Long time reader, first time poster here. I am wondering what you guys think about these away dilemmas. Background: I am from a SE school with new Rad Onc program and plan on doing a rotation with them. I realize that I need to do an away at an upper tier program to get a good letter, and I also plan on doing a rotation at an attainable place that I would like to end up at. The first question is: for the big name away, should I rotate at a place like MDACC or MSKCC vs. at a "reach" program with big name faculty, but that is more attainable? The second question is: How important is it to do a rotation outside the SE in order to get an interview outside the region? Thanks
Strategy for Rad Onc Aways
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For your first question, there are two schools of thought.
1. Rotate at "elite" programs because you will be working with leaders in the field and any LOR you procure will carry great weight.
2. Rotate at a program which is very good but within your "reach" because you will still work with great people, can still get a LOR from good/great faculty AND have a reasonable shot at matching there.
I recommend the former, but many users have argued eloquently for the latter.
As to your second question, conventional wisdom is, "Rad Onc programs show strong regionalism so it would behoove you to geographically 'diversify' your rotations to maximize your chances." In my case, it didn't work out quite that way. I went to med school in the SE and did an away on the West coast but virtually all of my interviews were from the East Coast. I'm curious if more recent applicants have had this experience. If so, our field may be finally shifting away from this silly practice, freeing you to rotate where you want rather than where you "have to."
1. Rotate at "elite" programs because you will be working with leaders in the field and any LOR you procure will carry great weight.
2. Rotate at a program which is very good but within your "reach" because you will still work with great people, can still get a LOR from good/great faculty AND have a reasonable shot at matching there.
I recommend the former, but many users have argued eloquently for the latter.
As to your second question, conventional wisdom is, "Rad Onc programs show strong regionalism so it would behoove you to geographically 'diversify' your rotations to maximize your chances." In my case, it didn't work out quite that way. I went to med school in the SE and did an away on the West coast but virtually all of my interviews were from the East Coast. I'm curious if more recent applicants have had this experience. If so, our field may be finally shifting away from this silly practice, freeing you to rotate where you want rather than where you "have to."
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The problem with rotating through an elite program where a lot of students rotate is that unless you do something to stand out (start a successful research project, wow everyone with your talk, etc), your LOR from famous Dr. X will probably be somewhat generic and/or look like all of the other LORs from famous Dr. X, and probably not carry that much weight. So if you opt for Gfunk's option 1 (and don't think you otherwise would be offered an interview at that program), you need a strategy to stand out among your peers; otherwise go for option 2.
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Spent my life in the NE and a mountain state, did med school in NE, did one mountain away and one west coast away. Only 1 interview in the NE, 1 interview in the SE, 3 interviews west coast, majority of my interviews in the midwest. Matched in the SE.
As for standing out on an away rotation, consider spending an extra month or several months to do research there. Otherwise it very much is luck of the draw, and some programs are notorious for not interviewing you post-rotation and/or not giving you a great letter.
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as a current applicant, i can say that regional bias is still rampant. i'm in med school on the west coast, did a mountain state away rotation, and got very few interviews in the northeast or southeast (but plenty in the west). i would say definitely do an away in the northeast if you would be open to matching there.
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Can anybody else comment on this? I wasn't planning on doing any aways in the NE but wouldn't mind at all, maybe even love living there.
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I'm a current applicant and can confirm the regional bias exists. Other applicants I've talked to seem to agree.
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In your, and other applicants opinion, can this truly be ameliorated by an away in the region? Or is it just true that where you went to medical school will determine where you get interviews?
I don't think strategies for doing away rotations and procuring letters and interviews are particularly generalizable.
You should probably have a reasonable idea at this point of how adept you are at making a good impression on people. I think it's a leeeeetle bit aggressive to strategize a way to "stand out among your peers." You're read it a million times on this forum; be nice, work hard, try to get involved in research.
Whether you go with GFunk's plan #1 or plan #2, there's a vast amount of variability (and like Neuronix said, plain old luck!) in how things could pan out. You never know when you're going to hit if off with an attending (although you increase your chances if you are nice, work hard, try to get involved in research). Even then, you don't know if that attending is going to be the type who takes the time to write an individualized LOR, regardless of how much you "stood out." If you go with #2 - the 'attainable reach' - there's no way of predicting your chances of matching there, which will be based on far more than your performance during your rotation (other applicants who have multiple graduate degrees and cured a few cancers and have a 290 on step I, attendings you didn't work with who don't like the way your eyelashes curl, etc.).
Of course even after you get an LOR saying you are the most stupendiculous rad onc rotating M4 ever and you practically cured a sarcoma just by talking, there's still going to be programs that you think will offer you an interview that won't...and you'll never know why.
As far as regional bias goes, I can only give my n=1, anecdotal, experience (which you can smush together with all the others). Spent my entire life in the midwest including undergrad, med school, rotated out east and in the midwest. Had 2 interview offers in Cali (of 3 I applied to), about half a dozen in the midwest and east coast each, 2 in the rockies. Only applied to two places in the South/Southeast (I don't deal well with humidity) and went 1/2 there. I think it's totally 100% random. That said, you can hedge your bets by "diversifying" like GFunk suggested. Either coast would work; just demonstrate your willingness to change locations. Or come to the midwest (I still haven't figured out why so many people deem it so "undesirable." I think it's jealousy)
Aside from letters, there's a couple of other very valuable (and underrated on this forum) things I got from my away rotations 1. An understanding the key differences between rad onc programs, and how much things like size, didactics, role in tumor boards, research opportunities, clinical volume > reputation, etc. meant to me when I applied and made my rank list 2. The friends I made (If anything "stood out" at my big cancer center rotation, it was probably how well the co-rotators all got along) 3. A solid rad onc learning experience (the alleged goal of a any rotation...)
Rotate where you want to, not where you feel like you have to. Be the change
You should probably have a reasonable idea at this point of how adept you are at making a good impression on people. I think it's a leeeeetle bit aggressive to strategize a way to "stand out among your peers." You're read it a million times on this forum; be nice, work hard, try to get involved in research.
Whether you go with GFunk's plan #1 or plan #2, there's a vast amount of variability (and like Neuronix said, plain old luck!) in how things could pan out. You never know when you're going to hit if off with an attending (although you increase your chances if you are nice, work hard, try to get involved in research). Even then, you don't know if that attending is going to be the type who takes the time to write an individualized LOR, regardless of how much you "stood out." If you go with #2 - the 'attainable reach' - there's no way of predicting your chances of matching there, which will be based on far more than your performance during your rotation (other applicants who have multiple graduate degrees and cured a few cancers and have a 290 on step I, attendings you didn't work with who don't like the way your eyelashes curl, etc.).
Of course even after you get an LOR saying you are the most stupendiculous rad onc rotating M4 ever and you practically cured a sarcoma just by talking, there's still going to be programs that you think will offer you an interview that won't...and you'll never know why.
As far as regional bias goes, I can only give my n=1, anecdotal, experience (which you can smush together with all the others). Spent my entire life in the midwest including undergrad, med school, rotated out east and in the midwest. Had 2 interview offers in Cali (of 3 I applied to), about half a dozen in the midwest and east coast each, 2 in the rockies. Only applied to two places in the South/Southeast (I don't deal well with humidity) and went 1/2 there. I think it's totally 100% random. That said, you can hedge your bets by "diversifying" like GFunk suggested. Either coast would work; just demonstrate your willingness to change locations. Or come to the midwest (I still haven't figured out why so many people deem it so "undesirable." I think it's jealousy)
Aside from letters, there's a couple of other very valuable (and underrated on this forum) things I got from my away rotations 1. An understanding the key differences between rad onc programs, and how much things like size, didactics, role in tumor boards, research opportunities, clinical volume > reputation, etc. meant to me when I applied and made my rank list 2. The friends I made (If anything "stood out" at my big cancer center rotation, it was probably how well the co-rotators all got along) 3. A solid rad onc learning experience (the alleged goal of a any rotation...)
Rotate where you want to, not where you feel like you have to. Be the change
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While I agree that you should rotate where you want, and do so for the educational experience, the original post said " I realize that I need to do an away at an upper tier program to get a good letter ..."
Unfortunately, simply doing an away rotation at an upper tier program is not going to get you a good letter. For most rotatores, the LOR is either going to be a generic letter (most likely listing the accomplishments from the CV), or a very favorable letter that is the same for every other applicant by that faculty member. If you want to your LOR to stand out from others, you need to make an impression. The best way to do this is (as others have mentioned) is to get involved with a reserach project. It need not be the next NEJM or Lancet rad. onc. paper, but simply a project that will allow the famous faculty member to actually spend time with you and get to know you a bit better.
Unfortunately, simply doing an away rotation at an upper tier program is not going to get you a good letter. For most rotatores, the LOR is either going to be a generic letter (most likely listing the accomplishments from the CV), or a very favorable letter that is the same for every other applicant by that faculty member. If you want to your LOR to stand out from others, you need to make an impression. The best way to do this is (as others have mentioned) is to get involved with a reserach project. It need not be the next NEJM or Lancet rad. onc. paper, but simply a project that will allow the famous faculty member to actually spend time with you and get to know you a bit better.
I don't think strategies for doing away rotations and procuring letters and interviews are particularly generalizable.
You should probably have a reasonable idea at this point of how adept you are at making a good impression on people. I think it's a leeeeetle bit aggressive to strategize a way to "stand out among your peers." You're read it a million times on this forum; be nice, work hard, try to get involved in research.
Whether you go with GFunk's plan #1 or plan #2, there's a vast amount of variability (and like Neuronix said, plain old luck!) in how things could pan out. You never know when you're going to hit if off with an attending (although you increase your chances if you are nice, work hard, try to get involved in research). Even then, you don't know if that attending is going to be the type who takes the time to write an individualized LOR, regardless of how much you "stood out." If you go with #2 - the 'attainable reach' - there's no way of predicting your chances of matching there, which will be based on far more than your performance during your rotation (other applicants who have multiple graduate degrees and cured a few cancers and have a 290 on step I, attendings you didn't work with who don't like the way your eyelashes curl, etc.).
Of course even after you get an LOR saying you are the most stupendiculous rad onc rotating M4 ever and you practically cured a sarcoma just by talking, there's still going to be programs that you think will offer you an interview that won't...and you'll never know why.
As far as regional bias goes, I can only give my n=1, anecdotal, experience (which you can smush together with all the others). Spent my entire life in the midwest including undergrad, med school, rotated out east and in the midwest. Had 2 interview offers in Cali (of 3 I applied to), about half a dozen in the midwest and east coast each, 2 in the rockies. Only applied to two places in the South/Southeast (I don't deal well with humidity) and went 1/2 there. I think it's totally 100% random. That said, you can hedge your bets by "diversifying" like GFunk suggested. Either coast would work; just demonstrate your willingness to change locations. Or come to the midwest (I still haven't figured out why so many people deem it so "undesirable." I think it's jealousy)
Aside from letters, there's a couple of other very valuable (and underrated on this forum) things I got from my away rotations 1. An understanding the key differences between rad onc programs, and how much things like size, didactics, role in tumor boards, research opportunities, clinical volume > reputation, etc. meant to me when I applied and made my rank list 2. The friends I made (If anything "stood out" at my big cancer center rotation, it was probably how well the co-rotators all got along) 3. A solid rad onc learning experience (the alleged goal of a any rotation...)
Rotate where you want to, not where you feel like you have to. Be the change
In the SE, does an MDACC rotation fall outside the realm of a regional rotation, or would one need to do another rotation outside the SE? I guess the same question would apply to MSK and Harvard for people in the NE.
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I second this question.
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I would focus on getting a LOR from your home program, from people that know you well, who want you to succeed. On most aways you spend a few days with each attending. If you form a good relationship then thats great, ask them for a LOR but do not bank on one.
I'd do away rotations at places you'd like to go. They can without a doubt increase your chance at matching there. There is a regional bias, its one of the ways programs can attemp tp select people likely to rank them highly. Someone who grew up in the NE and has no ties to the South is likely to rank Southern programs lower. That being said, doing aways is a way to overcome this, if you'd like to go to a region you have no obvious ties to.
Aways can also hurt you. From my experience each year there are students who do aways and its obvious they are not a good fit or more commonly they rub someone the wrong way and it hurts them. Sometimes being an unknown can be to your advatage, especially if you look good on paper and interview well.
I'd do away rotations at places you'd like to go. They can without a doubt increase your chance at matching there. There is a regional bias, its one of the ways programs can attemp tp select people likely to rank them highly. Someone who grew up in the NE and has no ties to the South is likely to rank Southern programs lower. That being said, doing aways is a way to overcome this, if you'd like to go to a region you have no obvious ties to.
Aways can also hurt you. From my experience each year there are students who do aways and its obvious they are not a good fit or more commonly they rub someone the wrong way and it hurts them. Sometimes being an unknown can be to your advatage, especially if you look good on paper and interview well.
