Are aways necessary for IM?

[coldcase331]

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I've been getting conflicting answers from my school, my advisor, my IM residents, and my friends about whether doing an away for medicine is required to go to a good program.

For background: Step 1: Upper 240's, mostly H for M1/M2, mix of H/HP in clerkships so far.

My plan is to go to a top program in the southeast, but I don't have a particular one in mind. My school is in the northeast, but I grew up/went to college in the south. So I guess my question is: Given my stats, and where I grew up, would I need to do an away at a good program in the region to show interest?

 

[Quantal Reasoning]

Just do one to be sure

 

[y123]

Depending on your school
If u are from a top school then the answer is no

 

[fasteddie911]

No

 

[LyMed]

If:
-There's a particular program you want to go to.
-If you have time and money to spend and would like to check out how another institution is run
Since you said no to the first question, then ask yourself if you fit in the second category

Generally, aways for IM isn't needed.

 

[21Rush12]

Don’t worry — there’s a lot of great community IM out there in the Midwest that won’t require an away. Plus I heard the reserved parking is usually 240+ instead of 250

 

[Jesus1]

No. Save money for interview travel.

 

[IMreshopeful]

Not necessary for IM

Firstly, IM is a huge field where programs routinely interview 300+ applicants for 30-40 spots. It’s unlikely that you will make a huge dent. This isn’t plastics or NSG or cardiothoracic i6 where they are interviewing to match two people per year.

Secondly, If you don’t have the scores or the grades or whatever - then that top program you do a one month cardiology or rheum or whatever elective at is still unlikely to invite you

If you screw up big it’s likely to bite you in the butt. Imagine the stress of doing a sub I at your own institution - now compound that with trying to learn a new system, EMR, hospital layout, etc etc.

I think if you have a strong regional preference and the program is more upper mid tier it can be a useful thing to do. I did an away at one and ultimately matched at said program. However, on speaking to the PD after match, I would apparently have matched there without doing an away... so it was probably a waste of time. Also programs will probably note that you have ties to a particular place and take it into account.

Tl;dr you can do it but don’t expect huge returns.

 

[DBV]

Am currently at Duke (since you mentioned good programs in the SE) and I really dont think any of my cohort did aways here. If any did it's the vast minority and I'm certain it doesnt help.

 

[KeikoTanaka]

My question is: Is doing an away rotation a hinderance? Because if it's not, it can't hurt, and you should go for it. Life is full of so many hidden surprises. Sure, at an extremely competitive place like Duke, they're gonna take the first 10 people with perfect board scores. But, maybe just maybe at another competitive location, a student can make a really amazing connection with the faculty and they will pick you. Like someone said earlier, go for it but don't expect huge returns. If you're dead-set on a certain program, I say 100% go all in because you'll only ever regret it if you don't.

You'll be at another lesser-quality program hating your life (which you will most likely do at ANY program) and you'll focus on the negatives, and there could be this burning thought in your head that if you had just done that one rotation at the other program you could have gotten in... And, at least if you do the rotation and still don't get in, you'll know you've tried all you could.

 

[Deecee2DO]

How would being a DO change this story? Should a DO do an away at said program because they are at disadvantage to start out?

 

[siliso]

No, not necessary. Maybe if you were an IMG from an unknown quantity type institution and you connected with someone to vouch for you at the institution where you hope to match. US MD or DO, no, you don’t need to. If you’ve got good numbers for the programs you want to go to you’ll go to one of them.

 

[KeikoTanaka]

How would being a DO change this story? Should a DO do an away at said program because they are at disadvantage to start out?

As a fellow DO, Im gonna say it PROBABLY is more dependent on board scores and location.

For example, post-merger, if you're applying to a previously AOA accredited program, they're probably gonna look a lot at your COMLEX scores.

If you're applying to an ACGME program that has always been ACGME, but has previously accepted DOs in the past, I'm gonna say you don't need to do an away, but your USMLE is going to be weighed heavily. If it is a program that shows they have only taken 1-2 DOs a class for the last 5 years, I would do an away there to stand out to be one of those very select DOs who get taken. If they take way more and don't seem to be biased, I wouldn't do an away and hope that the USMLE score will carry.

 

[siliso]

Having served in residency recruitment, it might even be perceived as odd and your opportunities to hurt your chances by acting weird or rubbing someone the wrong way may be greater than your chances of buffing your application. Your stats are your stats, the interview is for making sure you’re normal. Do an away if you want to but don’t expect it to change your prospects.

 

[Deecee2DO]

As a fellow DO, Im gonna say it PROBABLY is more dependent on board scores and location.

For example, post-merger, if you're applying to a previously AOA accredited program, they're probably gonna look a lot at your COMLEX scores.

If you're applying to an ACGME program that has always been ACGME, but has previously accepted DOs in the past, I'm gonna say you don't need to do an away, but your USMLE is going to be weighed heavily. If it is a program that shows they have only taken 1-2 DOs a class for the last 5 years, I would do an away there to stand out to be one of those very select DOs who get taken. If they take way more and don't seem to be biased, I wouldn't do an away and hope that the USMLE score will carry.

Yeah makes sense. Thank you

 

[coldcase331]

Having served in residency recruitment, it might even be perceived as odd and your opportunities to hurt your chances by acting weird or rubbing someone the wrong way may be greater than your chances of buffing your application. Your stats are your stats, the interview is for making sure you’re normal. Do an away if you want to but don’t expect it to change your prospects.

What do you mean exactly as perceived as odd? Do you mean that it's so odd for an IM applicant to do an away, that it would hurt my application because they would question my judgment?

 

[sunshinefl]

Can I ask a dumb question? How do I fill 4th year if I don’t do aways? Do I just do related IM subspecialty electives at my core rotation site? (Current 2nd year DO interested in internal med-primary care track in Florida).

 

[siliso]

What do you mean exactly as perceived as odd? Do you mean that it's so odd for an IM applicant to do an away, that it would hurt my application because they would question my judgment?

Yeah, maybe. I would wonder what is this person trying to make up for or why are they here. If they had a reason I don’t mean I would hold it against them for coming...but it would make me curious. My perspective is attending in general IM at a midwestern university program so maybe it would be different if I were at a super specialized or highly coveted location, I don’t know.

 

[whoknows2012]

Can I ask a dumb question? How do I fill 4th year if I don’t do aways? Do I just do related IM subspecialty electives at my core rotation site? (Current 2nd year DO interested in internal med-primary care track in Florida).

I did electives and sub-i’s at NYC programs (st Luke’s, Cornell, Sinai) to be closer to where I lived and for electives in specialized areas (ie BMT at a hospital had leukemia/lymphoma/myeloma and BMT expertise, ccu at a big heart hospital) where my med school didn’t really have those options. Aways can also be a great opportunity to visit another city or state if you have the money and are interested in that. What they’re not great for is for auditions or letters. This is true except for rare circumstances, ie applying to a dream high ranked program without much chance for an interview otherwise. So this is high reward low risk.

Otherwise 4th year you can take advantage of time and partake in interesting opportunities like electives your school might offer that are not classic clinical rotations (ie I did a public health elective, worked at IBM on the Watson project). You can also do some research in a field of interest.

 

[7331poas]

I did electives and sub-i’s at NYC programs (st Luke’s, Cornell, Sinai) to be closer to where I lived and for electives in specialized areas (ie BMT at a hospital had leukemia/lymphoma/myeloma and BMT expertise, ccu at a big heart hospital) where my med school didn’t really have those options. Aways can also be a great opportunity to visit another city or state if you have the money and are interested in that. What they’re not great for is for auditions or letters. This is true except for rare circumstances, ie applying to a dream high ranked program without much chance for an interview otherwise. So this is high reward low risk.

Otherwise 4th year you can take advantage of time and partake in interesting opportunities like electives your school might offer that are not classic clinical rotations (ie I did a public health elective, worked at IBM on the Watson project). You can also do some research in a field of interest.

Would you recommend it for a student who goes to a newer program? Or do you still think your application speaks for itself?

 

[whoknows2012]

Would you recommend it for a student who goes to a newer program? Or do you still think your application speaks for itself?

Really depends on the situation. How good are your grades? Your steps? Aoa? research? Etc. if you’re middle of the road and new school I’d say the risk benefit starts to shift but again, you have to be careful.

 

[siliso]

Do electives that interest you and that you won’t get to do again. I did ethics, forensic psych, autopsy pathology, some low-hours TA things that allowed plenty of time off and relaxation, vacation months...if you have strong knowledge base and good board scores do whatever sounds fun to you. If not so much then you might do well to take a few more medical subspecialty electives. Cards, liver, renal, ID. I think ICU is good to do either way, as a sub I or an elective.

 

[jdh71]

I've been getting conflicting answers from my school, my advisor, my IM residents, and my friends about whether doing an away for medicine is required to go to a good program.

For background: Step 1: Upper 240's, mostly H for M1/M2, mix of H/HP in clerkships so far.

My plan is to go to a top program in the southeast, but I don't have a particular one in mind. My school is in the northeast, but I grew up/went to college in the south. So I guess my question is: Given my stats, and where I grew up, would I need to do an away at a good program in the region to show interest?

No

 

[Instatewaiter]

I've been getting conflicting answers from my school, my advisor, my IM residents, and my friends about whether doing an away for medicine is required to go to a good program.

For background: Step 1: Upper 240's, mostly H for M1/M2, mix of H/HP in clerkships so far.

My plan is to go to a top program in the southeast, but I don't have a particular one in mind. My school is in the northeast, but I grew up/went to college in the south. So I guess my question is: Given my stats, and where I grew up, would I need to do an away at a good program in the region to show interest?

No

/Thread

 

[7331poas]

No

No

/Thread

To clarify, the message you are saying is that his app already secures him a spot at a top IM program, or is it that an away will not help his chances at getting a top IM program?

 

[jdh71]

To clarify, the message you are saying is that his app already secures him a spot at a top IM program, or is it that an away will not help his chances at getting a top IM program?

Will NOT help. Could hurt. I’m making no assessment of app. That can be done much better than here in the IM forum.

 

[Instatewaiter]

Will NOT help. Could hurt. I’m making no assessment of app. That can be done much better than here in the IM forum.

This

/Thread (again)

 

[mrbreakfast]

To stress this, for aways:
-in order to increase your chances of matching you have to impress everyone (including every resident you work with)
-in order to decrease your chances of matching you have to rub just one person the wrong way

Aways are only worth it if you can say yes to all of these:
1) You have a literal dream program
2) You have a low step score or something else that, right now, give you almost/no chance at getting an interview there
3) You're well-above average both as a clinical student and at being a personable being

 

[7331poas]

To stress this, for aways:
-in order to increase your chances of matching you have to impress everyone (including every resident you work with)
-in order to decrease your chances of matching you have to rub just one person the wrong way

Aways are only worth it if you can say yes to all of these:
1) You have a literal dream program
2) You have a low step score or something else that, right now, give you almost/no chance at getting an interview there
3) You're well-above average both as a clinical student and at being a personable being

Is there a reason why this mindset is so different than other specialties where aways are encouraged or required? Do they also reject applicants who rub *anyone* the wrong way?

 

[mrbreakfast]

Is there a reason why this mindset is so different than other specialties where aways are encouraged or required? Do they also reject applicants who rub *anyone* the wrong way?

Some academic surgeon can correct me, but I think for the surgical subspecialties they want to see you perform in a variety of settings/get letters from a diversity of people, plus probably view aways as a trial by fire of sorts. I think surgeons have much thicker skins than other physicians (have you been in an OR?) whereas on the other specialties, you spend a ton of time on rounds with different subspecialists so already have that diversity. For smaller fields, aways increase the chance your interviewer personally knows your letter writer.

For emergency, I have no idea why they make you do aways, but have heard personality fit is the #1 most important factor.

I have heard (again, could be wrong) aways are becoming less common for things like GS and OBGYN as well.

 

[siliso]

It’s a less competitive field than ones where aways are expected. It may well be that people doing aways in other fields do lose opportunities by not impressing people at their away sites - those fields can take their pick of applicants even more so than IM can. But, if you need letters from aways to get into the field you want, guess you have to take the risk. In IM you just don’t. It may also be that most schools will have plenty of home rotations in various medicine specialties but may only have one in urology or whatever.

 

[DokterMom]

To stress this, for aways:
-in order to increase your chances of matching you have to impress everyone (including every resident you work with)
-in order to decrease your chances of matching you have to rub just one person the wrong way

Aways are only worth it if you can say yes to all of these:
1) You have a literal dream program
2) You have a low step score or something else that, right now, give you almost/no chance at getting an interview there
3) You're well-above average both as a clinical student and at being a personable being

If you don't do aways and are applying to programs with a 'largish' number of spots, to the people reviewing your application, you are just a set of numbers and fairly generic comments. If those numbers and comments represent you fairly or put you in a flattering light, then there's not really much of an advantage and plenty of potential downside. All it takes is for one person to dislike you.

But if you're much better in person than your numbers and comments would indicate, doing an away gives you your best opportunity to secure a spot that might otherwise be unlikely. If everyone likes you and your numbers are 'OK' then that rotation could be the thing that gets you the nod when you otherwise might not have even been interviewed. I'd caution that if you aim too high and your numbers are too low, though, that even the best in-person experience may not be enough to get you ranked above a "seemed nice at the interview" rock star. I'd suggest you aim for top-of-your range-level programs rather than 'dream' sites.

For highly-competitive specialties where programs only have a few slots, aways can be invaluable. Again - select those programs carefully to avoid wasting your resources.

 

[caffeinateddoc]

Are there any DO students who matched without doing aways? It seems like everyone I know is doing aways and I don't want to be at a disadvantage come application time by not doing an away.

 

[MedicineZ0Z]

Are there any DO students who matched without doing aways? It seems like everyone I know is doing aways and I don't want to be at a disadvantage come application time by not doing an away.

Yeah like.. a crap ton lol. Aways will most likely hurt you unless you do it somewhere that's out of your competitive range and you kill the rotation.

 

[mrbreakfast]

Are there any DO students who matched without doing aways? It seems like everyone I know is doing aways and I don't want to be at a disadvantage come application time by not doing an away.

DOs have different rules. If you want to go to an academic, I would do an away or two regardless of field.

Alternately, if you really want to go to X program and they have zero DOs on the roster, that might be a good way to get an interview you otherwise wouldn't. Key rule is an away has no risks if you wouldn't have had much of a chance to interview there in the first place.

 

[Dwan]

It’s a less competitive field than ones where aways are expected. It may well be that people doing aways in other fields do lose opportunities by not impressing people at their away sites - those fields can take their pick of applicants even more so than IM can. But, if you need letters from aways to get into the field you want, guess you have to take the risk. In IM you just don’t. It may also be that most schools will have plenty of home rotations in various medicine specialties but may only have one in urology or whatever.

I don't think that's necessarily the case. IM at top tiers is highly competitive, some moreso than getting into other competitive fields. However, aways at those institutions don't tend to help regardless. IM is a large field, and they care about honors/AOA more than research and connections (unless PSTP); in many competitive, smaller fields, the research and connections are such a big deal that these can even overcome mediocre #s. It's similar once we apply to competitive fellowships - getting into any onc/cards/GI isn't necessarily harder than getting into a top IM program, however, connections and research will carry much more weight there.