EM Away Rotations in a Pandemic

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Author: Lauren Lamparter – President, AAEM/RSA Medical Student Council

Originally published: Common Sense
March/April 2021

For the third-year medical student, the emergency medicine residency application process starts with applying to away rotations. This year, uncertainty remains around the possibility of aways, but hopefully, as COVID-19 vaccines are distributed more widely, travel and away rotations can become possible. One of the past AAEM/RSA Medical Student Council Presidents, Dr. Michael Wilk, wrote an article, “Seven Tips for Selecting Your EM Away Rotations.” His advice remains true whether you are able to rotate only at your home EM rotation, participate in one of the new virtual EM electives, or travel and participate in an away. So, here are his seven points, with my updated insight and an eighth point, for approaching the EM away rotations in a pandemic world.

First, apply for your rotations early. Whether virtual or in person, the application process for away rotations is rolling, so the earlier your application is submitted, the greater chance for acceptance. Most programs rely on the VSAS application system, but some schools have their own or a supplemental application. If there is a particular program you would like to apply to, be sure to follow their website instructions closely. Additionally, almost all programs require vaccination titers, so check your records and update as needed to prevent any delays in acceptance.

Second, location, location, location. If you know you would like to go to residency in a particular region of the country, this is where you should apply for away rotations. If you are unable to travel, there might be a program in this region offering a virtual rotation experience. These virtual rotations allow you to interact with a wide range of EM faculty, residents, and fellows and can give you a real glimpse into life at that program.

Third, academic vs. community vs. county. One benefit of an away rotation is experiencing a type of hospital that is different from where you have done your medical school training. In an ideal world, your away rotations would allow you to experience and compare these hospital systems to assist in your decision of which residency program you would like to attend prior to the application season.

Fourth, three vs. four-year programs. It is stated that the ideal EM residency length is 3.5 years, so programs have chosen either three- or four-year models. If a program is ACGME accredited, it will give you a good EM training regardless of the length of time. Ultimately, choose based on the programs you love, rather than the length of training.

Fifth, how many rotations should I do? This past year, EM applicants were advised to do only one EM rotation to obtain one SLOE (standard letter of evaluation). If you are allowed to travel and do away rotations, the recommended amount is two, a rotation at your home program and one away. Some students choose to do more, but keep in mind how draining these rotations can be as you “audition” for an entire month. If in person rotations are still not allowed, some of the virtual rotations offered narrative letters of recommendation, which can also be included in your residency application.

Six, when should I actually rotate? You should try to rotate early enough that your SLOE will be submitted prior to the submission of your residency application so that your file can be complete and ready for evaluation. It is also advised that you do an away rotation after completing your home program’s EM rotation, but this might not be possible.

Seven, have fun! You have finally made it to the goal, EM! Be yourself and enjoy learning and experiencing emergency medicine. Get to know the residents and assess the environment to see if it is right for you. Even if the rotation is virtual, you will be able to meet potential future co-interns and gain insight into your future specialty.

Lastly, eight, write down any memorable patient experiences or stories.
In just a few short months, you will be on the interview trail. What you experience at your home rotation, an away, or even a virtual rotation will become stories to answer residency interview questions. The more you record as you experience it, the better memory you will have of these moments.

Good luck!

Dr. Michael Wilk’s original article with his seven points and advice can be found on AAEM/RSA’s website: Seven Tips for Selecting Your EM Away Rotations. https://www.aaemrsa.org/get-involved/students/selecting-away-rotations.

For more information and advice on the EM Clerkship, see also our AAEM/RSA podcast episode 76: Ask Me Anything: About the EM Clerkship. https://www.aaemrsa.org/get-involved/podcasts/episode-76