This past week I witnessed and participated in something I would say is akin to the secretive and mysterious process of choosing a pope…ranking ortho sub-interns.
For the uninitiated, sub-interns are 4th year medical students from Hopkins or from other medical schools who spend 2-4 weeks rotating at our hospital to find out if they would want to spend the next 5 years here as a resident and to give the residents and attendings here a chance to see if we would want them here. There are a lot of things that go into doing a good job as a sub-intern but I will go into that in some future post.
The ultimate job of ranking sub-Is is done by the chairman and program director. However many residency programs value the input of the residents because we have had the most contact with them and we will have to deal with their shortcomings if they match here. Here at Hopkins we have a powerpoint presentation with the pictures of all the students who rotated at our program. As each rotator’s picture is displayed the residents as a whole have the opportunity to voice how much they liked or disliked the applicant.
It was truly a surreal experience to be part of this process because just 1 year ago I was still a 4th year medical student, rotating at Hopkins, hoping that I had impressed them enough for them to rank me highly. Seeing the process now as a resident I saw how easy it was to rise quickly to the top of the rank list or drop to the bottom. It lead me to offer this advice to MS-4s who are are rotating around the country for different residencies:
- Try to get to know as many residents as possible at the program, because you want multiple residents vouching for you during the ranking process
- It was very rarely mentioned that such and such student was smart but really couldn’t suture well. Don’t fret if you mess up once in the OR. That will not hose you as much as pissing off a resident or attending in some other way
- Students rose to the top of the list when it was mentioned that they were 1) extremely hardworking not just in front of attendings but residents also and 2) were cool to hang with outside of the hospital
- Students who’s pictures popped up and no one could really remember them rotating were shot down to the bottom of the list. Meaning, if you spent 1 month at a program and no one can remember it, you did not do a good job
- Never ever ever lie. If you are caught in a lie while rotating you are finished.
Sitting through this process as a resident, I remember being a MS4 and fretting about messing up on a subcuticular stitch. After that day I was sure that I had completely destroyed my chance of matching at Hopkins. But there is a lot more to being a good rotator than perfect suturing skills. You will definitely learn those manual skills as a resident. What most programs seem to look for are hard workers who are fun to work with. I saw many a high board scorer drop low on our list secondary to not working hard enough or having personality that wasn’t interesting to be around. With that being said, if you have the combination of good scores and a strong rotation, then you are golden.
Part of me wished I could have been a fly on the wall last year when these same residents were discussing my rotation. Who liked me? Who advocated for me? I will never know, but I truly praise God for the favorable outcome.