away rotations: is it necessary for a general surgery residency application?

[grae]

hi all!

i'm at a crossroads. i am currently a third year student trying to figure out my fourth year electives. my first choice of general surgery residency is my home institution, and i'm doing an acting internship there in sept. is it necessary to do an away rotation during your fourth year? as my schedule stands, i would have to do it from mid-oct to mid-november, which is a little late of LORs. my current schedule is such that i have an away rotation in cardiology, just because the cardiology electives at my home institution have been all taken. i have an option of doing a gen surg away rotation in a place that is not necessarily where i want to go, so despite that, is it even worth it?

so bottom line, will it hurt my application if i do NOT do a general surgery rotation during fourth year?

thanks for all your help!

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[filter07]

you will be fine without an away rotation. GS is not like ortho.

 

[njbmd]

hi all!

i'm at a crossroads. i am currently a third year student trying to figure out my fourth year electives. my first choice of general surgery residency is my home institution, and i'm doing an acting internship there in sept. is it necessary to do an away rotation during your fourth year? as my schedule stands, i would have to do it from mid-oct to mid-november, which is a little late of LORs. my current schedule is such that i have an away rotation in cardiology, just because the cardiology electives at my home institution have been all taken. i have an option of doing a gen surg away rotation in a place that is not necessarily where i want to go, so despite that, is it even worth it?

so bottom line, will it hurt my application if i do NOT do a general surgery rotation during fourth year?

thanks for all your help!

In general, when I set up my electives for fourth year (I knew that I wanted to go into surgery), I chose things that would make me a better intern (radiology, cardiothoracic anesthesia, gastroenterology, neurology) and things that were excellent experiences (away rotation at top institution in endocrine surgery and trauma surgery). I had good USMLE Step I and Step II scores + strong performance in academics (honors in everything except OB-Gyn [high pass]. In the end, Based on that experience, I don't think that loading up with surgery rotations as a fourth year medical student was crucial for me.

If you have a place that you are something of a "long-shot" in terms of match, then an audition rotation with a good performance might put you ahead of people that didn't do that rotation. Outside of that, if you are a good candidate for the places that you have applied to and you don't get "crazy" with your rank list, then you don't need to do general surgery rotations outside of what was required by your school. You don't want to be in the "scramble" position for general surgery (has been very unrewarding in the past few years).

You may want to shore up your knowledge in things like ICU (could be done in any good teaching ICU- medical or surgical), radiology or even something that your school offers that would be useful clinically (mine offered electives in Clinical Pharmacology [easy and very useful] and clinical research methods [easy and useful]). In short, pick your electives based on your interests and what you need to make yourself the best candidate for match and a good resident once you get that match. Again, this is my perspective based on my experience and the advice given by my faculty adviser. In the end, I ended up in a solid residency program that more than fit my needs.

 

[treehorsio]

You already got great advice, but I'll throw mine in.

I knew I wanted to head back to my family for residency, which was many time zones away. Therefore, I knew I would likely have to do an away to have a shot at the more competitive academic program in my hometown. So, I did an away at the "reach" institution, worked my tail off, and matched there, although I was the only non-AOA, non-260+ Step I resident in my class (and think I've done just fine there despite my "inferior intellect").

If you definitely want to stay at your home institution, or even in the same city, it is not mandatory at all. And if you think you are competitive for your program, it would honestly save you some time and money and hassle to not do an away.

That being said, I believe that training somewhere different for residency is quite important; I think it gives you unique new perspectives as to the practice of surgery and medicine in general. The two environments of my med school and residency could not be more different and I've learned a lot from that. Also, I have continued to foster contacts from my med school so have doubled my "network". Just something to think about.

 

[thedrjojo]

There are a few variables not listed... are you MD, DO, US IMG? Most seem to assume MD, and since you list about your home institute, it most likely is true. Second, are your scores/stats up there, middle of the road, or low? Third, how many students from your class are going into surgery, and how many want to stay at your home institution? Last year, we had like 20 wanting to go into Gen Surg, we matched 3 at our home institution, but I know of several who matched at places lower on their rank list than the home institution. The 3 of us that did match, one common demoninator was multiple surgical rotations within our program and those with important members of the faculty (Myself was well known and liked by PD, Chairman, and chair of surg onc, as well as the residents who I've been told went to bat for me). Another student was very well known by the trauma team which has a lot of pull with our selections, and the last was also very well liked by the PD, known to chairman (but unsure of his perception of her). So don't just assume you will match at home institution. It seems your schools academic year is very late if you are just setting up 4th year schedule in mid july, unless you are slightly off schedule. Our 4th year starts June 1, and for June, July, August, September, and October I did surgical rotations (Community college affiliated with my school, Surg Onc, Chairman's rotation[AI], Away, and PD's rotation). You don't have to go that rediculas, but you need to assure yourself 3 letters of recommendation from surgeons, and you probably can't necessarily bank of 3 from an AI... 2 wouldn't be unheard of (i only got 1, but could have gotten a second if I needed it). It also doesn't hurt to let your intentions of staying fairly well known so residents can help you out, give you advice, and in the end, if they like you, lobby for you.

Now, another, unrelated to getting in reason pro doing an away is this: If all you ever know or see is your home institution, how do you know if surgery or that school is where you want to be for residency? Every place, and everyone does things slightly different. Teams are organized differently, computer systems, services, operative experience, academics/didactics. And believe me, you don't get to see much of anything during your interview, especially nothing that really matters for how life will be as a resident. By the time I made my rank list, I had seen at least a day around the surgical residents in 5 programs (home program, 3rd year rotation at an affiliated institution, 4th year rotation at community hospital that rotated residents through it, my away, and a second look) and there are similarities and there are vast differences. I was much more comfortable staying at my home institution (a "mid" tiered academic institution with inner city trauma experience) over going to a bigger name (and was actively recruited by 2 places appearing on the honor roll of top hospitals in the country, one because of my away, the other because of my letters/application).

So bottom line: Don't have to do aways, but i'd recommend doing them for yourself (so doing late october/november and not getting a letter is fine, you still will make an impression on them and it will make an impression upon you). You don't need 5 surgical rotations at your home institution, but if you truely want to go there, you would probably benefit from more than just 1, and for letter receiving purposes, you probably need more than 1 anyway. Let your intentions known (but not too loudly) and get in good with the residents at your home program, cause some places they have more swing than you'd think (especially chief/administrative chief residents)