Away rotation advice and requirements for medical school clinical rotations with Mark Meyer, MD

. 8 MIN READ

AMA Update covers a range of health care topics affecting the lives of physicians, residents, medical students and patients. From private practice and health system leaders to scientists and public health officials, hear from the experts in medicine on COVID-19, medical education, advocacy issues, burnout, vaccines and more.

Away rotations play an important role in the clinical education of medical students. Mark Meyer, MD, senior associate dean for Student Affairs, at University of Kansas School of Medicine, joins to provide an overview of away rotations and discuss their benefits and the impact they can have on residency applications, matching and students' free time and finances. AMA Chief Experience Officer Todd Unger hosts.

Speaker

  • Mark Meyer, MD, senior associate dean for student affairs, University of Kansas School of Medicine

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Unger: Hello and welcome to the AMA Update video and podcast. Today, we're talking about the latest trends in away rotations. Our guest today is Dr. Mark Meyer, senior associate dean for student affairs at the University of Kansas School of Medicine. I'm Todd Unger, AMA's chief experience officer in Chicago. Dr. Meyer, thanks so much for joining us today.

Dr. Meyer: My pleasure. Thank you for the opportunity.

Unger: Well, for many medical students, away rotations play an important role in the clinical years of their education. Let's start with a brief overview of what away rotations are and what their benefits are.

Dr. Meyer: Sure. Thank you, Todd. An away rotation is a clinical experience completed outside of the student's home institution or its affiliates. While traditionally performed at academic health centers, community hospitals, both metropolitan and rural, can offer away rotations.

Key benefits include they can potentially increase the likelihood of a student matching with the program or at least within the specialty itself. Additionally, students often are able to obtain letters of recommendations from faculty at the away rotation, which are essential in the overall application portfolio.

The student also can gain additional experience in that specialty at a facility outside of their home institution. And finally, most students view it as a month-long audition with the program. But it also importantly allows the student to gauge their interest in that program as well.

Unger: Well, you're kind of touching on the next question a little bit. But let's just talk more specifically about how away rotations can play a role in helping students stand out in their residency applications. We know matching is kind of probably top of mind at this point for those students. How has that role kind of changed in recent years?

Dr. Meyer: Yes, indeed. The end goal is to have a job at the end of medical school. And with respect to the importance of away rotation, it depends in part on the specialty itself. Generally speaking, surgical subspecialties place greater emphasis on away rotations than, say, do some or most primary care specialties.

For the competitive specialties, such as the surgical subspecialties, as well as, say, dermatology, away rotations are considered almost an essential component in the overall application strategy as programs place great value in these experiences in terms of gauging student interest, assessing their abilities and overall compatibility with the program.

From the student's perspective, away rotations provide an extended opportunity for them to demonstrate not only their knowledge, skills and abilities, but also their work ethic, communication and team-based skills, and overall professional attributes. I'll also mention importantly that away rotations are mandatory when a student's home institution doesn't have a residency program in that field for example, ophthalmology, urology, EMT, to name just a few.

With respect to recent changes and, again, primarily for the most competitive specialties with step one going pass/fail, away rotations provide another data point or source for programs to consider and likewise for students to distinguish themselves.

And long-term away rotations do provide maybe an opportunity for students to engage potential future colleagues in that specialty field not only at the program where they match but with future faculty and residents at other programs as well. Because as students go into specialties, the population—the size of those entities becomes smaller and smaller.

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Unger: We've mentioned some of the benefits for both the institution and for the students. Let me ask you a follow-up question on the student front too. We recently had an episode about how students can evaluate if a program is a good fit for them. And determining kind of cultural fit, obviously hard virtually, which is where a lot of the interviews are today. But has that had any impact on how students think about their away rotations?

Dr. Meyer: Yeah, absolutely. Because the landscape is changing. During and now post-COVID, things continue to be somewhat in a state of flux. But in general, as everyone knows, medicine is a social, interactive profession. And in-person engagement is always better than virtual engagement in terms of assessing the full extent of other individuals, as well as programs.

Away rotations are a two-way process. Programs assess students and students assess programs. Away rotations allow both parties to gain a broader and deeper understanding of one another. While many students fully enjoy most of their away rotations, there are instances where students decide not to rank or will rank lower a program based on that away experience.

Away rotations aren't just a way for students to stand out to residency programs. They also are a way for students to see which programs stand out to them, how well they fit, what's their gut tell them about the program. Because rotations are valuable on multiple fronts, students should initiate exploration of programs well in advance.

These are important decisions. And so a proper amount of investment and investigation should occur. Web resources such as the AMA's FREIDA program, as well as the Residency Explorer tool, are valuable on multiple fronts. And students should initiate this exploration well in advance.

Unger: You mentioned the word "investment." And for a student thinking about an away rotation, they're going to have to consider the cost implications and obviously the time commitment. Just for perspective, how much time and money are you seeing students invest in their away rotations? And is that investment paying off?

Dr. Meyer: Yeah. Away rotations require, as you referred to, both an investment of time and money. Rotations are typically four weeks in duration. And the dates provided by host institutions may not align with the student's school-based rotation thus requiring adjustments in their schedule. There's also the monetary investment, including not only travel to and from the site but travel while at the site, as well as food and housing and other incidental costs.

Depending on the location, these expenses can range from a few hundred to over $1,000 when factoring in all expenses. With that said—and I emphasize this to my students—performing in an away rotation may provide an excellent return on investment, particularly when considering the student's overall medical education debt.

Unger: Absolutely. Well, you've certainly given students a lot to think about. For students who want to learn more about away rotations and the process of applying for them, where should they go?

Dr. Meyer: Well, there are several valuable resources. Probably, a hallmark site that they should look at very early on is the Visiting Student Learning Opportunity site through the AAMC. I previously mentioned FREIDA. The AAMC site also gives you access to the Residency Explorer tool.

There are other resources out there. And students should always consult with their home student affairs office for direct guidance and personalized guidance because it is a process. And the more students engage others within the field and their home office, they will be much more effective and efficient in carrying out this important part of their professional careers.

Unger: Excellent. And you mentioned FREIDA. For those of you who are not familiar with that, FREIDA is the AMA's residency and fellowship database, where students can find all sorts of information about potential programs. And you can find that at freida.ama-assn.org. And FREIDA is F-R-E-I-D-A. We'll put a link to that in the description of this episode.

Dr. Meyer, thank you so much for joining us. That wraps up today's episode. And we'll be back soon with another AMA Update. Be sure to subscribe for new episodes. And find all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us today. Please take care.


Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.

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