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The fourth year consists of twelve four-week periods beginning in April/May following the completion of required clerkships. The curriculum for this year consists of electives and acting internships selected by students as well as one required capstone course, Transition Into Residency. In order to graduate, students must complete at least 25 elective credit hours, including credits in both the basic and clinical sciences. For more additional information on the course selection procedures and policies by graduating class year, please visit this webpage: Clinical Course Offerings and Procedures.


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Intramural Electives

  • The College of Medicine offers over 200 electives. In January of the third year, students enroll in the Elective Lottery to select their electives for the fourth year. This process is faciliated through the Registrar's Office and is described in detail here: Electives and Elective Lottery. All electives offered through the College of Medicine can be found in the Course Selection Handbook. If students want to create an elective experience that they do not see offered in the Course Selection Handbook, they can propose a Unique Elective.

Away Electives

  • "Away Electives", which involves spending several weeks at other medical schools, at the Center for Disease Control or the National Institutes of Health, or seeing patients in medically underserved parts of the United States or in other countries. Some students take an away elective the summer after their first year at SUNY Upstate.

Unique Electives

  •  Unique Electives, are electives proposed by students who wish to do research in a specific field which will allow them more in depth exposure to that particular area of medicine.  The forms should be filled out six weeks prior to the date that research/elective is scheduled to begin.

Acting Internships

All MSIV are required to take at least one Acting Internship(AI) consisting of four credits at Upstate Medical University. Approved Acting Internships can be found here.

Transition to Residency

This required, three-credit capstone course is designed to prepare students for their first day as an intern. The course consists of large-group lectures, small-group discussions, procedures and simulations.

Step 2

MSIV students are required to take and pass Step 2 CK as a graduation requirement. Our students must sit for both components of the exam by December 1st of their fourth year.

Clinical Skills Exam (CSE)

The CSE is required to be taken by all students transitioning to the MSIV year. Students must pass the CSE as a graduation requirement. The exam is taken in the Clinical Skills Center and consists of multiple stations that test the clinical skills acquired throughout the MSIII year.