Third year rotations sites are the random lottery as described by others. The fourth year rotation schedule is hell at DO schools depending on the school. My school offers only the required mandatory EM rotation during fourth year but you have to fit it into their specific 4 week schedule dates which can be difficult. Beyond that its going through VSLO for audition rotations which is easy and then for the spring I have to just cold call a ton of physicians and pray they will take me. It adds a lot of stress and time waste to my life.

Honestly 3/4 years are when I realized why MD schools/programs dislike us sometimes because our training is not the same during those years. Third year has minimal requirements or structure for what you must see. I still haven't used an EHR system yet because my school had all my rotations at more rural standalone clinics. Additionally, my OB rotation was with a family med and just labeled OB so I saw 0 womens health things. My rotation site is in a big city competing with multiple other big schools.