Plan your rotations and choose electives that support your family medicine goals.
On this page: Core Rotations vs. Electives | Top Electives for Family Medicine | Excel in Rotations | Away Rotations | Mistakes to Avoid | FAQ
Your clinical rotations are more than just a graduation requirement — they shape your career, impact your residency applications, and give you firsthand experience in the specialties you might pursue. Choosing the right rotations and making the most of each opportunity can open doors, help you build strong recommendation letters, and allow you to confidently step into your future as a family physician.
Choosing the right medical school rotations sets the foundation for your clinical training and future career. Balancing your required core rotations with carefully selected electives can help you build essential skills, explore specialties you’re passionate about, and strengthen your residency application.
Core rotations, also known as clerkships, are required in the third year of medical school. Core rotations are where you apply the classroom knowledge acquired during your first and second years as a medical student to clinical experience. The required clerkships at most medical schools are:
Note: Not all schools require a family medicine rotation. If you’re interested in family medicine, be sure to pursue it as an elective if it’s not part of your core curriculum.
At the end of each core rotation, many schools require students to take a shelf exam—a standardized subject exam created by the NBME (National Board of Medical Examiners). Shelf exams assess your understanding of the clinical knowledge and reasoning skills specific to that specialty. Your performance on shelf exams may be factored into your final rotation grade and can influence your MSPE (Medical Student Performance Evaluation), which is reviewed by residency programs. Preparing for these exams while actively participating in clinical duties requires good time management and a consistent study plan.
Electives offer the flexibility to explore specialties that interest you and build skills beyond your core rotations. They also provide a strategic opportunity to strengthen your residency application—especially when aligned with your career goals. Thoughtfully chosen electives can expand your clinical experience, demonstrate your commitment to a specialty, and help you form valuable connections with mentors.
Electives give you the flexibility to dive deeper into areas you're passionate about — and they can also make a big difference when applying for residency. If you're considering family medicine, here are top elective picks that build strong skills and demonstrate versatility and a commitment to holistic care.
Gain firsthand experience in resource-limited settings where family doctors often manage a wide range of conditions. These electives are ideal if you're interested in full-scope family medicine, including obstetrics, procedures, and continuity of care across generations. They also demonstrate your readiness to serve in underserved or rural communities.
Work with patients facing social determinants of health like housing insecurity, food access, and language barriers. These electives help you understand how to care for diverse, underserved populations and reflect the community-oriented mission of family medicine.
Build essential skills in prenatal care, contraception, reproductive health, and routine gynecologic screenings — all central to full-spectrum family medicine. These electives are especially helpful if you're interested in including obstetrics in your future practice.
Learn to recognize, manage, and support mental and behavioral health conditions such as depression, anxiety, and substance use — which are commonly encountered in family practice. These electives can improve your communication skills and expand your comfort with holistic, whole-person care.
Get hands-on experience diagnosing and managing musculoskeletal injuries, overuse syndromes, and other physical activity-related conditions. Sports medicine is a common fellowship path for family physicians, and early exposure can help you decide if it's right for you.
Fast-paced and procedure-heavy, urgent care electives help build your diagnostic efficiency and decision-making under pressure. You'll also become more confident in managing common acute complaints — from lacerations and infections to fractures and asthma exacerbations.
Rotations mark your transition from the classroom to the clinic—and how you show up matters. Success in rotations goes beyond medical knowledge; it’s about demonstrating professionalism, curiosity, and the ability to work as part of a care team. Clinical preceptors will notice your attitude, work ethic, communication skills, and responsiveness to feedback just as much as your clinical skills.
To make a strong impression, come prepared each day, actively participate in patient care, and take initiative when appropriate. Be respectful and reliable, and always seek opportunities to learn from everyone around you—including residents, nurses, and patients. Ask thoughtful questions, accept feedback with a growth mindset, and reflect on each experience to improve your skills. These habits will not only help you succeed in rotations but also lay the foundation for strong letters of recommendation and a confident start to residency.
Planning the logistics of your rotations can be overwhelming — from securing spots at other institutions to handling housing, costs, and paperwork. Here's what you need to know to keep the process organized and stress-free.
Even the most prepared students can run into challenges during rotations. Knowing what pitfalls to watch out for can help you stay focused, make a great impression, and get the most out of every clinical experience. Here are some common mistakes medical students make during rotations — and how you can avoid them.
Still have questions about rotations and electives? We’ve gathered some of the most common student questions to help you feel confident heading into your clinical years.
Q: What are clinical rotations/clerkships?
A: Hands-on patient care experiences across different specialties like internal medicine, surgery, and family medicine.
Q: What is the purpose of clinical rotations?
A: To build clinical skills, explore specialties, and prepare for residency through real-world patient care.
Q: How can I find a clerkship?
A: Find a list of clerkships by state, using AAFP's Clerkship Directory.
Q: What experiences should a family medicine clerkship include?
A: The Society of Teachers of Family Medicine (STFM) has developed a family medicine clerkship curriculum. STFM describes this as a "list of common and important presentations that students should experience during their clerkship experiences."
Q: How long are medical school rotations?
A: Core rotations: 6–12 weeks each; Electives: 2–4 weeks each
Q: What are shelf exams?
A: Standardized subject tests taken after core rotations to assess medical knowledge and clinical reasoning.
Q: What happens if I don’t pass my shelf exam?
A: If you don't pass a shelf exam, you’ll likely have the chance to retake it or complete remediation work.
Q: Can I still rotate outside my intended specialty?
A: Absolutely — a well-rounded experience is valuable, but make sure your core specialty shines.
Q: What if I don’t get my first-choice rotation?
A: Stay flexible — any good clinical experience will strengthen your skills.
Q: When should I start applying for away rotations?
A: Most away rotations open applications 4–6 months before the start date. Earlier is better!
Q: Are there options available for international electives?
A: Yes. A variety of options exist for those seeking international experiences. The AAFP has a robust resource for Global Health Opportunities in Family Medicine. These resources offer additional information on international elective options: