Year 4

During the Year 3 intersession, students and their advisers begin planning the fourth-year schedule. Together, they will develop a Year 4 program that reflects students' career goals, individual strengths and educational needs — all informed by the themes of the Mayo Clinic School of Medicine curriculum.

There are 45 weeks in the fourth academic year. The curriculum is composed of the internal medicine subinternship, emergency medicine, elective rotations and a three-week intersession. Time is allotted for board exam prep, residency program interviews and vacation.

The student goals for Year 4 are to:

  • Expand the breadth of medical knowledge and skills needed to be well-versed in many fields of medicine
  • Establish patterns of independence and initiative for lifelong learning
  • Successfully complete all requirements for graduation
  • Demonstrate the medical knowledge and clinical skills necessary to enter graduate medical training programs

USMLE: Step 2

All students must complete and pass both Step 2 components — Step 2 CK (Clinical Knowledge) and Step 2 CS (Clinical Skills) — of the United States Medical Licensing Examination (USMLE) before graduation from the M.D. program.

Required clerkships

  • Emergency medicine
  • Internal medicine hospital subinternship
  • Residency boot camp (held at the simulation center)
  • Social medicine


Students complete at least one of each category (medicine, pediatrics and surgery) in addition to general electives. These can be completed at Mayo Clinic campuses in Rochester, Minn., Arizona or Florida, as well as national and international locations. Many students complete an international or underserved population elective in the spring of the fourth year.

Community Physician Apprenticeship Program

The Community Physician Apprenticeship Program (CPAP) elective is a 12-week community immersion experience focused on continuity care in the outpatient and hospital environment. It is a collaboration among Mayo Clinic School of Medicine, the Department of Family Medicine at Mayo Clinic in Rochester, and Mayo Clinic Health System.

Designed to immerse the fourth-year medical student in a community care system outside of the Rochester environment, it consists of outpatient and inpatient experiences at a Mayo Clinic Health System location with a physician mentor.

The student follows patients through the care process and becomes a part of care teams that include other community physicians, specialists and subspecialists, nurse practitioners, physician assistants, therapists, social workers, and nurses. A community health project serves as a bridge between the community and the student.

The 12 weeks of CPAP satisfy the required three-week specific electives in medicine, pediatrics and surgery, plus three weeks of general clinical electives.

Surgery electives (partial list)

  • Anesthesiology
  • General surgery
  • Gynecologic surgery
  • Ophthalmology
  • Orthopedics
  • Head and neck surgery
  • Surgery subspecialties (trauma, cardiovascular, colorectal, pediatrics, plastic)
  • Urology

Pediatric electives (partial list)

  • Community pediatrics and adolescent medicine
  • Critical care (neonatal and children's)
  • Hospital pediatrics
  • Pediatric subspecialties (infectious diseases, hematology/oncology, gastroenterology, neurology)

Medicine electives (partial list)

  • Critical care medicine
  • Family medicine
  • General internal medicine
  • Medicine subspecialties (cardiology, gastroenterology, hematology, infectious diseases, nephrology, rheumatology)
  • Physical medicine and rehabilitation

General electives (partial list)

  • Dermatology
  • Neurology
  • Obstetrics
  • Pathology
  • Psychiatry
  • Radiology
  • Urology
  • International and underserved populations
Jan. 23, 2014