For the PreMeds: What’s the Difference bewteen 3rd and 4th Year, anyway?!


Ah, after a bit of a hiatus filled with colorectal surgery and a relaxing summery vacation, I am back in full-force MD2B action. During this time, I officially made the long-awaited transition to my fourth year of medical school. Our fourth year orientation was filled with anxiety-provoking lectures about letters of recommendation, personal statements, and ERAS (the Electronic Residency Application System). While I always knew applying to residency would be challenging and stressful, I remember sub-I (4th year) students being relaxed, knowledgeable, and incredibly helpful to me this past year. Actually, if I think back even further, I’m not sure that as a first year student – let alone a PreMed – I even knew there was a difference between third and fourth year students. With that said, I thought I would take some time to explain exactly what it is that third- and fourth-year medical students do every day.

While the first two years of medical school are spent mastering the basic sciences – biochemistry, physiology, pharmacology, etc – the third and fourth years are spent “on the wards,” working alongside residents and attending physicians and mastering the art of clinical medicine. During the typical third year, students are required to complete rotations in what are known as the “core” clerkships – Internal Medcine, Pediatrics, Family Medicine, Surgery, OB/GYN, and Psychiatry. Students take national, standardized exams in each of these subjects, commonly called “Shelf Exams.” Depending on the program, the timing and length of these rotations may vary and students may also get the opportunity to take some electives. While overwhelming, students generally have some idea about what they do (or do not) want to do in terms of their career after third year.

During fourth year, students have more freedom to take elective rotations in their respective fields of interest. For example, since I will be pursuing a residency in Internal Medicine, I will be taking elective courses related to this specialty – cardiology, critical care, physical diagnosis, etc. Fourth-year students are busy taking the second part of their medical board exams, known as Step 2 (If you already read I Smile, U-SMILE, you’ll know that students take Step 1 after second year!). Unlike Step 1, Step 2 is composed of two parts: a written, standardized test, and a practical, clinical skills exam. Early on in the year, students write the personal statements and obtain the letters of recommendation that they will send to residency programs, and as the year progresses they get invited to interviews at those programs. The year culminates in March on Match Day, when all fourth year medical students find out where they will be working as interns, or first-year residents, after they graduate.

It still hasn’t set in that this year, it will be my turn to match into a residency program. The process of applying to residency is a complex one that, like third and fourth year, I continue to learn about daily. I’m thrilled to be working in the field that I truly enjoy for the rest of the year, and hope to more clearly define my career goals. Finally, although anxious, I’m looking forward to the challenges ahead, and look forward to sharing them here.

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3 thoughts on “For the PreMeds: What’s the Difference bewteen 3rd and 4th Year, anyway?!

  1. Pingback: Taking a (Partial) Break from School | Jessica Sideways.com

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