School of Medicine

Outside/Elective Rotation Process for Graduate Medical Education


To qualify for an elective rotation at Baylor College of Medicine for a learning experience that is not available at the home institution, you must meet the following requirements:

  • Elective must first be approved by Baylor’s clinical department you are wanting to rotate through (approved by DRMAC).
  • Must be a U.S. Citizen or permanent resident.
  • Outside rotators that have a J-1 visa AND are currently a resident/fellow in the United States with the proper paperwork can work with the program at BCM to see if they are approved to rotate through.
  • Obtain a Texas Medical Board license or permit.
  • Sending in a PLA (Program Letter of Agreement) between Baylor College of Medicine and your institution for each rotation (must start this process at least three months in advance). The goals and objectives need to be included with the PLA for each rotation.
  • COVID-19 Immunization required.
  • Pay elective fee, if not with an affiliated hospital.

    Affiliated Hospitals: 
    • The Methodist Hospital 
    • UT Health Houston and San Antonio
    • MD Anderson Cancer Center 
    • St. Joseph’s Houston 
    • CHRISTUS San Antonio 
    • UTMB Galveston 
  • Elective Program Letter of Agreement Template
  • Smartsheet Elective Rotation Process and the documents that need to be downloaded.



The below fees apply based on the date that the GME office is notified of the visiting resident elective.

  • Processing Fee (waived for U.S. Military trainees and affiliated hospitals in the Medical Center)
  • $500 if GME is notified at least 90 days prior to start
  • $750 if GME is notified less than 90 days prior to start
  • $1,250 for any elective scheduled between June 1 – July 31



For questions about the Outside/Elective Rotation Process contact Reagan Sadler at


Frequently Asked Questions