Away rotation necessary? Strong candidate with great home program

[Graywolf]

Thank you ahead of time to those that give me advice.

I am a 3rd year US med student pursuing an Otolaryngology residency and I feel that I am off to a good start. 260 Step 1, top 10% of class preclinical, haven't gotten any official 3rd year grades yet (just started in May), but optimistic about doing well. I have one middle author publication (research was quantifying upper airway pressure generation using high flow nasal cannula in spontaneously breathing 3D-printed pediatric airway models - still not sure if that would classify as ENT or Pulm) and I just started another research project within a Senior ENT resident. My goal is to have a minimum of three actual publications in ENT by my residency application in one year.

My home institution is a strong program in the Pacific Northwest (that narrows things down a bit), so I am asking if it's necessary to do an away rotation in this situation. I plan to do a 4 week ENT elective at my home institution after 3rd year required rotations are done, and then likely another 4 week rotation at a regional hospital in my home state. So, if you were in my shoes would you still do an away rotation? I am interested in doing residency in TX at all possible (went to college there).

Tl;dr - decent candidate with great home institution, plan to do 8 total weeks of ENT rotations, is an away necessary?

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[AcademicNeurosurgery]

Yes, I would strongly encourage you to still do aways. Especially if you want to move to another state, doing an away in Texas will show programs you are willing to move. Why are you doing a rotation at a regional hospital? Does this hospital have an ENT residency program? If not, it is a waste of 4 weeks and you should do your 1 home rotation and 2 aways. Also, you can read stories on these forums for yourself but there are many candidates in the past who had a false sense of reassurance from their home program and ended up not matching. It's simply not worth the risk, especially for a small field like ENT that has been volatile in recent cycles.

 

[Graywolf]

Yes, I would strongly encourage you to still do aways. Especially if you want to move to another state, doing an away in Texas will show programs you are willing to move. Why are you doing a rotation at a regional hospital? Does this hospital have an ENT residency program? If not, it is a waste of 4 weeks and you should do your 1 home rotation and 2 aways. Also, you can read stories on these forums for yourself but there are many candidates in the past who had a false sense of reassurance from their home program and ended up not matching. It's simply not worth the risk, especially for a small field like ENT that has been volatile in recent cycles.

Thanks for the reply. The rotation at the regional hospital does not have an ENT residency program. It is in my home city and I am connected to some of the ENTs there and they also have a reputation for great teaching. I was also hoping get some solid letters of recommendation as well. That's the only reason.

 

[AcademicNeurosurgery]

Thanks for the reply. The rotation at the regional hospital does not have an ENT residency program. It is in my home city and I am connected to some of the ENTs there and they also have a reputation for great teaching. I was also hoping get some solid letters of recommendation as well. That's the only reason.

Gotcha. I am obviously not well-versed in ENT matching so take my advice with a grain of salt. Generally-speaking, the advice I see is to do a home away if you have a home program and then do the rest at places you would like to match. The only time I think it is beneficial to do a rotation at a hospital with no program is so you can make a bunch of mistakes and the hospital will groom you into a good sub-I so you shine during aways. You are still early in your journey but if you continue to be a strong candidate, my suggestion is to do your home+2 aways and forget the local hospital with no program. You can still get a letter from them but letters from your away rotations will take priority. Also remember that your application is more than just your Step 1 score so research, clinical skills, your ability to work well with others, etc. all factor in.

Again, seek advice from someone knowledgeable in your field but the way I see it is that statistically you have the greatest chance of matching at places you do aways so maximizing aways = maximizing your chance at matching.

 

[Lexicon0]

Au contraire, I actually think an away rotation is not an absolute necessity. I met a lot of people on the interview trail who had very strong home programs and were actively encouraged by their home institutions not to do away rotations. They all ended up doing very well. It really comes down to being able to getting strong LORs and if you can swing 3-4 of them by doing just a home rotation I think you would be in good shape.

 

[operaman]

This is a commonly asked question that gets a variety of answers. My personal thoughts are that always can be valuable if done by the right person for the right reason. I didn't do one and don't think it hurt me in the least, but I did find myself wishing I'd done one or two when it was time to make my rank list. I would probably still be where I am now, but would have made my decisions based on a wider breadth of experience rather than gestalt and advice.

Don't forget that when it comes to making impressions on a program, the majority make a neutral or negative one. A month is a long time to be totally on your game. I remember interviewing alongside awesome people who matched at top programs but didn't get an interview from one of their aways.

Would also suggest doing some recon about potential rotations and find one that truly suits your needs. Someone looking for letters would probably fare better on a rotation where they spend most of their time with the same core group of people and get a decent amount of face time; someone who has letters covered but wants exposure to the entirety of a program may prefer a rotation where they spend a little time with each and every service. Try and be deliberate about your choices.

 

[OtoHNS]

You'll probably be fine whatever you do, assuming you don't have any glaring personality issues/psychopathology.

If you want to maximize your potential for matching at a residency in Texas, I would advise:

1. Do an away rotation at a Texas ENT program instead of your hometown community hospital and work your ass off (though this is less important for you since you already went to college in Texas so that proves you are willing to live there)
2. Get all your letters from faculty at your home program or from faculty at the Texas program you rotate at. No one cares that much about letters from random community ENTs, no matter how glowing. Academic attendings know what makes a good resident, not community docs who have been out of the academic world for years.

 

[altoid25]

PGY3 here. I never really understood the argument against away rotations. Especially if you are a normal person which 95% ent applicants seem to be. Even if you rotate somewhere and hate it, that's good. It gives you insight into what ENT residency is like at other places. I can tell you that when I was in your shoes, my "top choice" away rotation became a program I put at the bottom of my rank list...had I not rotated there (if I still got an interview) I would have ranked it #1. So it really gives you an all access pass behind the glossy pamphlet on the website or sugar coated interviews.

Also, It makes you well rounded having to quickly learn new EMR's and experience a new hospital that you may not know well (similar to what your intern year first month will likely look like, unless you match at home program). It is a stressful experience that costs money but certainly one that you gain tons of insight from regardless of fitting in at the program you rotate at.

Also, every program is different but I can tell you where I'm at, resident input can frequently be the most influential item in the rank list. If you rotated and got an interview(we do not interview all rotators), you have already demonstrated that you fit in and can handle the work load in addition to having all of the usual pre-req's. Everybody at the interview stage has the research, step scores, honors, letters, volunteering and look great on paper. Most people also interview well because we happen to be in a field that attracts smart chill likeable people. Programs want to know that you are that smart likeable team player that would work well in their specific team.

Obviously you can't rotate everywhere and there are always people who match at places they haven't done away rotations.

That said, I would never talk someone out of doing an away rotation no matter how great they look on paper.

 

[gordec]

Only recommend doing away if you really want to go there, and this is a chance for you to understand the strengths and weaknesses of the program in person. You could really impress them or do the opposite. I wouldn't do aways to try to look stronger on the resume. G Luck.