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Away Electives and Acting Internships

Toward the end of year three, as students begin to focus in on their specialty choice, Acting Internships and Away Electives are important considerations. Each of these experiences gives students a more comprehensive view of the fields they are considering, while at the same time, giving them more experience. Acting Internships or "AI's" are clinical rotations, during fourth year, in which students act in the capacity of a first year intern supervised by attending physicians. In these rotations, students are afforded the opportunity to experience their future career while being well supervised. All students complete an AI at Upstate and many complete additional AIs at institutions where they might want to apply for residency. These are often referred to as "audition rotations" for the students to demonstrate to programs their interest not only in the field of choice, but also the specific program.

For Acting Internships or other electives taken at institutions other than Upstate (a.k.a. "Away Electives"), students use VSLO, the Visiting Student Learning Opportunities program. This service provides applications for electives at U.S. medical schools. See the list of participating schools at Visiting Student Learning Opportunities. To apply to a school that does not participate in VSLO, students may contact the school directly. The timing of applications for Away Electives is typically February-March, though students may start researching such opportunities sooner.

Some questions to consider:

  1. Should I take my electives in my specialty interest or other specialties?
    The first goal of summer/early fall electives is to enhance your application. You want from them a good grade, narrative, and letter writer. So they should be in your specialty.
  2. How many electives should I take in my specialty before I begin interviews?
    You don’t need any more than two, but some will take more "away electives" in one specialty, particularly in highly competitive fields.
  3. Should I take an AI (Acting Internship) in my specialty area before interviews?
    In specialties where AI’s are encouraged, you should take one before interviews. At many schools, AI’s are required, so directors are surprised not to see one on the transcript. The AI will give you confidence, and it is the standard benchmark of your clinical skill at the end of the third year. Note: This is specialty specific! Be sure to have a look at the Q&A from the specialty advisors. It will shed additional light on this topic.
  4. Can I adjust my rotation schedule to accommodate an elective?
    You can try, but it is difficult and sometimes a mistake. And, the Academic Review Board (ARB) approves delays in clerkships only under exceptional circumstances. Even then, it may be difficult to move a clerkship because the Registrar is bound by the number of students in the clerkship and by constraints imposed by the clerkships. The Registrar is responsible for all clerkship moves, so do not try to negotiate this directly with the clerkship director. Before requesting a move, talk to an advisor lest you move a clerkship from its original period to a worse one. In general, you would prefer not to have clerkships in the Summer, December, or January of your MS4 year.
  5. Should I take an extramural elective at my first choice hospital? When?
    Program directors say a letter from their own institution carries a little more weight. This is the sole strategic rationale for taking an away elective (extramural elective) - to get a letter for that school. Some schools will give an automatic courtesy interview to anyone taking an elective there. That said, lots of students match well without taking away electives. This requires careful planning. Many extramural electives fill up early or have specific application deadlines. Early January is a good time to begin inquiries of electives.