I was shocked when they told me they refer to pulm to start/manage Flovent and get PFTs.
But flovent... Really?
These are great points:
-No person is going to write some glowing LOR for a resident who is rotating for 1 month from a different hospital system (unless you’ve know that person for about 2 years before and after the rotation).
-Don’t do away rotations as a resident. It will only make you look bad as all the other residents will be able to navigate their home system while you fumble around and will be of no benefit to you.
-The answer might be going to present your research at a conference specific for that specialty rather than trying to finagle an away rotation.
Also from 2020 data posted matched IMG applicants:
44/231 - 19% NICU
29/195 - 14.9% CCU
But risk/reward scenarios:
-you don't rotate at said top reputation program, and with your current application, top place/others do/don't interview you (unknown odds)
-you rotate at top program, you look like a fool, they don't offer you an interview, you don't get a letter from anyone (worst case outcome)
-you rotate at top program, and you clearly "know your stuff" and work hard (in spite of EPIC - might be worth knowing if they use same EMR), they offer you an interview, and a positive letter (good outcome)
-you rotate at top program, and they love you, they offer you an interview/rank you, and writing you a glowing letter, get more interviews out of it (best outcome?)
Some people have described an away as a 30 day interview. Always on, with every staff member. If people tend to like you more over time, might be a good fit. If people like you less over time, strictly avoid (also maybe think about why that's happening...)
In any case, with current scenario - presenting/abstract accepted at a research conference (more like "zooming") for speciality or publishing is still the gold standard in academic medicine - so you can do this in all cases. Actually, one strategy for your away rotation might be to find a mentor/project (which academic clinician doesn't have work that could be done by someone willing?). That could benefit your research skills, their project, your application - all wins. Unless again, you don't do a good job/work hard - in which case, why stress yourself out at a top tier?