4th Year Rotation School Policies

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Mr. Babe

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My school has given all current 3rd year students a document to sign saying that we comply with school policies for 4th year rotations. This is mostly based on recommendations from the Coalition for Physician Accountabilities Away Rotation Recommendations.

Specifics in the document include have only one away rotation and that they will not start until after August 1 2021. And of course that residency programs should be encouraged to take into consideration if a learner exceeded the one away rotation limit.

So the issue here is that my school is trying to get us students to sign a document saying that we will comply with these "recommendations".

Are there any other schools that have a similar situation going on and how is this being handled? Many at my school are refusing to sign at this point and are waiting for further direction because this does not seem to be in our best interests.

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I’m graduating this year and I can tell you with certainty there are programs that questioned me about why I did 2 subIs instead of the recommended 1, and weren’t satisfied with my explanation that not only did I not have a home program but I also took a gap year between 3rd and 4th years.

Your school is looking out for your best interests.
That may be true, but what specialty did you apply to? And was this a couple programs or most?
 
I’m graduating this year and I can tell you with certainty there are programs that questioned me about why I did 2 subIs instead of the recommended 1, and weren’t satisfied with my explanation that not only did I not have a home program but I also took a gap year between 3rd and 4th years.

Your school is looking out for your best interests.
Dang, I already have 2 SubIs scheduled, and my school encourages us to go on more than one SubIs. Their reasoning was the fact that we don't have home programs, so it's allowed for us.
 
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That may be true, but what specialty did you apply to? And was this a couple programs or most?
I’m matched into EM. It wasn’t all of them but it was enough, and I fell past the ones that did.
 
Dang, I already have 2 SubIs scheduled, and my school encourages us to go on more than one SubIs. There reasoning was the fact that we don't have home programs, so it's allowed for us.

There are ways around stupid policies. 1 away was more reasonable last year, this year especially with soon to be mass vaccinations and current trends that’s ridiculous and hamstrings you. Make sure to read your guidelines and find out if say moving your core location to an area with a large density of programs in the field you’re interested in is a possibility
 
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Dang, I already have 2 SubIs scheduled, and my school encourages us to go on more than one SubIs. There reasoning was the fact that we don't have home programs, so it's allowed for us.

Did you schedule them through VSAS? I thought that didn't open till the 15th
 
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Dang, I already have 2 SubIs scheduled, and my school encourages us to go on more than one SubIs. There reasoning was the fact that we don't have home programs, so it's allowed for us.

I don’t agree with continuing to limit aways to 1 by any means. We’re all getting vaccinated, it’s perfectly safe to go back to a more reasonable average of 2 aways for everyone without a home program and 1 for those with. Tbh the above should be a national policy, none of this insane 5 aways for some folks that you hear about.

But my recommendation is follow whatever guidelines they end up deciding because there are certainly programs that’ll ding you for it. And unfortunately there’s no way of knowing which programs those are in advance.
 
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My school has given all current 3rd year students a document to sign saying that we comply with school policies for 4th year rotations. This is mostly based on recommendations from the Coalition for Physician Accountabilities Away Rotation Recommendations.

Specifics in the document include have only one away rotation and that they will not start until after August 1 2021. And of course that residency programs should be encouraged to take into consideration if a learner exceeded the one away rotation limit.

So the issue here is that my school is trying to get us students to sign a document saying that we will comply with these "recommendations".

Are there any other schools that have a similar situation going on and how is this being handled? Many at my school are refusing to sign at this point and are waiting for further direction because this does not seem to be in our best interests.
But my recommendation is follow whatever guidelines they end up deciding because there are certainly programs that’ll ding you for it. And unfortunately there’s no way of knowing which programs those are in advance.

What is your personal really good reason why these recommendations should not apply to you?
 
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What is your personal really good reason why these recommendations should not apply to you?
The biggest issue that I have is the fact that I don't have the opportunity to check out multiple programs and get a feel for how I would fit. If the majority of interviews are virtual again, it would be difficult for me to see hospitals and actually be in the place where I might do residency as well. That's kind of a lose lose situation. I feel like away rotations are more of an opportunity for me to see what aspects of programs are attractive rather than for programs to see if they like me and to give me a leg up.

What if the one away rotation that I do is at a place that I hate? Or what if I have unrealistic expectations for what I want in a residency when I don't have any other programs to compare to?

I don't want to start the vaccine discussion,.......but why get the vaccine if it doesn't actually open any doors for you? You still have to wear a mask and pretty have the same restrictions as everyone else. Why not allow vaccinated students to have more freedom with away rotations? Most students are in the age range of the smallest risk for COVID in the first place. (.......side note: I am vaccinated)
 
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The biggest issue that I have is the fact that I don't have the opportunity to check out multiple programs and get a feel for how I would fit. If the majority of interviews are virtual again, it would be difficult for me to see hospitals and actually be in the place where I might do residency as well. That's kind of a lose lose situation. I feel like away rotations are more of an opportunity for me to see what aspects of programs are attractive rather than for programs to see if they like me and to give me a leg up.

What if the one away rotation that I do is at a place that I hate? Or what if I have unrealistic expectations for what I want in a residency when I don't have any other programs to compare to?

I don't want to start the vaccine discussion,.......but why get the vaccine if it doesn't actually open any doors for you? You still have to wear a mask and pretty have the same restrictions as everyone else. Why not allow vaccinated students to have more freedom with away rotations? Most students are in the age range of the smallest risk for COVID in the first place. (.......side note: I am vaccinated)

You’re absolutely spot on. I’m hoping when they reevaluate this stance next month they decide that y’all can do say 3 aways if fully vaccinated. Keeping my fingers crossed for you to get multiple aways because I can guarantee my app cycle would’ve been drastically different without the auditions that I was able to do
 
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The biggest issue that I have is the fact that I don't have the opportunity to check out multiple programs and get a feel for how I would fit. If the majority of interviews are virtual again, it would be difficult for me to see hospitals and actually be in the place where I might do residency as well. That's kind of a lose lose situation. I feel like away rotations are more of an opportunity for me to see what aspects of programs are attractive rather than for programs to see if they like me and to give me a leg up.

What if the one away rotation that I do is at a place that I hate? Or what if I have unrealistic expectations for what I want in a residency when I don't have any other programs to compare to?

I don't want to start the vaccine discussion,.......but why get the vaccine if it doesn't actually open any doors for you? You still have to wear a mask and pretty have the same restrictions as everyone else. Why not allow vaccinated students to have more freedom with away rotations? Most students are in the age range of the smallest risk for COVID in the first place. (.......side note: I am vaccinated)
Our class didn’t get to experience many programs at all...it isn’t the end of the world. Basically the policies may be stupid but they can fail you, programs can take offense to it (as mentioned before it happens), and all other headaches. Just because it “isn’t fair” doesn’t mean that you get to skirt the rules. Life ain’t normal now and it will be slowly get back to it with vaccinations. Just go with the guidelines you (And other applicants) aren’t that special
 
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What is your personal really good reason why these recommendations should not apply to you?
The guidelines should apply to nobody because they are not reasonable among a population of students that are already vaccinated and already rotating in hospitals and clinics ("the covid is coming from INSIDE the room"). I don't see how it decreases risk in any appreciable way to restrict rotations like this.

But I agree the guidelines should generally be followed because there is risk that programs will dislike rule-breakers. It sounds like competitive specialty applicants have a lot more reason to ignore the guidelines, however.
 
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The guidelines should apply to nobody because they are not reasonable among a population of students that are already vaccinated and already rotating in hospitals and clinics ("the covid is coming from INSIDE the room"). I don't see how it decreases risk in any appreciable way to restrict rotations like this.

But I agree the guidelines should generally be followed because there is risk that programs will dislike rule-breakers. It sounds like competitive specialty applicants have a lot more reason to ignore the guidelines, however.
What specialties are really following the guidelines tho? Based on last year it seems like it was only really EM programs (where there was big risk of contracting covid) that cared if you didn’t follow the guidelines, haven’t heard about any other specialties tho.
 
I’m graduating this year and I can tell you with certainty there are programs that questioned me about why I did 2 subIs instead of the recommended 1, and weren’t satisfied with my explanation that not only did I not have a home program but I also took a gap year between 3rd and 4th years.

Your school is looking out for your best interests.
Wow sorry to hear about this. A lot of my EM colleagues told me that EM does things a bit differently. They were strict about doing 1 away so everyone has a chance at getting a SLOEs. Similar to AAMC discouraging people from interview hoarding.

But I believe programs did not have access to our full 4th year schedule since everything was constantly shifting. Sometimes a sub-I won't even be listed as one, so I think it's definitely more apparent for EM.
 
Wow sorry to hear about this. A lot of my EM colleagues told me that EM does things a bit differently. They were strict about doing 1 away so everyone has a chance at getting a SLOEs. Similar to AAMC discouraging people from interview hoarding.

But I believe programs did not have access to our full 4th year schedule since everything was constantly shifting. Sometimes a sub-I won't even be listed as one, so I think it's definitely more apparent for EM.
Yea I heard it was more of an EM thing, it was not brought up on interviews for any other specialty to my knowledge..
 
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I mean tbh programs are going to move towards these kinds of restrictions as just an institutional policy Regardless of COVID, and they should. Nobody needs to be doing more than 2-3 away rotations.

This year serves as perfect evidence that programs are going to fill regardless of whether students get to spend a month there, students are going to place without them, and it got to this point for the same reason that everyone is applying to 60+ programs for residency.
It's good that it's cheaper and way less stressful but the elevation someone from a low ranked program can obtain from impressing/obtaining letters from highly ranked programs is something I don't think should be reduced. On the other hand maybe it will provide a little tiny bit of pressure on DO programs to have more 4th year rotation organization (a guy can dream).

Overall I value the ability of an underdog (AKA someone that didn't hit a 3.7/510 or whatever) to elevate themself via an away-heavy 4th year a lot more than instituting a cost-reducing measure like this, that further favors med school prestige and how you did on the MCAT.
 
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I’m matched into EM. It wasn’t all of them but it was enough, and I fell past the ones that did.
Dang man. I literally just got told the other day by our advisor to "do 5 if you can". I have two sub-I's scheduled already. Does this include US/tox/peds EM?
 
Dang man. I literally just got told the other day by our advisor to "do 5 if you can". I have two sub-I's scheduled already. Does this include US/tox/peds EM?
No one knows if they will be that strict this cycle.. I doubt they will be, especially with everyone getting vaccines and there is supposed to be new recommendations by April 15th. I wouldn’t sweat it too much, last year was obviously different
 
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The biggest issue that I have is the fact that I don't have the opportunity to check out multiple programs and get a feel for how I would fit. If the majority of interviews are virtual again, it would be difficult for me to see hospitals and actually be in the place where I might do residency as well. That's kind of a lose lose situation. I feel like away rotations are more of an opportunity for me to see what aspects of programs are attractive rather than for programs to see if they like me and to give me a leg up.

What if the one away rotation that I do is at a place that I hate? Or what if I have unrealistic expectations for what I want in a residency when I don't have any other programs to compare to?

I don't want to start the vaccine discussion,.......but why get the vaccine if it doesn't actually open any doors for you? You still have to wear a mask and pretty have the same restrictions as everyone else. Why not allow vaccinated students to have more freedom with away rotations? Most students are in the age range of the smallest risk for COVID in the first place. (.......side note: I am vaccinated)
You can sign ‘under duress’ and then just do 2 aways anyway. Or just ignore it, or sign Mickey Mouse, one of my personal favorites with overzealous admins. If I was in EM I would do 2 aways for the SLOEs and submit whichever one was better if they were only requiring one this year again.
 
Dang man. I literally just got told the other day by our advisor to "do 5 if you can". I have two sub-I's scheduled already. Does this include US/tox/peds EM?
Recommend reading the ask a PD thread by GamerEMdoc in the EM forums. He has given advice on this. I think he recommended maximum 2 SLOEs.
 
My school says we can only spend a max of 12 weeks at any one site (we have no core hospital). It’s actually in our policies.

I’m thinking that getting disciplinary action because I tried to follow the coalition recs and stayed in one place too long is gonna look worse than doing a bunch of aways, so I’m going to do a bunch of aways.

Really ironic how a lot of programs are limiting visiting students to 4 weeks total at their institution because of the recommendations. That just guarantees people like me who aren’t allowed to stay in one place are gonna have to be at probably 6+ hospitals instead of just 3-4, and I will *absolutely* point that out if anyone asks. Bonus points if the institution interviewing me is one of those 4 week places.
 
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My school is assuming things will be back to normal. If it isnt they have us declare a "homebase" and then we can rotate at any hospitals in a 2 hours radius of that and it isnt considered an away.
 
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