Tag Archives: Selectives

The Clinical Years of Med School: What to Expect

Once medical students complete their time in the classroom, they move on to what many consider to be the real reason they went to med school in the first place: treating patients. This transition usually occurs during the second or third year depending on the length of a school’s pre-clinical curriculum, and is comprised of clerkships, selectives, electives, sub-internships, away rotations, and various other scholarly pursuits. If you are considering medical school, here is an overview of the opportunities and experiences during these clinical years.

Clerkships, Selectives and Electives

The core clerkships beginning in the second or third year of medical school are mandatory for all students. They typically include rotations through some variation of the following: neurology, internal medicine, obstetrics and gynecology, pediatrics, psychiatry and surgery. Each core clerkship lasts several weeks, with many schools also mandating a certain number of selectives interspersed throughout.

A selective will be in a more specialized area as compared to the more general core clerkships. Georgetown University School of Medicine offers a multitude of selectives ranging from anesthesia to child psychiatry. Schools also require a certain amount of elective time, which can span a variety of areas. Thus, even in the universal core clerkships, there is still substantial room for personalization during the clinical years.

Sub-Internships

During a sub-internship, the medical student assumes even more responsibility than he or she would during a clerkship or elective. According to Dartmouth Geisel School of Medicine, the level of clinical responsibility expected during a sub-internship is comparable to that of an intern (someone who already graduated medical school). Students typically choose their sub-internship in an area that they are considering applying to for residency.

Away Rotations

Away rotations provide a unique opportunity for fourth year medical students to explore residency opportunities at other institutions. To streamline the process of applying, there is a universal application through the AAMC, known as VSAS. However, policies vary by school so it is important to carefully research the specific program you are planning on applying to. Pritzker School of Medicine explains that some specialties, such as dermatology and emergency medicine, essentially require students to complete away rotations before applying for residency.

Other Opportunities

There are a number of additional opportunities available to medical students during their clinical years. Many schools offer a focused, in-depth experience in a specific area of interest. Several medical programs, such as Weill Cornell Medical College, Alpert Medical School, and Columbia University’s Vagelos College of Physicians and Surgeons offer a scholarly concentration program, which allows students to participate in an in-depth study of a particular area of medical practice or research under the mentorship of faculty. Certain schools, such as Duke University School of Medicine, dedicate an entire year to scholarly research.

Another important element of these years is dedicating sufficient time to prepare for the United States Medical Licensing Examinations (USMLE) Step 1 and Step 2. However, it should be noted that the timing of these exams varies widely among different medical schools.

The clinical years of medical school are fundamental in shaping students’ future paths. During this time, students gain in-depth clinical experience while pursuing scholarly endeavors and delving deeper into their individual interests. It is essential to carefully compare the curricula of various medical schools so that you ultimately attend one that is compatible with your future goals.

For guidance on navigating the medical school application process, feel free to contact us. As always at Collegiate Gateway, we’re happy to help!