The Ortho Gunner

Away Rotations - Directory of Posts

This category is about Away Rotations. Please check out the following posts:

Away Rotation Etiquette
Where To Do Aways?
Mapping A Program

Mapping A Program

What does "mapping a program" mean? It means exactly what it says - you need to draw a map or diagram of any Orthopaedic program you are rotating at. Like any culture, every Orthopaedic Program has a politic and life of its own. You need to put your finger on the pulse of the dynamic within the department. You need to be in the know. Here are some questions you need answered:

Who is in charge? Who makes the decisions? Who has input? Who is liked? Who is disliked? Who knows someone you know? Which residents will help you out? Which residents are most liked or disliked?

These are all questions you NEED TO KNOW when you are at a program. You do not want to ask an attending his name. If you do that, then just go home and forget about that program, you will be done.

When you rotate at a program, you are trying to break in and kiss some serious butt and get on their good side. You are really utilizing the 3-Pronged Approach in a face-to-face format and trying to break into Fort Knox. In order to do this, you need a map of the program and a plan of how you are going to use that map.

Once you figure out your strategy of getting in good with the people who have the most influence in the department, then you need to execute. Work hard, round early, stay late, and follow Away Rotation Etiquette and you will do well.

Where to do Aways?

If you are starting your 4th year of medical school and are applying for Ortho, then this question must be consuming you. We have been there and understand the anxiety, stress, and indecision that can come with selecting a program to do your away rotation. Depending on your medical school, you only have time for two to four away rotations. You want your rotations to be high yield. No matter what your numbers are or what you look like on paper, you need to be hopeful and ambitious, yet practical and realistic through the application process. Choosing where to do aways is perhaps the one remaining thing that can significantly affect your match outcome.

For the most part, Ortho programs will usually take a rotator versus a non-rotator with equal qualifications as long as that rotator did well during his rotation. Most programs will probably take a rotator who is slightly worse on paper than a non-rotator. Most programs will probably not take a great rotator with significantly sub-par numbers and paper application.

Much of the decision about choosing an away, depends on what you are looking for in a program. We have a post about "Choosing A Program" that outlines more general considerations for choosing a residency program. This post is about choosing your away rotation. As an applicant your main objective should be to match at your most desired Ortho program.

If you are an all-star applicant on paper, you will likely get many interviews based on  your numbers and thus our advice is to rotate at one dream program and one upper middle tier program.

If you are an average to above average applicant, you want to find a program that favors rotators and that has some above average residents. Our advice is to rotate at either one dream program and two middle tier programs or at three middle tier programs.

If you are a below average candidate, you want to find a program that favors rotators, has few rotators, has a lesser reputation, and anywhere your advisor or supporters might have a connection. If you are in this situation we recommend rotating at as many programs your school allows, usually three to four lower tier programs. We do not recommend even considering programs out of reach other than your home program.

When choosing your aways, you have to understand that this is a competitive process and you want to go where the money is. It is a good idea to find out what the ratio of rotators is to available residency spots. If you desired program has two spots and typically 30 students rotate their per season this is definitely lower yield than a program with 30 rotators and 10 spots available. Thus we recommend that you do your homework, make phone calls to find out how many rotators come through each year at various programs.

In choosing where to do aways you have to take into consideration YOUR priorities in a residency. Do you want to live in a particular state? Do you want to stay close to family? Will your spouse or partner be happy at that program? Do you want a career in academics or are you going to be a community practitioner? You ultimately want to find a program that you will thrive at for the next 5 or 6 years. You don't want to be in misery for your residency and you don't want to be in the situation where you need to switch programs.

Away Rotation Etiquette

Since we are knee deep into away rotation season, we wanted to provide you with some pointers on Away Rotation Etiquette. There is an etiquette you need to follow when rotating at an Ortho program. You need to understand that an away rotation can make or break you. You need to fit into the program you are at. You need to kiss ass without giving people the impression that you are kissing ass. You need to understand that you are a guest at a program. You are on a month long job interview. Here are some tips:

1. When you see any Orthopaedic Attending, greet him appropriately. If you are bold,  you can introduce yourself. The point is that if you greet attendings, they will wonder who you are and will ask the residents about you. It is flattering for them to know that you want to come to their program. Know everybody's name.

2. Do not annoy anyone. This one is easier said than done. There are some residents who will dislike you after ten minutes. The point is to not give anybody a reason to think you are annoying. Do not keep saying that you want to go to this program. Do not keep asking stupid questions. Do not show off or answer questions that make your resident look bad.

3. Be everywhere at all times, but be invisible. You want to be there always, but you don't want to be around so much you get on people's nerves. You don't want people asking where you are. Just be around, be accessible. Blend in without crowding space.

4. Do not try too hard to fit in. Be yourself. The thing about away rotations in Ortho is that everybody is trying to impress and fit in. Residents don't really care what your numbers or resume looks like. Residents want to know that you are a hard worker and won't weaken the team. Residents want to know that you will be a friend of theirs if you come to the program. They want to know that they can grab a beer with you or go hang out. They want people that are going to make life as a resident easier and more fun. So if you are rotating at a program, realize this and try and figure out if the residents are the kind of people you would hang out with. If you don't like them, then they probably won't end up liking you and you will probably be unhappy at that program.

5. Do not ask for favors. Doing an away rotation sucks. You are poor. You do not know anybody. You will likely need favors such as rides to here and there, etc, etc. Do not ask to crash at their place for a few days. In general, do not ask for favors from residents. They are not your friends. Hopefully by the end of the rotation they will be, but asking for favors with get you know where. Similarly, do not ask if they want to hang out or go out. If you are liked, they will ask you.

6. Do not treat your rotation like a vacation. If you are rotating at a place near fun activities, you don't want to let everybody know that you are taking the weekend off to go skiiing. Nobody wants to hear that while they were on call their medical student was off enjoying life that they can't. Save your vacation for after you match. You don't want to be regretting that weekend skiing when you don't match.