An Intern’s Advice on Thriving through Fourth Year

20 Jun 2018

As I was entering my last year of medical school, I did not feel like I had a good source of information for navigating the demands fourth year, so I decided to write this post in hopes of providing my advice on how to be successful as a female medical student entering surgery. I have attempted to touch on all aspects of fourth year from away rotations to ERAS to interviews. I have also attempted to stress the importance of staying true to yourself as you conquer the exciting, yet challenging, year ahead of you.

Define your role. Be straightforward in asking what is expected of you. Rotations as a fourth year student can be frustrating because you’re dying to show that you can take on more responsibility, but you’re limited by what you can do as a medical student. Try to see the positive in getting to focus on learning, with no true responsibilities.

Away or visiting rotations are becoming more common and provide a great opportunity to see different programs. They can be very beneficial if you’re willing to work hard and make a good impression. Know the reason why you’re going to a particular program and what you want to get out of the experience (recommendation letter, connections, location close to a significant other, etc). You need to be 120% committed and should treat it like a month long interview. Even if you find out the program isn’t right for you or the program doesn’t offer you an interview, stick it out and give it your best every day. No one can fault you for that.

On ERAS, the safest thing to do is apply broadly with programs distributed in a bell curve. Most applications should go to programs where you consider yourself an average applicant, and fewer applications to programs you consider your fall backs or reaches. Start working on ERAS early. It takes much longer than you would think to transfer information from your CV into their format. You want to have something in every category (research, work experience, volunteer experience). Remember that everything you list is fair game during interview season. Don’t lie or embellish your role. You need to be able to talk intelligently about your experiences and how they impacted you.

Have a pitch. You are your biggest sales representative on your application and during interview season. Figure out what it is about you that will make a program want you–how are you going to make that program better, or how are you going to change your field for the better? And say it with confidence.

Ignore the “too’s.” You’re too nice, too smart, too pretty, too something that makes people think you should try something else besides surgery. Only you know what’s right for you, so stand firm in your truth. There is no one way a surgeon looks, or acts, or talks. And that’s great! That diversity is what drives us forward as a field. So don’t ever think because you’re different, you can’t be a surgeon.

Interview attire: conservative is always the way to go. It might help you to find something, a shirt or pair of earrings or shoes that when you put them on makes you feel like you’re ready to take on the world. For me, it was a coat that made me feel like my most Olivia Pope self. For the interview dinners, it’s better to be overdressed than under-dressed.

Be kind to yourself. You’re going to meet people on the interview trail who blow you away, and it’s easy to start comparing yourself to them (especially because you know you’re being compared to them behind closed doors). But your accomplishments and path to surgery are just as valuable and worthy of being heard. It’s hard not to anchor your self-worth to your rank list. But remember you are more than which programs you list 1, 2 and 3.


Emily Barrett is a general surgery intern at the University of Michigan. She is originally from Arkansas. She completed her undergraduate education at Hendrix College, and her medical education at the University of Arkansas for Medical Sciences. Her clinical interests are surgical education, global surgery, and critical care. Her twitter handle is @Emily_CBarrett.

Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author and are not necessarily the opinion of the Association of Women Surgeons.

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