what fourth year electives to take?

[dr2b0804]

Hi, I'm getting ready to start my fourth year electives and I was wondering what the best ones to take would be (in terms of what residencies want/require). Is neurology required? Thanks!

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[ckent]

I'm pretty sure that most, if not all, psychiatry programs require electives in neurology during residency. If I were you, I would do electives in medicine, endocrinology, and ER. Medicine because if you want to be an in-patient psychiatrist, you will probably have to manage a lot of their medical conditions when they are admitted. I know that a lot of in patient facilities don't have any other physician's other then psychiatrists on staff. That's why psychiatry programs require medicine during residency too, but you can never get too much medicine training. That's why I'd reccomend doing ER too, because I know that most of the times, when a psych patient codes or goes down the tubes medically, they have to call an ambulance. While they are waiting for the ambulance which can take 10-30 minutes, it will be your job as the psychiatrist or the only MD in the area to stabilize the patient and if necessary, rescusitate the patient or at least direct other people to do it. The MD is always in charge of such situations on hospital floors. It can be pretty frightening if you have an in-patient ward full of depression with co-morbid panic disorders and you get called about chest pain all the time, you can't just call 911 every time, you have to know how to evaluate the patient to figure out whether or not they really have to go or whether or not you can keep them at your facility. ER would be perfect training for this, but I don't think that any psychiatry residencies require this. Finally, I would choose endocrinology because a lot of psychiatrists mis-diagnose people with mood disorders when they in fact have an endocrine disorder. If you see it enough, you will get more comfortable with the presentation of endocrine disorders and have that in your tool chest as well. It's just like they say, if you only have a hammer, everything starts to look like a nail. In other words, if you only know psych, everything starts to look like psych.

 

[Asher]

I may be mistaken but I think ckent was referring to electives during your intern year. Most of the programs I've looked at have PGY-1s doing six months of psych, four months of primary care (combination of medicine, peds, family, ER), and two months of neurology.

 

[Big Lebowski]

I cannot think of any 4th year electives that psych residencies would "require" you take during med school.

The beginning of the 4th year, you should take electives where you could get a strong LOR. Whether this is psych, med, neuro, whatever. The med sub-I is good for this if you do well. Also, if you are considering any away rotations at programs you will be interviewing at, I would do them early.

Any "medicine" elective is a good idea, especially since most programs will only have you do 4 months of primary care during residency.

Otherwise, fill up your schedule with something fun. This is probably the last opportunity you're going to have to take just about anything in medicine. I took forensic path, history of medicine, and an alternative medicine elective at the end of my 4th year and loved them.

Good luck...