No its not like that at all. There are a couple things you should consider. First, do you want this to be a clinical or a research away. They have a very different focus. Second, are you going to go through the VSAS system or attempt to secure an away elective directly through the department of interest. If the former, its just an application and acceptance is based on availability. The latter requires more initiative on your part. Personally, I did a research away elective for 3 months the summer before I applied. I emailed a few researchers who had a specific focus in an area I was interested in. Since I had a plan in place already and knew their work, they were happy to accommodate me. The results were an IOVS pub in retina OCT which certainly helped me match in a top program.
Good luck
