advice needed

[Big McHuge]

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My 4th yr schedule only has 2 free months (one being my vacation) before the match. I was planning on doing two aways, one being an AI, but the rotation dates are 10/21-12/13 (each being 4 wks). Hopefully I will have some interviews to go on during this time. I'm thinking it will look bad taking days off during a rotation, especially an away at a place that I may want to do my residency at. Does it look worse taking days off from an AI? Any advice or recommendations? Most of my electives are scheduled after the match and my school won't let us change this.

 

[justdoit31]

Is there a reason you can't do your rotations earlier? I did mine in August and September then was able to do most of my interviews before my last away in Jan, during that one I took a couple days off for interviews but kept it to a minimum with no negative responses.

 

[pooh86]

I wouldn't take any more than 2-3 days off during your away rotation, even if it's AI. When I was a 3rd yr doing Peds PICU, a 4th yr student was gone for interviewing and step 2 CS/CK stuff multiple days. All the residents and attendings took notice and said behind her back that she clearly had no interest at our institution even though she made the effort to do the away rotation. Needless to say she didn't match there. It looked really bad on her part.

(remember that you often need to take 2 days off for travelling when interviewing)

Peds is not that competitive, so I'd recommend not doing the away at all rather than taking days off.

 

[Slade]

I wouldn't take any more than 2-3 days off during your away rotation, even if it's AI. When I was a 3rd yr doing Peds PICU, a 4th yr student was gone for interviewing and step 2 CS/CK stuff multiple days. All the residents and attendings took notice and said behind her back that she clearly had no interest at our institution even though she made the effort to do the away rotation. Needless to say she didn't match there. It looked really bad on her part.

(remember that you often need to take 2 days off for travelling when interviewing)

Peds is not that competitive, so I'd recommend not doing the away at all rather than taking days off.

Another vote from me for NOT doing an away. There is absolutely no reason to do an away in peds. In fact, it might hurt you (applicants never looks as good as they do on paper).

 

[Cuthbert]

Another vote from me for NOT doing an away. There is absolutely no reason to do an away in peds. In fact, it might hurt you (applicants never looks as good as they do on paper).

I would disagree with that last part. I spent three years on the selection committee at my program, one as chief. Each year we had multiple people who did not look the best on paper but did rotations with us and stood out (great interpersonal skills, good work ethic, personality, etc). These people were ranked higher. Likewise, there were some really smart applicants who rotated with us and had no clinical skills whatsoever. These individuals were moved down the list.

Ultimately, it depends on what kind of applicant you are. If you are a hardworking underdog, an away rotation can help your chances. If you look great on paper but are a douche bag (pardon the appropriate phrase)... You get the idea.

 

[michigangirl]

Another vote from me for NOT doing an away. There is absolutely no reason to do an away in peds. In fact, it might hurt you (applicants never looks as good as they do on paper).

Cuthbert beat me to it. I vehemently disagree-- there are many reasons not to do an away, but there are some reasons to do them. For me, doing an away in the city where my fiancee was in school and at my dream institution in that city opened doors that would not have been opened by me on paper. I'm still here, and it changed my life.

If you're great on paper and are concerned about how you may come off in person, don't do it. But there are no absolutes on this topic.

 

[Big McHuge]

thank you for the responses. If I wasn't worried about missing days, I was going to do the away rotations regardless. Maybe I should just do one away, and try to schedule most of my interviews during my vacation month (mid October-mid November). I don't even know if that's possible. On paper, I'd say I am an average student so I was gonna apply to a lot of programs.

 

[jkurtz02]

thank you for the responses. If I wasn't worried about missing days, I was going to do the away rotations regardless. Maybe I should just do one away, and try to schedule most of my interviews during my vacation month (mid October-mid November). I don't even know if that's possible. On paper, I'd say I am an average student so I was gonna apply to a lot of programs.

If you can take the other month as vacation I would do that. Some programs do start interviewing in Mid-October, but most don't start until mid-November and the peak is End of November into December before the holidays. With ones you can't fit in going into January. I did 13 interviews and 8 were in the mid-November to December.

 

[michigangirl]

pick one program to do your away, your "reach" program that you would love to go to. Do the majority of your interviews during your vacation month.

 

[GoSpursGo]

Personally, I'm also in the "don't do an away" camp. Unless there is a program that you really, really want (ie significant other or family in the area), I just don't think you gain much by doing an away. Of course, if you DO have a really compelling reason to shoot for one specific program, by all means go for it--but once you're there, give 110% and don't ask for days off to interview elsewhere or take Step 2 or anything like that.

 

[Slade]

When you do an away, it's really hard to shine. You're in an unfamiliar hospital with an unfamiliar system and unfamiliar EMR. It likely takes at least 2 weeks just to figure out how to log in, order labs, write notes, find the cafeteria, find patient rooms, and learn all of the different protocols (antibiotic protocols, asthma protocols etc are completely different at different hospitals). You really only have the last two weeks to shine if you're very good and even then you might see multiple attendings with limited exposure to a particular attending from which to get a letter. It's quite a gamble.

 

[Siverhideo1985]

how to log in, order labs, write notes, find the cafeteria, find patient rooms, and learn all of the different protocols

none of these are important in determining if you will do well on an away rotation. Being a clinically competent med student has about 5% to do with how your attendings will remember you...

Dont listen to med students giving advice on away rotations - listen to that guy/gal up top who was on a selection committee. Or even better, go ask any program director at your home institution and then talk to your trusted advisors, they will be able to give you honest advice about whether you are the kind of person that will do well on aways.

 

[Slade]

none of these are important in determining if you will do well on an away rotation. Being a clinically competent med student has about 5% to do with how your attendings will remember you...

Dont listen to med students giving advice on away rotations - listen to that guy/gal up top who was on a selection committee. Or even better, go ask any program director at your home institution and then talk to your trusted advisors, they will be able to give you honest advice about whether you are the kind of person that will do well on aways.

Well, this is not advice I'm spouting out of my ass, I got this all from my home program's director AND my advisor AND residents. Not one of them ever advised any student to do an away in peds (the only exception is if the student is a bad applicant, in which case an away is a hail mary, basically the only chance to get your foot in the door). Because of all of these technical things that I mentioned, it takes a while for a student to look competent. For the first two weeks most people are floundering, not due to any incompetence, but because they just don't know the system yet.

In any away, you are competing against home students. I can tell you anecdotally that we completely outshined the students who were doing aways with us despite us trying to help them as much as possible (even their way of presenting was different). The residents were not impressed, despite them being good students.

I just don't get your comment about how doing well on an away is on not dependent on how your attendings remember you... I mean, that is sort of exactly how aways are evaluated - a letter of recommendation at the end of the rotation by an attending. At our program, residents and attendings evaluate a student and see if they left a positive impression. How do you think an away is evaluated?

OP, do what you want, but at least you'll have heard a POV from the other side.

 

[GoSpursGo]

When you do an away, it's really hard to shine. You're in an unfamiliar hospital with an unfamiliar system and unfamiliar EMR. It likely takes at least 2 weeks just to figure out how to log in, order labs, write notes, find the cafeteria, find patient rooms, and learn all of the different protocols (antibiotic protocols, asthma protocols etc are completely different at different hospitals). You really only have the last two weeks to shine if you're very good and even then you might see multiple attendings with limited exposure to a particular attending from which to get a letter. It's quite a gamble.

I completely agree, and this is in line with the advice I received from the PD and residents at my home institution as well. It doesn't matter how personable you are, if you slow the team down (more than the regular student) because you don't know all of these logistics, while the residents may not actively DISLIKE you you may not get the glowing endorsement you were hoping for.

 

[mvenus929]

In any away, you are competing against home students. I can tell you anecdotally that we completely outshined the students who were doing aways with us despite us trying to help them as much as possible (even their way of presenting was different). The residents were not impressed, despite them being good students.

So, my residency adviser (who also is the go-to person for all of fourth year electives) says that you shouldn't go on an away unless your specialty requires it (the surgical subspecialties, military, etc), because most people from our school look better on paper than they do in person. On the other hand, most of the residents I've talked to in the past month since starting fourth year have told me it's good to do an away just to see how other hospitals work and to see if you'd like a certain type of program (stand alone children's hospital vs. hospital within a hospital, etc).

That said, I wanted to comment on the above quote, because my inpatient peds rotation during third year was an away rotation. We have an agreement with one of the hospital systems in another city to take our students, but only with peds. Another school sends their students up there for everything. I didn't have any problems adapting to their way of doing things (other than the fact that they still had a paper charting system, while we were using EMR at our home institution). I also did an away for my surgery rotation, to a different hospital system where another medical school sends their students through... and my classmate and I completely outshined the 'home' students.

So, I think it's really important just to figure out what kind of student you are. If you're going to work hard for a month and quickly adjust to the new system, then do an away. If you're the type of person who just skates by, then you're probably going to look better on paper than you will in person.

 

[Siverhideo1985]

Let me try to clarify. The decision whether to do an away, even in peds, should be an individual consideration. There is no black and white answer to this question. Telling someone who wants to go into peds never to do an away is careless advice in my opinion, especially since we don't know anything about the persons application strength, their goals for residency placement or their motivations for considering an away rotation.

There are some very good reasons to do an away rotation, even in pediatrics. Just to name a few: if you want to try to impress a "reach" program that you would otherwise not have a chance at, if you want to experience a type of pediatric medicine unlike the kind at your home institution (outpatient vs inpatient, big academic hospital vs community), if you just want to see if a particular program is to your liking, or to experience a subspecialty that may not offer a rotation for med students at your program.

If you have a good reason to do an away you should carefully weigh the risks and benefits of doing this away. What has your clinical performance been so far at your home institution? Do you struggle with the constant change from one rotation to the next? Do you have an easy time adapting to new people, new residents...do you work well with a large variety of people? There are people that are better at walking the fine line of 3rd and 4th year medical school and there are people who struggle. Which one are you? Which one do your trusted advisor think you are? Just ask someone who will give you an honest answer...in fact, ask a few people!

Do this self-assessment in the context of what you are trying to get out of this away rotation. Are you taking that one shot at the big-time academic, top-ten program that you would otherwise never stand a chance on paper? In that case, what do you have to lose? Is it a safety school that you just want to see what their residents are like and what the program feels like?

In the end, its just a risk-benefit assessment. Be honest with yourself, your goals and your reasons for doing an away. Then make up your own mind and give it your best shot.

If you decide to do an away rotation, there are some pretty easy ways to look good even if you don't know how to order tylenol or how the paging system works. But that's another whole post on its own.

 

[GoSpursGo]

I don't think anyone was disagreeing that doing an away at a program that you have good reason to be very highly interested in was a reasonable idea. If there's a particular difference between your program and another that you'd like to explore (ie big academic vs community), I suppose that makes some sense.

What we're simply trying to say is that doing an away is definitely not NECESSARY in peds like it is in some other specialties. Even if you assume for the sake of argument that you will shine wonderfully, given that doing an away rotation is generally very expensive (cost of flight each way, housing at probably a very high rate if you're only renting for a single month, and all of the other incidental expenses of traveling) on top of all of the other expenses that you'll incur over the course of interview season, it is important to make sure that if you do an away that you have a clearly defined goal that you want to accomplish and that it's worth the cost.

 

[BabyDoc86]

So I have a question that is sort of related. My med school is ~10 hours away from home. I have been looking into doing away rotations at a school that is ~20 minutes from "home", and I can do up to three rotation months there. My goal is to come home for residency; there are five programs within close proximity that I am (for now) hoping will wind up on my ROL, and this school is one of them. I wouldn't have any of the additional costs of housing for those months since I could bunk with friends/family. Yes, I plan on applying there for residency and am considering an away rotation in peds there, but the additional months would just be to stay in one place for rotations that are at home. Good/bad idea? Any insight would help.