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Fourth-Year Curriculum


Fourth-Year Curriculum Overview

The fourth year curriculum builds on the academic and clinical foundations student have established in years 1 through 3 and prepares students to make the transition to being physicians. The fourth year curriculum is composed of 11 four-week blocks. To meet requirements for graduation, student complete a 4-week critical care selective, a 4-week core sub-internship selective, a 4-week classroom-based radiology course, a 4-week classroom-based transition to residency course, 20 weeks of electives, and 8 weeks of vacation. Of the 20 weeks of electives, no more than eight may be non-clinical.

Required Courses

Sub-Internship (Sub-I)

The core sub-internship selective requires students to complete a 4-week inpatient clinical rotation where they are expected to function at the level of an intern, with the opportunity to assume more responsibility for patient care for under supervision of a senior resident or attending.


Radiology is a four-week classroom-based course, completed entirely online. Students are required to attend or otherwise view faculty-led didactics on core radiology topics. Students also complete a series of radiology image reviews. Grading is based on an online final exam covering concepts taught in the course.

Critical Care Medicine

The Critical Care Medicine selective covers core concepts in critical care. Students may rotate at UCR core sites or they may apply for a critical  core rotation through VSLO. Students may complete their rotations in a medicine, surgical, pediatric, or neonatal intensive care unit. All students attend four hours of faculty-led didactics once per week to learn core concepts in critical care.

Transition to Residency

Transition to Residency is a four-week classroom-based course attended by all fourth year students in March. The course uses simulation, lecture, and small-group learning to teach and review core concepts that help prepare students for residency. Topics include lifesaving courses, medical knowledge (common procedures, management of medical emergencies) and soft skills (time management, stress management, financial planning).

The first two weeks teach universal concepts, and during the second two weeks, students attend tracks in surgery, acute care, psychiatry, OB/GYN, pediatrics, family medicine, or emergency medicine, based on their matched specialty. The course is pass/fail and passing requires students to complete all relevant certifications and attend all relevant coursework. 


Students may choose electives either at core UCR sites or through VSLO. Students must complete a minimum of 20 weeks of electives, including a minimum of 12 weeks of clinical electives. Students may complete up to eight weeks of non-clinical electives which may include research, online modules, reading electives, teaching electives, wilderness medicine electives, or any other electives that do not involve direct patient contact.

Visiting Student Learning Opportunities (VSLO)

VSLO is designed to streamline the application process for senior "away" electives at U.S. medical schools and independent academic medical centers. With VSLO, the applicant only needs one application for all participating institutions, reducing paperwork, miscommunication, and time. Each site has the option of inserting their own criteria and costs, however.

Vacation Blocks (2)

It is recommended that students schedule their vacation blocks strategically, such as taking time off for travel to residency program interviews that typically occur between November through January. To facilitate this, the UCR School of Medicine recommends that at least one of the vacation blocks be taken during the November through January interview season.

Example Schedules

Month Example 1 Example 2 Example 3
July Sub-I Elective Elective
August Elective Elective Elective
September Elective Critical Care Sub-I
October Elective Elective Critical Care
November Elective Radiology Vacation
December Vacation Elective Radiology
January Elective Vacation Elective
February Critical Care Elective Elective
March Transition to Residency Transition to Residency Transition to Residency
April Radiology Sub-I Elective
May Vacation Vacation Vacation