Elective Rotations FAQ

Written by Simon Shapiro, TouroCOM Class of 2011

How to set up elective rotations in general - how does the whole process begin?
  • Decide what you want to do or where you want to go.
  • If it's a particular rotation at a particular site, look on www.scutwork.com and see what people have said about it.  Some reviews are from residents in the program and some are from students.
  • Go on your target school's website and look at the rotation pre-requisites.  For instance, some rotations will require that you have completed your core medicine and/or surgery clerkships.  Some don't.  It varies by school/hospital.
  • Doing a google search like this will usually get you where you need to be: "NYU elective visiting clerkship medical"
  • Look at the school's application process.  Everyplace is different.  For some places (like NYU, North Shore Univ Hospital, et al), you contact the specific program directly, send your application directly to the attending (or program manager) and they send it in to their registrar or handle it themselves.  For other places (like Columbia, St Lukes/Roosevelt, UCONN, et al) you apply through a central service, usually within the registrar's office.  
  • Follow their directions, but if you have questions, just call them up and ask.  For instance, the NYU site says they have 2 applications, one for LCME students and one for non-LCME students (the LCME is the accrediting body for US allopathic schools).  When I inquired about this, I was instructed to fill out the LCME paperwork, because they intended the non-LCME application for FMG's/IMG's, and consider all US med students to be "LCME" (even though the AOA accredits osteopathic schools, not the LCME).  Don't bother explaining this to them, just get the info and do what they tell you.
  • Follow Touro's directions too.  You have to request approval for your rotation.  Use the form in the Clinical Handbook.  You can submit the required application paperwork to them along with this form.  Most schools have their own paperwork that they will require Touro to fill out.  It should probably go to Dean Taintor / Nadine.  For the most part, it's a letter of good standing.  Some schools also want a transcript.  
  • There may also be a specific health form you need filled out.  Let your doctor know you're going to be sending these to them.  They're basically checklists saying you got your vaccinations, recent negative PPD's, etc.  Alternately, some schools may accept Touro's health report on you, in which case you need to request that Touro sends that.  In most cases, you can complete these forms without actually going for a doctor's visit.
  • Personally, I like to put all the paperwork together and send it myself.  That way I know the right documents went in.  But first and foremost, follow you target school's guidelines and use their paperwork.  
  • None of this applies if you do electives at Touro's core sites.  Then you just ask your DME and submit the elective form to Touro. 
  • To look up allopathic residencies where you might want to rotate: https://freida.ama-assn.org/Freida/user/viewProgramSearch.do
  • To look up osteopathic residencies where you might want to rotate: http://opportunities.osteopathic.org/search/search.cfm
Who should the 2nd years be trying to contact? (Residency program directors or others?)
  • Depends on the program.  Follow each program's instructions individually.  See above.
When should 2nd years begin trying to find elective rotations?
  • The sooner the better.  At least 3 months prior to the month you'd like to do the elective is a good rule of thumb.  But depending on the month, you may have to get your documents in earlier to get a spot, or you may be able to get one last minute.  But in my experience, it can take Touro anywhere from 1 - 8 weeks to get the paperwork filled out for you, depending on what else they have on their plates at the moment.  So it's best to plan ahead.
  • The process is a little different in 4th year.  You want to set these up ASAP after you get your 4th year schedule.  Some places will let you apply as early as January for the following academic year whereas others fill their rotations with their own students first and let you apply in April or May.  Some will take your application early and let you know in May.  It is not uncommon to apply for multiple 4th year electives in the months of Aug-Sept.  For instance, apply for an emergency medicine elective in August at NYMC, Metropolitan, NYU, and Maimonides.  You'll find out later if they have space for you or not.  You can always cancel an elective if a preferable one comes through later.  Be professional, of course... give plenty of time and follow the hospital's guidelines for canceling a rotation.
  • The reason Aug-Sept are popular months is because this is a good time to do a rotation and get a LOR in time for ERAS.
  • Anytime before December can be considered an "audition rotation."  At an audition rotation, you rotate at a program you'd like to attend for residency.  It's a double-edged sword.  If you really shine, they will know how great you are from first hand experience.  If you screw up, they will remember you that way.  Whether to do an audition rotation or not depends on several factors, such as how the rest of your application looks, if you are a good "people person" or not, etc.
  • The audition rotation also allows you to check out a program you have applied to so that you have a better idea of where to place the program on your rank order list (for the ERAS match).  
  • But this is all for later in your 3rd year when you start to plan your 4th year schedule.
How long does setting up elective rotations take?
  • See above. 
  • It can be a labor-intensive process.  You've got to get all the paperwork for both the school you want to go to and for Touro, and you need to get a health form filled out by a doctor (unless they'll accept Touro's info).
  • You can streamline the process by following both Touro and the Elective site's instructions.  Clearly, if you want to rotate at Hospital X, you need to follow their instructions and use their forms.  Don't cut corners.  
  • Be pleasant but persistent in order to make sure things get done.
Where should you be doing elective rotations?
  • Depends what you want to get out of it.
  • If you want to hone your skills in an environment that won't negatively impact your ability to apply to a residency program, then do it at one of Touro's core sites.
  • If you're considering applying to residency at a given hospital, doing a rotation there will give you a sense of the culture there, even if it's in a different dept from your desired residency.  Also, a LOR from within their hospital may be more valuable to a program director or may make you stand out from the crowd.
  • If you are confident you can shine, doing an elective in your specialty of choice at your program of choice can be a way to make connections and secure an interview.
  • It also depends on where you do your core rotations.  You need 3-5 LOR's for the ERAS residency application process.  These should ideally come from attendings or PD's at academic programs, in other words a dept with a  residency.  If you do all your rotations at Palisades, which has no residency program, you need to get some LOR's from somewhere that does.  Your electives are the time to do that.  On the other hand, if you rotate at Bronx Lebanon for IM, FM, or Peds, these are all academic programs and a LOR from them will be acceptable.  
  • LOR's from rotations w/o residencies can also be valuable, but you should have an academic LOR at least in your specialty of choice.
  • Another possibility is that if your 4th year electives are late in the year they will really have no bearing on your ERAS application and match process, so you may as well do something fun.  You could arrange an elective near your family, or do something you'll never have the chance to do again.  Interviews occur during Nov-Jan, so some people like to schedule something with a lighter or more flexible schedule during one or more of these months.  Different rotations have different work guidelines.  Neurosurgery will probably push 80 hours a week, whereas family or emergency medicine may be more like 40.
  • My personal opinion is that unless you have a compelling reason to stay at core Touro sites for your elective then you should look around and experience some other places.  
What should you do after finishing an elective rotation?
  • Depends on the rotation. 
  • If it will be useful, get a LOR.  
  • Coordinate with Touro to get your evaluation paperwork so you can get graded.
About how many elective rotations can you do?
  • We (2011) had 2 open blocks in 3rd year.  One designated for an elective and one for vacation.  Most people did just one elective.  Some used their vacation to do another.
  • Personally, I recommend taking the vacation time.  You can set up a short clinical experience during your vacation if you want to, but there's no need to do a whole additional rotation unless you have a compelling reason.  You will need the time off to refresh.
  • During 4th year, we have a designated study month (July).  Some people may choose to use this as an elective but I think most will study for step 2.  Touro has also designated June as a non-clinical month, and our graduation is scheduled for June.  That leaves 10 months, of which 4 are designated as electives and 2 as "selectives". 
  • Selectives for us are essentially elecctives, but one has to fall into the category of "surgical subspecialty" and one has to fall into the category of "medical subspecialty."
Final Thoughts:
  • You will work hard on all your rotations.  But when you rotate at an outside hospital/program, it is time to shine.  Be ready to go above and beyond.  You may be many place's introduction to TouroCOM.  Represent!
  • First and foremost, this means getting along with people and being a team player.  You are not expected to know everything, especially as a 3rd year student.  You are expected to be interested and engaged, ask intelligent questions, and be teachable.  
  • You should be pleasant with everyone... the nurses, the secretaries, other students, everyone.  Especially the secretaries.  
  • You definitely need to be dependable and competent, but being collegial, socially normal, and easy to get along with will definitely make people remember you in a positive light.  
  • In my opinion, the most pivotal times in a rotation to make an impression are the first few days and the last week.  It's hard to get over a bad first impression.  And when someone sits down to assess you at the end of the rotation, the last week will be most fresh in their mind.  Whatever you do in between, don't screw up during these important times.  Or if you make a blunder somewhere along the way, know you can save it with a strong performance at the end. 
  • The clinical phase is awesome.  Enjoy!