A frank discussion

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5 years 10 months ago #33549 by averagejoe33
Replied by averagejoe33 on topic A frank discussion
Qualifier - PGY1, feel like I just went through all of this.

Everything in here is great advice. Some of it I knew was important last year after interviewing, other stuff I've realized this year seeing rotators and hearing some of the discussion among residents and staff.

Sticking with the topic though, and echoing what others have said, the best advice I have for any applicant is to be honest with yourself before you apply for aways. I know the common formula is shoot for 1 reach, 1 realistic place, and 1 safety. I'm not a proponent of that formula though, especially coming from a lower-tier med school with a bunch of other applicants. If you have any doubts at all about your competitiveness, I really urge you to only rotate at places where you think you'll have a good shot with a good performance on your rotation.

The next question is, how do I know how competitive I am? Look to see if previous applicants from your school (or similar tier/reputation) have matched there. Everyone wants to rotate at HSS, I'm sure it's a great experience but probably not the most effective use of your very limited time for 90% of people.

What are your goals? Do you want to write books? Do you want to be a program director? Do you just want to operate all day long? There's nothing wrong with lying either way on the spectrum, just be realistic based on your goals. If you have a strong interest in research, I would advise against rotating at multiple community programs, even if you feel you're not a strong applicant. It's pretty obvious to residents whether or not you'll "fit in." Likewise, if you just want to learn how to be a great surgeon, I wouldn't waste time at a research powerhouse. Maybe you aren't sure about your goals now, and that's fine. Try to find some places that have a good mix of everything. These also tend to be the places with 5+ rotators every month, meaning by the end of it you're competing against tons of other qualified applicants.

These seem like simple guidelines now, but I really didn't think this way when I was looking at places to rotate. Bottom line is that rotating at a place is the number 1 way to increase your chances of matching at that place. Choose your rotations wisely, don't waste a whole month somewhere you aren't going to be a good fit.

Good luck everybody.

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5 years 10 months ago #33580 by bonetrauma2
Replied by bonetrauma2 on topic A frank discussion
Agree with much of what has been said already. Also a PGY1 here so have recently seen both sides. Apologize ahead of the time for the length.

Away rotations- Bonedoc is spot on about away rotations. They can be extremely helpful if you do all the things you are supposed to do like reading for cases, being involved, interested and engaged, knowing the patients your team is taking care of, and generally being a normal human being. That may all sound like common sense but clearly not after witnessing some of our rotators this year. Laziness, not knowing a darn thing about the cases you are scrubbing on (provided you knew the cases ahead of time), falling asleep in conferences etc. This is a month long interview, it is a long process and its tiring but don't let up on your away rotations, it will hurt you and you will have wasted a month. Do all the things you are supposed to and do them well. Don't be fake, be yourself (really, trust me, everyone will be happier that way) and work hard. And absolutely what averagejoe said, pick your aways wisely and pick places you are really interested in ending up at.

Step 2- Step 1 is obviously one of, if not the, most important factors in getting interviews. However, Step 2 is becoming more important. If your step 2 score isn't in by applications or you drop significantly from your step 1 score that becomes a big deal in my opinion. There are plenty of people with high Step 1 scores, all else being equal, Step 2 can elevate your application or hurt it if you think that because your step 1 is high enough that it can overcome a pending or a lower Step 2 score. You've obviously done well on step 1, take step 2 early and take it seriously. If you score 270 on step 1 that is obviously hard to replicate but if you score 257 or something on Step 1, it looks weird if your step 2 comes in at 242. The vast majority of people improve on Step 2, do not underestimate the importance of improving or coming pretty close to matching your step 1 score.

AOA- I've mentioned it before but I think it is becoming more and more important in distinguishing applicants that all look very similar. Don't disregard early classes because you think no one cares about pre-clinical grades. Pre-clinical grades matter for class rank and they matter for AOA nomination.

Research- any research. Ortho is better but any research will do. Programs want to see that you have done some, understand the steps of a project and have demonstrated at least some minimal interest in advancing medical/scientific knowledge. You have to complete a project in residency, they don't want to hold your hand through the whole project if you have zero experience in how research works. Huge advantage if ortho, pubs, or numerous presentations but have some research on your app even if it didn't amount to anything, it shows you've done some and know something about the process.

Connections/Letters- not always a whole lot you can do about these but ortho is a small, small world. Everyone knows everyone in their field it seems and who your letter writers are and how strongly they recommend you play a big role come interviews. Multiple interviewers brought up my letter writers and where/how they knew them. One place even called up one of my letter writers to ask about me :ohmy: . We always say it is more important to have a great letter from someone who knows you than an ok letter from a big name. Whats even more important is a great letter from a big name. If there is faculty at your program that you feel comfortable with and have a good relationship, it may be worth it to have them contact people they may know at other programs and put in a good word. You have to have that type of relationship with them which is why it is important to start making connections as early as possible. I would recommend getting letters from people that are involved in their respective sub-specialty meetings/organizations because they are more likely to know and have relationships with faculty from other programs which can help out when they are reading your letters.

Just my two cents from my own experience and thoughts on a very convoluted, non-straightforward, stressful process. Others may disagree or have different experiences which I think just shows that nobody really knows everything that goes into a successful application.

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5 years 10 months ago #33669 by recentgrad
Replied by recentgrad on topic A frank discussion
I've been through five years of residency applicants and medical student rotators, and agree that away rotations are key. There have been a handful of applicants so good on an away rotation that nearly nothing else mattered, and the residents advocated for them to get an interview and get ranked to match.

I do disagree a bit with the idea that folks should only rotate at places that interview all rotators. Here's what I think: your away rotation IS AN INTERVIEW. It is a month-long, 24/7, high stakes interview. If after that interview, the program doesn't think you are a good fit, then they are doing you a favor by not inviting you back for the one day interview. They are saving both you and themselves time and money. This, of course, makes the decision of where to rotate critical. You should be able to see from this site or word-of-mouth which programs are blue-collar hard-working places, and which are buddy-buddy Game of Thrones style political institutions. Know what you are getting into.

Also, the only people I remember not giving an interview to after rotating all made critical mistakes: not being teachable/humble, not working hard, lying, or throwing residents under the bus. All these seem like things no one would ever do, yet I saw them all.

Away rotations ARE interviews. Do well and you are well on your way to a spot. You can mess up by rotating at places you should have known weren't a good fit for your personality, or you can mess up by your personality - and if your personality flaws are substantial and you can't hide them over a month while tired/hungry/stressed, then no board score or AOA or research can save you. And if you rotate somewhere and don't get an interview, as much as it sucks, I still think that's better than a program wasting your time by giving you an interview if they have already decided that they will never rank you to match.

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