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by Medisid



‘’If I have seen further it is by standing on the shoulders of giants/predecessors.’’ – Sir Isaac Newton

During the process of applying to electives and choosing between the elective choices, months and places; I committed or observed other’s mistakes pertaining to overspent application fees, missed rotations, listing too competitive departments, overlapping acceptances, F1,B2 visa overlapping problems. So I would like to share the experience and some ‘personal/my own/sixth sense’ thoughts. Everyone’s entitled to one and I am expressing mine here.

Choosing your specialty:

Decide what you want to become now! A gastroenterologist, Oncosurgeon, Radiologist .........Remember we have to prove during our residency interview/personal statement why we want that specialty and justify it (electives in that specialty is a good solution for it).

For pure terminal branches like Rads there is no difficulty in choosing your rotation. Start with basic radiology, then higher branches like interventional etc.

For other non-terminal branches you face problems in choosing your specialty. In fact IM, Peds and Surgery are the most sought after specialty for rotations. Their sub-specialties usually follow the trend of fellowships popularity. If you want IM, then always give preference to IM subspecialties of your interest or previous background. Remember Sub-Internships are the best and are the most difficult to get. Many places IMGs are ineligible for it. Usually there are multiple choices to fill. Try to list initial choices from your sub-specialty of interest. You can fill the last choice from your backups. Cards, Gastro, Hem/Onc are the popular ones. Less popular IM rotations are Nephrology, Pulmonary Medicine, Infectious Disease, HIV, Geriatrics (in a crude decreasing order of popularity). Even Peds or Neurology rotation can complement your IM and vice-versa. Similarly for Surgery you can list subspecialties of your choice. The lesser known surgery rotations which you can use for back up are Transplant, Bariatric. Given your interest in surgery, you can also list cardiothoracic surgery, neurosurgery, head and neck surgery as backup. These do involve surgery and will be better than doing IM/Peds/or even OBGYN. There are some interdepartmental electives which can be useful for both IM as well as Surgery applicants; like Infection in Transplant Surgery, Surgical Nutrition and SICU. Nonetheless there are also some peculiar electives you’ll come upon which you may have never heard of. Sometimes the hospital location of electives can give you a hint. VAMC (Veteran Affairs Medical Centre) locations in each specialty are less sought by US seniors and we stand a good chance there. Ultimately, Diagnostic radiology is the best backup and would supplement any specialty you are interested into. Furthermore the ‘maximum number of students permitted per month’ are higher for radiology. So try to squeeze it into the list.

Months to Apply:

From my experience I feel that Jan-Feb-Mar-Apr-May months are easier to get into. The reason being US seniors(final year US students) usually prefer Jun-Jul-Aug-Sep-Oct-Nov months to do away rotations or visiting electives to get an idea about that residency program, impress faculty of that department for a prospective residency and so we have less chances of getting selected against them. Remember they have to complete this impression gimmick before/during the residency interviews which happen around Nov-Dec-Jan.YES! they sure are juggling with away rotations, step 2 CK and application and interviews all at the same time. (I once read on a forum how a Sub-Intern used his high number of interview calls to bunk his boring elective duty giving valid reasons as attending interview; 15 interviews = ½ month off from his boring sub-internship). During the next months ie Jan onwards, the away rotations hardly matter for their residency matching and seniors usually take up lighter rotations at home school so as to complete the need/credits/prerequisites for their successful graduation with the MD degree.

Arranging the Months and Places:

There are three types of application processing, namely:

1) Rolling: Applications are reviewed as they are submitted and usually decisions (acceptances or rejections) are declared in 1-2 months. Try to apply in advance so that during your processing period there would be vacant slots in your rotation period listed. But here your credentials matter more. Eg NIH, MSKCC...

2) First come first serve(FCFS): Applications are received and processed in order of submission and priority is given to those who apply early. Northwestern, Tufts, Brown Alpert etc

Though there are considerable overlap between rolling and firstcomefirstserve type, like weill.

3) Deadline: Applications are received as they come, but they are neither opened nor processed till the deadline is over. So there is no distinct advantage in applying early. Harvard is one of them.

When you read the details of application process of each program, you’ll identify the type.

Usually we try to do around 3-4 months of electives and wouldn’t it be great if we did it consecutively in a single trip. Electives are itself a costly affair and overstaying in USA and additional air trips can be expensive. Since rotations are 4 weeks in length or more accurately 26 days (1st Monday to 4th Friday), people get 2-3 days in between consecutive rotations to travel and settle for the next elective. So consecutive IS possible!

My advice is to apply to rolling applications first like NIH (it usually processes your applications in approx 2 weeks). Wait for its result. When they schedule you for any month(which they usually do!) Strike out that month from your elective planner and try sending applications to other rolling places and FCFS like northwestern, mskcc, brown and other places which do not have a deadline system. There are several ways you can avoid overlapping of acceptances for a single month. A) Arrange two different places with same months in reverse preference. Eg Place A – Jan, (1st), Feb(2nd) Mar (3rd) while Place B – Mar(1st ), Feb(2nd), Jan (3rd). Furthermore for a single month try to pair your top choice with your lowest. Eg for Jan; pair SUNY(my top choice coz of no fees) with Harvard (last resort coz of high fees). So if suny(top) accepted, I was fine. But if suny rejected and Harvard accepted then too I was fine,as anyhow I’ll have to do as it is the last option. Also you may pair two expensive and equal ones like harvard n yale, if u can afford only 1 month of paid elective so your choosing between the two was imminent and doesn’t hurt. Apply to deadline strict places like harvard at last when you have not received any confirmation from any places and the deadline for that month is approaching. From my experience I think DHL takes 5 days at max, Indian Govt Speed Post (10 days), Indian Post Regd Mail(15-20 days). Do Not forget to take flat 50% student discount from DHL (Yes! Half Price) if you are sending to any address listed as a university in USA. I even convinced the dhl guys that ECFMG, PA is an educational institution and we have sent documents there with the discount.

One more thing: If you plan on applying to Mt Sinai, Baylor or those places which need F1 visa, try to plan them at the end of your rotation period, so that you go on doing all the electives at B2 visa and then come back home change your visa to F2 and go again. It would be a muddle if u have to do a F1 rotation in between two B2 visa ones. Plus since F1 is strictly limited to the period of your rotation, returning immediately after its end would not be a problem if you are doing that F1 rotation at the end of your elective venture.

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TIPS for Choosing & Planning Elective months and rotation choices. * by Medisid ''If I have seen further it is by standing on the shoulders .During the process of applying to electives and choosing between the by Medisid ''If I have seen further it is by standing on the shoulders ...

In my opinion there are golden tips regarding Choosing and Planing Elective months and rotation choice. First of all you have to select the line that which medical line are you willing to go .Then go for the perfect preparation about the H1 and N1 visa. This procedure is happening on first come first basis.