Can someone further explain rotations?

[deleted74029]

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This is the one part of medical school that I still don't think I have a good idea of how it actually works. Can someone explain exactly how they work ie how long they last, are there any type of elective rotations, and anything else you feel I may want to know?

 

[MrBurns10]

Rotations, aka clerkships, are done during the clinical year (at most med schools during the 3rd year), as well as the 4th year...when students talk about being on rotations, this implies the 3rd year since 4th year is usually made up of sub-Is (where you act as an intern), away rotations, and electives. The required 3rd year rotations are surgery, internal medicine, ob/gyn, pediatrics, psychiatry, and family medicine (though I think I've heard of a few schools who have outpatient IM instead of FM). Neurology is also a required rotation at many schools. These clerkships last anywhere between 3-8 weeks long, and at the end of each rotation there is a test, which can either be a departmental exam or a nationally standardized test called the NBME shelf exam. Your grades are comprised of evaluations from residents and attendings and the exam at the end (which usually makes up 10-50% of your grade). Some rotations will also require things like formal presentations to be included in your grade. These rotation grades are widely considered one of the more important components of your application.

As far as electives go, this varies by school. Some will have all their elective months in the 4th year while others will have some elective time during 3rd year. My school, for example, has two 2-week blocks and one 4-week elective block during the clinical year. That's about all I can think of at the moment. Did I answer your question?

 

[Depakote]

Rotations, aka clerkships, are done during the clinical year (at most med schools during the 3rd year), as well as the 4th year...when students talk about being on rotations, this implies the 3rd year since 4th year is usually made up of sub-Is (where you act as an intern), away rotations, and electives. The required 3rd year rotations are surgery, internal medicine, ob/gyn, pediatrics, psychiatry, and family medicine (though I think I've heard of a few schools who have outpatient IM instead of FM). Neurology is also a required rotation at many schools. These clerkships last anywhere between 3-8 weeks long, and at the end of each rotation there is a test, which can either be a departmental exam or a nationally standardized test called the NBME shelf exam. Your grades are comprised of evaluations from residents and attendings and the exam at the end (which usually makes up 10-50% of your grade). Some rotations will also require things like formal presentations to be included in your grade. These rotation grades are widely considered one of the more important components of your application.

As far as electives go, this varies by school. Some will have all their elective months in the 4th year while others will have some elective time during 3rd year. My school, for example, has two 2-week blocks and one 4-week elective block during the clinical year. That's about all I can think of at the moment. Did I answer your question?

This is a great answer, I'll try to add a little to it...

At my school, during your third year you do your core rotations (surgery, internal medicine, ob/gyn, pediatrics, psychiatry, and family medicine) as mentioned above. If I understand correctly, you may have some say as to which sub-specialties you get exposure to in those rotations... i.e. if you want to do 2 weeks of cardiology during Internal Medicine, you have that option, if you want to do 2 weeks of Ortho during Surgery, you have that option. This likely varies from school to school. I believe we have a required neuro clerkship during 4th year and I think they're working on restructuring 3rd year to give us some elective time (again, varies from school to school)... These are things you'd want to look at and ask about when selecting your school.

Also, shelf exams (our school's testing) or departmental exams are pretty standard. But there's usually a subjective part of the grade for your clerkship which most students hate b/c it's very non-standardized. You can work your ass-off in one rotation and get a pass or high-pass and where as you had no idea what you were doing in another rotation and somehow honor it just because there were two different people filling out the evaluation form.

At my school we have one required rotation which is to an rural or underserved area. This can be good b/c you tend to get a lot of hands-on experience there.

As for away/elective rotations, you mostly do them in your 4th year when you're trying to match. You head out to places you want to go and try to make a good impression. I haven't run into a school that doesn't let you do these.

 

[Law2Doc]

Also, shelf exams (our school's testing) or departmental exams are pretty standard. But there's usually a subjective part of the grade for your clerkship which most students hate b/c it's very non-standardized. You can work your ass-off in one rotation and get a pass or high-pass and where as you had no idea what you were doing in another rotation and somehow honor it just because there were two different people filling out the evaluation form.

Bear in mind that the "subjective part of your grade" is frequently 75-80% of your grade at many (most?) schools, so you will be subjectively graded during third year for the most part. That means showing up early, doing scut with a smile, and trying to be up on things so you shine when you get pimped. And still sometimes getting burned because an attending didn't like the way you yawned during post-call rounds. In terms of getting to do certain subspecialties during various rotations, sometimes you have a small say, often you don't. In surgery, you frequently will be doing some amount of time on a number of specialties, and probably end up doing a week or two of ortho whether you have an interest or not. In medicine you probably won't be doing any significant time in a given subspecialty like cards at most schools, if you have an interest, you take the elective the next year. But you might get to go to a cardiology clinic one day during outpatient medicine. And the real key to seeing subspecialties is to FOLLOW YOUR PATIENT. If your patient is going down to get an echo or stress test, you ask if you can go down to cards with the patient and watch. If your patient is getting a cath or getting bronched, you ask if you can go. Your chief resident or attending will almost never say no.

 

[hopefuldoc87]

Rotations, aka clerkships, are done during the clinical year (at most med schools during the 3rd year), as well as the 4th year...when students talk about being on rotations, this implies the 3rd year since 4th year is usually made up of sub-Is (where you act as an intern), away rotations, and electives. The required 3rd year rotations are surgery, internal medicine, ob/gyn, pediatrics, psychiatry, and family medicine (though I think I've heard of a few schools who have outpatient IM instead of FM). Neurology is also a required rotation at many schools. These clerkships last anywhere between 3-8 weeks long, and at the end of each rotation there is a test, which can either be a departmental exam or a nationally standardized test called the NBME shelf exam. Your grades are comprised of evaluations from residents and attendings and the exam at the end (which usually makes up 10-50% of your grade). Some rotations will also require things like formal presentations to be included in your grade. These rotation grades are widely considered one of the more important components of your application.

As far as electives go, this varies by school. Some will have all their elective months in the 4th year while others will have some elective time during 3rd year. My school, for example, has two 2-week blocks and one 4-week elective block during the clinical year. That's about all I can think of at the moment. Did I answer your question?

that was very informative, but I was just wondering what application you were referring to?

 

[Law2Doc]

that was very informative, but I was just wondering what application you were referring to?

Your application for residency. The premed application isn't the last stop on this train, I'm afraid. Your Step 1 score and rotation grades/evaluations will be the big guns in determining what you end up doing.

 

[neuro1617]

that was very informative, but I was just wondering what application you were referring to?

Residency application. And for the OP, you can go to a school's website and check out their rotation schedule- where you'll rotate at, how much time you'll spend at each, and what electives they have.

 

[Lokhtar]

I'm assuming he means to residency. For example, if you want to do Neurosurgery, and you didn't do well on your surgery rotations, it would hurt you.

Someone can correct me if I am wrong.

EDIT: Haha, ouch...beaten.

 

[deleted74029]

As for away/elective rotations, you mostly do them in your 4th year when you're trying to match. You head out to places you want to go and try to make a good impression. I haven't run into a school that doesn't let you do these.

Are these usually pretty close in proximity or can you go pretty much anywhere you want? For example, if someone who attends USC wants to do rotations in Texas, maybe to get their foot in the door for a residency or for whatever reason, would that be possible?

 

[Law2Doc]

I'm assuming he means to residency. For example, if you want to do Neurosurgery, and you didn't do well on your surgery rotations, it would hurt you.

Someone can correct me if I am wrong.

EDIT: Haha, ouch...beaten.

You aren't wrong, but yes, you are too slow.

 

[Law2Doc]

Are these usually pretty close in proximity or can you go pretty much anywhere you want? For example, if someone who attends USC wants to do rotations in Texas, maybe to get their foot in the door for a residency or for whatever reason, would that be possible?

They can be anywhere. You apply for them. The goal is to allow yourself to audition to folks you may be applying to later in the fall. Getting your foot in the door is the whole point.

 

[harposnarpo]

How often do people get residencies at programs that they didn't rotate in? If I rotate in SLU ortho, for instance, how strong of a candidate would I be for Ann Arbor ortho residency?

 

[Depakote]

Are these usually pretty close in proximity or can you go pretty much anywhere you want? For example, if someone who attends USC wants to do rotations in Texas, maybe to get their foot in the door for a residency or for whatever reason, would that be possible?

You can pretty much go wherever you want, but you'll be in charge of setting it up. Don't expect USC to call MD Anderson and do all the work for you.

 

[harposnarpo]

They can be anywhere. You apply for them. The goal is to allow yourself to audition to folks you may be applying to later in the fall. Getting your foot in the door is the whole point.

How many away-rotations are there? Are they mostly all the same specialty? Also, if you rotate at say, SLU ortho, in your 3rd year, is that enough for your residency application to SLU ortho, or should you rotate again in the 4th year?

 

[Law2Doc]

How often do people get residencies at programs that they didn't rotate in? If I rotate in SLU ortho, for instance, how strong of a candidate would I be for Ann Arbor ortho residency?

The majority get residencies at places they didn't rotate in. Schools can only accommodate a small percentage of folks who want to do away rotations at their sites, and certainly don't limit their offers to that group. But if you are the kind of guy/gal that is good at wowing folks when they meet you in person, it can help a lot when you are able to show off what you've got in person, before the more stuffy interview environment.

 

[harposnarpo]

You can pretty much go wherever you want, but you'll be in charge of setting it up. Don't expect USC to call MD Anderson and do all the work for you.

How competitive are away-rotations? What do they look at? Mostly your step-1 and grades? Research too?

 

[Law2Doc]

How many away-rotations are there? Are they mostly all the same specialty? Also, if you rotate at say, SLU ortho, in your 3rd year, is that enough for your residency application to SLU ortho, or should you rotate again in the 4th year?

Rotations and electives are not the same thing. So if you did a bit of ortho in your surgery rotation in third year (there is no 3rd year ortho "rotation"), you would still want to take the ortho elective in 4th year. Since you start applying in the early fall and interviewing in the late fall/winter, you don't have time to do more than a couple of away rotations toward the end of the summer before the time is up. And you still need to be doing sub-Is and other requirements at your home school, so it's not like you can just say "see ya in march" and go do your own thing elsewhere. Most people do 0-2 away rotations (with 1 being most common). And then still apply to many many more places than that.

 

[Depakote]

How competitive are away-rotations? What do they look at? Mostly your step-1 and grades? Research too?

This is new territory for me, I've never actually set one up. But it's more of a paperwork issue than something you're competing for. As long as the other school agrees to take you (and your school agrees to let you do the away rotation) you can do the away rotation. It's not a huge application process, it's more of a "Can we fit this person here with this schedule?" issue.

 

[MrBurns10]

This is new territory for me, I've never actually set one up. But it's more of a paperwork issue than something you're competing for. As long as the other school agrees to take you (and your school agrees to let you do the away rotation) you can do the away rotation. It's not a huge application process, it's more of a "Can we fit this person here with this schedule?" issue.

The only thing I would add to this is that students often apply for more than one away rotation, even for the same month, because they can be very competitive. You typically apply for them mid-way through your 3rd year.

 

[lord_jeebus]

One of my aways required an essay and CV, but most were simple apps with basic demographic info and proof of vaccination.

 

[hopefuldoc87]

I'm assuming he means to residency. For example, if you want to do Neurosurgery, and you didn't do well on your surgery rotations, it would hurt you.

Someone can correct me if I am wrong.

EDIT: Haha, ouch...beaten.

Residency application. And for the OP, you can go to a school's website and check out their rotation schedule- where you'll rotate at, how much time you'll spend at each, and what electives they have.

Your application for residency. The premed application isn't the last stop on this train, I'm afraid. Your Step 1 score and rotation grades/evaluations will be the big guns in determining what you end up doing.

haha thanks.

 

[RySerr21]

Can someone expalin how it works at Duke? They boast how they only have 1 year of basic sciences and then you go into clinical stuff...so does that mean you just have an extra year of rotations? Is 2nd year the same as 3rd year at most other schools? Does this allow you to have electives during 3rd year and 4th year? Thanks!

 

[ChemGrad08]

My understanding from reading their website is that 2nd yr is the same as 3rd at most places. 3rd yr is dedicated to an independent project of some sort (normally research but also dual degrees etc). And 4th yr is like a normal 4th yr.

 

[MrBurns10]

Can someone expalin how it works at Duke? They boast how they only have 1 year of basic sciences and then you go into clinical stuff...so does that mean you just have an extra year of rotations? Is 2nd year the same as 3rd year at most other schools? Does this allow you to have electives during 3rd year and 4th year? Thanks!

The first year is a little longer than the year at other med schools and they cut out some material they consider relatively superfluous (e.g. not much embryology goes on then). 2nd year is exactly the same as 3rd year at other schools, without a required neuro rotation and with the three elective blocks I mentioned in my original post. 3rd year is spent either doing research or a dual degree, and you take step 1 anytime during this year (whereas most schools require their students to take it between 2nd and 3rd year). 4th year is like other schools, with lots of elective time and two required rotations: one sub-I and one critical care rotation (e.g. ED, SICU, MICU). Let me know if you have any other questions.

 

[RySerr21]

The first year is a little longer than the year at other med schools and they cut out some material they consider relatively superfluous (e.g. not much embryology goes on then). 2nd year is exactly the same as 3rd year at other schools, without a required neuro rotation and with the three elective blocks I mentioned in my original post. 3rd year is spent either doing research or a dual degree, and you take step 1 anytime during this year (whereas most schools require their students to take it between 2nd and 3rd year). 4th year is like other schools, with lots of elective time and two required rotations: one sub-I and one critical care rotation (e.g. ED, SICU, MICU). Let me know if you have any other questions.

hmm. very interesting. So if you arent interested in doing research for a year/aren't interested in a dual degree, would it be pointless to go to Duke? I applied to NYCOM b/c of their dual degree DO/MS in Clinical Nutrition and its the only school I found (DO/MD) that offered that. It would be cool if i could find something similar at Duke.

EDIT: visited Dukes website and answered a lot of my own questions. go figure. 😛

Thanks for the info.

 

[MrBurns10]

hmm. very interesting. So if you arent interested in doing research for a year/aren't interested in a dual degree, would it be pointless to go to Duke? I applied to NYCOM b/c of their dual degree DO/MS in Clinical Nutrition and its the only school I found (DO/MD) that offered that. It would be cool if i could find something similar at Duke.

EDIT: visited Dukes website and answered a lot of my own questions. go figure. 😛

Thanks for the info.

Well, really, the 3rd year can be doing anything you want, so long as you relate your project to medicine somehow. You can get an MS in ethics, for example, or go abroad for the year do to public health research. Or say you want to get an MS in Nutrition that Duke doesn't offer...you can go to the institution that offers it and do it there. It's very flexible.

 

[RySerr21]

Well, really, the 3rd year can be doing anything you want, so long as you relate your project to medicine somehow. You can get an MS in ethics, for example, or go abroad for the year do to public health research. Or say you want to get an MS in Nutrition that Duke doesn't offer...you can go to the institution that offers it and do it there. It's very flexible.

that would be amazing. they mention going to a different country as an option when desribing the 3rd year, but i couldnt link that went in to any more detial (do you know if it exists?). one of my goals is to go abraod to Africa. Since I was unable to do it during undergrad, I have made it a point to go during med school. I have been planning on going for one of my elective rotations during 4th year, but if I can make it happen during the 3rd year, for a WHOLE year, that would be unbelievable.

 

[Law2Doc]

that would be amazing. they mention going to a different country as an option when desribing the 3rd year, but i couldnt link that went in to any more detial (do you know if it exists?). one of my goals is to go abraod to Africa. Since I was unable to do it during undergrad, I have made it a point to go during med school. I have been planning on going for one of my elective rotations during 4th year, but if I can make it happen during the 3rd year, for a WHOLE year, that would be unbelievable.

There's really no point putting your stock in one school though. Odds of getting into a specific top school simply aren't that good. Odds of getting into one of many schools is significantly better and you sort of have to look at it that way and not focus in until you have acceptances in hand.

And I'd have to say a lot of residencies would raise eyebrows on spending an entire year abroad. A lot of what you do in med school needs to be tailored to where you want to end up after.

 

[MrBurns10]

that would be amazing. they mention going to a different country as an option when desribing the 3rd year, but i couldnt link that went in to any more detial (do you know if it exists?). one of my goals is to go abraod to Africa. Since I was unable to do it during undergrad, I have made it a point to go during med school. I have been planning on going for one of my elective rotations during 4th year, but if I can make it happen during the 3rd year, for a WHOLE year, that would be unbelievable.

Duke has a program in Moshi, Tanzania where a couple students and several faculty go each year and do public health and primary care there (in conjunction with the new international health residency track). A couple of my classmates got funding to go for the year. There is also a Duke program where you do basic science research for the year in Singapore, which is funded. Another one of my classmates is going to spend 6 months in India, again doing public health stuff. This is in addition to the several students who went away from Durham to do the 4-week elective month during 2nd year (two went to Jamaica, one did Cardiology in Scotland, another went to India, two to rural Alaska, etc.). There are lots of options, and while I agree with L2D not to put too much stock into one school (as most schools will let you go abroad for at least one month in 4th year), I definitely don't think doing a legitimate project abroad is seen as a negative at all.

Edit: If you have any other questions, feel free to PM me. I don't want to derail the OP's thread too much 🙂

 

[RySerr21]

There's really no point putting your stock in one school though. Odds of getting into a specific top school simply aren't that good. Odds of getting into one of many schools is significantly better and you sort of have to look at it that way and not focus in until you have acceptances in hand.

And I'd have to say a lot of residencies would raise eyebrows on spending an entire year abroad. A lot of what you do in med school needs to be tailored to where you want to end up after.

oh i konw. i'm not putting my stock all in one school. i never even said duke was my first choice. I am fully aware of the process and its competitiveness. I'll tell you flat out I think Duke is a long shot for me, and so are many of the schools I applied to. But does that mean I cant be excited about it? I'm just learning as much as I can about each school that I applied to.

MrBurns - thanks for the help, I'll be sure to PM you if I have any more questions. I am also aware that most schools wil llet you go abroad during 4th year, and that has been my intention. I even mentioned that in a previous post on this thread. Thanks again.

 

[Law2Doc]

But does that mean I cant be excited about it?

Kind of. You want to have the mindset that one of the schools you actually get into is your "first choice"/"dream school". There's nothing better than that feeling, and you cheat yourself out of that bliss if you focus in on other places before all the votes are in. It's hard to get this mindset when you get excited about "what could have been".

 

[RySerr21]

Kind of. You want to have the mindset that one of the schools you actually get into is your "first choice"/"dream school". There's nothing better than that feeling, and you cheat yourself out of that bliss if you focus in on other places before all the votes are in. It's hard to get this mindset when you get excited about "what could have been".

i disagree. I am very excited about the chance of going to Duke, and I think I should be.. I am also very excited about the chance to go to USC, UCSD, Des Moines, NYCOM, etc. etc. enter any school from my MDapps here and I could talk to you about why I am excited to go there. Is that really focusing in on places before all the votes are iN?

you are basing your opinion on 3 posts in one thread. I've been talking about Duke the whole time b/c I had a question about Duke that was relevant to the thread topic. I am equally excited about every school I applied to and would be happy to end up at any one of them.