Med School Residency

Dermatology Away Rotations (Part 1): How to Pick

5 min read

Dermatology away rotations are popular among applicants because they’re an opportunity to familiarize oneself with the department on a more personal level. Historically, away rotations were seen as “guaranteed interview invites,” with programs extending invitations to their away rotators as a courtesy (or acknowledgement of their existence). With interviews being so hard to come by nowadays, it’s no wonder that applicants spend thousands of dollars auditioning in various cities, all in the hopes of landing prestigious interview slots.

The reality is that away rotations are no longer “backdoor entries” into the interview pool. Each year, disappointed applicants come to the realization that they wasted time and money that would’ve been better spent elsewhere. Be smart about choosing away rotations and know what to expect when you arrive so that you maximize your chances of making a good impression. Check out Part 2 to see how you can prepare for away rotations. Be sure to check out How to (Actually) Match into Dermatology for a closer look at match strategies.

Consider if an away rotation would benefit you.

This is something you really have to think critically about before you make a thousand dollar investment into something low-yield. Not everyone is cut out for an away rotation. Some top medical schools in the country will dissuade their students from rotating externally out of fear that they’ll fail to meet expectations. The logic makes sense. If you’re hailing from a top-tier medical school, programs are going to have preconceived notions about your clinical abilities (unfair, I know). So if you’re not a superstar on the wards, you might self-sabotage your chances.

Only you know if you can shine on the wards. You have to be strong clinically AND socially. Only then will you be beloved by the department. If you know you’re not that person (not everyone is a vivacious extrovert, and that’s fine!), maybe it’s best to maintain some type of mystery. No impression is much better than a bad impression. For more details on performing well on away rotations, stay tuned for my upcoming blog post!

Do your research.

To pick the most appropriate away rotations, you have to assess your own competitiveness for each program. Find ones you have a realistic shot at. Unfortunately, we don’t have great nationally recognized rankings for dermatology programs so we have to use what we got.

  • Doximity Residency Navigator is a good overview for basic stats of residency programs, but the actual ranking algorithm is not very robust.
  • Cutis recently published their own US Dermatology Residency Program Rankings Based on Academic Achievement, but it’s limited to only the top 20 programs.
  • The other “unofficial” resource would be the SDN spreadsheets archived each year (links below). A word of caution, these documents are compiled ANONYMOUSLY by anyone and may be highly inaccurate and misleading.
DISCLAIMER: I am not responsible in any way for content displayed in the following documents, nor for any error or omission. I am not the owner nor content creator. I am simply providing addended archived copies. Tabs deemed inappropriate were removed. Last archived April 17, 2019. 

SDN Dermatology Applicant Spreadsheet, 2015-2016
SDN Dermatology Applicant Spreadsheet, 2016-2017
SDN Dermatology Applicant Spreadsheet, 2017-2018
SDN Dermatology Applicant Spreadsheet, 2018-2019

  • Lastly, program websites are incredibly useful. They provide profiles of current and past residents. That can give you an idea of the kind of residents they look for. Maybe they’re partial to students from the Midwest. Maybe they care a lot about pedigree. Or maybe they’re chock full of women and are looking to recruit a male resident. These are all factors that go into faculty members’ decision-making processes so start to think like them.

May the odds be ever in your favor. (Pick big programs if you can.)

The bigger the program, the more room they have to take external or merit-based applicants. For instance, Program A has 2 spots and Program B has 6 spots. Even if both programs have a few top students that their admissions faculty have a vested interest in (i.e., internal medical students, research fellows, or pure nepotism), the rest of their list should theoretically be merit-based. So in this case, even if you’re ranked top 10 on both lists, you’ll have a higher chance of matching at Program B than Program A.

Geosignaling.

If you’re dead set on matching in a particular state (which I’d caution against!), you should probably try to rotate there. If your transcript indicates you focused on a particular geographic region, programs might think you’re serious about training there. Similarly, if your letter-writers all hail from the same area, you are also signaling (intentionally or unintentionally) to programs where you want to end up.

Adding to that, think of every long lost cousin or distant uncle you ever had when trying to make a case as to why you want to train in a particular area. Alabama? Great – my sister-in-law’s cousin lives there. Minnesota? Pretty sure that’s where my neighbor’s ex-dog walker is from.

Don’t cast too wide of a net.

It’s going to be awkward when you turn down away rotations, no matter how far in advance you cancel them.

You think you’re telling programs:

I’m so sorry but last-minute/unforeseen/MANDATORY scheduling conflicts prevented me from visiting your program. But I’m still incredibly interested (otherwise why would I apply??) and would still love to be considered for an interview!

What they hear is:

I am aware that you’re setting aside time for me to rotate at your program, but by rejecting your offer, I have indicated that I have a million better things to do than visit your crummy institution. Maybe we’ll match in another lifetime.

Just remember that dermatology is a small field, and people have egos. How would you treat someone who rejected your rotation offer? You have literally hundreds of other applicants who would bend over backwards to try to match at your institution. Thank you, next.

Therefore, opt to apply for multiple spots at a particular institution rather than multiple institutions. Away spots OPEN UP ALL THE TIME, so don’t feel like if you don’t apply to every program on VSAS, you’ll end up with nothing.

Timing matters.

When you schedule them is a personal decision. However, the unanimous sentiment is that you should schedule your HIGH-STAKES rotations (i.e., more academically competitive or one of your top choices) after your low-stakes rotations. Sometimes home programs will recommend you rotate at home first so that you get some clinical experience before you’re released into the wild.

The following scheduling strategies are copy/pasted directly from my Ultimate Medical School Survival Guide. There are pros/cons to each month. Typically dermatology programs start sending out invites in November, but the majority will be sent out December/January. Interview season goes from November to February, but December/January are the heaviest months.

Pre-ERAS (June-September)
Pros: You’ll get the opportunity to secure a letter of recommendation from an away rotation.
Cons: These are the most popular rotation months and you’ll likely be rotating with very strong candidates. It’ll be harder to stand out. If you don’t need a letter, I’d advise rotating later in the year.

Post-ERAS/Pre-invites (September-December)
Pros: You’ll be fresh in everyone’s minds when they’re considering applicants for interview invites. There will also be less rotators so you’ll get more one-on-one time with the department.
Cons: It’s super awkward to rotate someplace that denies you an interview invite WHILE YOU ARE THERE (this happens).

Interview season (December-February)
Pros: You’ll be fresh in everyone’s mind when they’re RANKING YOU. If you make a great impression, this can be a great opportunity to jump up the rank list.
Cons: You’ll be interviewing at the same time and will be missing days.

That’s about it! Check out Dermatology Away Rotations (Part 2): What to Expect and How to Prepare next!

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