Most away rotations are now coordinated through the Visiting Student Application Service (VSAS), which streamlines the application process for fourth-year medical student away rotations. You may apply after your medical school distributes application tokens. Programs not participating in VSAS will have separate, individual application processes and it is important to reach out to those programs individually. Apply to programs early, as many sub-internships are competitive and are quickly filled.
Not enough can be said about doing away rotations, especially if you have your sights set on a particular program where you would like to match. 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. If you demonstrate this over a month-long rotation, program directors will be eager to have you. Many students opt to do more than one away rotation and programs to visit should be individualized to the student in conjunction with their home program faculty mentor.
By forming ties with people in the department(s) that you visit, you greatly increase your chances of matching at those programs. Be a team player with an impeccable work ethic, shows a high level of knowledgable (without showing-up the residents), is present and is interested. Introduce yourself to every faculty member and do at least one clinic with them. Be helpful, but not pushy. Interact with all of 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 feel you are a good fit with a particular 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. Regardless of whether you liked your away rotation, it is wise to obtain a letter of recommendation from the department, preferably from the program director or chair. It is typically understood by departments that rotators will need these letters. However, at each rotation, you should determine the protocol for requesting a letter – it could be an interview at the end of the rotation or simply an email. An additional resource for tips on navigating the away rotations and interviews process is the Field Guide to the Neurosurgery Match.