Rotation Dilemma

[OR_Gas_Him]

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I'm planning on doing an anesthesia elective in the beginning of my 4th year but i'm getting conflicting opinions as to where to do it. I was planning on doing the elective at a small hospital where i can get one on one interaction with the Gas attending. I thought this would be good because then the doc would get to know me well and write a very good recommendation for me. However...someone told me that i shouldn't do this. She recommended working at a large hospital where i'd have a chance to interact with the head of the anesthesia program and that this would be better because I'd be getting a letter from well known "name." However, i'm hesitant to follow this advice because i don't know how much interaction i would have with the head of the program and that he'd probably just write me a mediocre recommendation.....what do i do???

 

[2ndyear]

I would recommend the big hospital with a residency program. Here's why:
1) You actually get to see what residency is like and if you fit in with the residents. Just like you do on your core rotations.
2) Chances are that you'll see much better cases that are much more interesting for you, ie hearts, trauma, transplants, peds. How much of that gets done in a small county place?
3) It will be an 'audition' rotation and if you decide to pursue a career, you can get a letter from someone in the academic community.

Just my opinion.

 

[PassinGas]

If you do an away rotation, I would definitely go somewhere with a "good" residency program. It doesn't have to be MGH, Duke, UNC, etc. Just pick a nice program that you think you would like to check out as a possibility for residency. It doesn't have to be your future #1 program; although, if you are going to shine like a rockstar, it may not hurt if it's your top pick. Just remember that top picks may change after the interview trail, so don't put too much emphasis on it. Just make a decision and move forward. Also, you may shine more and get more personal interaction with a PD and/or chairmen at a somewhat more regular program than say MGH. This fact may well play into you getting a better letter out of the rotation. You get the idea.

I would suggest doing a rotation at your home program first to learn the baiscs, so that you are more than ready for your away rotation.

When you are at your away rotation, you can make it a point to meet the chairman and PD. You could get a letter from whomever you jive with the most. I got one letter from my anesthesia chairman (I'm at a medical school that has an anesthesia program which is facing difficult times right now). It didn't matter that my school's program is having trouble, and I didn't even do an away rotation. I can't tell you how many times on the interview trail this year that interviewers would ask, "How is Dr. so-and-so doing these days." Dr. So-and-so may be the chairman of a program with problems, but chairmen seem to know each other. A strong letter from a chairman goes a long way. It just so happens that my chairman was a previous faculty member at one of my top choices, which I did not know until the interviewer at that program mentioned it. Also, my chairmen goes to all the various meetings, so he has friends everywhere just like most other chairmen...that's why they are chairmen.

If you do an away rotation, don't forget to get a strong letter from your own program's chairman. Just be sure to let your chairman know at the outset of your rotation that you are interested in anesthesia. Make an effort to get to know him/her. Try to work directly with your chairmen when the opportunity arises. Don't be pushy, but do make an effort. It will most likely pay off with a nice letter.