What's the difference between a hands-on rotation and an observership?

While both types of clinical experiences can be valuable for your education or residency application, there are some key differences between them. 

Hands-On Rotations

A hands-on clinical experience includes patient-focused clinical exposure. These rotations allow visitors to engage in some form of patient interaction. This may include recording patient histories, examining patients, presenting cases, and giving differential diagnoses to the supervising physician. During clinical experiences, visitors must adhere to HIPAA, Joint Commission regulations, and state regulatory guidelines

Hands-on does not mean the visitor is free to function as a licensed physician would. It is the responsibility of each medical student to ensure they are not engaging in unsupervised practices or representing themselves as a licensed physician. Doing so is considered a felony criminal offense in most states.

Hands-on electives are recommended for clinical year medical students who may be eligible for elective credit. Graduates who have passed the USMLE Step 1 are also eligible for these experiences. 


An observership is a structured and supervised clinical rotation without direct patient contact. This type of rotation offers visitors exposure to the U.S. medical system but limits them to observing. One may be able to participate in active case presentations and practice differential diagnoses. Visitors have no effect on patient care or the physician’s practice of medicine. Visitors must follow patient privacy regulations in accordance with HIPAA and joint commission regulations and policies.

Observership rotations are recommended for graduates to gain medical knowledge about the U.S. system and its clinical practices.


Here more about each rotation type from the AMO team!