If you didn't do an away and matched.... (or not)....

[deleted128562]

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...I'd be interested in hearing how you did in the match, and if you think not doing an away hurt, helped, or had no effect.

Hoping to match EM next year. I go to a respectable midwest school (MD) with a good home EM program. Am signed up for an EM Sub-I and an elective, both of which I can get SLOR's from. Step 1 of 230, about equal numbers of H/HP/P in 3rd year rotations.

I really don't want to do an away due to family and financial concerns. It really would create some strain which I'm just not sure is necessary. Also, there is no specific program that I am just gung-ho about matching at. I'd be happy to match at my home program or any of the several others I'll be applying to. In some ways I can even see downsides to an away, as I could botch it, or be asked in interviews at other programs why I did an away somewhere else and not there.

Would appreciate thought and any relevent stories.

 

[Dr Roboto]

Asking applicants why they didn't do an away rotation at the interviewer's program isn't a fair question. I haven't heard it asked. But I have been asked why I chose a certain program for my away rotation. From my experience during this past interview season, I think my away SLOR had a bigger influence than my home SLOR only because most of my interviewers brought up the comments written in my away SLOR. It could've been that my home SLOR was lukewarm. But I like to think that an away SLOR may have more weight presumably because the away program has no particular investment in the applicant as he/she is not from their institution.

 

[blackavar]

The benefit to an away rotation for your application is that with an away SLOR you get external validation for everything else written about you. Your home institution knows you best, but, it's also in their interested to see you do well, and generally they want you to do well, so they will present you in the best light possible. An away rotation has no such attachments, so if when they provide you with a SLOR, they have no vested interest inflating your eval and can be seen as "less biased."

I don't know that it's imperative to do an away rotation, but I do think you need at LEAST 2 SLORs for your application and I think it is helpful to get one from an away institution. That said, I don't think not doing an away will keep you from getting into EM, but it might reduce the number of interviews you get because doing an away rotation seems so common place now for applicants.

I'd be interested to hear if there is anyone out there in EM that matched without doing an away rotation. One way you might try to get around doing an away rotation would be to do two EM rotations at different hospitals within your system, but making sure that you can get a SLOR from each rotation.

If you don't do an away, you may be asked why, but I think the financial constraints and family commitment points are valid and if explained in an appropriate manner would be fine. Those are my thoughts.

 

[stooges287]

I matched without doing an away. On interviews I was asked both about any EM rotations I did (in a general sense) and if I did any aways. I just explained that my advisor advised against it, so I didn't do one. The interviewers all seemed ok with that, and I was quite satisfied with my match, but of course I really have no way of knowing if that hurt me or not.

However, it did seem like the majority of applicants did aways, so I did feel like I was unusual in not doing one. FWIW, I actually wish I did an away to see a different hospital system for my own benefit when it came time to looking at different programs.

 

[gman33]

Not matching would create even more strain.

Your application just won't seem that strong to some people without an away.
A strong SLOR from an away is very helpful.
Probably more important than the home SLOR for the reasons stated above.

Do everything you can to make yourself have the strongest app possible.

 

[ruralmd]

I applied, got tons of interviews, and matched at my #1 doing only one EM rotation at my home institution without an EM residency program. 😱

I was asked about it and gave the reasons why I only did one month. I must warn you though, it was a pretty common question on the trail as most EM applicants do one or (in a lot of cases) two away rotations. Not sure if it hurt me with some places as I didn't get an interview at a 100% of the EM programs I applied to but I got interviews at some pretty competitive places (Pitt, SUNY-Downstate, Cook, Emory just to name a few).

 

[turkeyjerky]

...I'd be interested in hearing how you did in the match, and if you think not doing an away hurt, helped, or had no effect.

Hoping to match EM next year. I go to a respectable midwest school (MD) with a good home EM program. Am signed up for an EM Sub-I and an elective, both of which I can get SLOR's from. Step 1 of 230, about equal numbers of H/HP/P in 3rd year rotations.

I really don't want to do an away due to family and financial concerns. It really would create some strain which I'm just not sure is necessary. Also, there is no specific program that I am just gung-ho about matching at. I'd be happy to match at my home program or any of the several others I'll be applying to. In some ways I can even see downsides to an away, as I could botch it, or be asked in interviews at other programs why I did an away somewhere else and not there.

Would appreciate thought and any relevent stories.

My school is affiliated w/ two EM programs, and I rotated at each, getting slors at both. I did very well in the application cycle/match. No one asked me about not having done an away.

For your situation, I would do one rotation at your home program and one away. I don't think there's any utility in rotating twice at the same program. I also think it's very helpful to you to rotate through different types of programs--county vs community vs university. That'll help you w/ choosing the type of residency you want, and will be beneficial in exposing you to different medical practices. Just pick a program in a nice city that you'd like to spend a month in.

 

[EMandM]

Did my away so late that none of the schools who decided to interview me knew I had done it. Everyone asked if I had done one at interviews but no one seemed overly concerned not to have my SLOR since the rotation was so late. My #1 program never even downloaded the SLOR from my away but I matched there anyway.

My takeaway at the end of the season is that an early away with a good SLOR is probably helpful for getting interviews but is nowhere near as essential as people make it out to be.

 

[Docuronium]

Friend of mine didn't do an away, was asked "why not?" multiple times on the interview trail, yet still matched at a pretty awesome place.

Like everything, I think SDNers make it out to be a bigger deal than it really is.

 

[nycqqe]

You should consider doing an away if you can, especially at a program where you want to increase your chance of matching, or at a geographic region where you want to go to, let's say for example, NYC, where there are many programs that know each other well and a solid letter from any of them could help. Trying out that program or region is also for your own benefit to see if living there for the next 3/4 years is a good fit for you. Sure it'll cost some money but it's not exactly an unworthy investment.

I know, for example, my home program, Maimonides matches a good 30 - 40% of its class every year from students that rotated there, and some of them wouldn't have been interviewed if not for the rotation. They are confident that they can train you into a star, as long as the "fit" is right, so the "fit" is more improtant than anything else (pedigree, scores) given the unique working environment and patient populations. Honestly there is only so much "fit" a program can see out of the applicants based on paper and the interview, and it goes both ways for the applicant and the program. If a program or applicant isn't the most picky about "fit" then they are more likely to be numbers and pedigree trolls and when matched with each other, both parties end up treating each other with a tight fist(i.e. malignant program vs unsatisfied resident), and that's not a happy 3/4 years of your life. So yes, I think an away is important for that reason.

 

[SDEM2012]

I did one away rotation but got a lot of surveys after match from programs saying that I was 'ranked to match' so I don't think it makes a huge difference where you go, as long as you do one and get a SLOR.
However, if you've lived in one part of the country for most of your life (ie west coast) and want to go to another, I would make sure you do one away in that region so that schools believe that you will make the move.

 

[Hamhock]

I admit, I have not read most of this thread.

But I will offer my uninformed opinion anyway:

The value of of an away is three-fold, as I see it:

1. SLOR from outside your home program is more respected (despite this talk about how much in kahoots PDs are) and more easily compared to other SLORs

2. EM is drastically different across the country -- an away gives a lot of perspective

3. In agreement with other posters: Doing well on an away (even in your own city: I guess the OP doesn't want to leave home) is going to drastically help you match...and matching ANYWHERE is no longer guaranteed.

HH

 

[Dane07MD]

I'm a big proponent of the away rotation.

I did two, for reasons stated above: was an east coast med school applicant hell bent on returning to the West Coast, and wanted to increase my chances of interviewing/matching in the West.

EM is a regional specialty, I think more so than we would like to admit. An all-honors, 250 USMLE applicant is good to go anywhere, but the run of the mill students tend to not have the exact same luck. Your home letters are important obviously, but they may mean less to programs that are over 2500 miles away. If you are motivated to match far from your school, an away is important.

However, that being said, I think that the blanket statement that it is a necessity is wrong. Just keep in mind what you want and where you want, and make the decision from there.

(And for what it's worth, I matched into a West Coast program where I did an away rotation... I have a hard time believing I may have even gotten an interview otherwise...)

 

[StealthNerd]

My .02 FRN:

It doesn't matter unless you are specifically looking to go to the place where you're doing an away, or are thinking about it and want to see what it's like there. My situation: I didn't do any aways cause I couldn't think of one program I wanted to go to more then any other and knew I really liked my home program. So rather then randomly pick one, I just took one more cool elective. When asked about aways on interviews (came up rarely) I responded as above. No big deal at all. I ended up deciding to put another awesome program first (fell in love unexpectedly on the interview trail) and my own program second, matched at first choice.

 

[Braves123]

Friend of mine didn't do an away, was asked "why not?" multiple times on the interview trail, yet still matched at a pretty awesome place.

Like everything, I think SDNers make it out to be a bigger deal than it really is.

that's what happened to me, but I'm sure I got burned off several place's lists because I didn't do aways and i didn't get invited to a bunch of places cause of that as well. I say do at least one away, two if you can manage it and make a good effort. I got asked at a ton of places about why I didn't do aways, and it was always an embarrassing question to address. The large ivory tower academic places tended to care a bit less about aways, exposure, leadership and more about board scores/grades/academic achievements from my personal experience, whereas places with great community reputations grilled me about it.

 

[Docuronium]

that's what happened to me, but I'm sure I got burned off several place's lists because I didn't do aways and i didn't get invited to a bunch of places cause of that as well. I say do at least one away, two if you can manage it and make a good effort. I got asked at a ton of places about why I didn't do aways, and it was always an embarrassing question to address. The large ivory tower academic places tended to care a bit less about aways, exposure, leadership and more about board scores/grades/academic achievements from my personal experience, whereas places with great community reputations grilled me about it.

I agree, I think it's a smart idea to do an away, and there are numerous benefits.

I just doubt that an excellent/good applicant won't be considered simply because they didn't do an away rotation. It's also tough to explain why you didn't do any aways if you were just spending those months coasting (not suggesting that you were, just saying that it'd be tough to explain).

If you were showing genuine interest in things that would benefit you as an Emergency Medicine resident, then, according to our Chair, it doesn't hurt.