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FAQs: 4th Year

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Elective Lottery and Fourth Year Scheduling FAQs

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What are the absolute requirements needed for graduation?

  • You need to take a total of 25 elective credits throughout your four years of medical school. A limited number of credits taken earlier than your fourth year can be applied toward this graduation requirement.
  • No more than 16 of those 25 credits can be within the same discipline (i.e have the same 4 lettered course assignments such as PEDS)
  • No more than 12 of the 25 credits can be done extramurally (outside of Binghamton, Syracuse or Guthrie)
  • 2 of those 25 credits need to be a basic science. (See course book for which courses meet this criteria)

What is the elective lottery?

This is a FAIR method to give everyone equality in course selection for their fourth year. (4)

How exactly does this elective lottery computer program work?

  • The lottery runs in rounds. Each round you will have a different pick so that the average of everyone's picks in each of the rounds will be the same. For example if you pick first overall in the first round you will pick last overall in the second round. (BUT YOUR BEST CHANCE AT A PARTICULAR ELECTIVE IS WITH YOUR PICK IN THE FIRST ROUND)
  • A round in the lottery does not equal periods of your fourth year
  • Each round in the lottery allows each student the option to select one elective
  • Round one of the lottery will begin by attempting to place you in the elective that you have selected in group A, line 1; in the period you have listed first.
    • Should that elective not be available during that period it will continue to read left to right in the desired period column until it either finds on opening or runs out of selected periods
    • Should all of the periods in Group A, line 1 be filled then it will jump to Group A, line 2 and again try to fit you in the desired period starting from left to right
    • This process will continue until you have found an opening from Group A
    • Note: If all of your group A selections are filled then the computer will jump to group B so that you do not waste your first round draft pick. This is highly unlikely.
  • Round two of the lottery will begin with group B, line 1. The computer will try to place you in your desired period again from left to right. The same process listed above will then continue.
  • Round three of the lottery will begin with group C line 1. And will work the same as groups A and B.
  • Beginning with round 4 all remaining selections will come from Group D. The computer will start with line 1 and go left to right in the period column until it has a match. If no match occurs it will jump to line 2. If you match is line 1 of Group D for round 4 then round 5 will start with line 2 of group D.
  • The process will continue until you have no selections remaining in group D or your credit requests have been fulfilled. (When you go through MyUpstate to fill out your lottery sheet you will be asked to fill in the total number of credits you wish the lottery give you) (4)

Where can I find the course book?

A hard copy of the course book will be available at the clinical campus at the student affairs office but you can also find a copy, in pdf format, of the course book online.

NOTE: Be sure that you are looking at the updated course book as the course book from the previous year may still be online and thus not updated yet. Course numbers can change from year to year. (4)

Are there ever any opportunities to get electives outside the lottery and even before the lottery opens?

Yes! All electives that are listed as "by arrangement only," that are offered for multiple credits, that are concurrent, or that are at the Guthrie site can all be arranged outside the lottery before or after the elective lottery draft. You may also create a unique elective that can be added to your schedule before or after the elective lottery. (4)

Are there any particular helpful hints that you can provide me about the elective lottery?


  • Keep in mind this is only your initial schedule. You will likely change this many times before you actually take these electives.
  • Keep in mind that geriatrics is already scheduled for a particular period per your 3rd year track selection schedule. There is some flexibility here, please inquire with student affairs. You may not want to schedule an elective at that time.
  • Do not schedule any electives in periods 11 and 12. You will graduate in the middle of period 11.
  • November (Period 5), December (Period 6) and January (Period 7) are interview months. Schedule wisely during those months.
  • Don't waste periods and/or selections in the lottery with away electives. You may be certain that you have an away elective set up but if that should fall through for any reason you will be stuck with nothing. Use the lottery to fill that period with an intramural elective and once all the paperwork is submitted for the away elective you can always drop that intramural elective (You never know if your hepatitis B titer will be back in time for you to be able to do that away elective)(4)

When should I schedule my Acting Internships?

You should complete an AI in your chosen specialty early in your fourth year (or late in the 3rd year if you schedule permits). This will be the evaluation that will be weighted heaviest in a residency programs assessment of you. (2)

This rotation will also be the best chance for you to get a letter of recommendation so be sure that you take it in July or August. You can take an AI in September and still get the letter of recommendation into your ERAS application in time but you will definitely need to speak with your letter writer about how sensitive time will be. (4)

Should I do an audition rotation? (A rotation at the site of a residency program that I really want to get into)

This is not an absolute necessity unless you are getting into programs such as neurosurgery and orthopedics (here it is essentially an unwritten rule). Otherwise it can be a double edged sword. Sure you can go in and do what you have always done and shine and thus increase your chances of matching at that program. But you can also go in and be put under undo scrutiny because of your interest in that program and because you will be compared to medical students already at the institution. (They likely will not be better than you from a knowledge standpoint but they also will not be fumbling around lost in the new hospital trying to figure out a new computer system) The general recommendation is that you only do audition rotations if it is a program and/or specialty that is a long shot for you and you should probably try to avoid it if people from your university have already matched at that program because in that case the program likely has a good impression of your medical school. (2)