Preparation is key

Strategies for planning audition rotations

The process of planning fourth-year rotations can be challenging. In this article, Miko Rose, DO, and Jane Dalisay, DO, share their advice.


Audition rotations, also called “sub-Is” (short for sub-internship), are fourth-year clinical rotations in which osteopathic medical students put their best foot forward as acting interns with residency programs they hope to match into. Elective rotations more commonly refer to fourth-year rotations that are required for graduation, but not necessarily in the specialty of your interest.

The springtime for third-year medical students is a huge turning point as it is the time when they begin planning their audition rotations in their specialty of interest. However, with so many programs and different rotation dates, the process of planning fourth-year rotations can be challenging.

Miko Rose, DO, founding dean for Indiana University of Pennsylvania’s proposed college of osteopathic medicine, has served as an attending for multiple COMs and a career advisor for hundreds of medical students. She teamed up with neurology resident Jane Dalisay, DO, to prepare this article. Below, Dr. Rose and Dr. Dalisay share their joint advice and experiences scheduling audition rotations.

How do osteopathic medical students apply for audition rotations?

There are different platforms students can use to apply for audition rotations. A common one is the Association of American Medical Colleges’ (AAMC) Visiting Student Learning Opportunities (VSLO) program, which allows med students to pursue shorter-term learning opportunities. Various residency programs may have their own application on their website as well, or your medical school may have a base hospital system. It is important to follow the steps that your medical school outlines to ensure you get credit for each rotation and can fulfill your graduation requirements.

Is there an ideal time of the year to schedule audition rotations?

Audition rotations are generally completed in the first half of fourth year, from about June to January the next year. If possible, try to get these done (at least one) by August if you would like a letter of recommendation from a certain program/program director. 

Keep in mind that the Electronic Residency Application Service (ERAS) application is due around the end of September during fourth year. Ideally, you will have all your letters and everything ready for submission to ERAS prior to then, especially for specialties like emergency medicine that might also require standardized letters.

However, with the challenges of scheduling the auditions you want, the timing isn’t always possible, and you will need to work with the scheduling you have. For example, let’s say you have two audition rotations completed by August and you have two of your three letters of recommendation uploaded. You can still submit your application, and when you get the final letter later, you can add it to your application and let programs know you’ve provided an update. As long as you’re only adding a letter of recommendation, that’s okay. You cannot replace or switch any letters once they are submitted.

How should applicants approach scheduling audition rotations when there is an overlap of rotation schedule? 

Space out your application request dates for your top-choice programs and try to “batch” the number of programs you apply to. You can apply to four to five auditions and request dates that do not overlap, wait four to six weeks and then send out another “batch” based on responses or lack of response.

What should students do if they are accepted to an audition rotation when they already have another audition or rotation booked for the same time? 

First, all programs will deeply respect that if you are already scheduled, you will be unable to participate. It is recommended to let them know that while you are very interested in their program, you need to keep your original commitment. That level of integrity reflects very well on candidates and is understood by other programs. It often earns respect.

To not do so can also put a strain on your COM’s relationship with the program. Let’s say a handful of students all cancel audition rotations at a residency program with close affiliations to a certain medical school. It’s not uncommon for the program director of that residency to contact the school and let them know it reflects poorly on the school and those students.

What should students do if they do not hear back from clerkship coordinators when trying to schedule their rotations? 

As long as the programs do not state on websites “do not contact us except through ERAS or VSAS/VSLO,” you can contact the program coordinator and follow up. Let them know you remain very interested and why you chose their program. Ask if they have any updates regarding your application.

How much time should students allow before reaching out? 

Generally, six to eight weeks. However, check with each program on their timeline to respond and follow their guidelines.

What’s most important for all of these is to narrow down your list of top-choice programs to 10-15 programs, and then find out about sub-Is—the timing, when to apply and how, and any specifics about the program. Each residency program is different, so having a top choices list makes it easier to track all the different guidelines within each program.

Editor’s note: The views expressed in this article are the author’s own and do not necessarily represent the views of The DO or the AOA.

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