Clinical Rotation Terms | USMLE Wise
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Clinical Rotation Terms

Last updated: November 2026

These Clinical Rotation Terms (the “Rotation Terms”) govern every clinical rotation, observership, externship, sub-internship, research elective, and virtual clinical experience (each a “Rotation”) that USMLE Wise (“we,” “us,” or “our”) arranges for you. Because a Rotation puts you inside a working clinical environment with real patients, the rules here are considerably more detailed than those covering our coaching and editing programs.

These Rotation Terms form part of, and should be read together with, our Terms & Conditions, Refund & Guarantee Policy, Disclaimer, and Privacy Policy. Where these Rotation Terms and our general Terms & Conditions differ on a point specific to Rotations, these Rotation Terms control.

By paying a deposit or any Rotation Fee, submitting documents for a placement, or beginning a Rotation, you confirm that you have read, understood, and agreed to these Rotation Terms.

Contents

1. Our Role, and What We Are Not

USMLE Wise is a placement and advising company. We use commercially reasonable efforts to place you with an affiliated U.S.-licensed physician (a “Preceptor”) at a clinic, hospital, university, or other clinical facility (a “Host Site”), and we provide the advising, document preparation, and on-rotation coaching described on the relevant rotation page.

  • We are not an educational institution. We do not grant academic credit, issue transcripts, or hold SEVIS accreditation, and we cannot sponsor a visa.
  • We do not employ Preceptors. Preceptors and Host Sites are independent third parties. They are not our employees, agents, or partners in a legal sense, and we do not control their supervision, teaching quality, accreditation status, staffing, scheduling, or day-to-day conduct.
  • The Rotation itself is delivered by the Host Site, under its own policies and the supervision of its own clinicians. Our obligation is to arrange and support the placement, not to deliver the clinical experience.
  • You are responsible for confirming suitability. Before you pay, you must satisfy yourself that a placement meets your medical school’s curriculum requirements, your licensing body’s expectations, and your own goals. We will tell you what a Rotation involves; we cannot tell you whether your school will accept it.

2. Eligibility and Your Representations

Rotations are available to medical students and graduates who are at least 18 years old. By enrolling, you represent and warrant that:

  • You are currently enrolled in, or have graduated from, a medical school, and the educational details you give us are accurate and complete;
  • Every document you submit to us is authentic, unaltered, and issued to you;
  • You hold any immigration status or travel authorization needed to attend the Rotation in person, or you understand that obtaining it is your responsibility;
  • You are not subject to any licensing restriction, disciplinary action, or legal order that would prevent you from participating in a clinical environment.

Submitting false, altered, or borrowed credentials is grounds for immediate termination under Section 19, with no refund.

3. Background Screening and Drug Testing

Host Sites grant students access to patients, controlled areas, and medical records. Most require screening before they will confirm a placement. By enrolling in a Rotation, you authorize the following:

  • Background investigation. You authorize us, our placement partners, and our service providers to investigate your criminal, educational, employment, and (where a Host Site requires it) credit history, including by obtaining consumer reports from the appropriate agencies. This authorization applies whether or not the relevant jurisdiction mandates a check.
  • Convictions. We will consider whether you have any misdemeanor within the last 10 years or any felony conviction. A record does not automatically disqualify you, but the Host Site makes the final decision, and some sites will decline.
  • Driving under the influence. We cannot place you where a DUI involved injury to any person, or where the DUI occurred while you were travelling to or from a medical job or educational responsibility.
  • International applicants. If you studied or lived outside the United States, you may be asked to provide an official police certificate from your home country.
  • Drug testing. You consent to random drug testing before, during, and for up to 30 days after any Rotation, where we or the Host Site require it.
  • Ongoing duty to disclose. You must notify us promptly of any change to your criminal record at any time while these Rotation Terms are in effect.
  • Disqualifying findings after payment. If screening reveals disqualifying information after your payment has been processed, your placement and these Rotation Terms terminate immediately and you will not be eligible for a refund.

How we handle the personal data collected for screening, and how long we keep it, is described in our Privacy Policy.

4. Your Obligations Before the Rotation

A placement is confirmed only once the Host Site has your complete file. Before your start date, you must:

  • Submit accurate personal and educational details so we can identify suitable placements;
  • Provide every required document listed on the rotation page, by the Document Deadline described in Section 9. Requirements commonly include an updated CV, AAMC standardized immunization records, a medical school transcript, proof of identity, and proof of health insurance, and they vary by Host Site;
  • Meet any additional requirement that arises after you enrol. Host Sites add and change requirements (new immunizations, titre results, respirator fit testing, additional forms) and you must meet those too;
  • Complete HIPAA certification, plus any further training, quiz, or certification the Preceptor or Host Site requires;
  • Disclose any infectious disease or mental health condition that could create a risk of injury or liability to a patient, a Preceptor, or you. Tell us immediately, and before your start date;
  • Arrange your own travel and accommodation to and from the Host Site, unless housing is expressly included in your Rotation. Where we suggest nearby accommodation, that is a convenience, not a booking or a recommendation we stand behind;
  • Obtain any required U.S. visa or travel authorization yourself. See Section 10;
  • Not contact the Preceptor or visit the Host Site before your confirmed start date, directly or indirectly. Early contact regularly costs students their placement.

If you do not submit your documents on time, we are not responsible for a delayed start, a lost placement, or a turnaround time missed as a result.

5. Your Obligations During the Rotation

While on a Rotation, you agree to:

  • Follow the Host Site’s policies, the Preceptor’s instructions, and all applicable state and federal regulations;
  • Comply fully with HIPAA. Do not share, photograph, copy, or discuss confidential patient information outside what the law and the Host Site allow. This duty continues after the Rotation ends;
  • Observe professional medical dress code as set by the Preceptor or Host Site;
  • Refrain from using your mobile device during clinical activity;
  • Never use alcohol or drugs while at the Host Site or while involved in patient care;
  • Decline all payment, gifts, services, favours, or other consideration to or from a Preceptor, a Host Site, or anyone affiliated with either, and accept no compensation for your own activity during the Rotation;
  • Report any criminal conduct by a Preceptor promptly to the proper authorities, and tell us;
  • Contact us immediately if a Preceptor or Host Site dismisses you. Do not return to the Host Site and do not contact the Preceptor after a dismissal: doing so may expose you to legal action by the Host Site or Preceptor;
  • Leave at the end of your Rotation. Do not stay on at the Host Site, or with the Preceptor, past your end date;
  • Complete a Preceptor evaluation before starting any subsequent Rotation. We may publish the evaluation data on our Site, never attributed to you by name;
  • Remain in good financial standing. If you are on a payment plan and default, the Rotation is placed on hold until the account is current.

Virtual and telemedicine Rotations. Join from a quiet, private, professional location, free of interruption from children, pets, or background noise, with a stable connection and a working camera.

6. Scope of Practice: What You May Not Do

This section is the most important in these Rotation Terms. Breaching it endangers patients, exposes you to criminal and civil liability, and ends your placement immediately. You agree that you will never:

  • Practise medicine, with or without medication, as defined by the relevant state and federal regulatory authorities. This includes giving a diagnosis or prognosis, interpreting laboratory data, providing behavioural therapy, or giving health advice;
  • Perform an invasive procedure, unless you are a currently enrolled medical student completing the Rotation as part of your school’s curriculum and the Preceptor and Host Site expressly permit it. An “invasive procedure” means any procedure, test, therapy, or surgery that punctures skin or muscle or enters a vein or artery (for example starting an intravenous line, cardiac catheterisation, injections, or inserting central lines), or any other procedure that could pose a risk to a patient;
  • Provide hands-on medical care if you are a U.S. pre-medical student, or where the Preceptor, the Host Site, or the state in question prohibits student patient contact;
  • Interact with patients without the direct supervision of your Preceptor;
  • Represent yourself as a physician, or use any title, degree, credential initials, badge, or other designation that could lead a patient or colleague to believe you are one;
  • Engage in any activity prohibited by a relevant state or federal regulatory authority.

Practising medicine without a licence is strictly prohibited and may be punished under criminal and civil law.

7. Liability, Malpractice, and Licensure

You acknowledge and agree that:

  • You are solely liable for the outcome of any action you take outside the scope of these Rotation Terms;
  • You are not covered by our insurance. Neither USMLE Wise nor our insurers, insurance agents, or affiliated Preceptors has any obligation to provide medical liability or malpractice coverage for any part of your Rotation. Where a Host Site requires malpractice coverage, obtaining it is your responsibility, and you should assume you need your own coverage unless a Rotation page states otherwise in writing;
  • You bear all malpractice exposure arising from your participation, including any suit or liability;
  • Prohibited activity terminates the agreement. If you engage in anything that could be construed as the practice of medicine, give health-related advice, or interact with patients without direct supervision, these Rotation Terms terminate immediately and no refund is due;
  • We are not liable for damages or liability arising from your act or omission in breach of Section 6.

Our total liability for any claim relating to a Rotation will not exceed the amount you paid us for that Rotation, as set out in our Terms & Conditions.

8. Fees, Deposits, and Payment

8.1 Rotation Fee and deposit

You agree to pay in full the fee shown for the Rotation you select (the “Rotation Fee”), in U.S. dollars. Payment normally runs as follows:

  • Deposit. A $500 deposit secures your request and is applied toward your Rotation Fee. Some programs require a higher deposit; where they do, the amount is stated on that rotation’s page.
  • Refundable until we confirm. If we cannot secure a placement matching your requirements within 5 business days of receiving your deposit, we refund the deposit in full.
  • Non-refundable once confirmed. Once the Host Site or Preceptor approves your placement within those 5 business days, the deposit is non-refundable, subject only to the exceptions in Section 11.
  • One change after approval. After your placement is approved, you may change either the Preceptor or the proposed start date once. Further changes are subject to the change fees in Section 9.
  • Balance. The remaining balance is due before your Rotation begins, by the date we give you in writing.
  • Immediate availability. Where a Rotation is listed as immediately available and needs no separate approval, the full Rotation Fee is payable at the time you book it.

8.2 Advising and consultation sessions

Rotation advising, document review, and coaching sessions are payable in full in advance. Each program page states the turnaround time and the number of revisions included. Revisions beyond that number incur the additional fee stated on the same page. If you do not submit your initial documents on time, we are not liable for any delay past the published turnaround. Your advisor is not obliged to share a mobile number, a LinkedIn profile, or any contact detail other than an email address. Changing a confirmed appointment incurs a $99 fee.

8.3 Fees charged by others

Fees payable to independent third parties are never included in your Rotation Fee and are never refundable by us. These include visa and consular fees, immunisation and laboratory costs, background check and drug screening charges where billed directly to you, travel and accommodation, and any charge levied by a Host Site in its own right.

9. Changes, Late Documents, and Deadlines

9.1 Late document fee

Each placement has a Document Deadline, falling between 7 and 35 days before your start date, by which all pre-rotation requirements in Section 4 must be complete. If you miss it by 48 to 96 hours, a late fee of $199 to $250 becomes immediately due. Failure to pay that fee means you will not start on time, and you may forfeit both the placement and the fees you have already paid.

9.2 Change fee

  • If payment and outstanding requirements are not submitted 7 days before your start date, your start may be pushed back by 7 days.
  • If the Preceptor cannot accommodate the new start date, you must select another Host Site, pay any difference in fees, and pay a $250 change fee.
  • If the new Host Site costs less, the difference is not refunded. It is held as an account credit, usable toward future purchases for up to 24 months.
  • A second change costs up to $500, depending on the Host Site involved.
  • Hospital application programs. Where a Host Site requires a hospital application a set number of weeks before the start date, you may change your placement only up to one week before that application window opens, so that we have time to offer your place to another student. No change is possible after that deadline.

9.3 Account credits

Credits issued under these Rotation Terms expire 24 months after issue, have no cash value, are not transferable, and may be applied to any USMLE Wise Rotation or service. We will confirm your credit balance in writing on request.

10. Acceptance Letters and Visa Documentation

10.1 Program Acceptance Letter

A Program Acceptance Letter (“PAL”) can be issued once you have paid your deposit, the Preceptor has approved your request, and you have uploaded proof of education and proof of identity. A PAL sets out your full name, your address, the Rotation start and end dates, the specialty, the Rotation location, the Preceptor or Host Site name, and the goals and objectives of the Rotation.

  • The PAL is issued on USMLE Wise letterhead. We cannot guarantee that a Preceptor or Host Site will issue one on its own letterhead.
  • A PAL is issued only after payment and after all requirements other than proof of visa are met.
  • Fee: $50 to $75 per letter, per Host Site. This fee is non-refundable.
  • A PAL is not immigration advice, and it is not a guarantee of visa approval. We are not a visa sponsor and we hold no SEVIS accreditation.

10.2 Hospital invite letters

Some programs also offer a hospital invite letter. Where they do, the required deposit and the letter fee are stated on that program’s page. We cannot expedite these letters, and the letter fees are non-refundable.

10.3 After your visa decision

  • Visa approved. You must finalise payment within 5 business days of your visa being approved. If you do not, we may: retain your deposit, which you forfeit; notify the relevant consulate or embassy that the placement has been cancelled; and charge the outstanding balance to the payment method you used at enrolment, under the card authorisation you provide at checkout.
  • Extensions. We may extend that payment deadline, but only by written agreement reached before you pay your deposit.
  • Visa denied. See Section 11.2.
  • Switching programs. Once your visa is secured you may switch to another program, subject to a $99 transfer fee.

11. Cancellations, Refunds, and Credits

This section sets out the refund rules for Rotations, and it replaces the general case-by-case treatment described in our Refund & Guarantee Policy for Rotations only. Rotations do not carry a pass guarantee, a first-session guarantee, or a trial period.

11.1 No refunds, with narrow exceptions

Apart from the visa and border-entry situations in Section 11.2, the documented medical emergency route in Section 11.3, and a cancellation by the Host Site under Section 11.4, fees paid to USMLE Wise for a Rotation are not refundable. This includes a placement you withdraw from, miss, abandon, or fail to attend, and a placement lost because you did not meet a deadline or a requirement.

11.2 Visa denial and border entry

  • If you cannot obtain a valid visa and you give us proof of visa rejection, we refund your deposit in full, less a 5% card processing fee.
  • If you cannot provide proof of rejection, the funds convert to an account credit valid for 24 months rather than a refund.
  • Exception for inpatient hospitalist placements. If you do not already hold a visa and you enrol in a Host Site served by a hospitalist (that is, a 100% inpatient placement), your deposit is not refundable and not creditable if your visa is denied. Please raise your visa situation with us before enrolling in one of these placements.
  • A documented problem crossing the U.S. border is treated in the same way as a visa denial.

11.3 Medical emergency

We will consider a partial refund, case by case, for a medical emergency affecting you or an immediate family member (brother, sister, mother, father, child, or spouse). The emergency must be documented. Approved partial refunds take up to 30 days to process and are subject to a merchant processing deduction of up to 10%.

11.4 Delay or cancellation by the Host Site or Preceptor

If a delay or cancellation is caused by the Host Site or Preceptor, we will immediately offer you alternative Preceptor options and issue a credit toward a future Rotation, a service, or a later fee. The credit expires after 24 months and is sized by how close to your start date the cancellation falls:

  • $100 where notice comes more than 30 days before your start date;
  • $250 where notice comes within 14 days;
  • $500 where notice comes within 7 days.

11.5 Events outside anyone’s control

We are not required to provide a refund where a Host Site cancels because of an infectious disease outbreak, a natural disaster, or a travel ban. In those cases we will work to re-place you.

11.6 Travel and accommodation costs

We are not responsible for any accommodation, travel, visa, or other cost you incur as a result of a delay or cancellation by a Preceptor or Host Site. Book refundable travel wherever you can, and do not book non-refundable travel before your placement is confirmed in writing.

11.7 How to request a refund or credit

Email admin@usmlewise.com with your full name, the email address used at enrolment, the Rotation and start date, what you are requesting, and any supporting documentation (visa rejection notice, medical documentation, or Host Site correspondence). Approved refunds are issued to the original payment method.

12. Unsafe or Hostile Placements

You should never feel unsafe on a placement we arranged. A “hostile environment” means unwelcome or offensive behaviour at the Host Site that leaves you uncomfortable, frightened, or intimidated.

  • Tell us immediately. Report it to us as soon as it happens so the Host Site can decide on a course of action, and so we can act.
  • We will offer alternatives first. Our first step is to offer you other Preceptor options.
  • Refund or credit as a last resort. Where no suitable alternative works, we may issue a partial or full refund, or a credit.
  • If a Preceptor is charged with a crime, you may reschedule with another Preceptor for a $199 fee.

If you are in immediate danger, leave and contact the appropriate emergency services first, then tell us.

13. Letters of Recommendation

Letters of recommendation are always performance-based and can never be guaranteed, including on Rotations advertised as including a letter.

  • A Preceptor is under no obligation to write a letter, and no obligation to share one with you.
  • Where a Preceptor does share a letter, we will notify you and make it available to you.
  • A letter may arrive on clinic, hospital, university, or other letterhead. We are not obliged to provide a refund if the letterhead differs from what you expected, or if the letterhead details change.
  • We coach you on earning a strong letter, but the content, tone, length, and timing are entirely the Preceptor’s.

14. What We Do Not Guarantee

  • Hospital exposure. We cannot guarantee hospital-based exposure or any particular clinical experience unless we hold a direct contract with the hospital in question.
  • Case mix and procedures. Patient volume, case mix, procedures observed, and weekly schedule depend on what walks through the door.
  • Letters of recommendation. See Section 13.
  • Residency outcomes. We do not guarantee a residency interview or a match position through the NRMP.
  • Visa approval. We do not guarantee a visa, and nothing we provide is immigration or legal advice.
  • School acceptance. We do not guarantee that your medical school will grant credit for a Rotation.

Our Disclaimer covers these points in full.

15. Site and Physician Information May Change

Information about a Preceptor or Host Site, including affiliated hospitals, in-office procedures performed, weekly schedule, pricing, and anything else shown on a rotation page, is subject to change without notice. Preceptors are independent contractors rather than our employees, and availability moves with supply, demand, and circumstances outside our control. We update listings as we learn of changes.

16. Directly Contracted and Partner-Sourced Placements

We offer Rotations under two arrangements, and it matters to you which one you are buying. We will tell you which applies to a placement if you ask, and before you pay.

  • Directly contracted. We hold a direct agreement with the Preceptor or Host Site and support you through the whole process ourselves.
  • Partner-sourced. We hold an agreement to market and enrol students into another organisation’s rotation, research, or consulting program. We work through that organisation’s coordinator and do not have direct access to the Preceptor or the hospital coordinator. Our fee covers enrolment, documentation, advising, and support, so the price may be higher than approaching that organisation directly.

For partner-sourced placements:

  • We are not responsible for delays or physician changes caused by the partner organisation;
  • Questions about the clinical experience itself go through the partner organisation’s coordinator, because we cannot reach the Preceptor or hospital coordinator directly;
  • We will escalate to the partner organisation’s coordinator where they have not responded within 10 business days;
  • We do not provide refunds for service problems caused by the partner organisation, and we are not responsible for housing the partner organisation arranges;
  • Where you leave us a public review, we ask that it reflect the communication and support you received from the USMLE Wise team, rather than the conduct of a partner organisation’s staff.

17. Non-Solicitation and Confidentiality of Site Contacts

Our Preceptor and Host Site relationships are the product of years of work, and they are what lets us keep placing students. You therefore agree that you will not:

  • Contact a Preceptor, or visit a Host Site, before your confirmed start date;
  • Arrange your own Rotation directly or indirectly with any Preceptor or Host Site we introduced you to, for 12 months after your Rotation ends;
  • Share a Preceptor’s name or details with anyone else without our prior written consent.

Contacting a Preceptor directly in breach of this section, or otherwise circumventing us to reach a Host Site we introduced you to, incurs a $1,000 fee and may end your placement with no refund.

18. Promotions, Discounts, and Credits

We may, at our discretion, offer promotional discounts, coupon codes, credits, referral incentives, or other offers (“Promotions”). A Promotion may be a percentage discount (for example “10% off”) or a fixed amount (for example “$200 off”), and may carry additional terms disclosed when it is offered (“Promotion Terms”). Unless the law or the applicable Promotion Terms say otherwise:

  • Eligibility and limits. A Promotion may be limited by account, location, service, specialty, date, payment method, minimum purchase, or other conditions. Promotions may be limited to one per person or account, may not be combinable with other offers, and are void where prohibited.
  • No cash value. Promotions have no cash value, are not redeemable for cash except where the law requires it, are non-transferable, may not be resold, and may not be substituted.
  • How to apply one. A Promotion must be applied at the time of purchase. Promotions cannot be applied retroactively to a prior purchase, invoice, or completed transaction.
  • Exclusions. Unless the Promotion Terms say otherwise, Promotions do not apply to taxes, third-party fees, bank or wire fees, or any charge that is not the USMLE Wise service price.
  • Changes, termination, and errors. We may modify, suspend, or end any Promotion at any time. We may correct typographical, pricing, or system errors and may cancel, modify, or refuse a transaction affected by such an error, to the extent the law permits.
  • Misuse. We may refuse redemption, reverse a Promotion, cancel an order, or adjust pricing where we reasonably believe a Promotion is being used in breach of these Rotation Terms, the Promotion Terms, or the law, including suspected fraud, abuse, or circumvention.
  • Refunds and cancellations. Where a Promotion applied to a purchase that is later refunded or cancelled, in whole or in part, any refund is limited to the amount you actually paid, net of the discount applied. For percentage-off Promotions the discount is allocated proportionally across the discounted services. For fixed-amount Promotions we allocate the discount across eligible services at our reasonable discretion. Any used portion of a Promotion is not refunded or reissued unless the law or the Promotion Terms require it.

19. Suspension and Termination

We may suspend or terminate your placement, with no refund, where you:

  • Breach Section 6 (scope of practice) or Section 3 (screening and disclosure);
  • Submit false, altered, or borrowed documents;
  • Are dismissed by a Preceptor or Host Site;
  • Default on a payment plan and do not bring the account current;
  • Behave abusively toward our staff, a Preceptor, Host Site personnel, a patient, or another student;
  • Breach Section 17 (non-solicitation and confidentiality).

Sections that by their nature should survive termination, including Sections 6, 7, 13, 17, and 20, continue to apply afterwards.

20. Governing Law and General Terms

These Rotation Terms are governed by the laws of the Commonwealth of Pennsylvania, United States, without regard to its conflict-of-law principles, and any dispute is subject to the exclusive jurisdiction of the state and federal courts located in Pennsylvania. If any provision is held unenforceable, the rest remains in force. We may update these Rotation Terms from time to time; when we do, we will revise the “Last updated” date above. The version in effect on the date you pay your deposit is the version that governs your Rotation.

21. Contact Us

Questions about a placement or about these Rotation Terms, before you pay, are welcome:

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