Answers to this list of frequently asked questions have been provided by:

 • Dr. Masis Isikbay (MI), Diagnostic Radiology Resident at UCSF

 • Lynsey Maciolek (LM), MS4 at The University of Texas Medical Branch School of Medicine

 • Hanssen Li (HL), MS4 at The Medical College of Georgia

Additional answers have been collected from RFS articles, with links to these original articles provided when possible.

Why do an away rotation?

Why do an away rotation?

(MI): It is important to realize that the decision to complete an away rotation is multifactorial and there are multiple reasons why one should consider an away rotation:

You are interested in learning more about a specific program: if you are interested in going to a specific institution for residency, arguably the best way to learn more about the program is to rotate there on service, meet the residents/fellows, and work directly with the attendings.

You want to be competitive for an integrated IR position at a specific program: while the culture and expectations of away rotations are still being formed and established in interventional radiology, it is important to acknowledge that even the largest integrated IR programs still only have a small number of spots. For candidates who are interested in trying to be competitive for a certain program, it can be very advantageous to have the opportunity to make an impression for what is typically a 4 week rotation so that the program can learn more about you.

You want to get more experience in IR outside your institution: the practice of interventional radiology varies by institution, sometimes greatly. For many medical students it can be valuable to see how IR groups at other institutions differ with case variety, volume, and other practice patterns. Also regardless of where you are going to medical school there are a finite number of “home” rotations you have available to you, and if you would like to do more rotations some of them will be aways

(Source): Away rotations are more important for IR than DR. They are not required to be successful in the match, but many integrated IR applicants do a couple. Some institutions like the University of Washington give preference to applicants who do aways with them, while others do not. Generally, they are great opportunities to see how other institutions do things and network. You should definitely consider doing one if you have a strong preference to match at that program or region or if you do not have access to IR at your home institution.

Check out the SIR RFS Away Rotation Spreadsheet that lists various programs with application information and contacts.

If my institution does not have an IR department, should I do an away for a recommendation letter?

If my institution does not have an IR department, should I do an away for a recommendation letter?

(Source): A letter from an IR is not necessarily “better” than a strong letter from a diagnostic radiologist. A letter that speaks highly of you with depth and sincerity is the kind of letter a program director would like to see. For students who are in the described situation, the PDs recommended away rotations for getting more experience in IR primarily for more experience and mentorship before deciding on a specialty.

What are factors to consider in choosing away rotation sites?

What are factors to consider in choosing away rotation sites?

(Source): There are often two strategies in choosing institutions for away rotations: either an institution near your hometown to spend a month at home or an institution of your dreams/an institution in a region you would like to be for residency. The first is self-explanatory – learn at an institution near home to not only spend some time with your family and old friends, but also ask yourself, ‘do I want to come back home for residency?’ The second and third are of course how most students think about away rotations; work at a specific institution or a region where one would theoretically like to commit for residency and beyond. This may be a great opportunity to get to know about an institution in depth. However, the program directors noted that students should be prepared to work very hard. An away rotation could easily feel like “a month-long interview”.

In terms of strategies with regional references – if you are graduating from the east coast medical school and wish to match on the west coast, it could help to convey the idea by doing an away rotation on the west coast. The general consensus by the panelists was that away rotation sites can definitely set a precedence and trend for a students’ probable regional preference. However, keep in mind that because of the limited number of integrated residency, the region of the away rotation site may only play a small role in considering the students’ regional preference for a residency.  

Should I do a Sub-I or elective rotation?

Should I do a Sub-I or elective rotation?

(Source): Whichever that allows you to maximize your experience at an away rotation and get the most out of your goal. For example, if your goal is to get a strong recommendation letter from the program director, then do a sub-internship and work hard.

When should I do an away rotation?

When should I do an away rotation?

(MI): The timing of an away rotation can be broken down into two categories: early away rotations that will appear on your application transcript, and late away rotations that will not appear on your transcripts. You may want to check in with your medical school about when they update your transcript before it is submitted for your residency application as it may be different for each program.

Early away rotations: these rotations are completed before your application is submitted (often times August is the last rotation month that can appear on a transcript before it is initially submitted). The significance of this is that all the programs you apply to will see where you did your away rotations. While doing more IR rotations can show that you take initiative, it might also beg the question of why you chose to do rotations at specific programs (and this may be a point of discussion during interview season).

Late away rotations: these rotations are done after transcripts are submitted but before rank lists are submitted (generally September to January). Performing an away in this time frame is when it will be “blind” to other programs who will not know where you are rotating. Conversely it may seem as though especially during these months (after your application is in) that the month will feel more like a month-long interview.

(LM): An important piece of information you need to gather from your medical school is whether the name of the institution you complete your away rotations at will appear on your transcript. My transcript did not include these names, so this did not impact the timing I chose to do my away rotations. Early away rotations (before September when residency applications are due) will benefit you for a few reasons. Before September, you can ask for a letter of recommendation to include in your residency application. If institution names for external rotations aren’t on your transcript, this may be the only way programs are aware you are truly interested in training outside of your geographical region. Additionally, early away rotations can show a program your strong interest in training there, which may help you secure an interview with them. Generally, I wouldn’t recommend completing away rotations in October/November- December, as you will likely have to ask off for a large chunk of time to travel for interviews. Although they will probably understand the busy nature of the interview season, this may leave a negative impression. Completing an away rotation in the time frame January-February (before rank lists are in) will show your serious interest in a program. Furthermore, you will be fresh on the selection committee’s mind rotating at that time.

Keep in mind that you may be a little burnt out after other away rotations + interview season, but it is definitely an option to consider.

Are rotation dates flexible?

Are rotation dates flexible?

(MI): Generally speaking it is preferred not to adjust rotation dates, however there are some instances where this is unavoidable. This mainly becomes an issue when rotation schedules differ between your home institution and where you are planning to do your away. In these cases it is advisable to reach out to both your home institution and where you are planning to do your away to see if there is any flexibility in the dates. It is not a guarantee, but there are instances where students have had their schedules accomodated.

(LM): Don’t be surprised if you find your home institution rotation dates don’t match up with away rotation dates. This can be very frustrating, but it is more common than you think. This doesn’t always mean that you cannot rotate there. There are a couple of options you can consider to get around this issue. You can ask the away program if they would be able to accommodate a truncated rotation- such as a 3-week rotation instead of 4 weeks. If you don’t ask, you will never know! But be sure to look on the institution’s website or VSAS to see if they have already voiced their policy on rotation dates/lengths. You can also strategically place the rotation so that it runs into an “off” month. As you are working through these options, be sure to keep your home institution in the loop so that they can (1) advise/help you and (2) approve the schedule adjustment.

How do I schedule my away rotations?

How do I schedule my away rotations?

(LM): If you are strongly interested in rotating at a particular institution and they do not offer an IR elective through VSAS, try looking for a DR elective offered at that same institution to apply to. Oftentimes, radiology departments will be flexible and allow you to work in the IR department for the month despite it not being an official IR rotation. The VSAS page for each elective should have institution-specific contact information that you can use to reach out about an opportunity as such. 

What are some tips for navigating VSAS for IR away rotations?

How do I navigate VSAS for IR away rotations?

(Source): Currently, searching for IR rotations on VSAS can be a convoluted process because the rotations can be labelled as an independent IR rotation or IR rotation within the DR category. This video by Ryan Kiefer will walk you through how to navigate VSAS to maximize IR rotation search.

How many away rotations should a student do to be a competitive applicant?

How many away rotations should a student do to be a competitive applicant?

(Source): There really isn’t a particular number of away rotations that the program directors would recommend to be a competitive candidate. Do aways for your own interest and to get to know how IR is practiced at other institutions. A recent publication in JVIR has shown that according to the Match data from 2017, an average number of away rotations that matched students have done were an average of two to three. In summary, the attendings noted if you have a convincing reason and curiosities about other institutions, do away rotations. However, it is definitely not a requirement that the program directors are looking for from an applicant.

How many away rotations should we apply for?

How many away rotations should we apply for?

(Source): A general advice is apply to three for one and five for two. However, this is all based on scheduling and individual differences, so this may be very different for many students.

Will turning down an away rotation look bad?

Will turning down an away rotation look bad?

(Source): Be judicious about where and how many away rotations you apply to – remember, they are about $100 per application. However, most PDs will not hold a student accountable and fault her/him/them for declining an offer for an away rotation. PDs understand there are many potential schedule conflicts and quite frankly too many to remember the names of the students who declined.

What stipends/scholarships are available?

What stipends/scholarships are available?

Please take a look at SIR’s GEMS Program!

How can I find housing for my away rotations?

How can I find housing for my away rotations?

How can I make a good impression on an away rotation?

How can I make a good impression on an away rotation?

(Source): A student who is motivated to learn and be part of the team. It may sound simple, but again, to be the first person in and the last person out is tough and will demand a lot of time and diligence. Know the patients and their procedures. Offer to present in journal club or do a presentation if you are not already asked to do so during your rotation.  Work well not with faculty, residents, and fellows, but also with the nurses, techs, and secretaries. Offer to help set up the room, write pre-procedural notes, etc. Remember, you are there to learn about IR and the program but also to be part of the team! Keep your eyes open and watch for what you like and don’t like as well. Take the time as a privilege to soak in what you would like to learn – everything you have been doing during your entire third year of medical school!

(Source): Three major categories that are important to consider: fund of knowledge, effort, and networking.

In terms of knowledge, brush up on anatomy (segments of the liver, vasculature, variants). Know the clinical indications for procedures. You can look up cases for the next day to prepare and think of non-obvious questions to ask about the technique, device selection, or relevant literature if there’s an opportunity.

Regarding effort, there are few subtleties. Work hard, and remember that no task is beneath you. This includes running errands, delivering scripts to patients, wheeling the bed in and out of the IR suite, pre-rounding, getting bedsheets for the patient, etc. Basically, make yourself useful, and realize that your learning comes second to patient care. Try to your patients’ stories, labs, indications, and previous procedures before you step into the IR suite.

As for networking, try to introduce yourself to everyone and make a good first impression. Getting to know nurses and APNs is as important as knowing fellows,residents, and attendings. The techs also are very knowledgeable and can help you look good in the IR suite. Be authentic, curious, and genuine.

Also, check out this RFS article on away rotations.

What are some general tips on how to do well on IR rotations?

What are some general tips on how to do well on IR rotations?

A few general tips are:

  • Ask to present the patient and find appropriate imagining during morning rounds
  • Help the team field consults when they come in, including looking up patient history, indications for the consult procedure, and looking up labs
  • Learn and help with wire work during procedures
  • Be prepared for any opportunities for participation that arise by doing an early scrub, finding appropriate attire, finding appropriate lead and eye protection, and knowing how to self gown in cases of necessity
  • Work well with other rotating students to divide up the work
  • Teach/guide junior medical students so they have a great impression of their experience in IR

Last updated 6/4/20

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