1. I think by the prereq of having an ortho rotation is that they want you to do an ortho 4th year rotation at your home program (meaning they don't want you there on July because they are busy with their own students). My home program does this, they do not taken outside rotators in July.

2. Basically by doing an ortho rotation during the first month of 4th year, you should be able to meet enough people and formally ask for your letters. That's what everyone did at my home program..we have a 2 week ortho elective during 3rd year, but no one asks for letters at that time. That is something to do formally during your 4th year. You can definately shadow in clinics and try to scrub some cases when you have down time, but I think you should delay asking for a letter until later.

3. The VSAS system is how you apply for aways. Typically most students do 2 or 3 away rotations. It's kind of a tricky subject on how to apply and all that jazz, but basically its a first come, first serve system (usually). The easiest thing to do is talk to 4 years in your class to get recommendations on where they rotated and what their experiences were like. I think the application opens up March, so actually now is the time to get that set up in terms of looking at programs and trying to decided on 3 or 4 you would like to go.

What do you do if there isnt an ortho program at your home school? The VSAS service isnt for all programs. I filled out 2 applications today for programs that still use there own applications. I guess its just one of those awful process that you have work your way through and make the best of it.

I'm not really sure what to do in that case. My crappy answer would be to find a rotation that does not require a previous ortho rotation, however that might be easier said than done. I did not know about this requirement because my home program had an ortho rotation, so this issue never came up for me. I would assume that not every program requires a home rotation. One of the 4 programs I applied to did a paper application. Your best bet is to find the orthopaedic department secretary/coordinator person and get his or her's contact information. A lot of times you will get transferred or forwarded to a person that really can't answer your question because they have no idea. That's basically how I proceeded with things; picked a few programs and started searching around; usually you need to find someone in a school's graduate medical education office or someone directly in the program's orthopaedic department.

Find a program with an IMG resident. They will be much more receptive to you rotating. Drexel has a few residents that started in the carib and transferred to US schools, just off the top of my head.

Find a program with an IMG resident. They will be much more receptive to you rotating. Drexel has a few residents that started in the carib and transferred to US schools, just off the top of my head.

This didn't really answer your question. Most programs, if they are receptive to non-US students and DOs, will have a separate paper application outside of VSAS.