Dhimitri Nikolla, DO, PGY-II
AHN Saint Vincent Hospital, Erie, PA
While many of us spent more time on away rotations than home rotations during medical school, doing an away rotation as a resident may be like learning to ride a bike again. As residents, we work hard every day to not only learn medicine but to learn to see patients as independently possible. We know that someday soon we are going to be the attending responsible for patients and there may not be a colleague at our side to ask for help. While climbing the ladder to autonomy is expected of us at our home program, it can often lead us astray during away or off-service rotations. As EM residents, most of us do a few away rotations, whether it may be Pediatric EM, Toxicology, or Trauma. But, no matter the rotation, here are some tips to get the most out of your away rotation.
Be humble. As we develop more and more skill and autonomy through residency, we naturally become more confident in our abilities. At our home programs, our attendings know us and our capabilities, and they are likely comfortable giving us autonomy. But, at an away rotation, the attendings don’t know us. While we may see patients almost independently at our home program, attendings at an away rotation may not even be comfortable letting us put in orders without discussing the case with them. It is important to learn what is expected of you and perform that job well. If you are unsure what is expected of you, just ask!
Be a student again. We all want to be that senior resident running the department, but on an away rotation our job is first and foremost to learn. Dedicate time before or during the rotation to reading pertinent literature even if it is simply reading (or re-reading) the relevant chapters in Tintinalli’s or Rosen’s. Likewise, pay attention to how your new attendings approach different clinical situations and how it may be different from how you were trained. You may have seen a hundred children with abdominal pain at your home institution, but a fellowship trained Pediatric EM physician will likely approach that scenario differently than you were trained. Sometimes, the best way to appreciate this is to take the passenger seat!
Away rotations, whether mandatory or elective, are an awesome opportunity to gain exposure to things you may have very little experience with at your home institution. Do everything you can to learn from those opportunities while doing everything that is expected of you without overstepping your bounds.