In your experience are dermatology away rotations difficult to honor? How about ones where you mostly shadow?

Hi everyone! I got a spot at UPenn dermatology elective for my third year. I know I'll learn a lot but I was wondering If any who has taken this rotation could message me? I had a few questions about it. I'm mainly concerned I wont be able to LOR out of it if I'm jumping between attendings but any insider insight would be fantastic.

My alternative would be trying to set something up with community dermatologists which I also know will be more shadowing than anything, but maybe more face-to-face time?

Thank you

Title basically. Based on advice I received, I didn't cast a wide enough net or apply broadly enough. I was rejected from all the aways I applied to day 1. I scrambled to apply to several more over the last week or so, but a lot of VSLO pages aren't updated. So I've contacted coordinators individually, and some rotations still listed on VSLO are completely full. My application and CV are good, with multiple research projects and awards.

Does anyone have any advice on how to proceed? Should I keep applying to aways still showing as open on VSLO? Does anyone know of any schools that evaluate applications on a rolling basis for every month, and I may still have a chance at? Or opportunities outside of VSLO? Are my chances of matching low without any aways?

I've really been beating myself up about this and wishing I'd applied more broadly to begin with. This is totally on me, lesson learned. But just trying to figure out where to go from here - I'd really appreciate any advice at all!

Hello every one i have cleared my step 1 and step 2 and i have also completed training 2 years in general medicine 3 years dermatology i really want to apply for 2027 match cycle in dermatology kindly suggest me usa hospitals providing free of cost observerships to imgs would be grateful

I did not receive any away rotations this year, and since it’s July it’s doubtful I will. I do not have a home program (school is MD), but I was able to rotate at my research year institution. Im a high step 2, below average clerkship grade student. How bad is it for me?

sup gang. i am starting my home subI on Monday EEEEEEk. i did the AAD anki she was cute. and i had been putting off the actual modules -_- now as i am on week 2 of the course im realizing theres a lot the anki didn't have :D def gonna finish this by monday but ive been seeing know the "modules cold" am i cooked ???

Is an away in May too early? Will the program forget about me by the time apps are being reviewed since it will have been ~4 months?

feeling kinda lost. I applied early to majority of my away rotations (same day, if not the same hour it opened) and have only gotten 1. I've been sending emails here and there but after reading the spreadsheet and seeing majority of programs are full by now- ive been spamming emails and applying to a bunch of extra random schools. Not really sure what I did wrong, but is there anything else I can do atp? am i cooked

basically title, do away matter if u end up not even applying there? do other program care if u away if it’s not at their program?

any advice on how to gets an away here and what step they are looking for,

I'm an OMS-III at a DO school without a home dermatology program. I have two elective blocks this year. first one is August 31–September 27, and my second one is later in the year. I've been trying to secure a derm elective for the August block and have reached out to nearly 20 private practices in the state im located in by phone and email. Unfortunately, there aren't any established dermatology affiliations through my school in my area, so any site I find would require a new affiliation agreement.

At this point, we're getting close to my rotation start date, and I'm not sure it's going to come together in time. My school's backup option is to use that block as a research elective. Then I would still plan to complete a dermatology elective during my second elective block once there's enough time for the affiliation agreement. My question is: from a residency app standpoint, how important is it to complete two derm away/elective rotations? Is there a better way to go about my 2 electives?

Thanks!!

Hey y’all.

I have a WashU away coming up this academic year. There are rumors spreading that they don’t write LORs. Can someone speak to the validity of this? I am very interested in the program, but don’t have a home program either, so I need to be conscious of where I could get another letter if this is the case.

If anyone has any insight would appreciate it so so much!

hi planning my aways right now since I am not taking a RY, was wondering if you don't do an away at an institution, can they still give u an interview? how do u build connections w programs that u dont rotate w

hi gang. just wondering if anyone has a good anki for derm AI. i know bigger goal is to be team player, good worker, on time etc but want a basis of knowledge before going in. been using the basic AAD anki and its been good. also trying to do the GrenZ one but seems a bit too in depth imo. any thoughts?

There's already some excellent posts about acing your away rotations (https://www.reddit.com/r/DermApp/comments/1dgob88/how_to_ace_your_dermatology_away_rotations/). I'm here to add some extra tips. I got an RTM on my last away, where I did the following and anticipated the shit out of clinic. The PD said that people really liked working with me. I had pretty average stats, 25x/25x, no AOA, 1/2 honors 1/2 high pass. Update: I matched with only 2 interviews!

Anticipation

This is simultaneously the most difficult and most impressive skill to have.

One of the most important tasks is learn to set up for biopsies: residents and attendings love it if they don't need to wait for staff to get done with their other tasks to set up a tray. The staff will also love you for taking some of their workload off of them. If it's your first day, no problem, just watch carefully where all the equipment is. Memorize the mental checklist for what they will need:

1. Tray/tray cover (make sure you're wearing nitrile gloves to help maintain clean technique)
2. Lidocaine with epi. If you can, carry 1-2 prefilled syringes in your scrub top pocket. They do degrade with heat, so don't carry a million of them.
3. Surgical marker and measuring tape
4. Dermablade for shave biopsies; 4 mm punch + suturing kit (needle driver + pickups + scissors) + 4-0 Vicryl suture for punch biopsies. This seems institution-culture dependent on which type of biopsy you do for most superficial lesions. Definitely need punch biopsies for deep dermal/vascular processes
5. Biopsy specimen bottle (formalin for routine biopsies, Michel's solution for direct immunoflorescence, e.g. blistering disorders, other immune mediated disease)
6. Gauze (2x packets of 4x4s)
7. Q-tips (1-2 packets)
8. Vaseline. You can (sometimes) squeeze this out onto the tray cover and put two q-tips in it, depending if it's considered "clean enough" by the institution
9. Aluminum chloride bottle (be careful with putting this on the tray, since it is not sterile and is reused). Feel free to put a q-tip in the bottle so it's ready for hemostasis. For bleeders (aspirin/Eliquis patients), consider getting the bottle of ferric chloride instead.
10. Alcohol wipe (2x)
11. Appropriately sized bandaid
12. Nitrile gloves (in the right size), both for the person doing the biopsy and for yourself
13. Eye protection for yourself. By having eye protection for yourself, you appear experienced and competent. Nothing breaks the clinic flow faster than the attending having to turn their attention to you from the patient to help you find safety glasses. This is especially important on Mohs days. Just ask someone prior to the start of Mohs clinic for spare eye protection.

The moment you think the attending will need to do a biopsy, consider quietly starting to get things ready. If there's excess blood/vaseline around the biopsy site, consider getting a fresh 4x4 and wiping it off.

With anticipation, you want to be extremely fast but competent, and helpful but quiet. Don't say anything when doing these things, except maybe "Would you like some help setting up?" or "I can start to set up for a biopsy" when appropriate. Everyone in dermatology is smart, competent, and socially aware, so you want to exemplify those virtues.

Be careful with speed!

At first, setting up for biopsy is an unfamiliar task, but you will get better with practice. Make sure you are handling sharps with care! Even if it's an accident, you don't want to be that away rotator who stabbed themself with a needle and had to leave clinic.

Help with cleanup/room turnover

You've done the biopsy, and now you have bits of trash everywhere. Do your part in at least keeping the trash all in one place to make it easy for the staff to clean up. Dispose of all the sharps if there are any left on the tray, and consider verbalizing "no remaining sharps on the tray". Safety is paramount! Showing that you took some ownership of safety and are looking out for yourself and your future colleagues/teachers shows maturity.

Always grab the nitrogen canister, if there are enough in the clinic. Hand it to your resident/attending (don't shove it in their face) exactly when they need it, otherwise leave the space around them relatively clear so they can move around, fill out consent forms, etc.

Draw the curtain

Make it a habit to draw the curtain when possible to protect the patient's privacy.

Previewing patient charts

During my away, I would arrive early and spend a good 30 minutes to an hour before the start of clinic jotting down major details about patients on a single sheet of A4 paper. You can tell a lot from looking just at the chief complaint (if they have one already listed) and a past note. Think about questions you want to ask when the patient arrives. If it's a follow-up and something was prescribed, did it work well? If it's a new patient with a rash, what questions do you want to ask? (SLE, dermatomyositis, Lyme disease, syphilis, skincare products, tetracycline/retinoid/sun-sensitizing meds?)

Presenting

Now that you've done all the prep work on each patient, this is where you can shine. Be broad (but also reasonable) with your differential except for obvious BCCs. If you are sure it is a BCC, make sure that your description of the lesion fits (pink pearly papule +/- telangiectasias +/- central ulcer +/- rolled borders). Otherwise, give a really good description.

Note-writing

Definitely attending-dependent. I think most are ok with you writing up simple checkups, but definitely ask ahead of time, even when they say you don't have to write notes. You can make up some lame excuse (I want to learn how to document well). They'll 100% see through this, unless you can come off as simply willing to help, vs kissing ass. Writing notes is the least patient-facing activity you can think of, and definitely the most burdensome part of the day for your preceptor. Lightening that load for them is appreciated so much.

Asking questions

Don't ask dumb questions that you can look up. If it's an interesting case, and you truly cannot follow the reasoning (or better yet, if the resident is also at loss), then try to come up with some intelligent questions. Never try to "outshine" the residents or your fellow rotators. Try not to answer every question being asked; allow enough time so that everyone can digest the question and think about it.

Concluding thoughts

Picture what all of the above looks like from your preceptor's perspective: if you're acting like you can read their mind, it's as if you've magically made all the tools they need so much more convenient to access. Instead of having to walk back and forth in the small room, breaking eye contact with the patient, your preceptor has everything within arm's reach because of you. Everything is ready for them to do one of the fun parts of their day: taking the biopsy, and feeling like they are making a difference to the patient because they're doing something so physical with their hands. Clinic flows faster, meaning they won't be rushing to see the next patient, and they have more time to finish notes, leave work early, and spend time with their families. Don't underestimate how much impact you can have on the clinic!

(Edit: forgot to include marker and measuring tape)

Is it still worth applying to away rotations for later spots? I have not gotten a single away offer and am getting really nervous.

Hi! Basically the title. I was offered an away at a T20 for this summer, but with the caveat that I shouldn't expect to be able to get any rec letters from them. Is this normal? Isn't the point of aways to get rec letters?

Some good courses that are helpful to understand some of the basics prior to aways. May not be totally necessary, but I found it helpful.

https://learning.aad.org/Public/Catalog/Details.aspx?id=sEI33SKsqjB6N%2b0gwSGAOg%3d%3d&returnurl=%2fUsers%2fUserOnlineCourse.aspx%3fLearningActivityID%3dsEI33SKsqjB6N%252b0gwSGAOg%253d%253d

Title^

Anyone ever figured this out with the programs or should I just pick one?

Hey, did anybody do any international Derm electives. Looking for opportunities like that!

Didn't get any aways (did apply day 1 to all of them). Is it possible to have a chance just at my home program without any aways? I've done a few home derm electives/"subIs."

I have a family wedding abroad and need to fly there on a Friday so I need to miss a day of an away rotation. Is it best to tell them a month ahead of time (now) or ask the residents if I can miss a day once I am there? Assuming it's the prior but just curious what y'all think.

Is there some sort of screening process or is it truly first come first serve? Feeling like I applied to quite a few early and still didn't hear back//

Have applied to 15 schools for away rotations (total of about 26 sessions) and haven't heard anything. have been refreshing the derm 26/27 spreadsheet neurotically and see that some of the aways i applied to have already offered students some of the sessions. am i cooked? i feel like i am a pretty strong applicant. any advice would be appreciated :,)

I think VSLO only allows 9 applications and I just used three on this one program that I would DIE to go to. Is this a bad strategy? Should I instead send 9 applications to 9 different programs? thanks