Advice wanted on away rotations. Thanks in advance!

[tpsreport]

Hey guise

Stats:
239 Step 1
P on every rotation, in the midst of surgery rotation with 4 weeks left, then a 2 week EM rotation

In Upstate NY

Yes my school has an EM rotation, and there's also an affiliated institution an hour away with an ED but it's nowhere as good for exposure/learning.


I'm still split between surgery v. EM, but now heavily leaning towards EM.

Planning to take step 2 early, and studying my butt off for it, aiming for 260+. I'm hoping that this will take some attention away from my average clerkship grades. Family stuff took away a week of dedicated studying from Step 1


My question is: should I do an away? Because my home institution already has an EM sub-I, how important is this considering my stats? (I do not have a preference on location in terms of residency or away rotations).


Any response is much appreciated

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[Cinematographer]

Hey guise...

P on every rotation, in the midst of surgery rotation with 4 weeks left, then a 2 week EM rotation... Planning to take step 2 early, and studying my butt off for it, aiming for 260+.

I'm hoping that this will take some attention away from my average clerkship grades.

I... Good luck.

 

[BoardingDoc]

Hey guise

Stats:
239 Step 1
P on every rotation, in the midst of surgery rotation with 4 weeks left, then a 2 week EM rotation

In Upstate NY

Yes my school has an EM rotation, and there's also an affiliated institution an hour away with an ED but it's nowhere as good for exposure/learning.


I'm still split between surgery v. EM, but now heavily leaning towards EM.

Planning to take step 2 early, and studying my butt off for it, aiming for 260+. I'm hoping that this will take some attention away from my average clerkship grades. Family stuff took away a week of dedicated studying from Step 1


My question is: should I do an away? Because my home institution already has an EM sub-I, how important is this considering my stats? (I do not have a preference on location in terms of residency or away rotations).


Any response is much appreciated

A guise is one's appearance.
The straight Ps are going to hurt you. If you get a P at your home EM rotation as well, that will be particularly damning. Yes, you should do an away rotation if you want to match into EM and you should honor it.

 

[Geomadonna]

I... Good luck.

Why the jerk response bro? This guy is asking a legitimate question about what he should do. Why don't you help him out?

Tps - do an away if you think it will help you. You already know that posting that question in this forum will get you 3 responses

1. Yes
2. No
3. People that were the most neurotic posters on this forum who matched and are all of the sudden the man and critique your word usage.

Ridiculous

Do what's best for you and don't let anyone stop you

 

[doggydog]

Is passing non-EM clerkships really that bad?

 

[whiplashWhoMD]

Is passing non-EM clerkships really that bad?

No. There is a large element of hype on this forum.

 

[Cinematographer]

Is passing non-EM clerkships really that bad?

Probably bad if you're looking into competitive programs. Otherwise a Pass here and there shouldn't be a big issue.** Just be aware that grades play a significant role in the writing of your MSPE (Dean's letter), too.

Spoiler

**As long as it's not your EM rotation. A classmate who didn't match into EM was told by faculty (at his last away rotation) that getting a Pass (on his previous away rotation) was viewed as a red flag. Otherwise his application was great.

 

[medic4lyfe]

Yes do aways. And passes aren't going to kill your application if you do well in your EM rotations and have good SLOEs.

 

[goodoldalky]

If you get Honors and a good SLOE from your EM rotation the P will not hurt you elsewhere. If you P in your EM rotation you may have trouble. Your scores are otherwise solid.

If you are worried or have any other red flags in your application then you should consider doing an EM away as two honors grades will erase any doubt about your application. Otherwise the only reason to do an away would be if there is a program you are highly interested in which is competitive, it may be to your advantage to rotate there if you perform well.

 

[hoot504]

Bewildering thread, reasonable questions, and with that user name/avatar, the man earns a little respect in my book.

Yes, you should do an away. It goes beyond raising your competitiveness. If you have the EM bug in 4th year, as any applicant should, doing aways is FUN

Mine were by far the most enjoyable months in medical school. One in LA, one in Hanover, NH. Two entirely different ways of living, two entirely different programs. Both really enjoyable months that affirmed my career decision.

At this point, with the rising competitiveness of EM, if I had to pick residents, I would be very wary of someone that hadn't done any aways. To me it signals a lack of interest. I did 3 EM Sub-Is and an U/S month AND a Tox research month and I f-ing loved it. Damn the torpedoes... I may have had attendings warning me about 'doing your intern year during MS-IV' but in retrospect I wouldn't have changed a thing.

 

[IH8ColdWeath3r]

DO student here,

At my school, it is borderline impossible to honors a rotation. Like, less than 2% of students do it. In order to get honors, you need over a 110/120 on the COMAT (very hard to do AND 4.8/5 on your eval from your preceptor. It is so hard that my school has looked into changing the rules for future classes, but, because they are so slow at implementing any kind of change (and our dean left)...the new rules will not apply to us.

Thus, most of us have P on rotations (I myself fall into that category). And, the COMAT tests are really poorly written. This was the first year that the AOA designed the ER comat, and it was no exception. I had friends with 249 and 256 board scores not be able to crack a 70 (whatever that means in terms of scaling)...


So...is all of this really going to hurt me as I apply for a ACGME EM residency?

 

[IH8ColdWeath3r]

Bewildering thread, reasonable questions, and with that user name/avatar, the man earns a little respect in my book.

Yes, you should do an away. It goes beyond raising your competitiveness. If you have the EM bug in 4th year, as any applicant should, doing aways is FUN

Mine were by far the most enjoyable months in medical school. One in LA, one in Hanover, NH. Two entirely different ways of living, two entirely different programs. Both really enjoyable months that affirmed my career decision.

At this point, with the rising competitiveness of EM, if I had to pick residents, I would be very wary of someone that hadn't done any aways. To me it signals a lack of interest. I did 3 EM Sub-Is and an U/S month AND a Tox research month and I f-ing loved it. Damn the torpedoes... I may have had attendings warning me about 'doing your intern year during MS-IV' but in retrospect I wouldn't have changed a thing.

And thank you for this! I am going to do 3 EM rotations and one US and one Tox or 4 EM rotation and one US month and I can't wait! Which would you recommend?

 

[racerwad]

DO student here,

At my school, it is borderline impossible to honors a rotation. Like, less than 2% of students do it. In order to get honors, you need over a 110/120 on the COMAT (very hard to do AND 4.8/5 on your eval from your preceptor. It is so hard that my school has looked into changing the rules for future classes, but, because they are so slow at implementing any kind of change (and our dean left)...the new rules will not apply to us.

Thus, most of us have P on rotations (I myself fall into that category). And, the COMAT tests are really poorly written. This was the first year that the AOA designed the ER comat, and it was no exception. I had friends with 249 and 256 board scores not be able to crack a 70 (whatever that means in terms of scaling)...


So...is all of this really going to hurt me as I apply for a ACGME EM residency?

DO at an ACGME program here (who also had a decent number of passes/HPs).

Honestly, doing well on boards, rotating at programs you are interested in, and having great SLOEs is more important than clinical grades. Obviously, everyone should put in honors level effort on every rotation, but everyone also knows that not everyone can get honors and a cutoff must be made at some point.

Don't focus too much on what your MSPE says and focus more on making sure you SLOE says how hardworking, enthusiastic, and teachable you are. Getting honors on said SLOE at an institution that rarely gives honors is the cherry on top.

 

[IH8ColdWeath3r]

DO at an ACGME program here (who also had a decent number of passes/HPs).

Honestly, doing well on boards, rotating at programs you are interested in, and having great SLOEs is more important than clinical grades. Obviously, everyone should put in honors level effort on every rotation, but everyone also knows that not everyone can get honors and a cutoff must be made at some point.

Don't focus too much on what your MSPE says and focus more on making sure you SLOE says how hardworking, enthusiastic, and teachable you are. Getting honors on said SLOE at an institution that rarely gives honors is the cherry on top.

Well, I have taken step I (220's) and plan on taking step II. Despite my school saying that I really don't need to, and that most ACGME programs take COMLEX, I ahve found this to be contrary to the truth. Actually, both of the places that I have been invited to audition mentioned that they liked that I took step I and encouraged me to take Step II, so I will be taking it in June prior to starting audition rotations. I have a background in EM and I feel like I will do what it takes to do well when I am auditioning, so that the residents and faculty can see my passion for EM and that I am hard working. The one thing I learned about my surgery rotation was, that, even though as a student you often feel like you're in the way, and that you can't contribute, there is always one small way that you actually CAN contribute, whether it be reassessing the patient, grabbing some CoBand, wheeling over the Ultrasound machine, reassessing the patient. I am hoping that doing these things compensate for my mediocre pre-clinical grades/clinical grades and average step score (trying to jump 15-20 points on step II).

Thank you for your advice btw!

 

[racerwad]

Well, I have taken step I (220's) and plan on taking step II. Despite my school saying that I really don't need to, and that most ACGME programs take COMLEX, I ahve found this to be contrary to the truth. Actually, both of the places that I have been invited to audition mentioned that they liked that I took step I and encouraged me to take Step II, so I will be taking it in June prior to starting audition rotations. I have a background in EM and I feel like I will do what it takes to do well when I am auditioning, so that the residents and faculty can see my passion for EM and that I am hard working. The one thing I learned about my surgery rotation was, that, even though as a student you often feel like you're in the way, and that you can't contribute, there is always one small way that you actually CAN contribute, whether it be reassessing the patient, grabbing some CoBand, wheeling over the Ultrasound machine, reassessing the patient. I am hoping that doing these things compensate for my mediocre pre-clinical grades/clinical grades and average step score (trying to jump 15-20 points on step II).

Thank you for your advice btw!

The best advice I can give you is to not follow your school's advice on anything, ever, but especially in the context of ACGME. There are vanishingly few programs that would be satisfied with COMLEX only. Honestly, I can't think of a single one offhand. The one dual accredited place I interviewed at (MD side) had no idea what to do with my COMLEX.

It sounds as though you have a solid plan for success. You are totally right that there is always something we can do as students to be helpful (or at least try).

It sounds like your grades and scores are fine as long as you aren't just shooting for only West coast academic programs. Sprinkle in some (maybe a lot) programs in the flyover regions and you should be ok.

 

[AceH]

I honestly hope that I don't ever end up working with people who are anal enough to judge based on a few spelling errors. Now that is out of my system, Passes on all rotations are not a huge problem, but as stated above, may prevent you from competitive places. I personally know of a few people who actually failed clerkships, who nonetheless, ended up at pretty solid programs. Aways with strong SLOEs would make your application stronger. Remember, they look at the whole package.

 

[Arcan57]

I don't know that I'd devote my life to nailing a 260 on Step 2. I would do some soul searching regarding getting straight 'C's on my clinical rotations and what I need to change to Honor my EM home and away rotations.