Away rotations - yikes! If you’re like me, you’ve probably heard a lot of conflicting information from a lot of different people that isn’t all that helpful. Let me try to make it a little more simple!
Before we begin, here are some abbreviations to know (and helpful links):
CV: Curriculum vitae - a short written summary of a person's career, qualifications, and education.
ERAS: The Electronic Residency Application Service - the centralized online application service you'll use to deliver your application, along with supporting documents, to residency programs
MSPE: Medical Student Performance Evaluation - a summary letter of evaluation intended to provide residency program directors an honest and objective summary of a student's salient experiences, attributes, and academic performance.
NRMP: National Resident Matching Program - also called The Match, is a United States-based private non-profit non-governmental organization created in 1952 to place U.S. medical school students into residency training programs located in United States teaching hospitals
What is an away rotation?
You’ll hear away rotations called “sub-Is”, “audition rotations”, and “visiting electives” interchangeably. They’re all the same. An away rotation is basically a four (sometimes two or three) week rotation spent at a different institution. They can be fairly high-stakes… it’s a chance for a program to get to know you, and for you to get to know them! But it’s also like a month-long interview, so there can be a lot of added pressure to perform your best every day.
The main goals of an away rotation are to:
Explore a residency program
Secure a letter of recommendation
Better understand the culture of the specialty at different hospitals
Meet specialty or degree requirements (these count as an elective)
Consider a specialty not offered at your home institution
Explore a specialty other than your intended specialty
Who should do an away rotation?
This varies! It depends on the specialty you’re applying into - the more competitive specialties (surgery, ortho, etc.) have an expectation that you complete at least one away rotation, sometimes more. Other specialties don’t expect or look for it on your residency application. Ask your advisors, people that sit on the admissions committee for your home program, or current residents what the trend is in your specialty.
You’ll hear conflicting advice about if you should or shouldn’t do away rotations! The answer is (unfortunately), it depends. Here’s a few pros and cons to consider:
Pros:
It’s a chance for the program to get to you, and for you to get to know them! Assuming all goes well on the rotation (i.e. you’re prepared, you work well with your team, you show up early and stay late, you generally exceed expectations) it can drastically help your chances of matching to that program. It’s also a great opportunity to learn more about the realities of the program - you’d be surprised to find places that you thought would be a great fit really aren’t.
It can help you learn what you want to prioritize in programs! You’ll get a feel for big or small, type of didactic, call schedule, etc. It’s the best exposure to various types of training you’re going to get!
It’s a small world - the staff from one place will inevitably know people other places, and if you do well, they can call on your behalf (this arguably matters more than anything else during interview season).
Cons:
They’re tough! Being fully prepared, all day, every day for a month is challenging. You’re also expected to be a stellar member of the team - meaning you should be carrying a lot of patients or scrubbing almost every case on a surgery rotation. They expect you to function like an intern, but that’s a big jump from the end of third year rotations and can be challenging to adjust to quickly. If it’s not a super smooth transition, it can hurt your chances of matching there.
Hours - you don’t track work hours at other institutions, so it can be VERY easy to end up at 90 or 100 hours a week, especially on surgical services. If you’re the only visiting student on service, you’ll be on call 24/7 for the month. You’re quietly expected to be in every case or checking in on every sick patient, irrespective of if you stayed the night before. Moral of the story - stacking rotations back to back (with only two days between to move and get settled) is TOUGH.
They’re expensive - the applications, deposits, subleases, travel, general life expenses cost a LOT. Plan for them - and reach out to financial aid early if you’re going to be swinging two rents.
How do I apply to an away rotation?
VSLO! It’s an online system that’s fairly easy to use.
All of the rotation offerings will be posted here, often before the actual application opens. Start looking early (Dec/early-Jan) to get an idea of the application requirements and the dates that are offered.
You can apply to as many dates and specialty combinations at an institution that you want to - the fee is per institution, so if you’re going to apply to one, apply to multiple. You get to rank the date and subspecialty preferences, and can change this list as time goes by.
Some of the rotations are on a rolling acceptance so time does matter! Others have a formal review date - just check each VSLO information sheet for the programs you’re comparing.
Here’s a list of documents you should do your best to gather as early as possible (start working on this in January). Some of these take time and/or are expiring, so make yourself a checklist and an easy-to-access folder. If they expire before the rotation is over, renew it now!
There’s a Brightspace page for Away Rotations - this includes a list of the documents that’s also below. They have contacts links for who you should talk to in order to obtain these… follow that advice! They know to expect your requests this time of year. Before randomly emailing (and overwhelming the Student Affairs inbox), check the site or see if it’s something you can obtain on your own! Once again, this list is based on the requirements listed on the Away Rotations page on Brightspace and students' individual VSLO research. Always do your own research (I especially encourage taking a look at individual program websites in case they ask for something that is not listed below) and refer to the updated official MCASOM intranet instructions and documents FIRST.
Optional Short Bio in VSLO (4k characters)
There’s conflicting opinions on whether this is required or not! The advice I most commonly heard was to offer your short elevator pitch as you would in an interview - where you’re from, what you’re pursuing for residency, any abnormal or interesting facts about your path so far. I’d keep it to a paragraph or two, nothing too elaborate. The programs that want a personal statement will ask!
ACLS training: it’s quite rare for programs to require this as it’s typically a fourth year curriculum component. If they do ask for it, you’ll need to get approval through MyLearning to join the course. There’s an online learning module (~2-3h) and an in-person component with the mannequin.
Course Title: Advanced Cardiac Life Support (ACLS)- HeartCode Complete
Course Code: 471001ALSS20
BLS certificate card - can find on MyLearning
N95 Mask Fit
Data and documentation of your recent/current N95 respirator fit testing results can be accessed through the OHS portal at the following link: https://ohs-prod-portalui.mayo.edu/OhsHome/Index
Fittings are offered on a walk-in basis at Mayo Clinic Occupational Health (Phoenix Campus SSB Building Room 2-900 (2nd floor) Hours: M –F 7 am – 4:45 pm)
Vaccination record
request through mccmsstudenthealth@mayo.edu OR
Download by yourself: on the intranet, go to mayoemployees.org >>
Current Employee >> Occupational Health >> Immunization History > Download Report OR Customize
Be sure this includes an updated TB test, flu shot, and COVID vaccinations.
TB test needs to be valid through the END of your rotation, not the start.
COVID is usually within 3m of starting the rotation
Influenza is annual.
***some institutions require MMR and Varicella titers in addition to Hep B, updated TB screens, and updated N95 fit tests through the end of your elective dates
Letter of Good Standing (LoGS): this is in the MedHub “Documents” tab and will be provided by the school. You shouldn’t have to request it unless one of your rotations opens for application VERY early in January.
This document should stand in for Professional & General Liability and Insurance at all programs. If you need a specific “Certificate of Professional and General Liability Insurance” you can request this through mcasomarzyr34@mayo.edu.
Some programs will also accept this for the background check and drug screen - others will want a more recent one within the last 6 months.
Drug Screen - LoGS should cover this, but if you need an updated screen:
Mayo Clinic Occupational Health Phoenix Campus - SSB Building RM 1-200. Call 480-342-2304 to schedule an appointment.
Identify yourself as a student from Mayo Clinic College of Medicine and Science when calling to schedule your drug screen. Remember to bring a photo ID.
The cost of the test will be billed directly to the college and there is no charge to you. It will take several days for your sample to be processed and results returned for the Mayo Clinic Medical Review Officer (MRO) to process. Once it is complete, you will receive a copy of your results from Student Services.
School Transcript
Email comregistrar@mayo.edu
USMLE (STEP 1) score report
If you did not retain the original score report, you can request a replacement copy from USMLE! Keep this one - they expire after a few years.
MyLearning Transcript
check out this instructional manual for how to download the transcript
CV
Personal Statement
Pay attention to if they ask for a personal statement or a cover letter for that program - you’d personalize the cover letter
You’ll need to submit this to Mayo - it shows approval from the Residency Advising Director for each away rotation you accept. Super easy - just email them and say you’re doing a rotation at XX institution and need their approval in writing. They’ll send back the okay - download this and submit! You’ll likely also need the course description from the VSLO site or the school catalog and the letter (or email) of acceptance from the host institution.
Don’t do these until you’ve finalized your rotation schedule! There’s no rush - just a few weeks before you get started on the aways.
Elective Proposal Form
If you worked with a mentor at a different institution to schedule a rotation outside of VSLO, you’ll need to fill this out to get credit!
Fall - January
Meet with your career advice to talk generally about your match strategies
Write/update your CV. You will send this to your letter writers and it will be helpful for completing your ERAS application
Start brainstorming your personal statement. Some letter writers will ask for this so it is helpful to have a draft. Most students don’t finalize this until the summer, however.
Identify potential letter writers
Register for VSLO (you'll receive an email from MCASOM)
January - February
Gather documents necessary to apply
Finalize list of places you want to rotate at
Set up VSLO profile
End of Feb - March
Applications will begin to open and you can start applying (rolling admissions)
April - May
Start hearing back from programs
This is the tricky part where you're often given a few days to respond and accept your admissions. What can be tricky is accepting an admission in time may mean potentially losing out on a program that hasn't gotten back to you yet. It's generally considered poor form if you accept a spot then drop it later (i.e. closer to the start date) because you're throwing many different schedules off, so make your choices wisely and stick to your decisions. You can always ask for an extension if you really need time to think! You may not get it, but it's better than dropping a program (and garnering a bad reputation).
June - September
Go be a great Sub-Intern! Check out this page for tips on how to be a Stellar Sub-I.
You might have already written a CV in medical school, but you will definitely need to update it for your VSLO/away applications and may need send it to your letter writers and advisors to show them what you've been involved in during medical school. It is also helpful to reference when completing your ERAS application.
Recipes for Success:
Do this early like in January or February.
The medical school has a template on the intranet you can find if you need help getting started.
It can be helpful to divide research into “publications, presentations, under review, and in process” rather than discussing each individual project.
You can underline or bold your name in the list of authors for your research projects to make it easy to find your name.
Focus on making your CV easy to read and professional. No crazy templates, doodles, or pink font.
The residency personal statement is very similar to the medical school personal statement but shorter. It should be less than one single spaced page in 12 pt Times New Roman font. DO NOT go over one page because some people will simply throw out your essay without reading it if it goes onto a second page. It should be narrative, engaging, well organized, easy to read, and highlight why you will be a great resident in your speciality. Obviously this is a tall order and it takes time to write a strong personal statement. Ask for edits from people who know you well both inside and outside of medicine. Mentors who review applications for a residency or fellowship can be especially helpful.
Recipes for Success:
Focus on why you want to be a doctor in your specific specialty rather than why you want to be a doctor in general.
Avoid listing the aspects of the speciality that you like and instead connect your interests/passions/experiences to specific parts of the specialty. Most people who choose orthopedic surgery like working with their hands and most people who choose OB/Gyn love the variety of the field. Instead of listing those things, use stories to illustrate how the field connects to you personally. Imagine you are seeing a unique version of your specialty through the lens of your experiences and interests.
Also remember you're not trying to convince your reader why this specialty is so great. They're already doing it! They want to know why YOU want to do it.
I have heard mixed advice about starting your essay with a meaningful patient encounter. Some people feel it is overdone and others think it can be effective. I personally chose to avoid it because I thought it would help my essay stand out. If you do start with a patient encounter, make sure the focus quickly shifts back to you and your strengths. And this should be obvious, but be careful about sharing protected health information.
Don’t be afraid of the Terrible First Draft. One of the hardest parts of writing a personal statement is starting. I wrote many terrible drafts and it took time for me to connect ideas from different drafts into my final personal statement.
Don’t use AI/Chat-GPT to write your personal statement because it will sound generic. You can use these tools to help proofread or fine-tune what you write.
You can personalize your personal statement to different residency programs if you want.
***
Away rotations are EXPENSIVE. There’s a lot of expenses that pop up that you might not anticipate… work with financial aid to be sure you’re not going to cut it too close on your budget.
Processing/application fees: It costs $15 per program that you apply to - this covers as many dates and subspecialties within that department that you want, but once you branch out of that “program” you’ll owe another $15. (Ex. you can apply to colorectal surgery for 3 different months AND transplant surgery for two different months for $15, but if you add a critical care rotation (i.e. department of medicine, not surgery), you’ll owe another $15.
Most programs also require a deposit if you accept the spot. This ranges from $50-300 per program and will be due within 48h-7d of being offered the spot.
Traveling: plan to pay for your flights/drive to rotations. If you’re doing back-to-back rotations, you’ll need to arrange to travel the Sunday before - occasionally they’ll want you to round on Saturday morning at the end of the rotation.
Lodging: if you have family/friends in the area that you can crash with, DO IT. You likely won’t be there all that often anyways. Otherwise you’ll need to sublease - rotatingroom.com is designed for students/residents. Other helpful sites are those designed for travel nursing. There are also Facebook sites in major cities for subleases/short-term rentals. Other options include AirBNB or long-term hotel stays.
The cost varies widely by city and the living arrangement. Most that I talked to averaged between $1000-1500, but this is super variable.
Other Expenses:
Parking - sometimes you’ll need to pay for parking at the hospital! Anywhere from $50-200 for the month.
Transportation - public transit or Uber, depending on the city you’re in.
Food - you’ll likely have less time to cook/meal prep than you’re used to, which translates to more meals bought in the hospital cafeteria or eating out.
Random things - budget some extra cash for the random things you’ll forget/want on the rotation. Some subleases don’t have a coffee machine (yikes), tupperware, basic cooking ingredients, detergent, etc. It’s easier if you have money set aside for things instead of stressing about each last-minute purchase of something that you had at home.
Here are some helpful slides from the Jan 2024 VSLO webinar. You can find the full webinar PPT here.
Goals for Pursuing Away Rotations: students use away rotations to...
Explore a residency program
Secure a letter of recommendation
Meet specialty or degree requirements
Consider a specialty not offered at their Home institution
Explore a specialty other than their intended specialty
Before you start your Sub-I:
Know the differential diagnoses for common complaints
Can’t miss diagnoses
Common clinical decision rules
Common treatments
Presentation skills
Ask yourself:
What interests me the most?
Where am I deficient or less strong?
During the Rotation:
Be on time
Be enthusiastic
Be prepared
Never lie
Own your patients
Ask questions
Interact with your team
Adhere with administrative requirements
Be humble
Have some fun!
Exercise, sleep, rest
Do something “local-ish” - great thing to ask residents/attendings!
Meet with faculty & residents
Interview with us
Request a Departmental SLOE
written February 2024 by Megan Campany and Isra Abdulwadood