(anonymous reply)
Hm. in terms of scheduling your 4th year…doing ad med, then step2, then the 4 away…you can do this (I think you can do max of 2 rotations at the same institution, you might only be able to do 3 national, 2 international but double check with OME) but make sure that the OME has the proper affiliation agreements in place for the school that you're looking to rotate in. If they don't, make sure you do this ASAP. This was an enormous problem for my class, and I don't want you to have the same problems I did. (http://ubmedicinefaqs.wikidot.com/forum/t-44675/how-to-initiate-away-rotation-applications-at-ub) might help you out. Hopefully my class paved the way for yours.
It sounds like you want to do a lot of aways. I've heard that sometimes schools will ask you what programs you've done aways at, and may not like it if you say you're rotating through a whole bunch because it sounds like you're not committed to theirs. I wouldn't lie to them in case they find out somehow. So if you can find students/residents from that school, maybe you can talk to them first and make sure you definitely want to rotate there so it's not a wasted month. And remember that if you're always away from Buffalo it might cause some difficulties if you need to ask for LORs and the person wants to meet with you in person to discuss your CV or something, or if you want to meet with Dr. Nielsen for questions or guidance (not usually necessary).
And if you really like the program, make sure that you try to do an away there! I sincerely feel that it helps your chances if you're not horribly inept…2 of my friends have already early-matched in amazing places where they did away rotations!