No Home Programs, Away Rotations Questions

[TenaciousDaedalus]

👋

Browsing these forums, it seems like residency reputation is important for fellowship application. In light of that, I'm hoping to match in a "high-middle to highly ranked" IM residency. The kicker is that I'm from a "mid ranked" at best, US MD institution and don't have home programs.

Wisdom of the masses seems to be that doing an IM away rotation might actually hurt a candidate, but with no home programs I'm forced to ask if my situation is special enough to warrant it? A fellowship in one of two fields is important to me because of personal background reasons.

What are thoughts on:
1. The real v.s. med student perceived importance of residency reputation for fellowship application.
2. "Higher ranked" IM residencies that are friendly to not so high ranked med schools. (I know its sometimes score/analytics dependent, but a general idea would help)
3. Doing an away rotation at a very well respected institution in the area of my school when I have no intention of actually applying there, and only doing it for a letter of rec.
4. If an away is just worst case scenario and doesn't go well because of personality or fit, would that tank chances at other programs, or only have repercussions at the away program?
5. Any other insight that I'm just blind to, and don't know to ask about.

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[the argus]

Gonna guess you're at Drexel, and the very well respected institution is Penn? Either way,

1. Residency reputation definitely matters for fellowship, moreso for the very competitive subspecialties (GI, cards). That said, it's not the be all end all. A good candidate from a lower tier residency can still match and a bad candidate from a higher tier residency can struggle. Plenty of DOs and IMGs match into the competitive subspecialties every year.
2. This is dependent on the individual applicant. There are too many to individually name.
3. There's nothing at all wrong with doing this, especially if you have no intention of applying there. "Audition" rotations are often discouraged, but that's not what you are describing.
4. Repercussions only at that program (other than transcript/evaluation repercussions that are true of any rotation). IM residency PDs are too busy to call around and sink applicants at other programs, especially someone who was just there for an away rotation. Now if you ask them for a LOR, and it's a bad LOR, then thats different...
5. It seems like you are spending time worrying about things that are out of your control (will xxx IM program interview someone from my school, etc). Spend your time on the things you can control that will make you the best possible residency applicant. This includes excellent grades (preclinical and clinical), high board scores, do some sort of research, and be hardworking and helpful during your clinical rotations so you can get excellent LORs. Then apply broadly to residency programs. Anything beyond that is out of your control and worrying about it is a waste of time.

 

[TenaciousDaedalus]

Gonna guess you're at Drexel, and the very well respected institution is Penn? Either way,

1. Residency reputation definitely matters for fellowship, moreso for the very competitive subspecialties (GI, cards). That said, it's not the be all end all. A good candidate from a lower tier residency can still match and a bad candidate from a higher tier residency can struggle. Plenty of DOs and IMGs match into the competitive subspecialties every year.
2. This is dependent on the individual applicant. There are too many to individually name.
3. There's nothing at all wrong with doing this, especially if you have no intention of applying there. "Audition" rotations are often discouraged, but that's not what you are describing.
4. Repercussions only at that program (other than transcript/evaluation repercussions that are true of any rotation). IM residency PDs are too busy to call around and sink applicants at other programs, especially someone who was just there for an away rotation. Now if you ask them for a LOR, and it's a bad LOR, then thats different...
5. It seems like you are spending time worrying about things that are out of your control (will xxx IM program interview someone from my school, etc). Spend your time on the things you can control that will make you the best possible residency applicant. This includes excellent grades (preclinical and clinical), high board scores, do some sort of research, and be hardworking and helpful during your clinical rotations so you can get excellent LORs. Then apply broadly to residency programs. Anything beyond that is out of your control and worrying about it is a waste of time.

More south, and when I say mid ranked at best, I'm stretching it (at least based on US News rankings )

Thank you, the other parts of my application are in line with my goals at least according to my mentor/advisor (I.e. good number of pubs and possibly one 1st author by next year, clinical grades mostly H with 2 HP's, competitive Step 1, etc). Of the things you mentioned, LOR's are one of the last things I need to figure out. I needed to know if it would look bad to do an away rotation only for a LOR from Duke or Emory both of which I have a foot in the door for aways at (personal connection and prior work experience). That might be more than enough to ID me from my class so I don't feel comfortable giving more info unfortunately (I understand that limits how people can advise me)

I'm shoring up what I can, but I also need to know if my administration is hand-waving and telling me not to worry, just trying not to let on that it is a big detriment. And if it is a detriment, will away rotations help or hurt.

 

[chessknt]

You would benefit from academic IM attending support behind your application. If you can't get that at your home institution I think doing an away for that support is reasonable though you are going to be at a disadvantage (unfamiliar system, outsider reputation, short time period to perform etc). If it is a financial/time strain I wouldn't contort your schedule and finances to do multiple aways however.

Was so confused by this post but realize all these word replacements are SDN 4/1.