No you don’t have to stay your course site. You can literally just find a random doc to take you for a month if you want. You can set up most of your rotations either through VSAS (aka VSLO, which is just a website for submitting away rotation applications) or you can contact programs directly and set it up with them which is what I did for most of my rotations. The school will have a meeting in a few months talking about setting this stuff up. If you apply to ortho you will need to set up 4th year way earlier than everyone else, like start contacting programs in October. Otherwise you can start looking into programs and stuff in Jan and start sending apps in Feb-April. Most rotations on VSAS open in April. Clinician Nexus is like VSAS but it’s mostly for HCA programs. Earliest you can finish 4th year is usually end of April, but for my class (2023) we only have to have stuff scheduled through then end of March and the school has some required course for us in April, think it’s all online stuff that’s replacing Comlex 2 PE. We also have to travel back to KC for a practical some time between Jan-Mar but not sure when that is yet.
For interviews the school only lets you take a few days off per rotation for interviews. Just ask your preceptor/residents about taking days off for interviews and don’t tell the school. That also applies to 3rd year, just ask your preceptor for days off and don’t tell the school. You can also schedule easy rotations or time off during your interview season during 4th year. Some specialties interview early like FM/IM I think and others later like most ortho interviews are in January and DR are like Nov-Dec. You just have to figure that out once you decide on a specialty.
Also some hospitals/programs will require you to have an affiliation agreement set up between them and KCU for you to rotate as a 4th year. You need to find out if they require that early because those can take months to set up and be a real pain to deal with.