Elective Planning - Class of 2020

Message sent to the Class of 2020 by Dean Mellman (11.16.18) 

Dear Class of 2020,

Many of you are starting to think about your schedule for D&I. We will have the duplicate D&I meeting on November 29 at 6:30 p.m. in VEC 201, and will go over the information below and sample schedules in more detail.

Although our elective registration for March-June 2019 doesn’t begin until the 3rd week of January, I thought this would be a good time to provide some advice about structuring your schedule based on your particular career interests and the timeline for electives and scholarly project for your specialty.

You will have 14 months for D&I, from March 2019 through April 2020. The requirements include:

  • 8 electives of which 5 must be clinical, 5 must be at CUMC or an affiliate (these don’t have to be the same as the 5 clinical), 1 must be a subI at CUMC or an affiliate in medicine, pediatrics, general surgery, or SICU, and 1 must be Ready4Residency (R4R) in March or April 2020.
  • 4 months of scholarly project (if you do a dual degree or take a research year of 12 months, you can choose between doing a scholarly project or doing 4 more electives). Students doing Scholarly Project Plus will have a reduction in their nonclinical elective allowance to compensate for the increased SP months. The last month available for SP is March 2020.
  • 2 months for residency interviews in Nov, Dec or Jan (depending on when your specialty interviews). Most interviewing periods take up 2 months. At least 1 month must be used only for interviews and not scholarly project or electives. Some students make the 2nd heavy interviewing month a scholarly project month if their mentor agrees so they can work from the road during interviews. That way they will have a month available for vacation for later if they wish. If you are traveling widely for interviews you may need to designate both months just for interviews.

To think through which electives to take, ask yourself:

  • What will help me decide on a specialty? (usually 1 elective in each specialty under consideration is enough) (March-Aug)
  • What will help my application? (subI in specialty and 1-2 other electives in specialty-anything that could lead to a letter of recommendation for residency) (March-Aug/Sept)
  • What additional electives will make me a better intern (see file of suggested electives for specialty in Courseworks P&S Career Advising) (March 2019 –April 2020)
  • What will be fun and I’ll never get to do again? (typically Oct 2019-April 2020)
  • Do I want to take a global health elective? (typically taken in Feb-April of final semester)

Goals of first 6 months of D&I and planning for your residency application

The goals of electives in the first 6 months (March through the end of August) are to:

  • decide on a specialty,
  • complete a subI at CUMC in your specialty (or do another type of senior elective in the specialty at CUMC if there isn’t a subI in the specialty), and get a letter of recommendation for the residency application,
  •  complete audition electives at other schools (if expected for your specialty or if you are interested in checking out a program) and get a letter of recommendation from them
  • For away electives, be sure to find out when visiting student elective registration opens at schools/hospitals you are planning to apply to, particularly applying early for any of the most competitive specialties (check to see if they are on VSAS and if not, go to the school’s website for visiting students). Many visiting student sites open in March/April for registration but some competitive specialties open as early as January, so be sure to check VSAS or the away school’s visiting student site to check for when it opens.  There are many specialties in which an away elective is not necessary. Away electives are typically important in the surgical subspecialties, emergency medicine, dermatology and radiation oncology. 
  • In addition, for most students, the goal from March to October is to complete 1-2 months of Scholarly Project (2-3 for very competitive specialties) so you have something scholarly to talk about on your residency interviews.

Letters of recommendation for residency

We will go over who to ask for your letters when we meet for your MSPE and career advising meeting. Most of you will want to hold off on requesting your letters until the summer, when you have elective evaluations back and you know exactly which ones to ask for. 

Residency programs want 3-4 letters of recommendation in your application, all as clinical letters except 1 research letter from scholarly project (if you’ve had enough SP to warrant a letter) or a research year (you always should have a research letter if you did a research year). August is the last elective month from which to comfortably get a letter of recommendation. Letters can sometimes come from a September elective, but that is riskier because the writer needs to upload it in September, and some programs want all letters by September 15 when your residency application becomes available to them. October 1 is when the MSPE is released by ERAS.

In the surgical specialties, all the letters usually come from electives and scholarly project/research year in that specialty. In other specialties usually 2-3 letters come from the specialty, often 1 of them from a subI, and the last letter can come from a different specialty.

MSPE and electives

We place onto your MSPE the grade and narrative comment excerpts from one elective of your choosing, taken between March and July. Students usually select their CUMC subI for this, and if not, a consult or similar elective from the specialty at CUMC or Allen. So this means you probably want to complete a subI by July in case you want it to go on your MSPE.   

Specialty specific suggestions for schedules:

Students applying to very competitive specialties (e.g. surgical subspecialties, radiation oncology and dermatology):

Between March and August

  • Complete 3 subI’s in the specialty (1 at CUMC and 2 away-ask a residency advisor in the specialty where to do your aways, tailored to your geographic interests and credentials), (some students have done 2 subIs total in oto and ophtho but most do 1 home and 2 aways)
  • Complete 2-3 months of Scholarly Project in the specialty between March and September/October. Scholarly project should be in the chosen specialty if possible.
  • Students deciding between specialties should do one elective (CUMC) in each and then 2 more (away) in the chosen specialty.
  • Students without honors from MCY and with Step 1 in 230’s or below should consider taking a year for research if applying into a highly competitive specialty.
  • An away elective in September in a very competitive specialty may be ok if necessary if a letter from the elective is uploaded by the end of September or if a letter is not needed from it.

Students applying to moderately competitive specialties (e.g. anesthesiology, emergency medicine, OBGYN, general surgery, radiology):

Between March and August

  • Complete a minimum of 1 elective in the specialty (at Columbia)
  • Complete 1-2 additional electives in the specialty (1 at Columbia or away, and if a 2nd, at an away) with the intention of getting a letter of recommendation from each for your residency application.
  • Complete at least 2 months of scholarly project between March and September/October. Scholarly project should be in the chosen specialty if possible.

Undecided students deciding between a 2-3 specialties:

  • In the first few months of D&I, complete 1 elective in each specialty to decide, and then 1-2 more in the specialty selected for residency by August (2 more if a highly competitive specialty)
  • Complete 1-2 months of scholarly project by September, in the specialty for moderately or highly competitive specialties.

Students applying to less competitive specialties (e.g. medicine, pediatrics, family medicine, neurology, psychiatry):

Between March and August

  • Complete a minimum of 1 elective in the specialty (at Columbia)
  • Complete 1-2 additional electives in the specialty (1 at Columbia or away, and if a 2nd, at an away) with the intention of getting a letter of recommendation from each for your residency application.
  • Complete 1-2 months of scholarly project between March and September. Scholarly project should be in or can be generalized to the chosen specialty if possible.

Students with top grades and high Step 1 (240s on up) and/or applying in a less competitive specialty probably don’t need to do 2-3 months of their scholarly project early to bolster your application. However, all students should start SP by Oct so when you start interviews so you can talk about it.

Students with few or no honors and without honors in the specialty you are applying to and/or with low Step 1, (229 and lower) should focus on performing well in the subI and other electives in the specialty as the higher priority over completing most of their scholarly project by August. Doing both is even better.

We strongly urge you to self-assess your profile for the specialties you are interested in by reviewing the P&S Match Profile data in the Courseworks Career Advising site. These are profiles of P&S students who have matched into the specialty in the past 2-3 years. We will discuss your specialties of interest and your profile and feasibility of matching in our individual Career Advising and MSPE meeting.

In sum, deciding on a specialty and registering for and taking relevant electives to aid in that decision, as well as electives appropriate for your residency application is a process. We in the Office of Education are here to help you with it. Feel free to speak with your advisory dean, Class of 2019 students (a great resource- in early December we will get you a list of students willing to be contacted), faculty advisors (also found in Career Advising site) and/or me with your questions.

You are welcome to come to my office hours to briefly go over your elective plans if you don’t have an MSPE and career planning meeting before elective registration begins. I will double the office hours Jan 3-17 for your class. 

Lisa A. Mellman, M.D.

Senior Associate Dean for Student Affairs

Samuel Rudin Professor of Psychiatry at CUMC

Columbia University Vagelos College of Physicians & Surgeons


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