Away Rotations and Sub/Acting Internships can play a large role in the application process for a Neurosurgery residency. Firstly, they offer applying medical students exposure and access to neurosurgeons, neurosurgical cases and even health systems that are different from their home institution, broadening their understanding of the field. Secondly, they offer students insight into the culture and workings of programs they are most interested in matching with. Lastly, Neurosurgery residencies are small in size, and matching someone who is not only intelligent and skilled, but fits in well and will excel with the team, is the goal of nearly every program. Away rotations also serve as a way for programs to meet interested applicants early.
By forming ties with people in the department that you visit, you greatly increase your chances of matching there. Be a team player with an impeccable work ethic, show that you know something (without showing-up the residents), be present, and be interested. Introduce yourself to every faculty member and try to gain some clinic exposure with them. Be helpful but not pushy. Interact with all the residents and take call. Anticipate where a need might arise and be there to fill it. Try and do at least one project or case report at each location to show initiative and follow-through. Read before cases and demonstrate preparedness. Stay until the end of a long, complicated case, and you will stand out. Investigate and review a few memorable cases so that you can demonstrate knowledge if asked during interviews — what was done and why. Remember that your audience is a neurosurgeon — ensure that you have taken the time to learn about the procedure and its indications.
Of course, there is always the chance that you will not click with the program you visit. This, too, is a benefit, as it is better that you discovered this before, rather than after, you have matched. Make a note of the elements of each program that you like and dislike so as to help judge similar programs with whom you interview.
Regarding Away Rotations, the SNS currently recommends that no more than TWO 3-4 week sub/acting internships are done, excluding a 3-4 week rotation done at one’s home institution. Students without a home program should perform 1 rotation of neurological surgery at the closest ACGME accredited program (adopted home program), and up to 2 rotations at external sites. Most away rotations are now done through the Visiting Student Learning Opportunities site, which streamlines the application process for away fourth-year medical student rotations. You may apply after your medical school distributes application tokens. Programs not participating will have separate, individual application processes.