Transitional Year Rotations

There are 13 four-week, block rotations

Required Rotations


Inpatient Medicine*


Medicine ICU




Ambulatory (General Internal Medicine, Pediatrics, Gynecology)


Emergency Medicine


Elective Rotations***


*Includes the option of pediatrics at Seattle Children's.

**Surgery rotations include:

  • general surgery
  • cardiothoracic surgery
  • vascular surgery
  • plastic surgery

***Elective rotations include System Based Practice Rotation

System Based Practice
System Based PracticeThe Systems Based Practice elective provides an introduction to quality improvement (QI) and the opportunity to experience the Virginia Mason Production System first hand. You will go behind the scenes to meet directly with system leaders and team members directly involved with QI at Virginia Mason, and you will develop a better idea of the culture and unique, world famous quality improvement system that drives Virginia Mason. During this elective you will participate in Kaizen event improvement workshops. During the workshops you will get first-hand experience examining how system changes are made and the science used to eliminate waste and improve experiences for patients and team members. You will perform “causal analysis” of active safety alerts, and study the forces that influence health care costs, demand and quality. Ultimately, you will emerge from the elective with a better understanding of how you, as a critical member of the health care team, possess the beginning skills and have access to the tools to lead implementation of improvement changes yourself.