Do programs take into account timing of away rotators?

[plasticsday1]

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Obviously, someone doing their fourth away rotation in September will theoretically be a lot more knowledgeable and prepared than someone doing their first in June. Do programs take this into account when evaluating and comparing these applicants? It would seem very unfair if they didn't. Why would anyone do away rotations early on then, or put the top programs they want to match into as an earlier away rotation?

 

[operaman]

Nope we don’t consider that even one little bit. The truth is the good students are good all the time and make a great impression regardless. The best superstar medical student I’ve ever worked with rotated with us early. We have a sub-I with us right now who doesn’t even want to go into our field and is so good already that we are all trying to lure him into changing.

Needless to say we’ve had some less than impressive rotators come through at all times. Some of them are duds and some just don’t quite fit in with this particular group. Others do pretty well and then blow it by saying or doing one or two things that sink them. A month is a long time to be on.

Just be awesome all the time and you’ll be fine.

 

[Keladry]

For EM it does - the SLOE specifically asks what # rotation it was. Don't know about any other fields.

 

[plasticsday1]

Nope we don’t consider that even one little bit. The truth is the good students are good all the time and make a great impression regardless. The best superstar medical student I’ve ever worked with rotated with us early. We have a sub-I with us right now who doesn’t even want to go into our field and is so good already that we are all trying to lure him into changing.

Needless to say we’ve had some less than impressive rotators come through at all times. Some of them are duds and some just don’t quite fit in with this particular group. Others do pretty well and then blow it by saying or doing one or two things that sink them. A month is a long time to be on.

Just be awesome all the time and you’ll be fine.

Nothing personal, but that is bull$hit. No student is just naturally "good." You get good by studying and preparing over time, and the rotator in September will have had far more time to study and prepare than the rotator in June. Maybe you're right that programs don't take this into account at all, you probably know way more than me. But that's still fu3ked up and just another reason why any part of med school after second year (aka all this subjective trash) is goddam awful and the reason why physicians today are so cynical and hate their careers.

 

[operaman]

Nothing personal, but that is bull$hit. No student is just naturally "good." You get good by studying and preparing over time, and the rotator in September will have had far more time to study and prepare than the rotator in June. Maybe you're right that programs don't take this into account at all, you probably know way more than me. But that's still fu3ked up and just another reason why any part of med school after second year (aka all this subjective trash) is goddam awful and the reason why physicians today are so cynical and hate their careers.

Well even the earliest rotators have had about 3 years of medical school before they get to us. I think that’s plenty of time for good students to read and prepare and develop enough clinical acumen to be genuinely helpful on a rotation. I’ve personally had 2nd and 3rd year students who were better than many sub-Is. While I’m sure every student will personally get better after each rotation, I doubt this difference is enough to overcome significant between-student differences.

I didn’t realize that was part of the EM SLOE. I wonder if any of their literature has ever looked at whether number of rotations correlates with performance on that evaluation.

 

[Keladry]

I didn’t realize that was part of the EM SLOE. I wonder if any of their literature has ever looked at whether number of rotations correlates with performance on that evaluation.

I'm def not the most informed, but perhaps @gamerEMdoc could shed some light on it?

 

[doyouhaveaflag]

Obviously, someone doing their fourth away rotation in September will theoretically be a lot more knowledgeable and prepared than someone doing their first in June. Do programs take this into account when evaluating and comparing these applicants? It would seem very unfair if they didn't. Why would anyone do away rotations early on then, or put the top programs they want to match into as an earlier away rotation?

The problem with doing them late is that at the top programs, you're never rotating alone. You'll be directly compared to people on those rotations who started earlier. My school's curriculum starts fourth year late and I didn't do my first away until August. The others on the rotation were on their second and third aways by then.

I agree with above though in that those couple months shouldn't make or break whether or not you're competent or whether you fit in with the group. You read for cases to prepare ahead of time regardless of how many months you've rotated so far. I think the biggest difference is in practical knowledge, like knowing the type of dressings you'll need to bring on rounds for certain types of patients (so you don't have to go running to the supply closet and make everyone wait) and knowing what you need to fetch to bring to the ED when you go on the burn debridement/lac repair/bedside revision amp so everything is ready to go when the resident joins you. That's the stuff you get better at as you do and see more.

 

[gamerEMdoc]

Yes, the SLOE asks what rotation # this is. And programs definitely consider how good a candidate is based on experience. A student who is just average who has had 4 EM rotations is a lower quality candidate than someone who is just average who has never spent a day in the ED and is starting July 1st. They both might be just middle of the road candidates, but the second student has more room for improvement. That's a common comment on SLOEs too. Many people will note that its just the students first rotation, and they are expected to improve, etc.

As for the comment that some students are just great, there is some truth to that. I have had students as late 3rd years or early 4th years who were miles ahead of others. So that certainly can happen.

 

[Chillbo Baggins]

Well even the earliest rotators have had about 3 years of medical school before they get to us. I think that’s plenty of time for good students to read and prepare and develop enough clinical acumen to be genuinely helpful on a rotation.

This also depends on what specialty you are. Most students haven't gotten 3 years of ortho knowledge and skills before aways rotations, and those residents specifically told me they know you won't know everything on your first and try to help you for your next ones.