FAQ: What Are Clinical Rotations? (Plus Their Importance)
By Indeed Editorial Team
Published April 8, 2022
The Indeed Editorial Team comprises a diverse and talented team of writers, researchers and subject matter experts equipped with Indeed's data and insights to deliver useful tips to help guide your career journey.
Medical school is a four-year period during which a student receives formal training to become a doctor. The latter half of medical school comprises clinical rotations, where the student gets the chance to apply the knowledge they've learned in the classroom. If you're looking to pursue a career in the medical field, it's important to understand what clinical rotations are and how they count toward your training. In this article, we define clinical rotations, discuss their importance and answer several frequently asked questions about them.
What are clinical rotations?
Clinical rotations, also known as clerkships, refer to a series of assigned shifts at a medical facility during which a medical student delivers medical care under the supervision of an attending physician and alongside residents and other medical students. Rotations are an integral part of medical education, as it allows students to apply classroom knowledge to clinical practice. They begin in the latter half of a medical student's education—years three and four—and comprise a specific amount of time in each of the following core specialties:
Family medicine: Family medicine refers to medical care provided to patients of all age groups, including children and the elderly.
Internal medicine: Internal medicine focuses on the prevention, diagnosis and treatment of internal diseases in adult patients.
Neurology: Neurology relates to conditions relating to the nerves and the nervous system.
Obstetrics and gynecology: Obstetrics and gynecology relate to women's health and involve prenatal care, labor, delivery and postpartum care.
Pediatrics: Pediatrics is the branch of medicine that focuses on the care of children and adolescents, from birth to age 18.
Psychiatry: Psychiatry relates to the diagnosis and treatment of cognitive, emotional or behavioral conditions.
Surgery: Surgery relates to the treatment of injuries, diseases or other conditions through operations involving physical modification, removal or repair.
Some medical schools may also require rotations in ambulatory medicine, anesthesiology, emergency medicine, intensive care medicine and radiology. In addition, there are elective rotations that provide students with exposure to their chosen subspecialty.
How long is a clinical rotation?
The time spent on each rotation is usually four to 12 weeks. Core rotations, being essential components of medical education, are generally longer than electives. The former may last six to 12 weeks, while the latter may be four to eight. A single shift during a rotation may last eight to 12 hours. These may include scheduling during the day, the night or weekends, with possible overnight call duties as well.
Why are clinical rotations important?
The importance of clinical rotations lies in the clinical experience they offer medical students. The first and second years of medical school are largely devoted to academic learning, with the education deriving from lectures, textbooks and other literature. It's during the last two years, with clinical rotations, that medical students get to apply their classroom learning to clinical practice.
Most significantly, clinical rotations provide medical students with the opportunities to encounter variables and nuances that their classrooms material couldn't cover. Real-life medical cases may involve pathologies that test and defy textbook definitions. As a result, to make an accurate diagnosis, the students are compelled to take into consideration the unique factors that apply to a specific patient and a specific situation. By gaining this experience, they become better prepared to handle similar cases as medical professionals in the future.
What are the benefits of clinical rotations?
In addition to the ability to make accurate diagnoses, clinical rotations can benefit individual medical students in the day-to-day skills they can learn in the process. These include:
Clinical settings involve a variety of roles, all working together to provide patients with quality treatment. These include hospital administrative staff, physicians and residents, all of whom a medical student interacts with during their rotations. Exposure to this environment can reveal the scope of everyone's responsibilities and how their roles complement one another, which is practical knowledge that can inform how the professional practice of a future medical doctor.
Bedside manner refers to the attitude or manner that a doctor takes with a patient. A good bedside manner helps to foster a trusting relationship between them. During clinical rotations, medical students undergo their first interactions with patients as a type of medical authority. In this way, they gain practical knowledge that helps them to develop their method for engaging with patients and resolving common interpersonal problems relating to them.
The experience offered by clinical rotations allows aspiring doctors to shift from thinking like a medical student to thinking like a medical practitioner. Every day on rotation allows the student to understand more deeply the responsibilities of being a doctor. Aside from interpreting symptoms and tests to make diagnoses, they encounter ethical questions and challenges to ideals, which are important for helping the practitioner to focus on doing what's best for the patient.
Deciding a specialty
Exposing students to all the core specialties, plus electives, rotations can help an individual choose the medical specialty that's right for them. Often, students enter rotations with a particular specialty in mind. In such cases, rotations can be valuable as a way to affirm that they've made the right decision. Others may find they're not a right fit for the specialty they wanted. With that new knowledge, they can reassess and revise their plans and choose a specialty better suited to them.
By working closely with medical practitioners, students begin to build a network of professionals who can help to facilitate their future careers. One of the common requirements for a later residency is a letter of recommendation from a physician, and rotations present the ideal period in which to develop a relationship and make an impression that may lead to the acquisition of such a letter. Additional network connections made at this time can lead to employment opportunities in the same hospital or someplace known to a member of the network.
What are some challenges associated with clinical rotations?
With the transition from an academic to a clinical, the medical student is likely to encounter several challenges, the most common of which are:
Clinical rotations may introduce medical students to terms and concepts that their classroom material hasn't covered. One of these bits of unfamiliar knowledge is the large number of initialisms used in clinical settings, which often function as shorthand in patient histories, examinations, impressions and plans. Another is the range of less-common diagnoses and diagnostic tests they may encounter. In either case, it's a good idea for students to take notes as they go through their rotations, which can familiarize them with the new knowledge and prepare them for the next time it arises in a clinic.
Though clinical rotations can be rewarding, they can also put significant pressure on the student. Aside from dealing with the unfamiliarity of a clinical setting, there's also the necessity of preparing for shelf exams—year-three assessments of a student's familiarity and application of medical knowledge in a clinical setting. To keep from being overwhelmed, try to establish and keep to a system that balances study, rotations, personal obligations and recreation. Compartmentalizing the facets of your life as a medical student can help you more easily set priorities and shift mentally into the appropriate modes of behavior.
Part of treating people with illnesses or injuries is encountering instances when treatment doesn't succeed. Such times can be inherently challenging, especially so if you've established a bond with the patient. To handle these moments as a professional, it's essential to acknowledge that you did what you could to help the patient. On a personal level, it's appropriate to express sorrow, which can help you overcome feelings of grief. You might also consider seeking guidance from others, particularly attending physicians and residents, who have more experience in dealing with these situations.
How can you succeed in your clinical rotations?
Learning more about your patients' conditions is a good way to succeed in your clinical rotation. After getting to understand their symptoms, seek information that can contribute to their treatment. Not only can this benefit the patient, but it also helps you to think and work like a practitioner. Here are some more tips to help you succeed during your clinical rotations:
Interact with attending physicians. Your clinical rotations put you in contact with professionals in various specialties. Speaking with them, asking them questions and observing them as they work can provide you with invaluable knowledge that's unlikely to be accessible otherwise.
Interact with patients. As a medical student, you're likely to deal with fewer patients than residents and physicians, making it easier to learn about the specific condition of each. Understanding the variables unique to every patient can help you better understand diagnoses.
Interact with residents. They have more experience than you and are likely more accessible than the attending physician. Ask them for feedback on your clinical decision-making skills and guidance on how to improve.
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