Students use the time in Year Four to complete core rotations and the following requirements:

• A sub-internship in a core discipline. Every clinical department offers sub-internships, during which students assume the role of the intern on a hospital-based team, usually with fewer patients and more direct supervision.
• Advanced Critical Care Clerkship. Students have a core didactic and simulation curriculum for this rotation, and choose from nine different intensive care units for the clinical experience.
• OR Students may choose the Advanced Ambulatory Clerkship to satisfy the advanced clerkship requirement. Students care for adult patients with acute or chronic medical conditions in an ambulatory care setting under direct supervision of a Primary Care preceptor.
• Transition to Residency and Internship and Preparation for Life (TRIPLE). This two-week capstone course is offered twice in April of Year Four.