Some advice from a fourth year who just finished with this whole process. My first disclaimer would be that unless your school helps you out and is an "away-friendly" school, I would seriously rethink your options. The whole process is a huge pain in the ass and so seriously expensive that unless you have a pre-existing desire for a location or program, it's not worth it. I'm not saying I didn't have some fun, but if I had known then what I know now.......
If you're still determined, I say remember these things:
1) Start early, especially if you want a competitive program. If you're a third year, I mean start looking right now.
2) Once you've selected your electives and started applying, bug them like crazy until they assure your application is complete. Most require somewhere between 10-15 different documents and its a long shot that you'll get them all in the first time.
3) If your schedule isn't very flexible, and you have very specific time slots to fill, pick several different options for one month. Don't feel bad about cancelling the other options once you've got one nailed down. Trust me, as med students we are the very definition of unnecessary, they can fill your spot at once. You, on the other hand, will be screwed with a gaping hole in your schedule.
4) Just because they accepted you as an away student doesn't mean they feel any kind of obligation to you. While I was doing an away in Seattle, my next elective in Boston called to let me know the service I was going to be on dissolved and they probably wouldn't have anywhere to put me. My home school in Houston didn't know what to do with me with 2 weeks notice either. That's cool, you know - it's not like I spent hundreds of dollars on plane tickets.
5) When scheduling your elective, make sure they give you a specific assignment before you leave. Likely they'll have you rank a list of the rotations you want, but make sure they have one of these available. I arrived in a strange city, a new hospital system thinking I would have a fairly relaxed month on a consult service, maybe make a good impression. Oh no, they put me in the NICU.
Well, needless to say, my aways were fraught with complications, which I'm sure isn't the case for everyone. However, I wish someone had warned me about everything that could go wrong, so here it is. I think once I arrived in these locations, the experience was overall positive, but worth the hassle of getting to that point? Questionable.
It helps to have someone in the city who's got your back and can influence proceedings, whether it be family, friends or program connections. One of my friends did all of her aways through the Office of Minority Recruitment - which took care of the paperwork and covered most of the expenses. If you are fortunate enough to have this available to you - I say take advantage. The process can be expensive.
Otherwise, good luck to all the third years now contemplating this, I'm glad its behind me.
