Commonly Asked Questions about 4th Year Electives

Timing of Electives

Most students interested in Pediatrics or Medicine/Pediatrics take electives in the summer/fall and early winter.  The timing of these electives helps with career selection and obtaining letters of recommendation.  However, not everyone can do all their desired electives during the summer! This is NOT a problem.  Please do not worry if you don’t get the “perfect” schedule (there isn’t one) with your initial scheduling.  People often change their minds about career choice as the 3rd year progresses and the late spring and early summer is a big time for drop/adds. 

In particular…it is fine to do electives at Seattle Children’s Hospital through mid-January in order to be better known by the residency program at Seattle Children’s for purposes of residency selection. 

You will need to leave enough time to interview (typically about 6 weeks).  Remember that during a 4 week elective, you can only miss 2 days of the rotation.  You have to make the time up or drop the elective.  Also, when planning your schedule for 4th year, not all programs offer a lot of interviews between Christmas and New Years. 

Elective selection

In general, 4 week electives are preferred for maximal exposure to the field.  If you do only 2 weeks, you will likely not have enough time with an attending to get a letter of recommendation (if that is your goal).  Students who completed their peds clerkship in WWAMI should try to schedule another rotation (even a two week rotation) at SCH before doing a Sub I.

Completing a Sub Internship is NOT a requirement for applying to pediatric residencies.

All the electives we offer will help prepare you for residency.  Choose ones that interest you.  Electives commonly chosen by students who are applying in pediatrics or medicine/pediatrics:

Advanced Pediatrics (Sub I)
NICU (4 weeks)
Infectious Disease
Pulmonary
Nephrology
Heme/Onc (4 weeks)
Endocrinology
Pediatric ER rotation
Behavioral Pediatrics (4 weeks)
Free Teen Clinic (6 weeks-one day/week)

Other electives that students who are applying in Pediatrics or Medicine/Pediatrics often also take:

Genetics
Pediatric Cardiology (2 or 4 weeks)
Pediatric Surgery Sub I (also great for letters of recommendation-will count as a surgery selective too)
Pediatric Psychiatry
Pediatric Neurology

Final selection of electives should be modified by your own interest and conversations with your career advisor. 

Letters of recommendation from electives

You should plan on having 2 letters of recommendation from pediatricians when you apply to pediatric residency programs.  One of these letters can be from the department chairman.  In addition, letters from your third year clerkship are acceptable.  For Med/Peds programs you will need a chairman’s letter from both departments.   It is NOT expected that all of your letters will be from pediatricians. 

Electives that allow you to have significant patient care and direct interaction with attending physicians over a prolonged period of time are rotations appropriate for obtaining letters of recommendation.  The electives listed above (commonly chosen electives) all meet these criteria. 

Electives and your transcript/MSPE

It is likely that the grades from your 4th year electives will not be in your MSPE because the release date is in early October.  It is possible that some 4th year rotation grades will be included.  In general, any rotation (including your required rotations) completed in the 4th year will be reviewed by the residency program and are important; therefore do your best on those rotations, too.