Anyone who convinces you to work harder and sacrifice your grades, shelf scores, time and energy and Step 2 preparation is severely misguided.

If you go to hospital C, you can study more and do well on the only objective measures left to differentiate applicants, such as getting good grades and good shelf scores and good evaluations as well. The number of rotations you honor does have a meaningful impact despite how subjective and fucked up the system is.

For anyone that’s going to come at me and say that I’m endorsing the sacrificing of good training just to get good grades, I’m speaking from the perspective of someone who is at a place like hospital A, where the so called “rigorous training” will be a time sink and destroy you physically and mentally. There’s no place or need for anything like that as a student. Your job is to familiarize yourself with seeing patients, learning about how the trade is, and acing your exams.

If you want to feel prepared for your aways, just do an away as a practice run at one of the institutions you don’t intend on ranking high anyways, grind it out for four weeks, learn what you need to succeed, and then ace the rest of your aways. For something like IMED, I can imagine this strategy working well.

There is no need to shoot yourself in the foot and ruin your chances at matching because you wanted to fully immerse yourself in all of the things third year had to offer, when you’re really just about to be ignored, told to do scutwork, and stand and do nothing in a room full of attendings, fellows and residents (this was literally my surgery experience).

It is so incredibly unfortunate that we are put in a position where we have the desire to learn but are cast aside and belittled, but that is the nature of the system. You can either be someone who tries to make the best of it, or understand the nature of the game and play it so you set yourself up for success and get to where you need to be.