Curriculum: Fourth Year
July Through May (32 weeks)
- One 4-week required SMHS Acting Internship (AI)
- Seven periods of electives (28 week total)
- 12 weeks for Step 2/interviewing/extra electives/vacation
- One day for Senior Colloquium before commencement
The fourth-year program includes eleven periods, plus a Dean's Colloquium which is just prior to graduation. All fourth-year students must take one required SMHS acting internship (AI), seven four-week electives during their fourth year and are expected to participate in the Dean’s Colloquium. In order to prevent overcrowding on any one campus, sixteen weeks must be scheduled to be completed on the student's assigned clinical campus in the fourth year. The required acting internship must be completed at UND SMHS.
Some electives are unique to a specific campus. Students may choose to use one of these unique electives (designated by a 95** course number), to count as a home-campus elective.
International rotations arranged through individual departments are not considered on-campus rotations. Students may not participate in international electives during match week.
Students in the fourth year of medical school may not take more than a total of four electives in a single specialty. Within these four electives, no more than two may be general electives in the specialty and no more than two may be in a single sub-specialty area unless they wish to forgo a vacation month in which case they may take three. This includes the acting internship requirement.
Year 4 Objectives
- Obtain a history and perform a physical examination (EPA #1) and present the information orally (EPA #6) for both complete and focused patient encounters.
- Document accurately and succinctly information gained during patient encounters using an electronic medical record. (EPA #1, #5)
- Form an appropriate differential diagnosis and document the clinical reasoning behind that differential. (EPA #2)
- Recommend and interpret common diagnostic and screening tests. (EPA #3)
- Formulate and update an accurate problem list for patients under their care.
- Communicate effectively with patients and their families regarding differential diagnoses, treatment options and care plans in light of social, cultural and economic factors affecting the patient’s healthcare. (EPA #1, #3)
- Work effectively as a member of an interdisciplinary healthcare team including being able to call a consultant and request a consult. (EPA #9)
- Give and accept patient handoff reports for transitions in care. (EPA #8)
- Formulate accurate and appropriate patient care orders and prescriptions. (EPA #4)
- Recognize a patient requiring urgent or emergent care and initiate the appropriate initial steps in that care. (EPA #10)
- Effectively receive and give feedback.
- Obtain informed consent. (EPA #11)
- Research a clinical question relating to patient care with appropriate evaluation of resources and use of evidence-based information. (EPA#7)
- Formulate appropriate and evidence-based diagnostic and treatment plans for common medical conditions.
And will have:
- Completed all assigned rotations in a professional, ethical, confidential, and respectful manner. This will include appearance, timeliness, completion of assigned tasks and interactions with patients, families, coworkers and staff.
- Completed the assigned curriculum in patient safety and quality (EPA #13)
EPA 1: Gather a history and perform a physical examination
EPA 2: Prioritize a differential diagnosis following a clinical encounter
EPA 3: Recommend and interpret common diagnostic and screening tests
EPA 4: Enter and discuss orders and prescriptions
EPA 5: Document a clinical encounter in the patient record
EPA 6: Provide an oral presentation of a clinical encounter
EPA 7: Form clinical questions and retrieve evidence to advance patient care
EPA 8: Give or receive a patient handover to transition care responsibility
EPA 9: Collaborate as a member of an interprofessional team
EPA 10: Recognize a patient requiring urgent or emergent care and initiate evaluation and management
EPA 11: Obtain informed consent for tests and/or procedures
EPA 12: Perform general procedures of a physician
EPA 13: Identify system failures and contribute to a culture of safety and improvement
Academic Year 2019-20
- Period 1 - July 1 - 26, 2019
- Period 2 - July 29- Aug 23, 2019
- Period 3 - Aug 26 - Sept 20, 2019
- Period 4 - Sept 23 - Oct 18, 2019
- Period 5 - Oct 21 - Nov 15, 2019
- Period 6 - Nov 18 - Dec 13, 2019
- Period 7 - Dec 16, 2019 - Jan 10, 2020
- Period 8 - Jan 13 - Feb 7, 2020
- Period 9 - Feb 10 - Mar 6, 2020
- Period 10 - Mar 9 - Apr 3, 2020
- Period 11 - Apr 6 - May 1, 2020
- Dean's Colloquium - May 7-8, 2020
- Commencement - May 10, 2020
Academic Year 2020-21
- Period 1 - June 29 - July 24, 2020
- Period 2 - July 27 - Aug 21, 2020
- Period 3 - Aug 24 - Sept 18, 2020
- Period 4 - Sept 21 - Oct 16, 2020
- Period 5 - Oct 19 - Nov 13, 2020
- Period 6 - Nov 16 - Dec 11, 2020
- Period 7 - Dec 14, 2020 - Jan 8, 2021
- Period 8 - Jan 11 - Feb 5, 2021
- Period 9 - Feb 8 - Mar 5, 2021
- Period 10 - Mar 8 - Apr 2, 2021
- Period 11 - Apr 5 - 30, 2021
- Dean's Colloquium - May 6-7, 2021
- Commencement - May 9, 2021
Registration is completed through the Office of Student Affairs and Admissions at the School of Medicine & Health Sciences. Tuition and fees will be charged according to a published schedule.
- By February 14, students meet with advisor (Campus Dean and/or Associate Dean of Student Affairs and Admissions) to select a tentative schedule. The tentative schedule must be coordinated, reviewed, and approved by Campus Dean.
- By March 4, the Campus Dean will meet with the student to review the schedule.
- Between March 7 – April 1, preceptors will review and approve requested rotations.
- The approved schedule will be mailed to the student by May 2.
- Schedule changes requested by students and preceptors should be completed by May16. If changes are requested after that date, the instructions outlined below for filing a Senior Elective Change Form must be followed.
- The Campus Dean confirms the rotations with the preceptors between May 16 and June 3.
- A finalized schedule is submitted to the student, advisors and preceptors by June 3
When a senior elective change is requested after May 16, it will require written approval from the following persons and/or office, using the Senior Elective Change Form and requesting the signatures in the sequence listed below:
- Administrative office of assigned campus
- Preceptor and department chairperson of new elective
- Preceptor and department chairperson of original elective
- Campus Dean
- Associate Dean of Student Affairs
Note: Electives cannot be changed any later than one period prior to the start of the next elective period. Dropping an elective after the thirty-day period requires that vacation time be used to offset the cancellation of the elective. (The thirty-day period commences when the form is submitted to the student's Campus Dean.)
To register for a senior elective that is offered on another UND School of Medicine & Health Sciences Campus, the student should contact his/her Campus Dean's administrative office for assistance. The Campus Dean's administrative office will request the off-campus elective and coordinate arrangements with the student, the off-campus Dean's Office, and the Office of Student Affairs and Admissions to finalize the student's schedule and to assure he/she is registered appropriately for the off-campus elective.
Students will use VSAS to apply for away electives at participating schools. To obtain instructions for filing for a senior elective to be taken at an out-of-state institution not participating in VSAS, students must contact their home Campus Dean's office. Students are responsible for scheduling and making all necessary arrangements for senior electives under the direction of the other institutions. The students also are responsible for any additional required fees incurred for out-of-state electives. The campus office will review the application materials and forwarded necessary forms to the appropriate administrative offices. Upon notification, the Office of Student Affairs and Admissions will register the student for this elective. Away electives must be affiliated with an LCME accredited school.
Course acronyms and numbers for fourth-year electives are identified as follows.
- ANAT - Anatomy
- BICH - Biochemistry
- MBIO - Microbiology
- PHAR - Pharmacology
- PHY - Physiology
- FMED - Family Medicine
- MED - Interdisciplinary
- IMED - Internal Medicine
- NEUR - Neurology
- PSYB - Psychiatry and Behavioral Science
- OBGY Obstetrics & Gynecology
- PATH Pathology
- PED Pediatrics
- RAD Radiology
- SURG Surgery
For more information, please contact the appropriate campus office.