How to Choose Your PA School Elective Rotations

By: Savanna Perry, PA-C

TL;DR

Elective rotations are your chance to shape clinical year around your goals. Use them to explore a specialty you missed, strengthen a weak area for boards like cardiology, build experience where you want a job, or even audition with a future employer. Pick based on what will make you a stronger, more confident new grad.

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How Do You Use Electives to Explore or Confirm a Specialty?

One of the fun parts of clinical year is choosing where you'll do electives, though it can feel stressful too. A great first question: is there an area you didn't get to rotate through that might interest you? Electives let you test-drive a specialty without committing to a contract. My school didn't require orthopedics, but it's popular and a good chunk of the PANCE, so a lot of my classmates rotated through ortho.

Another angle is a rotation you loved but aren't sure you'd want daily. Maybe you just need more time, or maybe you want to try a different setting. If you liked a specialty but only saw it in a hospital, find an outpatient office, because the difference can be huge. I spent my whole psychiatry rotation on inpatient wards and hated it, while classmates loved outpatient psych.

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Should You Use Electives to Prepare for Boards?

Yes, especially for areas you feel shaky on. For me that was cardiology. I still wish I'd done a rotation specifically in cardio, since it's such an important part of boards and of seeing patients across settings. I did general internal medicine and endocrinology instead, which I'd recommend, but cardio or pulmonology would have been really useful.

Doing an elective in an area you don't feel comfortable in pushes you outside your comfort zone and helps you feel more ready for the PANCE. If you also want extra study time, keep in mind that some rotations are more laid back than others. ER, for example, often requires a set number of shifts, so if you can stack them early you might finish a rotation ahead of schedule and free up study time.

In Our Experience

In our experience coaching students through clinical year, the best electives do double duty: they cover a board weak spot and open a door to a job. I used mine to lock in a dermatology position before graduation, and that head start on training made my first months as a new PA so much less stressful.

How Can Electives Help You Land and Prepare for a Job?

If you already have a specialty in mind but no job yet, rotating in that area gives you extra experience and gets your interest known, so preceptors and employers with connections can help you find a position. And if someone has made or is considering an offer, doing one or all of your electives with that group is smart. It lets you see if you fit and gives them months of free training, which means you'll be working independently sooner.

That's exactly what I did. I knew I wanted dermatology, used my 2 months of electives as a benefit during my interview, and got hired before electives even started. Those months were great training, and I was seeing patients on my own about 1 month after I was licensed because I already had 3 full months of training in.

Every Pre-PA Should Know...

Using electives to train with a prospective employer can shave weeks off your ramp-up, since you may start seeing patients solo within about a month of licensure.

What Else Should Factor Into Your Elective Choices?

Think about whether a complementary specialty would make you a better provider in your future field. Many fields overlap or refer out, so spending time in a related area helps. In derm we refer to rheumatology a lot, and to Mohs surgeons. For primary care, extra time in derm, endocrine, or ER is helpful. For ER, a derm or surgery rotation where you really work on suturing is a good idea.

Electives are also a chance to explore a different city or state. A classmate of mine rotated in Texas, Tennessee, Wisconsin, Washington, and Alaska, where she now works. If you have the financial means and flexibility to travel, go for it. Rotating in other regions shows you how healthcare differs from place to place, which is valuable perspective for any new PA.

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Need to Know:

Use electives to explore specialties you didn't rotate through
Shore up weak board areas like cardiology or pulmonology
Try a different setting (outpatient vs inpatient) for a specialty you liked
Rotate where you want to work to build experience and connections
Audition with a prospective employer for built-in training
Consider electives in another city or state to broaden your perspective

FAQ

What should I consider when choosing PA school electives?

Think about specialties you missed, board areas you feel weak in, where you want to work, and whether a prospective employer would let you rotate with them. Each elective can serve a goal.

Should I do an elective in a specialty I'm worried about for boards?

Yes. An elective in a weak area like cardiology pushes you out of your comfort zone and helps you feel more prepared for the PANCE.

Can electives help me get a job?

Definitely. Rotating where you want to work builds experience and gets your interest known, and rotating with a prospective employer can lead to an offer and a head start on training.

Is it worth doing an out-of-state elective?

If you have the money and flexibility, it's a great way to explore another region and see how healthcare differs from place to place. One of my classmates landed her job in Alaska that way.

How do electives affect PANCE study time?

Some rotations are more laid back than others. Scheduling lighter or shift-based rotations like ER early can free up extra study time before boards.

Should I pick an outpatient or inpatient elective?

If you liked a specialty in only one setting, try the other. The difference between a private office and a hospital can be huge, and it may change how you feel about the field.

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The Bottom Line on Choosing Electives

Your electives are some of the most flexible time in PA school, so spend them with intention. Whether you're filling a board gap, chasing a specialty, or auditioning for a job, choose rotations that set up your transition to practicing PA. If you want help thinking through your clinical year strategy, we're here for that.

How to Choose Your PA School Elective Rotations