Fear

If there's one word that can strike fear into my heart it's CLERKSHIP. I will be starting clerkship next year. For those of you who don't know, clerkship is when medical students start actually working in the hospital full time. Essentially the lectures are over and the real learning begins. Clerkship is the new thing that keeps me up at night.

Having recently got my schedule for clerkship, things are becoming a lot more real to me. Fortunately, I almost got the schedule I wanted. Unfortunately, my school has a policy where one can switch their family medicine block with electives, meaning that everyone in the class put family medicine in their top 5 rotations***. This switch really disadvantages people who want to actually do family medicine. I have family medicine in the very last block, after CaRMS (Canadian Residency Matching Service). This means that when I apply for residency I will not have completed my family medicine core rotation. I wonder if this will look bad to residency program directors when I'm applying to do family medicine. Most of them probably understand that it's the luck of the draw, but what if they don't. I know that family medicine isn't very competitive but the programs I'm looking at are extremely small and I want to get the one I want! CaRMS is the point of no return - you have to take whatever position you match to, so I want it to be a good one!

Right now I'm trying to plan electives in order to show my interest in family medicine but also my diversity as a student and my other interests. So far know I'm doing a rural family elective way up north which is confirmed. My other elective time I hope to spend in Obstetrics, ER and dermatology. A fellow blogger suggested that derm would be a perfect elective for family medicine, and I really appreciate the suggestion as I hadn't really thought about it until then! My big dilemma is whether to do an ER elective that's family medicine based (part of the time is spent in the office) or one that is purely ER based.

I find it hard to make decisions so far in advance, but elective forms for some schools are due up to 12 months in advance and you really have to get on it if you want to get your first choice! And then, on top of that, is the huge amount of money in administration fees we have to pay other schools to process our applications. I wish there was some kind of reciprocal agreement between schools that this would be rolled into our tuition. Medical school is a giant money pit!

*** I've been asked for an explanation of this so here goes: Because at my school we only have one set of electives before CaRMS and they're in the second slot after block 1 of our clerkship you don't have lot of experience before you go out and try to impress people. If, say, you got family medicine in block 4 you could put your family medicine in the electives time and electives in block 4, meaning that you would have much more time to get experience (blocks 1-3 + family) before you went on electives and thus would seem a lot smarter. In addition, some electives require you to have done your core rotation in that subject before you can do an elective in it. By doing the family switch you can get in more core blocks, meaning that you can complete your core prerequisite more easily.

But, only a set amount of people can have family medicine in each block. People who want to do the switch really want to have family medicine in blocks 3 or 4. We get to put in a request sheet for our top 5 subjects and which block we want our number 1 subject to go in. So, if say 50% of my class wants family in block 3, and they submit request slips saying family is their top choice and they want it in block3, it is likely that trying to accommodate all of those people will fill up a lot of the family spots in early blocks because if they don't get it in block 3, the algorithm is likely to give them family in other blocks around the same time, i.e. block 4 or 5. To make a long story short, this makes it hard to get a family medicine rotation in a top block. Especially since I wanted to rank Obs/gyn as my number 1 block in order to get a prerequisite for electives. I know it's all complicated and this probably doesn't make sense to a lot of people!