DO rotations

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Espressso

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Why is there not a stronger emphasis on the quality of the rotations at the level of administration? It just baffles me, really. We seem to often get really great preceptors. But the variability is obnoxious.

Is there any hope?
 
Why is there not a stronger emphasis on the quality of the rotations at the level of administration? It just baffles me, really. We seem to often get really great preceptors. But the variability is obnoxious.

Is there any hope?
I don't think variability is a uniquely DO problem actually. What we really lack in our rotation is a structure that protects teaching. I think the general attitude of DO schools towards their students is more problematic and is just expressed via poor quality control on rotations where students get used as pure scut, and get minimal education.

It also shows when you compare time off during 4th year for boards/interviews. I was talking to an intern at one of my aways and she was talking about having 12 weeks off for boards/interviews in 4th year plus a research month. Compare that to my school that has the asinine rule about you can only miss 2 days a 4 week rotation for interviews, and gives 4 weeks total for boards/interviews. Its just a different mindset. DO schools are very reactive and don't see the need to change anything till it really doesn't work (i.e. students stop matching/placing at all) vs USMD are very concerned with how, where, and when they match.

The relationship with MD schools and their students is, in general, cooperative vs DO school where its often adversarial. And I think this trickles down into rotations as well. Our schools (DO) are not actually committed to our success, they just need somewhere to stuff us, and many times they don't want to help out if your trying to do anything different. If you tell your MD school you want to ENT, at most programs they will hook you up with a mentor, arrange rotations at the home program, try to set you up with a research project. If you tell your DO school you want ENT, you will get a 'good luck' and then they will try to restrict how many ENT rotations you can do while forcing you to do 5 primary care rotations during 3rd year.

Anyway, I am generalizing. This is obviously not true at every DO or every MD, but it is something I noticed. And I have gone off the deep end, so its time for me to go do some work.

The only hope is the ones who did it before you and got what they wanted. We just have to overcome, its all that there is.
 
I don't think variability is a uniquely DO problem actually. What we really lack in our rotation is a structure that protects teaching. I think the general attitude of DO schools towards their students is more problematic and is just expressed via poor quality control on rotations where students get used as pure scut, and get minimal education.

It also shows when you compare time off during 4th year for boards/interviews. I was talking to an intern at one of my aways and she was talking about having 12 weeks off for boards/interviews in 4th year plus a research month. Compare that to my school that has the asinine rule about you can only miss 2 days a 4 week rotation for interviews, and gives 4 weeks total for boards/interviews. Its just a different mindset. DO schools are very reactive and don't see the need to change anything till it really doesn't work (i.e. students stop matching/placing at all) vs USMD are very concerned with how, where, and when they match.

The relationship with MD schools and their students is, in general, cooperative vs DO school where its often adversarial. And I think this trickles down into rotations as well. Our schools (DO) are not actually committed to our success, they just need somewhere to stuff us, and many times they don't want to help out if your trying to do anything different. If you tell your MD school you want to ENT, at most programs they will hook you up with a mentor, arrange rotations at the home program, try to set you up with a research project. If you tell your DO school you want ENT, you will get a 'good luck' and then they will try to restrict how many ENT rotations you can do while forcing you to do 5 primary care rotations during 3rd year.

Anyway, I am generalizing. This is obviously not true at every DO or every MD, but it is something I noticed. And I have gone off the deep end, so its time for me to go do some work.

The only hope is the ones who did it before you and got what they wanted. We just have to overcome, its all that there is.
Very spot on for paragraph 3. I had a good clinical experience that prepared me well, but I didn’t work with residents until my aways. So, sure I was confident in my exam and thought process but I had nooo clue how to function as a resident. I’m also a blunt person who prioritized my learning so if I needed a preceptor to answer something I would straight up ask them. I never wasted their time but I wasn’t so meek that I wouldn’t ask. I think that speaks to DO education. The ones that are proactive and persistent will turn out fine. It’s the lazy and meek students that will not learn what they need to in order to progress in their education.
 
In 2019, rotations are mostly similar nowadays between DO and MD. As long as there's a reasonable structure, you have the same responsibilities (see pts, present, +/- write notes)
 
I don't think variability is a uniquely DO problem actually. What we really lack in our rotation is a structure that protects teaching. I think the general attitude of DO schools towards their students is more problematic and is just expressed via poor quality control on rotations where students get used as pure scut, and get minimal education.

It also shows when you compare time off during 4th year for boards/interviews. I was talking to an intern at one of my aways and she was talking about having 12 weeks off for boards/interviews in 4th year plus a research month. Compare that to my school that has the asinine rule about you can only miss 2 days a 4 week rotation for interviews, and gives 4 weeks total for boards/interviews. Its just a different mindset. DO schools are very reactive and don't see the need to change anything till it really doesn't work (i.e. students stop matching/placing at all) vs USMD are very concerned with how, where, and when they match.

The relationship with MD schools and their students is, in general, cooperative vs DO school where its often adversarial. And I think this trickles down into rotations as well. Our schools (DO) are not actually committed to our success, they just need somewhere to stuff us, and many times they don't want to help out if your trying to do anything different. If you tell your MD school you want to ENT, at most programs they will hook you up with a mentor, arrange rotations at the home program, try to set you up with a research project. If you tell your DO school you want ENT, you will get a 'good luck' and then they will try to restrict how many ENT rotations you can do while forcing you to do 5 primary care rotations during 3rd year.

Anyway, I am generalizing. This is obviously not true at every DO or every MD, but it is something I noticed. And I have gone off the deep end, so its time for me to go do some work.

The only hope is the ones who did it before you and got what they wanted. We just have to overcome, its all that there is.
Soooooo true. It hurts.
 
I don't think variability is a uniquely DO problem actually. What we really lack in our rotation is a structure that protects teaching. I think the general attitude of DO schools towards their students is more problematic and is just expressed via poor quality control on rotations where students get used as pure scut, and get minimal education.

It also shows when you compare time off during 4th year for boards/interviews. I was talking to an intern at one of my aways and she was talking about having 12 weeks off for boards/interviews in 4th year plus a research month. Compare that to my school that has the asinine rule about you can only miss 2 days a 4 week rotation for interviews, and gives 4 weeks total for boards/interviews. Its just a different mindset. DO schools are very reactive and don't see the need to change anything till it really doesn't work (i.e. students stop matching/placing at all) vs USMD are very concerned with how, where, and when they match.

The relationship with MD schools and their students is, in general, cooperative vs DO school where its often adversarial. And I think this trickles down into rotations as well. Our schools (DO) are not actually committed to our success, they just need somewhere to stuff us, and many times they don't want to help out if your trying to do anything different. If you tell your MD school you want to ENT, at most programs they will hook you up with a mentor, arrange rotations at the home program, try to set you up with a research project. If you tell your DO school you want ENT, you will get a 'good luck' and then they will try to restrict how many ENT rotations you can do while forcing you to do 5 primary care rotations during 3rd year.

Anyway, I am generalizing. This is obviously not true at every DO or every MD, but it is something I noticed. And I have gone off the deep end, so its time for me to go do some work.

The only hope is the ones who did it before you and got what they wanted. We just have to overcome, its all that there is.
Aside from over generalizations and the rant-like nature of this point, this should be sticky'd and read by every pre-med considering embarking on the journey to DO schools with their associated ~350k total COA tuition. Never mind having to take twice the number of boards (and the expense of that). The BS never ends.

The time off thing really grinds my gears because that too, financially stresses you. When you don't have time you end up making costly mistakes.
 
@BorntobeDO? makes a good point. Another problem is that when you don't have a home hospital your ability to pressure preceptors or hospital systems is decreased. They can simply refuse to make certain changes, not take students from the DO school anymore and take Caribbean students instead if they really want students around. They also might just have to deal with certain known problems. For example, my school has some preceptors where you'll see like ten patients a week. They know its a problem but don't have other options.
 
Edit: lol nvm im tired and cranky, post contained typical complaints about admin and lack of elective time
 
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From an administrative point of view what you should be fighting for is more inpatient DO rotations during 3rd year. They tend to leave this up to students to find on their own in 4th year electives. Quality is just a buzzword that doesn't mean much. The MD students at my teaching institution don't learn or perform differently on rotations than I did as a DO student. What is important is seeing what happens in hospitals and understanding the workflow of residents. The best training you can get as a medical student is at hospitals without any residents--you will get to do more if you want to do more.
 
I don't think variability is a uniquely DO problem actually. What we really lack in our rotation is a structure that protects teaching. I think the general attitude of DO schools towards their students is more problematic and is just expressed via poor quality control on rotations where students get used as pure scut, and get minimal education.

It also shows when you compare time off during 4th year for boards/interviews. I was talking to an intern at one of my aways and she was talking about having 12 weeks off for boards/interviews in 4th year plus a research month. Compare that to my school that has the asinine rule about you can only miss 2 days a 4 week rotation for interviews, and gives 4 weeks total for boards/interviews. Its just a different mindset. DO schools are very reactive and don't see the need to change anything till it really doesn't work (i.e. students stop matching/placing at all) vs USMD are very concerned with how, where, and when they match.

The relationship with MD schools and their students is, in general, cooperative vs DO school where its often adversarial. And I think this trickles down into rotations as well. Our schools (DO) are not actually committed to our success, they just need somewhere to stuff us, and many times they don't want to help out if your trying to do anything different. If you tell your MD school you want to ENT, at most programs they will hook you up with a mentor, arrange rotations at the home program, try to set you up with a research project. If you tell your DO school you want ENT, you will get a 'good luck' and then they will try to restrict how many ENT rotations you can do while forcing you to do 5 primary care rotations during 3rd year.

Anyway, I am generalizing. This is obviously not true at every DO or every MD, but it is something I noticed. And I have gone off the deep end, so its time for me to go do some work.

The only hope is the ones who did it before you and got what they wanted. We just have to overcome, its all that there is.

My theory is that it has to do with the type of faculty available and the kind of relationships DO schools have with specialists in general. This is another reason I think most people are better off at "established" DO schools. My school has ENT faculty (just to use your example) and a decent alumni network with occasional events to help students find mentors. Subspecialist DOs will probably become more common as time goes on, but will probably become more detached from their alma maters if I had to guess. So maybe the future will even out for students wanting to go into such fields.

We have a urologist that gives lectures that is all about helping interested students get into urology. Same with ENT, gen surg, cardiology, etc. It would probably be a lot harder to make those connections and find mentors at the new schools, but a handful of go-getters do it every year.
 
This is just me being jealous but I met a few of MDs that get full 2+months off plus another 1 month of an online course (run by their school) to use at any time for 4th year. Compare this to my school where you get 5 weeks and can't take more than 2 weeks off in a row.

Also, as I meet residents and ask how their they got their letters and such when they were applying for residency, I got a lot of "the PD from my home program just wrote one for every student interested". Must be nice 😢
 
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My DO programs gets a kickback and more money for grants the more students they place into primary care.

So.. I'm sure many other DO programs have the same thing going on.

Rotations have been a hit or miss for the most part. Had some really good inpatient rotations. Had some ridiculous ones that were all outpatient and didn't learn jack.

It is what it is.
 
I don't really have much complaints about my experience so far as I feel I will be able to hold my own against any other medical student doing the same stuff, but the whole "only 2 days off for interviews in any given month" is complete horse$h!t. It's like schools have forgotten the entire reason for their existence, to create residents.
 
I don't really have much complaints about my experience so far as I feel I will be able to hold my own against any other medical student doing the same stuff, but the whole "only 2 days off for interviews in any given month" is complete horse$h!t. It's like schools have forgotten the entire reason for their existence, to create residents.


What I did and highly recommend is do not tell your school anything. Keep them completely in the dark. Sign up for preceptors who have the reputation of being easy. Just tell them. Make a deal with them if you have to. This is literally your future. You need to go to as many interviews as you deem necessary.
 
What I did and highly recommend is do not tell your school anything. Keep them completely in the dark. Sign up for preceptors who have the reputation of being easy. Just tell them. Make a deal with them if you have to. This is literally your future. You need to go to as many interviews as you deem necessary.

Yeah I'm already planning out that December and January to do just that, and I'll probably still be on an audition in November. My ultimate goal is to roll into graduation and have the admins go, "oh right he was a student here" lol
 
Yeah I'm already planning out that December and January to do just that, and I'll probably still be on an audition in November. My ultimate goal is to roll into graduation and have the admins go, "oh right he was a student here" lol
Audition in November? How's that going to work?
I thought Nov/Dec was the peak of interview season.
 
My theory is that it has to do with the type of faculty available and the kind of relationships DO schools have with specialists in general. This is another reason I think most people are better off at "established" DO schools. My school has ENT faculty (just to use your example) and a decent alumni network with occasional events to help students find mentors. Subspecialist DOs will probably become more common as time goes on, but will probably become more detached from their alma maters if I had to guess. So maybe the future will even out for students wanting to go into such fields.

We have a urologist that gives lectures that is all about helping interested students get into urology. Same with ENT, gen surg, cardiology, etc. It would probably be a lot harder to make those connections and find mentors at the new schools, but a handful of go-getters do it every year.
I go to a new school and they have a list of paid preceptors in a variety of different specialties and subspecialties available to us since first year. We even have a Capstone course during our first year solely for us to make connections and rotate with any one of them for a day or two and learn about their specialties.
 
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Audition in November? How's that going to work?
I thought Nov/Dec was the peak of interview season.

Assuming you interview with them, they still must rank you.
 
What I did and highly recommend is do not tell your school anything. Keep them completely in the dark. Sign up for preceptors who have the reputation of being easy. Just tell them. Make a deal with them if you have to. This is literally your future. You need to go to as many interviews as you deem necessary.

Im taking November/December off. The classes above us have told us in the past which rotations are cool with this and which aren’t. For example, where I did peds.. they’d NEVER allow more than three days off. Which is complete bs, because remind me why we go to med school again?
 
The lack of self-awareness of DO schools and some of their preceptors is shocking and concerning. It's like they need a 1 page sheet explaining the goals of the process to review each morning.
 
Audition in November? How's that going to work?
I thought Nov/Dec was the peak of interview season.

It is, I’m still feeling out how what I should do but for the field I’m going for I will probably need as many auditions as I can squeeze in. We’ll see though, I haven’t fully decided for that very reason of it being peak interview season.
 
It is, I’m still feeling out how what I should do but for the field I’m going for I will probably need as many auditions as I can squeeze in. We’ll see though, I haven’t fully decided for that very reason of it being peak interview season.
People usually interview in January. Nov-Jan is your peak season. You will be tired by then and want to cancel a lot. A lot of people end up cancelling January interviews. You can do two options. See if you can audition in January and just interview with that program on one of their last days. Or just be tired and realize the majority of your interviews will be dec-Jan
 
People usually interview in January. Nov-Jan is your peak season. You will be tired by then and want to cancel a lot. A lot of people end up cancelling January interviews. You can do two options. See if you can audition in January and just interview with that program on one of their last days. Or just be tired and realize the majority of your interviews will be dec-Jan
How likely is it to have interviews in January? I actually have an audition during that time, was hoping not to leave during it...
 
How likely is it to have interviews in January? I actually have an audition during that time, was hoping not to leave during it...
For peds, I saw open interview dates through mid January. The specialty usually just invites you and lets you pick your dates. Idk about other specialties. So I think I cancelled 3 of 4 January interviews I had. It’s going to depend on how your specialty offers interviews.
 
My DO programs gets a kickback and more money for grants the more students they place into primary care.

So.. I'm sure many other DO programs have the same thing going on.

Rotations have been a hit or miss for the most part. Had some really good inpatient rotations. Had some ridiculous ones that were all outpatient and didn't learn jack.

It is what it is.
Most state funded MD school get this too. And are encouraged to push primary care.
 
In addition to many marginal rotatations, and all associated rotation travel/lodging expenses many DO students incur during their 4th year, I really dislike all of the interviewing expenses which many DO students get stuck with as well. Many of the PD's I'm familiar with interview at least 10 to 30 candidates for each residency spot they have to offer. They don't care, the applicants generally are responsible for all interviewing costs, so at the most, the PD's just pick up the tab for a dinner the night before. The entire system sucks from a residency applicant perspective in my opinion.
 
In addition to many marginal rotatations, and all associated rotation travel/lodging expenses many DO students incur during their 4th year, I really dislike all of the interviewing expenses which many DO students get stuck with as well. Many of the PD's I'm familiar with interview at least 10 to 30 candidates for each residency spot they have to offer. They don't care, the applicants generally are responsible for all interviewing costs, so at the most, the PD's just pick up the tab for a dinner the night before. The entire system sucks from a residency applicant perspective in my opinion.
Again...this isn’t just a DO problem though
 
My theory is that it has to do with the type of faculty available and the kind of relationships DO schools have with specialists in general. This is another reason I think most people are better off at "established" DO schools. My school has ENT faculty (just to use your example) and a decent alumni network with occasional events to help students find mentors. Subspecialist DOs will probably become more common as time goes on, but will probably become more detached from their alma maters if I had to guess. So maybe the future will even out for students wanting to go into such fields.

We have a urologist that gives lectures that is all about helping interested students get into urology. Same with ENT, gen surg, cardiology, etc. It would probably be a lot harder to make those connections and find mentors at the new schools, but a handful of go-getters do it every year.
My school has alumni, and they do try and hook us up with them if possible. But there is a big difference between a community doc/resident who might or might not be able to help you on the side and a academic mentor at a teaching institution who has mentoring students as part of his job description. Thats not even talking about home PD's writing letters, home subi's, having tons of residents to get advice from during 3rd year, or the research projects that they get hand fed if they have any desire at all.

Audition in November? How's that going to work?
I thought Nov/Dec was the peak of interview season.
It is, I don't like November auditions unless your doing a specialty where your only chance is via audition at old AOA (Nuerosurg, Ortho, ENT, etc).
 
Audition in November? How's that going to work?
I thought Nov/Dec was the peak of interview season.
It’s that struggle of wanting an audition heavy specialty but not getting audition/elective time until august 🙂 if i stay with my current interests ill be in the same boat oof
 
When do most people do there audition rotations? And how easy are they to get when you apply via VSAS?
 
When do most people do there audition rotations? And how easy are they to get when you apply via VSAS?

You apply during the spring. Most people shoot for July thru October, as November is usually when interview season REALLY starts to heat up. Some people do an audition in June, but that's school dependent and you have Level 2 CE/PE to consider.

VSAS is honestly a crap shoot. If an audition is listed, you need to apply for it the day it opens. However, I highly recommend that you simply contact any programs you are interested in for audition info as the majority of the audition rotations my classmates obtained seemed to be non-VSAS.
 
You apply during the spring. Most people shoot for July thru October, as November is usually when interview season REALLY starts to heat up. Some people do an audition in June, but that's school dependent and you have Level 2 CE/PE to consider.

VSAS is honestly a crap shoot. If an audition is listed, you need to apply for it the day it opens. However, I highly recommend that you simply contact any programs you are interested in for audition info as the majority of the audition rotations my classmates obtained seemed to be non-VSAS.
What time period do people usually begin reaching out/applying for auditions?
 
What time period do people usually begin reaching out/applying for auditions?

From what I've seen it is kinda all over the map and program specific. For example, for Pinnacle Health ortho I know you can apply pretty much a year or more in advance because it's just through their own system. For the program with my school it's not until late spring lol.
 
From what I've seen it is kinda all over the map and program specific. For example, for Pinnacle Health ortho I know you can apply pretty much a year or more in advance because it's just through their own system. For the program with my school it's not until late spring lol.
Bruh i am in no way ready to decide my specialty let alone the programs i want to check out lol, i was hoping to at least have till December
 
Bruh i am in no way ready to decide my specialty let alone the programs i want to check out lol, i was hoping to at least have till December

Lol I don't think it's a big deal. Honestly from what I've seen is that most programs now, in most specialties, are using VSAS.
 
"Sir, here is my receipt for my Adidas lifting shoes. I highlighted the date of purchase."
You forgot the obligatory photo of you doing some sort of undergrad collegiate sport at a higher than intramural level while looking swoll.
 
This is why OK state is the GOAT DO school.

Hella research for a DO school.

100% wards based rotations at a teaching hospital in the same town as school without moving if you want them to be.

Access to competitive residencies and fellowships in house.

I will have July- end of January for auditions / interviews the way I set my schedule up.

As tough as it is to be a DO, your school can really make a huge difference in your odds. Plenty of people on the audition trail I have met can only do 3-4 auditions MAX. I could do 6-7. Almost doubling my odds of matching in the DO world. I had no idea of this before starting school. Pick you school's carefully pre-meds reading this and make sure they have a flexible 4th year if you want competitive specialties.
 
This is why OK state is the GOAT DO school.

Hella research for a DO school.

100% wards based rotations at a teaching hospital in the same town as school without moving if you want them to be.

Access to competitive residencies and fellowships in house.

I will have July- end of January for auditions / interviews the way I set my schedule up.

As tough as it is to be a DO, your school can really make a huge difference in your odds. Plenty of people on the audition trail I have met can only do 3-4 auditions MAX. I could do 6-7. Almost doubling my odds of matching in the DO world. I had no idea of this before starting school. Pick you school's carefully pre-meds reading this and make sure they have a flexible 4th year if you want competitive specialties.
Unless they're 2 week rotations, that is impossible....I'm going to be doing 4, 4 week away rotations, and that's by using end of 3rd year, so....

Or you have auditions during interview season?
 
Unless they're 2 week rotations, that is impossible....I'm going to be doing 4, 4 week away rotations, and that's by using end of 3rd year, so....

Or you have auditions during interview season?

I have auditions during "interview season" which is typically November-december in the DO world, but many programs have stated they will move interviews or have an interview date in January since this is more congruent with the acgme side of things. If I have interviews that will interfere with a late audition to the extent that I cannot justify the rotation I will consider that a good problem to have and adjust accordingly.

I have five 4 week auditions and two 2 weeks. July - December
 
I have auditions during "interview season" which is typically November-december in the DO world, but many programs have stated they will move interviews or have an interview date in January since this is more congruent with the acgme side of things. If I have interviews that will interfere with a late audition to the extent that I cannot justify the rotation I will consider that a good problem to have and adjust accordingly.

I have five 4 week auditions and two 2 weeks. July - December
Can anyone confirm this?
 
Met someone recently from a DO school (an M4) who is only now doing their second inpatient rotation. This is insanely troubling to me.
 
Met someone recently from a DO school (an M4) who is only now doing their second inpatient rotation. This is insanely troubling to me.
It's very site specific. At my school, some sites are horrible and others are actually pretty good. My site is shared by an MD school and they have a lot of the same gripes we do (and we have literally the same rotations for certain specialties)
 
It's very site specific. At my school, some sites are horrible and others are actually pretty good. My site is shared by an MD school and they have a lot of the same gripes we do (and we have literally the same rotations for certain specialties)

Yeah, but not having inpatient experiences? Being in an outpatient office only? THAT is the problem.
 
I’m rotating with fourth year US MD students right now. Same complaints. Now that I’ve had multiple rotations with numerous diff US MD students (double digit diff schools) I can confidently say the whole rotation thing is blown way out of proportion. My “crappy” third year was literally just as crappy as their “amazing” third year. I’m actually shocked this is the case. I used to be like you, but now I’ve seen the other side and have done a 180

You definitely need to be exposed to more honest MD students. There's a world of difference between MS 3 as an MD and a DO without a legit teaching hospital. Perhaps you were one of the lucky ones who got to do all of 3rd year at a real academic institution, but most DO students are not that fortunate.
 
It's very site specific. At my school, some sites are horrible and others are actually pretty good. My site is shared by an MD school and they have a lot of the same gripes we do (and we have literally the same rotations for certain specialties)

But that's the thing, it shouldn't be site specific. I was at one of the best sites for my school and my surgery rotation was outpatient. WTF? Until DO schools get their act together and realize that MS 3 year and the quality of rotations matters way more than whether or not they have the coolest anatomy lab, this won't change.
 
But that's the thing, it shouldn't be site specific. I was at one of the best sites for my school and my surgery rotation was outpatient. WTF? Until DO schools get their act together and realize that MS 3 year and the quality of rotations matters way more than whether or not they have the coolest anatomy lab, this won't change.
It's amazing though, I have numerous smart and talented colleagues who during 2nd year did everything they could to end up at outpatient sites in the middle of nowhere (partly as a trade off to end up at one single good site). Whereas I did everything I could to get inpatient rotations.
 
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