Away Rotations for MS4's

[phonyreal98]

Every year there are a couple of threads by MS3's/rising MS4's about whether or not to do an away rotation at a program they may want to go to for residency. In these threads the advice always seems to be something along the lines of "away rotations are a double-edged sword, because if you do an away rotation, if you are absolutely stellar then you'll end up as their #1 choice, but if you are not stellar then you are going to fall way down that place's ranklist or be DNR'd"

This always struck me as a bit odd, because by definition most MS4's are going to be average MS4's, and the large majority of average MS4's who go into psych are going to do just fine. So my question is, why is it so bad to go to a place on an away rotation and be an average MS4 without any personality issues that are toxic to the workplace and why is the thinking that if you are average then you get dropped off someone's ranklist? And also for residents/faculty on here, have you ever seen a med student do an away rotation and it didn't really end up affecting their ranking at a program (presumably because they were pretty average for their level of training)? I generally am not super involved with recruitment at my program so I generally have no idea which of the folks applying did an away with us.

I'm an upper level resident now so I have no dog in this fight. Just was curious as this seems to be the prevailing thinking not just in psych but in a bunch of different specialties.

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[Celexa]

When you have relatively little information from which to judge people, your mind tends to fill in the blanks with a slightly positive average of your prior experiences (most of us involved with these decisions are in education by choice, and we feel fairly benevolent towards our trainees in general). So, let's say that the blank space left by in mind after reading the average application is given a generic B/B+ sort of feel.

If you do an audition, you have filled in that blank space. If you fill it in with A/A+ material, you feel like a sure bet. This person was great! We liked them. Let's keep them. When they're application comes up during the formal season, it might as well have a golden glow around it.

If you do just.... Meh, then you've given your evaluators something tangible that's not getting that generic sheen of optimism that comes from ignorance. You've replaced it with cold reality. At that point even a B/B- performance is going to drop below the average applicant who didn't audition and gets the benefit of the doubt.

Additionally, the roulette wheel of rotations and clinical grades applies just as much to auditions as it did to clerkship. Maybe you get put on a rotation with a random resident or attending who you just don't get along with. Maybe you'd do better with literally any other attending or resident in the program and wouldn't have had any major problems as a resident. But the sample of information you've given at that point is just enough to hurt your application, and you don't get a redo.

This is why it is both high risk and high reward.

 

[clozareal]

For the average MS4, it tends to help rather than hurt. Many stay where they are on the rank list but most go up in my experience on the resident selection committee.

The bigger benefit is having you as the med student audit their residency program. You can really get the inside scoop on the residents when you have more time with them. I couldn’t decide between two programs and the away rotations made it clear which one was on top. That wouldn’t be the case with just the interview day since the one I ranked lower probably had the better interview day experience.

 

[Merovinge]

 

[Stagg737]

I agree with Cloz.

We have M4s rotate through our consult service to audition all the time. If they show up, work hard, and show improvement over the course of the 4 weeks, it's almost always positive for them in terms of ranking as it shows they were actually interested enough to rotate here and have potential for solid growth. It typically only hurts them if they struggled and don't show improvement or there are significant concerns. I'd say a solid 80-90% are helped by the rotation, I can only think of 2 students that it truly hurt in terms of being ranked.

 

[LeaveNoTrace]

When would it be an actively bad idea to do an away rotation? You're applying to say 50 programs. You do two away rotations and bomb both. You're not getting ranked at those programs...but you've got another 48 that you have a shot at. Would it be any better if our hapless hero bombed at his home institution?

 

[milesed]

I did two away rotations in my 4th year but was not really wanting to get residency spots at either. One was to get CAP experience as my med school had no fellowship program. It was an outpatient clinic the residents and attendings ran and it helped me decide that I truly wanted to do CAP. It also let me know I did NOT want to apply to that particular residency or fellowship program. The other was dermatology. It was also great as I just wanted to learn more Derm and allowed me to interview for nearby psychiatry residency programs. I never felt I was auditioning at all.