how important are audition rotations?

[exjersey]

Could anybody comment on if they did away rotations in IM and how important they were in obtaining interviews or matching at programs.

The subtext to my question is this: Top 25 school, 225 Step 1, 2-3 clerkship honors (one in Medicine) but no AOA, excellent LOR and a few publications under my belt (before med school) with some current research projects cooking.

Is it worth my while to spend a month away from the wife and kids and fly across the country to try and impress the docs at some "reach but attainable" programs. Or should I take my chances and apply based on being a decent candidate on paper. Any ideas?

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[afmsboy]

The short answer is yes!

The long rational to it is simple. You have stats to be proud of. But if you want to go to that "attainable but reach" program, your stats are average. That means more or less you blend with the crowd. The danger here is you will be lost with the crowd. Another reason, one I only just picked up on the interview circuit, is the clannishness of programs. On the East Coast virtually every one I met went to school east of the I-95 and north of the Mason-Dixon line. I do not know if that is the case on the West Coast. Also from questions I was asked on interviews programs really want to know if a candidate is willing to move from out of town and far away to their program. Simply, they dont want to rank a person that they are unsure is willing to move. A couple of residents have also told me they sometimes use geography to screen i.e. someone from sunny CA is not going to come to cold Chicago, so we are not going to waste an interview spot.

One of the surest ways to overcome the above POTENTIAL hurdles is to do the away rotation. The most important thing is you find out whether or not that program is conducive for you. Second, you get a chance to meet someone/people who may become your advocate(s) in the selection/interview/ranking process. Third, you have shown more than passing interest in the program. I did two away rotations, during interviews at both institutions I was told that my application and ranking potential had been boosted by rotating there. It did not hurt that I had strong LOR from faculty at those institutions. Also important was that I got a chance to see the programs for extended periods, knew what the life of residents was like and also to sample the town/city that I could potentially be moving my family to.

Yes I spent two months away from mi familias and it hurt. Then I thought of the men and women in uniform who do the same for longer periods and decided to grin and bear it.

Good luck

 

[jon_jon]

I definitely agree with afmsboy. Doing a rehearsal month usually helps.

On the other hand, during the elective month, you do have to show some interest and iniative. If you constantly show up late and are unprepared during rounds, etc, the elective month can hurt your application as well.

Try to get to know the chief residents, who can be your ally when application and interview time comes around. Depending on the program, chiefs often have quite a bit of say in the appplication review process.

 

[Rigomortis]

I think they can either help you immensly or hurt you. By going up there it shows you're serious about the program. However, it is highly dependent on the month you have there. I did one away, and it was equivocal: multiple attendings, some which liked me, some that didn't. In the end, one guy told me that it wasn't that I didn't do well, but that I didn't blow him away. With that being said, I'm of the opinion that if there is one place that you are just dying to see, go for it. It's expensive and inconvenient, but residency application time is not the time to be playing it safe anyways.

 

[mjg]

It also depends on how competitive you are, of course. If you are a long shot for a program, it certainly can't hurt. And it may be what gets you the interview and on their rank list. But as long as you're reasonably competitive, it might not be worth your while.

And consider that you'll probably never do better in a rotation than at your home hospital (i.e. the whole point is to get strong letters).. one, because you're comfortable, and two, your school has a real interest in seeing you do well. Those things won't be in place at the other school.

I would introduce yourself to your school's PD, lay out your CV, and ask what he/she recommends. It's definitely an applicant / program dependent thing.

No matter what, though, go to kick ass, or don't go at all. 'Cuz as Rigo pointed out, sometimes that still ain't enough.

M

 

[DR]

I agree with Rig. I think you can go to a place and work your ass off, and show major enthusiasm, and all that crap...and for whatever reason, the attending you're with, or residents, or whatever...they're just not that impressed. Or they are just the type that don't put too much into recommendations. It's a gamble, sort of...it can help you if there are people there who understand what the away rotation thing is all about; but let's say they are clueless, or indifferent/just don't care that much, or let's say for whatever reason you just don't happen to click with them...then you're screwed. I didn't reserve mine for my absolute favorite place, and it turned out that the attending was one of those guys who NEVER writes good evals (even the residents told me so). However I was fortunate because the residents themselves liked me and told the PD personally that I would be good for the program.

 

[afmsboy]

A lot of valid advise on general stuff has been given by all the respondents. However, I am trying to answer the specifics for the original question. The candidate has a couple of places he is interested in. He looks good on paper but is not spectacular i.e. as it stands his application will be lost in the crowd. He needs something to boost his application. Yes he can stay in his homeschool, wow his attendings (which is not guaranteed anyway) or he can take the chance and go visit one or more of his dream places. Yes he runs an equal risk of not wowing them but what if he does? He/she gets a letter or even a personal word put in to the people that count. While at the program he can request a meeting with the PD there, let them know his interest and possibly discuss his candidacy. Very often, if interested the PD will make enquiries from attendings and residents that worked with the candidate. As I stated in my first posting he also gets to evaluate the program and the city and decide if it is worth all the trouble.

Having done the away rotation and interviews I can honestly say the away rotation gives a much better picture of what one can expect of daily life in a program. Interviews are such a big show. Heck, I barely recognised my own schools program after it was packaged for the interview. I agree with the suggestion of speaking with physicians you trust and respect and getting their input. Speak with your PD if you have a personal relationship and trust him/her. If not I would be wary. PDs in every program have a duty to secure the best candidates they can get and some employ tactics that will make even trial lawyers blush.

 

[exjersey]

I appreciate all the replies. Just to add a bit more information: I have no interest in staying at my school for residency (a good program but I want to explore some new parts of the country), am not shooting for Top 10 programs and am interested in some places where students from my school don't usually apply to. Any of these factors sway my decision to go away?

 

[med03ibd]

top ten school or not, i would still check it out with an away rotation, especially since people from your school don't typically go. like people said before, it really gives a true picture of living in that city, working in that hospital, and the overall dynamics of the program and residents that you'd never get in one day. it's also a cool experience. i would try to do one or two. of course it will always highly depend on having a wife and kids at home. another suggestion is to do a consult month besides cards or pulm. something like heme-onc or ID will get you doing consults all over the hospital and meeting lots of people and residents, but will keep you with decent hours and maybe even weekends off. and DEFINITELY meet with the PD while you're there. who knows, it could get you into a program that might not have even interviewed you.

 

[mjg]

Sorry.. didn't see you posted your stats.

The good news is that you look to be competitive at any non "top ten" program. 225 puts you in the game at many fine places, and AOA is not a prereq in the face of excellent letters. Coming out of a good school helps.. as do publications. The "top ten" level prgrams do have Step 1 cut-offs that might hurt you.. Brigham, so I was told, opens your file at 235.. but I imagine other things, ex. a strong audition or excellent LORs from people they know, can open the door as well if your step score is close (like, 234..)

If you want to do MGH (which you don't), I would think the AI audition is a must do. Less than that.. do an elective and get to know them without the AI scrutiny.. otherwise, if you're eschewing the elite-elite programs, I think you've got "matched in top 3 choices" written all over you.

Your PD, of course, is far more seasoned to tell you how competitive you are at the schools you're looking at. Contrary to the above post, your PD has no incentive to give you bad information whether you know him or not. We are actually required to have this meeting (or with the dean) as 3rd years to plan our 4th year strategy at my MS.

Good luck. You'll do well...

 

[Acro Yali]

Which rotation should be done for an away? AI or consult? I have hearddifferentthings but an AI just seems more "relevant" than doing an consult, where you don't do that much.

 

[Mav]

If you pick up First Aid for the Match, there's a section on this.

Basically, it says to do an AI if you are a long shot for the program.. but that it's harder to look good against a school's own students.. with the upside being that some programs offer "courtesy" interviews to those that rotate with them.. etc. It says AIs in medicine are NOT the norm (but are for ortho) and that if you just want to get to know a program, an elective is an easier way to do it without AI pressure.

At my school, an AI basically means 100 hours a week with 1 day off. An elective tends to be closer to 50-60 with no weekends. There are just some things you don't want to do as a 4th year..

So sure it's more relevant to do the AI - but electives still get you good interaction with housestaff.. and your chance to get a nice letter from an elective might be even better as you tend to have less people on the team and the attending can get to know you better.

Whether you NEED the AI depends on how strong your application is.

 

[chichi]

Just wanted to relay my experience in figuring out whether to do an away rotation or not. I talked to many fourth years at my school who had gotten into very good/great IM programs (hopkins, georgetown, mich, ucsd) and NONE of them did audition rotations there. All of them talked about how it's a gamble like people have already mentioned on this forum. They did have one classmate who did boost her application by doing an away at UCSF and she eventually matched there. The sense that I got from them was that if there was once program you want desperately, go for it, but otherwise it wouldn't make that much of difference. Seems the biggest factor is whether you honored medicine or not.

For me, I decided to do one away rotation in my hometown at a community hospital just to be home for the month.