Wednesday, September 8, 2010

Advice from a Doctor's Wife: Away Rotations

Now granted I am a very new to being a "doctor's wife," but nonetheless we survived medical school and here I am to tell about it.

While in medical school, I sought out advice from the wives of doctor's that had successfully made it into competitive residencies.* I sought advice as a way to be supportive, but I also think I sought advice because, I am a control freak, and I needed to be involved in the process of applying to residency, in order to deal with the whole lack of control of the process, (but that's a whole other post)!

I am so grateful for the advice of these women, that I would like to pass it on to other medical spouses in hopes that it will lead to a successful match* for some of you.

For anyone applying to a competitive specialty or to a specialty which their medical school does not have a residency program, away rotations* are crucial. There is no way to minimize how beneficial they can be. Both Mr. Dawkter and I agree that he would not have matched if it were not for his away rotations.

Away rotations are crucial for several reasons including:
  1. They open doors because they essentially try-outs or an extended interview. You have days/weeks to prove yourself as opposed to a 24-48 hour interview visit.
  2. They are an opportunity to get great letters of recommendation from programs that are not your medical school (and therefore may be interpreted as more genuine because the doctor's have no motive to say great things unless you have done great things).
  3. They allow you to prove yourself as a contender in your specialty. (For example if you come from a program that does not have orthopedic surgery - you can show that can handle the demanding schedule of such an intense specialty.) Bottom line - programs want to know you can "cut it."

And of course away rotations are valuable because they allow you to learn a lot about a program - more than you could learn about them in a 24-48 interview visit. Mr. D is a perfect example of this - he had his heart set on a program, he glorified that program. After a 4 week rotation there, the husband realized that maybe that program wasn't going to be ranked #1 after all...

Anyways, on to my advice regarding away rotations:

For the medical spouse:

  • Buy/pack lots of cliff bars or high calorie energy bars and snacks that the medical student can munch on in the stairway, elevator or in the bathroom (there will be many times when he or she will not have time to eat a meal).
  • Buy/pack non-perishable meals for them to make quickly whenever they do get home for dinner (like canned ravioli, healthy choice pastas or easy mac).
  • Don't go visit the medical student on their away rotation. I say this because if you do they will be torn between spending time in the hospital and spending time with you. If they have any time off, you'll want them sleeping.
  • Don't expect phone calls, don't be disappointed when you don't get to talk to them on their away rotations. They should not be seen on the phone while working and they may just be too exhausted to talk at length when they are done fore the day. Most of our conversations were "I just got done, can I call you after I eat... I just finished eating can I call you after I shower.... I'm exhausted do you mind if I go to bed?"
  • Send encouraging texts, notes, letters.
  • Plan to see each other between away rotations.
  • Know that this is only temporary, you will both get through it. It will only make you stronger individuals and a stronger couple.
  • Keep yourself busy, take a class, try a new hobby, plan to visit friends - keep yourself distracted!
  • Don't freak out if they go a little crazy from sleep deprivation... hopefully they will adjust and it will only last a few days

For the medical student:

  • Have the mindset that this specialty is your priority (nothing else) and act consistently with that attitude.
  • Never sit, rest, eat, relax, anything when your resident or superior is not sitting, resting, etc.
  • Never ask to leave for the day; do not leave until they tell you to leave.
  • Don't eat unless your resident is eating.
  • Carry cliff bars, energy bars or other snacks in your pockets to snack on when you have a moment: don't expect to get a "lunch" everyday.
  • Don't make phone calls while in the hospital; text when you have a second and no one is around (stairwells, bathroom, cafeteria).
  • Always ask what you can be doing.
  • Try to be helpful rather than getting in the way.
  • If you are exhausted, try not to show it, always be willing to help or stay longer.
  • Remember that this is not forever - this is just a "try out" in which you will need to make the best possible impression.
  • If you start questioning your specialty or something else unusual, don't freak out, you may just be sleep deprived. If this does happen DO NOT indicate this to anyone at the hospital - they should not think you have any doubts. If you do have doubts resolve them later, but do not address them during the away rotation because it may just be sleep deprivation.
  • Thank your medical spouse for being so supportive.
Although this advice may be intense, Mr. Dawkter worked at least 100 hours a week in his first two away rotations. (For some of my posts about his first away rotation, click here.) There are no laws or restrictions to the number of hours a medical student can be "working," so the more hours they are at the hospital, the more they can be learning/proving themselves.

Please note that this is just my advice, take what you find useful and disregard the rest.

*Residency is the training a doctor must go through after medical school in order to become an internist, a surgeon, a pathologist, or whatever it is that they desire to be/practice.
*Match is the term used for describing how a medical student is "matched" to their residency program. For an explanation of how match works, click here.
*Away rotations are clinical rotations in a certain area of medicine that are performed at a hospital or academic institution other than where the medical student goes to school.


  1. Ok so I have the same problem - I want to know what's going on, what I can do, what we can do, etc. It's bad because I know there are times when I need to just shut up or stop. This list was extremely helpful. We are 3 months in to the first year of rotations so far and things have been fairly easy, but I know they won't stay that way the entire time. Thank you for sharing, I would love for you to share any other wisdom you have!

  2. Wow, I thought being a law school spouse was complicated. The idea of my husband spending a semester away is making me cringe - but knowing that you all have to do it more often? Mine isn't so bad, I guess!

  3. I love this post. I'm working on the whole "don't expect to hear from him thing." You add some really great perspective though...I never thought of what it looks like to the resident when he makes a call or sends a text.

    Do they apply for away rotations or just sign up? And do you remember when you guys applied/signed up?

    I'm like you, I need to be involved since it's my life hanging in the balance here too :0)

  4. The away rotations were definitely challenging though once we knew hubs wanted to concentrate on the NY area we did rent a house on the North Fork for one of his rotations to make sure I would also feel at least okay with the area since one of his top 3 was kind of way out on Long Island.

    I think for me, it was a great introduction to this first intern year that we're currently in. I had to entertain myself, take care of a house, and adjust to a new areas. We ended up in a program still on Long Island but much closer to the city so it's not so isolating. However, that month we spent with him working crazy hours and me just being there when he needed me was a true trial run for our lives now.

    Since he's in the ER we still stock up on Zone bones and Kashi bars because often that and a peanut butter and nutella sandwhich is all he eats on a 12 hours shift!

  5. 100 hours a week? Wow. DH (MSIV) is currently in an away rotation (pediatric nephrology) and it is very similar to his other elective rotations at home. They are pretty much doing the 6 days on/1 day off for now, and luckily it is a consult setup. Third and fourth year have been a bazillion times better than first and second for us!!

  6. I forgot to mention that we are with him this month because we have family here (which makes everything much more tolerable!)

  7. Another suggestion for spouses: for my husband's first away rotation I called his hotel to get their address to send a care package. I mailed the package a week before he got there, and the hotel put it on his bed when he checked in. It was just some (good) coffee, candy, a photo frame with a picture of us, some comfy slippers, and stupid stuff like that, but it really helped him make his hotel room a home for that month. sorry if you got this twice, my computer freaked out.

  8. When do they normally do away rotations? Are they able to do them only in MSIV or are there summer programs available?


  9. Annoyed Army Wife- wow, you are one rockin wife! That idea never would have dawned on me!- but now that you have shared, I will steal it ;0) Thanks!

    Thanks so much for sharing this. I too am obsessive about knowing everything that goes into this journey every step of the way, and usually I am doing the research and telling him how things work because he just doesn't have time.

  10. Great entry! My husband is currently a MSIV {going into radiology} we've actually been told by numerous people NOT to do away rotations for radiology because 'your just in the way in the dark room'... my husband is doing 1 so hopefully everything works out in our favor. One thing I am actually personally freaking out about is the money that its going to take to do 1. away rotations and 2. interviews and moving of course. Its a happy and stressful time!

  11. Thank you so much for sharing this info! I'm nervous about DH being away for a whole month on an away rotation. That means I'm in charge of everything! Which, I mean, I usually am anyways, but it's just nice to know you've got someone to fall back on when you get stuck. 4th year is definitely more overwhelming than the other years, and I know it's just going to get more stressful as it goes on. Thanks for your insight! It's such a comfort to know that other people have been/are going through the same stresses we are.

  12. I'm on an away rotation right now. Your advice is spot on! More advice for the other spouses- this has been the most stressful part since starting medical school. I actually cannot wait until it's all over. and remember that there are other students doing rotations at the same time that are competing for the same spots. Be supportive of your spouse's freakouts.

  13. My husband is an M4 on an away rotation at a top 10 hospital, and after reading your post I realize how lucky he is to be at his program! Every rotation must be different, because he has weekends off and is usually home by 5:00.

    I disagree that you shouldn't plan to visit your spouse - I spent a weekend there and was so glad that I did because it gave both of us the opportunity to sight-see, visit neighborhoods, and get a feel for the area. Every program is different, so see what the time will allow and do what's right for you both!

  14. Thanks for this post! We have a little while until we have to worry about this, but my husband is hoping to do at least one away rotation, just to because we'd like to end up in a certain location.

  15. I think having children throws a wrench in all this. It also depends greatly on the type of program that your spouse is trying to get into. If it is not as "intensive" then this might be a little too much. My husband is a Pain Management Fellow, and he completed away rotations both during med school and residency. We spoke everyday. During his last away, we (our boys and I) went and spent 4 days with him.

    I totally think keeping in mind the type of program, is essential. :-)

  16. I agree with you Joz1234 and anonymous (not me, the other one)... it totally depends on the type of program your DH is in and what they're going into... my DH is currently on an EM away rotation and it's basically the same as his EM rotations was here at home. 6 days on, one day off.
    I went to visit him last weekend and it was wonderful. We both said it was great for our mental health and happiness to spend time together. We also talk everyday, which is a must for both of us. Sometime the calls aren't long and sometimes they're at odd hours but it's important to keep updated on each other's lives and it's a good pick me up, since we're both busy, tired and stressed.
    I don't know how people do it with kids, away rotations are hard but each couple has their own way of making it work.

  17. This is wonderful! Thank you so much for this post! I 100% agree. My husband is away right now (3 long distance away rotations this year) -- as he's applying for a competitive specialty. I have made plans to see him in all cities -- and the most pressured one IN BETWEEN the rotation. I knew getting married last year that our first year of marriage would be mostly apart. This is what you sign up for. It's not ideal -- but it's do-able with committed individuals. I do not enjoy pity from anyone - family, friends included. We had both eyes open going into this process -- and we are determined to do everything we can as a team to help him match well. Thank you again for this! Wonderful!!!

  18. Thank you very much for this post! My husband will be starting his military away rotations this fall and it helps me keep things in perspective! Its difficult but I know in the end it will make our relationship stronger & he will need all the support he can get :)


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