How To Approach Choosing Your Fourth Year Rotations

by | May 8, 2020 | Career, Pharmacy Student

Many of you that say the fourth year, the year for rotations in many programs, is the best year of pharmacy school. The freedom that you have during rotations is the glimpse of light at the end of the tunnel toward you becoming a pharmacist and your dream realized. It has been a long road, and soon you will be free to practice as you choose. First, you will need to create and execute a great year of rotations. In this article, I hope to help you create that great rotation schedule.

First, we must find out what rotations mean to you. Many of you came into pharmacy school with a plan to practice in hospital, ambulatory, community, development, or other specialized practice. For this, your rotation efforts may prove a time for you to focus and develop the skill you went to school for. Consider this an opportunity to build upon all that you have done in order to propel you into the practice that you seek.

For many, you may not know exactly what you want. The good news is it that there is still plenty of time to figure out your perfect fit in pharmacy. The rotation schedule may be the best time for you to find out what it is you would like to do. They are in fact small internships to develop your skills. The pharmacy program you are in wants to hear your rotation preferences, so it is your chance to develop the one that is best suited one for you.

Schedule is About Timing

There are four core learning experiences that your schedule will be centered around: hospital, ambulatory, community, and health system pharmacy rotations. Once these have been fulfilled, the remainder of the rotations are up to you. If you want the opportunity to try bone marrow transplant in the hospital setting, for example, then you will need to set your general hospital rotation early on to allow yourself time to do the specialty rotation. In general, your specialized rotations will build off these four core rotations, so make sure and do the core rotation as early as possible.

Expand Your Horizons

Rotations are a time to get out of your comfort zone of where you’ve been interning at and learn new things. A time to curb your curiosity and expand your horizons. One of the best ways to do that and develop your skills is to study abroad. Enhancing your cultural acuity while developing pharmacy skills can be invaluable. Consider one rotation as a trial period for something you haven’t considered. This could mean working in a specialty like nuclear pharmacy or critical care or learning that your passion lies in medical affairs and public health;  or maybe you would like to develop medications and present new medications in pharmaceutical companies. These opportunities rarely show themselves in other parts of your career. The greatness of your career will be by the experiences you have had.

With that in mind, avoid doing rotations that are redundant. Wisdom comes from understanding the multidisciplinary approach to healthcare. Through your career you may perfect your skills in a specialty but consider your rotations a time to better understand different aspects of care.

Find The People You Want to Learn From

Using the experience of a veteran in pharmacy will allow you to make the most intellectual progress. By talking to upper classmen, you can find out where the best mentors are. By finding the best mentors, you can open the doors to your career. Start with where you are and who you know. Your professors often can be a great resource in this. Keep these relationships strong by showing your appreciation by a small token of your gratitude.

Keep The End Game In Mind

You will need to study for the NAPLEX and MPJE, and apply to jobs or residencies during your final year of pharmacy school. The rotations you have off are your friends in this. That may mean taking your off rotation around February through April may be most beneficial, so you are best able to prepare for the big life changes ahead. Consider these articles as you think about preparing NAPLEX and MPJE.

Example 1 Month Rotation Schedule


*Ambulatory Care


Research Abroad


*General Medicine Inpatient


Critical Care Inpatient


*Community Compounding Pharmacy




General Surgery Inpatient


Bone Marrow, Stem Cell Transplant Inpatient


Bone Marrow, Stem Cell Transplant Outpatient

* Core Rotation. Remember that you can fulfill two requirements (For example, hospital and health system in one rotation).

In this example, if you found that you really enjoyed the bone marrow stem cell transplant unit, then it might be a great time to double down and learn more about it in the outpatient setting. This may need to be modified for 6- or 8-week rotations accordingly!


It is important to remain flexible among the scheduling process. Usually, there is some sort of lottery system, where popular rotations are only available for a limited number of students. Work with your APPE manager on this, especially if you are not satisfied with the results. Also, consider what other students wouldn’t by choosing rotations abroad or in other states. See them as an opportunity to visit friends and family as well as getting great experience.  All good professionals are very busy, respect their time by coming in organized and ready to tackle the objectives you set out to do.

It’s Your Time to Shine

Take all that you’ve worked so hard to learn in pharmacy school and use it to become an asset to your team. You’ve earned it! If you want specialty rotations, schedule core rotations early. Consider rotations that you wouldn’t normally as an opportunity to grow and learn. Find great mentors to teach you and take time off close to when you’ll be studying for licensure exams and applying to jobs and residencies. Lastly, always show your gratitude with a token of your appreciation for all the hard work that went into mentoring you through rotations as well. Best of luck to you and your journey through pharmacy!

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Creating Happy Pharmacists

If you really want to build the career and life that you’ve dreamed of, one where you are helping people and working in a field that you love, you need to do something different than what you’ve been doing.

Through coaching you can re-discover why you became a pharmacist and find your passion again.