Tips about away rotations

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I know it's been pretty well established here that aways can hurt you just as often as they help. Some of the older posters on this board who have experience doing away rotations themselves, as well as evaluating rotating students, have advised against aways. That being said, I'd like to know what some of your recommendations are to students who are absolutely set on doing an away. What can you do to stand out and to make the program remember you later when you are interviewing there.

Not sure if this topic has been asked before. If so, feel free to link the thread and lock. Thanks!

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I'd be one of those who says SubI aways tend to hurt more candidates than are helped. But, to answer your question, here it is:

1 - Your mission is to make your team look good, so:
a - do know every lab, every radiograph report, every path report on every patient as soon as humanly possible. Don't jump the line, tell the most junior resident first if possible (interns from other services not included).
b - do round on every patient on the service and write notes if allowed even if the team says it's not necessary. It may not be, but doing it and doing it well will set you apart
c - don't answer out of turn. If a resident is getting grilled and they don't know the answer but you do, don't shout it out. Wait until you get asked. Looking like a know-it-all might help you in the eyes of the attendings but if you piss off a resident you're going to really make it hard on yourself.
d - do be the first to scrub out of the case to do scut, don't stick around just to suture something if that makes the junior resident scrub out to round
e - don't be obnoxious. don't tell about all your great accomplishments unless asked. don't brag. Your hard work will win you questions that will then set you apart
f - never talk another student, resident, attending down. ever. Even if others are jumping on someone you can laugh along if appropriate but don't bite and add your own 2 cents.

2 - You need to look good, so:
a - be underfoot. I want my subI to be grabbing a CT or pulling it up on PACS when I show up to do it. Have bandage scissors ready when I want them. Same with a stethoscope. Yes we still use them.
b - dress appropriately. Always wear a tie. Always change out of scrubs into professional clothes if possible even if the residents don't. Your job is to look good as much as possible, not comfortable.
c - don't ask questions to make yourself look smart, that is so transparent. Ask real questions when you have them. The more intelligent the question, the better you will look. In general, if it's easy to find in a book, you probably shouldn't ask it. One exception can be in the OR.
d - KNOW your anatomy backwards and forwards. It's the most common thing you'll get pimped on. You have to know this because the good students will. Read every day, every night. Read the basics first. ENT secrets, KJ Lee, not Cummings.
e - KNOW the case before you arrive in the OR. I mean know the indications, the anatomy, the patient, the pathology, the radiology. KNOW IT!!!! The actual procedure itself isn't as crucial, but knowing why it's being done, the potential complications, and the pathophysiology of the presenting issue are absolutely crucial.
f - spend time with the chairman when you can. No one has more power to make or break you. This is a delicate balance. Too much and you're a pain in the butt, too little and he/she won't know you.

THESE ARE THE 2 POINTS I CANNOT POSSIBLY EMPHASIZE ENOUGH:
If your team loves you, your golden. You make them look good, they'll love you. They love you everyone hears how great you are. Everyone hears how great you are, you've done your job. You will have a significantly higher chance of a high ranking in the match when you've done your job.

Never, ever get outworked by anyone and never look miserable. Smile like Phil Mickelson choking away the US Open. No one should outwork you. Period. Not the attending, the chief, the R2, the intern, the other SubI(s). NO ONE!!!!
 
Wow. I feel inspired to go do a SubI right now....wait, I have a job already. Nevermind.

I agree with everything resxn said. I didn't do a subI, but one of my good friends did and he always would give pointers to the new subI's. My advice is to live/eat/sleep ENT for a month. You can't/won't know everything from a book knowledge standpoint, but you can round on every patient, write notes, etc.
 
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Wow thanks for the advice. It was way more extensive than I had expected. I actually have another question :D. How do programs feel about students who do multiple aways, especially in the same city?

Does it send a message to the programs you did aways in that your interest level in their program is not THAT high, given that you rotated at some other institutions?

Do the programs in regions that you DIDN'T rotate in feel like your heart lies elsewhere and that you aren't actually interested in being at their program?

I realize these are a lot of questions, so feel free to answer at your leisure if you have some free time. Thanks!
 
uhhh. Don't tell them. If they ask you, your only interest is in their program.


But, if they see you at the other place, say, "Well, uhhh, this is awkward. I, uhh, was on my way home, you see, when this resident asked for my help, and, uhh, well one thing led to another and, well. . .I don't love them. I love you. It was never about the rotation. I swear."
 
Great advice here -- also know your head and neck cancer staging, as it is a favorite pimp topic.

Following what has been said before, the key things are to BE PROFESSIONAL and to put the patient first. If you always keep those two things in mind, you'll be fine. You want to be friendly with the residents, but remember that they're not your friends (at least not yet). Smile and laugh a lot -- you'll be amazed how far this takes you.

Remember that when you're doing an away, you're on "enemy territory" since the program you're visiting has absolutely no vested interest in seeing you do well. Your home program, on the other hand, has some obligation to educate you and make you as successful as you can be, especially since you'll go out there into the medical world and represent them forever. So while all the advice here applies to both home and away rotations, you'll have to be all the more outstanding on an away rotation.
 
uhhh. Don't tell them. If they ask you, your only interest is in their program.

The programs wouldn't know from your transcript that you rotated at another hospital?
 
The programs wouldn't know from your transcript that you rotated at another hospital?

My above was just tongue-in-cheek. Being more serious, I would just avoid always drawing comparisons between the programs at which you did your SubI's except in the specific situation I mention below. In other words, don't say crap like, "Well, when I was at U of Whatever, they always did _______ and they never ________. The SubI's always got to _________ and never had to _______." That kind of thing.

Good question about transcripts. I matched when it was still an early match so most people had only done their first SubI by the time the transcript went in and the first SubI was typically at the home school. Now with the regular match, I'm not sure how many people are typically doing before the application is submitted.

Personally, I don't think they'd really care. You're a student, you have no idea what each program is like. You're supposed to find out so that you can make the best decision for yourself. Having gone to more than one can be advantageous to you anyway because you can say, "Now that I've seen 3 departments and how they function, I have a much better idea of what I'm looking for in a program. I see very strong advantages to this one. . ." And then name those strong points.

Unless you have garbage for grades or a conviction on a misdemeanor or felony, there's not much you can't turn into an advantage. I can pretty much guarantee that a selection committee is not going to look at an application and say to themselves, "Well this candidate did a SubI here, we clearly cannot invite him for an interview." That's just silly.

I know the interview process is scary, but it's not ridiculous.
 
I know the interview process is scary, but it's not ridiculous.

Then again, you could look at my post about the worst interview ever. Sometimes it borders on being ridiculous.
 
Thanks for the clarification. I'll be sure to keep this all in mind if I decide to do aways next year.
 
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