Anesthesia Away Rotations?

[chromuffin]

MS3 considering doing an away rotation to help my chances with matching geographically. I have a low step 1(218) but my ck practice exams are predicting 250-260 (if that matters).

Anyone know the success of away rotations? I have heard anesthesia programs don’t really care about aways. Can anyone speak against this? Particularly in the south/southwest? Considering aways at UTSW, UT-San Antonio, wake forest, Emory, UNM.

---

Members don't see this ad.

 

[Nivens]

MS3 considering doing an away rotation to help my chances with matching geographically. I have a low step 1(218) but my ck practice exams are predicting 250-260 (if that matters).

Anyone know the success of away rotations? I have heard anesthesia programs don’t really care about aways. Can anyone speak against this? Particularly in the south/southwest? Considering aways at UTSW, UT-San Antonio, wake forest, Emory, UNM.

I know I’ve personally written a lot about this in other threads- I’d recommend a search, as there were a lot of comments for and against.

 

[AdmiralChz]

I know I’ve personally written a lot about this in other threads- I’d recommend a search, as there were a lot of comments for and against.

Many of us have, and I agree just do the search.

My opinion - if you’re a marginal candidate, an away is a good idea. I wouldn’t waste a rotation at Emory, WF or UTSW as your step 1 will likely keep you out of serous contention. The others are good targets.

 

[Ready_User_1]

My opinion - if you’re a marginal candidate, an away is a good idea. I wouldn’t waste a rotation at Emory, WF or UTSW as your step 1 will likely keep you out of serous contention. The others are good targets.

Say you were a marginal candidate, in a perfect scenario of knowing that you would have an great rotation and get an excellent letter at a higher tier program vs. going to a place where you could potentially match and getting an equally strong letter. Would you still advise against an away at a reach, or does the program where the letter originates from not of significant value?

 

[chromuffin]

I appreciate the advice. Forgive me for posting a question that is seemingly asked so often. I had no idea how many people are/have been in a similar situation.

 

[AdmiralChz]

Say you were a marginal candidate, in a perfect scenario of knowing that you would have an great rotation and get an excellent letter at a higher tier program vs. going to a place where you could potentially match and getting an equally strong letter. Would you still advise against an away at a reach, or does the program where the letter originates from not of significant value?

The "perfect scenario" is a tough sell - the reality is, it's hard for medical students to shine on anesthesia rotations since there isn't much they can really do. Often the student is working with a different attending each day if they are staying with the same resident, which isn't conducive to getting a letter from some big hitter at the department.

Doing an away at a realistic reach is a good idea, but going for big brand name U which has a step 1 cutoff of 230 isn't a good idea.

I can say this in hindsight as I did an away (in my original specialty, search my post history for more) and not only did I not get a LOR I didn't even get a courtesy interview at the place. I don't view it as a total waste, though - I got to explore a new part of the country I'd never seen before and made some great memories during my month.

 

[Ready_User_1]

Great info! Lots of factors to consider and all with unique consequences.

I appreciate the response. I've lurked on this site for a long time and I've always appreciated your thoughtful, direct and deliberate feedback.

 

[MightBeACylon439]

I can say this in hindsight as I did an away (in my original specialty, search my post history for more) and not only did I not get a LOR I didn't even get a courtesy interview at the place. I don't view it as a total waste, though - I got to explore a new part of the country I'd never seen before and made some great memories during my month.

Yikes! Did they give you any reasoning behind this? I am on an elective away right now and if I could avoid this I would like to as I plan on asking for an LOR at the end of the period.

 

[DivineInterventionPod]

You should speak to the PD at your school to see what they think. In general, aways are not needed in anesthesia. I would only do aways if you have certain programs you for sure want to attend. And don't forget to apply broadly.

 

[AdmiralChz]

Yikes! Did they give you any reasoning behind this? I am on an elective away right now and if I could avoid this I would like to as I plan on asking for an LOR at the end of the period.

Well, I had the letters I needed and felt good about them but they had me all over the place and didn’t have much continuity with attendings. I also was pretty naive to the process and didn’t do enough to set myself up for success.

Not getting an interview was frustrating for sure. They were not up front about that chance and they sent a letter saying they got enough exposure to me while I was there and there was no need for me to come back for a formal interview - I later found out they brought back their preferred candidates for a formal interview.

I wouldn’t worry about your situation, mine was unique and in a different specialty. I’d focus on getting ample face time with the attending and getting all buddy-buddy.

 

[MightBeACylon439]

Well, I had the letters I needed and felt good about them but they had me all over the place and didn’t have much continuity with attendings. I also was pretty naive to the process and didn’t do enough to set myself up for success.

Not getting an interview was frustrating for sure. They were not up front about that chance and they sent a letter saying they got enough exposure to me while I was there and there was no need for me to come back for a formal interview - I later found out they brought back their preferred candidates for a formal interview.

I wouldn’t worry about your situation, mine was unique and in a different specialty. I’d focus on getting ample face time with the attending and getting all buddy-buddy.

I am sorry to hear about that, it sounds like an unfortunate situation all around. It can be frustrating the lack of honest feedback and transparency in medicine sometimes.

I do get quite a bit of time with the attending I am with 2nd to the specifics of the rotation, so I guess I have that going for me, which is nice.

Thanks for the bolded portion, I am a medical student who has yet to match posting on SDN...so worrying is kind of my thing.

 

[agent_purple]

I know a lot of places are already booked up. Getting aways through VSAS has been pretty difficult. I'd recommend applying as soon as possible to the ones that havent opened yet, and apply to several. I've heard hopeful EM applicants trying to get anesthesia rotations as well since EM rotations are getting hard to come by for some. Some places have cut offs for USMLE too so you may want to research that. Cleveland Clinic I think has a 225 minimum.

 

[agent_purple]

I kinda disagree on the away rotations though. If you have an applicant who did 3 anesthesia rotations I would think they would be viewed as a more serious candidate than someone who has only done 1. From PDs that I have talked to they want to see serious candidates and the more letters you have from anesthesiologists you worked with the better. Unless you have a shoe in at your uni and if your uni has an anesthesiology residency doing one might work.

I'm curious though if you only do 1 anesthesia rotation and only have 1 LOR, where are you getting your other LORs from? Surgery? IM? Anything? Does it necesaarly have to be within an associated field? Like could I get one from Peds? I can't see those being viewed as equal or higher than one from in the field.

 

[Psai]

Did zero aways. Was taken seriously by PDs at top programs.

 

[nimbus]

I kinda disagree on the away rotations though. If you have an applicant who did 3 anesthesia rotations I would think they would be viewed as a more serious candidate than someone who has only done 1. From PDs that I have talked to they want to see serious candidates and the more letters you have from anesthesiologists you worked with the better. Unless you have a shoe in at your uni and if your uni has an anesthesiology residency doing one might work.

I'm curious though if you only do 1 anesthesia rotation and only have 1 LOR, where are you getting your other LORs from? Surgery? IM? Anything? Does it necesaarly have to be within an associated field? Like could I get one from Peds? I can't see those being viewed as equal or higher than one from in the field.

How many PD’s have you talked to? Did they really say that?

In my day, the vast majority of applicants had only one anesthesia rotation. I think programs consider all applicants to be serious whether they have 1 anesthesia rotation or 3. They offer interviews based on an initial screen of the applicant’s qualifications. Being a “serious” vs “not serious” candidate is not even a consideration. All applicants are considered serious. Who would waste their time being a “not serious” applicant?

And yes, IM and surgery letters would be good since they are usually the longest clerkships. The content of the letters are more important than who they’re from. Get them from someone who knows you well.

 

[agent_purple]

Yeah so I heard that from 2 PD. But TBH we need to be honest with ourselves that this is on a case by case bases. If you are at a top med school, do one rotation, have great board scores, maybe thats all you need. However if maybe you need some uphill work (i.e. failing class, low board scores, any other red flags) I think its best to do some extra anesthesia rotations. My opinion is that if you know you wanna go into anesthesia why not do more rotations since every other person going into a specialty will atleast do 2+ rotations in the specialty they want.

This is what I've heard and I'm just trying to help you guys and some of it may be hear say, but its just what I've heard. Again, I'm sure if you got a 240+, top 10 med school, with one rotation is different from someone with a 220, with 3 rotations. Personality and work ethic is obviously important too.

 

[Psai]

Away rotations are bad. We have away rotators all the time and it's hard for them to make a good impression. I almost invariably prefer our home students that are going into surgery over the guys coming in to try to "impress" us. I see what the surgical subis do and compare their hustle to our away students who refuse to go to any of our conferences or show up right before we're about to induce while knowing nothing about the patient, I can't imagine why people would think that an anesthesia away is a good idea.

 

[abolt18]

I did one away rotation. I am a DO, Step 1 and 2 in the 240s.

My away was at a "top" anesthesia program, in the city where I already lived. The rotation was my favorite rotation of all medical school for me. I received excellent/positive reviews from all my attendings (they submit evaluations of me each day to the preceptor). My evaluation by the preceptor of the rotation was seriously glowing. No other eval had been so thorough or detailed while being entirely positive. I got a very supportive letter of recommendation from a big name at the program. That letter was mentioned in quite a few of my subsequent interviews.

I interviewed at this program, and ranked it #2. I ended up matching at my #4.

It's a crapshoot. Do what you want. I had an excellent experience and would do it again, even knowing I didn't match there.

 

[agent_purple]

Away rotations are bad. We have away rotators all the time and it's hard for them to make a good impression. I almost invariably prefer our home students that are going into surgery over the guys coming in to try to "impress" us. I see what the surgical subis do and compare their hustle to our away students who refuse to go to any of our conferences or show up right before we're about to induce while knowing nothing about the patient, I can't imagine why people would think that an anesthesia away is a good idea.

So how does anyone get experience that doesnt have an anesthesia home rotation?

 

[abolt18]

So how does anyone get experience that doesnt have an anesthesia home rotation?

I reached out to a private practice anesthesiologist who sits all his own cases and ended up working with him for a month. It was a phenomenal learning experience for me.

 

[Reveler]

One PD told me that he discouraged aways unless an applicant needed an LOR. After that, 4th years should be rotating in other specialties that interest them and to prepare for intern year. I agree that it's hard to look good and easy to get in the way.

I did a 3rd year anesthesia elective and one away prior to applications going out. My goal was to have two anesthesia LORs. Some people from my school went bonkers and did like 4 or 5 aways. If I did it over again, I'd stick with my 1 away.

 

[AdmiralChz]

If you have an applicant who did 3 anesthesia rotations I would think they would be viewed as a more serious candidate than someone who has only done 1. From PDs that I have talked to they want to see serious candidates and the more letters you have from anesthesiologists you worked with the better. Unless you have a shoe in at your uni and if your uni has an anesthesiology residency doing one might work.

If you think we (in general, "admissions committee") has time to delve THAT deeply into your application to see who had more aways you are fooling yourself. Doing any number of away rotations doesn't show dedication to the field - theoretically, you spending money to travel to different programs proves dedication. If you want specific things in your application to show interest, then get an anesthesia LOR or two or involve yourself in some sort of related research. I can't think of a single applicant in two years that I reviewed their actual rotation schedule.

As for letters, "we" don't necessarily want to see letters from anesthesiology (that being said, you should probably have at least one) as much as we want to see letters from people who genuinely know you and can contribute thoughtful commentary on your potential as a resident and physician. This is important, as some of the best letters I've read have come from Peds/IM/FM where applicants spent many weeks on their service or at their clinics.

Finally, grossly speaking as general advice, a lukewarm letter from a high-level academic person (I.e. chairperson who maybe never even worked with you) is easily spotted and definitely worth less than a very strong performance letter from an internist or family medicine doc. All things being equal, of course.

 

[agent_purple]

If you think we (in general, "admissions committee") has time to delve THAT deeply into your application to see who had more aways you are fooling yourself. Doing any number of away rotations doesn't show dedication to the field - theoretically, you spending money to travel to different programs proves dedication. If you want specific things in your application to show interest, then get an anesthesia LOR or two or involve yourself in some sort of related research. I can't think of a single applicant in two years that I reviewed their actual rotation schedule.

As for letters, "we" don't necessarily want to see letters from anesthesiology (that being said, you should probably have at least one) as much as we want to see letters from people who genuinely know you and can contribute thoughtful commentary on your potential as a resident and physician. This is important, as some of the best letters I've read have come from Peds/IM/FM where applicants spent many weeks on their service or at their clinics.

Finally, grossly speaking as general advice, a lukewarm letter from a high-level academic person (I.e. chairperson who maybe never even worked with you) is easily spotted and definitely worth less than a very strong performance letter from an internist or family medicine doc. All things being equal, of course.

Thats really good advice. I definitely appreciate it. I've been getting near honors on all my rotations and havent considered asking them for LOR since the field isn't closely pertinent to anesthesia (family, geriatrics). I guess I'm just a little more concerned to do more aways since my step score is under average so doing more aways might help me?

 

[Iso4ane]

There are three scenarios when you do an away:

1) You are a screw up and don't click with the program
2) You are just average and meh
3) You are a superstar

Only one of those three outcomes will really help you, and realistically how many people do you think fall into that category.

 

[AdmiralChz]

Thats really good advice. I definitely appreciate it. I've been getting near honors on all my rotations and havent considered asking them for LOR since the field isn't closely pertinent to anesthesia (family, geriatrics). I guess I'm just a little more concerned to do more aways since my step score is under average so doing more aways might help me?

It's not a bad idea to do an away especially if you don't have a home program - it's a good hands-on look at how day-to-day life is like a resident in the field. But I think 3 is excessive, and the point is more than they aren't required to be considered an interested/competitive/serious applicant.

 

[Psai]

I'm sure that my best letter came from a peds guy that I worked with closely in clinic.

 

[vector2]

Posted this before but I'll reiterate, got 2 anesthesia letters and 1 family practice letter. I'm pretty sure it was the FP letter that helped me match at my number one because that was the person who highlighted that I worked hard and got along well with people even when rotating on a specialty that I would never do in a million years.