I want to impress on away rotations but I won't have any good experience beforehand. Any advice?

[gregoryhouse]

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So I am getting ready to apply for away rotations but I am so nervous about how I should set them up. I don't have a home ophtho dept. and so I have next to no experience with the exams. I bought a 20D lens but haven't found much use for it besides practicing magnifying things inversely. I have done a few days of shadowing with the local ophtho PP docs so I at least have laid my hands on a slit lamp and indirect but have not had a chance to do these exams on patients. I did use an indirect and 20D lens to view the retina on an eye model but I don't imagine that it will be the same on a real person. I also got to look through a teaching lens on a slit lamp and was shown all the steps but again observing and doing are completely different.

I really want to do an away at a top program but I feel like I'll look like an absolute idiot if I go to one without knowing how to do these exams. I think doing an away rotation at a top program is the only chance to get into one. I come from a low tiered school. I got a 258 on Step 1, so far I've honored every rotation and most likely will honor these last 2, I have 3 pubs with 2 specifically related to ophtho and 3 poster/presentations. Even with these stats I'm just scared most top programs will be out for me without impressing them like hell on an away.

I feel like I could prepare well to appear knowledgable on the rotation but without knowing how to do proper exams it seems like it won't do me any good. I usually get along well with residents and attendings and have not had any trouble honoring yet but I feel like ophtho is in a world of its own as far as rotations go.

I would appreciate any advice at all.

Thank you.

 

[DrZeke]

Contrary to what everyone says, I don't care when med students can use a 90 or a 20. Those exams are hard and those skills don't come over the course of one rotation. When Med students want to play w my lenses they sometimes slow down clinic unless they do it while I'm presenting to my staff. But then they miss out on presentation. (Not trying to sound like a jerk, just stating the realities of an overbooked residents clinic)

What I care about is that they are interested and asking questions or helping me with paperwork, drops, assisting with injections...
Also, if I can show them an exam finding or they can tell me little things about ophthalmology bread and butter. Or they can talk to me and it's clear they have been reading. Or they ask questions...

I don't think it's fair for faculty/residents to judge med students on whether or not they see CSME or whatever. That's not the point of the rotation, it's to see whether or not med student has good attitude, is good fit and isn't afraid to work hard/ help residents/stay late/ pitch in where they can.

I wouldn't worry too much. If people like you, and you can show your strengths you should be fine. If you are teachable, someone will show you how to use their 78/90 and you will be fine. But maybe I've got it all wrong.


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[Bronze Medal]

An away rotation is NOT necessary to match at a top program. As long as your letters are solid and your personal statement is not terrible, I anticipate you receiving interviews from some highly-regarded programs. Aways can help or hurt, but one or two are probably necessary as a student coming from a school without a home program. Good luck!

 

[iapplicant]

Why not do an away at a less highly regarded program first, and then an away at a top program. That way you'll have at least some experience before going to the away at the top program

 

[DrZeke]

Just make sure you do them early so you have letters


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[gregoryhouse]

Contrary to what everyone says, I don't care when med students can use a 90 or a 20. Those exams are hard and those skills don't come over the course of one rotation. When Med students want to play w my lenses they sometimes slow down clinic unless they do it while I'm presenting to my staff. But then they miss out on presentation. (Not trying to sound like a jerk, just stating the realities of an overbooked residents clinic)

What I care about is that they are interested and asking questions or helping me with paperwork, drops, assisting with injections...
Also, if I can show them an exam finding or they can tell me little things about ophthalmology bread and butter. Or they can talk to me and it's clear they have been reading. Or they ask questions...

I don't think it's fair for faculty/residents to judge med students on whether or not they see CSME or whatever. That's not the point of the rotation, it's to see whether or not med student has good attitude, is good fit and isn't afraid to work hard/ help residents/stay late/ pitch in where they can.

I wouldn't worry too much. If people like you, and you can show your strengths you should be fine. If you are teachable, someone will show you how to use their 78/90 and you will be fine. But maybe I've got it all wrong.


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That is good to hear. That makes me feel better. I definitely plan to go into my rotations prepared with knowledge so I think I'll be strong on that front.

As far as doing a less highly regarded program first, I have definitely considered that. Our school has an affiliated program that it often sends its students to and I have been hoping to get into there for July, however, it is not guaranteed.

There are some really good programs I am applying to that offer a special clerkship scholarship for URMs. They offer a stipend and the ability to work closely with the program director and other faculty associated with the program. Under these circumstances, do you think it would be worth it to apply to these programs for the months of both July and August so I have a higher probability of being accepted to one despite the fact I'll be going in somewhat blind if I get into it for the July month?

Also any advice on what book would be the best to read before rotation? I've heard ophthobook is good but if you know of another book that is maybe more in depth or covers material that would impress you for students to know, please let me know.

 

[Trefoil]

That is good to hear. That makes me feel better. I definitely plan to go into my rotations prepared with knowledge so I think I'll be strong on that front.

As far as doing a less highly regarded program first, I have definitely considered that. Our school has an affiliated program that it often sends its students to and I have been hoping to get into there for July, however, it is not guaranteed.

There are some really good programs I am applying to that offer a special clerkship scholarship for URMs. They offer a stipend and the ability to work closely with the program director and other faculty associated with the program. Under these circumstances, do you think it would be worth it to apply to these programs for the months of both July and August so I have a higher probability of being accepted to one despite the fact I'll be going in somewhat blind if I get into it for the July month?

Also any advice on what book would be the best to read before rotation? I've heard ophthobook is good but if you know of another book that is maybe more in depth or covers material that would impress you for students to know, please let me know.

Ophthobook is great as you stated. I actually really like Ophthalmology Secrets and wish I read it sooner. It has some really great info that is "pimpable." I would definitely check out EyeRounds (website). Read cataract surgery for green horns and all of the student to student guides (they have one on diabetic retinopathy etc). They also have some really great cases on EyeRounds. EyeWiki is a great resource in the fly. When you come across something you haven't seen before, it helps to read the EyeWiki page on it. I agree with those who recommend doing a rotation at a mid-tier program first. This will allow you to get your feet wet, but it also broadens your application. You have outstanding stats and will likely do well in the application, but I think it is wise to apply broadly. Having a mid-tier program really like you will be a nice safety net.

 

[Bronze Medal]

Ophthobook is great as you stated. I actually really like Ophthalmology Secrets and wish I read it sooner. It has some really great info that is "pimpable." I would definitely check out EyeRounds (website). Read cataract surgery for green horns and all of the student to student guides (they have one on diabetic retinopathy etc). They also have some really great cases on EyeRounds. EyeWiki is a great resource in the fly. When you come across something you haven't seen before, it helps to read the EyeWiki page on it. I agree with those who recommend doing a rotation at a mid-tier program first. This will allow you to get your feet wet, but it also broadens your application. You have outstanding stats and will likely do well in the application, but I think it is wise to apply broadly. Having a mid-tier program really like you will be a nice safety net.

I second the Ophthalmology secrets recommendation.

 

[Whomp]

Has anyone tried the wills eye manual?

 

[Trefoil]

Has anyone tried the wills eye manual?

This is a great book, but not necessarily to read through prior to a rotation. It is great to reference when you want to know the work-up/tx. Most residents use it as their "bible" for call / urgent care clinic. As a result, many residencies will purchase it for you. Useful, but not necessary for a rotation. Buy a cheap or used one if you are to buy it.

 

[elementals]

As someone who was in your shoes not too long ago, I'd advise you to do one away at a top program and then another at a program that's just a little bit of a reach for you. Don't do what I did and waste both of your aways at top programs. I went on two aways at top 10 programs, honorsed both with flying colors, interviewed at a bunch of top schools, and then didn't match the first time around because I didn't have any safeties. The second time around I was a lot smarter about it and matched at a 'top 30%'-type program; I wish I'd done that the first time around and saved myself a lot of effort and stress!

Keep in mind an away is your chance to get something in your back pocket before the season even begins. The bottom line is top programs recruit VERY heavily from other top programs; they might interview you, but they likely won't match you. I've met dozens upon dozens of mid-tier applicants at top-tier programs. The only one I know to have matched at a top ten was in another league entirely -- as in, multiple first-author high-impact publications that are probably going to be classic papers in 10 years. As one of my attending mentors said, it's not impossible, but you really have to be head and shoulders above everyone else they're looking at.

As for how to do well in aways: don't freak out. No one expects you to know everything. Read ophthobook so you have a grounding, but the most important thing is to TRY HARD. Be nice. Be enthusiastic. Be helpful. Be someone that the dept would like to work with closely for 3 yrs. If there's downtime, ask yourself what you can do to help out. Never stand around looking bored or zoned out. I'd even keep reading on rotation to a minimum. Have something on hand to read, but if you can be working (even if it's at something no one assigned you to), work. The bottom line is, you should go out of your way to make the residents' and attendings' lives easier, even if it's something so simple as helping your resident figure out the refraction on a pair of glasses while he/she does the BCVA.

And this should go without saying, but for god's sake never ever leave until everyone else is leaving. If you're asked if you want to leave early, say thanks but no thanks. If you're actually dismissed, it may be acceptable to leave... but if I were you I'd go help someone else, or look for an open case, or something. I've seen students ask to leave early, or scamper off as soon as someone gives them the nod, or even dismiss themselves(!) at 430pm. What the ****? An away is a one month interview; treat it like that. Go above and beyond!