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Clinical Curriculum Component IV

The fourth year consists of eleven four-week periods; two of which may be used as vacation months and for interviewing. Students are encouraged to seek a full and balanced combination of experiences as they pursue personal medical interests and investigate medical fields in which they have no previous experiences.

Fourth-year experiences are graded using the full grading scale of Honors, High Pass, Pass and Fail. General requirements exist, but are not tied to specific departmental courses. Each fourth-year student must complete at least nine months of clerkships; up to three of these months may be devoted to research experiences.

Students also have the opportunity to elect clerkships at hospitals throughout the country and the world. Most off-campus experiences are arranged by students and all require the approval of the appropriate clerkship director.

Basic senior requirements include:

Subinternship: In the eight-week subinternship, each fourth-year student, as an active member of the health care team, assumes major responsibility for patient care. Students enjoy the subinternship enormously because they have primary responsibility for the care of their patients, and greater autonomy in patient care decision-making. As subinterns, students are given as much responsibility for their patients' care as is possible within legal limits.

Intensive Care Unit (ICU) Experience: Often taken concurrently with the subinternship, the ICU experience provides not only an opportunity for students to participate in the management of critically ill patients with diseases or conditions affecting multiple organ systems, but also the opportunity to witness the profound effects of life-threatening acute illness on patients and their families. Students find the ICU to be of particular educational value because the immediate effects of treatments are frequently more evident in patients who are so unstable.

Advanced Basic Science Experience: This experience is also called Science in Clinics, and is designed to update and augment students' basic science knowledge. These rotations typically allow students to focus on one or a few specific problems in depth, which students report is very satisfying intellectually after three years of absorbing information at a breathtaking rate. Having now acquired a solid clinical base, students can appreciate the basic science underpinnings of medicine more clearly than before.

Electives: Students can choose from more than 200 electives offered at the UM and UM-affiliated hospitals, in addition to working with faculty to develop independently structured experiences. Formally-structured rotations range from trauma surgery in Detroit to developmental pediatrics to a critical review of the influence of law on medical practice. Students are encouraged to sample widely in the senior year, while also maintaining appropriate rigor, ample clinical exposure, and a suitable blend of experiences. Up to three electives may be taken nationally or internationally.

Medical students have prepared the following descriptions of the Component IV experiences.

Component III

Component IV