Selecting the Best MS3 Clerkship Track Order

Am I going to go over a couple of factors to consider when selecting your 3rd year clerkship track order? Absolutely. But is there some magic formula to picking the “best” or “perfect” one? No. Plus, at the end of the day, it doesn’t matter all that much. Clerkship track order really won’t make a substantial difference on your success as an MS4 – no, that’s up to your individual effort. So, even if you do not get your 1st, 2nd, or even 3rd choice, please, do not panic and make the best of it.

Understanding Clerkship Track Options

The current 6 options for tracks feature either a front-heavy or a back heavy schedule. The heavy-hitting clerkships are classically Surgery, Internal Medicine, Pediatrics and OB/Gyn. Generally, any specialty that requires a lot of inpatient work will demand much more time. This past year, the tracks and a couple of the clerkships themselves have since changed to reflect real-world practice.

Current Clerkship Structure

• Surgery and OB/Gyn: From what I know, these specialties did not see any major revisions.
• Pediatrics: This was lengthened out to 8 weeks, allowing for more time in a private practice, outpatient setting.
• Internal Medicine: This features a 1-month outpatient and 1-month inpatient schedule, which is a much better balance because most internists/sub-specialists practice in an outpatient setting and it gives you a glimpse into the sub-specialties.

Tips for Selecting the Best Clerkship Order

Now… for some tips to select the best clerkship order for your goals:

1. Evaluate schedule density. Ask yourself if you want a front-heavy track or wish to ease yourself into the year by selecting a back-heavy track. Are you the type of person that likes to “get the hard stuff out of the way”? In the spring semester, many of you will be trying to arrange your away rotations, plan/study for Step 2 CS/CK and get things in order for ERAS. Having a steady 8am-6pm Monday thru Friday type schedule will make this planning much easier.
2. Strategically place your specialty of interest. Try to put the specialty you are most interested in toward the middle – but be wary of the last clerkship of 1st semester because you will be burnt out. This is the optimal placement because after a couple of months, you would have gotten the hang of how to get around the hospital, how to navigate the electronic medical record [Epic], and how to use UpToDate like a pro.

Timing and Burnout Considerations

My recommendation is that you should put the specialty you’re most interested in at the beginning of second semester. You don’t want to wait too long because knowing what specialty you’ll be applying for at the end of the year and planning for 4th year is much easier when you’ve answered that looming question of “what am I going to do when I grow up?” Be aware that even with an “easier” first semester, students were still tired and ready for a break by the time December rolled around. That low level of general enthusiasm for being at the hospital or clinic really does not bode well for impressing your residents and attendings, who you may be asking for a letter of recommendation from.