A New Boss Every Month — The Rotational Reality of Medical Training

This week, I’m sharing the perspective of Maha Ali — a third-year medical student navigating the unpredictable world of clinical rotations. Every month, she starts over in a new hospital or clinic, learning under different supervisors with different systems, expectations, and dynamics. Her experience offers a raw and eye-opening look at a version of work that rarely gets talked about — one that blends learning, labour, and survival in equal measure.

If you’ve ever felt disoriented starting a new job, imagine doing it every single month. That’s the reality for many third-year medical students, especially those in decentralized programs without a dedicated academic hospital. Each rotation means entering a new clinic or hospital system — with different policies, cultures, workflows, and preceptors.

“It’s like starting a new job every month. You finally make a friend, figure out where the bathroom is — and then it’s time to go.”

These students aren’t embedded in one system. Instead, they’re sent into “the community,” rotating across multiple locations. The variety offers exposure to different clinical settings — but it also means constant onboarding, HR paperwork, and adapting to new expectations. Coordination is often handled by a central figure on the school’s side — a kind of remote HR — but when it comes to resolving workplace issues, the lines of responsibility can be unclear.

“Every month, it’s new HR, new systems, new people. We try to get the documents done early, but it still feels like restarting from scratch.”

Despite working long shifts, engaging with patients, and supporting medical teams, these students are unpaid. Their compensation is framed as learning and experience — but that tradeoff can be complicated when the educational value varies widely. Many find themselves navigating not just medicine, but also the emotional math of endurance. When preceptors are great educators, students often feel it’s worth pushing through the discomfort. But when learning is minimal and the environment is toxic, it becomes harder to justify staying silent.

“If I’m learning and being challenged, I can overlook a lot. But if I’m being disrespected and I’m not learning? That’s where I draw the line. I’m literally paying to be here.”

Students in these programs are constantly assessing: Is this worth it? Is this environment helping or hurting my learning? What should I speak up about — and what should I let go? Because rotations are short (often just four weeks), many choose to keep their heads down and get through it — especially when power dynamics make speaking up risky.

Professionalism isn’t always guaranteed. In some environments, inappropriate remarks, lack of support, and poor leadership go unchecked. And when systems are set up without clear recourse or accountability, students bear the weight of navigating these situations alone.

Rewriting Work

Maha’s story is a different kind of 9-to-5. It doesn’t live in an office or Zoom room — but it’s still work. Demanding, skilled, and unpaid.

Her rotation model offers something unique: exposure, variety, adaptability. But it also reflects what so many early-career professionals experience across industries — unclear boundaries, inconsistent support, and emotional labor that goes unrecognized.

So what can we take from it?

• Let’s stop calling it “training” when it’s actually unpaid labour. Learning doesn’t cancel out the real work being done.

• Support systems shouldn’t disappear just because someone’s temporary. Rotating workers, interns, and temps still need feedback loops, recourse, and psychological safety.

• Professionalism starts at the top. If senior people in any system aren’t modeling it, no amount of hierarchy will make up for that.

• Adaptability is a skill — but we shouldn’t glorify survival. The ability to adjust shouldn’t be mistaken for an acceptable status quo.

This newsletter is called Work, Rewritten for a reason. It’s here to hold space for other rhythms of work — and the people who live them. Maha’s version of the workday might be unfamiliar to some, but it’s rich with insight about what it means to work, learn, and endure all at once.

And maybe — just maybe — it’s time we rewrite the systems that expect so much from people giving everything they've got.