Kenneth V. Iserson, M.D., MBA
Professor Emeritus, The University of Arizona, Tucson, AZ

You will probably do an elective in your first-choice specialty, as do nearly 95% of your fellow medical students. More than a third of them take at least three such “audition” electives.

How should you approach this? It depends on how competitive you are in that specialty. For the few who qualify as “stars,” use the rotation to demonstrate to residency programs that you are as good as your file says you are.

If you fall into the “struggling” category, your record may not guarantee you an interview. You will want to do more than one specialty rotation so you have the best opportunity of demonstrating to a residency faculty that you not only are capable of doing a solid job as a resident, but also are a good fit with their department.

Most of you probably fall into the middle category of applicants who may decrease their chances of obtaining a residency spot with anything less than a superstar performance on an elective rotation. If you are in this group, reconsider doing a rotation at a residency to which you would like to apply (unless the program requires it).

Prepare for your specialty elective rotation by honing your clinical knowledge and skills. Immediately prior to your specialty rotation, do a strong subinternship where you have to take on a lot of responsibility. If you have the time, and if you feel that you will be exceptionally weak clinically, you may want to first do a specialty rotation at your home institution.

Since traveling to the away rotations can be pricey, ask them if you can interview while you’re there. Some programs will allow that. Use specialty electives to “show your stuff,” evaluate your fit with a program, and re-evaluate your interest in choosing that specialty for your career.


Based on: Iserson’s Getting Into a Residency: A Guide for Medical Students, 8th edition
Tucson, AZ: Galen Press, Ltd.


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