key: cord-0020425-vg1oi6bm
authors: Dekker, Paige K.; Abu El Hawa, Areeg A.; Fan, Kenneth L.; Song, David H.; Baker, Stephen B.
title: Shifting Gears Toward the 2021–2022 ERAS Application Cycle: Implications of a Single Away Rotation
date: 2021-08-25
journal: Plast Reconstr Surg Glob Open
DOI: 10.1097/gox.0000000000003776
sha: a4c50eeb4188dcb4541620f7e087b2e5ef0e2c68
doc_id: 20425
cord_uid: vg1oi6bm

nan

T he COVID-19 pandemic has brought unprecedented shifts in medical education, particularly for medical students who have already or will be applying for residency positions during the pandemic. The Coalition for Physician Accountability is a cross-organizational group with representation from various medical societies that has provided guidance regarding away rotations, residency interviews, and the ERAS timeline since the start of the pandemic. On April 14, 2021, the Coalition outlined its updated recommendations for the 2021-2022 application cycle: (1) in-person away rotations should resume with the first block of offered rotations concluding no earlier than July 2021, (2) each learner can participate in no more than one away rotation per specialty, and (3) virtual electives may continue. 1 Although not a required component of the residency application, away rotations provide a number of beneficial opportunities for both applicants and programs. Away rotations allow applicants to showcase their work ethic and "fit" at a given institution while also signaling their serious interest in that program. Research suggests that an applicant's performance on an away rotation is one of the most important factors considered by a program director in developing a rank list. 2,3 A survey-based study published just before the pandemic indicated that on average, 67% of interns at a given integrated plastic surgery residency program either went to medical school or participated in an away rotation at the institution where they ultimately matched. 4 As prospective applicants and program faculty and administrators begin to prepare for the upcoming application cycle, a number of considerations should be made with respect to planning away rotations (Table 1) :

• Choice of program: While this has always been an important consideration for students, a student's choice will carry even more weight in this cycle because they can only participate in a single away rotation.

• Timing and letters of recommendation: The first block of away rotations can conclude no later than July 2021 and this year's ERAS deadline is September 29. This timeline theoretically gives students three full months to complete an away rotation before applications are due. This condensed timeline may make it difficult for rotators to obtain a letter of recommendation at their away rotation. Because of this, applicants and program coordinators alike should prepare for a high density of applicants for the months of July and August. Given the limited capacity of institutions to accommodate their own students in addition to away rotators and students without a home program, it is likely, if not guaranteed, that many students will not be able to complete an away rotation in this timeframe. • Guidance versus requirements: Although the Coalition has outlined its guidance regarding in-person away rotations, the language of the recommendations allow medical schools and residency programs to utilize their own "independent judgment" in determining how to proceed with away rotations. This flexibility may lead to more flexible options-both in terms of timing and number of allowed rotations-for some applicants. The ability to do an away rotation will be of great benefit to upcoming applicants, but the limitations imposed by the Coalition with respect to number of allowed rotations and timing of rotations present unique challenges for students. 

The Coalition for Physician Accountability's Work Group on Medical Students in the Class of 2021 Moving Across Institutions for Post Graduate Training

Resident selection protocols in plastic surgery: a national survey of plastic surgery program directors

Away rotations and matching in integrated plastic surgery residency: applicant and program director perspectives

Away rotations in plastic and reconstructive surgery: a survey of program directors