Course Offerings in the Fourth Year of Medical School

How U.S. Medical Schools Are Preparing Students for Internship

Clerkship Directors in Internal Medicine/Association of Program Directors in Internal Medicine Committee on Transition to Internship

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

The fourth year of medical school remains controversial, despite efforts to reform it. A committee from the Clerkship Directors in Internal Medicine and the Association of Program Directors in Internal Medicine examined transitions from medical school to internship with the goal of better academic advising for students. In 2013 and 2014, the committee examined published literature and the Web sites of 136 Liaison Committee on Medical Education-accredited schools for information on current course offerings for the fourth year of medical school. The authors summarized temporal trends and outcomes when available. Subinternships were required by 122 (90%) of the 136 schools and allow students to experience the intern's role. Capstone courses are increasingly used to fill curricular gaps. Revisiting basic sciences in fourth-year rotations helps to reinforce concepts from earlier years. Many schools require rotations in specific settings, like emergency departments, intensive care units, or ambulatory clinics. A growing number of schools require participation in research, including during the fourth year. Students traditionally take fourth-year clinical electives to improve skills, both within their chosen specialties and in other disciplines. Some students work with underserved populations or seek experiences that will be henceforth unavailable, whereas others use electives to "audition" at desired residency sites. Fourth-year requirements vary considerably among medical schools, reflecting different missions and varied student needs. Few objective outcomes data exist to guide students' choices. Nevertheless, both medical students and educators value the fourth year of medical school and feel it can fill diverse functions in preparing for residency.

Original languageEnglish (US)
Pages (from-to)1324-1330
Number of pages7
JournalAcademic Medicine
Volume90
Issue number10
DOIs
StatePublished - Oct 1 2015

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internship
Internship and Residency
Medical Schools
Students
school
student
Internal Medicine
director
medicine
Vulnerable Populations
Medical Education
Medical Students
Hearing
Intensive Care Units
Hospital Emergency Service
school education
medical student
experience
educator
Research

ASJC Scopus subject areas

  • Medicine(all)
  • Education

Cite this

Clerkship Directors in Internal Medicine/Association of Program Directors in Internal Medicine Committee on Transition to Internship (2015). Course Offerings in the Fourth Year of Medical School: How U.S. Medical Schools Are Preparing Students for Internship. Academic Medicine, 90(10), 1324-1330. https://doi.org/10.1097/ACM.0000000000000796

Course Offerings in the Fourth Year of Medical School : How U.S. Medical Schools Are Preparing Students for Internship. / Clerkship Directors in Internal Medicine/Association of Program Directors in Internal Medicine Committee on Transition to Internship.

In: Academic Medicine, Vol. 90, No. 10, 01.10.2015, p. 1324-1330.

Research output: Contribution to journalArticle

Clerkship Directors in Internal Medicine/Association of Program Directors in Internal Medicine Committee on Transition to Internship 2015, 'Course Offerings in the Fourth Year of Medical School: How U.S. Medical Schools Are Preparing Students for Internship', Academic Medicine, vol. 90, no. 10, pp. 1324-1330. https://doi.org/10.1097/ACM.0000000000000796
Clerkship Directors in Internal Medicine/Association of Program Directors in Internal Medicine Committee on Transition to Internship. Course Offerings in the Fourth Year of Medical School: How U.S. Medical Schools Are Preparing Students for Internship. Academic Medicine. 2015 Oct 1;90(10):1324-1330. https://doi.org/10.1097/ACM.0000000000000796
Clerkship Directors in Internal Medicine/Association of Program Directors in Internal Medicine Committee on Transition to Internship. / Course Offerings in the Fourth Year of Medical School : How U.S. Medical Schools Are Preparing Students for Internship. In: Academic Medicine. 2015 ; Vol. 90, No. 10. pp. 1324-1330.
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