All right, welcome everybody. This is our first road to residency program. We're putting on this event quarterly or every four to five months to help all the medical students that are currently applying for residency in physical medicine rehabilitation. So hopefully that's everybody here. What we're trying to do is create these events so they're timely in the application process. So your road to residency, so we're able to answer questions that we know are on your mind. And then of course, we'll always have a Q and A. At the very end, we'll talk about what our future events are going to be. We're going to use social media to be able to get any of the questions that you may have for the future. So we can be as best prepared to help you get the residency spot of your choice. We're going to keep this less of me talking and more of these great, amazing speakers from the MSC, MSEC and the RFC. I will let the residents introduce themselves and what institution they're at so you know who they are. We will have their email addresses available so you can ask them questions, but please don't spam them with a thousand questions at once. But Mark, do you want to, why don't we just go through the list, everyone can introduce themselves. Sounds good. Hi everybody. I'm Mark Wolker. I'm a senior resident at the University of Minnesota. Also the current Medical Student Affairs rep on the AAPR Resident Fellow Council. I'm hoping to go into sports application. I'm also going through application season now. So I'm right there with you. But I'm excited to be here. Now popcorn to Eric. Hi everyone. I'm Eric. I'm a current intern at UT Southwestern. I'll be going to Mount Sinai, my PM&R residency next three years. I am interested in sports versus pain, I think more towards the outpatient side of things, but we'll see. Still a lot to experience in PM&R and then I'm also on the AAPR FC as the Advancement Representative. Hey everyone. My name is Evelyn. I'm a PGY4 and Chief Resident at the University of Washington along with Katie Spolinski here today. And I am the APWMCORR, a lot of acronyms, I can talk more liaison and I will be doing fellowship next year at Memorial Sun Kettering Cancer Center for Cancer Rehabilitation. Hi everyone. I'm Katie. I'm one of the Chief Residents at University of Washington also. And I'm doing a fellowship in interventional spine and sports medicine at University of Utah next year. All right. And the attendings? Me? I'm Dr. Ravi Kassi. I am the Chair of the MSEC and I'm the Program Director at Rush University in Chicago. I'll give it to Dr. Sautter. Hi. Good evening. Carly Sautter. I am from the Medical College of Wisconsin. I'm the past Chair of the Medical Student Educators Council for AAP. Okay. And Ashley? Hi guys. I'm Ashley Bolger. I am the current Secretary of the Medical Student Educators Council. And clinically, I'm in Cincinnati at Cincinnati Children's and I need to repeat that. So Maya, you're up. Okay. I'm Maya Theriotal. I do inpatient rehab in Princeton Medical Center in Princeton, New Jersey. But I'm also the Pathway Director for Physical Medicine and Rehab at Drexel University College of Medicine, Philadelphia. And my name is Nikolaj Dreguelovic. I'm the Program Director at UTHealth Houston in awesome Houston, Texas. And I came here for the good coffee. Awesome. All right. So we've got a great panel, residents, attendings, and then we have some amazing students that are going to be listening to all of our wisdom. I hope it's great wisdom. We're going to be accomplishing two things. One is answering questions that were posed regarding VLSO. And then two, about how to prepare and get yourself ready for your audition elective. The VLSO questions are going to be handled by the attendings. So I'm going to pose the question and I'm going to leave the floor open for our attendings to answer. I'm going to have the chat open, or at least I hope I do. Amy can help me with this. So if there are any specific nuanced questions, we'll be able to answer it in real time regarding VLSO. So the first question that was posed was, what if I can't apply until June? Will I be able to do an away rotation at an institution of choice? Ashley, maybe I'll just give that question to you. I was going to say I can take it because I'm the Clerkship Director at my institution. So I think it really depends on just the institution you're at. I think there's a lot of factors that go into us allowing students to come resonate, rotate, or pick students that come rotate. I think every institution is going to have probably a defined number of students that they will accept on any given block. And that's probably your biggest limiting factor. And there's a lot that goes into that, whether it's a large program, a large residency program, a smaller program. I think most of us who do medical education don't want to overwhelm our systems. We want, if you're going to come and rotate with us at our institutions, we want you to have a great experience and get a lot of good one-on-one or kind of individualized attention. And so that's where a lot of just the limitations come for how many people we can have rotate us at any given time. June is a little late. I would say if you're looking for doing kind of one of those hot months, so sort of the July through, I would say, September, maybe even October. I think if you're trying to apply to a program, and I'll use mine as an example. We take typically two students a block because we're a smaller program. I have no spots at this point. We've already given away all of our spots through, I think, at least October. We might even be into November. So it does get a little more difficult. So I would maybe be a little bit more cognizant about how many students people take or like, is it a bigger versus smaller program? I think you might have a little more luck with larger programs or maybe, quote unquote, less popular programs or something like that. But I still encourage you to apply. I think you never know until you do. And I mean, there's so many factors that go into things. So you just never know. I was going to add, too, if it's all right. You know, we in PM&R, you know, I think there are a lot of factors that could make a student not be able to apply until June, obviously. But, you know, I want to provide some reassurance that while it's a, if you have the opportunity and the means to do an away rotation, particularly if there's somewhere that you really, really want to be for either, you know, family reasons or educational reasons, like, absolutely, you should try to do it. But, you know, I think it's important to also know that we are not yet a field where it's a requirement. And so you aren't necessarily, as a student, at a disadvantage if you don't have the opportunity for whatever reason to do an away rotation. And so, you know, I think that can be a huge source of stress for students. And so there are some very obvious reasons to do one. But just to give a little reassurance that it's certainly not a requirement at this point for this, you know, coming year. Wherever, you know, these things can change year to year, of course, but it's and so it would be, you know, favorably looked upon it in a lot of ways, assuming you do you are your do a great job on the rotation, of course, but, but certainly not at a point where it would be a requirement for an application. And as a, just as an added thing as well, people sometimes rescind their away electives. So if there are institutions that you're really interested in, email them with your situation as to why you can't apply until it's too late. And then if a spot does open up, perhaps you can pick up that that spot. And hopefully we can transition to the second question, because I know this gets posed a lot, which is, is it true that programs will remember if you are offered and then decline in away rotation at their institution? Will they hold it against you? Or is it just if you fully accept it after the offer and proceed to cancel or withdraw from it later on? So what do we all think? I'll take this one. I don't think we're that mean in PM&R. We very much understand that you all are applying to many different places for your rotations as, you know, Ashley and Carly mentioned. And we know that people's schedules change. We know that financial situations change. We know that family or personal obligations come up. And so I think the best thing that you can do is notify a program as early as possible that you can't make it. Be professional about it. Be willing to offer that spot to somebody else who wants it. I don't think programs are going to hold it against you if you, if you go about it in a professional and responsible way. I think as long as you don't ghost them, I think it's all, it's fine. So I think ghosting is never a good thing in any aspect of your life, I think. Yeah, that will be remembered. Agreed, totally agree. And I'll just throw in, you know, I don't really remember, like I can tell you and maybe others have a much better memory or have more bandwidth inside their head, but I personally do not remember all the students that applied and were on sort of like the wait list-ish or whatever, or then, you know, then like pulled their application back. And honestly, sometimes I don't even know that at my level. My program coordinator sort of just pieces all that together in the background. That may be different at other institutions. I don't know if that's how it works for everybody. But we got a lot of things going on in our head related to all of this. So I don't, I'd be shocked if people remembered every single person that they offered a spot. I agree with Ashley as well. Especially as you grow older, it's hard to remember names and things as much as we did much earlier. And I think that, you know, one of the things that, you know, you all as applicants may not realize, but, you know, this is the time that program directors start getting bombarded with emails from applicants saying, oh, I really like your program. I'm applying to it through VSLO. I couldn't get into VSLO, but I still really like your program. And, you know, here's all the cool stuff I'm doing. I mean, literally we get hundreds of those, right? So being able to keep track of like who did what, just like Ashley said, is really, really hard. So, you know, if you send in an email inquiry about something, don't expect an email response back within 24 hours, especially in the ramp up to, you know, these rotations and interview season, right? Program directors are super busy and program coordinators are super busy onboarding the new residents in July, right? Offboarding the graduates who left at the end of June. And the start of the academic year is a really busy time for us. And it's not that we're ignoring you or that we don't like you or something. Don't read into it that way. It's just that we're tied up with a lot of other stuff and we promise to get to you as soon as we can. Well, this is perfect timing. So maybe you can continue this and we'll ask more of an explicit question on, you get a thousand emails. Should people contact you as a program director, if they're interested in doing an away rotation before they submit the application and what should they say if they are, you know, going to contact you? I think for my smaller program, the only way that that might be helpful is if you already had a connection with our program that I might not know about. But we're also a program that requires like a brief paragraph. So that's what I'm really hoping that people put in there. And I also would say, I can't personally guarantee that that email won't get lost. Regardless, I feel like there's just so much stuff coming in. Um, so I feel like for me, at least it's, it's the like, you know, I, the regional schools that maybe they worked with one of our residents on a project that I might not have been involved with and just didn't know. And so know a little bit more that I might remember. But I don't know that, I don't know, at least for me, I'm not sure. I remember a lot of those. If I'm reading the question correctly, I think one of the answers that Ravi said earlier also works for it. The fact that people do drop out. So if you did want to reach out to the program, saying that I've applied to it, I don't know whether I'll get in. But, you know, please keep me in mind, because I would really like to come over there for whatever the particular reason is. Now, if you were to write an email like that, that would make sense. I tell my students to do that when they really can't get in somewhere, because I do know that people do drop off at the last minute. And you could be really lucky to get into one of those. So, you know, being at the right place at the right time does help at times. To piggyback on what Maya said, and was said before, I think the email has got to be twofold is one is the timing. So Maya's email that she's recommending sending is down the road, maybe June, or even July saying, like, I really love your program. I'm very flexible with my schedule. I still have, let's say, August or October open. You know, if you have that spot open, please let me know. I'm willing to travel to be at your program. That timing makes sense, because if we have an open spot, I sometimes I get frustrated. I'm like, gosh, I would have given it to somebody. Hopefully we can find somebody that can take that spot. And the other part is in the email, if you just write a generic email, may not be able to capture us, because like everyone had said, if you're doing something extraordinary, and your mentor in PMAR says, man, this is awesome, including this in your email, great. You know, if you're, whatever it might be that you think is cool. Otherwise, if you're like, hey, I do well in school, and I eat my Cheerios every morning, you know, we're just going to say this is going to look like every other email that's coming through. So really highlight, be very brief, but highlight something extraordinary that you're doing. Or like you might say, you know, whatever it might be, that really goes a long way. So Carly, any thoughts before we go into the next question? Well, I was just going to say, you know, just to kind of comment on one of Ashley's comments is most programs do require some kind of a personal statement, like a mini personal statement. And that's, I think, a great place to add some of that additional information that's really personal. And so making sure that as you put your applications in, even if you don't send emails for all the reasons we've maybe kind of discussed here, that that's a great place to highlight some of those things as well. So you really take advantage of that. Awesome. And I think I've inappropriately ignored our great residents that are helping us out. Evelyn, do you want to give your thoughts? you don't have to put in the chat, you can discuss with the group. Sure, I was just saying that the two away rotations I did were at the NIH kind of doing like a research type of rehab experience and then a pediatric rehab rotation in Kansas City and gave me a lot of exposure to different areas and then again had a lot of great discussion my interview season. So if you find that you aren't getting rotations that you want in certain locations, there are some unique opportunities out there for sure. Thank you so much. And then our fourth question, how long do institutions take to come to decisions regarding applications? That probably helps some time when they should send the email being like please take me to your program. Ashley, I know you said you're the one that reviews them at your institution, do you want to take this to start? I can do that. So I would say for us, I try to do it within a month of whenever we open our application for us and I know that that is different for each institution because at least for us it's set by our GME and all of our programs open at the same time. But I would say I usually am trying within three to four weeks that I have essentially the list handed to my program coordinator to start that process of scheduling. We are also an institution that has started eking back our start day for fourth year, so this was our earliest VSLO or VLSO season ever. And I think we opened in, let me remember, the February beginning of March or something kind of crazy, which we've never done before, but it's just the way our calendar falls. Our first fourth year rotation is the beginning of May, so we had to kind of get all that situated and we were taking away rotators to be able to get them in and badged and all that good stuff. So I don't know, for me it's usually three to four weeks. Some years are better than others. Some years I happen to have a great like breadth of time in the week after VLSO opens and sometimes it takes me a little longer. It totally depends on my schedule and what else is on my plate at the time. Yeah, our program is shooting for a one-month turnaround and we're reviewing them on a rolling basis, but like the first week we got 50. So, you know, it takes some time, but we're shooting for a one-month turnaround. I'll also put in a plug, you mentioned that's a good one, like a rolling thing. The way that VLSO is set up on our end, it's not the easiest to see when new people apply. So if you're somebody that is like, you know, whoever submitted the June question and that's a little bit later than when that school's applications opened, that might be a good reason to shoot the program coordinator an email and just say, hey, you know, I was, for whatever reason, I applied late and I just wanted to make sure you saw my application. I don't know if that's the same for everybody, but we have not come up with a great consistent system to figure out if people are applying much after our initial opening. It's just not the easiest system from that standpoint. Okay. And then, yeah, and then how many OA rotations are a safe number to apply to? Open this to anyone. Because at most you can do two to three, I would assume at most med schools. I would say, you know, it doesn't hurt to apply, right? Sort of like we've been mentioning, you may need to apply broadly in order to secure one or two at places that you want. And so I don't think it hurts to apply broadly because you never know how the timing of your fourth year is going to pan out and what obligations may come through or change over that time. As, you know, Carly mentioned previously, I really don't think that having an OA rotation is a requirement in our specialty. As program directors, we're very cognizant of the fact that many medical schools do not have home PM&R programs for people to rotate at. And if you're not able to get an OA rotation for a variety of reasons, that's not necessarily a dock on your application. And so I wouldn't look at an OA rotation as a requirement. So get the rotations that you want, that you can, because you want to visit a place and see if it's a right place for you. And you want to see what the resident life is like and the learning environment is like and the teaching environment is like. Those are all great reasons to do an OA rotation, right? You want to try to impress the faculty there with your hard work and dedication to patient care. That's another great reason to do an OA rotation, but it's not a requirement. But that being said, you know, it really has the potential to help you, especially if you're applying to a program or there's a program that you're interested in and you don't even have, and you don't have an immediate connection to the program on face value, at face value. It could really help you get to know the faculty there and give you an opportunity to let the faculty and the residents know how interested you are when you are there. Awesome. I was going to say, I would just also, and I might have interpreted the question a little bit differently, but just in terms of like, if you want to have the best shot at getting some OA rotation, like if that's a really important thing for you, I think the more months that you can rotate or the more blocks that you can put on there for each school certainly helps. And if you're, you know, if you have like one very finite, my school's only going to allow me to leave for this one block, then I think applying more broadly is probably in your best interest because that just, it just narrows down your options. And so kind of balancing those two things is pretty important. Also, I think some of the rotations don't like coincide with your home school's rotation. So it might be that you might only get like two weeks or you have to make use of the extra two weeks that you get at the beginning or the tail end of your rotation to do something else. So it's not a bad idea trying to see which all programs might have their rotations, which coincide with yours. It happens to the students from our school all the time. And I wanted to pose a question written by Austin Anderson. Maybe the residents, the residents that are speakers here can kind of help guide this, but how do you choose between so many great programs when many offer a four-week rotation and time is limited? So what did you all do to help figure out where you wanted to go? Maybe Evelyn, you can start. I think you had kind of answered this a little bit. Sure. I honestly only applied to those two places because I'm one of those people who likes really early and the NIH one was actually one that opened up really early compared to the other programs. Because I applied so early, then I got it. And I think it was a rolling sort of admission. And then again, pediatrics, I don't think was very competitive. So I'll let someone else answer if they applied to maybe more than I did. I had a lot of flexibility at my medical school to do more than four weeks of away time. I went to VCOM, an osteopathic school in Virginia, and we didn't have any PM&R presence or an academic institution that we could get any sort of connection with a PM&R doctor. So for me, I felt like I really did need to apply to a few any sort of connection with a PM&R doctor. So for me, I felt like I really did need to do an away rotation to get a letter of recommendation from a PM&R doctor. I don't know that it's a requirement necessarily to have that, but I do know in my experience, now being on the other side too with doing some recruitment at UW, I do think having a letter of recommendation from a PM&R doctor who is associated with a residency program or who works with residents is helpful. Perhaps not required, but I think it is helpful for your application. So I can't remember how many I applied to, but I ended up doing like 14 weeks of away time at four different institutions. And for me, I thought that I wanted to be in a certain area geographically, so I sort of focused there. And then I ended up matching and ranking somewhere that I didn't rotate. So for me, it was just geographic at the time. I could like live at home and go to some of these rotations. So I think the general consensus will be there's no right or wrong way in terms of looking at a program because people got things out of whichever experience that they went to. As long as you work hard and you show yourself in a positive light, hopefully you get a strong letter of recommendation and the doors will open for you. And also the consideration of picking programs that may have not intangibles, right? It's the location. This might be your one month to be closer to your best friend before you go off to the different coasts. That one month may be worth a lifetime of experiences. I can speak to my cousin being in Chicago for two years. It was just the best time of our lives when we were young and having fun and I wouldn't trade it for anything. So a lot of different factors. For the interest of time, we're at the 728 mark. I want to make sure that we're able to flip to the audition elective questions and then we'll make sure to sprinkle in a lot of the questions that were posed. All right, audition elective. So we'll just open it to everybody, but hopefully the resident council can take the lead because they're the ones that are going to help guide a lot of the decisions made by the attendants in the future. So question one, how can I do well if it's my first exposure to a rehab floor? What are you looking for in a student? So I know when I have students with me, I'm not terribly interested in what's your rehab knowledge already. I know you're going to go, this might be your first exposure. You might know nothing about rehab. So what I'm looking for in a student when they're working with me is how engaged are they? Are they interacting with the team? Are they asking questions? Do they respond well to feedback and build upon things that we've taught them? Just kind of, are they a good team player? That sort of thing. I don't necessarily care if you have good rehab knowledge. You're going to learn that during residency and it's not something you pick up during med school. So we don't expect that of you. I think too, something that I got advice on and is kind of applicable for everyone is honestly just showing commitment by like knowing the patient entirely. So going to their therapies in the afternoon, I remember one of my rotations, there was this spinal cord injury rep that came to visit the patients after hours and just talked about community resources and things like a portable ramp for your home and things like that. And I stayed an extra hour and I learned a ton outside even the medical realm. And then the next day on rounds, I could mention, oh yeah, and the patient saw this guy at five o'clock last night. And it just helps the team in kind of more intangible ways. And so I think that there is a lot you can do beyond just the PM&R knowledge and honestly makes it a lot more fun, well-rounded experience as well. I would say definitely okay to say it's your exposure if it is, or if you don't have much exposure to say that and that will be kind of where you're at. I would say some successful rotating students have really gotten to know the therapist really well and established just with other members of the team, including the medical team. And I think it really is the relationships and trying to help the team with like printing the lists out or just like being helpful. But yeah, definitely agree that the rehab knowledge doesn't have to be strong at this point, just being engaged. I don't have much to add. I think that was all really good advice. I think echoing what some of the residents said about getting to know the players on the team is really important too. And learning the names of the nurses on the unit and the therapists and the social worker, because when the rotation ends, I think that the doctors, whether it's the attendings or the residents you work with, will be looking to those other people on the team to hear how those interactions went with you as a visiting student. And I think that that's important to get strong feedback from those people too. Attendings, any thoughts? Yeah, I would agree. When we have medical students rotating with us, I am looking a lot more at their interactions with other team members and soft skills, leadership traits, because we can teach the knowledge. But if you are socially awkward and yell at colleagues, I don't think we want you at our program. Just to add to that a little bit, even though we do say that the knowledge is not necessary, we also do want to see you learning as you go through the rotation. So be attentive. I mean, if people have gone over stuff one or two days, and then you come the next week and you act as if you've never heard it in your life, that might not be a good thing. So absolutely, if you're taught something, learn it. Not only learn it, go home that day and read more about it so you know more about it. You don't have to come in with knowledge, but what you see, you should learn. I think that is exactly kind of how I view things. I don't know if anybody out there has heard of the term growth mindset, but kind of doing things for the benefit of growing as a physician and not necessarily performing to get a grade or a letter of rec or things like that. And I think students that are able to do that well and are genuinely wanting to interact and do things in a way that they just want to learn, it always stands out in my mind. So I think that that's a really good thing. So that's kind of what mine would be. And remember, you're going to be spending a lot of time with the residents. So after the rotation, we're all going to ask the resident how is so and so on the rotation. For a lot of the residents, their second year or their inpatient year is going to be very stressful for them. So ways that you can shine is do all the things that you know is stressing them out on a certain day. If they're like, oh, I've got to run over here to do this. You're like, no, I'm going to run. I got my running shoes on. I'll run over here and do this. They'll be so happy with you because you're reducing their stress. Going along with that education piece is that if a resident is stressed, but they are taking the time to teach you, they're going to be very invested in that. Maybe I'm an old attending. I'm like, I guess I did a bad job of teaching. If the next day you come in, you're like, what? Just like someone had mentioned, it's going to be very frustrating for the resident because they're going to say, well, I spent all this time teaching you and you didn't even pay attention and go home and look it up. And the final piece is that you all have family, friends, people that you connect with. Really, what a resident ends up telling me, I'm like, how smart were they? How good were they? They're going to be like, oh, man, they were such a great hang. We went out afterwards. We did this. And I'm like, but are they a good worker? All the things that the residents tell me is how much they liked someone as a person and they loved having them in the room. Even that person did zero work. They're like, we just had a great time. And while that seems silly, that really does play a lot into how residents perceive you as being someone that can be in that room and make them smile. All right, for the interest of time, I'll continue. How can I get a good letter of recommendation from an away elective? Maybe this is an attending question. I see Ashley's face. So maybe Ashley, you can answer this. I mean, I think just making, I think it's different. I think this one's a hard one because I feel like just talking with my other colleagues, I feel like everybody has a slightly different preference. I'm one that within a first few days of a rotation, if there's a student that realizes we're gonna be together a lot, like at least saying like, hey, can I meet with you? And this is my goals. I mean, for the vast majority of us, we know that if we have a student for a week to two weeks with us, that you're gonna ask us for a letter of rec. But I think just maybe having that conversation earlier rather than later, because in my mind, I tend to take notes and I tend to like kind of put those somewhere so that I can remember when I write. But I also have colleagues that don't like that. So I don't know if anybody else has any other thoughts with that, but I do think it's a little bit variable depending on the attending. Yeah. So from my standpoint also, somewhere around the mid rotation, I would like my student to tell me that they're expecting a letter and then go over things, go over the goals. I usually, once they say that, I review things which they've done during the previous time that they've been with me and kind of give them goals to work up towards the end of the rotation. So when I write that letter, it can be more meaningful. And I will put in those specific things that they did, which is out of the ordinary, because turning up every day and being there and doing what you're expected to do brings you to a five on 10. If you wanna go up from that five anywhere close to the 10, you need to put in extra effort. And that's what I think shines in the letters that people write for you. So that's normally what I expect from a student who wants a letter from me. I would also echo a couple of things. So I think you should also be prepared to provide the attending with an updated CV. And depending on the time of year, a personal statement, because I think that can give them more context as to who you are and your sort of greater dedication to the field or leadership. And it allows them to really highlight some things they might not otherwise know about you. And I wanna kind of just, to one of the points in the chat too, I think usually students have a pretty good feel of who they're getting along with well and so on, but I do think it's important to not have a lukewarm letter. And so there may be times when attending doesn't know you very well or knows you less than you think they know you, or they may be busy with other things or overwhelmed. And so I think giving the attending an out, for them to not feel trapped, not trapped, that sounds so negative, but give them an opportunity to say no. And that doesn't mean they don't like you. And it doesn't mean, it may mean they are too busy to do it well. It may mean that they don't know you as well as they could. And so I think the strong letter, a single strong letter compared to a couple, maybe not as strong letters, just, I think that's a way that you can sort of in a professional way, have that conversation with an attending. And so they don't feel put on the spot to write a letter that maybe isn't as strong as you deserve. I think, and this is, I wanna make sure I word this properly, but not everyone is gonna write a good letter, even if they intend to write a good letter, because not everyone is a good writer and they may not have time. So one of the things you can do, if you get in good with a resident and you're really cool, you can ask them, hey, who should I get a letter of rec from? So it looks at, and they'll be honest with you. Be like, hey, don't ask so-and-so because it's not gonna be good, ask so-and-so. Or they might say, you know, that attending, I'll help you get on a week or a two-week rotation experience with Attending X, because Attending X is so well-known in the community and their letter means a lot, even if it's not written properly, because they'll text on your behalf X, Y, and Z. So that's another thing you can do, but some programs will have already self-assigned experiences that you're gonna be doing. So it may not allow you, but there's a lot of places where you can get in a day or two with somebody else too. So, all right. What are common mistakes you see students make on their ways that we should avoid? Maybe the residents can talk about things that have made them frustrated with a student. Oh, go ahead. Sorry, I was just gonna say, I think we had some students who came who were trying to show that they were easy to get along to, but then it maybe came off as too laid back. And so then they maybe didn't spend enough time working with the team and putting in as much effort clinically. So I think balance between those soft skills and clinical skills, even if you are laid back, definitely put in the work as well. So we wanna see you in action. Sam, you got five minutes. Other things I would say is, basically don't do the opposite of what we said before. A lot of the students that kind of had stood out negatively to us are people who weren't team players. They would show up late. They wouldn't follow up on the tests that they had ordered or they just really weren't reliable on some of the clinical things. And then the other thing that really kind of grinds our gears at Minnesota are when people copy forward and don't pay attention to the details and don't update their notes. We've had a few students who tend to do that. So just making sure you're fairly meticulous and making sure the note is up to date and doesn't have things left over from days or weeks ago. If you do have that capability of writing notes as a student those are a couple of things that we've seen a few times that just really don't sit well with us. I think another thing to add, your first couple of days on rotation, obviously you're gonna have a lot of questions about like the workflow and what your role actually is. But once you're like at least a week in, I think when we start getting like questions like, well, what can I do to be helpful? Or like, how can I help is usually not helpful. So learning a lot in that first week so that you can just sort of do things and show initiative without asking us how we can have you help us can be helpful for the team. So that's one of those things that you'll have to sort of figure out as you go. But don't be afraid to show initiative and as long as what you're doing is safe it's probably gonna be helpful to go see a patient without necessarily telling us that you're going to or to follow up on the lab without asking us if it's okay. So that can be really helpful. One other thing to comment and hopefully this goes without saying but it's sometimes surprising to see in certain students that what you do and how you behave and how you present yourself matters not only in the clinical environment but in your interactions outside of clinic too. So if there's like after hours journal clubs or social events that you might go to, your interactions with other like staff and things like that, those things really do matter. And so, just remembering to be professional at times even outside of clinic it matters. Those things can come back to haunt students at times if they're just a little too casual or a little unprofessional at times, those things matter too. Also in the way that you deal with patients as well because PM&R a lot of times your patients become very close to the attendings or have different relationships. So a lot of times the patients and their family members give a lot of feedback about medical students. In general, patients love medical students but they also do notice who's a good medical student and who's not. So remember patients are watching too. Awesome. All right. Some of these questions have been answered or maybe unanswerable by question six but just a quick question answer. Do you all recommend offering to do an educational presentation of five minutes? I think most people would say it goes without saying even if they say you don't need to do one unless they tell you, please do not do a presentation. I think a lot of programs will require it but I'll open it to the floor. How do you all feel if you disagree or agree? Agree. All right. Well, we'll keep it moving. I think that's an easy one. So for the residents, what can a student do to help the team that a resident or attending may not be able to do or have as much time to do? So what are examples of just ways to be self-directed without being inappropriate, I guess? So I've had students sometimes go ahead and do things with patients, like go over instructions, especially for patients getting discharged home. There are a lot of things that people might not have the time to go over in detail with them. And if a student takes up that as their responsibility and spends like a 45 minutes when the patient's not in therapy to go over those things, help them to understand the medications that they're taking, the exercises that they might be doing and the follow-ups that they need to do would be a great thing to help the team out with. And an easy way to cheat so everybody knows what you've done is when you can write it, I always tell our students, just write a quick one-liner from a medical documentation perspective of what you did. So you said, if every note has your name in the chart because you, hey, went over medications, patient's questions answered, wants to know about that listen or whatever, then you document it and then we know what work you're doing too. So me as an attending, I'm like, holy crap, this student was all over this patient's chart in a positive way. I think there was a resident that wanted to chime in, sorry. No, that's okay. I think that answer was probably close to what I would say. It's hard to know like, I guess how much, like what your knowledge base is, but oftentimes I feel like when you're rounding as the team in the morning, a patient will want to talk about something in a little bit more detail and maybe the whole team doesn't have time at that moment. So circling back and just spending time. Sometimes it's really just the FaceTime that the patient wants and you don't necessarily need to give a lot of information like medically speaking, but just being there and listening and following up and things like that is always helpful. Then I just want to point out and give a shout out to Evelyn. Given some specific examples in the chat as well. So things like talking more with patient's family or their caregivers, printing out the list for the team, following up on labs and consults that were placed earlier in the day, looking at literature that may be relevant to their patient just for some very specific examples. And Mark, thank you for pointing to the chat. There's just a lot of questions being answered in the chat. So please look at the chat because all the attendings at Horizons are doing phenomenal. I wish I could repeat all of them. Okay, just for the interest of time, I'm going to keep it moving and then we can go through some of the chat questions. What's the best learning resources for our weight rotations? Anyone present have any thoughts and things that they would recommend? I think PM&R knowledge now is kind of a good resource for a medical student. It's learned about basics of common PM&R issues. Essentially it's up to date for PM&R if you haven't looked into that yet. Yeah, that's usually the one I go to too. So definitely recommend that one for the students. Am I dating myself as a geriatric millennial by quoting PM&R Pocketpedia? No, you aren't. Our clerkship coordinator always gives that one out to our students too. Yeah, I think that's probably, that's the easiest one that you can like slip into your white coat pocket. Have like quick access to dermatomes, myotomes, basic pathophys, basic differentials for common complaints. And honestly too, I think PM&R knowledge now is something fantastic you can do from home. But when you're on the floors, you want to be mindful of not being on your phone because while you might be looking at PM&R knowledge now, I don't know if you're making your next TikTok video or you're on Instagram or whatever. So it might be good to have a Pocketpedia so it looks like you're actually opening up a book. And I would also tell you just some etiquette with using your phone, just being like, you know, if something is questioning you, you can be like, hey, you can ask the question, be like, hey, do you mind if I look it up on my phone? Don't be overbearing with it because then you can be like, hey, I found someone's asking, you know, someone's quizzing like, what's the highest dose of medication X? And you're like, hey, I found it on my phone. And that's also appropriate, but just be mindful. The phones are a good thing, but, you know, we all know what young people do on the phone and myself as well. We're always goofing off on the phone. All right, so we've got 10 minutes left. We can do our final finish. Like this is PTI. If I'm dating myself, that's an ESPN show that is Tony Kornheiser, which is awesome. Anyways, let's look at some of these questions here. We can just give, you know, we'll just do like a quick tidbit here. All right. I think a lot of these have been answered in the chat. I don't know if there's, maybe, yeah, there's a lot of these have been answered in the chat. Maybe, I think Reza had mentioned, what are your thoughts on doing an away elective in January and February? I think Ashley and Nicola had answered this. Nicola, do you want to just give your tidbit so the group can understand or know? Sorry, what was the question? About doing the away rotation in January or February? Oh yeah, honestly, I think that's a great idea. First and foremost, it pulls you out of the most competitive time when people are trying to get away rotations, but you can still get an away rotation ahead of rank list matching time. So, and arguably you may have a better learning experience because you're not competing with as many learners who are trying to get in, you know, like June, July, August, September. And it's still plenty of time to let your interests be heard in a particular program. So I think January or February is the like secret move to be able to rotate at a place that would be harder to get into in the prime months. Awesome, Christian had mentioned, how do you view letters of recommendations when you do not get an away rotation and therefore will have a harder time getting PMAR letters? This is something Carly had answered. Carly, do you wanna answer that question? Uh oh, I think we lost Carly. Carly's muted. Oh. Whoops. Sorry. Um, okay, so I'm pretty sure that I wrote, um, that, uh, it's okay to have two letters from the same institution. Um, you know, especially if you've rotated in two different, like, electives, like maybe you did spinal cord and then maybe you did a, like, outpatient MSK rotation, they're going to have two very different perspectives on you, um, uh, and so it's, it's okay to have letters. If you don't have an away rotation, it's totally okay to have letters from the same program. I don't, I don't see that as a, as a bad thing. I think many students are in that, in that scenario. The more diversity, I think, in terms of the clinical settings, where those letters are coming from, the better, um, but, uh, but I, I don't think that's necessarily a problem. I hope that answers your question. I lost the question in the chat, so I didn't reread it there. I was also responding to another one, so I was off for a second there. Yeah. And I think if you're having a tough time getting a lot of PMAR experiences is exactly what Carly said is make the most out of your situation, but it's also, you know, if your school had put up some, some restrictions, that is going to be a narrative that you want to write in your personal statement of, I had one opportunity and I went to program X or clinic X because they wouldn't let us let you go different places, whatever it might be to explain yourself and your commitment to PMR. And remember in that scenario, you know, where, when you can't do that many clinical experiences, you are extracurriculars need to be strong. You can't say you've done no extracurriculars in PMR, no scholarly activities, and you've did one, two week PMR elective, you know, you're not really going to be selling yourself to us, you know? So it's got, it's, we're doing a holistic review. So this is just one component of that. I think there was a question that I think is important here by Chris who said, how do you navigate a schedule overlap? Lots of schools are on different blocks, schedules and overlap by a couple of days. Would one still be able to apply to those blocks if they still have to miss two to three days coming off another elective? This is another one that Nicola, you had answered if you want to answer it from your perspective. Yeah, I don't think it's a big deal. You know, if you have to take two or three days off because the schedule doesn't quite line up with your schools and the visiting program, just be upfront about it and do everything you can to maximize the time that you're there. I would say too, and I think I said this in the chat, sometimes it can be more than that. Like if it's like a week or something like that, I would recommend starting with your home institution. And we see this with our students a lot. Every school is going to have sort of different policies on this, but depending on how much vacation you get, if you get study time, interview time, a lot of schools will be willing to flex that for you a little bit. Like for example, if you get a vacation month, but that block of an away rotation is sort of at a time that doesn't quite add up, they may allow you to do a week of your block in the beginning and then the rotation and then three weeks later. So there may be some flexibility. And so I think starting with your home institution, if it's more than a couple of days and see what they can offer, they're going to be used to dealing with this because medical schools are on very different rotation schedules for a lot of times. And a question, I think we're running low on time, but Ashley can answer this question because she is the program signaling geographical preference guru. So our away rotation generally offered an interview at your program. If you are selected for an away rotation at your program you're interested in, should you also signal them, Ashley? I think Ashley is fine. Ashley hopped off. Oh no, okay. I'm on the same committee as Ashley in the AAP that's tackling this stuff. So the AAMC will be announcing recommendations to signal whatever programs you want, including your home program or visiting away rotation. So PM&R will have five program signals in the next application season. So use your program signals as you see fit. Awesome. Andrew had a question and said, if you are couples matching and your partner is auditioning in a different specialty, should they make it known that you're interested in that systems PM&R programs? How should that be approached if they're not also applying for PM&R? I would say, I didn't hear anybody. I would say that, I would say that just be honest about the fact that you are applying for as in a couples match, because I think getting that information out might move things in your favor. So if your partner is also trying to get into an institution for an audition elective, the program directors can talk to one another and kind of make it happen for you. Or, you know, as you're trying to start to apply in September, October, that same thing can kind of happen. So I think being open and honest can be helpful because then there are ways that the programs can help make things happen for you. Or they can also guide you with other people that they've known have couples match so they can, they can get you the mentorship that you might need. That's the best way that I can answer it. I think anyone else have any thoughts? I agree. I think any kind of special circumstances like that, it can be helpful. Yeah, everybody's programs around your side. Right. And we want students to be successful. And, and so if there's circumstances like that, and, you know, because that may, again, nothing can be truly said, right. But on the other hand, if you let a program know, hey, we're couples matching. And this is something that we really want to do together. Right. I think if you make that known, that can be a really positive thing. And, you know, even historically, you know, programs would try to coordinate interview dates for people who are couples matching whenever possible. I think I think it's, especially if it's a program you're really interested in. It's, it's helpful for for programs to understand that there may be special circumstances involved in your match. I can't see how that would be detrimental to let them know. All right, we are down to the final minute. We're going to end at eight o'clock sharp. I know people have to get to NBA watching because the playoffs are on. But thank you all for joining us. Just want to let you know that the MSC will be using social media, Twitter to get information out for the future events. They are going to be asking you about your questions. So please pose those questions so we can ensure that they are the first questions that we end up answering. Our future events are going to talk about how to write your personal statement, how to pick and highlight your meaningful experiences, program signaling, geographical preferences, do's and don'ts on interviews, and, you know, how to create your rank list. So we look forward to mentoring you and seeing you all in our programs. Thank you, everyone, and have a great night.

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