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BigRedDeal

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3rd year here and I will be applying to a competitive specialty with what I suspect is a below average application based on my Step 1 score. I plan on doing two away rotations, with BAMC, MAMC, TAMC, WR, EAMC, and WBAMC as options. I obviously have a preference to where I end up, but honestly, I just want to match in my intended specialty.

Should I go ahead and rotate at my preferred hospitals? Or does it make more sense to rotate at a hospitals where I have a better chance at matching? And how does one know which hospitals are more competitive than others?

Thanks
 

colbgw02

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Guessing you're applying to ortho, since the only specialties that fit those locations are ortho, general surgery, and internal medicine. I wouldn't consider IM to be a competitive specialty, and you'd have to reapply as an intern to a GS PGY-2 spot anyway.

In general, I think that WBAMC and EAMC are less competitive, based chiefly on the size of the hospitals and - in the case of WBAMC - location. Since you're concerned about matching at all, I would do at least one rotation at one of those two places. The other rotation could be at one of the "big 4" (WR, TAMC, MAMC, SAMMC) that you consider most desirable, or you could just rotate at both WBAMC and EAMC. Consider it the difference between 1 safety school/1 reach school and 2 safety schools.

Unfortunately, the military match makes judging competitiveness difficult. That said, try to improve your decision-making calculus by getting more information. Program directors, especially experienced ones, will be the best source of information to gauge where you rank, but they may be tight-lipped. Failing that, see if you can speak to any junior residents who might be willing to give you an honest assessment.
 

bleeker10

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I just matched ortho at EAMC and rotated at WBAMC, TAMC, and MAMC. All of the programs are competitive. MAMC and TAMC highly valued applicants that rotated there and if you didn't, you have a very slim chance of matching. Both usually have multiple students at a time.

When I was at TAMC, there were 10 of us. We had weekends off (we were "forbidden" from coming into the hospital Friday night through Monday morning before pre-rounds) and they wanted one student on call M-Th. You pre-round on a couple patients before the residents go over the list as a group at 545. You will run over the pertinent facts of the patient, keeping it to 15 seconds or less. If you are on call, you will present a case at morning report. You will also take part in OITE questions and try your best to give an educated answer based on your fund of knowledge.

At MAMC there was one other student with me but the month after there were 5. Expect to work a lot. They want you to take a call a week and either be on call Friday/Sunday or Saturday only. I worked over 90 hours in one week since call is in house for students and you stay until the post call day is over. I did a cadaveric presentation on the shoulder to all the residents, attendings, PA staff/students and an anatomy professor from University of Washington med school. The other student did the brachial plexus. Expect to present a call case to all the residents/staff at morning report. I summarized an article at breakfast journal club one morning with the residents. Jump on any chance to present your fund of knowledge whether it be the cadaver anatomy, journal club, etc.

WBAMC tends to take a couple people who never rotated at that facility. They go for higher board scores and research. They are the biggest program. They either take 4 or 5 residents a year. This year they took 5. They don't usually have a lot of students who rotate. Since I stayed in the hospital, I was "on call" every night and the residents would text me if something came in. Usually they don't get much on a given evening. I rounded with the on service intern every morning.

MAMC and TAMC rarely take a TY/GMO (one every couple years) while WBAMC usually takes at least one a year.

Some other advice: If you are going to TAMC, make sure you have a credit card with a large limit (>$6000) or parents who can help you out. I stayed at the Hale Koa (military resort) and paid close to $5000 for the 28 days. If I could do it again, I would've requested a pay advance. MAMC was cheaper since I stayed at Rainier Inn (~$2100). WBAMC offers free housing in the hospital. I went there on NADT and it was a cheap trip. My flight wasn't too bad and I got a rental car the last two weeks. If you are staying in the hospital, get a rental car. The hospital is not on the main post. A taxi costs you about $20 round trip to Fort Bliss.

So how do you increase your chances of matching? Know your anatomy cold. Seriously this is vitally important. You will impress the residents/staff by answering anatomy questions. Get along with the residents. If they invite you to do something, go. Attend journal clubs, barbecues, get togethers, birthday parties, etc. They want to find people they can work and hang out with for 5 years. If you do well, the PD's will go to bat for you and talk you up to the other programs. Conversely if you suck or do something stupid on your rotation, they will tell the other programs. Many of the PD's did residency together and are close friends.

If you aren't applying ortho, this information may not all apply to you. If you have more questions about specific programs, PM me. I chose where to rotate based on the simple fact of going to places I've never been to before. I didn't have inside knowledge or a special formula. I've just been to the other three places in my lifetime.
 

BigRedDeal

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colbgwo2 and bleeker10 :thumbup::thumbup:

Thank you. That helps a lot.
 
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