Away rotation advice

[baculum1]

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Hey guys,

I secured an away rotation in a month and I'm applying for a few more. My initial excitement and anticipation to receive an away rotation was recently replaced by some anxiety. I rotated at my home program a while back but i was basically an observer and did a presentation at the end. Obviously i've rotated with most other disciplines and have student clinical experience but as a student my rad onc clinical experience is very limited. As I prepare for my away rotation, can residents please share what is expected of me as a rotating student or provide me with some general advice? I ordered the Hansen/Roach book already and it's on it's way. Any other tips?

 

[Linaculous]

In my opinion, your main goal should be to absolutely kill every consult you do (metaphorically of course). That's what med students should be able to do: see a patient, get a history, do a physical, formulate a plan, and know the disease. Be enthusiastic about treatment planning and such, but go ALL OUT on consults.

To do that, go overboard on preparation. Look up patients the night/weekend before and write up their consult notes. If you have access to good records, you can have surprisingly few holes in your note before you even see the patient. Know each patient's story: initial presentation, diagnosis, staging, other providers, treatment to date, reason for consult, labs, imaging, and probable recommended RT. This will help a ton when you see the patient as you just can fly through a quick review of the HPI (minus new events/symptoms) instead of getting it from them fresh, which can take forever if you go in cold. Also know the work-up, staging, and treatment of the disease (easy pimp fodder), and do your best to formulate an appropriate RT plan with some literature to back it up. Doing this preparation can take a lot of time initially, but it will pay off big time and you'll get faster with practice. Having a complete, typed-up, bosstacular H&P in hand when you go to present is what you want.

Follow-ups are probably less important, but know their story and new imaging/labs. OTVs probably aren't worth a ton of preparation.

Of course this assumes you're rotating at a place where students get EMR access, see consults alone, write notes, etc. It obviously varies, as demonstrated by your experience at your home institution.

And last but not least, do your best to hold back whatever horrible personality flaws you have (easier said than done).

 

[runnerdoc7]

Prepare for patients thoroughly, as the above poster noted. Beyond that, just try not to be annoying (this should be a primary goal in all medical student clerkships IMO). You will need to know the patients well and give thorough but concise presentations to impress attendings but to get the residents on your side it is about being a hard worker and not annoying them. This can be a hard balance for those with gunnerish personalities.

As far as for clinical knowledge, I don't think much is expected, however for straightforward consults, a working knowledge of the staging and seminal papers related to a given case could help you stand out. Anything you would need to know at your level is in the blue book.

 

[Chartreuse Wombat]

I concur with comment above. Engaging the residents and demonstrating that you are a team player (and not a prima donna) is vital. Many a visitor has fawned over the faculty and ignored the residents…behavior that is not likely to help with match prospects.

 

[ramsesthenice]

I'd say the next most important thing, after being good at seeing patients, gathering data, presenting them, and not being a douche would be to show that you are a fast learner. Med school doesn't teach you much about clinical rad onc and there is no expectation that you know a whole lot coming into it. That is ok. Just show you can learn rad onc and more importantly, how rad onc is practiced at the institution you are rotating with. When you see something done a little different at a new place, ask why and what they think of other practice patterns. Thats upper cut med student material right there.

 

[Scatter]

1. Don't be fake nice and thereby annoying.
2. Make it known in the residents room you're there to learn but also HELP (e.g., offer to give it a try on contouring normal structures, esp. H&N (you get a gold star for cochleae, mastoid air cells, major salivary glands, brainstem, optic apparatus, etc); prepare a word document H&P (two copies, one for your presentation to the attending, one for the resident to make her/his dictating load easier, and email .doc to the resident) for any new patient you see. This shows INITIATIVE, which will separate you from the rest. Don't be a wallflower and wait for them to think of something for you to do, because it's becomes another chore for them. Another gold star: write down indications for radiotherapy for every new patient you see. It'll show the resident and the attending that you're not just an H&P monkey, but actually put some thought into why you're recommending RT.
3. Be there early.
4. Don't fall asleep during Didactics, as boring as neutrinos or Law of Bergonie & Tribondeau can be. In fact, attend all didactics. FACETIME matters on an away rotation. Otherwise, I'm not a big believer in facetime.
5. Attend TUMOR BOARDS with attending-du-jour/week; inquire about TB schedule on your first day, learn the lay of the land like where the conference rooms are, etc, and BE SEEN.
6. Don't be too serious.

 

[RadOncDoc21]

Just be extremely awesome and fun! If you're attractive... Even better! Always remember to be smart and cool.

 

[Totem]

Give the same lecture/end-of-rotation presentation at every away rotation--no need to reinvent the wheel each month. Get residents to look it over for you and make suggestions. Pick an interesting topic and include your research if you can.

 

[lazers]

Give the same lecture/end-of-rotation presentation at every away rotation--no need to reinvent the wheel each month. Get residents to look it over for you and make suggestions. Pick an interesting topic and include your research if you can.

I would advise against this if you're going to be asking for a recommendation letter, as some recommenders do put the topic of your presentation in their evaluation.

 

[Totem]

I would advise against this if you're going to be asking for a recommendation letter, as some recommenders do put the topic of your presentation in their evaluation.

I don't see why that would be a problem--I received this advice at each place I rotated.
If you talk about your research, your presentation is going to be similar each time anyway.
IMO, your best chance at giving a memorable presentation is speaking from an area of some 'expertise' and that probably means giving a similar presentation that incorporates your research at each away rotation.
I guess I just don't see why anyone would care if you repeated a presentation. Perhaps others had different experiences.

 

[lazers]

I don't see why that would be a problem--I received this advice at each place I rotated.
If you talk about your research, your presentation is going to be similar each time anyway.
IMO, your best chance at giving a memorable presentation is speaking from an area of some 'expertise' and that probably means giving a similar presentation that incorporates your research at each away rotation.
I guess I just don't see why anyone would care if you repeated a presentation. Perhaps others had different experiences.

I guess it depends on the individual interviewer, some could see this as being lazy.

 

[ramsesthenice]

I guess it depends on the individual interviewer, some could see this as being lazy.

I don't think it will matter most of the time but I have to agree with lasers on this one. If I saw someone gave the same talk again and again I'd perceive it as lazy. Talks are easy to put together and you should have no difficulty putting together one evidence based talk per month. Showing you can give good talks on multiple topics that are well received at multiple places could be viewed as a strength because it's what your expected to do as a resident. You should be reading enough on rotation that this is not hard to do.

All the same, I highly doubt this will be a major issue either way most of the time. Above is just my two cents.