How Important Are “Away” Rotations for Matching in Radiation Oncology? An Applicant Survey

Abstract

It is common for radiation oncology (rad onc) applicants to perform visiting (“away”) rotations. Though the nominal purpose of such rotations is educational, for competitive specialties like rad onc they are often perceived as an “audition” for particular residency programs. Away rotations entail financial costs (travel and board) and also consume limited elective time. We surveyed rad onc applicants regarding the perceived value, opportunities, and barriers presented by away rotations for medical students seeking to enter the field. An anonymous survey was emailed to all applicants to a single rad onc program from 2015-2017. Questions assessed number of away rotations, funding, motivations, and barriers, along with perceived impact on match results. Away rotations were defined as any rad onc rotation outside of the student’s own medical school. The overall response rate was 39% (n=194). The vast majority (89%) reported at least 1 away rotation. Among respondents, 39% (n=67) matched to a program where they did an away rotation. The median number of away rotations was 2. The vast majority felt that away rotations were extremely important (71%) or important (22%) to applying in rad onc; only 8% felt they were unimportant. Most (56%) felt the optimal number of away rotations was 2, while an additional 28% preferred 3 away rotations. The most common motivations were interest in a specific program (44%) and to obtain recommendation letters (31%). 9% did away rotations because they did not have a home program. Of those who did not do away rotations (n=22), 50% believed that it would not improve match chances, while 7 (32%) reported barriers such as costs (n=1), family responsibilities (n=3), and lack of opportunities (n=3). Sources of financial support for away rotations included personal savings (29%), family support (26%), or additional loans (22%). 67 respondents (35%) reported that costs were a limiting factor, stating they would otherwise have done more away rotations. These survey results confirm that most rad onc rotations perform away rotations, and do so in an effort to increase chances of matching successfully. A significant proportion of respondents matched at a program where they did an away rotation, and most respondents felt that 2 or 3 away rotations were optimal. This perceived importance of away rotations should be weighed against the costs, as many applicants reported being limited in doing away rotations due to finances. This suggests a role for measures to reduce barriers to access, such as flexible scheduling, 2-week rotations, and/or offering interviews at rotation’s end. It could also be considered whether the pressure to use limited elective time during medical school to perform “audition” rotations is ultimately in the best educational interest of medical students and the next generation of radiation oncologists.