Away rotations for Anesthesiology

[21Rush12]

I am an M3 finishing my first rotation at an MD school in the northeast and interested in Anesthesiology. I am hoping to go to a competitive West coast program.

What is the consensus on doing away rotations for someone aiming for West coast who isn’t from there? It’s hard for me to tell how competitive I am as an applicant for these places and I want to do all I can to match there.

Thanks in advance!

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[zero0]

Aways in anesthesia are a double edged sword

That said it might be your only way of getting your foot in the door out west

 

[21Rush12]

Aways in anesthesia are a double edged sword

That said it might be your only way of getting your foot in the door out west

I have heard similar things as well. Any idea how this changes based on how competitive the applicant is?

 

[UnoMas]

If you absolutely must do an away rotation, do an ICU rotation at that institution. Talk to your attending, program coordinator once you get there to see if you could spend a day or 2 with the Anesthesiology department or at least meet with the program director there. Or better yet, do a CT-ICU or SICU rotation, if you are doing a good job on that rotation, the CCM docs would be more than happy to talk you up with the Anesthesiology staff. This was the advice that I was given.

You learn a lot more on an ICU rotation than just running around intubating down in the ORs.

 

[21Rush12]

If you absolutely must do an away rotation, do an ICU rotation at that institution. Talk to your attending, program coordinator once you get there to see if you could spend a day or 2 with the Anesthesiology department or at least meet with the program director there. Or better yet, do a CT-ICU or SICU rotation, if you are doing a good job on that rotation, the CCM docs would be more than happy to talk you up with the Anesthesiology staff. This was the advice that I was given.

You learn a lot more on an ICU rotation than just running around intubating down in the ORs.

You bring up an interesting point — I hadn’t heard/thought of this. I’ll definitely do some digging. VSAS is coming up quickly and I still have to figure out scheduling.

Does anyone know what situations make it a disadvantage for visiting students?

 

[Angus Avagadro]

I like the idea of such away rotation if you can get it. Problem is both are upper level rotations. I know my students have a hard time getting an anesthesiology rotation as 3rd years. Most programs near us wont take 3rd years. Dont know about ICU, but would assume the same

 

[21Rush12]

I like the idea of such away rotation if you can get it. Problem is both are upper level rotations. I know my students have a hard time getting an anesthesiology rotation as 3rd years. Most programs near us wont take 3rd years. Dont know about ICU, but would assume the same

I have an option for third year rotation at my home institution which I’m definitely doing. We aren’t allowed to do any of the third year away, only fourth. I’d plan to do two aways in Anesthesia and one in maybe ICU if its feasible just to increase my chances/show I’m serious, but I wonder about what the return on investment is and what risks there are. Does this change with the strength of the applicant?

 

[UnoMas]

Do a 3rd year rotation in Anesthesiology at your home program, work hard, get the letters you need. It's easier to stomach an Anesthesiology rotation as a 3rd year than a 4th year. I personally find it very hard to transition from being essentially a sub-intern in the ICU to essentially just a shadower in the OR taking space behind the drape, maybe it's the program that I did an away at that sucked. Not complaining, just sharing my experience. They'll send you home early most of the time after you done a few rounds of IVs, intubations, maybe an a line or central line.

It's pretty high risk high reward for an away in Anesthesia, essentially it's a 4 week interview. It's hard to impress people at least in my impression. If you do, make sure you go to all the lectures, stay until the residents are done, ask if they want you to help set up the room in the morning, help them draw drugs, pick up stuff from pharmacy and the supply room. If you know it's a difficult airway case, have the glidescope in the room and ready, volunteer to present on a topic or something etc.

I was told with good scores you'll get the interviews you need to match. The only time is necessary to do an away rotation is (1) to opening up a geographical area that you are interested in (2) your #1 and you want to blow them away (3) getting an inside look at a program that is very high on your list.

 

[Moose A Moose]

If you absolutely must do an away rotation, do an ICU rotation at that institution. Talk to your attending, program coordinator once you get there to see if you could spend a day or 2 with the Anesthesiology department or at least meet with the program director there. Or better yet, do a CT-ICU or SICU rotation, if you are doing a good job on that rotation, the CCM docs would be more than happy to talk you up with the Anesthesiology staff. This was the advice that I was given.

You learn a lot more on an ICU rotation than just running around intubating down in the ORs.

I agree. Work the SICU for 4-weeks. The great equalizer.

 

[NotYou20]

I'm in a similar spot. From the midwest thinking about anesthesiology hopefully out west. Good board scores. I'm also a DO student. Besides this eliminating programs like Stanford how else does it affect matching in anesthesiology?

I'm starting my third year anesthesia rotation soon, any tips on doing well?

 

[Angus Avagadro]

I'm in a similar spot. From the midwest thinking about anesthesiology hopefully out west. Good board scores. I'm also a DO student. Besides this eliminating programs like Stanford how else does it affect matching in anesthesiology?

I'm starting my third year anesthesia rotation soon, any tips on doing well?

Read UnoMas above. They said it well. Whenever you do a rotation at your home hospital, you will get to do more. Doing an away rotation, they will treat you like an assassin until you prove to them otherwise. This goes for outside rotations as a resident also. But if this is a possible first choice, go there and shine, show up early, hang around late, offer to help or give a talk on a topic. They will first want to see how you interact with patients, residents,nursing and staff. This is very important. No one wants to hire a bright resident with a bad attitude/work ethic. No one wants to hire a problem
Good luck and best wishes!

 

[zero0]

I have heard similar things as well. Any idea how this changes based on how competitive the applicant is?

Not much I would assume. It would help in securing an away but once you get there it doesn't guarantee anything.

 

[21Rush12]

Not much I would assume. It would help in securing an away but once you get there it doesn't guarantee anything.

This makes sense. The other component I wonder about is does it pay to NOT rotate at your top choice if you have the numbers to expect an interview, or is it worth doing an away there?

 

[zero0]

This makes sense. The other component I wonder about is does it pay to NOT rotate at your top choice if you have the numbers to expect an interview, or is it worth doing an away there?

The traditional wisdom is let your numbers do the talking and stay the heck out of there

 

[bamboo18]

The traditional wisdom is let your numbers do the talking and stay the heck out of there

You meant don't do away rotation at top choice? Mind to explain why?

 

[UnoMas]

You meant don't do away rotation at top choice? Mind to explain why?

It's pretty dam hard not to be annoying on an Anesthesiology rotation. You could come in early, set up the room, help draw the drugs, set up the pumps, stay late, attend all lectures etc. all good stuff there.

If you run room to room doing intubations, lines, IVs you could come off as too aggressive/gunnerish. If you stay in 1 room with a resident, you'll eventually run out of questions to ask and start to become a nuisance. They'll send you home early but you might come off as lazy/in it for the lifestyle. If you stay too late and they don't let you do anything, you'll be bored the **** out of your mind just shadowing. If you run into a nice attending, they'll let you tag along but at one point you gotta let them have some space.

There's only so much space at the head of the bed inside an OR for so many people. You'll feel like you are just taking up space and wasting oxygen.

You can see patients in preop and try to present the patients but most of the time, they are so pressed for time, it won't happen. If they don't care to ask/pimp/teach you, you'll just stand there wasting space. There just isn't as much opportunities for teaching points like in other specialties (during rounds)

This isn't like an inpatient rotation where you could wander off doing notes/checking on patients/calling up consults/sit in a corner and read/chatting up the nurses.

Do it at your own risks.

Thanks Jesus it's a board score based specialty

I have great evals/feedback from my 3rd year rotations and 4th year subIs so I am not socially awkward or a blithering idiot and I find it incredibly hard to be a 4th year on Anesthesia away.

 

[Neopolymath]

Aways in anesthesia are a double edged sword

That said it might be your only way of getting your foot in the door out west

As a DO, what did you end up deciding to do?

 

[21Rush12]

@UnoMas thank you for the insight, especially your experience doing fourth year aways. I have a lot to figure out between now and VSAS!

 

[zero0]

As a DO, what did you end up deciding to do?

I did decently on the USMLE so the plan is to go ahead with gas, EM is a close second

 

[UnoMas]

@UnoMas thank you for the insight, especially your experience doing fourth year aways. I have a lot to figure out between now and VSAS!

No problem! Make sure you do a 3rd year rotation tho to confirm it's truly what you want. Kick ass, get some letters and enjoy your 4th year (or do some ICU rotations)

 

[Neopolymath]

I did decently on the USMLE so the plan is to go ahead with gas, EM is a close second

Sorry, I realize that. I meant your strategy for aways and getting letters.

 

[MedicineZ0Z]

Any anesthesiology rotations you guys would recommend for someone who wants to practice intubating as much as possible?

 

[Black Coffee 24/7]

Any anesthesiology rotations you guys would recommend for someone who wants to practice intubating as much as possible?

You should get plenty of intubation at all Anesthesiology rotations. The key is to find rotations with other experience. Honestly, intubation is fun initially, but it’s overrated as hell and blows ball after your first 10.

 

[DocVapor]

You should get plenty of intubation at all Anesthesiology rotations. The key is to find rotations with other experience. Honestly, intubation is fun initially, but it’s overrated as hell and blows ball after your first 10.

lolwut

You aren't going into Anesthesiology, are you?

 

[MedicineZ0Z]

You should get plenty of intubation at all Anesthesiology rotations. The key is to find rotations with other experience. Honestly, intubation is fun initially, but it’s overrated as hell and blows ball after your first 10.

Right but I mean more in terms of volume. It's good to have a 4 weeks where you really kill the volume and they let students have a go at tough airways.

 

[21Rush12]

I’m going to look for programs with a defined curriculum rather than a more amorphous experience

 

[zero0]

Sorry, I realize that. I meant your strategy for aways and getting letters.

I only get one elective 3rd year and I'll try to secure an away but it likely won't happen. More than likely I'll just wind up using that time to study for Step 2.

4th year I'll schedule 2 aways before ERAS opens and get LORs there. That's pretty much the game plan anyway.

 

[Psai]

You should get plenty of intubation at all Anesthesiology rotations. The key is to find rotations with other experience. Honestly, intubation is fun initially, but it’s overrated as hell and blows ball after your first 10.

I love intubation. I think it took me more like 100 to really get what I'm doing and I still make improvements.

 

[Angus Avagadro]

It's pretty dam hard not to be annoying on an Anesthesiology rotation. You could come in early, set up the room, help draw the drugs, set up the pumps, stay late, attend all lectures etc. all good stuff there.

If you run room to room doing intubations, lines, IVs you could come off as too aggressive/gunnerish. If you stay in 1 room with a resident, you'll eventually run out of questions to ask and start to become a nuisance. They'll send you home early but you might come off as lazy/in it for the lifestyle. If you stay too late and they don't let you do anything, you'll be bored the **** out of your mind just shadowing. If you run into a nice attending, they'll let you tag along but at one point you gotta let them have some space.

There's only so much space at the head of the bed inside an OR for so many people. You'll feel like you are just taking up space and wasting oxygen.

You can see patients in preop and try to present the patients but most of the time, they are so pressed for time, it won't happen. If they don't care to ask/pimp/teach you, you'll just stand there wasting space. There just isn't as much opportunities for teaching points like in other specialties (during rounds)

This isn't like an inpatient rotation where you could wander off doing notes/checking on patients/calling up consults/sit in a corner and read/chatting up the nurses.

Do it at your own risks.

It's pretty dam hard not to be annoying on an Anesthesiology rotation. You could come in early, set up the room, help draw the drugs, set up the pumps, stay late, attend all lectures etc. all good stuff there.

If you run room to room doing intubations, lines, IVs you could come off as too aggressive/gunnerish. If you stay in 1 room with a resident, you'll eventually run out of questions to ask and start to become a nuisance. They'll send you home early but you might come off as lazy/in it for the lifestyle. If you stay too late and they don't let you do anything, you'll be bored the **** out of your mind just shadowing. If you run into a nice attending, they'll let you tag along but at one point you gotta let them have some space.

There's only so much space at the head of the bed inside an OR for so many people. You'll feel like you are just taking up space and wasting oxygen.

You can see patients in preop and try to present the patients but most of the time, they are so pressed for time, it won't happen. If they don't care to ask/pimp/teach you, you'll just stand there wasting space. There just isn't as much opportunities for teaching points like in other specialties (during rounds)

This isn't like an inpatient rotation where you could wander off doing notes/checking on patients/calling up consults/sit in a corner and read/chatting up the nurses.

Do it at your own risks.

Thanks Jesus it's a board score based specialty

I have great evals/feedback from my 3rd year rotations and 4th year subIs so I am not socially awkward or a blithering idiot and I find it incredibly hard to be a 4th year on Anesthesia away.

Thanks Jesus it's a board score based specialty

I have great evals/feedback from my 3rd year rotations and 4th year subIs so I am not socially awkward or a blithering idiot and I find it incredibly hard to be a 4th year on Anesthesia away.

Board score specialty? Not hardly. The OR is a small environment, you have to get along, show up on time, and be educable .Any decent program doesnt want bright and lazy or agnorant residents. Interviewing residents would be tops on my list

 

[Neopolymath]

Board score specialty? Not hardly. The OR is a small environment, you have to get along, show up on time, and be educable .Any decent program doesnt want bright and lazy or agnorant residents. Interviewing residents would be tops on my list

He is saying that it's thankfully not about research and kayaking/rock climbing or some other BS like some specialties.

 

[Psai]

He is saying that it's thankfully not about research and kayaking/rock climbing or some other BS like some specialties.

I am a foodie that enjoys traveling and make craft beer in my garage. I also wear flipflops with my suits.

 

[Jesus1]

Probably important to mention that you don't need to do an away on the West Coast to get into a West Coast program. If your scores are great and you have a strong app and good letters/excellent PS, you should be good to go.
Source: Me

 

[Chemstudent]

Probably important to mention that you don't need to do an away on the West Coast to get into a West Coast program. If your scores are great and you have a strong app and good letters/excellent PS, you should be good to go.
Source: Me

What is a great score?

 

[CyrusHabs7695]

Probably important to mention that you don't need to do an away on the West Coast to get into a West Coast program. If your scores are great and you have a strong app and good letters/excellent PS, you should be good to go.
Source: Me

So is it not like applying to med school out of undergrad where most state universities prefer their own residents and people from that region?

Ex. Like someone who has lived in PA their whole life, went to undergrad and med school in PA and wants to go do Gas in AZ or NV or something. Do they have a chance without an away?


Sent from my iPhone using SDN mobile

 

[Jesus1]

So is it not like applying to med school out of undergrad where most state universities prefer their own residents and people from that region?

Ex. Like someone who has lived in PA their whole life, went to undergrad and med school in PA and wants to go do Gas in AZ or NV or something. Do they have a chance without an away?


Sent from my iPhone using SDN mobile

Yes. As long as you have good stats.

 

[Jesus1]

What is a great score?

In general, >245 on Step 1 (saying based on my own limited experience)

 

[21Rush12]

In general, >245 on Step 1 (saying based on my own limited experience)

What is your experience? Did you match anesthesia?

 

[Dr. Stable-Genius]

It's pretty dam hard not to be annoying on an Anesthesiology rotation. You could come in early, set up the room, help draw the drugs, set up the pumps, stay late, attend all lectures etc. all good stuff there.

If you run room to room doing intubations, lines, IVs you could come off as too aggressive/gunnerish. If you stay in 1 room with a resident, you'll eventually run out of questions to ask and start to become a nuisance. They'll send you home early but you might come off as lazy/in it for the lifestyle. If you stay too late and they don't let you do anything, you'll be bored the **** out of your mind just shadowing. If you run into a nice attending, they'll let you tag along but at one point you gotta let them have some space.

There's only so much space at the head of the bed inside an OR for so many people. You'll feel like you are just taking up space and wasting oxygen.

You can see patients in preop and try to present the patients but most of the time, they are so pressed for time, it won't happen. If they don't care to ask/pimp/teach you, you'll just stand there wasting space. There just isn't as much opportunities for teaching points like in other specialties (during rounds)

This isn't like an inpatient rotation where you could wander off doing notes/checking on patients/calling up consults/sit in a corner and read/chatting up the nurses.

Do it at your own risks.

Thanks Jesus it's a board score based specialty

I have great evals/feedback from my 3rd year rotations and 4th year subIs so I am not socially awkward or a blithering idiot and I find it incredibly hard to be a 4th year on Anesthesia away.

Is it necessary to have 2 LoRs from Anesthesiologists/Anesthesia rotations? I was late to decide on the field of anesthesia and I only had time for one Anesthesia rotation. Everything else on my application is solid (scores, other letters) but not spectacular. I could add another anesthesia rotation that would start at the end of September and hopefully have another letter up by the end of October... is that necessary/would it significantly help me? ASA website says you only need one LoR... but the vibe I've gotten is that 2 is more the standard

 

[Oh_Gee]

Probably important to mention that you don't need to do an away on the West Coast to get into a West Coast program. If your scores are great and you have a strong app and good letters/excellent PS, you should be good to go.
Source: Me

what about DO students with good STEP scores?

 

[UnoMas]

Is it necessary to have 2 LoRs from Anesthesiologists/Anesthesia rotations? I was late to decide on the field of anesthesia and I only had time for one Anesthesia rotation. Everything else on my application is solid (scores, other letters) but not spectacular. I could add another anesthesia rotation that would start at the end of September and hopefully have another letter up by the end of October... is that necessary/would it significantly help me? ASA website says you only need one LoR... but the vibe I've gotten is that 2 is more the standard

What vibe? I only have 1 Anesthesiology LOR, maybe 1 more coming but I am not holding my breath since it's so close to submission date now. I think we are fine, at least from what I was told

 

[Dr. Stable-Genius]

What vibe? I only have 1 Anesthesiology LOR, maybe 1 more coming but I am not holding my breath since it's so close to submission date now. I think we are fine, at least from what I was told

Vibe meaning conventional wisdom of applicants of the current cycle (like you and I- our experience is obviously limited) and the previous cycle (friends from University of Utah, Creighton, my LoR writer from Rochester) all recommended getting 2 letters if possible

 

[MedicineZ0Z]

Soo.. following up - any rotations where you get a ton of intubation practice? Preferably non-vsas but of course wouldn't mind throwing in another vsas one 🙂

 

[Psai]

****...I got a 243 and looking at California programs.

... Come on

 

[UnoMas]

Vibe meaning conventional wisdom of applicants of the current cycle (like you and I- our experience is obviously limited) and the previous cycle (friends from University of Utah, Creighton, my LoR writer from Rochester) all recommended getting 2 letters if possible

I never heard such things. The residents I talked to who matched at places I want to go all had 1 letter only.

 

[21Rush12]

... Come on

Do you think this is in the ballpark for CA programs?

 

[Ho0v-man]

If you’re a DO but you have an anesthesia residency at your home hospital do you really need to do an away? Will letters from a community based anesthesia program be okay?

 

[nimbus]

Right but I mean more in terms of volume. It's good to have a 4 weeks where you really kill the volume and they let students have a go at tough airways.

No programs give students a go at tough airways nor should they. It is not possible to get anything more than superficial orientation to airway management in 4 weeks. For CA-1’s 6 months into residency, many normal airways will still seem unusual or difficult. That’s why residency is 3years.

 

[sniderwes]

No programs give students a go at tough airways nor should they. It is not possible to get anything more than superficial orientation to airway management in 4 weeks. For CA-1’s 6 months into residency, many normal airways will still seem unusual or difficult. That’s why residency is 3years.

I got a go at a Mallampati 2/3, obese patient with a fat neck. Successful on the first try. Was a huge confidence booster for my intubating skills.
But I agree if a patient is likely to desat quickly students should stay away.

 

[nimbus]

I got a go at a Mallampati 2/3, obese patient with a fat neck. Successful on the first try. Was a huge confidence booster for my intubating skills.
But I agree if a patient is likely to desat quickly students should stay away.

You just described 30% of all American airways. That’s a normal airway. Good job nevertheless. As you do more, they will seem normal to you too.

 

[MedicineZ0Z]

No programs give students a go at tough airways nor should they. It is not possible to get anything more than superficial orientation to airway management in 4 weeks. For CA-1’s 6 months into residency, many normal airways will still seem unusual or difficult. That’s why residency is 3years.

I know that but there's a variance in volume between away rotations. Some places you get a lot and some you get less. It makes a difference in comfort level and confidence.