Clinical Rotations

How much do away rotations affect physician residency placement?

Brendan Murphy , Senior News Writer

AMA News Wire

How much do away rotations affect physician residency placement?

Sep 20, 2023

Away rotations—those in which a medical student does a clerkship rotation at an institution other than one affiliated with their medical school—have long been considered auditions for potential residency slots. A recently published study of ob-gyn programs, however, shows that the conventional wisdom that a successful away rotation can affect residency selection may, at the very least, depend on physician specialty.

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One-quarter of ob-gyn residency program directors responding to an annual survey indicated that only 35% of students who completed an away rotation at their program were guaranteed an interview with that institution. Nearly 70% of the program directors said that less than 25% of their current residents completed an away rotation, says the study, published in the Journal of Surgical Education.

“Traditionally, medical students have viewed away rotations as a really important opportunity for a program to see me and interview me,” said one of the study’s authors, Maya Hammoud, MD, also associate chair of education and chief of the women’s health division at the University of Michigan Medical School. “The expectation is that when I do an away rotation that the program is going to offer me an interview and that it actually raises my chances of securing a spot at the program. That is not the case for ob-gyn.”

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Of surveyed program directors, 77% said their program offered away rotations. But only a minority of those program directors (26%) were involved in the selection process for which medical students participate in away rotations. The lack of program director involvement in that screening process likely explains the lower-than-expected correlation between away rotations and interview invitations and eventual residency spots. 

As a clerkship director on the medical school side of the equation, Dr. Hammoud has seen this dynamic at play.

“It's the clerkship director who's usually in charge of those rotations and that includes selecting the students,” Dr. Hammoud said. “As clerkship director, I don't necessarily discuss with the program director which students come, so it's not necessarily that there's no selection criteria, it's the program director might not know what that selection criteria is.”

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In discussing the study’s findings, Dr. Hammoud, who is a consultant working on medical education for the AMA, noted that the data only pertains to ob-gyn rotations. Data published in other physician specialties on the value of away rotations shows that for some specialties they may have significant value for residency placement. 

“The assumption was that for competitive specialties, and ob-gyn has become one of the more competitive specialties in recent years, is that away rotations were almost considered a requirement,” Dr. Hammoud said. “One of the take-home lessons here is that each specialty is different, and we cannot assume that what we learned from otolaryngology or dermatology apply to all specialties.”

Even without a guarantee of an interview, an away rotation has plenty of value, Dr. Hammoud said.

“Applicants should go into away rotations looking at what they are trying to learn about the program and how they can grow clinically,” Dr. Hammoud said. “It’s a much more beneficial experience than trying to guess what a program director wants from you.”

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