EM Away/Audition Rotations

[Hawkeye Kid]

This is mostly directed at current/soon-to-be residents, but info from anyone would be great. I'm trying to decide if an away rotation is in my best interest or not. I know the standard philosophy on the audition rotation if you have a specific program at which you really want to match, but what if you're like me and really don't have one (or two, or three) program that's really calling you name?

My advisor and the PD of my home program have both said that, in their opinions, an away in my case is basically a waste of a month that I could spend doing something I'll never do again. But, in reading/searching posts here and talking to people that just finished the match, it seems like there might be some disagreement on this. I'm pretty sure that I don't want to stay here for residency (mostly for the sake of living somewhere new) and am getting the sense that I might make myself more competitive by rotating away at a potential top choice (or maybe eliminating a potential top choice).

Then there's the argument of hurting vs. helping. On paper, I think I'm pretty solid but by no means incredible (mostly honors both clincial and pre-clinical, good step 1, ECs, etc). Given that, hurting seems more likely than helping. But I know that I could go somewhere, work hard, play nice, and all that jazz--I'm more worried about not having the right answers, missing dx's, etc. In your experiences, is this a good reason to stay home and do something I won't get in residency?

Any advice y'all can throw at me would be terrific. Oh, and I've used my googling skills and done a pretty extensive search and I haven't found anything that directly adresses this (I have read the stuff on SAEM which basically echoes the the docs here, but I get the impression that this is the party answer, so to speak). Thanks in advance--you guys and gals are awesome.

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[margaritaboy]

I agree that there is disagreement about the merits of away rotations.

Based on what I've seen from past threads on this subject, opinions range from absolute certitude of having to do an away rotation, to others who thought them unhelpful or even hurtful, to other more moderate experiences that fall between these extremes.

My thoughts on the subject have always been that an away rotation should really be used by the applicant to get a feel for a program, more than the other way around. And no, I don't think they are necessary. I did exactly zero away rotations and still matched #1. If you choose to do it, do it for yourself rather than thinking it will help your application.

Others on this board can probably relate their experiences from away rotations, and this may give you alternative points-of-view. Maybe that will help you decide if it is something you should pursue.

 

[anonymousEM]

As an almost third year resident in the position of supervising med students directly for most of the last year I can state that I look at work ethic, interest in learning much more than straight up book knowledge. I was in your situation somewhat...I thought I wanted to leave my hometown and community-yet-academic setting. So I rotated away at a university program and ended up at a county-type program where I'd rotatated on another service. I'm glad to have seen the different ways that a hospital operates...I think it's worth seeing to have an idea of what you'd be in for in the different settings. I don't think away rotations are necessary, but for me it was a chance to affirm that I wanted a change of pace and to learn in a new environment. Honestly the only way an away rotation can hurt you is if you go and act like unprofesionally or totally uninterested--knowledge deficiencies can be overcome with a good attitude and by showing genuine effort to learn and asking appropriate questions. I think previously there was a thread about how to do well on away rotations...personally my favorite and most highly graded students were the ones who took on fewer patients but worked them up thouroughly came to me with a plan not just an H&P, had a well thought out differential but were receptive to my tweaking...asked good questions about management and didn't need me to remind them to follow up on labs, tests, etc...and wanted to do as many procedures as possible.

That being said, use the rest of your elective time to travel or do some interesting electives you'll never get to do again. You shouldn't spend more than 3 rotations on EM Max (ultrasound, tox etc for one if you must do 3)

 

[Doczilla]

My away rotation opened my eyes to other ways of doing things. It also allowed me to explore some interests which are not available at my school, such as toxicology. This helped put some things in perspective when I was ranking programs.

Since you don't have a real strong idea about another program and don't want to match at your own, I would say that an away rotation or two would be a great idea to get a feel for other places. This might give you a better idea of what you are looking for in a program, since you don't seem to have found that at your home institution.

As far as doing things you won't get a chance to do again (medical examiner, international medicine, forensic pediatrics, and other such cool stuff), that's a good idea. If you need to make room in your schedule, ditch things like radiology, ICU, and trauma, since you will get them in residency. Doing an away rotation to try out a potential residency program in your chosen field or having a chance to do something unique and fun is more important than these rotations that you will just do again, IMNSHO.

When amassing letters of recommendation, one from an institution other than your own can be helpful. It shows that you can work and play well with others. AnonymousEM posted what I've heard from many residents and attendings as far as what they look for in a student. Don't worry too much about trying to know everything. You are a medical student. Knowledge will come; what programs are looking for is good work ethic as outlined by AnonymousEM's post.


'zilla

 

[Seaglass]

I think you should do an away unless you have a solid reason not to. At the very least it lets you see EM at another institution and that info can be priceless on the interview trail. Also getting LORs from another institution can be very helpful.

I'm more worried about not having the right answers, missing dx's, etc. In your experiences, is this a good reason to stay home and do something I won't get in residency?

I think that except for some very anal attendings students are not expected to know all the answers, they are expected to be honest about what they don't know and enthusiastic about learning.

 

[Hawkeye Kid]

thanks for the great info everyone. i'm definitely leaning towards doing an away, but now i have to figure out where. i think i might just throw a dart at a map and see what happens. also, in response to zilla's post--it's not that i don't want to match at my home program. in fact, i really like it--i think the faculty are great, i like the curriculum, the residents are happy, etc. BUT, if i found a comparable program in a different city, i'd go there first (just to live somewhere new, not because i don't like where i am). anyway, just wanted to clarify. thanks again for the help--feel free to keep it coming.