Do I Need to Do an Away Rotation?


Away rotations are generally done for three purposes:

  • For fields that require or generally prefer Letters of Recommendation from institutions outside of your home school: Emergency Medicine, some surgical sub-specialties (e.g. neurosurgery)
  • Audition rotations (especially helpful for marginal candidates trying to “come off the page” or when trying to break into a specific out-of-your-region program)
  • For fun!

There are caveats:

  • Rarely will an away rotation get you an interview you are not qualified for. An away rotation may get you an interview you might otherwise not get. Needing a LOR or wanting to see a particular program out of your region is a good reason, but being “accepted” for an away rotation is not an indication of acceptance for residency or even a guarantee of a future interview.
  • Don’t let success stories drive you to do more aways than you want or need to do for your residency goals. Most spots nationwide go to applicants whom programs meet for the first time on interview day. The positive anecdotes exhibit strong confirmation bias.
  • The reverse is probably truer: there are sadly many people who didn’t get interviews at programs they did aways at because the away was out of their reach academically. Or, they are simply interviewed as a courtesy. Don’t expect a miracle because you are pleasant and hard-working. Most people are pleasant and hard-working.

You will apply through VSAS (the Visiting Student Applicant Service), which opens in Feb/March for the coming academic year. You will need a professional-looking photo for both VSAS and ERAS in a suit/tie, nice dress, etc. You want this to be done professionally, as it will be the first thing people see every time they open your application. Leave the loud ties or deep v-necks at home. Your school probably has an on-campus photographer with reasonable rates. Not everyone can look good all the time (or even most of the time), so don’t be too embarrassed to let them touch you up, as long as they have a relatively subtle hand with Photoshop.

Keep in mind:

  • Rotation dates may not overlap perfectly with your school’s schedule. You may need to take vacation time to make your away rotations jive with your underlying schedule.
  • You may need additional liability insurance depending on the demands of the institutions you wish to visit. The coverage is usually required 30 days in advance of your rotation.
  • Some states that typically require more liability insurance on top of that which your school provides are Indiana, Kansas, Louisiana, Nebraska, New Mexico, Pennsylvania, South Caroline, and Wisconsin.

You may also be able to pursue international rotations (through your school or independently) but keep in mind that there are times (roughly September through January) that you will want to be around and available (Obtaining LOR, taking Step 2 CK/CS, interviews, submitting your ROL). If you’re gone around ROL time, you at least want to make sure you have reliable internet access.


Giles 05.10.15 Reply

Cheers for your excellent website! I’ve really enjoyed reading several of your pages. Might I please ask you a question about away rotations — would you say an IMG medical student would need to do an away rotation if he hopes to match in internal medicine with the hope of medical oncology sub-specialty fellowship? I’m not particular about where, and would be open to anywhere in USA. As I calculate, it would cost me thousands of dollars (US) to fly over, hire a car, accommodations, etc. I’ve heard away rotations might hurt as well inasmuch as I wouldn’t be familiar with US healthcare and might not impress immediately as I’m coming from a UK healthcare background. I don’t have visa issues however and speak English perfectly, albeit with a British accent. Would be grateful for your guidance. Cheers.

Ben 05.11.15 Reply

Typically international students do some sort of clinical work in the US, though I imagine a few get by when coming from the UK, Australia, etc. It’s defininitely an investment. Most programs would be looking to see that you know what coming here would be like, are serious about it, and know what it entails, as well as that you’re familiar enough with the system here to hit the ground running as an intern. Unless students from your school have a good record of matching without visiting rotations or your school advisors say otherwise, I’d venture that it’d be in your best interest to cross the pond. (Not having visa issues can go a long way though!)

RealHTC 11.22.16 Reply

IM elective vs. FM sub-I for IM residency candidate
Thank you for this awesome website. I am an international student who’s inclined to apply for IM residency.
Could you give me some thoughts on which rotation will help me most?
I recently received MSKCC elective at oncology department. However, UCSD also offered a sub-I rotation at FM in the same module dates.
In case I can not change my assigned period of time, which rotation should I go to?

Many Thanks!

Ben 11.22.16 Reply

I’m sorry I really have no idea. The better one is the one that gives you a chance to shine and will write you a good letter, but I don’t know which one that would be.

RealHTC 12.01.16

Thank you for your response. FM Sub-I offers inpatient service responsibility; whereas the oncology elective is outpatient-based. So I guess I should go for the FM sub-I? In terms of what I do, FM Sub-I works at medicine ward.
I am just worried that FM LOR does not count as IM LOR and I cannot make enough connection with IM through FM rotation.

Ben 12.02.16

Yeah, I do think an inpatient ward experience is generally the competence/experience people want to see.

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