Saying no

Pros and cons of turning down an audition rotation: What you need to know

Thinking about turning down or canceling an audition rotation and wondering what the consequences could be? DOs weigh in.

For osteopathic medical students, audition rotations are often an important part of the process of getting into residency. But in some cases, students are unable to accept an audition rotation after applying for one. In other cases, students need to cancel one that they’ve set up. The reasons for turning down or canceling an audition include the cost of traveling, scheduling conflicts, personal obligations or receiving a better offer.

We spoke to a program director and two DOs who had to turn down audition rotations. Shawn Cuevas, DO, who is in his fourth year of residency, turned down two audition rotations that couldn’t fit into his schedule. Adam Coridan, DO, who will begin his residency this fall, also had scheduling issues, which led him to turn down one audition rotation and cancel another.

For both physicians, opting out of some rotations better positioned them to concentrate on others that were higher on their priority list.

“Focus on the programs that you’re most interested in,” says Dr. Cuevas, an anesthesiology resident at OhioHealth Doctors in Columbus, Ohio. “And make sure you get in front of those people for an audition rotation.”

Thinking about turning down an audition rotation and wondering what the consequences could be? Here are a few key points to remember.

Why audition rotations are important

Audition rotations allow candidates to get a clearer understanding of the environment they’d be working in if they matched there, says Dr. Cuevas.

“Without an audition, you don’t truly know what you’re getting yourself into. You need to be there to see the patient interaction, the camaraderie between residents and the collaboration between different residency programs,” Dr. Cuevas says. “I work beside internal medicine residents, orthopedics residents as well as ob-gyn residents. That type of collaboration was important to me.”

Many program directors prefer to assess candidates via an audition rotation when possible, says Amjad Yaish, DO, the program director for the orthopedic surgery program at McLaren Health Care in Mt. Clemens, Michigan.

“The audition allows ample time for residents and staff to get to know the student so much better than we can in an interview,” Dr. Yaish says. “It allows us to see the student’s true personality, for better or worse, and it also gives the student more opportunity to shine.”

Programs may get hundreds of applications for only one spot, says Dr. Coridan, who will begin his anesthesiology residency at Penn State Medical Center this fall. “It may come down to the candidate who has demonstrated a continued interest in the program. Showing up for an audition rotation shows that you are indeed interested,” he says. “If it’s a place that requires an audition and it’s a top choice on your list, you have to say ‘yes’ to the audition rotation.”

When you have to say ‘no’

When Dr. Coridan turned down two audition rotations because of scheduling conflicts, he says he knew that he wouldn’t be offered interviews at those places. “They were not high on my list of residencies and that’s why I was OK with turning them down,” he says.

In addition to scheduling limits, there are physical limits. In the process of auditioning, it’s easy to get exhausted, says Dr. Cuevas. “Being away from your family and normal lifestyle and being on the road for three or four months can burn you out,” he says.

“That may lead to poor performance on an audition rotation,” Dr. Cuevas says. “Turning down a rotation is OK if you need time to recoup.”

Logistically, you may not be able to get to each rotation, says Dr. Cuevas. “Unfortunately, there will be some overlap, because you simply cannot do everything,” he says. “Students have to realize that there will be an opportunity cost to doing one thing and not the other.”

Programs understand that life happens, Dr. Coridan says. “But if you have to say ‘no,’ make sure you provide plenty of notice,” he says. “I let the programs know at least three to four months in advance when I was unable to do the rotation.”

However, applicants should also understand that canceling a rotation can have a negative impact on their candidacy, Dr. Yaish says.

“In the past, we have selected students who never rotated at our institution, but it is definitely the exception to the rule,” he says. “It reflects negatively. While there may be several reasons to turn down a rotation, the bottom line is something else was more important.”

Dr. Cuevas recommends that medical students work with a mentor. “Mentors can help navigate around turning down rotations and what to do next. I recommend a mentor a year or two above you in the specialty you’re pursuing,” he says.

Things to keep in mind

Candidates have to be mindful of the program’s position and the measure of preparation that is required to extend an audition rotation, says Dr. Coridan.

“The schools have to do a lot to provide a candidate with access to their facility, and the paperwork that goes along with that is extensive,” he says. “If you don’t attend and don’t provide sufficient notice, you’re making the programs do a tremendous amount of work for nothing.”

Dr. Coridan recommends no less than two months’ notice if you cancel an audition rotation.

“I would never recommend turning down a rotation if it’s where you really want to go,” says Dr. Coridan. “If it’s a program that places weight on the rotation, not going is a definite downside.”

For further reading:

5 ways to manage residency interviews, audition rotations like a rockstar

Audition rotations: 7 tips for success

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