I am going to my fourth year, I have two away rotations in rad onc set up, a medical oncology rotation at my home institution, and was planning to take a month of vacation to do rad onc specific-research at a neighboring institution. the problem is that I didnt know i wanted to do rad onc until a few months ago and therefore I could not shadow at my home institution during third year since they suck here and the chairman in rad onc makes us get waivers from the medical school (radiation exposure?) and the med school wont give waivers unless we get permission from the director of whatever clerkship we were on to let us be in the rad onc department during the clerkship, knowing no clerkship director would do that because we technically arent supposed to have time during the week since we are supposed to be busy with our clerkship duties. Anyway, so the point is my school sucks and they have not been helpful in me trying to get a rad onc spot so I have been shadowing away from home at a couple of neighboring institutions (none of them, including my home institution have rad onc residencies). I wanted to know how bad it would look if I dont have a letter from my home institution or that my home institution does not even know me. Would another program call up my home program to find out more about me and then have nothing to say (my school does not have a good reputation so they may not be well known)? Is this a legitimate concern? Is it worth it for me to take a month to do an elective at home even though they dont have a residency program so I can get a letter from my home institution?