Fourth Year (Beginning Academic Year 2016/2017)

Year 4 prepares students for residency training through experiences designed to promote advanced knowledge and skill development in an individualized manner. The year offers ample elective time for senior students to design a course of study that is both unique and defining. In addition, two innovative capstone experiences round out the year: the first focuses on preparation for supervised practice in residency, and the second promotes critical skill development and knowledge acquisition to prepare students for the opportunities and challenges of science and medical practice in the 21st century.

Innovative opportunities in the Year 4 curriculum:

  • Sub-Internship options in a variety of fields
  • Core competency training in economics and law in medicine, innovation, teaching skills, and leadership
  • Specialty-specific skills-based preparation for supervised practice in residency in Year 4
  • Medical Student Research Day to showcase student research and scholarship
  • Graduation with "Distinction in Research" and/or "Distinction in Medical Education" opportunities


Sub-Internship in Internal Medicine, Pediatrics, Obstetrics and Gynecology or General Surgery: The goals of the four-week Sub-Internship are to provide senior students with increasing responsibility for patient care and an opportunity to function as a more fully integrated member of the medical team on the inpatient services. Students render direct patient care and assume all the responsibilities of an intern with a reduced load. The sub-intern works directly under the resident and/or fellow and is responsible for discussing all care issues with the house-staff on a daily basis. The sub-intern also works closely with the service attending.

Emergency Medicine: This four-week clerkship helps students improve their evaluation and presentation skills and practice medical decision-making under the supervision of Emergency Medicine faculty. Clinical experiences in the Emergency Department allow students to evaluate patients of all ages with acute, urgent, and critical complaints, provide opportunities for advancement in procedural skills, and facilitate application of evidence-based medicine principles to plan appropriate diagnostic strategies and therapy. Patient encounters will promote efficiency in focused evaluation to address the major complaint, assessment of response, and practice in appropriate dispositions.

Introduction to Internship: This two-week experience provides just-in-time training for internship. Through small group activities, evidence-based medicine exercises, and simulator encounters students focus on acute management issues, advanced communication skills, teacher training, and specialty-specific preparation for internship. Introduction-to-Internship is offered in the second semester of Year 4 to allow for timely skill development prior to residency.


InFocus weeks across all four years provide core curricula in vital topics for medical practice and biomedical research in the 21st century. These in-depth immersion experiences bring together outstanding interdisciplinary faculty and emphasize skill development and knowledge application. During these weeks students do not have other class obligations. During Year 4, the two-week InFocus block entitled "Capstone for the Future" is devoted to leadership, innovation, teaching skills, and economics and law of medicine.

Capstone for the Future brings Year 4 students together for small-group sessions, team-based activities and interactive discussions. The core curriculum will focus on the topics below. The course will be scheduled during the first two weeks of March and will conclude with Match Day. Medical Student Research Day showcasing the scholarly work by medical students will occur during Capstone for the Future and bring together all students as well as faculty and institutional leaders.

  • Leadership in Health Care: This core leadership skill-building curriculum for students is designed to provide competency in navigating and implementing reform in a complex health care system via self-reflection on leadership qualities and barriers to effective leadership, effective communication and multi-disciplinary cooperation, conflict management and negotiation, and vision development.

  • Innovation: This InFocus theme will introduce students to core content areas in solution development including identification of a problem, concept creation, concept development and translation as well as economic impact assessment. Students will be exposed to experts in the field of innovation and entrepreneurship and gain an appreciation for the process of finding solutions to complex health care problems.

  • Teaching Skills: This InFocus theme provides a comprehensive foundation in the principles of practical teaching techniques. Students participate in small group workshops about learning theories and effective teaching techniques and have an opportunity to practice skills learned to prepare for teaching during residency and beyond.

  • Economics and Law of Medicine: This InFocus theme will introduce students to core concepts in health care economics and law. Through interactive discussions and presentations, students will explore funding, payer systems, health reform, and financial management. In addition, students will be exposed to legal experts to support their understanding of the regulatory aspects of medicine, medical malpractice, intellectual property, and litigation and licensure.


Electives facilitate self-directed learning and encourage students to experience new opportunities and explore career options. Students are offered a generous 18 weeks of elective time in Year 4. Elective time may be used to pursue scholarly activity, take clinical electives at Mount Sinai or its affiliates, visit academic institutions in the United States or, with the approval of the Global Health office, learn at an international venue. Students may also create tailor-made electives designed around their individual learning needs with guidance and support from the Department of Medical Education.