One of the most frustrating and confusing aspects of third-year as an international medical student who will eventually be applying to emergency medicine residency programs is navigating the process of away rotations. This guide has been written in Q&A format to answer the most common questions asked by third-year students. If your question is not answered sufficiently by this guide, please contact one of your fourth-year EMIG officers.
Also known as a “visiting student elective” or “visiting student clerkship,” away rotations are short, usually 4 weeks in duration, courses taken at an outside institution.
At Ochsner, an away rotation specifically refers to a rotation done at an outside institution during the fourth year of medical school. An optional elective is a rotation done at an outside institution during the vacation period between the third and fourth year of medical school. To prevent confusion, in this guide any rotation done at an outside institution will be referred to as an away rotation rather than an optional elective, but keep these terms in mind when dealing with Ochsner administration.
You can apply to do an away rotation in any specialty, but for the purposes of this guide only away rotations in the discipline of emergency medicine will be considered. Ochsner allows a maximum of one optional elective and 2 aways including 1 at Ochsner (home institution).
They allow you to obtain standardized letters of evaluation (SLOEs). This isn’t the only reason, but it is the most important. One SLOE is obtained per away rotation.
A SLOE is a letter of recommendation that is specifically used to evaluate emergency medicine applicants. It is unique to emergency medicine and is a major component of the residency application.
The letter itself is mainly in check-box format and requires the evaluator to assign the student to either the top, middle, or bottom third when comparing their performance on the rotation to that of their peers during that academic year. Some of the qualities assessed are listed below:
A SLOE must be obtained from an institution with a residency program.
Ochsner, as of 2020, has an ACGME accredited EM residency. Therefore, Ochsner is an official "home institution" and may grant a SLOE. It is highly advised to complete a home institution rotation.
Most Emergency Medicine program directors agree that 2 SLOEs from outside institutions is sufficient for an application from an Ochsner student. 3 SLOEs from outside institutions gives them even more information and is preferred to 2, but is not imperative.
There is also an option of doing a 2 week rotation in ultrasound, toxicology or general EM. These shorter rotations may not result in a SLOE but can get you face-time with a program and possible LOR.
In summary, try to schedule 3 away rotations which will result in 3 SLOEs. However, if only 2 away rotations are able to be completed that is perfectly acceptable. One away rotation may not provide programs with enough information about an applicant’s competence and commitment to Emergency Medicine and is considered risky.
This section will be fully updated once Ochsner administration finalizes the curriculum changes for this year.
It seems that there will be at least two opportunities to complete away rotations in EM during 4th-year. One will be the optional elective during the break between years 3 and 4, and the other will be during a dedicated elective rotation. The ED/Ortho block is another chance for a rotation. Per faculty, this one should be done at Ochsner if possible.
As of now, this option no longer exists. We will advise on any updates.
-Advanced Hospital Practice should be your first block with ED/Ortho either 2nd or 3rd rotation.
-Elective rotation should be 4th
-Australia return rotation can be done 1st, 2nd, or 5th
All US medical students use the VSLO system to apply for away rotations. It is an online application service that is used by the vast majority of Emergency Medicine programs to select students for rotations. Ochsner has limited access to this system. Instead, Ochsner students must contact programs directly or submit paper applications if the program happens to have them. This makes arranging these rotations a very labor-intensive process. The following is a step-by-step process for arranging an away rotation.
Look at the list of Emergency Medicine programs on this website to see which programs have accepted Ochsner students in the past. Other things to consider are location of the program, cost (most programs are free, but some cost $1000s), rotation difficulty, and program reputation.
For a real-time exhaustive list, visit the VSLO (Visiting Student Learning Opportunities) website to search for programs that offer away rotations. Ochsner students do not have full access to VSLO, but those programs who participate in Global Health Learning Opportunities may be available . Visit the program website, or search “program_name clerkship” to see what each specific program requires.
In the past, students have also had great success at securing away rotations by attending conferences. Talking in-person with program directors who want to talk to you will increase your chances of securing an away rotation. SAEM and ACEP have residency fairs for you to visit and talk with 100+ program directors/associate program directors.
Explore the program website to determine their application process. If the process is not clear from the website, which is often the case, contact the program coordinator to determine if and how you can apply. A step-by-step process and sample email are outlined below.
10. Thank them for their time.
Here is a sample email. Please do not use this verbatim.
Good afternoon,
My name is John Doe, a 4th-year medical student at the University of Queensland-Ochsner Clinical School in New Orleans. I’m very interested in the emergency medicine program at University Hospital and would like to apply for a visiting medical student clerkship. Although I do all my clinical rotations in New Orleans and am a US citizen, I am considered an international medical graduate since my first two years of medical school were done in Brisbane, Australia. As a result, I do not have access to VSLO. Am I able to apply for a clerkship and, if so, is there an application I can fill out?
I would be grateful for the opportunity to rotate at University Hospital and am happy to provide you with whatever additional information you may need. For your convenience, I have attached my USMLE Step 1 score report and my CV. Thank you for your consideration.
Sincerely,
John Doe
Be sure the dates of the rotation work with your year 4 schedule.
Once an application has been accepted by the institution, approval must be obtained from Ochsner and UQ administration.
The process is slightly different if arranging an optional elective or away rotation, but both are very similar.
Start by reading the Optional Elective or Away Rotation Process Form, depending on when you intend to do the rotation. These forms outline the rest of the approval process and may be found on New Innovations. The process may take 6-8 weeks, sometimes longer, so be sure to submit the paperwork as far in advance as possible.