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I think the negativity about doing away rotations is overblown. Anesthesiology is a field med students aren't expected to know much about, but have good opportunities to be useful in. That means that if you show up willing to help out and work hard you'll make a great impression and will really stand out from all the other 4th year students who are just there to fill an elective. I'm at the bottom of my class academically, but I got two LORs from one of my away rotations, and all the residents I worked with said I did a great job. They turned out to be my first interview invite, and there's absolutely no way I would have gotten an interview there otherwise. I'd recommend doing 1-3 away rotations at places you'd like to do residency at. I did two, and I wish I'd done one more. On the other hand, if the residents on your other rotations don't seem to find you all that helpful, you might be better off staying home.