Neuro Away Rotations Really Help???

[medsRus]

Since people have matched already and settled down, I think we should raised these two questions:

Question 1: "How much does doing an away rotation help you get into the program you rotated at?"

Question 2: “Does the advice hold true for IMGs?”

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[PhakeDoc]

I have two friends that were excellent candidates this past year in neurology during the match - above average steps (one blew out Step 2), good grades, excellent recs, etc., and just really good, friendly, personable folks whom I felt could have matched anywhere outside of the research elites. One did an away at a very respectable, but not research elite program, and the other did not. Both ranked that particular program as their number one choice. Unfortunately, neither matched there.

My attendings have said that for neuro, aways don't really matter. Now, that could be just a regional thing. I won't be doing one.

Perhaps things might be a bit different for IMGs - I couldn't say.

 

[Amos]

Since people have matched already and settled down, I think we should raised these two questions:

Question 1: "How much does doing an away rotation help you get into the program you rotated at?"

Question 2: "Does the advice hold true for IMGs?"

In my personal experience, program directors I have talked to, and after talking to other successful applicants, I have found that in neuro, away rotations rarely help you match at said program. I know many, many people that matched at very strong programs that did not do an away rotation.

Do one for your own education and fun if you think you would enjoy it, but don't think of it as improving your chances at most top places.

The only exception would be if you were an IMG that had no clinical experience in the US. Even then it would be more about getting a letter from the place you did an away rotation vs. it helping you match there.

My 2 cents.

 

[darksideone]

In my personal experience, program directors I have talked to, and after talking to other successful applicants, I have found that in neuro, away rotations rarely help you match at said program. I know many, many people that matched at very strong programs that did not do an away rotation.

Do one for your own education and fun if you think you would enjoy it, but don't think of it as improving your chances at most top places.

The only exception would be if you were an IMG that had no clinical experience in the US. Even then it would be more about getting a letter from the place you did an away rotation vs. it helping you match there.

My 2 cents.

Interesting. So what do you recommend to do for most of your electives 4th year? I only have 2 required rotations, the rest (8) are for electives. One good thing that I thought about an away rotation at your top 1-2 places is that it can give you a true view of what the program is like. It is easy for a program to be on their best behavior when you are there for a 1 day interview. But being there for 1 month, it gives you a true sense of what the program is like. Obviously you need to be hard working and a team player. No sense in doing an away if you aren't going to try and make a great impression.

 

[Amos]

Interesting. So what do you recommend to do for most of your electives 4th year? I only have 2 required rotations, the rest (8) are for electives. One good thing that I thought about an away rotation at your top 1-2 places is that it can give you a true view of what the program is like. It is easy for a program to be on their best behavior when you are there for a 1 day interview. But being there for 1 month, it gives you a true sense of what the program is like. Obviously you need to be hard working and a team player. No sense in doing an away if you aren't going to try and make a great impression.

Away rotations ARE a good way to learn about other places. If you have the time and money to live somewhere else and have a good learning experience go for it. They might also be good for applicants that aren't sure they want to do neuro and have weak neuro departments at their home school. I just wouldn't do an away rotation with the primary purpose of trying to improve my chances of matching at program X.


In fact, if I did an away rotation, I might do it at some places I was considering, but not at my very top choices. Maybe use it to figure out where I should apply. Want to get out of the Midwest in winter? Always wanted to live near your buddy in Phoenix? Want to try test out your medical Spanish in Manhattan? Go for it. I would probably go somewhere that is going to give me the benefit of the doubt if I mess everything up the first 2 weeks I'm there.

The risk of away rotations is that since you don't know the system somewhere else, where stuff is, etc. you might make a less than favorable impression and hurt your application. And at competitive programs that is going to be a problem, since other applicants are going to have stellar credentials. No matter how hard you try when you are visiting, just in terms of working the computerized medical record, putting in consults, finding the bathroom, etc. you will at times come across like a MS3 from July. Not that many busy residents and staff like showing a med student how to do everything in late fall when everyone else knows what's going on. You need to consider the odds of doing below average or average vs. the chances of really wowing your team.

You pick the letter writers for your ERAS application, but if you do an away rotation at hospital X, the program director there IS going to get your staff's input whether they liked you or not. In fact, at extremely competitive med schools it may be difficult not to be overshadowed by even the MS3s simply by the fact that they know where stuff is, how to write orders, etc. Perhaps you could work one on one with staff on an outpatient service to avoid this.

For some of these reasons, students will occasionally do a rotation at their top choice institutions in departments they are not applying to. Seems strange, I know, but some like that they get to live in a different city and see how people act at a hospital without the pressure of trying to impress everyone. I have known ENT applicants to do a G-surg rotation elsewhere, medicine students doing ER, etc.

Overall not that big of a deal. If you want to try neuro somewhere else, go for it. Just know it is a minor part of the neuro application process and has the potential to both help and hurt your chances.

If any IMGs have different advice for international applicants please speak up.

 

[darksideone]

Away rotations ARE a good way to learn about other places. If you have the time and money to live somewhere else and have a good learning experience go for it. They might also be good for applicants that aren't sure they want to do neuro and have weak neuro departments at their home school. I just wouldn't do an away rotation with the primary purpose of trying to improve my chances of matching at program X.

In fact, if I did an away rotation, I might do it at some places I was considering, but not at my very top choices. Maybe use it to figure out where I should apply. Want to get out of the Midwest in winter? Always wanted to live near your buddy in Phoenix? Want to try test out your medical Spanish in Manhattan? Go for it. I would probably go somewhere that is going to give me the benefit of the doubt if I mess everything up the first 2 weeks I’m there.

The risk of away rotations is that since you don't know the system somewhere else, where stuff is, etc. you might make a less than favorable impression and hurt your application. And at competitive programs that is going to be a problem, since other applicants are going to have stellar credentials. No matter how hard you try when you are visiting, just in terms of working the computerized medical record, putting in consults, finding the bathroom, etc. you will at times come across like a MS3 from July. Not that many busy residents and staff like showing a med student how to do everything in late fall when everyone else knows what’s going on. You need to consider the odds of doing below average or average vs. the chances of really wowing your team.

You pick the letter writers for your ERAS application, but if you do an away rotation at hospital X, the program director there IS going to get your staff’s input whether they liked you or not. In fact, at extremely competitive med schools it may be difficult not to be overshadowed by even the MS3s simply by the fact that they know where stuff is, how to write orders, etc. Perhaps you could work one on one with staff on an outpatient service to avoid this.

For some of these reasons, students will occasionally do a rotation at their top choice institutions in departments they are not applying to. Seems strange, I know, but some like that they get to live in a different city and see how people act at a hospital without the pressure of trying to impress everyone. I have known ENT applicants to do a G-surg rotation elsewhere, medicine students doing ER, etc.

Overall not that big of a deal. If you want to try neuro somewhere else, go for it. Just know it is a minor part of the neuro application process and has the potential to both help and hurt your chances.

If any IMGs have different advice for international applicants please speak up.

Amos, thanks for your post and offering your viewpoint. As a AMG, it gave me some perspective to think about as I am looking/thinking about doing some away rotations. It light of what you said, I am thinking that it might not be the best use of my time to do an elective at my top 1-2 programs in light of what you wrote. Instead, I might actually do a couple rotations at some programs that I wasn't planning on applying to, but that are in the same city as some of my family. That will at least give me free room and board. I guess it will also give me a chance to see another part of the country, and give me the chance to get a LOR from someone outside of my university. While I might not get the chance to make a good impression at one of my top programs, at least I don't have to worry about making a negative impression.

 

[typhoonegator]

I've seen the situation from both sides. I didn't do an away rotation myself, but I know a few of my residency-mates did. Not everything you do has to contribute to some sort of career advancement goal, you are allowed to do stuff for fun. An away rotation can be a great way to see how neurology is practiced elsewhere, affirm your career choice, and help you decide which cities seem good for you.

As a resident I had to take care of bunches of away rotators, and they tend to fall into two groups. There is the group of "explorers" as I described above, who just wanted to check out Boston and see how we do things at our institutions, and there is the group of "gunners" that are trying to dazzle the residents and staff with the hope of securing a residency spot.

While it is possible to be globally impressive on an away rotation and improve your chances of matching, you can also damage your chances if you rub people the wrong way, so you have to be careful how you present yourself, and decide what your goals are from the get-go.

 

[darksideone]

I've seen the situation from both sides. I didn't do an away rotation myself, but I know a few of my residency-mates did. Not everything you do has to contribute to some sort of career advancement goal, you are allowed to do stuff for fun. An away rotation can be a great way to see how neurology is practiced elsewhere, affirm your career choice, and help you decide which cities seem good for you.

As a resident I had to take care of bunches of away rotators, and they tend to fall into two groups. There is the group of "explorers" as I described above, who just wanted to check out Boston and see how we do things at our institutions, and there is the group of "gunners" that are trying to dazzle the residents and staff with the hope of securing a residency spot.

While it is possible to be globally impressive on an away rotation and improve your chances of matching, you can also damage your chances if you rub people the wrong way, so you have to be careful how you present yourself, and decide what your goals are from the get-go.

I'm curious if there is a third group; a group of students who just want to learn as much as they can about neurology and have a good experience at another institution. While this indirectly means making a good impression or not is dependent on the applicant. Can't you visit another place to have a good experience to see how they do things, without going to the point of being a "gunner" and coming off as a douche/someone that just tries too hard and annoys everyone? I hope to fall in the former rather than later group.

 

[Amos]

I'm curious if there is a third group; a group of students who just want to learn as much as they can about neurology and have a good experience at another institution. While this indirectly means making a good impression or not is dependent on the applicant. Can't you visit another place to have a good experience to see how they do things, without going to the point of being a "gunner" and coming off as a douche/someone that just tries too hard and annoys everyone? I hope to fall in the former rather than later group.

It sounds like you have the right idea. I would go for it and see how things go, especially if you can chill with your family for free.

As everyone has mentioned, I think going in as a "gunner" is a bad idea. You aren't going to be able to out-gunner the in house gunners and the odds someone gets a bad taste in their mouth is high.

 

[chickensoupdr]

I'm considering doing an away... but I'm not sure exactly where. Would it help to go to a more prestigious school and try to get a strong LOR? Or go somewhere I feel like my chances are realistically greater at? And how competitive is it getting an away rotation? Thanks!

 

[jd1031]

Since people have matched already and settled down, I think we should raised these two questions:

Question 1: "How much does doing an away rotation help you get into the program you rotated at?"

Question 2: “Does the advice hold true for IMGs?”

1) It depends on multiple factors: your personality, knowledge base, adaptability, etc. Above all, if you are personable and a pleasure to work with AND you have competitive stats for the institution of interest (USLME score and especially good LORs), an away rotation may help separate you from the crowd in a positive way. If you're not competitive to begin with or if you're not personable or easy to work with, it may not do anything or even harm your chances.

As a resident, I deal with away rotators all the time, and a positive impression goes a long way. The converse is also true. It rarely happens, but you also don't forget a negative (overall) impression. The neuro R2s pay close attention to the rotators. These away rotators have the potential to be their future junior residents who they could work with day in and day out

 

[Shazam243]

1) It depends on multiple factors: your personality, knowledge base, adaptability, etc. Above all, if you are personable and a pleasure to work with AND you have competitive stats for the institution of interest (USLME score and especially good LORs), an away rotation may help separate you from the crowd in a positive way. If you're not competitive to begin with or if you're not personable or easy to work with, it may not do anything or even harm your chances.

As a resident, I deal with away rotators all the time, and a positive impression goes a long way. The converse is also true. It rarely happens, but you also don't forget a negative (overall) impression. The neuro R2s pay close attention to the rotators. These away rotators have the potential to be their future junior residents who they could work with day in and day out

Soo, to sum up if you know for a fact that you have all of those positive factors going for you, then you should also be quite certain that you’ll be able to land a position at a midteir neuroresidency. So, in terms of increasing chances of matching to a program, there really isn’t that much sense to do an away unless if it’s for one of the top tier programs.

 

[chickensoupdr]

My grades/Step score are not the best, and I'm considering doing an away elective this Fall. How difficult is it to get offered an away elective? And how many aways do most people apply to? Do most people prefer to do an away at a categorical program or does it not matter? Thank you!!

 

[IonClaws]

My grades/Step score are not the best, and I'm considering doing an away elective this Fall. How difficult is it to get offered an away elective? And how many aways do most people apply to? Do most people prefer to do an away at a categorical program or does it not matter? Thank you!!

MS4 matched into Neurology bearing witness to the glorious death throes of medical school here.

Not that difficult to get an away rotation even with below average Step scores if you applied broadly. I applied to 20-30 places for aways and received 3 offers with a 218 Step 1 score.

I personally did 2 aways.

It doesn't matter whether they are done at places that have categorical or advanced Neurology programs. For Neurology, aways seldom have any impact on matching at the places where you do the aways. The most valuable thing you can get out of the aways are letters of recommendation from Neurologists, especially if your home institution has no Neurology department. You can also use the aways to see how the programs function and how much you like them.

 

[chickensoupdr]

MS4 matched into Neurology bearing witness to the glorious death throes of medical school here.

Not that difficult to get an away rotation even with below average Step scores if you applied broadly. I applied to 20-30 places for aways and received 3 offers with a 218 Step 1 score.

I personally did 2 aways.

It doesn't matter whether they are done at places that have categorical or advanced Neurology programs. For Neurology, aways seldom have any impact on matching at the places where you do the aways. The most valuable thing you can get out of the aways are letters of recommendation from Neurologists, especially if your home institution has no Neurology department. You can also use the aways to see how the programs function and how much you like them.

Did you apply to different electives within the same hospital/school? Or was it 20-30 different locations? And is that looked down upon at all? Some of the electives seem very specific, like Epilepsy elective, and I'm not sure if I know exactly what I want to do yet.

Also, are VSAS elective applications a rolling-admission thing? Some places seem to take students whenever there's a slot available, whereas others look at the application more...

 

[IonClaws]

Did you apply to different electives within the same hospital/school? Or was it 20-30 different locations? And is that looked down upon at all? Some of the electives seem very specific, like Epilepsy elective, and I'm not sure if I know exactly what I want to do yet.

Also, are VSAS elective applications a rolling-admission thing? Some places seem to take students whenever there's a slot available, whereas others look at the application more...

20-30 different locations. I'm not sure whether it's looked down on or not but the schools don't know where or how many places you've applied.

Yes, they are, so get your stuff in ASAP. Also, all places have different requirements so you'll need to ensure everything is done well ahead of time. Some places such as Brown University are rather strict with their immunization and ppd test result requirements, they need quantitative titers for MMR, hep B, and varicella, AND require TWO negative PPD tests 1-3 weeks apart.

 

[chickensoupdr]

Would y'all recommend two weeks or four weeks? I had initially thought it would take a good four weeks to figure out how the system works and to have enough time to work and hopefully get a recommendation letter if possible. However, schedule and budget-wise, a two week away would make things much easier... Also, on VSAS, can you go back and add more aways/change dates after you've submitted the application?

 

[IonClaws]

Would y'all recommend two weeks or four weeks? I had initially thought it would take a good four weeks to figure out how the system works and to have enough time to work and hopefully get a recommendation letter if possible. However, schedule and budget-wise, a two week away would make things much easier... Also, on VSAS, can you go back and add more aways/change dates after you've submitted the application?

I did 2 4-weeks, and more time will let you know the program better, but it also depends on what is convenient for you. Yes, you can always add stuff and apply to more rotations on VSAS.

 

[Dr. Bruce Banner]

so is my one 4-week neuro rotation in 3rd year enough?

 

[IonClaws]

so is my one 4-week neuro rotation in 3rd year enough?

I'm not sure actually. Does your school have a Department of Neurology with a Chairman who can write you a letter? Does your school offer electives in Neurology for 4th year? I've read that residencies like it when you demonstrate interest and electives in Neuro are one way to show that.

 

[Postictal Raiden]

Do one in your 4th year. Better be inpatient also. Do it at an ACGME site where you can have the PD write you an LOR.

 

[curiousneuro]

Since people have matched already and settled down, I think we should raised these two questions:

Question 1: "How much does doing an away rotation help you get into the program you rotated at?"

Question 2: “Does the advice hold true for IMGs?”

To answer the original question: I think in general, for AMGs, away-rotations rarely help, UNLESS you are gunning for a specific residency program. However, you take a big risk when doing an away-rotation; if they don't like you for any reason (or if you don't 'mesh' well with existing residents), you can forget matching there.

This may be different for IMGs though...I know two IMGs that matched with our program last year - absolute all-stars on paper, but I think the only reason they matched with us is that they did away rotations with us, and we really liked them.