Rotation

Most away rotations are now done through the Visiting Student Application Service (VSAS), 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.

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.

Neurosurgeon Examining Spine ModelBy 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 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 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. 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.

Kleineberg et al. found substantial variation among European countries in the duration of residency training programmes, and especially in the choice of obligatory rotations to external medical disciplines. Despite a presumably similar spectrum of patients, neurology residency training programmes across Europe are not harmonised. The structure of the programme should be determined by its relevance for neurologists today and in the future ¹⁾.