How Should I Plan an Audition Rotation?

Question

Can you tell me about audition rotations? When should I apply, and how can I ensure a successful rotation?

Response from Megan L. Fix, MD Assistant Professor, Tufts University School of Medicine, Portland, Maine; Director, Medical Student Education, Maine Medical Center, Portland, Maine

Also called an "away externship" and "away rotation," an audition rotation is defined by the McGraw-Hill Concise Dictionary of Modern Medicine as "a clinical rotation by a 4th year medical student interested in a specific residency program and/or target specialty in a location other than that of his/her medical school."^[1]

More simply stated, an audition rotation is a chance for you to shine and show the residency program of your choice that you are top notch.

When to Apply

Many students ask when they should plan their fourth-year audition rotations. As important as it is to plan when to do the rotation is when to apply for the rotation. Popular rotations fill up quickly, and many require a formal application. Some rotations even require an essay and a letter of support. Students should start thinking about planning an audition rotation as soon as a career choice has been made -- early to mid-third year. Ask graduating fourth-year students and mentors in your chosen specialty which rotations are desirable. Look online for the deadlines and application processes for these rotations and work with your home institution to make sure the dates will work with your required fourth-year clerkships.

When to Complete the Rotation

Most audition rotations are best completed after at least 1 solid rotation in your chosen specialty at your own institution. This valuable clinical experience allows you to perform well during the audition rotation. Schedule your audition rotation early in the fourth year before interviews, but close enough to interviews that the faculty will remember you. Typically, the months of July through December are best.

Some students choose to do an audition rotation during interview months in the hopes of doing a residency interview during the rotation. This saves money and helps the residency director really remember you when it comes time to make a rank list. Avoid scheduling your audition rotation in February because that is when most Match lists are due.

Where to Do the Rotation

Where you plan to do your audition rotation is just as important as where you plan to do your residency interviews. Remember, many graduating residents tend to practice close to where they completed their residency. Think about what is important and make your priority list first. For example, if geography is the most important priority for your residency choice, then you should make every effort to obtain an audition rotation in that geographic location. Residency directors tend to be close with their regional counterparts and frequently call each other to discuss candidates. So, even if your top rotation is unavailable, try to arrange for a rotation in that region. Alternatively, if program reputation is the most important priority for you, then you should apply early to get into an audition rotation at a particular residency.

How to Stand Out During the Rotation

An outstanding performance during your audition rotation may increase your chances of matching at that program, and a poor performance may reduce your chances of a match. Almost as important as your clinical skills during the rotation are your interpersonal skills. Know that you will be watched by everyone: the clerkship director, the residents, the residency coordinator, the nurses, the faculty, and the staff in the hospital. They want to make sure that you will be a good colleague for the next 3-7 years.

Before any audition rotation, it is a good idea to meet with a mentor in your chosen specialty and ask for specific feedback on your strengths and weaknesses. Make sure you bring a good textbook to read while you're on your audition rotation so that you can research your cases. You may be asked to give a presentation. Make this count! Consider using evidence-based articles and include handouts on your presentation topic. Everything you do during this month will be important. Be reliable. Be on time for everything, complete all tasks, and do your absolute best.

Letters of Recommendation

It is very important to obtain a strong letter of recommendation from a faculty member at your audition rotation. Some clerkships will extend offers for letters to all students on the first day. If this does not happen, try to wait until a week or so has passed and then ask a key member of the faculty (clerkship director, program director, associate program director, research director) after you have met this person. Be prepared with your CV, personal statement, and release form for your letter of recommendation.

Details

• Arrange for travel and start dates to fit with your home institution. Missing days on your audition rotation can look very sloppy;
• Ask early about housing options: Some rotations offer free or reduced-cost student housing. If that is not available, ask the residency coordinator for residents' addresses and email a few of them to ask for suggestions.
• Be appreciative of the clerkship director and coordinator;
• Be a good team player with the other students on your rotation. Do not try to sabotage other students to make yourself look good;
• Attend all didactic sessions;
• Arrive on time and plan on staying late;
• Ask for feedback early in the month so that you can correct deficiencies before your grade is assigned. Make all efforts to earn honors during your rotation;
• Try to socialize with residents and attendings outside of the hospital during your month;
• Attend journal club even if it is not mandatory;
• Be prepared for your first day. Make sure you have the proper identification, passwords, attire, parking, mental map of the hospital, etc.; and
• Be professional and respectful toward everyone during your rotation. Ask if you can do anything to help others, be kind to your patients, and communicate well with your supervisors.