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It’s around the time that medical students around the country start going to their away rotations to programs they may be interested in going to for residency. This audition can be very pivotal for successfully matching into the specialty of your choice. We have already posted some great tips on how to choose your away rotations.  Now let’s talk about some solid, tips on how to CRUSH your away rotations. I remember people always saying you should try your best to stand out at your away rotations to make sure you have the best chances of matching there. But no one ever actually told me exactly what we should be doing. Now that we are on the other side of things, we have seen some good rotators and some “not so good” rotators. We are going to break down the key tips to help you shine on your away rotation.

1. While seeing consults

• Have the splints rolled out.
  • If you know you have a distal radius fracture and that the resident is going to put the patient in a sugartong splint, go ahead and get the materials and roll out the splint. Look up what it looks like. Remember to always make it a little longer than you think.
• Take 5 minutes to read Orthobullets on the topic
  • This will help you get a better idea of what is going on and make it easier for you to help. This tip is worth doing even after the consult if you were unable to do it before. One of the purposes of doing an orthopedic away rotation is to learn orthopedics after all.
• Gather supplies, gather supplies, gather supplies
  • This just saves time. If you are at a program that uses webroll, plaster, and ACE bandages for splints, grab the materials.
• Offer to help out with the note
  • If you read our post on common ortho terms explained, then you should know some of the terminology. Offer to help out write the note, or at least the HPI. Gather the other details that the resident may have forgot, SH, Allergies, PSH, etc.
• Have consent forms in your bag/back pocket
  • If you are seeing a consult with the resident and know that it is probably going to go to the OR, have a consent ready and filled out. If you’ve never seen one filled out before, just ask the resident to show you what to put. Take note, and remember it for the future.

These tips are probably the most important of the article. Do these things and the residents will love you forever more. All of a sudden, you will become the hardest worker, the smartest guy/gal, a “good fit” for the program, etc.  Make our day easier and as long as you don’t have too many weird/awkward moments, you’re in there. I think this section is so important, I will even simplify it a bit for you.

• Take a basic H&P on your own if you can
• Have the splints rolled out as early as you can. Bonus points if the splint is rolled out before the resident even gets there.
• Have the consents filled out… Everytime.   Not much changes with our consents. Learn the few variations and you will be solid.
• Give residents a hand when reducing and splinting

Do these every time with every patient. This will go further than any article or orthobullet review you can look up. Orthopedics is a field that appreciates a hard worker that can do well independently. We know if you are competitive to match into the field, you can learn the rest of the knowledge needed to succeed.

2. On the floor

• Have dressing supplies ready to help with dressing changes
• Offer to change dressings
• If you have access, read up on patient charts. Check vital signs, culture results, etc.
• Take notes in the AM when the residents talk about the patients and what needs to be done, so you can help out
• Have an extra list in your pocket

This is another major key. Make the residents day lighter and no one will have much negative to say about you. Be hungry for dressing changes, wound checks, drain pulls etc. Some of these things require a MD to be around to complete but nothing is wrong with you getting started on some of these tasks to make things a bit easier for the resident. It’s nice to just have to go into a room and look at a wound because your all-star med student has already taken the old dressing down and can be trusted to redress the wound appropriately.

3. In the OR

• Introduce yourself to EVERYBODY
  • This includes the scrub tech, anesthesia, the nurses, EVERYBODY. And be nice to everybody, from everybody from the CEO to the Janitor. Everybody is an important part of the hospital and team. You will be surprised at the end of your rotation how some of the nurses will stick up for you and put in a good word because you were nice to them.
  • A simple” Hey I’m _____, one of the rotating students/Sub-Interns working with Dr. ____ today).” will suffice.
• Observe
  • This should be the first thing you do, every program does things a little different. Observe  what materials are typically needed. Does the doc use a tourniquet on his knee scopes or total knee arthroplasties? How do they prep the extremity? How do they position the patient? Just observe all of these little things and take note so you know how to help out.
• AFTER you observe a case or two, get a feel as to what things you may or may not be able to help out with as a student. Here are some things that may be appropriate for you to help out with AFTER you have seen it done and think you can do. (and some are just general things)
  • Position the patient
  • Take the old bed out of the room
  • Help prep the extremity or hold the extremity with sterile gloves
  • Get all of the residents that will be scrubbing in gloves size and give them to the scrub tech
  • Help drape the patient (if scrubbed in, once you get a feel for the attending/resident)
  • Put on the light handles (if scrubbed in, just don’t contaminate yourself)
  • Help hold retractors
  • Ask GOOD questions that show you are thinking (Ex: I notice you do a posterior approach to the hip, in your experience what advantages does that give you over doing an anterolateral approach?)
  • Get scissors and cut the sutures (if closing)
  • OFFER to help close. “Do you mind if I help you close this wound?”

Quick note: You kind of have to be on the line and take initiative sometimes in helping out. I’ve heard attendings say “ Yeah they were around but they really didn’t do much, weren’t impressive” about rotating students. Just being there isn’t enough, ask questions.

These are some general tips you should do during your away to be successful.

4. First and Last

Be the first one to arrive and the last one to leave. This is such a simple concept that most people know but don’t do. People notice when you leave early or show up late. Half of the battle of doing well on away rotations is being there. It shows that you are a team player and are there to help. The team needs to get used to seeing your face. They also need to know that their load is going to be a bit lighter now that they have you around.

5. Master the list

An easy rotator job to do is to prepare the list for the intern/ lower levels in the morning. It’s not a hard job to do. Go through the patient notes and update things you think may be important. Also, write down the vital signs and labs from THAT MORNING, and try to have it done BEFORE the interns need it. If anything seems off let the resident know ASAP. This is a simple task that when done correctly, can help you stand out.

6. Be available

There is a thin line between not being engaged and being annoying, it’s really an art. The best way to describe it is to say to be available. If there is a clinic going on and the resident can use some hands, offer to help out. If they are in the OR and the resident needs help holding the limb, be ready with some sterile gloves to hop in. If you got off early but there are cases going on, offer to go and help out. One of the guys I rotated with as a 4th year, did this EVERY day. I mean, every time I went to help out he was there helping out as well. Needless to say he ended up matching there at that program. He was a great rotator.

7. Don’t just leave

You wouldn’t think I’d have to make a post about this but it’s happened before. We’ve had students rotate and we would be in the middle of a reduction with a patient when another student would come and make themselves available to help, and the first person would say “Ok I’m leaving now he/she is here to tap me out”. As you can imagine, leaving during the middle of a reduction/splinting doesn’t leave the best impression. It reflects on how you may act as a resident and that you may not be a team player. This is something that I hold on to even as a resident. If I have a patient come in 15 minutes before sign out and I go see that patient. I don’t leave until that patient is squared away.

8. Meet with the program director

Definitely make an appointment to meet with the program director and/or get face time so they can get to know you. It holds weight if the program director can say that they worked with you and thought you were a good student. I was all about trying to meet as many of the key individuals of the program that I could while I was rotating. Let it be known that you are interested in coming to their program. Let them know of any ties you have to the city. Possibly see about getting a letter of recommendation (LOR) if needed. The ideal is for them to know that you are there and not to just blend in with the other rotators throughout the season.

9. Find a mentor in the program (or multiple)

If you followed our advice on how to choose aways, then maybe you have somebody in the program that you know. Meet with them at the beginning of the rotation and talk to them. Ask them questions about the program, what you can do best to make yourself stand out, what attendings to work with, etc. This can be an attending or some of the residents. I found this extremely helpful when I did my away rotations, not only did it help me understand the program and its culture more, but I also made friends/relationships with people that last till this day. Depending on how close you and this person is , they may even be able to give you the real scoop on your performance after you finish the rotation. We believe this tip is best to take care of before starting your rotation but it is never too late.

10. Your presentation

• Typically at the end of most rotations the students typically have to do a case presentation about a topic on a patient they saw. This is your chance to really shine in front of the faculty. Don’t sleep on it and really try to do a good job and make it concise. For tips on making a good presentation, subscribe below as we will likely release an article on it soon.

We hope this gives you some solid, useful tips on how to do a good job on your away rotations. If this article helped you, bookmark it, and share it with your friends/ fellow classmates. Also, did we tell you our PODCAST is coming soon. Subscribe to stay updated.

Written by: Wendell Cole, MD and Jamal Fitts, MD