The affiliates list for LECOM is very very long with the majority in PA, OH, MI, NY, and FL. However, you can set up your own rotations anywhere you want in the country. LECOM also has many international rotation sites in Europe, Australia, and Africa. It's really up to you where you want to go and you do the leg work and do that rotation. If you just want to rotate at affiliates then you sign up an you go to that rotation. As far as quality? It really depends on you as the student an what you expect, how enthusiastic you are and how well you are liked but the attending/residents you are with. Nobody can really tell you if the quality is good. I have done rotations that nobody else liked and I had a great time. On the flip side, there are hospitals I would never go to again and others flock there. There is no hard and fast rule.