The prevalence and cost of medical student visiting rotations

Abstract

BackgroundPerformance on visiting rotations during the senior year of medical school is consistently cited by residency program directors as a critical factor in selecting residents. Nevertheless, the frequency with which visiting rotations are undertaken and the associated financial costs they impose have not been systematically examined.MethodUnder the auspices of the Electronic Residency Application Service, a survey was sent in March 2015 to all U.S. applicants for residency programs in the 2014-15 academic year. Students were asked how many visiting rotations they performed; the estimated cost of performing each rotation; their perception of their educational value and primary motivation for performing them; and the Match outcome of their residency application.ResultsThe survey was completed by 2817 applicants, yielding a response rate of 11.3 %. 1898 applicants (67.4 %) performed visiting rotations: 647 applicants (30.0 %) performed one; 640 (22.7 %) performed two; 322 (11.4 %) performed three; and 289 (10.3 %) reported four or more. When accounting for potential response bias, the true prevalence of away rotators was estimated to be 58.7 % of all fourth-year medical students (95 % CI 54.0–63.4 %). The mean number of rotations for participating students was 2.1. Most students performed rotations equally as an audition for residency placement and for education, with some of the more competitive subspecialties reporting more of an audition experience. The mean estimated cost for performing a single rotation was $958. Thirty-six percent of applicants reported matching at an institution where they had rotated, either their home institution or one at which a visiting rotation was performed.ConclusionsVisiting rotations are prevalent, expensive, and only partly educational. As such, these rotations may impede optimal use of the senior year of medical school and limited student financial resources.

COVID-19 Implications on Clinical Clerkships and the Residency Application Process for Medical Students

“…Although educators may argue that away rotations are expensive and only partly educational, such clinical experiences are a critical part of the residency application process for many specialties [15][16]. Institutions such as the University of California San Diego School of Medicine and Boston University School of Medicine have already canceled or postponed current and future away rotations [17][18].…”

“…Medical students can elect to partake in away rotations for increased educational exposure in a specific specialty, assessment of fit at particular programs, desire for letters of recommendation, and the ability to show interest in a specific geographic region [15]. Survey data from the 2014-2015 Electronic Residency Application Service (ERAS) shows that 67% of fourth-year medical students complete an away rotation [16]. In certain specialties, such as orthopedic surgery and plastic surgery, the percentage of students that match into a residency program at an institution at which they rotated, including both home institution and away rotations is high, 57% and 44% respectively [19][20].…”

Not a Cheap Investment: Estimating the Cost of the 2017 to 2018 Ophthalmology Residency Match to the Applicant and Program

“…There is one limited survey including ophthalmology that found applicants completed a mean of 1.9 away rotations at a cost of US $990 per rotation. 28 Another study estimated a mean cost of US$1,100 for emergency medicine applicants. 12 Second, these figures do not account for the separate cost to apply and interview for preliminary year positions.…”

Visiting Student Away Rotations in Ophthalmology: A Study of Medical Students' Experiences and Perspectives

“…In fact, in regard to visiting rotations among all fields, the average expenditure per rotation observed in the literature was cited between 958 and 2,494 U.S. dollars. 1,2 There is also an opportunity cost. Away electives are typically performed during the fourth year of medical school and compete with curriculum time that might otherwise be used for broadbased medical coursework in other medical specialties.…”

“…11 Nonetheless, the prevalence of ophthalmology bound students performing away rotations ranges as high as 70 to 90%. 1,2 This ultimately leaves physicians, program and education directors, and mentors of these medical students in a difficult position from an academic advising standpoint. There are currently two major gaps in the body of knowledge on the subject.…”