The price of getting seen: Financial barriers to surgical away rotations.

BACKGROUND: Surgical visiting rotations are used to demonstrate clinical ability and gain program exposure, yet how financial factors influence application behavior remains not well characterized. STUDY DESIGN: We conducted a cross-sectional survey study of U.S. medical students applying to surgical visiting rotations (n = 116, response rate 14%). Data included demographics, socioeconomic characteristics, behaviors, and costs. Socioeconomic disadvantage (SED) was assessed using a composite score and the Area Deprivation Index (ADI). RESULTS: Nearly half of respondents reported refraining from applying due to cost. Higher SED was associated with greater likelihood of reporting additional rotations that would have been pursued if cost were not a factor (adjusted OR 1.42, 95% CI 1.03-1.95, p = 0.033). Higher ADI was associated with refraining from applying and unmet demand. Total costs were not associated with SED and one-third reported costs exceeding $5000. CONCLUSIONS: Financial constraints limit participation of visiting rotations, indicating that cost alone does not reflect burden.