Breaking Down MS4 Year: VSAS and Away Rotations

Whether you call them an away rotation, Sub-internship (Sub-I), or Acting Internship (AI), deciding if you should do a rotation at an institution outside of your own medical school is something you should start thinking about in the spring of your MS3 year. 

With that said, the answer on if you need or should do so is not always straightforward. There are a few things that you should consider when deciding if an away rotation is right for you:

  • Specialty choice: While there are many specialties that do not traditionally recommend an AI (ex. Family Medicine, Psychiatry) there are others where they are a real or unspoken requirement (ex. Emergency Medicine, orthopedic surgery)
  • Competitiveness: Remember – numbers are not everything, but they do matter (to an extent). If your application is not the most competitive due to STEP scores or clinical rotation grades, doing an away might help you if you perform impressively in a clinical setting 
  • Breaking into a geographic region: Throughout the season, I realized just how much geographic bias plays a part in residency applications. If you are set on going to a certain city/state for residency, it might be in your best interest to do an away there, regardless of the specialty. It not only shows demonstrated interest for your residency application, but it will also help tremendously with networking!

As always, be sure to speak directly with an advisor or trusted mentor to get their opinion on if you should do an away. For the rest of this post, I’ll be breaking down the application process and giving some of advice on how to perform well on your away rotation!

How to Find and Apply to Away Rotations 

The main way that students can apply for away rotations is through the Visiting Student Learning Opportunities Program hosted by the AAMC. To create an account, your student affairs office will have to send you a formal registration  invitation through the website. 

Once you have an account, you can begin looking through the database to see which programs are offering away rotations. Programs typically start uploading their catalog in February-March. 

There are also numerous resources for URM students. Many of these programs offer stipends to help you pay for travel, lodging, and other expenses. These opportunities do not specifically show up on VSAS, so you will need to research them separately. Here are a few to get you started!

Application Deadlines

On VSAS, programs may or may not have a deadline associated with the rotation. Typically, there is a generic deadline to apply that states “31 days before the start of the rotation”.

I strongly recommend submitting your applications by late April. Since applications are rolling, you want yours to be at the top of the pile. 

Best Time to Schedule an Away Rotation 

The earliest that you can start an away for most programs is June or July. I took my rotation in August-September. Taking it then worked out well with applications and allowed me just enough time to secure a letter of recommendation. 

Personally, I strongly advise against taking an away rotation during interview season if you can avoid it. While most programs are flexible with taking time off for interviews, it’s in your best interest to be “on” for the duration of your away rotation – this includes keeping time off requests at a minimum. 

Also, the further you progress through M4 year, the less you want to do, so do this rotation early. Senioritis is REAL

Me on the last day of my away rotation!

How to Impress on Your Away Rotation 

Going on an away rotation, is essentially a month-long interview. You want to show the program that you are hard-working, a team player, and the ideal future intern. These programs want a student that they can imagine working well with their faculty and current residents. 

  • Show up early: On the first day, establish what the expectations are as far as pre-rounding. You are essentially functioning as a resident, so plan to be there when the interns are there
  • Floor>OR: This one is specifically for surgical specialties. Much of intern year is not spent in the operating room, but more so on the floor triaging patients, placing orders, following up on labs, getting outside records, etc. It’s definitely the less glamorous side of surgery, but it is necessary! When there is a case going back to the OR, unless explicitly asked to scrub in, allow the M3 to go instead. You most likely aren’t going to do much as far as surgery (the residents will do that), but you can do a lot to help make things run smoothly and lightening the current intern’s workload  by sticking to the floor. For my rotation, I only went back to the OR around ~5 times.
  • Avoid doing/saying anything that can be perceived as negative: Once again – this a job interview! You don’t want to be looked at as a Debbie-Downer, by complaining about hours or workload. This can easily be misconstrued as being someone that is not prepared for the rigors of residency. Try to maintain a positive attitude as much as possible and stay away from negative talk, gossiping, etc. 
  • Secure a letter of recommendation: Don’t be afraid to get a LoR on this rotation! I know it seems rushed, but most faculty are understanding and know that the reason you are there is because you want to add something to your application. After my first week, I spoke with a resident about getting a letter and they advised me on which faculty member to speak with. 
  • If you are seriously interested in the program, arrange a meeting with the PD/APD: Simply introduce yourself via email or in-person, stating that you are excited about the rotation and would love to speak with them 1:1 about the program. At this meeting, bring your CV and personal statement. Also, come prepared with questions. Once again, network, network, network!

Are you planning on doing an away rotation? Drop any questions you have in the comments!

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