14022

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I have a concern about away electives. People always say that if you want to go to a solid program, you need to do an away rotation at the program and stand out. What if you are a solid applicant on paper (regardless of how you perform on the wards) going into a less competitive specialty? It seems to me that the away elective may hurt more than help.

I have performed well at the top of my class at an average medical school. Honored 2/3 of basic science courses, all of my clinical rotations thus far. Mid 240's on step 1. Research with pubs pending, volunteer work, member of committees. Good shot at AOA. Planning on going into peds. Yada, yada, yada.

I am afraid that if I do an elective at a top program that I may tarnish the way I look on paper. I perform well on the wards, but it is at an average program with average students. It will be much different being compared to top students at top programs. Also, what if by some chance I get assigned to a team with a resident or attending whose personality is not congruent with mine? I may get a mediocre evaluation just based on personality differences alone. Or by some freakish accident I show up late because of something stupid like car trouble, or getting lost in an area that I am not familiar with, or setting my alarm for pm instead of am, etc. It wouldnt be a big deal on any other rotation but when these people know I am on an audition rotation, they may be more cognizant of things like this. And in a big unfamiliar hospital, it will be much more difficult to do well compared to students who know their way around and know the computer system, students who may know their residents socially, etc. I know some of these things are unlikely and pretty stupid/paranoid but why take the risk of screwing up if you have a decent chance of getting into the program without an away elective?

Any thoughts from those who have matched or interviewed for peds at top programs?
 

DrScott

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scholes,

Although I am only an MS1, I have done extensive research into residency-related questions like this. This is just my opinion although I have heard it voiced numerous other places is that if you are stellar on paper(which you are) then an away rotation can only hurt. I think you are going to have your 'pick of the litter' regardless of not doing an away rotation. You also have to consider that pediatrics(as a whole) is not competitive. I have heard people say the exact opposite which is a little silly when looking at the US Senior unmatched rate for peds(very low). Anyway, my opinion is save your money, sit back and relax, and just enjoy the awesome position you are in right now. I can only hope to be in your position 24 mos from now. Good luck!

Scott
 

Stone'sDad

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I actually have a different opinion from DRSCOTT. I am a 4th year who is going into peds and I had a similar profile to you after third year, although my grades were a bit lower. I heard the same things about away rotations hurting you, but I still decided to do an away rotation at a "US News/Be All and End All" highly ranked program.

I followed a piece of advice from the PD in medicine at my school, which was to rotate with a consult service. First, these services are smaller and allow students to have a more one on one relationship with attendings. Second, because these services don't often have med students or lots of residents, I would not be being compared to "native" med students who were already comfortable with the mechanics of working in that hospital.

I spent three weeks away and learned a lot. In addition, I developed a great rapport with the attending with whom I worked (who happened to be the division chief). At the end of my time there, he was comfortable in supporting my application by getting in touch with the program director which gave me a leg up.

While peds in general is not competitive, if you are looking at the US News Programs, you are going to have to deal with competition. Most people will have great resumes at this level, so if you have the confidence in yourself that you can do well away, going into the application process with existing support from the program will serve well to make you stand out a bit more.

One thing about the general lack of competitiveness in peds in my opinion, is that if you are great on paper, and you apply to enough of the US News Programs you will likely get into one of them. The top candidates, by nature of the match, will distribute among these programs, so unless you have your heart set on only one program, a strong candidate should have no problem overall.

So, that's my story. I had the best possible outcome from my away rotation and recognize that it does not always break this way, but I think that if you can adapt to a new situation, and especially demonstrate a hard working, enthusiastic, and personable attitude you will be well served by going on an away rotation.

The end. Phew...
 

arydolphin

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I'm also a 4th year going into peds, and did 2 away rotations in the fall. Scholes, you'll obviously be an extremely competitive candidate, esp. with your Step 1 scores and all of the other attributes that you listed. With pediatrics not being the most competitive speciality, you should have a good chance at getting into many of the "top programs" that you talk about. So here's a novel concept: why don't you look at away rotations not as an "audition", but rather as a way for you to learn more about a program and see whether it fits well with what you are looking for in a program? The advice I got from my advisor when I was looking at what programs to do away rotations was only to go to programs that I was extremely interested in, because a month at a place would give me a much better view of the program than spending one day there on an interview.

In response to a couple of your concerns....if you're successful on the wards at your medical school, this will transfer over to a rotation at one of the top programs in the country. Characteristics like working hard and going the extra mile for your patients will be valued, no matter the level of the program. Also, you mentioned possibly having personality conflicts with residents or attendings. While this wouldn't be the best thing to happen on an away rotation, the silver lining would be that you'd be able to identify that you may not be a good fit for the program. As those of us that have just been through interviews will tell you, one of the keys when looking at a program is figuring out how you will fit in with the residents and attendings, no matter how prestigious the program may be. For example, I went to 2 different places on my away rotations, and will rank one place #1 because I had a blast during my entire month there, but I probably won't even rank the other program that I went to because I got a weird vibe from the residents. So when you're deciding on away rotations, focus on 1 or 2 places that you really want to go to, and you shouldn't have trouble being successful at the away rotations with your previous success in medical school.
 

NYtoCA Peds

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I'm another 4th year going into peds and I definitely agree with the above two posters. I also did two away rotations in the fall, and I found that I really did use them as a great way to evaluate the program for myself. I wouldn't worry so much about being late or getting lost in the hospital. Just remember that this is peds and people are friendly (for the most part!) and they realize that you're a visiting student and won't know your way around the area. Also there are usually lots of visiting students at that time so you most likely won't be alone. I actually met a lot of great people that I bumped into again on the interview trail and got some great info from regarding programs in that area. I would highly recommend doing away rotations because I think it gives you a great experience of what else is out there so that you can really get a sense of how to compare residency programs when you get to this point next year!! Good luck!! :D
 

docmartin

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I agree with the above posters. I did 5 away rotations in peds at 4 different hospitals. And in hindsight, this might have been too many, but I, like the other posters, figured out peds residency is all about "good fit". Remember, you will be spending most of your 3 years of residency in a specific hospital with the same people. So you have to decide if you like the hospital, if you like the residents, if you could imagine yourself at this place, etc etc. All in all, most residents and attendings in peds are nice people anyway, but every program has a different feel.

Good luck.

PS-Don't worry about not doing well on away rotations. You sound like a normal person. Most people do fine, unless you lack any social skills or are a moron (not that I think you are). :oops:
 

dr. maybe

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I am an MS3 and I want to schedule away rotations at at least 3 places. When is the latest I should apply to go if I actually would like to possibly go to these places for residency? And, is there any way I may not be "accepted" into the visiting student clerkship?
Thanks!!!
 

jackjinju

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Hi,

I think I wrote you privately about this topic....My personality is inclined not to do away rotations, but if you're comfortable, and personable (which I am, but I guess I just have a thing with the idea of being "watched", even if it's mostly a self-induced worry), I would do it. Probably thinking of it in terms of YOU evaluating THEM would be a good soothing way of viewing it. I guess I could have done an away rotation for fellowship, but I told my future program that they were my number one, and I had a good interview day there. Same went for my residency program. I guess what I"m saying is that I don't think there's any one right answer, and you should do what you feel comfortable with.

Andrew

p.s. -rereading your original post, I would definitely say that you definitely don't NEED to do an away rotation to get into a top program.....my 2 cents
 

windycitygirl

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DrScott said:
scholes,

Although I am only an MS1, I have done extensive research into residency-related questions like this. This is just my opinion although I have heard it voiced numerous other places is that if you are stellar on paper(which you are) then an away rotation can only hurt. I think you are going to have your 'pick of the litter' regardless of not doing an away rotation. You also have to consider that pediatrics(as a whole) is not competitive. I have heard people say the exact opposite which is a little silly when looking at the US Senior unmatched rate for peds(very low). Anyway, my opinion is save your money, sit back and relax, and just enjoy the awesome position you are in right now. I can only hope to be in your position 24 mos from now. Good luck!

Scott
I have to say that I think most people's advice here is good...I am hardly an expert, so all this is debatable--but just having matched in Peds though (yesterday!!), I have to say that the prevailing sentiment is that Peds has gotten relatively competitive and definitely more competitive than before--while most US seniors will match, there are some that did NOT and were not able to scramble in. This is a fact.

Also, there is a question of program--I saw a definite decrease in the quality of program that people matched into at my school--this year was lopsided in that there were a lot of high-end (Boston Children's, UCLA) and low-end (lots of community programs), but very little mid-tier stuff going on. Interesting turn of events. Plus, we have lots of people applying this year who were AOA and high boards scores, etc....this seems to be a strong trend. Keep all this in mind when applying...

Also, away rotations can work either way--if you get good exposure to an attending and not many other students, then it can work well. Put one gunner student or one grumpy attending in the mix, and it can all go sour....

Just my 2 cents...
 

spikyhairedgirl

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As someone at a relatively small medical school, I found doing an away rotation to be essential in order to get exposure to patients that I would never have the opportunity to see at my med school and the hospital we rotate through. I went to a top program for an away rotation and had a great time - I felt like I learned a whole heck of a lot and became much more confident in my ability to be a pediatrician. I also got some great letters of recommendation out of it - which was a slightly double edged sword in that when I went on my interviews I was frequently asked, "Wow, Program X loved you, why would you come here instead?" I ended up matching at my number 1 choice, which ended up not being the program I rotated through.

I heard that whole if you're a great student on paper, don't do an away idea, but to me it seems like at some point you're going to have to back up your paper rep with some quality clinical skills. And the time to fall short and try to ramp up your learning curve is 4th year of medical school. If you can, do two aways - one at a place that will probably end up somewhere in the middle of your ROL and another at a place you'd like to dazzle. Or do it at a place you're not super interested in, but one that has a patient population that will complement the patient population you see at your home med school.