Doing away rotations

[deschutes]

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I'd like to hear from any of you with experience setting up away electives.

Apparently whether the nature of the away rotation is an "elective" or an "observership" is a big deal. At least that's what my home GME dept has me believe.

An observership is easy to set up. All you need is your program director agree and write a letter stating that you have the appropriate credentials and proof of medical liability coverage.
However, an observership does not count towards residency training, supposedly per the ACGME. You will not be paid. You will have to extend your training if you wish to do such a thing.

Compare this with a formal away elective. You have to write up goals and objectives which will be submitted as part of a PLA. Your GME department has to have said PLA (I don't know what it stands for, some interinstitutional legal agreement needing many signatures from upper-level administrators at both institutions) available for ACGME review. Without that PLA in place before you go rotate, ACGME will not recognize that away elective.

If this is true, how come I hear of people doing "observerships" without blinking an eye during their PGY-3 year??

 

[yaah]

I think because observerships in pathology are different in that you can do most everything you are interested in doing (i.e. reviewing slides and sitting with the attendings, etc). And they use elective time at home institution to do that with. If you were in clinical medicine an observership is less useful because in order to actually do it you have to do work with patients. An observership in path is basically equivalent to a full away rotation.

Getting credit for it is the problem with doing the away elective, I think here we have to apply for it over a year in advance, among the other issues you mentioned.

Depending on your area of interest and other factors, you can get outside funding for "traveling fellowships" that last a week or two.

 

[deschutes]

I wrote to ACGME last night. They promptly replied this morning!

No, we do not require that your home institution have a PLA with the away institution for an elective rotation.

I'm confused by what your GME told you. We don't use the term "observership rotation," and I'm not sure what they mean by "recognized by ACGME." We would recognize the rotation as an elective experience, without a PLA.

I hope that helps. Please let me know if I can provide further clarification.

On the ACGME website (http://acgme.org/acWebsite/about/ab_FAQAgreement.pdf) it states:

"Question 5: What is the minimum experience for which a program letter of agreement needs to exist between a residency program and a site involved in residency education?

Answer:
Program letters of agreement are required between the residency program and all sites to which residents rotate for required education or assignments."

So my home institution had probably misunderstood and was making away elective arrangements more difficult than they needed to be 🙂

Anyway I'm glad that's all clarified.

Lesson learnt: It pays to write ACGME and get to the bottom of things.

 

[mcfaddens]

I did an outside elective rotation, and did have to fill out a PLA or whatever (I think it had to be justified of why I was getting paid while not at my institution). The process was pretty easy here, but we don’t have alot of residents compared to some of the larger programs out there. I also had to write a letter to the head of the GME stating why the elective rotation would be something more than I could get at my home institution. Overall pretty easy situation but then again we have really nice and helpful people in the GME and our PD is very helpful in getting us the time and resources to do such things.