Subinternship rotations are one of the most important parts of the clinical phase of medical school. These rotations—sometimes abbreviated as sub-I or called acting internships—offer a taste of life as a first-year resident physician, giving medical students increased responsibilities and more direct patient management. Excelling in these rotations can strengthen your residency application and prepare you for the next step in your medical training.
But what does it take to stand out? Fresh from completing their subinternships, two fourth-year medical students shed light on that question.
Know your patients
Success starts with preparation. During a subinternship rotation, you’ll carry more responsibility, and that means knowing key details about your patients.
“One compliment I got was that I did very thorough chart reviews” said AMA member Julianna Sim, a medical student from Ohio. “I had more knowledge of a patient’s history than some of the residents did. I had fewer patients and more time to dig into the full chart background with the patient.”
The AMA Succeeding in Medical School series offers tips and other guidance on a wide range of critical topics, including preparing for the USMLE and COMLEX exams, navigating clinical rotations, publishing scientific research, and maintaining optimal health and wellness.
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Act the part
During a subinternship, a medical student is expected to act the part of a first-year resident. That means you function much more independently than you would during a clinical clerkship rotation.
During clerkship, “you're probably taking on one patient, and you're just learning that one patient. And then by the end of the rotation, maybe you have three to four patients that you are kind of managing,” said AMA member Anand Singh, a medical student from Texas. “But then, as a fourth-year student on a Sub-I, you're expected to do more.”
Doing more can mean taking ownership of a patient with tasks like following up on labs and communicating with the team.
Singh chairs the AMA Medical Student Section (AMA-MSS) Governing Council. The AMA-MSS strives to be medical students' voice within the AMA for improving medical education and advocating the future of medicine.
Be engaged
During rounds, it’s easy to focus on your patients and tune out when other patients are being discussed. That’s a mistake, Sim said.
“When the team is not talking about your patient, it’s still important to be actively engaged,” said Sim, who is the diversity, equity and inclusion officer on the AMA-MSS Governing Council. “People notice if you’re looking at your notes and thinking about what you’re going to say next instead of focusing on what’s being discussed.”
She added that listening closely on rounds helps you learn and shows attending physicians that you’re invested in the rotation as a whole.
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Show you’re a team player
Your ability to work well with the entire team is crucial. During subinternships, you’re not just being assessed by your attendings—residents, nurses, and staff will have input, too. Simple things like checking in with nurses and co-residents make the right impression.
“Everyone’s evaluating you; they all talk. And so nurses can talk to our attending physicians, and vice versa,” Singh said. “If you don't treat everyone with respect, how you want to be treated, that will get around really quickly.”
Professionalism is paramount
Be on time, follow the dress code and bring a positive attitude. Even if your subinternship isn’t in your preferred specialty, it can still offer opportunities for growth.
“I was on a rotation with another student, and they asked if they could leave early [for the day] and go home,” Sim said. “That reflected poorly on them and it was definitely noticed.”
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