4th year visiting/away rotations?

[kidsthesedays]

What's your opinion on them? Are they important?

All my friends in other specialties are planning them now. I'd like to do one (in a city I want to move to), but don't know if I should chance giving up a spot for a subI and/or PICU early on, for a letter/talk about in interviews...

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[pooh86]

This topic have been talked about many times on the forum. Look for them. It really depends on which city that you want to move to is at and whether you can do a floor month at the away. I would recommend doing your sub I over the away, unless the city you want is NYC, Cali, or across the coast where you have no ties.

 

[RySerr21]

What's your opinion on them? Are they important?

All my friends in other specialties are planning them now. I'd like to do one (in a city I want to move to), but don't know if I should chance giving up a spot for a subI and/or PICU early on, for a letter/talk about in interviews...

i feel like doing aways or not is a personal decision, which is why so many people have differing opinions.

In my experience, doing an away to 'impress' a school that may be out of your reach isn't a very good idea. The top top schools will either give you an interview or they wont. Ive known multiple that have done aways at top tier programs and still been rejected for interview, even though they are good applicants and had good evals from the aways. Those top programs are just so competitive that they can pick and choose whoever they want.

Its also important to find out whether schools grant interviews to all of their rotating students. Some do, some dont.

Reasons I would do an away/reasons I did aways - again, not so much to impress the people at the school, but i did it for me because I wanted to see how I liked the school. I did aways at my pre-interview top 3 programs, mostly because I had fun doing them and I enjoyed seeing different programs and meeting people and getting that exposure to different hopsitlas and I was able to live in cool cities and do cool specialties, etc....you see the difference? I also got a 1K scholarship to go to one so that helped out with the cost of the away and the lviing...So for me, the aways were awesome because i learned A LOT about the programs and the cities that I otherwise wouldn't have known and it ended up having a huge impact on my rank list. However, I think if the mentality is "i have to do this away for an interview" the experience will be a lot different...ya konw what i mean?

None of my aways were intense in the sense that I didn't do any wards motnhs or ICU or anything. I did pulm, endocrine, and cards which were all mostly outpatient. The downside of that is that there wasnt as much interaction with the residents working day to day, but i still saw them regularly at conferences and interacted with them and talked with them and got a feel for what it was like at their program, ya know?

People will say that if you don't do a wards month or hard working month then it really isn't helpful in terms of having people vouch for you, but in my experince that was inaccurate. Everywhere I went, when i met with the program directors they all said to have people I worked with send them an email/letter kind of vouching for me and speaking about my performance....so it didnt really matter that i wasnt on the wards, I worked very closely with all of the attendings on those services so they got to know me well and were able to vouch for me in the end by personally sending a letter to the program director to support my application. How much will that letter impact their ranking? I dont know, but it makes sense that they care about how people who are already at their program think about you...

definitely for peds, I would say that doing aways is NOT necessary to help your application and to get an interview. It CAN help, but it is not vital to your application. If anything i think it will help or hurt you when it comes down to them deciding where they rank you. You are giving them a 1 month trial of your work ethic and personality, etc so they will definitely use the evals from their school in their overall opinion of you as an applicant..i say Do aways at programs that you are highly considering but maybe are out of your comfort zone (for whatever the reason - for me, i did an away in a state/city I had never lived and ended up loving the location...maybe if i hadnt done this i would ahve been more hesitant to rank it as high as i did). you will learn a lot about what you are looking for in a program and your expereinces may surprise you in terms of what you like and dont like about the program. a lot of it is gut feel. its a lot better to get a feelinlg about a program one way or the other if youve been there for a month vs visiting for 1 day. its not a surprise that my top 4 programs were the 3 i did aways and my home institution bc i know them the best and felt i was best able to make a judment about my happiness at those programs.

 

[Cookie Queen]

I did one away, and I'm not sure what that did for me. By the end of the first few days, I knew that I liked the program but maybe didn't didn't love it. But I was roped in for four weeks. I did get an interview there, but I met quite a few people on the interview trail who did NOT get interviews where they did aways. As other people of discussed in other threads, it can be difficult to impress when you don't know the hospital, medical record system, details of the subspecialty, etc. And I'd never recommend one over a sub-I at your home institution. Just my two cents. But it is a personal decision.

 

[RySerr21]

I did one away, and I'm not sure what that did for me. By the end of the first few days, I knew that I liked the program but maybe didn't didn't love it. But I was roped in for four weeks. I did get an interview there, but I met quite a few people on the interview trail who did NOT get interviews where they did aways. As other people of discussed in other threads, it can be difficult to impress when you don't know the hospital, medical record system, details of the subspecialty, etc. And I'd never recommend one over a sub-I at your home institution. Just my two cents. But it is a personal decision.

ive heard this argument before but it doenst really make sense to me....why do people think you are being judged on how well you know the hospital lay out, EMR, and details of a specialty? Might it be a little more difficult the first few days if you don't konw where things are? Yea sure, but its nothing you won't figure out quickly. EMR, for the most part, s not difficult to figure out either...and if you are in a subpecialty, no one expects you to know the details or to have the knowledge of a fellow, they just expect that you work hard, show up on time, are willing and eager to learn, and are a team player. Thats how you impress, and that shouldn't really change from location to location. but in the end agreed its a personal decision.

 

[BabyDoc86]

Thank you for the very detailed reply, RySerr21. Very good info!

 

[pooh86]

ive heard this argument before but it doenst really make sense to me....why do people think you are being judged on how well you know the hospital lay out, EMR, and details of a specialty? Might it be a little more difficult the first few days if you don't konw where things are? Yea sure, but its nothing you won't figure out quickly. EMR, for the most part, s not difficult to figure out either...and if you are in a subpecialty, no one expects you to know the details or to have the knowledge of a fellow, they just expect that you work hard, show up on time, are willing and eager to learn, and are a team player. Thats how you impress, and that shouldn't really change from location to location. but in the end agreed its a personal decision.

It makes a difference because often times how well you do a task is time dependent. If you spent an hr trying to find the patient you're to consult on and another 30 min finding the labs you need, you will not look very good. When I did an away, I never got a log-in for their EMR so I always had to ask the nurses to look up patient labs for me. I also couldn't write notes on their EMR so I couldn't help the residents where they needed help the most. Of course there are other aspects of your rotation they look at, but these factors shouldn't be ignored.

 

[justdoit31]

I did 3 aways and got interview from 2 of them- surprisingly the 1 that didn't offer an invite is where I had done research with pub, shadowed and volunteered through undergrad, and had amazing LOR from. Luckily it took me a week or less to know I didn't want to be a resident there just a fellow.

I really enjoyed my Peds ER away as we didn't have any ER option (adult or peds) where I am (a regional campus). I worked with a lot of residents and they had me function as an intern (I checked out to attending, wrote orders, did procedures, etc.

My hem/onc was good for the most part- 3/4 of the time I was one on one with attendings and the the teaching was top notch

My ID rotation was a bust- shadowed in outpatient for 1/2 of time then on floor consults other 1/2 but didn't see/examine a patient on my own the whole month.

For me if my school had busy wards and specialty clinics I wouldn't have done aways but I decided to do them since I wanted to see a place that was bigger and more tertiary compared to rural Texas.

 

[Siverhideo1985]

I've said it before (I think...maybe I just thought it often on these forums) and I'll say it again. The most important rule when deciding to do an away is:

Know Thyself.

You have to be able to assess your own strengths and weaknesses to assess whether or not an away at one of your potential top choices will help, hurt or do nothing for you.

The problem on this forum is that all you get is (essentially useless) anecdotal input (including mine, btw). There are thousands of different students, doing thousands of different away rotations at hundreds of different sites with thousands of different attendings/residents. Then they share their n=1 experience and extrapolate it to the entire, infinitely varied possibility of experiences.

So, back to knowing yourself. Looking at yourself as a student and your track record in medical school (especially during clinical rotations) will give you the best idea if an away is more likely to help or hurt your chances at school X. You have to be honest with yourself. Do you excel at adapting to different rotations, quickly figuring out what your attendings are looking for in their students and then adapting to the new environment? Or do you struggle with the different environments and changes every rotation? How many of your previous attendings (and residents) liked you, wrote you good evaluations? Do you find it easy to 'befriend' new people, fit into new social groups easily? Are you able to tip-toe that fine line in clinical rotations between being the enthusiastic, helpful, humble medical student without coming off cocky, annoyingly enthusiastic or outright clueless (which we all are at this point, but some hide it better than others).

If you think you are that good little med student and you have the track record to back it up so far in clinical rotations than your chances of having a good experience and making it work for you are much better. Be wary, though, this is a game of chance and all you can do is assess the odds for yourself.

In addition to assessing your own strengths and weakness you also have to think about the program you are going for, where it is on your list of possible places you want to go and what your chances there are without an away.

Ideally, you are a social, humble, hard-working medical student, with a nice track record of high pass/honors in clinical rotations who is well liked by residents and attendings. You can adapt quickly to new situations and problems, take criticism graciously, and work your butt of for what you want in med school. You are going for an away at a place that is slightly out of your reach by reputation and thus a good away rotation experience will give you an edge that you didn't have before.

Long story short: Assess yourself and know your weaknesses....are those weaknesses the type that will prevent you from excelling at an away rotation? No one on this forum can do that for you and their anecdotal advice won't help because they don't know you as a person. Maybe even ask a trusted friend/resident/attending (who will be honest & who has seen you in action on the wards) if they think you would do well on an away.

And now some random tips (based on my own n=1 experience):
1. Be humble - learned this the hard way on a core rotation that I wanted to do really well on but got overly enthusiastic (for example, just because you read and brought an article on every one of your patients or their treatment, doesn't mean you have to force it into your presentations every day)
2. Be proactive - ask how you can be helpful, what other work there is to be done if there is a slump, offer to help with scut work for your residents (they will love you for it - at home and on aways); seek out opportunities - ask if you can do that lumbar puncture, ask the nurses if they need help with something; don't be too persistent
3. Find out early how your attendings click, how they want their presentations, what makes them happy during the day; a simple "how am I doing? Is there anything I can improve on" after the first week gets you automatic bonus points for just wanting to improve and then you know what you can do better


In the end, I think some people know how to play this game in med school and some don't quite get it. I don't know what makes the difference...I've seen good people hit a wall during 3rd and 4th year and I've seen complete wallflowers ace their way through clinical roations and into top residencies. I have no clue what that X factor is, but I do believe that with some self-reflection you can determine if you possess it or not.

 

[RySerr21]

It makes a difference because often times how well you do a task is time dependent. If you spent an hr trying to find the patient you're to consult on and another 30 min finding the labs you need, you will not look very good. When I did an away, I never got a log-in for their EMR so I always had to ask the nurses to look up patient labs for me. I also couldn't write notes on their EMR so I couldn't help the residents where they needed help the most. Of course there are other aspects of your rotation they look at, but these factors shouldn't be ignored.

I guess you are right.....if it takes you an HOUR to find a room and an extra to 30 minutes to figure out how to log in and find the "labs" tab on the EMR then i wouldn't want you as a resident either...

cmon this is not rocket science. There are signs everywhere, and hospitals are not that complicated. It also doesn't hurt to ask. At most you would be disoriented for a day or two and then you will figure out where things are with almost your entire rotation left.

While I see how not having computer access would be annoying, thats more the programs fault than yours...you really think the residents were like "oh man this person sucks he wasnt even able to get computer access so he could write my notes for me..." I dont buy that at all. Residents and attendigns understand that you are a student and not a worker. Again, if you show up on time, work hard, are eager to learn and try to be a good part of the team, THAT is impressive. I think people blow out of proportion all of the things you mentioned.