Podling-
I rotated at Mayo, loved it, and ranked it second on my list. I matched at my first choice, but I really would have been thrilled if I matched at Mayo too. Mayo uses a point system and you are given extra points if you do a rotation. Obviously, there are people who matched there that did not rotate, so you can't say it is necessary, but my personal feeling is that like anywhere else, you greatly improve your chances of matching there by showing up. As far as why I liked the program, I found that everything good I had heard about it was absolutely true (see other Mayo posts) and that the knocks on it weren't necessarily true. For example, based on what I saw in my month, the rumor that you don't get to operate or that fellows steal cases is ridiculous. They have like 50-60 faculty and your rotations are on a one to one basis. You basically start out the three month block as a first assistant (early in your residency) and when you have seen a few, you and the attending trade places. There is no resident team heirarchy (except for trauma) so you don't run around finding films while the folks ahead of you cut. You are always in the OR. I knew very little going into the ortho matching process and in hindsight, you always see things you would have done differently. My rotation at Mayo, however, was one of the best choices I made.