I was reading over this as a gauge on how rough a plastic away can be:
http://forums.studentdoctor.net/showpost.php?p=7752520&postcount=18
That is a great summary, I am reposting the contents here, below.
As a mid-level integrated resident I have some experience with this process personally, as well as watching others go through the process year after year. A few additions to this older post, as many of these posts are from MS4 contributers. I think I even wrote one of these, it looks so familiar.
Overall, 2 aways is sufficient, with one AI at your home institution. I heard it from several chairmen: Too many aways is inappropriate/obnoxious. Try to go to a big ivory tower type place for one of them. Ask your attendings or residents at your institution who the biggest players are in PRS if you dont know, or read old posts on this forum or the archives on plasticseducation.com. Vary the aways geographically if there are 2 areas of the country that interest you it helps get people to know you and tells them you are open to really moving for great training. You don't have to be a walking encyclopedia, you must be familiar with basic concepts in plastic surgery - like the first 5 chapters pf grabb and smith, plus maybe some bread and butter cases that area common in the field ..the basics of local flap geometry, breast reduction and reconstruction, understand breast cancer concepts and basic treatment plan (dont memorize chemo drugs here) etc.
A REALLY important thing is that the rotator be balanced: be prepared, be early, have a good attitude, work well with your co-rotators, and despite the stress try be fun to be around. Remember that sometimes just doing nothing (in the OR) is the perfect thing to do. There is often nothing you can do to help, hold, or say, just try to read the situation and be cool. That was the hardest thing for me, I remember.
Here is that quote of med student experiences from a previous post:
From plasticseducation.com (it's since been overrun with spam), I found these 4th year away experiences quite telling. Yes, it's certainly different trying to impress as a medical student but I get the feeling life as a resident isn't much cusher.
1. "Aways can be brutal. On mine I would get in around 430 am and stay until last case every night ~9-10pm. Then I took call every night as well. However, the place I went to kind of left it up to you how "involved" you wanted to be. I hardly did any "scut". Usually rounded, operated all day, went to clinic, saw consults if no cases in pm, etc... Look at it as an "audition" even though most tell you its not. To most places a known commodity is usually better than someone you talked to for 20 minutes and read their application for 5 min. Be at the hospital and be visible all the time. Scrub with the dept heads/chairs/pd etc... All that aside, if you don't go all out on your away you can totally shoot yourself in the foot. In that case your still a known commodity, just not in a good way."
2. "Same thing on my away. Not quite so bad--I got there around 5 most mornings and rounded/changed vacs/dressings/etc. and then operated all day, until 7 most days but sometimes after 9. I also helped with consults/clinic/whatever and made myself available to the on-call resident every night (but that being said it was rare that I got called late at night). I also took zero days off and worked every day that whole month straight. To add to the lunacy, I also made a point of doing social stuff outside the hospital with the residents. I did it this way because I knew that this rotation was my one shot--the only thing I could really control--in terms of highlighting the stuff that doesn't show up on paper. I realize in retrospect that this schedule was a bit ludicrous, but no matter what anyone says, away rotations are absolutely an audition-- even if you're only trying to get a letter from the department/division chair. It would have been mildly fatiguing if I hadn't really enjoyed what I was doing.
I'm not trying to freak anyone out, but the fact remains that this is the most competitive specialty in medicine. Grades and board scores just don't set you apart--all the serious candidates look really impressive on paper, so the best way to set yourself apart is to make yourself a known (badass) commodity. A high Step 1 score and a high class rank guarantee nothing. If you want a program to think you're worth ranking highly, that program needs to be convinced you're going to be their best resident. In light of this fact, if you're going to rotate somewhere then you need to be prepared to be a machine--a walking copy of Grabb & Smith's (with OR and people skills) who needs very little food and less sleep. There's no point to going to the time, expense, and trouble to do an away rotation if you aren't going to go balls-out.
I actually think being a plastics intern/resident where I rotated could be marginally less stressful than being a rotator, but you've got to pay your dues if you want to get a ticket to the Promised Land."
3. "I did one plastics month at my home institution and 3 visiting plastics rotations in a row. I went all out on every single one. During all 4 months I had to drag myself out of bed every day with 4 hours sleep and put myself in the shower to wake up. I was at the end of my rope the last month but finished up strong.
2 aways are good. 3 aways if you can handle it mentally and physically.
Aways are very very taxing and expensive, don't do more than 2 unless you really can handle it. It was the most difficult 4 months of my life. The last thing you want is to burn out during an away and then you look worse than if you never did an away there. You also have to take in consideration your in a new environment that you don't know where anything is. This adds to the stress greatly.
I matched at one of the places I did an away at."
