Away Rotation Advice

By Guest on Sunday, 02 February 2003

Posted in Match Center

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A question for all in the know,
I know this has been talked about and talked about, but just thought I'd throw my thoughts out and see if I'm totally off track or not. Our school is kind of jacked up in that we don't really have the equivalent of an ortho sub-I available right now (that may change when Dr. Moed gets here and some more attendings are available as I understand). What we do have is about 6 plus 4th years all trying to get 2 spots in a pediatric ortho rotation that is a little more clinic based offered at the earliest starting July 7th.
Anyway, my plan was to try to get that as early as possible, and it sounds like we may be able to schedule something 4 week ortho sub-I like in July later. Then I planned on doing aways in August, Sept., October and maybe November (this will all get shortened/pushed back a month if I don't get the ortho slot I want AND the rumored sub-I's don't actually happen). Is this a good plan, or should I go ahead and do an Away in July if I don't get my home school ortho and risk looking like a moron. I don't want to schedule and away in July and then cancel it if we can get an ortho sub-I type elective here (bad idea to p@#$ off programs I hear). This is all complicated by the fact my little bro is getting married July 5th, so I can't really schedule anything in the little two week block we have open between end of third year in early June and the start of our first four week block (don't want to do a 2 week away somewhere and then ask off for the last weekend of the rotation b/c I'm the best man).
Any suggestions/critiques would be welcome.

Oh yeah, I know Step II doesn't really matter when you take it, and I did really well on Step I so I had planned on blowing that off until Feb. or even later, but if I have that two weeks free between end of third year in June and the start of July is it worth the risk of choking to take Step II then and get it out of the way ? I'll have had Eternal Medicine, Ob/Gyn and Psych the last semester, in theory it would be fresher in my mind, but I've sort of had a string of acing tests for awhile and I wouldn't want to have the bad day that has been hiding make an appearance.
Thanks for any info you care to share.

As far as the Step II question is concerned, many people seem to have opinions on this but I'll share mine. If you did really well on step I, I think you can take step II any time you want. I do not know many people who are currently applying to more competetive fields, whose step II scores were less than their respective step Is. In my opinion, the only time a rockin' step II score is needed is if one is trying to make up for a lesser step I score. Which has been discussed at length on several occassions on this site. A good marker, in my experience and many I've spoken with, is how well you did on the NBME shelf exams. Percentile-wise, I think people do fairly comparable (considering those shelf exams are primarily retired step II questions). I only had one interview where step II came up, and then it was only to ask whether I had taken it yet because they were trying to see if I had any fun plans for the rest of the year. I took it in Dec., and in retrospect wished I had not pushed it off that far. Plus, you don't even have to report it, should you not be happy with your score. Fourth year should be more like a vacation, and by the time you're done interviewing about the last thing you may want lurking in the back of your mind is the step II requirement.

I like the thinking that some of the less intriguing subjects will still be fresh in your mind, and this can only help you on the test. The only requirement I had not completed at test time was Neuro (which worried me a little), but while my test seemed to be neuro heavy, the questions were very, very fair having only studied the neuro sections in First Aid Step II and Boards and Wards. So I think if you have a window of time in which you think you want to get it out of the way, go for it. Hope this helps. Good luck!

Guest

23 years ago

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#46654

I've been there and am now a PGY-2...

Wait on Step II until Jan or later unless you are planning to study hard for it. If you did well on Step I there is no need to have your Step II scores appear on your application.

Do your ortho sub-I's as early as possible. Keep in mind that you will need to start requesting letters and waiting until Oct/Nov to ask will delay your completed application. I made the mistake of doing an ortho externship in November. It was a bad time because many programs have already begun to send out invites, faculty and residents have already begun to list their favorites, the Thanksgiving holiday will cut your month short, and you may have to leave your sub-I for interviews in November.

Good luck and play the game to win.

Guest

23 years ago

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#46655

Thanks, I guess that was my main concern, how late is too late to do aways. It sounds like best case if I have my ortho sub-I at home (or whatever we end up calling it) in July, that leaves me basically August, September and October to do aways. I guess my next question would be:
Is it better to do three full months, or try to maybe do 4 3 week aways or something like that if possible ? I want to do an away at WashU just b/c I'm here in St. Louis anyway (I could walk to Barnes, literally), it's a pretty well respected program so a letter from there would be helpful, and I think all things equal my girlfriend (and maybe I) would like to stay in St. Louis either there or at SLU (6 year thing making me skiddish though). That would leave time for onlyl 2 more aways, and I had planned on doing an away at a "lesser" ranked program in which I don't know that I'd really want to go to (we'll see if I get there I guess), but I have a place to live there and would get to see some family, which would now knock me down to only one away rotation at a "dream" program, maybe two if I split thing into 3 weekers (or 2 weeks ??). Any thoughts on this ? It just seems like there's about 10-15 programs I'd really like to both see and let see me (ie probably need to rotate there to have a good shot at matching), and nowhere near enough time to do even half of them.
Thanks for the help so far...

Guest

23 years ago

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#46656

Well i can tell you that SLU and Wash U are different places, having graduated from SLU and intervewed at Wash U. Of course the SLU you would experience will be nothing like when i was there, since all that turnover crap started happening my fourth year of med school. As far as aways, go early and i have seen people doing aways as late as nov or even dec(that might be kinda late, since some places will have interviewed before then) I did ortho in july, august, and october. As far as the peds ortho rotation goes, is dr thompson still the peds director? I am not sure how good of a letter he would write, as when i was there he was not exactly personable.... As for step 2 i would say if you are satisfied with step 1, put it off, or take it during a reading elective (what i did). If they have not changed the SLU 4th year too much, rotations that are easy and good for studying/going to interviews during are nuclear med, radiology, anatomy dissection, anesthesiology (especially if you set up you own elective at st johns). There are others, just ask around
Ohh, what part of st louis do you live in? I used to live right by barnes too (lindell and union)

Guest

23 years ago

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#46657

As far as I know it looks like Dr. Thompson is still doing the Peds thing. That's the only real rotation we have though, the only other officially on the schedule is a 2 week "Practical Ortho" rotation. I've heard that maybe once Moed gets here they'll open up more spots in July for a more adult oriented rotation, but we'll see. If they don't it sounds like I'm really f'd, but who knows. I would hope that Dr. Burdge will write me a letter (or Moed if Burdge stops doing that and Moed's here long enough to get to know me), but I havn't met with him yet to talk about all this (Tuesday).
I planned on doing at least a Rads rotation, so that's good that I could do it AND still be able to interview instead of just taking time off. Guess I'll go read or something to get my mind off the giant cluster f--- that is my 4th year schedule ...
Maryland and Taylor by the way..

Guest

23 years ago

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#46658

how many electives/away rotations do most of you get to do? we only get 2 or 3 max.

Guest

23 years ago

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#46659

At my medical school most people did 3 ortho sub-I's. One at the home program and 2 at other programs. Each medical school has it's own rules about these (we were allowed 12 weeks in any one given clinical field). Some only allow you to do one away sub-I (Pitt med school??) while others let you do as many as you like. No one will probably stop you from doing mulitple sub-I's but you may not get credit toward graduation for all of them and you'll have less vacation time.

You will need to check with each program where you plan to do a sub-I about how long the block is. I think in general most students do 4 weeks. Sometimes it takes a week to get used to the hospital, a week to find a couple residents to hang with, a week to begin looking like a stud, then a 4th week to shine.

Again, I would highly recommend finishing these sub-I's by the end of Sept at the latest. If you plan to submit your application in mid-Sept, keep in mind that a LOR from your Sept sub-I may not be complete and submitted to ERAS until Oct/Nov. which may delay your "completed" application. Bottom line, work your butt off and ask for LORs early.

Last thing...carefully chose your sub-I externships. Talk to as many people as you can about places that interest you before you go (ie. DON'T waste a month at a place that doesn't fit you if you can find this info out beforehand). As you'll see in the November issue of JBJS (Journal of Bone and Joint Surgery for the rookies), performance at the sub-I institution was regarded as the most important criteria by residency program directors when selecting ortho applicants.

Guest

23 years ago

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#46660