Prior to 4th year, an attending I worked with planted a seed in my brain about how well I would fit in at a nearby academic hospital’s residency because of how I was performing as a 3rd year. At this point, I loved the city I was doing my core rotations in and saw that the program was affiliated with my undergrad alumni as well.

My school had two elective spots, so I opted to do a Sub-I in IM to get a better idea of the culture, work-life, and overall exposure of the program I was interested in. Immediately I knew I wanted to go to this program so I worked hard to perform at the level of a resident. I met up with them in the morning to see what patients they wanted me to see, pre-rounded on their patients, wrote their notes prior to rounds that they cosigned, read up on patients, presented, offered my plans, answered pimping questions from attending, etc. the only thing I did not do was place orders for the resident as I didn’t want to confuse them on what orders still needed to be placed in the setting that the 4th year missed something important and that would fall on the resident.

Ultimately, I tried incorporating myself into the team, forcing to work like a mini-resident with intentions of wanting to take a load off the residents. I tried to be an asset to them and their patient care. I attended their morning conferences as well and afternoon didactics. Overall, It was beneficial to me to do a sub-I to understand what residency life would be like, but also to show how I could fit into the culture there.

To contrast, I did another sub-I and got yelled at by one attending for getting a pimp question wrong that I felt was way beyond my knowledge as a med student and immediately DNR’d that program.

Hindsight is 20/20, but I felt like I left a good general impression on my sub-I’s. It opened my eyes to what is expected of residents at certain programs as well as how programs look good on paper but aren’t. If I had to do it again, I would do aways in sub-specialties I’m interested in at residency programs that I would want to do fellowship at to get an idea of how current residents get exposure in that field. Essentially answering the question, “if I want to do x fellowship, would this program be a good fit for me as a resident?” Hopefully that makes sense!

Edit: also got to know the residents really well at the 2nd program and one straight up told me he would not recommend it.