Academics: Biennium II

The concluding two years are almost entirely devoted to learning clinical medicine. In our region, there are many hospitals and clinics where our full time and voluntary faculty both practice and teach and supervise medical students and residents. All third-year and the required fourth-year clerkship must occur at our affiliated hospitals whereby the school’s faculty can supervise a student’s progress. Required clerkships cannot be taken at other medical schools. Duty hours will not exceed 80 hours per week averaged over a four-week period, and each student must attest compliance with this requirement at the end of each clerkship. (See Duty Hours policy for further information).

All clerkships have a set of learning objectives that are congruent with the School's Educational Objectives and an assessment system. Faculty evaluate student performance in a standardized web-based format at the end of each clerkship; however, there is also a midclerkship formative evaluation process. All clerkships require the National Board of Medical Examiners (NBME) Shelf Exam as part of the final grade. All students must complete the School’s Fourth Year Objective Structured Clinical Examination (OSCE) within three months of finishing the third year. The USMLE Step 2 Clinical Knowledge and Clinical Skills examinations should be taken by the recommended date.

By the end of the third year, all students are expected to have demonstrated the ability to:

  • Establish rapport with patients, patient families, and co-workers
  • Obtain a complete medical history using the appropriate departmental format
  • Perform a complete physical exam using the appropriate departmental format
  • Recommend appropriate diagnostic studies
  • Interpret diagnostic studies
  • Synthesize data from the medical history, physical exam, and diagnostic studies
  • Develop a differential diagnosis
  • Develop management plans


In the fourth year, all students are required to take:

  1. One block Emergency Medicine clerkship
  2. A sub-internship in one of the eight core specialties.
    • a. An intensive, PGY1 type experience. Must be within the eight core clerkship departments.
  3. One block of Surgery (surgical sub-I does not fulfill this requirement)
  4. One block of Non-Surgery (non-surgical sub-I does not fulfill this requirement)
  5. Five blocks of electives
    • a. Minimum three blocks must be “clinically oriented” (direct patient contact is not required), e.g. radiology, anatomic pathology. Non-clinical electives include: research, GHI, medical education, or classroom-based academic electives. Required Sub-I does not fulfill this requirement.

Elective Parameters

  • a. Max of 4 blocks of extramural electives
  • b. Max of 4 blocks student Initiated Electives (SIEs)
  • c. Max of 4 blocks out of town electives
  • d. Max of 6 two-week blocks
  • e. Max of 1 block longitudinal elective (required a corresponding block in the schedule)
  • f. Max of 1 elective that is 8 weeks long – Must be taken as 2 consecutive blocks
  • g. Max of 3 identical electives
Last edited on 08/21/2018.