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Once you land an away rotation at a particular institution, how do you prepare and what can you expect?

Prepare clinically beforehand.

I will be the first to admit that I was underprepared for my away rotations. I did not read enough beforehand. This is a mistake!

Even if some residents say that “medical students are not expected to know anything,” knowing your stuff is what makes you stand out. If your rotation invites student participation during Kodachromes (picture slides of skin conditions) or allows students to see and present patients, you can really make an impression by preparing.

Some good resources:

• Lookingbill and Marks’ Principles of Dermatology – This is a nice short introduction to dermatology for med students. Definitely the easiest textbook to get through.
• Fitzpatrick’s Color Atlas aka “Baby Fitz” – Great atlas for helping you recognize skin pathology. My research mentor mandates that his students memorize every photo in this book before going on away rotations.
• Dermatology Essentials aka “Baby Bolognia” – This is another nice reference book to have. Less daunting than the real two-volume behemoth.
• Basic Dermatology Curriculum by AAD – These are nice introductory slides for common skin pathology. Also easy to get through.

Pronunciation is key.

Dermatologists speak an entirely different language and unless you’re around them all the time, it can be really hard to figure out how to pronounce disease names or even drug names! I mean, who really knows how to pronounce “Ustekinumab” or “Hidradenitis suppurativa” without hearing it first?? So I’d recommend googling these terms and listening to their pronunciations first before you attempt them the first time.

Shadowing

Most rotations are just shadowing. If you’re seeing and presenting patients by yourself, you can stand out by being efficient and giving organized presentations. But if you’re mainly shadowing, how can you stand out?

Be helpful.

This is the unanimous advice I always get. Medical students need to be helpful. Do everything in your power to make everyone’s jobs easier. Whether that’s helping them consent patients for biopsies, grabbing the liquid NO2, helping them with wound care, or handing them gloves. Try to predict what they need and get it done before they can say ILK.

Know who you’re working with.

If you know which attending you’ll be working with beforehand, you can read about them. It’s a great way to find connections with someone. Know where they trained, what their research focus is, and what they’ve published. It’s a bit like preparing for interviews. That way, you can ask them relevant questions about their background if there’s ever awkward silences to fill.

Familiarize yourself with the patient roster.

This is not always easy (or possible) to do. If you have access to the EMR and know whose clinic you’ll be in the next day, you can attempt to lookup their patients and diagnoses. That way, you can also read up on the current literature and develop questions that show off your knowledge base. Instead of asking, “what’s this _________ disease?”, you can ask, “in your experience, do you find _________ treatment to be effective? What do you like using?” Dermatology is rapidly evolving so those types of questions are great because attendings can describe their own approach to medicine.

You can also chime in about certain patients. “Oh, I read that Ms. Brown has calcinosis cutis! I’d love to see that.”

Get to know the residents.

It’s important to engage with the other residents. They usually have a large say in who gets interview invites or even who gets ranked highly. They are looking for future colleagues, so try your best to let your personality shine. Once again, this can be incredibly difficult because you’re in a high-stakes environment trying to impress others, and open up quickly to strangers.

Be friends with the other rotators.

Do not try to “outgun” the other students because residents hate seeing that. In all likelihood, you’ll probably end up really liking all of your fellow rotators and you can all commiserate together. When rotators get along, residents notice.

Be careful of what you say.

Word travels fast and any red flags will be brought to the program director’s attention. If you brag about all of the interviews you’re getting, or that you’re really into cosmetics (big no no!), or talk about all of the famous attendings you’ve worked with, you risk coming across as an ass. Even mentioning that your significant other wants to live in a different city than where you’re rotating at can suggest to others that you’re not serious about training there.

If the aforementioned advice sounds ridiculous and overkill, it’s because it really is. When programs only choose to interview a handful of their rotators, it’s not enough to simply be “nice” and “helpful.” You need to step up your game if you want to stay in the game.

Be sure to check out Part 1: How to Pick Away Rotations, How to (Actually) Match into Dermatology, ERAS Application Tips, and The Ultimate Medical School Survival Guide FAQ for more information on applying to residency.