How to DO 4th year rotations work?

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PreMedHeart

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I've always been a little unclear on this and was hoping someone could lay out in general, how fourth year DO students find rotations for fourth year. I know we have to set them up...and I believe there is some kind of service that lists them out? I'm sure it depends somewhat on schools, but can you essentially do fourth year rotations wherever you want geographically or is it typically only within the region of the school?

Thank you so much!

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My school had 6 months of required rotations and 6 months of electives. In regards to the required rotations, my school had a catalog of rotation sites affiliated with the school for each required rotation. You ranked the rotation sites in order from most preferable to least, and you were assigned your rotation site for each rotation by the school. This is how 3rd year worked. For the electives, you could basically go anywhere (even internationally) that would take you. Most hospital systems have forms on their websites for visiting students. Go to university of X's website and look for the visiting student tab. I, however, used VSAS (Information Regarding The Upcoming Merger of VSAS® and GHLO® - Services - AAMC) to set up my rotations at university hospitals.
 
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From what I gathered, there are two types of 4th year rotations depending on where you go to school

Students in schools with in house residency programs and teaching hospitals such as MSUCOM, Rowan, NSUCOM, OSUCOM, OHUCOM tend to finish 4th year at their own teaching hospitals, but may leave 1 or 2 months for audition rotations else where. This is depended on the specialty you are interested in. Some specialty will require away but some won't.

students in schools with no in house residency programs such as KCUCOM, LECOM, COMP, RVUCOM end to finish 4th year anywhere in the US, usually scheduled through VASA. When I was interviewing at KCU, students seem to know where they want to do residency so they would schedule most of their 4th year in that particular state or hospital.


My school had 6 months of required rotations and 6 months of electives. In regards to the required rotations, my school had a catalog of rotation sites affiliated with the school for each required rotation. You ranked the rotation sites in order from most preferable to least, and you were assigned your rotation site for each rotation by the school. This is how 3rd year worked. For the electives, you could basically go anywhere (even internationally) that would take you. Most hospital systems have forms on their websites for visiting students. Go to university of X's website and look for the visiting student tab. I, however, used VSAS (Information Regarding The Upcoming Merger of VSAS® and GHLO® - Services - AAMC) to set up my rotations at university hospitals.

When you are scheduling away rotation, do you pick the best ranked out there or pick the one you wish to do residency? Do you consider 4th you to be directed more towards auditioning for residency or gaining better clinical educations at a good academic hospital? Thanks!
 
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My school (WCUCOM) requires a total of 36 weeks of rotations. 16 medicine, 16 surgery, and 4 classified either medicine, surgery, or non-clinical elective. Choices are pretty wide open. Some did all ACGME, scheduled through VSAS. I did all AOA audition auditions at the top residencies on my list until December, Then the remainder have been at my original hubsite: Anesthesia, and starting a 2-month block of FM/IM on the 2nd.
 
When you are scheduling away rotation, do you pick the best ranked out there or pick the one you wish to do residency? Do you consider 4th you to be directed more towards auditioning for residency or gaining better clinical educations at a good academic hospital? Thanks!

The advice we had gotten was to pick ones at programs where you wanted to do residency. I know some of my classmates are also going to places to pick up some extra clinical knowledge in areas they feel like they're lacking. A couple of us even applied to NASA for the aerospace medicine rotation.
 
The advice we had gotten was to pick ones at programs where you wanted to do residency. I know some of my classmates are also going to places to pick up some extra clinical knowledge in areas they feel like they're lacking. A couple of us even applied to NASA for the aerospace medicine rotation.

That sounds great! Any chance of actually going to space with that training? If so that would be the most amazing rotation in my opinion.

How would you divide up the rotation time slots? For instance, my school will have 6-7 months of elective rotations. The school itself has in house residency programs in many specialty. But other highly ranked medical centers are also in state and close to campus. Assuming I did well with Step 1, would be wise to shoot for these highly ranked medical centers or be more conservative and choose in house residency for electives?
 
Thanks for all the feedback guys! So does that mean you can schedule rotations through VSAS pretty much anywhere in the country? Cause that would be awesome! It sounds like people set these up the end of third year?
 
This will be highly dependent on which school you go to and probably something to research/ask about when applying. But it can vary from a school having a few loosely associated community rotation sites and you are left to schedule a handful of electives around the country from a list of locations they have agreements with, to a more traditional setting with a school that has a local teaching facility where you do the majority of your rotations.
 
Thanks for all the feedback guys! So does that mean you can schedule rotations through VSAS pretty much anywhere in the country? Cause that would be awesome! It sounds like people set these up the end of third year?
Some away through VASA can be pretty expensive. These would be more loan burdens in addition to the 4th year tuition you are already paying.

International rotation depends more with schools, it is scheduled with the school and international hospitals
 
From what I gathered, there are two types of 4th year rotations depending on where you go to school

Students in schools with in house residency programs and teaching hospitals such as MSUCOM, Rowan, NSUCOM, OSUCOM, OHUCOM tend to finish 4th year at their own teaching hospitals, but may leave 1 or 2 months for audition rotations else where. This is depended on the specialty you are interested in. Some specialty will require away but some won't.

students in schools with no in house residency programs such as KCUCOM, LECOM, COMP, RVUCOM end to finish 4th year anywhere in the US, usually scheduled through VASA. When I was interviewing at KCU, students seem to know where they want to do residency so they would schedule most of their 4th year in that particular state or hospital.




When you are scheduling away rotation, do you pick the best ranked out there or pick the one you wish to do residency? Do you consider 4th you to be directed more towards auditioning for residency or gaining better clinical educations at a good academic hospital? Thanks!

I didn't rotate anywhere I wanted to do residency. I had good grades and scores, and I can be sort of awkward at times, so I didn't want to mess up my chances at a place I wanted to go. I scheduled elective rotations at local university hospitals and I got my LOR from the attendings I worked with. I matched my second choice.

Some people do easy rotations 4th year and basically goof around (I did radiology and pathology electives, which are both easy).

Some people rotate at programs they really want to go to, which was (is) basically a requirement for AOA surgical programs. If you're good and likable this can really help, but it also can ruin your chances if you suck; I've seen both.

I guess my point is there is not right answer. It depends on your current application and how confident you are in your abilities.

I highly recommend doing at least one critical care rotation. It seems like the hardest rotation for most interns.
 
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Thanks for all the feedback guys! So does that mean you can schedule rotations through VSAS pretty much anywhere in the country? Cause that would be awesome! It sounds like people set these up the end of third year?

Yea, most university hospitals across the country use VSAS. Some programs do not take DO students, however. Most places take DOs, though (or they did 6 years ago). You typically sent up your 4th rotations during the second half of your 3rd year. The highly desirable VSAS rotations will fill up quickly, so if you really care where you rotate you should fill out the paper work sooner than later.
 
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I didn't rotate anywhere I wanted to go. I had good grades and scores, and I can be sort of awkward, so I didn't want to mess up my chances at a place I wanted to go. I scheduled elective rotations at local university hospitals and I got my LOR from the attendings I worked with. I matched my second choice.

Some people do easy rotations 4th year and basically goof around (I did radiology and pathology electives, which are both easy).

Some people rotate at programs they really want to go to, which was (is) basically a requirement for AOA surgical programs. If you're good and likable this can really help, but it also can ruin your chances if you suck; I've seen both.

I guess my point is there is not right answer. It depends on your current application and how confident you are in your abilities.

I highly recommend doing at least one critical care rotation. It seems like the hardest rotation for most interns.

Thanks for the response!


My rotation will start on 2020 when the merger is scheduled to be completed. At that time when everything is ACGME, do you think it would still be good to do away?
 
Thanks for the response!


My rotation will start on 2020 when the merger is scheduled to be completed. At that time when everything is ACGME, do you think it would still be good to do away?

Depends on what you want to do, I guess. You need at least one letter from someone in the field, and your school might not offer rotations in the speciality you're interested in. It also depends on your grades/scores. ACGME programs, in general, do expect people to rotate at their program. If your application looks good and the speciality is DO friendly you should be fine. If your grades/ board scores are bad, but don't reflect your abilities, rotating at a program could really help. Additionally, in the past, if you wanted to do an AOA surgical residency you had to rotate at their program. I'd assume that will be true for the newly converted AOA to ACGME surgical programs. Moreover, if you want to do something DO unfriendly you'll probably have to rotate at programs that have taken DOs in the past. If you want to do family medicine and you don't care where you end up, you can do whatever you want.

In general, if you get an average usmle step 1 score, apply to a DO friendly-ish speciality (family, internal med, peds, ob/gyn, psych, PM&R, anesthesia, pathology, radiology), and you're flexible in location, you should fine.
 
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I've always been a little unclear on this and was hoping someone could lay out in general, how fourth year DO students find rotations for fourth year. I know we have to set them up...and I believe there is some kind of service that lists them out? I'm sure it depends somewhat on schools, but can you essentially do fourth year rotations wherever you want geographically or is it typically only within the region of the school?

Thank you so much!
There is a database of places that your school provides as well as VSAS (that's now being converted to VSLO).
 
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