Away Rotations

Away rotations also known as audition rotations or visiting student rotations are clinical rotations at an outside institution. They are usually done in your final year of medical school. They are not required, but may be highly encouraged depending on whether you are entering a competitive specialty (derm, Ortho, ENT, plastics) or if you have regional constraints, for example a significant other in a certain area of the country in which you are trying to match. Sometimes, like in my case, one might do away rotations simply to see how things are done in another location or explore a new city you might be considering moving to. Away rotations may also be beneficial if you thin you might lie to match at a certain institution or if you want to increase your chances of matching at one of your "reach" schools. 

Away rotations can be very consuming both time-wise and financially. You should think of them as investments. Prepare to work harder than you have ever worked on any clinical rotation, people are always watching so you will have to be on for the entire month. This could work for your benefit or your detriment. An awesome impression can secure your spot on the rank list, but a poor performance or even one bad day could seal your fate and ruin your chances. With that being said I would encourage everyone to reflect on their stamina and interpersonal skills, weigh the risk and reward, and decide if its worth pursuing. 

In terms of finances, these may include costs associated with applying, as well as costs associated with moving to another location for a month. I would encourage you to apply to places where you have family or friends you can stay with to decrease costs associated with housing. If those are not options Rotating Room has sublets posted by other med students and is reasonable and trustworthy site. Outside of housing one must consider costs to get to the location you are rotating at, as well as transportation to and from the site every day. Many programs also have tuition fees as well as extra malpractice coverage that must be purchased to meet the standards at their institution. Your immunizations must be up to date, you must have an up to date TB skin test, a background check (which your institution usually handles) and some places may require a 

urine drug screen. Now lets talk about the logistics of it all..


How to apply:   

-VSAS (Visiting Student Application Service)  is used to apply, its a portal through the AAMC, there is a cost associated with it, there is also a fee associated with each school you apply to. 
Students pay VSAS application fees based on the number of institutions they apply to, not the number of electives they apply for. The fee for the first institution applied to is $35, regardless of the number of electives applied for at that institution. The fee for each additional institution is $15, again, regardless of the number of electives applied for at those institutions. 
For example, if a student applies for electives at three institutions, their total fees will equal $65:

1st institution fee

2nd institution fee

3rd institution fee

TOTAL fees
**there may also be processing fees charged by the intitutions

On VSAS you can search for electives by specialty and institution. On the host sites page you can view the required documents for a complete applications. 

Many require:

-Immunization form (some have personal ones vs AAMC standardized form)



-Transcripts (uploaded by home school)

+/- step scores

+/- personal statement 

+/- drug screen

+/- Letter of recommendation 

+/- Letter of good standing 

You select rotations in the specialty for which you would like to apply (inpatient, outpatient, sub-specialty) as well as which block you would like to rotate.

**take note if schools are off-block or on the same schedule as your home institution. 

When to apply: 

VSAS typically opens in February but each institutions has specific deadlines that you will need to take note of. I encourage you to apply early because many of the spots are first come, first serve. In general you should apply between February-April, but again, the earlier the better! Your personal statement draft doesn't have to be perfect, but you will be grateful for it later when its tine to write your statement for residency applications. You will already have something to build on. Also think early about a faculty member you can ask for a recommendation letter as some programs may require. Be sure to check host institutions pages for minimum step 1 scores so you don' t waste your money applying to places you may not be offered a spot.

Where to apply:

This is dependent on your reason for pursuing a rotation. If you are trying to get your foot in the door in a traditionally hard region to break into (i.e. California) you may want to apply to mostly schools in that region. If you are applying to "reach" programs, do your research and evaluate what qualifies based on your application and apply to those. If you want to go to a specific program, apply to multiple electives at that institution. 

When to rotate:

This will take some foresight into what your 4th year schedule may look like. I would first decide when you plan to take step 2. If you need/want to take it early I would apply to blocks after the 1st or 2nd block, perhaps blocks 3 or 4. If you do not need/want to take it early, perhaps rotating early in block 1 or 2 may be best. Also consider when you would like to rotate at home. In general, I felt it best to rotate at home to get a feel for what was expected of a sub-intern or acting intern before rotating away. Therefore I planned to rotate home in the first two blocks, and away afterwards. I would also caution you to research what is prime interview season for your specialty. It can be very difficult to rotate away during interview season as you may be absent a lot from a rotation you are auditioning on and it can be very very difficult to group or reschedule interviews as dates are usually limited and overlapping. 

On your rotation:


-Read, read, read especially if you are at an academic program

-Take initiative, stay organized, get things done!

-Volunteer to do scut work so your resident can go to the OR/focus on more important things 

-Volunteer to do a talk or give some type of presentation on an interesting patient

-Challenge yourself and progressively carry more patients

-Take ownership of your patients (present them, on rounds lead the discussion, tell them the plan) 

-Ask for feedback consistently and make adjustments where necessary

-In general if you do not know, ask questions, but you need to commit the answer to memory write it down. Asking your resident something multiple times may annoy them 


Lagniappe ( a little something extra):

-Many places offer visiting student scholarships and/or scholarships, be sure to inquire or check their website. These may require an extra essay.

-It honestly can be hard to shine on an away, there is a learning curve initially with learning a new system, where things are located etc., but you will figure it out

-Ultimately aways are high risk, high reward, and only you can decide if its worth it, but if you set your mind to it, YOU CAN DO IT!


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