics
  • Ophthalmology
  • Pediatrics (emergency department or intensive care unit)
  • Radiology
  • Toxicology
  • Sports medicine
  • Ultrasound

Additional Information
More than two emergency rotations are unnecessary. Interview season is November-January; plan flexible rotations. Research and scholarship are preferred but not absolutely necessary.

Family Medicine

Suggested Electives for Preparation

Students interested in a career in family medicine should focus on clinical electives. The electives do not need to be taken with a family medicine faculty member or physician.

Suggested Electives
Adult or pediatric/inpatient or outpatient:

  • Cardiology
  • Dermatology
  • Endocrinology
  • Infectious disease
  • Pulmonary
  • Renal

Additional Information
An away rotation is recommended if a student has geographic ties, but not required.

Internal Medicine

Suggested Electives for Preparation

Students interested in a career in internal medicine should take a sub-internship in internal medicine as early in the year as possible. Do not stress if an early sub-internship is not available though; Departments of medicine across the country recognize that many students may not be able to take an early sub-internship. Sub-internships are also a good time to secure additional letters of recommendation.

It is also highly recommended that students take an intensive care unit month in addition to a ward sub-internship when possible. This will make students more capable and comfortable dealing with very ill patients.

Suggested Electives

  • Anesthesia
  • Cardiology
  • Dermatology
  • Infection disease
  • Intesive care unit
  • Electives that strengthen identified knowledge weaknesses; the goal is to be a good generalist; students can also take electives they would never get during an internal medicine residency.

Neurology

Suggested Electives for Preparation

Students interested in a career in neurology should take the neurology senior elective as this was designed specifically for a broad exposure to neurology. Students taking this elective get to work with most members of the admissions committee and common recommendation letter writers. This elective should be completed before September.

Highly Recommended Electives

  • Neurology sub-internship

Suggested Electives

  • Ethics/palliative care
  • Intensive care unit with focus in neuro-intensive care units
  • Neuropathology
  • Neurology research (need to establish a research mentor prior to choosing)
  • Other electives designed to deepen internal medicine knowledge

Additional Information
Away rotations are generally unnecessary unless a student is trying to match in a competitive area of the country or at a particular institution.

Neurosurgery

Suggested Electives for Preparation

Students interested in a career in neurosurgery should meet with a neurosurgery career mentor very early in their medical school years. Research is very important to neurosurgery and the medical student applicant needs to have published research preferably in the neuroscience field. The honors rotation in neurosurgery is recommended for students who meet USMLE requirements but did not fulfill research component. This consists of one month of clinical neurosurgery at Methodist and two months in a neurosurgery lab.

Highly Recommended Electives

  • One month of clinical neurosurgery at Methodist
  • Two months in a neurosurgery lab

Suggested Electives

  • Critical care
  • Neuroradiology

Additional Information

At least one away rotation (sometimes two-three) in neurosurgery that is planned in January of the third year of medical training (Phase 2). The rotation should be done before October, so a letter of recommendation can be entered into ERAS.

OB-GYN

Suggested Electives for Preparation

Students interested in a career in OB-GYN should take sub-internships that improve the breadth and depth of general medical knowledge and sharpen clinical skills.

Highly Recommended Electives

  • Critical care
  • Family medicine
  • Internal medicine
  • OB-GYN
  • Pediatrics
  • Surgery

Recommended Subspecialty Electives
One subspecialty elective in OB-GYN should be taken in the early months of the Phase 3 year.

  • Gynecology
  • Gynecologic oncology
  • Maternal-fetal medicine
  • Reproductive endocrinology
  • Family planning
  • Female pelvic medicine and reconstructive surgery

Other Suggested Electives

  • Anesthesiology
  • Becoming an effective resident teacher
  • Cardiology
  • Dermatology
  • Endocrinology
  • Female urology
  • Infectious diseases
  • Medical Spanish (depending on where the student plans to practice)
  • Obstetric anesthesiology
  • Pulmonary/critical care
  • Radiology – imaging of abdomen and pelvis
  • Surgical intensive care unit

Additional Information
External electives or sub-internships in OB-GYN at other institutions are strongly recommended if students have a unique reason to train in one particular program (e.g., proximity to family, career opportunity for spouse/partner, or couples match preference). If the goal is to learn about a given hospital or city, that can be accomplished with a non-OBGYN elective at that hospital and ask to meet with the OBGYN program director during time there.

Ophthalmology

Suggested Electives for Preparation

Students interested in a career in ophthalmology should take electives that will prepare them for a lifelong career in ophthalmology. Ophthalmology is not a required medical student rotation, however student can gain exposure by requesting the surgery subspecialty month in the third-year surgery block.

Highly Recommended Electives

  • Elective in ophthalmology during third year or early fourth year
  • Electives should include one month of radiology

Suggested Electives

  • Dermatology
  • Emergency medicine
  • Endocrinology/diabetes/metabolism
  • Infectious disease
  • Plastic surgery
  • Rheumatology/immunology

Additional Information
An away rotation in ophthalmology is not required. However, away rotations are a very effective way to “audition” before the program leadership and give the student a chance to explore the visited program in depth. The away rotation should be completed after the ophthalmology rotation at IU. Students hoping to remain at IU for residency training should complete their IU elective ophthalmology rotation in Indianapolis.

Orthopaedics

Suggested Electives for Preparation

Students interested in a career in orthopedic Surgery should take electives that will prepare them for a lifelong career in orthopedics. Orthopedic surgery is one of the most competitive fields of medicine, and ideally, planning and positioning oneself for a career in this field should start as early in medical school as possible. Many programs have USMLE cutoffs for applications to be considered. Research is also an important aspect to a student’s application and can be what distinguishes the student from others applying.

Highly Recommended Electives
Students interested in orthopedic surgery as a career should plan on taking at least one of the suggested electives either in the third or fourth year of medical school. Ideally this should be accomplished by August of the fourth year.

  • General orthopedic elective that is divided between two of four possible locations
  • Musculoskeletal oncology
  • Orthopedic trauma at Methodist
  • Pediatric orthopedics

None of these rotations is preferred over another. Several other orthopedic electives are offered throughout the state, and while many of these are excellent learning opportunities, they should not take the place of taking one of the above electives. These other IU electives should be treated more like an away rotation.

Suggested Electives
Other electives should focus on subspecialties that will foster skills useful for an orthopedic surgery career. The cursory list includes:

  • Emergency medicine
  • Neurosurgery
  • pPastic surgery
  • PM&R
  • Radiology
  • SICU

Additional Information
Orthopedics is not a required medical school rotation; however, students can gain exposure by requesting orthopedics during their third year subspecialty month during third year. This rotation occurs at Eskenazi, Methodist, Riley or the VA. The clinical experience will differ depending on the location, but a basic understanding of how to approach patients with musculoskeletal problems will be the foundation of each service location. The third year vacation month is also an opportunity to take an orthopedic surgery elective to gain more knowledge, determine if orthopedics is a good fit, and to demonstrate the student’s interest and dedication to a career in orthopedic surgery.

Away rotations are not required, but students interested in Orthopedics as a career typically do two away rotations both as an “audition” month and to obtain more in-depth knowledge of the visited program. These also are potential sources for a letter of recommendation (LOR), but are typically not as strong as letters from student’s home program because of the limited exposure time of the away rotation. Away rotations can be done later in the year (as late as November in some cases) than the students home rotations if students are not relying on it for a LOR.

Otolaryngology

Suggested Electives for Preparation

Students interested in a career in Otolaryngology Head & Neck Surgery (OHNS) should take electives that will prepare them for a lifelong career in OHNS. Students are encouraged to speak with a career mentor early in the Phase 2 year for guidance in this highly competitive specialty.

Highly Recommended Electives
A one-month elective in OHNS should be taken near the end of the third year, or early in the fourth year (before August ideally). The elective rotation provides the opportunity to work in the different subspecialty clinics with multiple faculty members and participate in the operating room. All students interested in pursuing OHNS as a career should complete their one month elective OHNS rotation in Indianapolis at IU.

Suggested Electives
Should provide exposure to other subspecialty areas that deal with health issues closely related to OHNS.

  • Dermatology
  • One month of radiology
  • Neurology
  • Neurosurgery
  • Radiation oncology
  • SICU

Additional Information
OHNS is not a required medical student rotation, however, students can gain exposure by requesting the surgery subspecialty month in the third-year surgery block. The surgery subspecialty rotation in the third year takes place at the IU Health University and Eskenazi locations. During this rotation, students learn the basic head and neck exam and have the opportunity to see and assist many types of surgery such as facial plastics and reconstruction, head and neck cancer removal, microscopic ear surgery, endoscopic skull base and sinus surgery, laryngeal vocal cord surgery, and pediatric otolaryngology procedures.

An away rotation in OHNS is not required. However, away rotations are a very effective way to “audition” before the program leadership and give the student a chance to explore the visited program in depth. The away rotation should be completed after the OHNS rotation at IU.

Pathology

Suggested Electives for Preparation

Students interested in a career in pathology should have a solid understanding of medical disease and surgery.

Highly Recommended Electives

  • Pathology survey rotation at IU Health Pathology Laboratory should be taken in July or earlier of the fourth year. This survey rotation provides exposure to the full range of very diverse subspecialties included within the very broad specialty of pathology. This allows students to be sure that they know what they are signing up for and so that they are confident with the career specialty choice before going further. While it is a great overview rotation that every interested student should absolutely take, the biggest downfall is that there is not an opportunity to work with any one faculty member for more than three days – meaning that it is impossible to get a meaningful letters of recommendation during this rotation.
  • A month of specific anatomic or clinical pathology subspecialty at the IU Health Pathology Laboratory. On this month, students will work with faculty members for a minimum of a week each and possibly quite a bit longer – giving more opportunity for meaningful letters. These could include:
    • Surgical pathology
    • Dermatopathology
    • Neuropathology
    • Forensic pathology

Additional Information
On any pathology rotation, students should attend the 4 pm surgical pathology daily quality control conference, where many rare/interesting/challenging cases are reviewed each day. The faculty who run this will get to know the residents better than any other faculty over their two months or more rotating with us, and these faculty are some of their best options for good letters of recommendation.

Pediatrics

Suggested Electives for Preparation

Students interested in a career in pediatrics or a combined pediatrics field are advised to take electives which will help the individual to become a better pediatrician.

Highly Recommended Electives
At least one month should be spent on a pediatric inpatient service in which the senior student functions as an intern (Peds sub-I). This expands the student’s basic pediatric knowledge, allows the student to gain intensive experience in the diagnosis and management of children with serious illnesses, and helps the student to become comfortable with technical procedures.

Suggested Electives

  • Child psychiatry
  • Dermatology
  • Ethics
  • Genetics
  • NICU
  • Pediatric anesthesiology
  • Pediatric neurology
  • Pediatric subspecialties
  • Pediatric surgical subspecialties
  • Radiology
  • Sports medicine

Electives in which the student functions as an intern enables the student to develop organizational skills which are necessary to become a successful and happy resident.

Additional Information
Students interested in improving their fund of pediatric knowledge and in developing advanced life support skills should take the Pediatric Therapeutics elective.

Radiology

Suggested Electives for Preparation

Students interested in a career in radiology should take an elective month in radiology in Indianapolis during their third year and spend two weeks in two different areas of radiology. This will allow students to meet lots of people and see a good cross section of radiology. Fourth-year students can do one of their electives any time before September to experience radiology.

Recommended Electives
The fourth year should be broken into three blocks.

  1. The first block is “pre-interview” and should be spent doing electives/away rotations, working on ERAS application, asking for letters of recommendation, and taking Step 2. It’s totally okay to do fourth-year core rotations during this time.
  2. The second block (Oct-Jan) is “interview season.” Students should try not to schedule fourth year core rotations during this time because it’s hard to get time off of them to interview. Instead, do flexible electives (path TA, anatomy TA, computers in medicine) and maybe a vacation month.
  3. The third block (Feb-May) is “post-interview” and largely doesn’t matter. This is a great time to schedule core rotations.

Additional Information
Away rotations are very effective if there is a specific program that the student wishes to receive an interview offer from and ultimately to match. Doing an away rotation gives students the same sort of “home court advantage” that a student has at their home institution in term of getting to know the residents, faculty, and program director. Students need to do their homework ahead of time, though, and work hard when they get there because it’s essentially a month-long interview. Students will need to apply online through VSLO. If there is not a specific program that a student has their sights set on, away rotations don’t make much sense.

Radiation Oncology

Suggested Electives for Preparation

Students interested in a career in radiation oncology should complete a full one-month elective in radiation oncology at IU at the end of their third year or beginning of fourth year.

There are no set electives for fourth year.

Suggested Electives
Cancer-related electives can be useful for learning more about the field and suggested elective include:

  • GYN oncology
  • Medical oncology
  • Palliative care

Additional Information
Some people recommend as many rotations as can be scheduled (this might be the best approach for someone with a less strong application, but who might be able to impress programs in person) or only doing one-two away rotations (this might be the best approach for people who have a very strong application and could potentially only lower their match chances with an away rotation). Away rotations can be targeted regionally, targeted at reach programs, or targeted at potential mentors/areas of research interest.

Recommendations
Cancer-specific research is not an absolute requirement, but very common for applicants. Students should reach out to faculty at their home institution about the possibility of research if interested in radiation oncology as a field. The clinical rotation is a great time to meet faculty and enquire about their research interest/possibilities. In reality it is hard to have a completed/submitted research publication by the September application deadline if the student does not reach out early to potential research mentors. Students will need to meet with a radiation oncology faculty to further discuss logistics.

Surgery

Suggested Electives for Preparation

Students interested in a career in surgery should note that experiencing surgery in the context of a fast-paced, surgery residency program (regardless of specialty) is important. The best way to know what to expect from training and what will be expected of a student as a resident is to experience an environment where students work closely with a resident team. Participating in education conferences, learning to manage services with various complex patients, reporting to several different faculty attending surgeons on top of working in the construct of a surgery team is critical to understanding the resident working environment.

The third-year clerkship at IU School of Medicine includes four weeks of general surgery and four weeks of a subspecialty surgery experience. Medical students are distributed among many hospitals and services including regional campuses – many of which offer excellent one-on-one experiences with practicing surgeons. Opportunities to preference specific rotations and/or sites are available, but due to the number of students in the third-year class across all campuses, it is not always possible to grant everyone’s preference. Receiving a different preference is not a “make or break” scenario for any student interested in surgery, as the school provides opportunities for both career exploration and electives. Students interested in any surgery specialty should not schedule their third year surgery clerkship in the summer months (before September). Experiences for those third-year students in these early months can be affected (diluted) by additional learners (fourth-year students) rotating on the same rotations in pursuit of letters of recommendation.

Highly Recommended Electives

  • Complete two surgical Sub-I elective rotations early in the fourth year of medical school

Suggested Electives

  • Cardiology
  • Nephrology
  • Preparing for Surgical Residency course
  • Pulmonary
  • Surgical ICU/medical ICU

Additional Information
An away rotation may be a good idea if there is a particular region of the country (especially coastal) that a student is extremely interested in, but may find it hard to “get a foot in the door” otherwise, coming from the Midwest. Also, if a student is trying to “level up,” or match into a particular program that is considered to be top tier, but the student is a second-tier candidate, an away rotation could potentially get the student an interview offer that may not have come otherwise. Only one away rotation is suggested, if determined that one is needed.

Urology

Suggested Electives for Preparation

Students interested in a career in urology should note that urology is a highly competitive specialty. Students interested in Urology are encouraged to seek career mentoring early in the medical school process, and for guidance in selecting fourth-year rotations.

Highly Recommended Electives

  • Urology Sub-I prior to October of the fourth year of medical school

Additional Information
In general, away rotations are recommended. Choosing programs for these rotations will depend on the student’s competitiveness and degree of interest in that particular program. We recommend completing two away rotations prior to October of the fourth year.