Ground Rules

Planning the Fourth Year

Students are encouraged to engage faculty specialty advisors while preparing their fourth year schedule. Keep long-term goals in mind when choosing electives to allow exposure to clinical settings you may not encounter during residency training.  Electives should be used effectively to prepare for future professional goals and to expose you to clinical areas you might not encounter in your residency training program.  Remember to use your experiences during third year to identify clinical  interests as the various departments of duty can help inform your choice of residency program as well as provide recommendation letters.

Most residency interviews take place in November, December, and January. Check with your OASA academic/career and specialty advisors about the wisdom of taking time off for residency interviews. You should plan to interview broadly. Students wishing to be excused one or more days for interviews must obtain approval from the course director in advance and should be prepared to make up time and work missed. Make it a point to clearly understand the director’s expectations of you.

NOTE: The School’s policy regarding time off for residency interviewing allows a maximum of two days from a required course and a maximum of five days from an elective to be granted at the discretion of the course director.

Course Requirements

Students must complete the following course requirements to graduate:

  • Required Courses:
    • Required Ambulatory Medicine (AMB 4000)
    • Required Advanced Patient Care (APC xxxx)
    • Required Critical Care (RCC 4000)
      • ACLS Certification – certification is completed during the RCC course
    • Transition to Residency (RTR 4000-412)
      • Medical Jurisprudence (JURI 4001-412) – administered through the Required Transition to Residency course
  • Elective Courses
  • Career Focus Track Completion (CFT 4001-444)
  • Comprehensive Clinical Competency Exam (CCCE) (TSKI 4002-001)
  • Up to 3 ½ Blocks of  Vacation*

*The amount of vacation time available for you to take is impacted by your prior academic progress.  For example, if you have third year clerkship coursework that you must still complete after the formal start of the fourth year, that will decrease the amount of time available for you to use as vacation.

Limits on Specialty Electives

You are permitted to take up to four electives in any one specialty. Electives, away rotations and Special Projects (clinical or research) are considered part of the appropriate parent specialty. Required courses do NOT count towards the specialty limit. You may take up to three blocks away from McGovern.

REMINDER: You may not take the same elective twice.

Specialty Advising

It is critical that you speak with your specialty advisors while planning your schedule.  The Fourth Year Lottery Preference Form must be signed by a specialty advisor from the specialty you indicate on your form. If you are undecided about a specialty, Dr. Lahoti and Dr. Reddy are available to meet with you and can sign your form. Forms will not be processed without this signature and will be returned to you.

Approval from Course Director

In addition to having a specialty advisor sign off on your form, some courses require director’s approval. In these instances, you must have the faculty in charge of the course sign next to the course title on the preference form. If you do not obtain the signature, that course selection will not be processed.

A signature from the course director is not a guarantee that you will be enrolled in the course.


February 23, 2024 5:00 pm Signed preference forms due to OASA (drop off in person to MSB G.400 or email directly to Nicole Dubuque).
Preferences must also be entered into One45 by this date.
March 13, 2024 MS4 lottery results should will be available on myUTH.
March 27, 2024 Add/Drop begins (never closes). ALL add/drop requests must be made via the MS4 Portal. Student then enters code on myUTH to officially enroll.

REMINDER: Students must contact each course coordinator for permission codes to officially enroll in courses not received through the lottery.

Timely submission of the preference form is your responsibility. Course assignments will be made by the lottery according to the guidelines and are not first-come, first served.

Schedule and Lottery Resource Documents

Review the course catalog to determine what courses you are interested in taking. Plan out several versions of your schedule so that you are prepared when changes arise.

Once you have your schedule planned out and you are ready to meet with your specialty advisor to review your schedule preferences, fill out the MS4 Lottery Preference Form to obtain your advisor’s signature.

When you enter your preferences in One45, be sure to refer to the One45 Lottery Instructions.

If you need assistance, please come by OASA to meet with a staff member.

On to Required Courses