External rotation timing

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Egghead34

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Hello, I have a question pertaining to the timing and choice of elective rotations for someone interested in cardiology. A little about myself...

I'm an American IMG nearing the end of my intern year at a small community program in a major city. Since we have no in-house cards fellowship, I'm doing my best to strengthen my CV. I'm well liked amongst my fellow residents and attendings, most of all the PD and our head cardiologists who have given me their full support and investment in pursuing cards. I've got 2 lower-caliber (review articles) in the line for publication, am co-investigator in one multi-center study with our local university hospitals (that may or may not see publication by the end of my R2 year), have participated in the local AMA chapter poster competition, and am involved in several residency initiatives that aren't publishable but do carry enough weight to go on my CV.

All to say that I'm working my butt off to be competitive in spite of my IMG and community program background.

As R2 year approaches, I'm planning ahead for my electives. Three options have come to mind...
1) Cardiology rotation at our neighboring major academic center (top 5 in the country). There's no way I'd ever have a shot of matching there with my pedigree, but perhaps a LOR from one of their cardiologists would carry significant weight. My home institution cardiologist can pull strings to help me rotate with them
2) Cardiology rotation at a medium-sized program of good repute that historically has taken residents from our program similar to me. The chief 2 years ago matched there and was from my medical school, similar scores, determination, publications. I'm using him as a template of what to shoot for during residency, and perhaps the the legacy component would increase my chance of matching there?
3) Medium-tier university program in my home town, on the opposite coast. I'd love to match there, be close to family and return home. They take IMGs, though very high quality IMGs with moderately impressive publications. Through family connections I could secure a rotation with them, but probably only available around December of this year (6-8 months before applications are sent out). Would my rotation there be so early that I'd have faded from memory come application time?

So those are my top options at the moment. Which one or ones would seem most beneficial in aiding my chances to match? And for the last 2, where I might have a chance of matching, when would be the best time to request a rotation? End of my second year? Beginning of my third? December of my second? I appreciate any feedback from those who have gone through the process themselves and have insight. Thanks!

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I would do #2 and 3 if you can do 2. Otherwise either one.

Option 1 is a waste of time. If it's a "Top 5" program, you're unlikely to impress anyone there, even if you can get a rotation.
 
What are your thoughts on timing of the rotations? End of my second year? Beginning of my third? December of R2? Or does it not matter
 
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Hello, I have a question pertaining to the timing and choice of elective rotations for someone interested in cardiology. A little about myself...

I'm an American IMG nearing the end of my intern year at a small community program in a major city. Since we have no in-house cards fellowship, I'm doing my best to strengthen my CV. I'm well liked amongst my fellow residents and attendings, most of all the PD and our head cardiologists who have given me their full support and investment in pursuing cards. I've got 2 lower-caliber (review articles) in the line for publication, am co-investigator in one multi-center study with our local university hospitals (that may or may not see publication by the end of my R2 year), have participated in the local AMA chapter poster competition, and am involved in several residency initiatives that aren't publishable but do carry enough weight to go on my CV.

All to say that I'm working my butt off to be competitive in spite of my IMG and community program background.

As R2 year approaches, I'm planning ahead for my electives. Three options have come to mind...
1) Cardiology rotation at our neighboring major academic center (top 5 in the country). There's no way I'd ever have a shot of matching there with my pedigree, but perhaps a LOR from one of their cardiologists would carry significant weight. My home institution cardiologist can pull strings to help me rotate with them
2) Cardiology rotation at a medium-sized program of good repute that historically has taken residents from our program similar to me. The chief 2 years ago matched there and was from my medical school, similar scores, determination, publications. I'm using him as a template of what to shoot for during residency, and perhaps the the legacy component would increase my chance of matching there?
3) Medium-tier university program in my home town, on the opposite coast. I'd love to match there, be close to family and return home. They take IMGs, though very high quality IMGs with moderately impressive publications. Through family connections I could secure a rotation with them, but probably only available around December of this year (6-8 months before applications are sent out). Would my rotation there be so early that I'd have faded from memory come application time?

So those are my top options at the moment. Which one or ones would seem most beneficial in aiding my chances to match? And for the last 2, where I might have a chance of matching, when would be the best time to request a rotation? End of my second year? Beginning of my third? December of my second? I appreciate any feedback from those who have gone through the process themselves and have insight. Thanks!

I would choose option 1. That is how I got Cardiology from a community program. If you can find your niche there, and work your ass off (like focus hard working) to one or two big name attendings. If they like you, and are willing to call for you in other places, it opens the door up for you in a lot of places. It worked for me, and gave me more options that way, but the thing is... you have to be directly working under them, do something useful for them, round on their patients, make their lives easier for them to go beyond to try to get you into a program. Even if it is not in their program, they know people, and/or people know them.

If you rotate in a program where you may have a chance, you may have a chance, you may not. If they don't take you, then all your efforts have been wasted.
 
Timing: Typically in your 2nd year. 2nd half is typically better so that they can have a recent memory of you.

As to where, you going to have varying experiences
1. I did rotate at an Ivy league during residency. They have their own bias of IMGs, no matter how good u are. By the end of the day they still want to match a similar caliber candidate from another ivy league. In terms of letters you really want a letter from somebody who really knows you. If you are rotating at an external institution what you should find out is how their cardiology floor or consult service is set up. A lot of programs have a cardiologist be the attending for a week and then turn over. In that case even if you worked with Braunwald one week is not enough for him to think you are great. If you will be with the renowned cardiologist for a month then it is worth it because it can boost your application. However, you have to be careful with a top 5 program. Hardworking is the minimum. You have to be able to engage some of the attendings at the level of basic science pathophysiology or be the master of clinical data out there to be able to impress them.
2. If there is a program that has the tradition of taking your residents then u shd probably skip rotating there (especially if previous residents didn't rotate there). The away rotation is a double edge sword which can break or mke u (sometimes due to factors out of your control).
3. University program-medium competitively is worth trying. Especially because it is near your family and those kind of programs take IMGs
 
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