4 Sub-Is

[userguest1000]

What is the verdict on whether doing 4 sub I rotations?

[Guest]

During your interviews you will be asked, "Why do the rules not apply to you?", and you better have an answer for why you didn't follow the SNS guidelines. Don't be that guy. Do your 3 and do them well.

[Guest]

first of all, the SNS guidelines are merely suggestions, not rules.

"More than three total AI rotations in neurosurgery are not advised as students are expected to focus on building a diverse clinical skill set prior to residency training."

i encourage every applicant to decide whether they want to take these suggestions (i, for one, do not see how a diverse clinical skill set and four subIs are mutually exclusive). if you can make it fit your schedule and feel confident you can perform at a high level for 4 subIs, then you should absolutely do it. there is no better way to leave a good impression with programs.

[Guest]

Are you involved in any way with the selection process? Sure, they are recommendations that can't be enforced. But I would not advise ignoring the guidelines that the organization that essentially governs the residency application cycle. These aren't random people, these are program directors/chairs who donated their time to create this process for a reason. You might think it will show your work ethic and ambition, but what it really reveals are try-hards who will do anything to 1-up the next person. I can promise you the marginal benefit from doing an additional sub-i is not worth it compared to the perception people may have on it.

But hey, just my 2 cents. Like I said, if OP does this, be prepared to answer why you think you are special compared to your fellow applicants, because at my institution we WILL ask you.

[Guest]

yes, I am. with all due respect to its members, at my program the sns as a governing institution is a busybody that seems to like the smell of its own farts a bit too much. and admittedly i am surprised to hear that anyone cares what they think. must be my bubble speaking, but i am confident we are not alone.

at least this brief discussion should be illuminating to applicants. some places will care deeply, others will not at all. thus generally speaking, to minimize pissing people off, i guess the other poster is correct. though if you are an applicant with an otherwise weaker than average resume, i still contend that a subI is your best chance to shine and you should maximize your aways. caveat lector.

[Guest]

I truly do agree with you regarding SNS, and the fact that their words are that important to some is mind-boggling. I would run things much, much differently lol. It is interesting to hear how your department views it. I'm all for not regulating what applicants should or shouldn't do, so long as those without the means to do >3 are not at a disadvantage. My advice is not my own thoughts on the matter, but what the reality is, perhaps in only my regional bubble. Everything I said above was advice to OP and applicants based on my experiences and feedback from our school's recent matches.

[Guest]

bad to do >3. perpetuates inequity, can't follow guidance/ direction, poor planning aka couldn't pick 2, concern over doing bad on subI or did bad so need to do more, trying to gain unfair advantage, not willing to round out medical knowledge via other electives, blah blah blah ... just follow the recs and move on.

[Guest]

4 sub-is means someone can’t perform well consistently enough and be confident in themselves enough to do 3. What does that person do when they have ONE shot at getting something right with permanent consequences for fucking up? It’s also an issue with a whole mess of other things like decisiveness, strategic thinking, critical thinking, etc. It would be seen by us as the same as a low step score: an obstacle to overcome, not a benefit.

[Guest]

^ I see your point, but does everything really need to be taken to such extremes? Not everything people do is a reflection of how they would behave in a critical situation.

Constantly on this site you see posts bearing the sentiment of “Oh, you did/didn’t do X? Well how will you EVER handle y!?” Even though X and Y are quite unrelated.

Many people do 3 aways for many good reasons. Not because they lack decision making skills. As above, some programs may not like it, but plenty also don’t care. I say this as someone only doing 2 sub-is.

[Guest]

It’s the same as why better Step or research means higher chance of matching. Those who decide think it helps predict who will be a better resident. We don’t have a lot of data-driven factors to go off of in terms of predicting who will make a good resident. If we did, our attrition rate would be better. You can’t Moneyball it because there’s not enough good data and a lot of noise. All we have is what we think is important based on our experience.

It is the applicant’s burden to assuage concerns about the application and convince programs to rank them highly. The program does not need to justify why it’s not choosing 390 of 400 people to rank in the top ten.