One of the coolest parts about medical school is the ability to go to other schools, hospitals, or institutions to see what medicine is like at their house – to explore a different area of the country, a hospital where you want to match, or just to take a trip. Typically we’ll do this during the tail end of third year and early fourth year (i.e., right now) before residency applications go out in September. I’m doing two – one this month and another in the fall.

These “away rotations” are also a great way for the applying student to get a letter of recommendation from a place not at their home institution into their application. This is extremely useful for programs as well as the student: if you think about it, home schools have practically no motivation to really discriminate between their students.Why shouldn’t they just give good grades to everyone? Many schools do just that.

An away institution has no reason to participate in grade inflation, so a good evaluation from there means a little more to a residency.

Not all specialties “require” away rotations, but many recommend it. The typical recommendation for emergency medicine is to do one; some crazy specialties like neurosurgery recommend three. I have no idea why.

That said, even if your specialty doesn’t require an away… why wouldn’t you do one?! It doesn’t cost you extra tuition and it’s an excuse to spend a month away doing something new.

Interestingly, medical school advising folks disagree. See, because you can get an honest evaluation at an away institution, if you are a robot with the personality of a baked potato you may want to avoid displaying your winning friendliness to the rest of the world. On one level this is pretty funny – a dean may legitimately say to you, “we don’t think you should leave here because you are literally too weird to make a good impression on another human being,” and mean what they’re saying – but on another it’s quite sad. We are collectively shielding the public from the future doctors with the interpersonal skills of a talking microwave, instead training them in the shadows before unleashing the robot army on the world. Which is probably bad for patient care. Probably.

It’s worth noting the deans won’t come out and say this – of course, no one with bad communication skills goes to MY medical school – but they’ll mention that “if you tend to be a bit more introverted, or have trouble immediately perhaps you should reconsider whether an away rotation is right for you.”

BS – I’m introverted, and away rotations are a great idea. There’s a big difference between being introverted and being the Comcast computerized phone assistant incarnate.

Okay, soapbox over.

I’m spending the month rotating at a county hospital on the West Coast. My home school is a big academic institution and doing emergency medicine can be very different in the community/county setting, so I figured if I was going to commit myself to this career I should probably see both sides of the coin.

Anyway. Away rotations are a lot of fun, and it’s always a great experience checking out a new place. The downside is that you have to learn an entirely new hospital, electronic medical system, and personalities.

My first shift was last Thursday, and I’ll be the first to tell you it was a total and absolute dumpster fire. I had no idea what I was doing. I blew an IV, couldn’t figure out how to find rooms, didn’t know what the difference was between two computer programs or how to use either, and I got yelled at for using lidocaine instead of bupivacaine for suturing.

(At my home hospital I’ve never seen bupivacaine, a longer-lasting local anesthetic than lidocaine, used outside of the hospital.)

It’s gotten better after that. The differences between here and my home are striking, but very helpful for helping tease out where to apply in the fall. More to come.