After you submit your list in February, the focus of medical school changes. Priorities morph to gaining clinical skills that will be needed as an intern and increasing your knowledge-base. Take electives that will enhance your ability to do and think independently. Some electives to consider in the fourth year include:
- General Surgery Sub-I: You will get to see cases that you were unlikely to see as a 3rd year and would probably not get a chance to scrub in on as an intern. This will also prepare you well to run the floor. Always be present, as no one will come looking for you to give you surgical experience.
- Medicine Sub-I: Every patient you will have from now on will have medical comorbidities. Learn how to manage hypertension (HTN), diabetes mellitus (DM) and chronic heart failure (CHF).
- Radiology: Be sure to take this rotation if you did not do so in your 3rd year, as a large part of neurosurgery is neuroradiology, and the acuity of our patients requires that we read our own films immediately and correctly.
- Cardiac or Neuroanesthesia: This is a great rotation to learn to do central lines (every cardiac patient gets one in the OR), intubate and to understand the basics of anesthesia.
- SICU or TICU: This is the place to gain critical care skills, including ventilator management, drips and do many procedures.
- Plastic Surgery: This is a good rotation to perfect your suturing and wound management skills, which will be some of the first things that you will need to demonstrate as a resident.
- Infectious Disease: Thorough knowledge of infectious disease treatment is essential for any surgeon.