joaquin13

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I know everyone is worrying about the match right now...but I was wondering when are the good times for scheduling audition rotations. I am trying to set up 3 elective EM rotations for the months of August,September, and October. Is the October one too late in the year? The Oct one I am scheduling last is my first choice, but I wanted to make sure it was my last one so I would really be prepared and make a really good impression. Please let me know your input! Thank you.
 

Seaglass

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First - why 3? One or, at most, two should be sufficient if you're already doing one at home. If not I still wouldn' do more than two.

Second, I don't think it requires 8 wks of EM to get up to speed on how to work in th ER. Most of the students I have rotated with were on the ball after 1 or 2 shifts. If you're doing them as a fourth year your knowledge base should be OK enough to do well. That said I believe strongly that what PD's value most in students and residents are 1) hard workers who are 2) teachable.

To answer your question the general consensus seems to be that, at programs that put all their interns in the ER in july, that July is not a good month. Despite that at least a few students who post here had good July rotations. It might be best to choose a program with a well developed student curriculum for July so you'll get more consistent teaching.

August and Sept are good months. I did one in Oct and got a letter by the end of the month. CW is that you're unlikely to get a letter in time in Oct. but my experience is programs know you need it for interviewing and will get one out STAT for you. Mine was sent to our student affairs office overnight mail IIRC.

Hope this helps.

C
 

roja

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I only did 2 rotations. One in May (long story) and then an away in Oct. I see no problem with doing 3. Especially if your school allows for that. its unusual where I came from for people to do that many but in NYC I noticed people often did 3 or 4 EM months. Probably because there are so many available in a small area.

I don't think Oct is to late.
 
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joaquin13

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I attend a DO school so we do not have a base hospital. I am doing the 3 outside EM electives because I want to do an allopathic residency and want to be competitive. Also, I enjoy doing emergency medicine, and I might as well do that as en elective as opposed to urology or something! Thanks for all of your help.
 

Andy Kahn

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I am at UTMB (Galveston, TX) which does not have an EM residency so I actually ended up doing my EM rotations in Dallas (June to July), Louisville (Aug to Sept), and Sacramento (Sept to Oct). I did an EM Ultrasound elective at UC-Irvine from Oct to Nov. It was nice that there was no limit on how many away rotations I did (but had to do Senior Surg, Neuro, and Derm/Rad in Galveston or Austin) just as long as the rotations were different. My Dallas rotation was my senior EM, Louisville was an elective, and Sacramento was my Acting Internship. Several faculty have suggested doing ophthalmology, cards, SICU, or something else since I would have my whole life to do EM. I thought those would all be helpful, but I am very happy with doing all the EM rotations because I really enjoyed each one and felt like I did know a whole lot more by my 2nd and 3rd rotation. I did lots of Histology, Biochem, and other medical courses in college which seemed to help for med school (and enjoyed them more than most non-science classes) so I feel the same way about doing lots of EM rotations if its fun and useful. ICU or anesthesia would have been great too, but I ended up "mixing in" the EM ultrasound month into my schedule (which was a little change but still nice to be in the good ole ED). I was able to stay with friends or family at Dallas, Louisville, and UC-Irvine, but Sacramento had a list of people who rented out a room in their house for the month and that worked out great. There are a few places that provide free housing so you might look into that also.

My first rotation was great. My first week or so was actually the last week of the year for the residents so I got to do lots of procedures (many of them were days from finishing their residency). The last few weeks actually were not too much different. The procedures were still there although there maybe was a little decline and things moved a little slower with brand new interns everywhere. Joaquin13, as far as your concern about doing your first choice after the other rotations, it makes sense but I knew that I would probably want to go to Dallas so I was worried about scheduling it as my first rotation of 4th year. I ended up doing fine and don't know if it would have made a huge difference if I scheduled it later b/c the residents and faculty understand that it is early in the year. If you work hard and apply the things that they teach you (as cg1155 mentioned), then you should be fine. I think they can tell if you are interested in EM field and/or their program and if you are doing your best. I would also add that if you get along well w/ the residents and faculty, then the word gets around and you will be a competitive applicant there. Whatever order you do your rotations in, just work hard, have fun, and make new friends. It has been nice keeping in touch with the other students I rotated with.

The SLORs are important so its definitely good to get them early and have them so that you can receive interviews as soon as possible (some programs may end up sending an interview before they get everything anyway). I ended up not getting letters from my last rotations, but then you might have the nice advantage of saving money by not having to return for interviews (Louisville let us interview while we were there and Sacramento said we did not have to interview if we rotated there. I was also able to do my UCLA-Harbor and MLK interviews while in the area doing the UC-Irvine rotation. Maybe the nicest thing for me was the chance to travel and really experience different places in the country for a month while getting to also see the different EDs and programs close up.

Good luck!
-Andy Kahn
 

roja

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Originally posted by Andy Kahn
I am at UTMB (Galveston, TX) which does not have an EM residency so I actually ended up doing my EM rotations in Dallas (June to July), Louisville (Aug to Sept), and Sacramento (Sept to Oct). I did an EM Ultrasound elective at UC-Irvine from Oct to Nov. It was nice that there was no limit on how many away rotations I did (but had to do Senior Surg, Neuro, and Derm/Rad in Galveston or Austin) just as long as the rotations were different. My Dallas rotation was my senior EM, Louisville was an elective, and Sacramento was my Acting Internship. Several faculty have suggested doing ophthalmology, cards, SICU, or something else since I would have my whole life to do EM. I thought those would all be helpful, but I am very happy with doing all the EM rotations because I really enjoyed each one and felt like I did know a whole lot more by my 2nd and 3rd rotation. I did lots of Histology, Biochem, and other medical courses in college which seemed to help for med school (and enjoyed them more than most non-science classes) so I feel the same way about doing lots of EM rotations if its fun and useful. ICU or anesthesia would have been great too, but I ended up "mixing in" the EM ultrasound month into my schedule (which was a little change but still nice to be in the good ole ED). I was able to stay with friends or family at Dallas, Louisville, and UC-Irvine, but Sacramento had a list of people who rented out a room in their house for the month and that worked out great. There are a few places that provide free housing so you might look into that also.

My first rotation was great. My first week or so was actually the last week of the year for the residents so I got to do lots of procedures (many of them were days from finishing their residency). The last few weeks actually were not too much different. The procedures were still there although there maybe was a little decline and things moved a little slower with brand new interns everywhere. Joaquin13, as far as your concern about doing your first choice after the other rotations, it makes sense but I knew that I would probably want to go to Dallas so I was worried about scheduling it as my first rotation of 4th year. I ended up doing fine and don't know if it would have made a huge difference if I scheduled it later b/c the residents and faculty understand that it is early in the year. If you work hard and apply the things that they teach you (as cg1155 mentioned), then you should be fine. I think they can tell if you are interested in EM field and/or their program and if you are doing your best. I would also add that if you get along well w/ the residents and faculty, then the word gets around and you will be a competitive applicant there. Whatever order you do your rotations in, just work hard, have fun, and make new friends. It has been nice keeping in touch with the other students I rotated with.

The SLORs are important so its definitely good to get them early and have them so that you can receive interviews as soon as possible (some programs may end up sending an interview before they get everything anyway). I ended up not getting letters from my last rotations, but then you might have the nice advantage of saving money by not having to return for interviews (Louisville let us interview while we were there and Sacramento said we did not have to interview if we rotated there. I was also able to do my UCLA-Harbor and MLK interviews while in the area doing the UC-Irvine rotation. Maybe the nicest thing for me was the chance to travel and really experience different places in the country for a month while getting to also see the different EDs and programs close up.

Good luck!
-Andy Kahn

Did you work with Cris Fox? He is such a trip! Good luck in the match.
 

Andy Kahn

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Thanks and yes, Dr. Fox was great. He was very laid back and funny. He made the rotation fun and was easy to joke around with. We had journal club at his house and watched the Monday Night Football game on his HDTV (nice!). He told us about some pranks he's pulled and they were hilarious. We listened to great music during QA and on some night shifts, but I learned so much during that month that I feel very confident about my ultrasound skills/knowledge going into residency. Obviously I still have plenty to learn but that was an awesome opportunity for a med student.

For any students wanting to do an away rotation besides the usual EM course, this was a good one. I saw lots of cool stuff (ICP evidenced by widened optic sheath, u/s guided IJ's/paracentesis/thoracocentesis, positive FAST, VSD! (showed up on Color flow Doppler as you scanned through the septum), gallstones, massively dilated bile duct, appy, IUPs at various gestational ages, and a subchorionic hemorrhage that looked like a separate possible second gestational sac. I looked for but didnt find any AAAs (although one Aortic root was a little dilated on the parasternal long axis view of the heart), DVTs, torsion, or ectopic pregnancies. I would highly recommend the rotation b/c Dr. Fox was a great teacher and a fun guy to be around. He reiterated the proper way to capture images, important things to look for, and normal anatomy. The fellow was cool and he taught us a lot also. They have a CD-ROM with good instructions on how to use/apply the u/s machine (but dont worry, they are great about answering any questions you have) and there were great u/s videos showing interesting pathology. He also provide a notebook full of articles, handouts, and info that was great background info. Dr. Fox was a trip and I would recommend any 4th years who want to do an elective related to EM to consider his ultrasound rotation. If you go at the right time, you might get to go with him to Mexico to help with the free clinic he works at and surf the waves with him there. The only problem with the rotation is housing. They provide you with a list of people that are renting out a room but they were expensive. I found a cousin(in-law) that I had never met but was cool enough to let me stay with him. He lives in West Covina so it was at least 30mins away, but the times were flexible with Dr. Fox. (You can call him Chris, but I just feel funny being on a first name basis w/ any attendings... until May 22 when I get my M.D. Hurrah!!!)
 

joshmir

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Is it possible to do away rotations as an intern (during your vacation) or after internship? WOuld there be coverage for liability? I feel like I made a mistake in not doing EM, and I have a transitional year coming up. I was planning on re-entering the match, but I wanted to do a couple of away rotations at the programs I am most enamored with to prove my mettle.

Anyone heard of anyone doing this? Or is 4th year the last year to do auditions?
 
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