Education for a career with hands-on patient care wouldn't be complete without a clinical rotation.

Students on rotation spend time working in a health care facility under the supervision of health care professionals before taking certification or licensing examinations. The length of the rotation depends on what they're studying.

Starting early

Registered nursing students at Century College in White Bear Lake ( begin rotations in the first semester of their two-year course of study, starting at long-term care and transitional care facilities. Their second semester finds them at acute-care hospitals, according to Kerry Keenan, RN, director of the nursing program at Century.

They'll spend 190 hours of each 16-week semester in clinicals, followed by an 80-hour preceptorship, working one-on-one with an RN before graduation. "Preceptorships are an opportune time for students to network and demonstrate their competence and their knowledge and to really be seeking out opportunities for the future," Keenan said. "Many of our students are hired upon graduation."

Rotating students are expected to act professionally with patients, family and staff; come prepared for work; have the knowledge and skills to safely care for patients; and seek help from faculty and staff when they need it. "Preparation is key to being safe, and also knowing when to address issues and concerns with the faculty and/or staff nurse, because patient safety is of utmost concern," Keenan said.

Inquiring minds

Medical students are also strongly encouraged to ask questions during clinical rotations and residencies, according to Anne Pereira, MD, director of the internal medicine residency program Hennepin County Medical Center in Minneapolis ( They spend two six-week required rotations in each of their third and fourth years of medical school.

Residencies, which occur after graduation, are highly competitive and may last anywhere from three to five years, depending on the area of interest. "What we try to look for when we're interviewing people are people who have insight and the ability to admit when they don't know something, Pereira said. "We have a very collegial atmosphere and we try very hard to reward people when they ask questions."

Residents can expect to spend an average of 60 hours per week with patients. "Every patient they care for is also seen by a staff physician and the plan is discussed with and approved by a staff physician," Pereira said.

About half of Hennepin's internal medicine residents will stay in the field while others go on to fellowships that may last one to three years and prepare them for a specialty such as cardiology or orthopedics. According to Pereira, 95 percent get the fellowship they want, and the general internal medicine physicians have no trouble finding jobs.