Away EM rotations

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katrinadams9

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I'm seriously interested in doing EM and I really don't care where I go for residency at this point, just away from where I am right now. My school only lets us do 3 away rotations. I've been told by many residents that I need to do away rotations at hospitals I plan on applying to. The only problem is I only have a general idea of where I'd like to end up. Should I just try to do my away rotations at well known hospitals? Do many people get matched at hospitals where they haven't rotated?

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Since most people don't rotate at every hospital, yes, many (if not most) people end up somewhere they didn't rotate.
I would try and find people that you know (classes ahead of you, other people on EMRA) that rotated places and ask them why they went there, if it was good, etc.
Then base your aways on that. 3 is pretty close to too many, I did that and wish I hadn't.
 
I too, did 3 EM rotations this year. I too, did not listen to "2 is all you really need." I too, became very burned out after two months of auditioning (cuz that's what you're doing, auditioning.) Stick with 2...you'll thank yourself later.
 
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Count this as the third strike against doing 3 rotations - again, I did three and I was burned by the end of my third. As far as your away rotations are concerned, if you just know a general area that you want to end up, then I would ask around and rotate at the "biggest name" in the area. You will find that EM is a very small community and that a good LOR will carry you far.
 
I only did 1 EM rotation b/c I got the short end of the schedule stick, and I had no problem getting interviews though I wish I had been able to squeeze another rotation in. You'll be fine with 2 rotations, 3 might make you a bit nutty.
 
I will also add, since I just thought of it, that some people will tell you lots of things about away rotations such as:
You have to go to a county-like program to get interviews at county-like programs.
You have to go to academic places to get academic places.
You have to go to California to have a chance there.

I will tell you that if your scores are high enough, none of those are true. If your scores are average or below average, those things will only help.

It is always better to get one smoking SLOR than two average ones, etc. However, most places want you to get at least one away rotation (if you are an average student), because most home institutions will write you a good letter regardless of the kind of student you are. It is those "outside eyes" phenomenon. Plus, you are pretty much assured an interview at the place you rotate.

Once again, though, the bane of my existence, if you have a 260+ Step I, you can in all actuality decide to apply to EM the day before you submit your ERAS, pound out a bland PS (that nobody cares about), and get one letter saying you like EM, and you'll get interviews. None of this guarantees a stop, but it helps you out.
 
one more question for those of you who have gone through this all - is it true that if you look pretty good on paper that away rotations can really only hurt you? i've heard this from multiple people about EM, and am wondering if its true because i'd really like to do an away or two, but don't want it to hurt me at all. any input would be appreciated.
 
if you insist on doing a 3rd EM rotation, try a EM related elective instead of a straight up sub-I. For example, I did emergency ultrasound which enabled me to network with some attendings and residents at yet a 3rd spot on my application list.
 
As others mentioned, I would stick to 2. If you are dead set on 3; do that third one as an EM elective like US or Tox.

As far as where, I took a look at where I would like to probably be (geography wise) and picked a smaller almost community based place and a much larger with much trauma place. I found it gave me a good contrast of the two general types of programs. I should also mention I have had several of the people on the trail who interviewed me say that they were impressed that a.) I had thought about what I looked for in an away rotation and b.) that having the two contrasts is a good idea... some told me that many students will do away rotations at some inner city place, yet apply to a community/rural type program....

The one mistake I DID make is that I did not get SLORs from BOTH places, and only the first. I felt I had enough letters already (one EM attending from a teaching hospital/univ but no EM resdency, IM attending who worked many years in an ED, and then the SLOR from my first EM rotation). I have been questioned about why I had no SLOR from the 2nd place on the interview trail and felt that at least one interviewer was concerned that maybe I had a bad time and the program would not write a letter. The opposite is actually true, I built a better relationship and would have gotten even a better letter from the place I did not get a letter...... Long winded answer to say always get a SLOR from wherever you go. You can always just not submit it...
 
make sure you find out in advance how much responsibililty they give med students. for example, BU has the pgy2 do ALL procedures (even YOURS). that's an example of a FABULOUS program that might not be super to rotate at. from what i've heard denver and bellevue are the most hands-on for MS4s.
 
All above advice is good (particularly about the 3rd rotation).

Location is key. Some markets are smaller than others. IE, if you are interested in NYC, you would be well off doing a rotation in NYC. Just one. Its a VERY VERY small world here, so do well and do one.

Cali, same thing. Do one there if you are interested there. Check scutwork.com for med school evals of rotations in the parts of the country you are interested in. If you have a particular part of the country, do some research and ask on the boards here (with a geographical hint).
 
another thing to consider is that some programs like highland and denver have this unwritten 'interview' component to the rotation. put it this way, of highland's current intern class, something like 2 of the 12(?) residents did NOT rotate there. the rest did at some point. the official party line of the program is that they trust what they've been able to observe for a month. when you rotate at highland, that counts as your interview and you automatically go into their pool for ranking consideration. you are not invited again for interview season, although you are welcome to go for a second look. (this is first hand info from having rotated there)

how do you know about things like this? you just have to find out by word of mouth. it's not officially published anywhere :(
 
another thing to consider is that some programs like highland and denver have this unwritten 'interview' component to the rotation. put it this way, of highland's current intern class, something like 2 of the 12(?) residents did NOT rotate there. the rest did at some point. the official party line of the program is that they trust what they've been able to observe for a month. when you rotate at highland, that counts as your interview and you automatically go into their pool for ranking consideration. you are not invited again for interview season, although you are welcome to go for a second look. (this is first hand info from having rotated there)

how do you know about things like this? you just have to find out by word of mouth. it's not officially published anywhere :(

Uh, oh. So what is Christiana's policy? Rotate or don't? Can't we make a list of which way these programs swing? :scared:
 
I agree with the above about doing 2 EM and 1 related (US, tox, peds, etc). I did 2 EM and a tox, and I thought it was great for networking, getting letters, and doing something EM related while being a bit more chilled out. Definitely would do the same again. That said, if you are the 260+ applicant, you may not be hurting for tons of great letters and contacts.

As for where to apply, I would recommend an academic and/or county and/or community. I was suprised at what I liked/disliked after getting experience in a couple different environments. You can also narrow down rotation spots a bit by what kind of area you like living in. I like medium/small-sized cities and my application went out to mostly (with few exceptions) places that fit this criteria. So if you must live in a big city (for example), check out rotations in big spots like LA, San Fran, NYC, whatever.

Good luck!
trkdster
 
Oh yeah, also want to add that it seems most places interview people who have rotated. I have heard of exceptions but usually not the case. If you have somewhere in particular that you think may make you warm and fuzzy inside, I would rotate there.
 
bumping this back up for the next class.

just wondering for those who did 3 sub-Is and burned out: did you do 3 in a row or 3 total to lead to burn out? would 2 EM sub-Is, an easy elective/month off, then another EM sub-I be any less taxing?
 
Thanks so much for bumping this!! I was just trying to figure out where to do my second away elective. EM is not a required third year elective at my school, so my first real exposure to it will be during my EM sub-I in August, and then in order to get more letters I'm planning on doing another elective right after.

I'm in a similar position as the OP, I know I want to go into EM, but I still don't have a set geographical preference, I'm pretty much open. I was skimming through different websites and Maine seems like a pretty nice place to do an elective, has anyone done one there yet?
 
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