Where to rotate 4th year??

[sailorgirl]

I have heard a few opinions on this but I thought I would throw this out here too--is it better to rotate to a program you are really interested or one that is more well known that will get me a letter that will mean something more to other programs? I am interested in the program at Ressurrection in Chicago but I have had really good contact with the Department head of the ED at University of Chicago. Is it better to find out if I really like my program of choice or should I go for the more well known program and get a stronger letter out of it?? Also, how far in advance do I need to start trying to book away rotations for my 4th year (I am a med3)?
Thanks for any advice!!

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[Seaglass]

You need to start looking now because many of the more competitive ones have a limited number of spots available for outside students. If you are a really good student then I would definitely rotate at your #1 choice, if you are mediocre then I would perhaps not rotate anywhere else. The world of EM is small enough that a letter from just about any program director will get noticed. While that kind of letter can do a lot for you, I have heard attendings say that they put more weight into letters from faculty who obviously worked a lot with you.

Casey

 

[greatdane]

saliorgirl, you will probably get a few different opinions on your questions, but I think one thing all will agree on is the statement "it is better to have a great letter from someone good, rather than a good letter from someone great" that being said, here are another couple things to consider.

-the more someone has worked with you and has had contact with you, like the department head you mentioned, the better letter they will be able to write. Remember, this is not IM or surgery with the same attending day in - day out. In your month at an institution, you may only work with a ?big name? you want a letter from one or two shifts if any at all?.or you may be able to work with them often??just something to keep in mind. The coordinator of that rotation may be able to answer a question like that.

-again, a different opinion than the above post. I had a PD at a very well respected institution where I worked before leaving for med school tell me this. If you are stellar on paper, DON?T do an away at your number one choice. He said you can only hurt yourself.

-Myself? I consider myself to be a little above average, not stellar. I chose to just hang ?em out there and do two rotations at two of the so called ?top programs? where I wanted to go, and I feel it paid off (I?ll know in march). Again, all opinion. But I would say this, don?t do an away rotation somewhere where you are not interested in. I hope all this rambling helps a little

good luck

 

[EMIMG]

Perhaps a more important question as to where to rotate for an EM rotation is when to do it. Obviously many people want to have strong letters before their interview deadlines so many will try to do it in July-September.

My personal opinion is that July sucks. The reason behind this is many departments have their interns in the ED for this month. Many programs start off with an orientation month where all of their interns rotate through the ED. Therefore, you may not get as much experience (procedures) as if you do it some other time.

Probably the best time to do an EM rotation is in June if you can swing it. The reason being is that all of the itnerns are now basically 2nd years and will have had a fair number of procedures. THe ED will not be as crowded as in July. So, if you can swing it to do it in June, it will probably benefit you.

 

[Seaglass]

I have a slightly different take on when to do it. I agree that July is the worst possible time but I also think you should try to do it relatively close to interview season and if you already have enough good letters even during interview season so that you will be easy to remember come ranking time.

 

[greatdane]

Just to restate what was said about times....and I am really not trying to always disagree...but just add another opinion. If you do them closer to interview season, the problem you will run into is that it will be very very tough to get letters from there completed and submitted to ERAS before "interview season" starts. As CG said, if you have letters already, maybe not an issue; however if you want a letter from there...beware it takes time. Most will agree on here that the quicker you have a complete application (excluding the dean's letter), the better off you are. And I think you will find when you go back to interview at the place you did your away, providing you worked your butt of during the rotation, the faculty and staff will remember you well.

As for July, that is when I did one of mine, and it actually worked out great. We went to all the intern orientation lectures and skills labs and learned a ton. But I can see where it could be hectic at some places...

 

[NinerNiner999]

I too agree that July is a horrible time for all of the above mentioned reasons. However, I do suggest August as a good time to rotate through EM. If you are a strong candidate with a good step I score, this will allow you to study for and take Step II at the end of July, leaving plenty of breathing room to concentrate on the application and interview process. Likewise, it will (at most schools) give you the oppurtunity to get a meaningful rotation such as Senior Medicine in before you leave, keeping medicine fresh in your head.

Whether or not you do your rotation at a program you would want to attend is your choice. I did and it worked out wonderfully (I also did it at a "big name" program, which gave my CORD letter some extra weight in my application). Essentially, any program is going to assume you want to apply there if you took the time to travel and visit for a month or so. That said, and being the small community that EM is, you will be looked at as a potential applicant regardless of your desire to attend there or not, and your CORD letter of recommendation will reflect your work- not your desire to join their program. In short, if you are enthusiastic, motivated, and work hard (no breaks, pick up any unread charts as they arrive, and show a commitment to learn from your mistakes [you are still a student-not a resident yet]), I don't think you can go wrong anywhere, including your first choice.

I also believe that if you are planning on doing more than one visiting EM rotation, you should schedule your last one for November, which is typically the start of the interview season. This would also be a GREAT time to schedule a rotation with your first choice location. The first rotation in August will give you a chance to "warm up", and also give you a (hopefully) strong letter to send to every other program through ERAS, including the one you will rotate to in November. As interview offers are extended throughout October and November, you might be more likely to recieve an interview while you are doing your rotation, which will give you a leg up on the competition, and allow those inteviewing you to observe you over the month and really get to know you. You will find that as you interview at programs you didn't rotate at, you might sit down for 5-10 minutes with each person interviewing you, and not really get t know them at all. A month with the program you most want to attend will afford you the oppurtunity to (at worst) know that they choose you because of the way you worked - which probably meant you wouldn't have worked out well there in the first place.

Remember, scores, numbers, recommendations, and personal statements might get you into the door, but there is no piece of paper that can replace live, observed work ethic. If you are scared or unsure of your ability to perform well at the program of your choice, that is one thing, but EM is a field where initiative, courage under pressure, and cajones may take you further in the long run (as long are you aren't reckless). It is OK to be aggressive with your career plans, but be smart about it too. I was scared and VERY unsure of my abilities when I started my first away EM rotation. I left confident and secure that I have without a doubt made the right career choice for the rest of my life. In short - take the plunge, it will be worth it.

Just my $0.02...