The fourth year features built-in flexibility to allow students to individualize their medical careers.  The early start to the fourth year in May allows students to pursue electives for early exposure to clinical specialties or to complete clerkships which may have been deferred.

Year 4

Electives (32 Weeks)

Acting Internships
Emergency Medicine
Advanced Clinical Clerkships
Clinical Didactic Courses

SSM or SPO (4 Weeks)

Special Study
Scholarly Project

Doctoring 4 (Elective)


All students are required to select 32 weeks of learning activities in addition to a single 4 week special study module or scholarly project.  Two, 4-week acting internships are required and a 4-week emergency medicine clerkship are required. 

Fourth year students are required to select a single 4-week Special Study Module from a range of offerings, or they may opt to complete a Scholarly Project.  The Special Study modules are designed to integrate basic sciences with clinical sciences, provide opportunities for students to practice and refine fundamental skills in critical appraisal and analysis of emerging scientific developments, and to allow students to focus in-depth on a multidisciplinary topic of special interest to the student.  The Scholarly Project requires independent inquiry with faculty mentorship and leads to a publishable manuscript and student presentation of the project at a research forum held in the spring. 

The Doctoring curriculum continues on an elective basis with Doctoring 4, a year-long course where students participate as co-facilitators with faculty in the Doctoring 1-3 curriculum and Y1-2 course, attend seminars on teaching, and complete a curriculum development project.

Individual student programs are designed under the guidance of career and specialty advisors, with the support of the Office of Student Development.  Each student’s fourth year program must be approved by the Fourth Year Oversight Committee to ensure appropriate breadth, depth, and vigor.  There are strict guidelines for the choices and time allowed away from the home institution. 

The fourth year curriculum also provides 18 weeks of unscheduled time for electives, research, residency interviews, national board study, or vacation.

Feedback and Assessment
A comprehensive clinical skills examination at the beginning of the fourth year features self-assessment, faculty feedback, and development of an action plan to improve clinical skills.  Fourth year clerkships use a competency-based framework for clinical evaluations that assess fourth year milestones.