How Much Does An Away Rotation Help?

[hothause]

So it's time to start thinking about away rotations and I was wondering: How much do they really help your chances at a given program? Say I want to go to x or z program in y region. Do I need to do an away there to up my chances? I've talked to faculty at my school and they keep saying that they'd rather have a known entity to an unknown entity. However, what about the handicap of learning a totally new system or regional differences in practice in the span of 4 weeks? And, what about missing out on cool electives at your own program for another rotation in what you'll do the rest of your life?

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[deleted109597]

A ton. Plenty of PDs have gone on record saying the slor is the most important part of your file. An away slor means an independent person has determined you are a stable person.

 

[Xerxes1729]

I think I was ill-advised by the faculty at my school in this regard. They discouraged aways unless there was one particular program that we were interested in, but I was asked at most interviews where I had done my aways, and I had to explain why I hadn't done any. Several interviewers really got into this, and I think it definitely hurt me.

 

[alexmtr]

However, what about the handicap of learning a totally new system or regional differences in practice in the span of 4 weeks? And, what about missing out on cool electives at your own program for another rotation in what you'll do the rest of your life?

Didn't do any aways for the same reasons (plus some family stuff). I got all the interviews that I really wanted to get and didn't get asked about it at the interviews at all (I did do two months of EM at my home instutution (which has a residency program and a high volume, urban ED) - an elective my third year and an AI fourth year) I guess I'll find out pretty soon here if it hurt me or not
But you should probably do one if you are interested in a particular program, especially if it is a 'universally desirable' one (like most of the NYC programs, for example).

(btw, really enjoyed the 'cool' electives I got to take )

 

[IdontTakeCall]

I was/am unsure on my chances for matching so I did an away month at my top choice, during which all of the residents told me performing well there during that month would shine more than anything on my transcript. I'll let you know if it worked out in 13 days

 

[in1Q84]

I think almost everyone should do one if possible. In most cases, it helps than hurts.

Reasons why you should do an away:
(1) Just to figure out what kind of program you want to end up at. Do you like urban vs rural? Do you like academic vs. academic?
(2) Signal your interest in particular geographical region.
(3) Show programs that you are a competitive applicant. Away rotation spots are somewhat limited at more competitive places. So, landing one shows other programs of similar caliber that you are someone they should consider.
(4) Few programs pull very heavily from away rotator pool. There are advantages to being a "known stock."

Pitfalls of away to avoid:
(1) I think even mediocre performance at an away is better than no away at all. But, subpar performance can hurt you. So, I strongly recommend that you get your feet wet at your home program before an away. (something I failed to do.)
(2) Make sure you are interested in the geographical locale. (I know it sounds common sense. But, this is NOT something I thought about when I was applying for aways. I did my away in an region I was not really interested in just because I liked this one particular program alot. I don't recommend others do what I did.)
(3) Make sure you do your EM rotations early enough to get SLORs in ON TIME (sooner the better but definitely BEFORE MSPE comes out which is going to be mid-October for current M3s).

How do you get an away:
(1) Look at the program's website. They will tell you whether they are on VSAS or not.
(2) Get your stuff in ASAP. VSAS is a bitch. It's pretty annoying to get all your forms converted to pdf and get more vaccinations that you don't really need. But, you gotta do what you gotta do. Some immunizations and tests (titers, ppd, etc...) takes TIME. So, get on it.
(3) Be nice to clerkship coordinator and ask her specifically for advice if you can get a hold of her. This will get you far.
(4) Don't over-apply. Most people get the aways that they want. So, don't unnecessarily hold up spots you are not going to take. You can always accept a spot and drop it later. But, it's just a bad form. I don't think they'll remember you and hold a grudge or anything... Still, remember that you might be applying to the same program that you are dropping for an away. So, always be courteous and prompt as possible. Use common sense.

Few other things I wish I had known as a M3:
(1) Programs will interview you even if you are only scheduled to do an away at their institution. Let's say you are really, super interested in program A. You couldn't get an away schedule in the high-volume months, but still signed up do an away in February. The chances are that Program A is going to offer you an interview even before you do your away. This is probably not universally true... but true enough.
(2) There are different types of EM rotations available for aways: ultrasound, tox, wilderness, and etc.

Alright, PM me if you have more specific questions.

 

[taylormade2006]

How many aways should you aim for? Can you do 4 different aways in EM? Does it make sense to take 4 months of EM during MS3/4?

 

[RxnMan]

A lot of this is covered in the FAQ (under scheduling your 4th year). But you shouldn't do that many rotations. One home AI in EM, with 1-2 aways was the most common I heard of on the interview trail.

 

[Richspiders07]

I'm also a HUGE supporter of away rotations. I did 2 away rotations [so 3 EM rotations total] and they were each VERY different. My home school has an EM program, but we dont really get to "do much."

So, my first away was at a country program where i could do anything and everything. IE: I presented a patient and said that I thought he needed an LP. Attending looks as me and goes "well did you do it." I also apparently got a great SLOR from this rotation - which I'm confident helped me get more interviews on the Western half of the US.

Second away was at a program that is well known for their teaching - I learned more in that month that will help me for residency than pretty much any other rotation in medical school. not joking.

Another thought about aways: Think about where you will live and how you will get around when there. One of my aways was within driving distance and I had friends to stay with [ie: little "extra expense"]. Another away I had to fly to, rent a car for a month, and pay for sublet a room [lots of expense]. That being said, I wouldn't have changed a thing

 

[Mighty Mouse]

doing an away rotation definitely gives you a month of exposure to the program and the residents you could potentially be working with. besides making you a known entity to the program....you get to find out more and research more about a program you'd be interested in. interviewing at a place you rotated at is a completely different experience...you know the people, the attendings interviewing you, the hospital layout. you make a much more educated decision about your future. when you interview at a random program you didn't rotate at, you have 5ish hours to figure out if you fit in, uncover red flags, and decide if its a place you want to start your career at. much harder to do.

 

[ShanFan]

So I'm hearing that two aways is ideal, but one is sufficient? Did anyone who just did one away feel like it hurt their application to not have a second?

I found out last week that my school will only allow us to do two EM rotations during 4th year. I'm planning to do one at home (there is a program here), and at least one away. Should I stress about doing a second away in u/s or tox, or should I just go ahead with doing a SINGLE away rotation?

Any advice on this for me would be much appreciated! Thank you!!!

(by the way, I am a DO student planning to apply to MD programs. Took USMLE step 1, got 240/99, and am at ranked at the top of my class... if that makes any difference)

 

[Blackjack870]

My Two Cents (probably worth less than that)...

Coming from the Northeast (and always having been from the Northeast & Midwest), I wanted to go out West for residency. As a middle tier applicant, that was going to prove difficult. Therefore, I decided to do an away rotation at a top program out West to improve my chances. In the end, it was the only interview West of the Mississippi I got. However, the more important aspect of my away rotation was realizing that I was underwhelmed by the experience.

Having said that, here's what I wish I knew...
1) Nobody should be worried about doing only 1. I think 1 is the norm. Particularly if you're going to a place where you're going to have to pay extra rent and so forth.
2) Nobody should be worried about doing none. However, if you don't do any away rotations, I think you should do a second EM month (or EM-related elective) at your home institution. I think programs definitely take a look at the amount of EM time you have so they know that you know what you're getting yourself into, and you're dedicated to the specialty. I say this though because I had the opportunity to rotate at 2 completely different hospital settings at my home institution.
3) I would pick away rotations at institutions that are completely opposite in practice to your home institution. County place if you're at a community-type ED at home. Academic if you're normally at County. You definitely should see the differences even if you don't think you'll like (because you may actually like it).
4) I would also pick away rotations in different parts of the country as well. Even if you think you want to stay at your home institution, try an away rotation elsewhere if you have the means and opportunity. Pathology and practice is different in different areas of the US.
5) Away rotation LOR can be important for your application. I think the best months to do them are September and October. After applications are in but allows you time to get in LOR for the decision-making process. Well, let me clarify...
=> If you definitely need another SLOR for your application before it can be considered, think about doing the away rotation in July or August
=> If you have enough SLORs from you're home institution, but another one would be beneficial, consider doing the away rotation in September or October
=> If you have enough SLORs but still want to do a "try-out" at another institution, consider doing the away rotation in October or November

 

[Hawkeye Kid]

There's some great advice in the posts above. Above all, I think that the traditional thinking that you shouldn't do an away if you're a competitive applicant is a thing of the past.

I definitely agree with the idea that you should do an away at one of theses two places:

1. a program at which you're really interested, or
2. a program that is dissimilar to your home program

I can also see the argument for doing a rotation in a geographical area that you think you might want to go, but I think that it's less important than the other two factors.

From the perspective of evaluating applicants, an away lets me see that you're capable of going into a novel evnironment and not only performing well, but catching on quickly. After all, this is largely what residency is--new rotations, hospitals, attendings, etc on at least a monthly basis. Your ability to catch on and become a high-functioning team member is a great skill/asset, and this is judged pretty well by your performance on an away rotation.

I disagree, however, with Blackjack's statement that if you don't do an away you should do 2 EM rotations at your home program. Doing a third year and fourth year rotation is OK, as is doing a month with an EM subspecialty (including research). But two fourth year EM rotations at the same place is overkill and I would prefer that a future resident either do an away or do a rotation that will give them EM-relevant learning. From a SLOR standpoint, the only thing this might do is say that you improve over time, which is what I would expect anyway. Besides, I would doubt that most schools would even let you do the same rotation twice.

In the end, do you have to do an away? Absolutely not. Would I spend interview time trying to figure out why you didn't? I doubt it. Can it potentially hurt you? Sure, but probably no more than subpar performance on any rotation. The bottom line is that it's good for students/applicants to branch out and see a different way of doing things, and it's good for the programs to see that you can go somewhere new and hold your own.

 

[Powdermonkey]

What about a mid tier DO student shooting for an allopathic residency program south of say... Ohio? I can do 2-3 EM months besides my required month in June of my 4th year, and have a few other selective spots that I can use for ICU and trauma rotations. I'm interested in EM/peds so I was thinking of doing something like:

Required EM
Elec - EM
Med Selec - PICU
Elec - EM
Med Selec - Inpatient peds
Elec - EM/Peds EM
Surg Selec - SICU or trauma surg


Is that too many, not diversified enough, etc? Any suggestions would be welcomed.

I did a wilderness medicine rotation as a 3rd year and wilderness medicine is something that I'm super involved and interested in, but peds and peds EM is as well. I was hoping that getting some exposure on what little off time I may have to the ER or peds ER during the peds rotations would be better than nothing, and at least I'd get to meet a few of the docs or residents that way.

 

[michigator04]

So I am at an MD school that has no EM program (closest is 3 hours away!). How does that change the numbers game as far as aways/SLORs? I figure I will want to do 2-3 aways, probably early in 4th year.

I am also trying to shift regions for residency and go back home to the midwest. So it sounds like I should try to get 1-2 of those aways in the midwest then?

This is a very helpful thread. This type of EM-specific info is not available when you don't have a home program to consult.

 

[FunnyDocMan1234]

Is a 2-week away enough to get your foot in the door in a region (that's all that might fit in my schedule)? Can you get a SLOE from a 2 week rotation? Or, if I have a strong app (~250 step 1, mostly honors) will this be enough to get me interviews in good Cali programs etc even if I haven't done any aways and am from far away?

 

[Sloow]

Is a 2-week away enough to get your foot in the door in a region (that's all that might fit in my schedule)? Can you get a SLOE from a 2 week rotation? Or, if I have a strong app (~250 step 1, mostly honors) will this be enough to get me interviews in good Cali programs etc even if I haven't done any aways and am from far away?

No idea about if 2 weeks is long enough to get a SLOE. I do know that I dont think you can even set up a 2 week rotation in VSAS because they are all listed as 4 weeks.....


In terms of your other question. I did an away rotation at a Cali program in October with a student from a school in like Ohio I think. He did 1 rotation at his home ED and Honored it, had good board scores/grades and since I was on the rotation with him in October we discussed interview invites etc since that is the time of year and by the end of the month he had interviews at pretty much every single Cali program and AZ program (his wife only wanted him to match on West so he only applied to CA/AZ schools).


So to summarize.


Rotated with a student from Ohio who only applied West Coast, he had invites from literally every single CA/AZ program by the end of October and he only had 1 SLOE in his file which was from his home ED back in Ohio.

 

[Alejandro]

Well, was his SLOE from Cinci?

 

[Sloow]

Well, was his SLOE from Cinci?

Nope, not from any "elite" program