Finding Audition Rotations (Sub-I’s)

Hello hello!

Long time no post. I know. I’m not sorry either, simply because my mental health has swiveled down the drain fourth year. And here I was thinking I was stronger mentally than that.

Oh well. Life is a bitch. And medical school has seriously worn me down.

But, back to what we were talking about!

So, you may or may not have ready my entry “Applying to VSAS”. There are still some good tidbits there. However, I am more aware now of some programs and how they operate than I was when I wrote that during my mid-third year. And to be honest, my school was absolutely no fucking help. Like at all. Basically they told us we needed 3 sub-I’s to graduate and after that they pretty much just got annoyed when I didn’t have my scheduled filled out on time for them to check their boxes and cross their to do list off.

Alright. I need to calm down. It’s like I’m starting to let ya’ll feel the hatred I have… I mean dislike I have for academic policies and their pencil pushers.

Back to why you are here!

What is a sub-I?

A Sub-internship, or sub-I, is the same thing as an audition or acting internship (AI). They all mean the same thing. Basically, it is where a residency program (of your choice) allows fourth year students to be there for a month and basically work as an acting intern. It is where you get to show your skills and learn all sorts of new stuff that will make you feel indefinitely inadequate (as medicine tends to do), and at the same time you are trying to get to know the program and try to get them to give you an interview. Interviews = increased chances at a residency slot.

So long story short, you work you ass off at a residency program and hope it is enough to impress some people into liking you to give you an interview and hopefully a residency spot.

No, you are not guaranteed an interview even if you do an audition. However, you are more likely to be put on a favorable list to get an interview if you do show up in person, take your time at their program, and try your little booty off in front of them. Although some places are just dicks and don’t care that you spent time and money trying to get into their program. C’est la vie.

Moving on.

How to find sub-I’s?

So, I promise this isn’t a shameless plug. But seriously all the links are in that VSAS post and I’m too fucking lazy to repeat it. Finding a list of residences through ACGME is one way. I do recommend this so you can at least see which programs are not doing well and are at risk of being pulled from being a residency or are on watch. You don’t particularly want to go to a residency if they are at risk of being pulled by the ACGME. But I digress.

Secondly, get you a FREIDA account. It gives you access to several different residencies and information on each. If they aren’t able to get you that information, it will at least give you the bare minimum and the site’s website so you can explore on your own. I’m talking how many spots they give, salaries, scores for boards and if you need both or not as a DO, childcare access, vacation days, how many DO, MD, and IMG’s they take, where they are located, average hours a week you work; all that fun stuff. They also give you the program director (PD) and their program coordinator/assistant’s information. YOU WANT THIS.

So, you do your research. By both specialty and location or just specialty. There are a lot of programs for some specialties, so you may need time for this. I’m a dumbass and always fly by the seat of my pants and it has definitely bit me in the ass more than once during fourth year BECAUSE I DIDN’T RESEARCH. But also, I’m a firm believer in the universe will put me where I need to be. I may or may not have leaned on that ideology too much. Oh well.

DO YOUR RESEARCH. FIND YOU THOSE PROGRAMS.

How to GET those sub-I’s?

Okay, so now you did your research like a good little medical student and you have programs you want to reach out to. Because most of ya’ll are super prepared and not at all like me. I will commend you for your work younglings.

Get that coordinator’s information off of FREIDA. Sometimes they have information on the ACGME list, but either way, contact the coordinator. NOT THE PD. The PD is the big guns. Contacting the PD directly could immediately make you lose your chance. They are busy, and usually have large egos (as one does accumulate if you are in charge of an entire residency program). So don’t head to the PD first.

Email the coordinator and ask about openings/auditions/sub-I’s/AI whatever term you want. Tell them you are interested in their program and would like to set something up for your fourth year. If they aren’t the ones you need to contact they will put you in contact with the right person. The following will be their response:
– Absolutely, here are the months open OR what month/dates are you available?
– Absolutely! We use VSAS, and recommend applying on there when it opens on XYZ date.
– No.
– We are not taking students for the next year yet. Please contact me/us at XYZ date to revisit this.

Now, DON’T LOSE THEIR INFO. Keep it. You want the names and emails and program of the person you spoke to and their responses. If you are able to start setting up auditions early in the year (so mid- third year, in January or February) fan-fucking-tastic! I’m proud of you. I was stupid and didn’t do this early. Not like my board scores would be helpful anyways.

I suggest making a document of some sort for this. I think I reached out to 30 programs this way. Because I did it later (like April or May or something) a lot of their responses were no or that they used VSAS and then denied me on there. Some I was able to start the process with and then once they saw my application materials outright rejected me.

THE AUDACITY. How could they? JK. Yea it stung but I’ll just talk about it in therapy or whatever.

Overall, I ended up with 2 out of my 3 sub-I’s this way. It is work, but since VSAS isn’t open that early (or at least they be slacking since COVID hit and they all use it as an excuse to not work) you can at least get your feet wet this way.

Again, save your responses and information in a document. You don’t need to enter your rotations yet for your school, but you will want to make sure you know your dates and where you will be going if you are able to secure a sub-I early.

Otherwise, you can use clinician nexus or whatever that program is and VSAS when programs open up to apply and try to find other sub-I’s. Most big academic institutions use VSAS. I find them stuffy but it was worth a shot. If you are able to secure the amount of sub-Is you want via email early then even better. You don’t even have to deal with VSAS. See that post for how to do that shit.

Google Doc For tracking. This is BASIC. I know. But if you want somewhere to start this is what I used. Please copy it to your drive and then you can edit your own version. NO I will not give you edit access to this one. Plus once you’ve copied it you can re-arrange it for how you like.

KCU students: How to enter your shit into e-value

  • Login to the portal and go to the e-value link.
  • Open e-value and and click zee schedules tab
  • You should find the link at the bottom of the small page titled “manage schedule requests”. Click that bitch.
  • The only thing you need to do, is under the first drop down (curriculum) change it to 4th year/student use.
  • Under clerkship is where you will add the elective. I.e. if it is a surgical elective versus a sub-I. It is actually pretty easy to navigate this. I know, I’m surprised too. Normally everything is unnecessarily difficult. Find your clerkship.
  • Then put your dates.
  • Next, put your site. There are A LOT. But it goes by state abbreviation and then alphabetically within the state.
  • Then put your preceptor name. I usually put UNKNOWN if it was for a sub-I and then filled out a form for unknown preceptor later. If it is at your home institution you should know who your preceptor is.
  • And then submit. It will need to be approved, but that is it. If you need to add a comment you can, but you don’t need to.

FOR FLEX TIME

  • Same as above, except for site you will put FLEX. It is there, I promise. It is under “F” alphabetically and just titled flex time.
  • For site, I just put my campus (i.e. Kansas City University-Joplin Campus)
  • For preceptor you put in FLEX, no preceptor. All you have to do is just put in flex and search and it will pop up.
  • You are welcome to put in why you are requesting flex in the comments but honestly, they don’t need to know.
  • You should be able to use 2 weeks of straight flex time (weekends don’t count as flex time) if you need to. But no more can be coupled. I used it like this to give myself more time for boards at the beginning of the year. Most students actually use it for traveling between sub-I’s/rotations, and also for holiday time around Christmas/New Year’s, etc.

FOR ONLINE ROTATIONS

I mean, I did this plenty of times since I had senioritis so bad fourth year. But you don’t have to use online rotations. It also helped give me a “rotation” in between actual in-person rotations since no one’s schedule lines up perfectly with yours. It is a pain in the ass to schedule shit in fourth year because everyone is on their own fucking timeline. But I digress. Plus, you can do it at home in your PJ’s.

  • CLMD 412 is the online course code
  • site is online course. It is under the O’s and squished between the states.
  • preceptor is online course. You will need to upload the certificate of completion when you are done with the course.

ALSO…

Your schedule requests will show up at the bottom of this screen. All of them that are either pending or accepted. You can look at things here too, especially if you forget how to enter flex/online course and you did one already. It also helps so you can see if you have any schedule gaps that you didn’t note on your own.

This is how it looks when you’ve filled out schedule requests.

Anywho, hope this was helpful. Tell your friends if you think it was, I could use the views boost. Toodles!

Internal Medicine Shelf

Sup ya’ll!

So you are looking into taking your internal medicine shelf or COMAT for your third year of medical school. Well, I didn’t do terribly on it but I am definitely a middle of the road type of student. So if you need some advice on just passing, then this is the place for you!

Your internal medicine shelf will be like a mini level 1 or step 1 exam. Internal medicine spans MANY different specialties and is the actual base of the medicine stepping stool. You need to know a lot about a lot for this shelf. So pace yourself a bit because it is a lot of information. Topics they like (at least on my shelf):

  • Screening. Know the different indications for this. I.e. colonoscopy, breast cancer screening, AAA screening, vaccinations for adults, etc.
  • Cardiac basics. I.e. ACS vs MI vs NSTEMI. How do you diagnose it. What do you order vs next steps. How do you treat?
  • Cardiac continued: there are several classifications. I.e. Diamond classification for ACS, CHADS2VASC score for anticoagulation, NYHA for CHF. They will ask questions about these. So will your preceptors, so just be familiar with them.
  • INFECTIONS. Oh man I was so mad about this. I’m terrible with infections and antibiotics. They will ask.
  • Sepsis is hit or miss. I had a lot of sepsis practice questions but didn’t feel like I had that many on my shelf personally. But either way, it is a big hitter in medicine in general and patients die from it, so understand it and how to treat it.

How I prepped:

My internal medicine rotations were back to back. So I started studying during my first rotation a little bit throughout regardless of if I was in clinic or not to try to get through some of this.

  • Online med ED videos and questions. There is a lot, and it can be difficult to get through all of it. I started with one topic and tried to dive into it. Some of it will come back from your first two years. The rest you will see for the first time (or at least your brain will think it has). You will be exposing yourself to a lot, so take it chunk by chunk.
  • Case X. Yes, very helpful!
  • Aquifer cases: more helpful for screening and outpatient medicine guidelines. Less helpful I thought for inpatient medicine.
  • Anki Dorian deck: oh yes. Wish I would have been able to get through more.
  • U world and Truelearn questions. Even if I only did 10 at a time, I tried to go through all those incorrect answers. I would pick the topics I was studying from the videos I was on at the time to really drive in the content home in my brain.
  • Case files. Helpful, just couldn’t get through that much. A good quick way to see high-yield or common presentations and how to assess them.

On my off days, weekends, or weeks where I was off to do my assignments as I am a hybrid student I tried to do a good mix of my assignments and the above. Weirdly enough my school didn’t require me to watch the OME (online med ed) videos/do questions for internal medicine which I thought was just whack. But I did it anyways, because it was a good source of information/study material for me.

My shelf exams were 125 questions. I think it is around 2 hours for a time limit? For the most part I was able to pace myself. The ending there I was a little peeved because I was worried I would run out of time. Just try not to spend too much time on one question. You can always guess, flag it, and if you have time go back and try to glean a better answer.

Anywho, good luck and cheers!