When do I do an away rotation?

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Asdf77

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Hey ya'll,

i'm a 3rd year working on my 4th year schedule looking to do an away rotation. When would you suggest doing it? Should I wait until Nov or Dec, or should I try and jump on the spots early in Aug or Sept?

Any advice is greatly appreciated!
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Asdf77 said:
Hey ya'll,

i'm a 3rd year working on my 4th year schedule looking to do an away rotation. When would you suggest doing it? Should I wait until Nov or Dec, or should I try and jump on the spots early in Aug or Sept?

Any advice is greatly appreciated!
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Depends on what you want out of it.

If you're doing it because you want a letter of rec or as an audition for surgery residency, then you're going to want to do it much earlier than Nov/Dec as the deadline for gen surg applications is November 1 (and October 15 in some places).

Nov/Dec/Jan is prime interviewing time so you want your schedule to be flexible to allow you to get away.

Most audition rotations or rotations in which you want to get an LOR are done in the summer/early Fall before applying.
 
Kimberli Cox said:
Depends on what you want out of it.

If you're doing it because you want a letter of rec or as an audition for surgery residency, then you're going to want to do it much earlier than Nov/Dec as the deadline for gen surg applications is November 1 (and October 15 in some places).

Nov/Dec/Jan is prime interviewing time so you want your schedule to be flexible to allow you to get away.

Most audition rotations or rotations in which you want to get an LOR are done in the summer/early Fall before applying.
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I agree with this. If you are rotating to get an LOR or "audition" try to find out what the reputation of the program is for that situation. Some like the chance to meet people and frequently match those who do well. On the other hand, at some programs an away rotation is the death knell for a match there.:eek:
 
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thanks so much for the information!
 
Asdf77 said:
thanks so much for the information!
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I'll jump in and make my annual "don't do away rotations" post.

There's more detail in my older posts, but basically it's a whole lot easier to look like an idiot and get blackballed than to look like a star. And the idea that you'll learn more about a school in a month than a day, while true, still isn't very useful. Lots of bad things can still hide (or simply change over 5-7 years). Give every program the same 36 hours, make the best decision you can, save the time and expense of an away rotation and come to a zen-like acceptance that residency choice is a crapshoot.

My only exception to the advice above is the special situations of either a very strong and narrow geographic preference or if you look so bad on paper that you have nothing to lose.
 
Pilot Doc said:
There's more detail in my older posts, but basically it's a whole lot easier to look like an idiot and get blackballed than to look like a star. And the idea that you'll learn more about a school in a month than a day, while true, still isn't very useful. Lots of bad things can still hide (or simply change over 5-7 years). Give every program the same 36 hours, make the best decision you can, save the time and expense of an away rotation and come to a zen-like acceptance that residency choice is a crapshoot.

My only exception to the advice above is the special situations of either a very strong and narrow geographic preference or if you look so bad on paper that you have nothing to lose.
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While this may be true in some places, it is not universal. I did have a good application, and did an away rotation. When rank list time came, I got a personal call from that program director and a detailed discussion of why he wanted me in his program. Granted, he may never have ranked me, and I will never know because I got my first choice, which turned out to be another program.

I just think that checking this out helps. A student ahead of me had the same experience at this program... they prefer to see a student for more than a day, and rank strong students who have rotated with them highly.
 
Respectfully Tigger, I agree with PilotDoc. Away rotations are a waste of time for the following reasons:

1. You will look dumb many more times than at your home institution. You don't know the people/hospital/way things run. You will learn the alternate spot for rounds starting/how to page people/where the secret spot is for test results/the special place for notes by not knowing them and looking stupid. You are only going to make yourself look worse by being under their careful watch for a month than by showing up for interview day looking nice and being on your best behavior.
2. You won't get the rotation that you should be on. They put the visiting students in the spaces after the home students had been assigned, and because it is another institution, you don't know which rotation has the good experience or attendings. I got put on an outside hospital service and was a glorified third year.
3. If you are going to match at that program (with the exception of a few programs), you will match there without doing an away rotation. At least at the top programs, there is no such thing as winning yourself a spot with an away rotation if you were not already qualified. Many people at my home school, who are great students or great residents, did away rotations and then didn't match there, either because they weren't qualified enough to begin with or because they screwed up enough there.
4. Just because you do a rotation at a program, doesn't mean that you know everything about it. You only see the snapshot of the rotation that you are on, which is a few months of resident's life. You don't know what the other rotations are like and what goes on when you aren't around. So your ability to do your research on that program is really no better than just going for interview day.
5. It costs you lots of money, time and effort for the privilege of the above. Take that money and take your significant other on a nice vacation, and you will come out ahead AND tan.

The one caveat about away rotations that is good is that they give you a chance to see how another hospital functions, and whether you like it better than your home institution. This can be accomplished by working on any service, and not just surgery.

If I had to do it again, I wouldn't do an away rotation in surgery. It hurt more than it helped, and cost me lots of cash for the privilege.
 
Tigger14 said:
they prefer to see a student for more than a day, and rank strong students who have rotated with them highly.
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Well, I think my arguments hold
1) I never said the rotations can't help - it's just easier to do harm than good. Yes, if you shine on a rotation, it might help you. But if you suck for a month - or even one day of that month, it's easy to kill your chances. If the intern or your attending's secretary thinks you're terrific, that's nice, it will probably help you. If either of those people think you're incompetent and/or difficult - you're very likely to blackball yourself.

2) ok - your n=1 program likes people who did rotations with them. If you have to be at that program, maybe it will help. Likewise, if you look so bad on paper that you need to buff your application, then you have to do a rotation somewhere or else you won't match. But for people who have a decent paper trail, there are 240 other programs, most of which routinely match students who they have seen for 1 day only.
 
I think there may be another instance where an away rotation may help you:

If your medical school is lower tier, you won't have the pedigree that students from more elite programs will carry. One way to offset this deficiency in your application could be to rotate at a top university program and obtain a strong letter of recommendation from a well-known attending who can benchmark your performance against their own students.

A letter that states, "this individual was the strongest student I've seen in years" may carry much more weight if it's written by Dr. Rock Star from Awesome Medical Center rather than by Dr. Joe Blow from Clown University.

I know of a few applicants this past year who were commended on their strong record, but also told that they hadn't accepted anyone from their weaker program in several years. It may be helpful to do what you can to offset this weakness.

A safe way to do this without sinking your chances at one of your desired programs? Maybe consider doing an away at a top program that you're not absolutely dying to get into.
 
If you are an osteopathic student and want to match into some of the more competitive fields (neurosurgery, orthopedic surgery, ent) Then you will HAVE to do an away rotation to be considered for acceptance at that site. So if you are a DO student and want to do osteopathic match in some competitive fields look into the hospitals that require rotations at their hospital. Not all of them require it but some of them do.
 
I did two away rotations at my top two choices of institutions. I ended up not matching at either institution. I was told by the primary attendings I worked with that I did an excellent job and they would support my application strongly come time for the committee meetings, but alas I guess my weak step 1 score hurt my chances more than the strength of my AI rotations. The rest of my application was strong. Or maybe I didnt do such a good job during the rotations and they were lying to me, but I dont see why they would do such a thing. They have nothing to lose by telling me I did a cruddy job. I still wonder how this whole process works, but I am happy with where I ended up. Final point, its all a crapshoot! The only thing you can do is work excessively hard first 3 years of medschool and kill step 1 and (most likely) you will get what you want.

Ill let you guys know how the whole process works when I am a senior resident participating in it.
 
Well, my issue is that I'm a moderately competitive student from a strong midwest public school who would very much like to land in the Washington DC area. I have been advised by my home institution to do an away rotation so that I can get a letter that gives me "a foot in the door" in the DC area. They have basically told me that they believe a letter from a fellow DC area school would mean more to the other schools than letters from those outside the DC area. Is this true? I very much want to live in Washington DC. My significant other's career would be better served in DC, and I love the city.

Does this change anyone's advice on whether or not to do an away rotation?
 
Asdf77 said:
Well, my issue is that I'm a moderately competitive student from a strong midwest public school who would very much like to land in the Washington DC area. I have been advised by my home institution to do an away rotation so that I can get a letter that gives me "a foot in the door" in the DC area. They have basically told me that they believe a letter from a fellow DC area school would mean more to the other schools than letters from those outside the DC area. Is this true? I very much want to live in Washington DC. My significant other's career would be better served in DC, and I love the city.

Does this change anyone's advice on whether or not to do an away rotation?
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If you're really from a strong school, there are attendings at your school who know people in DC. Scour the surgery department for people who can make phone calls on your behalf and then do a sub-I with them and kick ass. Have Dr. X call his old residency drinking buddy at GW or Innova, etc and tell them how great you are.

That having been said, your situation is one of the exceptions I noted - a strong, narrow geographic preference. Maybe try an away rotation somewhere just outside of where you want to be - Hopkins or UVa perhaps. That way if you do well, you can use the letter to your benefit and if you suck it won't kill your chances in DC.
 
I think you will find that almost all of the thoughts in this thread have some truth in them. Really it can go either way. My opinion, which is the entire reason I'm posting I guess, is that I think the benefits outweigh the risks.

1. You get to "audition" for the various attendings
2. You might be able to get a LOR - which can't hurt
3. You'll get a sense of the residency at that institution
4. You might get your foot in the door
5. You be able to see if you like the residents there

The biggest cons that I can think of are:
1. You might totally screw up
2. All the residents/attendings might not like you

Just remember nothing is guaranteed, everybody during the interview process seems to be telling everyone else exactly what they want to hear. But if you want to be in a specific area I think you should do an away subI - try to be a student on the PD's service if possible. I did 2 away rotations and I thought they were a great experience regardless of whether I got into that program or not. Considering the alternative is just staying at your home institution, I would apply for the away rotation.
 
Why I fight this battle with such missionary zeal, I don't know ... but I shall continue. My comments on the pros above.

1. Auditioning could be a good or bad thing.
2. You can also get an LOR by spending a lot of time with an attending at your institution.
3. True, but will that really help you? You'll get to know the program better, but far from perfectly. And that knowledge is only helpful in how you use it to evaluate other programs. You will never know what you would have liked or disliked about the 9 other programs your rank if you had spent a month there.
4. True. But again, you might get shown the door. This only becomes a clearly no lose proposition when you have no shot at a program to begin with.
5. True, but see #3. Not to mention, programs change. By the start of your 2nd year, 40% of the residents you met on your away rotation will have graduated.

Continuing to criticize the con list
1. You might totally screw up. You might also perform in a average or sub average manner such that you will do more poorly than if you had simply applied and interviewed.
2. Everyone might not like you. But at most places, it only takes 1 or 2 people not liking you (and they don't have to be MD's) to sink your ship.

And finally "considering the alternative is just staying at your home institution" I can't disagree with that enough. To me staying at my home institution means going to work at a place where I know the systems, know the building andand know the people, and I have to tools to concentrate on learning surgery and not learning how the computers work. It means working with people who are already invested in me. It means not spending a thousand dollars or more to exile myself from my home, friends and family for a month.
 
I can't disagree with Pilot Doc. He makes some well founded points.
I think there is enough on both sides of the issue. Its not an absolute either way. At the end of the day it comes down to what you want and what you think could happen.
 
eastcoastyall said:
Respectfully Tigger, I agree with PilotDoc. Away rotations are a waste of time for the following reasons:

1. You will look dumb many more times than at your home institution. You don't know the people/hospital/way things run.

If I had to do it again, I wouldn't do an away rotation in surgery. It hurt more than it helped, and cost me lots of cash for the privilege.
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Honestly, I think it's kind of p#ssy to be afraid of screwing up. Of course you can look good in your warm fuzzy familiar environment. If you're an excellent student, you will be able to excel in a new environment, despite such seemingly impossible obstacles as learning a new computer system, and finding out where orders go, etc.


Pilot Doc said:
1. Auditioning could be a good or bad thing.
2. You can also get an LOR by spending a lot of time with an attending at your institution.
3. True, but will that really help you? You'll get to know the program better, but far from perfectly. And that knowledge is only helpful in how you use it to evaluate other programs. You will never know what you would have liked or disliked about the 9 other programs your rank if you had spent a month there.

Continuing to criticize the con list
1. You might totally screw up. You might also perform in a average or sub average manner such that you will do more poorly than if you had simply applied and interviewed.
2. Everyone might not like you. But at most places, it only takes 1 or 2 people not liking you (and they don't have to be MD's) to sink your ship.

And finally "considering the alternative is just staying at your home institution" I can't disagree with that enough. To me staying at my home institution means going to work at a place where I know the systems, know the building andand know the people, and I have to tools to concentrate on learning surgery and not learning how the computers work. It means working with people who are already invested in me. It means not spending a thousand dollars or more to exile myself from my home, friends and family for a month.
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I usually agree with what you have to say, but come on! Staying at your home institution is going to limit your experience.

It's not always about impressing people or getting LORs. Away rotations are also about finding out how surgery residency can be different from your home institution. As you referred to earlier, most people who apply for residency have an n=1 experience, yet they somehow come to the conclusion that "this is what all surgical residencies are like." I've found this to be especially prevalent in students from northeast programs.

There are many advantages to away rotations, and I believe that every senior surgical student should do them. It shouldn't take away from your quality time with your home attendings, and it can give you some well-needed perspective on how different residencies operate, thus allowing you to more objectively evaluate the pros and cons of different institutions. This helps you to make a more informed decision for your ROL.

If you decide not to do them because of money, then I partially understand, but if you don't do away rotations because you're afraid of looking bad, then I think you're kind of a wuss, and I assume that you're a weak applicant. Strong applicants excel in multiple environments. Also, don't be surprised if interviewers ask you why you didn't do any away rotations, and don't be surprised if they can tell you're lying, and really you were just scared.
 
I can see how an academic program that has 20 of their own med students on service are going to probably just ignore you at best and likely be annoyed with you more often than not. I think the fact that you actually wanted to do an away at their institution may give you some credit when you interview and when you are compared to others, but it's not going to make up much ground if the institution you are applying to is out of your league or just isn't interested in you.

However, if you are interested in community based programs and you are doing an away at a community based program I think you do have better chances of impressing them. Every med student they see likely doesn't know the ropes of the institution so they won't be so quick to judge you for not knowing where stuff is or how to get stuff done at the institution.

Justin
 
I'll concede a couple good points

1) if the only med students a program ever sees are visiting sub-I's then the risk/benefit calculus does shift. Fair enough. I do still think it's easier to hurt yourself than help

2) Seeing how the other half lives is a great reason to do a visiting elective. In that case, I'd say go to a hospital or part of the country that you otherwise wouldn't see. Go to Parkland or Shock Trauma or ... Santa Barbara. But if you're doing an away with the goal of looking good to a PD, I stand by my comments.

Finally, about being a *****. In my experience, ******* don't go into surgery. This is about being smart and realizing whether an action is more likely to help or hurt you. Fear has nothing to do with it. I agree, that cream of the crop applicants excel in multiple settings. This will likely be reflected in their paperwork and they'll match fine regardless. For the rest of us who can have a bad day (and I maintain that's all it takes to make a rotation net negative), an away rotation has risks. Avoiding unneeded risks isn't wussy - it's smart!
 
Just want to say thanks again all the advice. A lot to think about. It's much appreciated.
 
So when is the "ideal" time to do an away (esp. for a LOR)? June, July, August, September?
 
SLUser11 said:
Honestly, I think it's kind of p#ssy to be afraid of screwing up. Of course you can look good in your warm fuzzy familiar environment. If you're an excellent student, you will be able to excel in a new environment, despite such seemingly impossible obstacles as learning a new computer system, and finding out where orders go, etc.

Well, you can certainly have your own opinion on that. I am certainly not scared of screwing up as we all do that many times a day. More my point is that when you are under the scrutiny of an away rotation, seemingly small things that you don't know will be magnified many times over and used to evaluate your professional prospects. I certainly have examples from my friends that will not be aired in a public forum.
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