Here are the answers to some basic and frequently asked questions medical students ask us about how to schedule rotations for their best chances at a successful application year.
1. When is “audition” season?
Essentially the season begins once students transition into the last year of medical school and ends with interviews, roughly from the end of June/early July to the end of November/early December. As with beach season, the beginning and the end of the season are the least crowded. Programs reach their student cap quickly for dates in August and October. Some programs don’t restrict the number of students simultaneously on service and as you might imagine, the OR’s can get kind of crowded during peak season. Check out the directory to see if the program your interested in restricts the number of students who can rotate at once.
2. Are two week or four week rotations better?
In an effort to choose the applicants with the best fit, many AOA orthopedic residencies will only consider those who have spent time rotating with the program. However, in an effort to create well rounded graduates, many medical schools limit the amount of time spent on rotations in a single specialty. Herein lies the rub. How does one optimize their limited time? Will visiting more programs by scheduling two week rotations or focusing on fewer locations by spending four weeks getting to know each program increase my chances of matching?
Most osteopathic orthopedic program coordinators I spoke to suggested four week rotations. Even coordinators for programs that allow two week rotations suggested that four week rotations were preferred. The exception to this trend was the South pointe program which only allows two week rotations. For the most part, I agree with this sentiment for two main reasons:
It’s hard to get to know someone in two weeks
When it comes down to selecting applicants to interview, the majority of the decision process is very subjective. Although applications help, residents and attendings mostly rely on their memory of a student’s performance to rank them. In some of the busier programs, there are over 30 students that rotate through the course of the season. If you consider that your schedule may be fairly scattered, residents are often on away rotations, and attendings take vacation, during a 2 week time period, you may only interact with a minimal number of residents and attendings on a one on one basis a handful of times. Will that be enough for someone to pick you out of a lineup of well qualified applicants?
It’s hard to get to know a hospital in two weeks
Much of the impression you make has to do with your effectiveness in integrating into the workflow. For better or worse, our medical education system is based on learning on the fly, often from people who are somewhat sleep deprived and under some form of duress. The students that have impressed me the most were the ones who decreased my workload when we were on call or operating together rather than adding to it. It’s hard to contribute to the daily work if you have no idea how to login to view XR’s or labs or are constantly lost. Two weeks can be too short to reach your peak effectiveness and just when you’re ready to rock a night on call by having everything ready for a distal radius reduction before your resident arrives, you’re packing your bags and onto the next place.
Prioritizing depth over breadth makes picking rotation locations even more important because you are putting your eggs in fewer baskets. You will be seen at fewer programs and will thus be eligible for fewer interviews. From the flip side, you’ll also see fewer programs which limits the number of programs you can evaluate for “fit”. Of course, there are exceptions to the rule. If you have a stellar application and are confident in your ability to integrate and make a good impression quickly, you might want to prioritize breadth. To a certain degree if your test scores are impressive enough (think COMLEX >700), your application will get special attention. As long as you avoid stepping on any toes and have a few positive encounters, you’ll likely get on the interview list.
3. What order should I book my rotations in?
I’ve heard several strategies on this topic. Some say it’s best to spend your first rotation at a program you don’t think you’ll like. This way you can use that rotation to get up to speed and then rotate at the programs you’re most interested at the end, when you’re at your peak of orthopedic knowledge. Some say you should go to your top programs first so you can make a good impression right off the bat. Others say that you want to rotate at your top program in the middle so you’re not missing any days going on interviews. While yet others suggest saving your favorite program until right before interviews so you’re fresh in everyone’s mind. Who’s right? No one. Or Everyone. I’m not really sure.
We asked current DO ortho residents across the US if they rotated at their program early, middle, or late in the season. Here’s what they said.
- Early in the season 37%
- Middle of the season 40%
- Late in the season 20%
- Did not rotate at that program 3%
There seems to be fewer residents who rotated at the end of the season but even so, the difference is not staggering. I’d be curious to see how many residents were surprised at which programs they liked the best and ended up ranking highest. Maybe a question for next year’s survey. All in all, I wouldn’t worry too much about strategizing your schedule around which programs you’re most interested in and consider some other logistics instead. For example:
- As a general rule, there’s no point in rotating at a program after their interview. Most programs only do one interview day for the whole year where applicants battle it out to the death. Kind of. If you show up after the interview day, you’re basically too late. Sometimes, multiple programs will pick the same day for interviews! Tragically, students who have invested away rotations at these programs will have to pick one and decline the others. The Osteopathic Orthopedic Residency Directory includes last season’s interview dates in our application tab. Obviously, there are no guarantees about when the interview dates for the upcoming year will be, but use the previous date as a ballpark estimate as to when that program will interview this coming season. Many programs will commit to a date sometime in spring so call and check periodically so you can make adjustments if need be.
- If you’re driving between rotations (which is much cheaper than flying and renting cars. Yes, you will need a car at every location), make sure that you plan in a way that you can safely get from one to the next over the weekend.
- Make sure your rotations in November/December are near a major airport so that you can easily get to your interviews.
- Of course, not every program will have an opening just when you want it. You may need to plan around when the available rotation dates at your top programs is. Start booking in January/February so that you’re not left in the dust.
4. How do I book these rotations?
- Make a sample schedule of your away rotation season with dates. Have a list of at least your top 10 programs even if you can only realistically rotate at 3 programs. There’s a chance that your top 3 may not fit into your schedule or have availability.
2. Apply for your dates. Each program has a preferred method for coordinating student rotations. It’d be too easy if it was centralized and standardized! Check out the Directory to see who to contact or where to download the application. Not all programs will get back to you in a timely fashion and it may be reasonable to pencil in a rotation at a program lower down your list while you wait for confirmation.
3. Submit your paperwork (vaccination records, letter of good standing, proof of insurance, etc). More often than not, this can all be sent in once you have your dates set.
4. Once your schedule becomes more solidified, be sure to cancel any extra rotations graciously and with plenty of notice so they can offer the spot to another student. On the flip side, if there’s a program you really want to visit but were unable to book because of availability, ask to be put on a wait list and call to check in on your status from time to time.
5. Be sure all your rotations are confirmed before rotation season starts. Then confirm all rotations and housing arrangements again at least a month before you’re scheduled to arrive at that program.
Hope this was helpful. Comment below or contact us with any other questions you’d like us to tackle.
Dr. Jeffrey Cochran is program director of the Aultman Orthopaedic Surgery Residency in Canton, OH. The Aultman program was formerly known as the Affinity Orthopaedic Surgery Residency but has changed affiliations. Despite the changes in hospitals, Dr. Cochran is...
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