Do I have to do an EM rotation at my home institution?

[JBlue]

I am a third year and thinking about my rotations for 4th year. Is it important that I do an EM rotation at my home institution? We rotate in the EM during our surgery rotation so I won't have an actual home EM rotation unless I do a subI. We do not have a residency program and our ED is pretty small. I have worked with the Chief of EM quite a bit already so I know he will give me a good SLOR but I am wondering if programs will expect me to have done an EM rotation at home? Thanks for any input and thanks to everyone who keeps posting great advice on this forum. We have no guidence whatsoever at my institution so this forum is a godsend!

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[Miami_med]

I am a third year and thinking about my rotations for 4th year. Is it important that I do an EM rotation at my home institution? We rotate in the EM during our surgery rotation so I won't have an actual home EM rotation unless I do a subI. We do not have a residency program and our ED is pretty small. I have worked with the Chief of EM quite a bit already so I know he will give me a good SLOR but I am wondering if programs will expect me to have done an EM rotation at home? Thanks for any input and thanks to everyone who keeps posting great advice on this forum. We have no guidence whatsoever at my institution so this forum is a godsend!

We don't have an EM program here either, though we have a huge ED. What I have been told by both individuals that matched and by out clerkship coordinator is that you don't need to if you don't have a program. However, a letter from the chief will be good. You should also use those months to do externships, and you should make sure to get some letters there.

Anyone who actually makes these decisions have feedback?

 

[SolidGold]

I think having a home program is a big advantage. If anything, you can do the home rotation first thing 4th year before doing away rotations to really prepare yourself to shine. I did 2 home rotations (one required 3rd year EM rotation and one first thing 4th year) before doing 2 aways. Getting great SLORS from outside institutions is more important than getting one at your home school, so impressing people outside of your institution will help a lot. Anything you can do to make yourself a cut above the rest will get you a long way with EM becoming so competitive.

 

[deleted52758]

if your home institution doesnt have an emergency medicine residency, i wouldnt bother doing a rotation there. im not sure, but i thought only emergency medicine attendings that are involved in a residency can write SLOR's. if you look on the SLOR, they have a box where the writer ranks you among all their potential applicants, which obviously wouldnt make sense if you're not part of an emergency medicine residency.

 

[oldtown]

My home institution doesn't have a program. i did a rotation there in July, and did one at a place with a program in october. I'm glad I did it the way I did, because I was able to work out the kinks in a low pressure setting before I had to go and really shine at an away rotation.

EM is so different from the medicine that we all had to learn in 3rd year, and I felt like I really benefitted from the "practice" month to get up to speed. If my first rotation was a "real" rotation, I would have been bumbling through 10 minute internal medicine type presentations of H&P's to attendings that would have been rolling their eyes their whole time and giving me the "hurry up and get to the point" hand motion. I think I got a good letter from our rotation coordinator (not sure if it was an SLOR or not). Plus, you get the added benefit of, if god forbid you don't match and have to scramble, you have people at your home institution that know you and can go to bat for you and call programs on your behalf.

Basically the way I see it is that you don't HAVE to do one at home, their are advantages and disadvantages. i'm glad i did. the way I see it too, is that you're going to apply to what, 25 programs or more. What's the difference if you rotated at one, two, or three of them? either way, the vast majority of programs you apply to you will not have rotated at.

just my $.02

 

[c.bear]

I did not do a rotation at my home ED because there was no program. Did rotate through as a 3rd year (which is how I got my advisor and one letter). Did two away rotations. One early to get SLORs. I think it is up to you on this one. Def. do not need to do a formal rotation there. If you need/want a letter writer from your home ED just see if you can work a few shifts while on another rotation instead of wasting a whole rotation on it.

 

[iatrosB]

I thought that the EM world frowned upon moonlighting (at least in EDs) because it gives credence to the notion that someone other than a residency trained EM doc can work there. Am I wrong?

edit:
What the hell did I post this in this thread for. Ignore.

 

[roja]

I did not have a home program. We had a very large ED but no residency program. Another local institution had an active duty residency. I shadowed and worked with the head of our department- who wrote me a letter- and also recommended that I *not* rotate in our own ED. I did a rotation at the active duty program and did an away rotation in nyc.

The benefit to doiing it this way is that you get a letter from someone showing how dedicated you are (because you are doing 'extra' work) and you get a letter or two from an outside place.

One thing that I find interesting (after a grand total of 3 years interviewing)- people who get all three letters of rec from thier home institution. While not a complete red flag, to me this is concerning. Home institutions have thier own reasons for promoting thier residents, plus it doesn't show that you can do well in another environment. Just something to think about.....

 

[JBlue]

Thanks for the replies. I will see how everything goes and I may do a subI in July before going off on my aways.

Can anyone clarify willynilly's comment about the SLOR? I thought the chief of our ED could write an SLOR for me even though we don't have a residency program? Is this correct or no?

Thanks!