As I progressed into my third year and especially my fourth, I would often brainstorm creative ways to disappear or otherwise leave rotations early. Here are some of the best strategies and tips for being the “absent” medical student while still achieving a passing grade.

1. Set The Bar Low
   The best thing you can do if you’re shooting for a month-long vacation is to never really make yourself visible that much from day one. Your first few days on a rotation can really set a precedence as to how much your residents expect to have you around. If you spend the first week of the rotation fully visible at all times and then mysteriously disappear, a few red flags will be raised. You do need to “feel out” the rotation to see just how much you can get away with, but don’t sit around the resident’s room in your downtime as this will increase your visibility.
2. Learn The Schedule
   Find out when the attending or your chief resident likes to round, since you’ll likely have to base your disappearances around these times. It may take a few days to learn the schedule, but often the attending will just come out and state that he or she wants to round at a specific time. If you’re taken by surprise, remember you’re just a page away.
3. Build Inconsistency
   Starting early on, you’ll need to build inconsistency with your team. What this means is that they will really never know what to expect out of you. To do this, you’ll want to disappear unannounced for half an hour or so during the first day or two of the rotation. Get lost at completely random times and random intervals, and then miraculously return. As the first week of the rotation progresses, increase the duration of your disappearance. Before you know it, you’ll be gone 2-3 hours at a time and no one will expect anything any different.
4. Study In The Library
   If you like to study in your downtime, always let it be known that you prefer to study in the library for minimal distractions. This gets you away from rotations and you’ll be less likely to be called on for scut. If the residents or attendings object, reinforce the fact that you’ll be available via page and that you are on campus. No argument against you studying in the library can hold much water, so you’ve just got to do it.
5. Map Your Exit Strategy
   Always know your route of escape for each rotation. A good rule of thumb is to never, ever take the elevator on your way out. You’ll inevitably run into an attending or someone that’s going to squeal. Even if you’re on the 11th floor, the stairs are your best friend. Once you’re in the stairwell you are generally home free.
6. Never Carry A Backpack
   Having your backpack on while walking down the hall is a sure-fire sign that you’re leaving. You should always carry just what you need in your white coat. By doing this, you never look like you’re leaving. While you want to create inconsistency with your presence, you’ll want to maintain a consistent appearance. If you plan to study in the library, simply leave everything in your car and then swing by and pick it up.

All Joking Aside

Even though this post is partly in fun, I did actually put these tips to use while on some of my rotations. Obviously, you’re going to have to use some common sense and feel out the residents to see if ducking out for any length of time is feasible. There were certain rotations where I would be absent 3-4 hours out of every day and left early without permission, while others would check up on the students so often that it just wasn’t possible to slip away.

Also, you guys are smart enough to know that if you employ these stealth tactics, you most likely won’t be honoring these rotations. If you get nailed or somebody has a sit-down with you, it’s best just to play the game and ride out the rest of the rotation without being gone too much.

The idea is to achieve the maximum amount of time away from the rotation while still receiving a passing score. In order to do this, sometimes you’ll need to balance a fine line.

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