Rotation, rotation, rotation

How to plan your fourth year of med school

Here’s what you need to know about planning audition rotations, housing and travel logistics, and fourth-year finances.

Editor’s note: This story was originally published on Finger’s blog and is republished here with permission. It has been edited for The DO. The views expressed are the author’s own and do not necessarily represent the views of The DO or the AOA.

Planning your fourth year of medical school can be complicated. You have the ability to rotate at various institutions, often at places you would like to go for residency. With this opportunity comes the responsibility of scheduling these rotations yourself. As a tutor, class representative and ambassador for my medical school, I have had the chance to mentor many medical students.

The best people to learn from are those who have walked the path before you. The following is knowledge I’ve gained from my own mentors as well as my experience planning my fourth year of med school. These are my best tips and tricks for the final year of medical school.

What is an audition rotation?

An audition rotation is just a term used to describe a rotation at a residency program you’re interested in. You may also hear these referred to as away rotations, acting internships or show rotations. It’s a chance for a residency program to get to know you and for you to get to know the program.

Scheduling audition rotations

Start planning EARLY. Even if away rotation applications aren’t open yet, start getting things together that you know you will need and act on any tasks that you can do now while you have time before the busy season hits. Most applications will open in March or April of your third year, so I suggest starting to plan in February or early March.

Create a file with all the documents you may be asked for, including your BLS/ACLS certifications, drug screen, background check, vaccination form, TB mask fitting and insurance. If you don’t have these things completed yet, go ahead and get them done before applications open.

Some rotations require a personal statement. Prepare a preliminary one. This doesn’t have to be the finished product you will use for residency applications.

Use a professional photo on your application. Wear a suit, do your hair and take a professional-quality photo.

Stay organized. I used spreadsheets to visualize my fourth year. You can download the spreadsheets I made here. Notice that there are tabs at the bottom for different sheets.

Plan around interview season. Plan to have at least one light rotation or month off during interview season. Interview season starts in mid-October and ends in late January. Typically, you’ll have the majority of your interviews in November and December.

Decide how many auditions you want to do. This number is totally different for everyone and is based on what specialty you’re going into, how competitive your application is, and whether you want to stay in a certain region. Reasons to do more auditions may include wanting to get a feel of various work environments or applying to a specialty that places a lot of importance on experience in the field.

Decide where you want to do auditions. You can use Doximity, FREIDA and program websites to learn more about each program. Mark down the date that each application opens and the documents they require. Have things ready to submit on the first day the application opens.

Talk to current residents at the programs you’re interested in. You can do this by contacting your school’s department chair to ask for a list of previously graduated students who went into your desired field. Sometimes your school’s interest group will have a Facebook page also, where you can contact alumni.

Apply. Most programs use VSAS/VSLO, but some use their own application systems. You can usually find this information on the residency program website under “medical students” or “visiting students.”


Housing is probably the largest expense you will encounter this year. Some ways to save money on lodging include:

  • Moving in with a roommate to cut your rent in half
  • Staying with friends or family—don’t be shy, let them help you!
  • Using sites such as AirBnB or Rotating Room for temporary housing, or to rent out your room while away

Other things to consider

TSA Precheck/Global Entry: I did not understand how great this was until I was running from interviews to catch the last flight out. TSA Precheck ($85) and Global Entry ($100) both last five years—worth the investment! To protect your information, only sign up at the official government website. You will need at least two to three months to complete the full verification process, so give yourself enough time before interview season to start this.

Get a credit card: You are going to be spending a significant amount of money on flights, hotels, temporary housing and application fees. You might as well earn some benefits from these expenses. Most credit cards provide free purchase protection and rental car insurance. Some even cover the cost of TSA Precheck or Global Entry.

Many airlines have their own credit cards, which can earn you miles, give you free checked bags on their flights and waive flight cancellation fees. That last point is a pretty important benefit to look for—you will undoubtedly have to cancel/reschedule multiple flights as you accept and cancel interview offers.


Some necessary expenses that you should account for while planning include:

  • VSAS/VSLO application fees ($40 base fee which covers three electives and $15 per elective after that)
  • Fees for audition rotations, such as admin fees and parking passes ($0-$200, depending on institution and location)
  • ERAS application fees ($500-2,000, depending on how many programs you apply to)
  • Housing and transportation for interviews

Travel essentials

These items made my life so much easier:

  • Toiletry bag that’s easy to unfold and hang up
  • Reusable water bottle
  • Collapsible coffee mug
  • Travel steamer
  • Lint roller
  • Hand sanitizer (so many germs on airplanes!)
  • Laptop and chargers
  • Two suit sets (shirt, pants, jacket) in case one gets lost or damaged
  • Comfortable professional shoes that you can wear on both your rotations and interviews
  • Snacks (don’t waste money on marked-up airport food)

You got this!

Remember that at the end of the day, you won’t be able to prepare for everything. This year won’t be perfect. But luckily, we live in a world where nearly anything forgotten can be bought at a convenience store and Ubers can be used when transportation falls through. Jump in, let things come as they will and enjoy the ride. 

Related reading:

Navigating the costs of OMS IV

Pro tips for nailing your residency interviews and audition rotations


  1. Pingback: Planning 4th year of med school

  2. Daniel Jennings

    I attend medical school on the west coast, but am originally from New England as is my partner who moved across the country with me. I plan on doing my residency on the East Coast, and understand that for some of the competitive specialties, they really want you to do a rotation there as an “audition”. I am a motivated and dedicated student, but would it be too much to assume there is the possibility for me to do the entire 4th year on the east coast? I have family within 30 minutes of all the major hospitals in Boston, Vermont, New Hampshire, Connecticut, and New Jersey, and would assume that there are people willing to let me stay with them in NYC if need be. Housing isn’t necessarily my concern, I am more concerned with all the moving parts and if it would rely solely on me. Thanks!

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