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Fourth-Year Medical Electives: Recharge Without Risking Your Resume

After three grueling years, you’ve earned some rest. How can MS4 medical electives help you recharge without sacrificing your residency application?

You’ve finally made it to your fourth year of medical school. While you know this year will include exams, completing your ERAS® and — hopefully — making plans for residency interviews, you’re also likely excited about the fact that the MS4 year is the “promised land” of medical school.

Though fourth year holds more opportunity for much-needed rest than any of the previous three years combined, you need to find a way to balance that rest with making sure your residency applications are as solid as possible. Carefully choosing your MS4 medical electives may be the perfect way to recharge yourself while also boosting your resume.

Acknowledge That Sometimes Rest Is Best

While you may be one of the few medical students who don’t feel burned out by the end of your MS3 year, know that your quickly approaching start of residency will be grueling. As an intern, you’ll have very little say in your schedule, so take advantage of the freedom of your final year as a medical student and choose at least a few relaxing rotations.

Keep in mind that fourth year is an important time for you as a physician, not just in terms of your knowledge base but also your emotional well-being. Going into your internship year already burned out will not benefit you or your patients. While you should certainly push hard where it counts, it’s also important to acknowledge that exhausting yourself your entire fourth year isn’t necessary, and it could actually be harmful if you don’t find a way to rest now.

Explore Your Interests

In your first three years of medical school, you’ve been required to take the same classes as the rest of your classmates, regardless of how interested in those subjects you were. Enjoy the freedom of choosing medical electives for your MS4 year and allow yourself to sign up for some opportunities that are unique to your personal passions.

One of my favorite classes was a course in nutrition. It’s a topic I’m interested in and had found sadly lacking in my other medical school classes. For another of my medical school friends, a course in counseling teens with eating disorders was a highlight of her year, even though she was applying to be an OB-GYN.

Don’t worry too much about only choosing classes that might look “best” if asked about them during interviews. Programs know that a resident’s personal interests are what make them unique, so give yourself permission to explore some of those interests while also getting a chance to be more memorable on the residency application trail.

Optimize Research Opportunities

MS4 year is a great time to build up your research resume, if necessary. Whether or not you can do this depends on your medical school’s policy, but many allow for elective time to be used for research as long as you meet certain requirements. Research is often more relaxed compared to a traditional clinical rotation schedule, giving you the chance to recharge from burnout.

For my own MS4 year, choosing a research elective not only helped me build up my resume, but it also allowed me to strengthen my connections within the specialty department I was applying to — while helping prevent clinical burnout, too. Plus, it gave me something interesting to talk about during residency interviews for programs that had an academic or research focus.

Seek Advice From Upperclassmen

Every school is different, and a course in nutrition might be an interesting and relaxing elective at one institution but a grind at another. Find out what an elective’s coursework is really like from upperclassmen before you voluntarily sign up for it, as online course descriptions may be deceiving.

If possible, seek specific rotation advice from former graduates from your own medical school who are now in the specialty you wish to pursue. They can provide you with excellent insight into medical electives they enjoyed taking that were also beneficial for their specialty.

Push Hard Where It Really Counts

Finally, depending on your overall schedule, know that you will still have difficult rotations to push through during your fourth year of medical school. Most MS4 years include a “sub-internship” (Sub-I) or “acting internship” (AI) rotation, where your role is to take on as much responsibility for your patients as a true medical intern would be expected to. This is an important rotation, because it prepares you for your role after graduation.

You may also need to complete away rotations during your MS4 year; performing well in away rotations can be key to obtaining excellent letters of recommendation for your residency application.

As you enter your final year in medical school, take advantage of the freedom you finally have in deciding some of your schedule. You’ve worked hard to get here, and you’ll work even harder once this year is over. While fourth year is vital for solidifying your skills as a physician as much as possible before actually becoming one, it’s also vital for refreshing your outlook on why you went into medicine in the first place. That perspective can be pretty hard to find if you’re too burned out.

Marilyn Chau

Marilyn Chau

Marilyn is a recent medical school graduate and current PM&R resident, working to find the balance between life as a busy resident and life as a new mom. She loves her field of medicine for the close connection she gets to make with patients and families as they work through their rehabilitation courses, as well as for its innovative research opportunities. Special interests within her field include pediatric and musculoskeletal rehab. She's also passionate about encouraging other women in medicine, advocating for resident well-being in general, and educating medical students on the role of rehabilitation medicine. Although she's currently spending most of her time grinding through the long hours of work as a resident, she covets her time away from the hospital and can sometimes be found running, visiting parks with her family, or trying to catch up on sleep.

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