A Detailed Strategy Guide For Scheduling Clerkships

Now that the first administration of the American Podiatric Medical Licensing Examination (APMLE) Part I is over for second-year podiatric medical students, they are directing most of their focus to the next big step in the Class of 2021’s journey: clerkship selection. 

This is understandable as picking externships can feel like a daunting task. Empirically speaking, most students end up attending residency at one of the programs they clerked for. What makes this reality an intimidating one for students is the uncertainty behind what they want and what they will get.

Unless you have visited a program as a student, you know very little beyond what you read or hear about it from upperclassmen. Even those who visit programs during their pre-clinical years are only exposed to a very small slice of that program’s whole experience. In this article, I hope to offer some tips to help guide you through this process and hopefully aid you in the goal of optimizing your fourth-year schedule. 

Clerkship Selection In Relation To The APMLE Part II Boards

First, try to plan your schedule so that you are in your optimal study environment before the APMLE Part II exam. Some schools give students the month prior to the exam off for dedicated study (if you attend one of those schools, you can skip to the next paragraph). Generally speaking, this exam takes place either in the December or January of your fourth year. Ideally, you want to always be studying for this exam in one way or another, but you never know what your circumstances could be leading up to the exam. If you can at least control the variable of scheduling, use it to your advantage. 

While you will have to work hard no matter where you extern, some programs have more rigorous schedules and expectations of students than others. Front-loading these programs well before your board exam may work to your advantage. Similarly, picking a program closer to your exam date that is on the lighter end of the spectrum and that does not require a long commute will make for plenty of studious afternoons and evenings that can pay off on exam day. 

Clerkship Scheduling Strategy In Relation To CRIP

When deciding which months to request for specific clerkships, there are several factors to consider. Like anything else we take up in life, first times are always rusty. The extern you will be right before the Centralized Residency Interview Process (CRIP) is not the same extern you are when you first start. That being said, you may not want to make your favorite program the first externship you undertake. Conversely, you do not want to hold off on being at your favorite program until the month of CRIP or afterward as this will give you minimum time, if any at all, to showcase your hard work and knowledge. My advice is to pick a rigorous program as your first externship. Your struggles that month will pay off in all your subsequent externships. 

Next, you want to start thinking about your schedule around the time of residency interviews. Keep in mind that CRIP interviews are usually held in January and as it currently stands, these interviews take place in Frisco, Texas, a suburb north of Dallas. If January is an externship month for you and you are not limiting your residency search to a particular region outside of the South Central United States, I recommend filling that month with a program that is relatively close to Dallas. One thing that slips the minds of clerkship applicants in the midst of all the excitement is how expensive the fourth year can be not to mention the physical toll of that year. Saving money and energy anytime you can is highly recommended, especially around a demanding week like that of CRIP.

Now that I have discussed the first externship and the last externship before CRIP week, it is time to talk about the months that fall in between. Incoming first-year residents across the nation begin their training on July first. This is arguably the most hectic month of the year in terms of graduate medical education, because the main objective is to have the PGY-1 residents efficiently acclimate to their respective programs with all of the intricacies that go into training. Consequentially, the student experience during this month is suboptimal. If you find yourself struggling to decide on the placement of two programs and the month of July is one of your options, rank the lesser favorite of the two for that month. 

Analyzing The Pearls And Pitfalls Of Externship Timing

What about the months before July? Some schools send students on externships as early as January of their third year. The truth is, these months are not as valuable as the later ones for several reasons. 

First, these clerkships are taking place many months before CRIP. As a result, the impression you leave will be a more distant one come January in comparison to that of perhaps a student who rotated only a month prior. On the flip side, the memory of your experience at the program will not be as fresh as you would like when it comes time to decide on how to rank your residency choices. Additionally, if you extern before the month of July, you will not be able to meet the incoming residents. As such, you will lack an appreciation for what it feels like to work with the residents who will potentially serve as your immediate seniors. The remedy for this is to visit the program as much as possible in the months after you extern. However, if possible, avoid prioritizing your favorite programs during the months before July. 

Finally, there are what I like to call the “Golden Months.” In my opinion, these months fall between August and December. During this time, you will be at your peak in terms of experience and knowledge, and will only be a few months away from interviews. For this reason, you want to prioritize your favorite programs during these months. 

Final Thoughts

Ultimately, you will win some and lose some in the process of creating the complete clerkship schedule. Do not worry. Although what I describe in this article are ideal scenarios, many students in the past have matched at their first month’s program, last month’s program and even programs they only visited or did not visit at all. I hope to soon write a piece regarding how to capitalize on your externship experiences and will elaborate on that subject then. 

For now, focus on your third year and take it one step at a time. No matter how your schedule ends up looking by the end of the clerkship selection process, if you put in the hard work, you will succeed. Good luck on this exciting next chapter of your journey to becoming a podiatric physician and surgeon. I wish the Class of 2021 a wonderful two years ahead!

Dr. Basatneh is a first-year podiatric surgery resident at the Detroit Medical Center. He can be found on social media on Instagram: @_podiatry and Twitter: @RamiBasatneh.