An Overview of Medical School

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YEARS 1 and 2: Basic Medical Science and the USMLE Step 1

Medical school is 4 years in length. The first two years of medical school are spent learning basic medical science in a classroom setting. The subjects learned include: Biology, Biochemistry, Anatomy, Physiology, Pharmacology, Pathology, Histology, Immunology, Infectious Disease, Behavioral Science, Neuroscience, and Medical Ethics. The second two years of medical school are spent doing 4-12 week clinical rotations where students gain practical experience working as part of the medical team. Through clinical rotations, medical students gain an understanding of the components of medical decision making, physical diagnosis, and cultivating the physician-patient relationship. Within this 4 year process there are three national board exams that must be completed (USMLE Step 1, Step 2CK, Step 2CS) as well as an application to residency programs (ERAS) and participation in the national residency match program (NRMP). You will also have the opportunity throughout medical school to participate in a wide variety of extra-curricular activities. While a career as a physician can be a rewarding one, the four year medical school process is stressful, rigorous, and financially taxing.

After you complete the first two years of medical school and prior to beginning your clinical rotations in your third year of medical school you must complete the USMLE Step 1 (National board exam). The USMLE Step 1 is the first of four exams you must take to apply for medical licensure.

Year 3: Core Clerkships and the USMLE Step 2CK and Step 2CS

During the third year of medical school the clinical rotations you take are considered core clerkship rotations. The term “clerk” refers to a medical student in his or her clinical years. The core clerkship rotations include Internal Medicine, Surgery, Pediatrics, Family Medicine, Obstetrics & Gynecology, Psychiatry, and in some schools Neurology. These rotations give the student a general idea of several main branches of medicine so that he or she can decide on what area to further pursue training in following completion of medical school. The core clerkship rotations also include a “shelf” exam that must be taken at the end of the rotation. A shelf exam is a written exam that tests concepts and material specific to the rotation that clinical students are expected to know.

After your third year of medical school you will take the USMLE Step 2 CK and Step 2 CS exams. The specific point in time that you will take these exams is determined by your schedule and your school’s preference. Most likely you will take both exams prior to December of your fourth year in medical school.

Year 4: Elective Rotations, Sub-Internships, ERAS, and the NRMP Match

Once you have completed your core clerkship rotations in your third year, you have the opportunity to take elective rotations during your fourth year of medical school. These elective rotations allow you to experience other specialties of medicine that were not included in your core clerkships. Some of these specialties include: Radiology, Radiation Oncology, Anesthesiology, Ophthalmology, Dermatology, Emergency Medicine, and others. You will also have the opportunity to participate in “Away Rotations” where you will be able to take a clinical rotation at another medical school after applying for the opportunity. Away rotations give visiting students the chance to evaluate the residency program prior to actually committing to attend residency at that program. Finally, you will be required by your medical school to complete at least one “Sub-internship” which is essentially a clinical rotation in which you are given increasing responsibility. The responsibility you should be given is similar to that of an “Intern” which is a first year medical resident. This rotation is geared towards giving you practical experience in the future role you will be having once you start residency.

During September of your fourth year in medical school you will submit the Electronic Residency Application Service (ERAS application). For the ERAS application you will need letters of recommendation as well as a personal statement. Through this application you will choose specific programs to apply to within a certain specialty of medicine. It is by this time that you absolutely must know what kind of medicine you would like to practice. From October through January of your fourth year of medical school you will interview at these programs. In February, you will submit your rank list, and in March you will be matched to a program on your rank list by the National Residency Match Program (NRMP). You will graduate in May or June of your fourth year of medical school and you will begin residency training on July 1st of the same year.

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