How to Order Your Clerkships

Anna Piazza - May 16, 2019
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M3 is the year you’ve been waiting for. It’s finally your chance to be in the clinic, put your knowledge to action and really be the doctor you’ve been training to become.

This year is your clerkships—also known as rotations—year, in which you’ll continue your medical education in a more hands-on way. You’ll encounter patients in the clinic side-by-side with physicians, go through differential diagnoses and determine next steps in patient management (with the help of the attending and residents). By now you’re definitely more than ready to start, but there is still one more thing to consider before jumping in.

Sometime around the middle of your second year, you’ll get the chance to submit your preferred ranking of clerkships, choosing the order in which you’d like to go through them. (Though, check with your university’s curriculum to see how much control you have over the matter. You might only be able to choose from a few specific rotations semester by semester or go through a lottery system). This is yet another chance in your medical career to be an active agent in your trajectory, and we have a few tips on how you can choose the order that works best for you.

What Clerkships Are All About

Clerkships are your chance to start learning by doing, to take all the knowledge you gained studying the Basic Sciences and apply it through actual examinations in the clinic. Major core clerkships that every student must take include Pediatrics, Ob/Gyn, Surgery, Family Medicine, Internal Medicine and Psychiatry, while specialties like Dermatology and Nephrology will come later, in M4. Each lasts anywhere from 2 to 8 weeks, usually ending with its corresponding NBME Shelf exam. Your Shelf score will contribute to your overall clerkship grade.

How you order them will be based mostly on personal preference and how different clerkships echo or complement each other—it’s completely up to you. With that said, we’re here to help you be more mindful of, even strategic about, how you choose.

Tips on How to Order Your Clerkships

Again, there is no right or wrong way to order your clerkships, but you can set your year up in a way that can be most optimal for you. Here’s what we can recommend considering:

Start with Family Medicine

Sometimes it’s best to ease yourself into the clinic with a clerkship that gives you a general survey of clinical medicine. Starting your M3 year with Family Medicine is a great way to do that, acting as a warm-up for the more intense clerkships yet to come.

Take Internal Medicine and OB/GYN before Surgery

Many current residents insist on getting this combination of clerkships right. Internal Medicine offers the foundational knowledge and OB/GYN the OR experience you'll need for what is considered the most demanding of all clerkships, Surgery.

Take Surgery next to last

You can expect long, grueling hours of quick-thinking for Surgery. In addition, you’ll need to be both knowledgeable in medicine (and you’ll really need to be, as, in this clerkship, the team won't have the time to go into medical issues in detail with you) and technically nimble. That's why it’s best to save this clerkship toward the end, after you’ve gained experience and confidence on the wards.

Or take Surgery first

There’s also an argument to be made for choosing to take the more difficult rotations early on in the year, when you're still fresh from your studies and feeling energized. If you already know you won’t be specializing in Surgery later on and don’t mind making a few rookie “mistakes” here and there, then taking it first could be an option.

Whatever you do, just don’t leave the most difficult clerkship for last

Burnout is very real, and so you might want to reconsider putting off the most difficult clerkships until the very end when you’re already sleep-deprived and wrung out.

Consider the specialty you’d like to go into

You won't be expected to know which specialty you’d like to get into at the beginning of M3, but if you do, you could use clerkship order to your advantage. Based on what was said above, you can aim to take your preferred rotation toward the middle of M3, when you’re less prone to making mistakes and not yet too exhausted.


 

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