Things to consider when choosing your Family Medicine Sub-I
Sub-Is are a valuable opportunity for you and a residency program to get to know each other. A FM Sub-I is STRONGLY encouraged if you are considering applying in FM. A FM Sub-I will fulfill your Advanced Patient Care Clerkship Requirement.
You only need one letter of recommendation from a family physician for your FM application, and you do not need a departmental or chair’s letter.
Be careful of generalizations! Every site is unique. These tips are just a start to help you make your decision. Wherever you go, the more you engage in your learning, the better your experience will be.
Timing of Sub-I
Early (Spring A- Spring C) Sub-I results are typically reflected on the MSPE. Summer A is often on the transcript, both materials contribute to your ERAS application. An Honors grade on your Sub-I can also be a plus for your transcript. Early sub-Is (Spring A through Summer B) give you a chance to get a letter of recommendation LOR for your ERAS application. (You need one letter of recommendation from a family physician for your FM application, you do not need a departmental or chair’s letter). We encourage an early Sub-I if you don’t think that your FM clerkship faculty can write a strong LOR for you, if your FM grade was a pass, or if you are trying to decide between FM and another specialty.
If none of these conditions apply to you, a later Sub-I (Summer C- Winter A) offers a good chance to get to know a program that you would like to apply to and can be easier to schedule since these slots are not as competitive. This may give you a better chance of getting the residency of your choice. Obviously, it is important for you to perform well. Sometimes programs will offer to interview you while you are there for your Sub-I. A later Sub-I can help your application anytime up to early February when programs and applicants submit their rank lists.
Which Program is right for you?
Do a Sub-I at a program that you may apply to or an area you would want to live in. For example, if you know you never want to live in Seattle in the future, don’t choose a Seattle site.
It can be helpful to think about what type of FM program would be a good fit for you. Think geographic location, program characteristics (eg., academic vs community programs, more or less OB), size, etc. Some programs have special tracks (eg, sports medicine) for residents and may have affiliated fellowships (eg, addiction medicine).
Special Circumstances
If you have had academic challenges during medical school (e.g., STEP failure, mostly Passes in your clerkships), it is a good idea to speak to a FM specialty career advisor (Drs. Sairenji, Christian, and Ellenbogen) to come up with Sub-I strategy together. CLICK HERE to make an appointment.
Plan Ahead!
All 4th year students applying in FM should plan to attend the AAFP National Conference. It is a good idea to schedule a flexible rotation so you can attend. FM Sub-I rotations are also good as all of the programs will be attending the conference too.
FAQ
- Should I do a Sub-I even if I honored my FM clerkship?
In addition to the other points above, Sub-Is demonstrate commitment to the specialty, so it is still a good idea to do a Sub-I, especially if you are thinking of staying in Seattle, as some of these programs are very competitive. That way, you can make a good impression on your Sub-I and increase your chances at matching at that program. - Can I do more than one Sub-I?
You can, but you don’t have to. You may not get your very top choices for all of them, but we try to help accommodate student requests. The limit for FM Sub-Is is three. - Can I still apply to FM if I don’t do a Sub-I in FM?
Yes, it is possible, and some students do. If you do a Sub-I in another specialty that you feel would benefit you as a family physician (e.g., general surgery) make sure to address that in your personal statement. - Can I do a FM Sub-I even if I don’t plan on going into FM?
Generally, residency programs are interested in having students who are considering FM. It is good to do one if you are on the fence. However, if you are absolutely sure that you are not going into FM, then it may not be a good idea to do a FM Sub-I as you are taking a slot from another student who may benefit from this opportunity.
FAMED 688: Family Medicine Sub-Internship
UW Student Registration Protocol
To register for a Sub-internship in family medicine please fill out the Sub-I survey supplied by Ivan Henson in the dept of Family Medicine, during the month of September. If you did not receive a survey, or would like to schedule a Sub-I later please fill out 2025-26 FM Sub-I Survey
REGISTRATION NOTES: Because residencies require timely registration information, enrolling in a Family Medicine sub-I is slightly different from other fourth year rotations. Please note the following:
A. Rank sites where you would seriously consider rotating.
B. Consider the following when considering a rotation time block:
a. The first five rotations time blocks (April through August) are highly sought after and you will likely have to rank the rotation as one of your top choices. Sub-I’s for audition purposes are often useful through January.
b. To guarantee your rotation will be included in your MSTP/Dean’s letter you will need to complete your rotation by the end of Spring Quarter. Transcripts are variable and usually include some summer quarter information, but there aren’t explicit timelines due to the nature of when grades are submitted, how long it takes upper campus to process the data, and when the students order the transcripts. Transcripts can also be updated throughout the application season.
Contact Ivan Henson famed@uw.edu in the Department of Family Medicine for more details.
c. If your priority is doing a Sub-I rotation at a particular site before a potential residency interview, we suggest requesting the rotation in the October and November time blocks. These time blocks tend to be less competitive.
C. Shortly after the registration period closes, you will be contacted by the Sub-I manager from the Department of Family Medicine to offer you a Sub-I rotation slot. Unlike other fourth year courses, you will need to quickly commit to the rotation that is offered to you.
- If, after the schedules are released, you decide that you would like to a Sub-I experience:
A. Visit the Sub-I Location or APC Location pages and see available programs in which you are interested.
B. Fill out 2025-26 FM Sub-I Survey which also contains current availability.
C. Once you have permission from the program and Ivan Henson in the Department of Family Medicine, contact the registrar to sign up for the course.
**Residencies depend on reliable student schedules. Therefore, as a professional courtesy, you should not drop this course unless there are considerable extenuating circumstances. Should you need to drop the course, you must first gain permission from Ivan Henson in the Department of Family Medicine. All drops need to happen more than six weeks before the start of the rotation except for extreme situations.

Updated September 2024