Fourth Year (MS4)
The Sub-Internship: Making the List
- How to stand out:
- Show initiative by making the patient list, including abnormal vitals, I/Os, microbiology and cultures and other to-do items
- Reach out to nurses proactively if there is missing data
The Sub-Internship: Supplies for "The Bucket"
- Staying prepared:
- Facilitate dressing changes by having supplies to carry with you
- Staple/suture removal kits, saline flushes, paper tape, ABD pads, Tegaderms, xeroforms, kerlix, 4x4, ACE rolls, marking pens, baci, lube, alcohol swabs, Q-tips, scissors and steri strips
- Take note of dressing changes for each patient so you are ready every morning
The Sub-Internship: Operating Room Etiquette
- Getting inside the operating room:
- In the operating room, be prepared for cases (why we are doing the case, surgical anatomy, complications, expected outcomes, etc.)
- Use three unique resources for each case preparation
- Help with rolling the patient in, transferring the patient and taking the bed out of the room
- Introduce yourself to everyone in the room (nurse, anesthesia, tech, etc.)
- Record your name on white board
- Prepare patient for surgery: Security belt, SCDs, Bair Hugger, padding pressure points, securing the arms, prepping, pull your gowns/gloves and ask other residents and nurses if they need gowns and gloves
- Read the room, and don't make small talk or ask questions during stressful parts of the case
- Ask the scrub tech/nurse before taking instruments from the Mayo stand
- After the case, grab warm blankets, ask anesthesia when to bring in the bed and help the resident write postop notes or give postop sign-outs
- Check your patients postop
The Sub-Internship: Navigating the Interpersonal Aspects
- How to conduct yourself:
- An extended interview where programs get to know you, and you get to know them
- Social and emotional IQ is important
- Treat everyone as you want to be treated (including other medical students)
- Start in a more reserved manner, get a sense of the environment, observe the dynamic and program culture before slipping in
- Always be a professional, be on time and prepared, own up if you make errors and keep a positive attitude
- Show interest in growing by asking for feedback
- Be respectful of other programs – no trash-talking
- Be honest with yourself: Can you see yourself in that program for six years?
Choosing Away Sub-Internships
- Picking your away rotations:
- Away rotations act as extended interviews, so choose programs you are interested in going to (consider family, geography and program size)
- Pick rotations in different regions of the country (shows programs you are willing to move)
- Look to see how many residents at a program did away rotations there as students (most programs favor taking medical students as residents who rotated there)
Interviews: Tips for Applicants
- Acing your interview:
- Be yourself
- Know common questions:
- Tell me about yourself
- Tell me why you decided to go into plastic surgery
- Tell me about a time that you failed and how you overcame it
- Be ready to talk about anything on your application – it is all fair game
Ranking Programs
- How to rank the programs:
- Extremely personal decision
- Take notes during interviews – goods and bads
Advice for Unmatched Applicants
- What to do if unmatched:
- SOAP
- Research year
- Advanced degree
- Involve mentors early
What If You Decided Late on Plastic Surgery?
- How to get caught up:
- Decide about halfway through your third year – get letters of recommendation or away rotations
- If deciding later, important things are letters of recommendation and research – identify mentors!
- Start doing research, especially on projects that can be done quickly
- Figure out who else in your class is applying, and compare your application against them
- Consider a research year – strongly recommended!