All across the United States during the months of July-September, 4th year medical students leave the familiarity of their home institutions and spend time on away rotations. What are these rotations you ask? Well, you can think of them as month long interviews. If you’ve ever been to an interview and thought a few hours with your potential boss was nerve wracking–try spending 30 days there.
For those of you unfamiliar with how your doctor got his job, the path towards becoming a bonafide, board-certified physician in any specialty starts with residency training–and residency starts with something called the Match. How do you get to the Match?–you interview at multiple training sites and then you rank them. The training sites rank all the candidates they interviewed and in the end a super secret, proprietary computer formula spits out a theoretical Match made in heaven.
The away rotations come in for several reasons. One is to simply get to know a program you may want spend 3-7 years training at and the other is to get letters of recommendation so that these places want to interview you! Either way, these away rotations can kind of make or break your application.
The whole process is fascinating to me because so much of your life is decided for you. When you apply for the Match you also sign a binding contract saying that whatever the computer decides is where you’ll go. You are locked in and you don’t even know where you are going. It’s kind of like that name your own price tool on Priceline. You put in your credit card info and if it matches what you are looking for you are committed to going there– yeah…well this is just a really long hotel stay. Again, away rotations are that much more important because you get to picture yourself at that institution. You get a test run.
I just had my first away rotation. I have to say, I got pretty darn lucky.
The nervousness of being at a new hospital with a new computer system and all new hallways to get lost in was short-lived. I don’t know if it’s the 300 days of sunshine, the beautiful beaches or the focus on work-life-balance but I have never seen such happy attendings and residents. I really did my best searching out for the grumpiest, unhappiest guy in the bunch, thinking he’d be the best person to ask what is terrible about the program–but I never found him.
I imagined that I would show up and be just another face in the crowd, blending into a sea of medical students that rotated before me. Instead I got a super warm welcome and genuine interest from everyone I came across. If you accepted their challenge this place really allowed you to step into the shoes of resident intern, pushing you to think of yourself not as a medical student but the doctor you will be in a matter of months. I absolutely thrive in that environment. Give me an inch and I’ll just run with it. Having someone put trust in my assessments, physical exams, ultrasound findings and differential makes me work that much harder. Every day I showed up and tried to push myself a little further. That attitude does not go unnoticed so as a result I had some amazing training opportunities.
I’m really glad that my first Emergency Medicine rotation was at my home institution. It was a safe place to fall a little bit and get helped up along the way. EM is a very different specialty and it takes some time to get used to the focused exams, presentation style and the way EM physicians think. My home institution prepared me extremely well in pointing out what I was doing wrong in those aspects. I had some wonderful residents who provided actual constructive criticism. Even though it is hard to hear that you forgot something obvious, I can promise you that the next time I have a patient with a headache I will never forget to walk them and check their gait before presenting to the attending. By the time I arrived at my away rotation I had the basics firmly in hand and could start to build on my skills.
During my month away, I came across another group of amazing teachers. People with genuine excitement about working with physicians in training. You can’t fake that kind of attitude and it was contagious. As a result I can now say that I’m entering residency having done two lumbar punctures, a chest tube placement, an intubation, a thoracentesis, a paracentesis, a cervical headache block and that I&D I somehow missed earlier. That in itself is amazing training!
The best part about 4th year has been rotating in my actual specialty and feeling like I am among my own. People who share my enthusiasm for crashing patients, multi tasking, having a good sense of humor and being accepting of anyone and everyone.
I have grown tremendously in the past month as a student, which is all I could ask for. I am really looking forward to one more away rotation…and another opportunity to keep improving.