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That process sounds very involved.

For the traditional track students, I believe our school makes you input like 40 different preference schedules into a program and the algorithm tries to optimize each person's preferences.

For the MD/MPH track students, each student ranks 8 different pre-crafted templates and the program optimizes those.
 
Complicated lottery system which determines

1. order of rotations
2. sites for rotations that aren't site locked (this is done sequentially, so there's a "first choice" lottery where you apply for one site at one rotation that's very important to you, and then another lottery to fill in everything else; a couple of our rotations only have one site so this lottery doesn't apply to them)
3. selective lottery for pass/fail 1 week rotations
4. At the end of this, you can trade with people
 
merit based?? thank god ours is purely lottery-based or I would have somehow ended up with all surgery rotations each in a different city
 
First, we all get randomly assigned a schedule with our rotation order. There are a few exceptions to this...basically if you have a pressing, prescheduled thing that you need to have your break/research block during, you can file for that ahead of time.

Then everyone decides that all of the other schedules are better and we all try to trade around with each other.

Then you rank your site preferences for each rotation. Before that rotation begins, they try to give everyone their preference, but can't always. They wait a few weeks for everyone to trade around again, and then figure out final rosters.

It sounds complicated, but it really isn't. We have more than enough spots at our main clinical campuses that it's not a big deal. We're only really choosing between 2-3 sites, total, and the same 2-3 for every single rotation. The farthest location away from us is a 20-30min drive, the rest are <5min from med school campus.
 
We rank in order of preference one of twelve rotation orders (below). Everyone rotates at our main hospital, VA, and Good Sam while on IM, otherwise everything is pretty much at our main hospital.

Everyone's rotation order preferences go into a computer program that attempts to put everyone at one of their top choices, so that the highest number of people get one of their top three or four choices. There are inevitably a few that get one of their last choices because starting with IM is so popular. There are no trades afterwards.

We do all our core rotations in M3 so that M4 is entirely electives (with some requirements like having to do at least two SubIs, etc). However, to accomplish this we have what is probably the shortest OB rotation in the country (4 weeks).
 

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Ours is a lottery where you rank 20 different tracks and the computer tries to make people happy. For each service (surgery, psychiatry, etc), they send out an email with the site preferences and they are assigned first email back, first choice basis. People get good at checking their email incessantly so they can get their first choice locations (if you really care).
 
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