How do Rotations Work?

[peweee17]

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Recently, I have had a few interviews and to help me make a better decision on where to go I would like some insight on how rotations are structured. I would welcome any insight on the matter, but I specifically have these questions:

~Is there a difference between MD and DO rotations?
- Most DO schools do not have there own hospitals as compared to MD schools... Does this imply DO students move around for rotations (ie. Different hospitals..different states?)? -OR- Is it also common for MD to move around or do they do all there rotations in one hospital?

How are rotations assigned? Do you have to apply for them like residencies?

Thank you

 

[Badgers326]

Recently, I have had a few interviews and to help me make a better decision on where to go I would like some insight on how rotations are structured. I would welcome any insight on the matter, but I specifically have these questions:

~Is there are difference between MD and DO rotations?
- Most DO schools do not have there own hospitals as compared to MD schools... Does this imply DO students move around for rotations (ie. Different hospitals..different states?)? -OR- Is it also common for MD to move around or do they do all there rotations in one hospital?

How are rotations assigned? Do you have to apply for them like residencies?

Thank you

This what I can tell you from my own research.

I would say in general, MD rotations are more structured in where you will do your rotations since many are affiliated with hospitals. For my state medical school, the students typically move around from place to place in the state for their rotations unless they are in a special program or have permission to stay at the main hospital. They perform a lottery to determine what location you will be doing your rotations with the option to swab with other students. This way the med students get to experience many different hospital settings and have more opportunities in some of their rotations when they are the only med student there and work directly with an attending physician. They have the option to do some rotations outside of the state especially at sites they are considering for residency.


For DO schools, it seems that it varies from school to school on how they do their rotations. I did find that many MD schools allow DO students to do some of their rotations in their program. Hopefully this link will give you more information on the process: https://www.aamc.org/students/medstudents/electives/

 

[nlax30]

Recently, I have had a few interviews and to help me make a better decision on where to go I would like some insight on how rotations are structured. I would welcome any insight on the matter, but I specifically have these questions:

~Is there are difference between MD and DO rotations?

Short answer... yes and no. Depends on what you mean by "difference" with lots of opinions here. And honestly I don't think one is inherently better or worse than the other, rather you could have a different experience.

Most DO schools do not have there own hospitals as compared to MD schools... Does this imply DO students move around for rotations (ie. Different hospitals..different states?)?

It certainly can mean that. At least here a good number of students leave the Tampa/St Pete/Sarasota area to do rotations back home or in a certain region. I chose to stay as I'm from the general area and had no problems scheduling all mine here. I would think that at most places you could probably do most of your core/required rotations near where the school is, but you most likely be at multiple smaller hospitals/clinics as opposed to a single large academic medical center with lots of residents.

-OR- Is it also common for MD to move around or do they do all there rotations in one hospital?

I wouldn't say it's common. Though that is the case at one of the state MD schools here (FSU) where they have a handful of regional campuses throughout Florida and for 3rd/4th years you basically pick a regional campus you want to go to. There is a decent size hospital in Tallahassee but it currently only has a FP residency program and only a few students stay in town there for years 3 & 4.

How are rotations assigned? Do you have to apply for them like residencies?

I'm sure this will vary among schools. Here we are split up into ~13 or so groups, each with ~10 students which determines the order of your rotations. And within these groups we sat down and decided who wanted to go where for our core rotation sites. Some of the sites can only take certain number of students so if everyone in a particular group wanted to stay in a certain area then that would be worked out in your group. I never ran into that problem. And then it's really just a matter of submitting your choices into the school's online portal system. Same for electives/selectives, you basically find a place that has an open spot for the timeframe you want and submit that online and the school sends the required paperwork to the site.


My 2 cents...... all that said, I think some of the responsibility is on you to shape the clinical years as you see fit. I can only speak to LECOM here, and while we don't have a single large mega academic center, we do have a LOT of flexibility in where we do rotations and if someone wanted to spend most of their time in a certain area at specific hospitals then it may be possible provided they put in a little extra legwork.

And I don't think you can generalize by saying large academic center = good and community hospital = bad. I've done my rotations at a mixture of places, and both have their advantages and disadvantages. I've been at a large academic center and experienced the pathology and access to numerous residents and fellows that a place like that affords. I've also been at community training programs where you may not be fighting a fellow and several residents for procedures, and with private docs where I've scrubbed in as first assist for each surgery.

Point is, I think it's important to have experience in all sorts of settings. You certainly don't want to go through these years only at private clinics or small hospitals where you may not work with residents and have structured didactics. And on the flip side, most of my experience in procedures and face-to-face time with attendings has been at these smaller venues.

 

[peweee17]

Thank you both for the responses. It was insightful. I am currently accepted into LECOM and hopefully soon be accepted into NYCOM. I'm just trying to understand how rotations work. There are pro's and con's of each school.

I'm not sure where I heard this and maybe you can tell me this is false...but I had heard that finding rotations at LECOM was challenging because they don't sponsor hospitals to take there students.

NYCOM is a great school but I don't know is I can fiscally afford to keep moving around every 4 weeks during 3 and 4 year.

These are deffently things I need to research....what is life without tough decisions.

 

[NYEMMED]

Thank you both for the responses. It was insightful. I am currently accepted into LECOM and hopefully soon be accepted into NYCOM. I'm just trying to understand how rotations work. There are pro's and con's of each school.

I'm not sure where I heard this and maybe you can tell me this is false...but I had heard that finding rotations at LECOM was challenging because they don't sponsor hospitals to take there students.

NYCOM is a great school but I don't know is I can fiscally afford to keep moving around every 4 weeks during 3 and 4 year.

These are deffently things I need to research....what is life without tough decisions.

Ive heard the same rumors about LECOM and ultimately that is what swayed my decision, I also heard you could be moving between states at LECOM? (thats rough) but I honestly dont know the truth on that...

I can give you Info on NYCOM though... NYCOM is already affiliated with about 30+ hospitals, That just means that you have options not that you will be moving around all over. NYCOM has regional rotations were you can choose to stay in one geographical area for years 3 and 4, ex Queens, Eastern LI, Western LI, Brooklyn SI Bronx, and Jersey. You can also do a traditional rotation where you rank each of the hospitals you want to rotate through (1-5) and they will give you at least one of your top 3 for each rotation. You can choose hospitals in one area yourself basically. Lastly find where all your rotations are going to be and get an apartment in a central location (If you selected rotations in Brooklyn, Queens and LI, then live in queens and drive... 30 mins-1hr is not a bad commute) No students at NYCOM that I know have moved around every 4 weeks unless they themselves chose to do rotations further away, out of NYCOMs network.

 

[peweee17]

Thanks for the post.

Does anyone know how they assess you doing rotations?

 

[nlax30]

It will vary among schools so I can only speak to LECOM's way...

At the end of each rotation you have your preceptor fill out an evaluation form that gets sent to the school. On it are a couple places for them to write out any comments (good, bad, praise, criticism, etc), some of which may eventually be used for your deans letter. And then another page where they basically grade you 1-10 on various categories that's basically averaged for rotation grade.

During 3rd year you also take the NBME shelf exams in Peds, FP, surgery, psych, OB/GYN, and IM that you must pass. For us they weren't used for actual grades, but I'm not sure if that has or will change.

There is certainly a subjective component to rotation evals which can be issue anywhere but usually not a worry unless you've totally pissed off your resident or attending.

 

[NYEMMED]

Thanks for the post.

Does anyone know how they assess you doing rotations?

For NYCOM you take the NBME shelf exams for the rotation and your preceptor fills out an evaluation. I believe but may be wrong, 80% of your grade is based on the shelf exam, and 20% on the preceptor survey, to eliminate some subjectiveness and allow you to have more control over your grade. Elective rotations I believe are Pass/Fail. The scoring above only applies to core roations

 

[zac16125]

Recently, I have had a few interviews and to help me make a better decision on where to go I would like some insight on how rotations are structured. I would welcome any insight on the matter, but I specifically have these questions:

~Is there a difference between MD and DO rotations?
- Most DO schools do not have there own hospitals as compared to MD schools... Does this imply DO students move around for rotations (ie. Different hospitals..different states?)? -OR- Is it also common for MD to move around or do they do all there rotations in one hospital?

How are rotations assigned? Do you have to apply for them like residencies?

Thank you

As far as the actual rotations, there may be some slight variables between schools, but as a whole both MDs and DOs will take the same "core" rotations in 3rd year (FM, IM, Surg, Ob/gyn, Psych, Peds) and have a number of electives in the 4th year. As DO's we may have some required rotations that the MDs don't have (for example at my school we have to take 2 months of "Ambulatory Medicine" which is essentially just 2 extra months of outpatient family practice) that they might have to fill with different cores or research or electives, I don't really know the details. But bottom line the bulk of the rotations will be similar in MD vs DO schools.

Yes it is true that many DO schools don't have their own hospitals, so how you go about getting rotations then again varies from school to school. At my school, LECOM-Bradenton, you have a couple options. One is to switch rotation sites from month to month (you can do them all in the same gerenal location or if you so choose you can do them all over the country). Some people find that advantageous and like the fact that they can be in Cali one month, then Pittsburgh the next, then Tampa the next. They use it as a way to figure out where they want to do residency. Since I find that to be a huge pain, I chose to do option number 2, which is a whole year at one of the hospitals affiliated with the school. There are a few hospitals where we have these year long arangements and although they aren't technically our teaching hospitals, we are at them for all our rotations in the given year and in that sense I would say its more like the "traditional" MD university hospital setting where you stay put all year. I assume most DO schools have affiliates like that, but I don't know for sure.

Some rotations are assigned (the cores I mentioned above), others are elevtives. As far as I know, no place makes you "apply" in that sense, but you may have to do some work and contact the right people if you want to rotate somewhere that isn't affiliated with your school.

 

[peweee17]

If you do rotations at different area, does the hospital help provide housing. I heard some rotations come with assistance living. Is this true?

 

[nlax30]

Also variable.... some provide housing for free, others have something available for a fee, and still others may not have any official housing options beyond you finding a hotel or your own apartment for the month.

 

[Siggy]

This what I can tell you from my own research.

I would say in general, MD rotations are more structured in where you will do your rotations since many are affiliated with hospitals. For my state medical school, the students typically move around from place to place in the state for their rotations unless they are in a special program or have permission to stay at the main hospital. They perform a lottery to determine what location you will be doing your rotations with the option to swab with other students. This way the med students get to experience many different hospital settings and have more opportunities in some of their rotations when they are the only med student there and work directly with an attending physician. They have the option to do some rotations outside of the state especially at sites they are considering for residency.

Which is exactly how Western University/COMP does it. There's a little less than 200 tracts for 3rd year (While COMP has over 200 students, some of those are in the Northwest Track and are handled in a separate lottery that's run the same way. I'm only discussing the So. Cal. lottery). Everyone ranks as many tracks as they want and a computer randomly takes one student at a time and places them in the first spot in their rank list that's open. Following that we have a week where we can trade tracks followed by a week where we can trade 3 month blocks, followed by a week where we can trade individual rotations.

 

[peweee17]

Which is exactly how Western University/COMP does it. There's a little less than 200 tracts for 3rd year (While COMP has over 200 students, some of those are in the Northwest Track and are handled in a separate lottery that's run the same way. I'm only discussing the So. Cal. lottery). Everyone ranks as many tracks as they want and a computer randomly takes one student at a time and places them in the first spot in their rank list that's open. Following that we have a week where we can trade tracks followed by a week where we can trade 3 month blocks, followed by a week where we can trade individual rotations.

I'm confused. If there are less than 200 tracts for more that 200 students..what happens to the students that "lose" the lottery? Where do they rotate? How does that work?

 

[Siggy]

There's two different lotteries. Until the Oregon campus opens up (next year I believe, don't quote me on that), the students in the Northwest Track do their first 2 years in California and their last two years in Oregon. When you combine the So Cal and NWT lotteries, there's enough for everyone plus extra spots.

 

[mauve]

Which is exactly how Western University/COMP does it. There's a little less than 200 tracts for 3rd year (While COMP has over 200 students, some of those are in the Northwest Track and are handled in a separate lottery that's run the same way. I'm only discussing the So. Cal. lottery). Everyone ranks as many tracks as they want and a computer randomly takes one student at a time and places them in the first spot in their rank list that's open. Following that we have a week where we can trade tracks followed by a week where we can trade 3 month blocks, followed by a week where we can trade individual rotations.

Siggy, by track, do you mean the order in which students do the rotations and at which hospital?

Also, i know that western has 5 core rotation tracks in Michigan. So in that case, if you get to the point where you're trading either 3 month blocks or individual rotations, you can customize your rotations to be partly in SoCal and partly in Michigan? Is there a way I could do some rotations in Chicago?

 

[Siggy]

The way Western sets up the rotation is in 4 3 month blocks. Block 1 contains 2 IM rotations and a psych rotation. Block 2 contains IM 3, surgery, and family practice. Block 3 is Peds and OB/gyn (both are 6 week rotations). Block 4 is elective, OMM, and vacation.

So, for example, (I'm too lazy to check the actual track demarcations)
Tracks 1-50 go block 1-2-3-4
Tracks 51-100 go block 2-3-4-1
Tracks 101-150 go block 3-4-1-2
Tracks 151-200 go block 4-1-2-3

So, if you have block 1 first and I have block 1 first and we want to trade, there's a week where we can do so.

Now, inside a block some people are going to be IM-Psych-IM or IM-IM-Psych, or Psych-IM-IM.

If our psych rotations match up time wise (for example, we're both block 1 and do psych first), there's a separate week where we can trade just the specific psych rotation.

In terms of Michigan, I'm not sure if we do or not. It might be in the NW track or be a 4th year rotation. Additionally, the elective rotations can be done anywhere provided enough time is given to get approval. So if you want to do your elective in MI and you can find a preceptor (electives are the only time we have the option to set up our own rotation), you can get approval to do it up there. I know we do have a few rotations in central California, and OMM rotations in Florida, Hawaii, and Encinitias, plus a few other places. However those are clearly marked and most of the time you can trade for them or trade them away if you don't want it but it's in

So, yea, if we have them (again, not sure and outside of the Encinitias rotation, I was avoiding out of the area rotations) you can try to fanagal your rotations so you spend some time up there. The one problem though is that, outside of track 4 (OMM, elective, vacation), each block ends with a diadactics week in Pomona with lectures and shelf exams.

 

[bleeker10]

Thank you both for the responses. It was insightful. I am currently accepted into LECOM and hopefully soon be accepted into NYCOM. I'm just trying to understand how rotations work. There are pro's and con's of each school.

I'm not sure where I heard this and maybe you can tell me this is false...but I had heard that finding rotations at LECOM was challenging because they don't sponsor hospitals to take there students.

You don't have to worry about finding hospitals at LECOM. Clin ed will get all the hospitals you can do cores at and you choose from there. There are hospitals that have mandatory spots students HAVE to fill before other hospitals can be picked. You choose a certain rotation schedule OR a geographical area (NYC, Buffalo, Central PA, etc). There are also "thirteens" which are students who do all their cores at one hospital. I am doing that in Binghamton, NY. Originally I wanted a certain rotation schedule bc the military match is earlier and I wanted to be able to take advantage of that. I wanted to drive around and see different hospitals but then I ended up getting a new car. I decided I didn't want to do put a lot of miles on my car so I chose to stay in one spot. There were 6 different "thirteens" to choose from. Most of my friends want to go to different hospitals in different areas. One advantage of going to different hospitals is if you know you want to do a certain specialty (i.e. surgery, IM, etc) you can choose to rotate at a hospital with a residency program. If you know you don't want to do a specialty (i.e. OB, peds, etc) you can choose to rotate somewhere where it is a lighter rotation and still learn. I know people who despise the idea of the OR so they chose rotations where they don't do as much in the OR and spend more time on the floor. In the end, most people got to go where they wanted.

One last thing. Before you start rotating, you really have no idea how good a hospital is other than the name (prestige factor). You can try to get ahold of third or fourth years but they are really busy. Keep an open mind. One thing I've heard from third year friends is the rotation is what you make of it. Try to learn and get something out of the rotation and you will have a great experience. Go in hating it and you will be miserable the whole time

 

[mauve]

is there a difference between audition and elective rotations?

i know audition rotations allow you some face time at places where you might want to do residency and you would also be doing it in the specialty of your interest.

how is elective diff from this?
thanks,

 

[cliquesh]

is there a difference between audition and elective rotations?

i know audition rotations allow you some face time at places where you might want to do residency and you would also be doing it in the specialty of your interest.

how is elective diff from this?
thanks,

You use your electives to do audition rotations.

By the way, you want to go to a school with lots of 4th year electives. 3rd year electives are kind of useful, but most places will not take 3rd year students.

 

[peweee17]

Can anyone elaborate on what elective rotations are?

 

[cliquesh]

Can anyone elaborate on what elective rotations are?

You can do a rotation in any field of medicine at any place that will take you. There are some restrictions, but not many.

 

[rc4ch]

Thank you both for the responses. It was insightful. I am currently accepted into LECOM and hopefully soon be accepted into NYCOM. I'm just trying to understand how rotations work. There are pro's and con's of each school.

I'm not sure where I heard this and maybe you can tell me this is false...but I had heard that finding rotations at LECOM was challenging because they don't sponsor hospitals to take there students.

NYCOM is a great school but I don't know is I can fiscally afford to keep moving around every 4 weeks during 3 and 4 year.

These are deffently things I need to research....what is life without tough decisions.

Some hospitals provide free housing. Actually, most of them, for PCOM anyways. We just did our matrix and most of my core rotations are away. I'm actually getting rid of my apartment. In the long run, this should save me a lot of money. Rent is pretty expensive in Philly, and I technically need only 2 months to be here. So, either I'll sublet an apartment, or worse comes to worse, live at a Extended Stay America places. Expensive, but cheaper in the long run than keeping an apartment here. Hopefully it all works out.