An away rotation is one that is not done at your home institution. It is often used as an audition for a program that you are interested in attending for residency. It is usually more for you than the program. It is an opportunity for you to see if you fit in with the residents, the culture and location, and whether you can see yourself long-term at the host institution. If you do one, realize that you are signing up for a month long ‘interview.’ General tips to succeed are to be adaptable, hard- working and knowledgeable. Although anesthesia is a procedural field, don't forget that as physicians we add the most value with our overall knowledge base. You will need to strike a balance between being present, demonstrating procedural acumen, using the breadth and depth of your knowledge and reading up on your cases.
Preparation before the rotation
Depending on how the clerkship is arranged, you will either be assigned to a room or have the opportunity to choose your cases. It can be helpful to familiarize yourself with what the residents and attendings look like, so that you can introduce yourself when you see them. A quick Google search of their name and institution is usually sufficient. You will want to balance your clerkship with a variety of cases and people you work with. At the same time, try to work with the same attending for at least a few days. This continuity will enable you to build rapport and advance your skills. The more comfortable an attending or resident becomes with you, the more likely they are to trust you to perform procedural skills (e.g., drawing up medications, intubating, helping manage the anesthetic plan). Adapt your techniques as you work with different people, as everyone will have different preferences for how they like things done.
As for knowledge base, there are several items that an MS4 should be familiar with: how to perform a preoperative history and physical exam, how to place I.V.s, how to intubate, rapid sequence induction, difficult airway management, all the medications used perioperatively (indications, pros/cons, doses, side effects, etc.), and PACU concerns. If you’ve never placed an I.V. or intubated before, there are numerous YouTube videos to familiarize yourself with the process prior to actually doing it. That being said, nothing compares to actually performing the skill, so always be on the lookout for any opportunity to try. The first few times will undoubtedly be nerve wracking, but the more times you practice the more confident you will be.
Once the rotation starts
Every day before you head home, check the schedule for the following day. Try to find the attending and/or resident you will be working with to introduce yourself and find out their preferences for when to meet in the morning. Look up the patient cases if you can and develop an anesthetic plan using the Anesthesiologist’s Manual of Surgical Procedures. Try to identify what challenges you may encounter given any patient’s particular history, comorbidities, past difficulties with anesthesia, etc.