Away Rotations

On January 25, the Coalition for Physician Accountability (CPA) released updated recommendations on medical student away rotations in the 2021-22 academic year. The CPA is comprised of several national organizations including the AAMC, ACGME, AMA, LCME, NBME, and FSMB. 

The CWRU Committee on Medical Education met on January 28 and affirmed that the School would abide by the CPA's recommendations listed below. 

For the 2021-22 academic year, away rotations will resume no earlier than August 1, 2021, with the following guidance:

  • After April 15, learners may begin applying for and scheduling in-person away rotations with a start date of August 1, 2021, or later.  
  • Away rotations in any specialty are limited to one per student, except in cases where additional rotations are needed to complete graduation or accreditation requirements.  The CPA is encouraging Residency programs to take into consideration if an applicant exceeded the one away rotation limit during the residency selection process.
  • Programs may continue to offer virtual electives to provide opportunities for students to explore the specialty and program.  

The CPA working group will continue to monitor the available information and will provide an update to the community no later than April 15, 2021, either confirming that August 1 remains an acceptable start date, or creating a new start date.

Available to M.D. students in their senior year of medical school, away rotations are generally elective activities that take place away from the student’s academic “home” institution and can be within or outside of the United States. The following information is provided to help guide you through the different application processes.

Effective with the Class of 2021, students will only receive AI credit for away rotations if the course is explicitly designated as an Acting Internship or Sub-internship in the course title by the host institution. 

How can I apply for an away rotation?

Students can also apply for electives at institutions that do not participate in VSLO. They can use the Extramural Electives Compendium (EEC) for visiting student application information.

We recommend also visiting these institution’s websites for application instructions and forms. Please review their program and application requirements and deadlines carefully.

International electives are elective activities that take place outside of the United States. All Case Western Reserve University medical students are required to submit international rotations to the Case Western Reserve University Office of Education Abroad using their electronic application. For more information about the application process, please review the information available on our website under Scheduling for International Electives.

Many away rotations use the AAMC Visiting Student Learning Opportunities (VSLO), which makes it easier for medical students to apply to senior away electives.  CWRU currently only participates in VSLO as a home institution within the U.S. network.  To read more about the service and application process, and to see a list of participating VSLO host institutions, please visit the VSLO website.

To access VSLO, the School Of Medicine Registrar’s Office will need to issue you a VSLO invitation. To request an invitation, please submit the VSLO Invitation Form. Once the invitation has been issued, students will receive an email from VSLO with login instructions.

Instructions for how to use VSLO.

Application requirements vary between host institutions and the electives for which you are applying. A complete list of an institution’s requirements can be reviewed in the elective details in the application service. In general, VSLO requires the following four standard documents to be uploaded to your application.

It is the student’s responsibility to be aware of any additional documents that may be required by a program. Please review program requirements, fee information, and application dates and deadlines for each participating Host institution. In general, students should start researching program requirements and application deadlines at least 4-5 months in advance.

As a final step in applying for electives in VSLO, you will need to complete and submit to the School Of Medicine Registrar’s Office, the VSLO Student Verification Form. It is helpful to review the verification form in advance so you are aware of the information being requested. Our office will not be able to verify you in VSLO, or release your applications to programs, until it has been received.

What do I need to know about program requirements that vary between programs, institutions and state, if applicable?

The most common requirements and supplemental documentation are listed and described below. These requirements can pertain to any away rotation, and students are responsible for reviewing specific program requirements at other institutions.

Students must be in good academic standing, in their final year of study, and have proof of completion of core course work.

Specific letters can be provided upon request (include the name, address, and pick-up/delivery instructions) by submitting the Student Letter Request Form (CWRU login required). The Form is available online and at the School Of Medicine Registrar's Office in the Samson Pavilion Room 413E. 

Students are expected to annually renew training in these areas, as applicable, and keep track of expiration dates. For more information, see "OSHA, HIPAA, TB Policies" in the Student Handbook.

University Program students who require an OSHA Infection Control certification for an away rotation can take the Biosafety class, offered by the Environment Health & Safety (EHS) Office, which includes OSHA bloodborne pathogens. This course is generally accepted by other institutions for this certification. The EHS Office offers this course at least once a week and training is valid for one year. Please contact them at (216) 368-2907 for additional information. 

CCLCM students can obtain proof of OSHA training through the Cleveland Clinic eTEKI website ( Students will need to sign in to "MyLearning" and then click on the "Transcript" tab for a list of completed courses.

Students can print out a copy of their immunization records.

For more details about immunizations, see "Immunization Records" in the Student Handbook.

Mask fit testing is not mandatory unless required for a specific rotation. For students who need respiratory training, review “Respiratory Training” on the Training webpage for Environmental Health and Safety or call EHS at 216.368.2907. When going to purchase a mask, any type is fine, but in general we use 3M N95.

Some programs require an official score. See "Requesting a Trancript of USMLE Scores". Also, see "Scoring and Score Reporting" in the USMLE Bulletin for more information.

All enrolled students must have proof of personal health insurance.

BLS and ACLS may be required for a specific rotation. Medical students receive BLS training in Year 2 prior to starting Clerkships.

For away rotations, it is the responsibility of the student to check program requirements and provide verification of BLS and/or ACLS certification, if required. Third and fourth year students may contact the SIM Center to check availability and costs for BLS re-certification. The SIM Center offers re-certification only when there are available courses or open slots and students must pay a fee. They do not offer ACLS or PALS training.  

You may also contact the following organizations to inquire about BLS, ACLS, or PALS training and certification. Advanced registration is required:

  • Cleveland Clinic Training Center at 216.636.2900
  • University Hospitals EMS Institute at 440.735.3513
  • American Heart Association at 1.888.97-ENJOY 
  • American Red Cross at 1.800.REDCROSS

Students are responsible for providing their own background check or drug screen. Specific requirements for the drug screen and for the level and type of background check can vary for each program.

Background checks are initially completed by the med school upon matriculation and are valid for five years only. Some students may complete a more recent background check, e.g., as part of their research credentialing. Anyone with a background check older than five years is responsible for obtaining an updated one and paying any necessary fees. It is highly recommended that students complete a background check within one year of the expected start date of the away rotation. For a Criminal Background Check, students can review Ordering Procedures.

The CWRU Police provide electronic fingerprinting (BCI/FBI) for in-state licensure along with ink rolled FBI cards for out-of-state licensure or in-state agencies that require a fingerprint card submission. Call Sergeant Daniel Schemmel at 216.368.5993 or email Sergeant Schemmel to make an appointment or ask questions.

Students can obtain drug panel testing at University Health Service (UHS), if required. The fee is $88.00 and it is the responsibility of the student to pay UHS at the time of service.

Official verification: If official verification of a successful background check or drug screen is required, students are responsible for providing a copy of the results with a written request for verification (include the institution name, address, and pick-up/delivery instructions) to the School of Medicine Registrar.

Requests can be submitted through the Student Letter Request Form

All CWRU enrolled medical students are covered for $1,000,000 per instance / $3,000,000 aggregate.

Proof of malpractice insurance can be provided upon request (include the name, address, and pick-up/delivery instructions) by submitting the Student Letter Request Form. The Form is available online and at the School Of Medicine Registrar's Office in the Samson Pavilion Room 413E.

Our office can upload a LoR to your VSLO application. Instruct your letter writer to email their LoR, if needed for your application, to All LoRs should be in PDF format, signed, dated, and on official letterhead. Our office will notify you upon receipt and upload the LoR to your VSLO Document Center. 

Does my away rotation require State Authorization?

Effective September 16, 2015, Case Western Reserve University was approved by the Ohio Department of Higher Education to participate in the National Council for State Authorization Reciprocity Agreements (NC-SARA). NC-SARA is a voluntary, regional approach to state oversight of postsecondary distance education. It is intended to make it easier for students to take courses offered by postsecondary institutions based in another state.

If rotating out of Ohio, it is extremely important for students to submit the Unlisted Elective Form at least 45-30 days prior to the proposed start date. The School of Medicine Office of the Registrar will review all Unlisted Elective requests to ensure that the institution meets state authorization requirements. Students will be contacted immediately if there are any questions or concerns.

Please note: Case Western Reserve University currently is not authorized but is pursuing authorization in Puerto Rico.

To review the list of states/territories in which CWRU is authorized, exempt, or permitted to operate under the terms of SARA, please visit the CWRU Authorization and Accreditation website and select the State Authorization pull-down.

Please also visit the Frequently Asked Questions page
Ms. Yolanda Cunningham is Coordinator of State Authorization and Compliance at Case Western Reserve University. Please feel free to contact Ms. Cunningham at for additional information.

How will an away rotation be added to my transcript?

The School Of Medicine Registrar's Office has prepared detailed information about how to add an away rotation to your transcript on our website. Please review information under Scheduling for Unlisted Electives and International Electives.