How to Choose Your Elective Rotations in PA School

With so many different types of electives out there, how do you choose!? Will this decision dictate your first job as a PA? Will this define your entire Physician Assistant career?

Here’s the truth. If you end up picking a great elective where you love the specialty and patients as much as you love the people you’re working with, you may end up getting a job out of it! On the other side of the coin, if you chose a miserable rotation, realize you cannot stand the specialty or the people at the site, it won’t cost you an amazing career. You can still end up with the job of your dreams out of PA school. So what’s the bottom line? You should chose wisely, but a wrong decision is not the end of the world.

Let’s get started on how we can tease out the rotations and pick the perfect one!

The first thing to ask yourself is, “What do I think I want to do?” Most people go into PA school with an idea in mind about what they’d like to do. What made you decide to be a PA? Did you meet a PA whose job you wished you could have? Did you meet a physician looking for a PA? Did you hear about the field and imagine yourself working somewhere in particular? Explore these ideas! It is definitely worth your time to get a rotation in an area you think you’d want to work in. If you’re 100% sure about the field you want to work in, there is no shame in getting multiple elective rotations in this specialty. The more you learn, the better prepared you will be to start and networking is gold. Keep in mind, sometimes the specialty that initially attracts us to the PA field is not the one we end up in. That’s okay! How great is it to learn that while you’re a student instead of figuring it out while you suffer through your first job. Also, some people enter the career without a specialty in mind. There are so many different types of jobs that there is something out there for you!

The best tip I can give you if you’re completely lost and not sure where to start is to shadow! Call around and try to spend a day with multiple different practioners and in multiple different specialties. Instead of committing to a month long rotation, see what happens in a day. You may get a warm fuzzy feeling about a specialty you didn’t consider and you may dislike a specialty you thought would be a perfect fit. Sometimes this has more to do with the environment than the specialty, so the more the merrier when it comes to shadowing opportunities. There was a time in my life I thought maybe my calling was in orthopedic surgery or oncology, so I decided to shadow a few people in both of these areas. It turns out neither were a fit. I’m so happy I shadowed before setting up a rotation because I gave myself an opportunity to explore more promising specialties. Read more about why I’m happy I took my first job in general medicine.

There is a common misconception that you should pick an elective that is highly weighted on the boards, like cardiology and pulmonology. If you have a genuine interest in these fields, you should definitely set up a rotation. However, if you’re only interested because you think it will help you pass a test, think again. The information you need to pass your boards isn’t always necessarily what you’ll learn on these rotations. I had a cardiology elective, so you can trust me on this one. Also, the chances you pass your boards are very high. Failing to pass your boards has more to do with how much time you spent studying, the information you studied and how well you understand the field than the elective you chose. Electives are meant to help you understand the field and prepare yourself for your future career as a physician assistant. Rotations are an opportunity to learn that you will have again, so don’t make it all about passing a test.

If all else fails, here are some general tips about specific fields.

Emergency medicine/urgent care

If you don’t already have an emergency medicine rotation, you should definitely consider this. Here you can get exposure to many different problems. You are the first to see these patients, which means your differential is huge and you learn to use your index of suspicion to select appropriate testing. You get quick feedback and learn how to stabilize patients. This experience is very valuable no matter what field you end up in.

Hospital medicine/acute care

I think that everyone should spend time learning hospital/acute care medicine. I believe this so firmly that I got my first job in this field. In a hospital setting, you learn what a sick patient looks like. You speak with many specialists and whether or not you save a patient’s life will depend on your ability to problem solve and get quick test results as well as have the ability to interpret them. There is also some continuity of care so you get a great deal of feedback to learn from. This knowledge served as a great frame work for my future as a physician assistant, so I would recommend it to all.


People get rashes. These tend to be a mystery to most people. Regardless of what field you are in, you’ll have patients with vague rashes. If you’re able to differentiate between different skin conditions, you may be able to tell if someone has a systemic illness or if they just came in contact with some poison ivy. If you are thinking about a career in emergency medicine, pediatrics or family medicine, dermatology knowledge is very valuable.


An orthopedic rotation is a great choice for a similar reason as a dermatology rotation. Sick people fall and have orthopedic injuries. Healthy, active people have orthopedic injuries from doing sports. Having this knowledge will undoubtedly help you if you are interested in working in emergency medicine, pediatrics or family medicine.

Surgical Specialties

The surgical world is very different from the general medicine world. If you think you love surgery try different surgical specialties. The more practice you can get with tying knots, suturing, operating instruments and learning anatomy the better. Not all surgeries are the same. You could hate one type of surgery, but love another. The only way to know is to try. Some rotations will offer you an opportunity to spend a week or so at each surgical specialty. These are very valuable.

No matter what specialty you select for your electives, there are always opportunities to learn. Whether your rotation becomes your future place of employment or just a memory, any knowledge you gain on rotations can make a difference in your patient’s lives.

One thought on “How to Choose Your Elective Rotations in PA School

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