Fourth Year Clerkships

The fourth year consists of eleven four-week blocks and a two-week winter break.

Fourth year required experiences are listed below. One block of the fourth year should be scheduled as independent study for the USMLE Step 2CK and CS. A course in Advanced Cardiac Life Support must be successfully completed before graduation.

All third year clerkships must be completed before taking required fourth year courses. Remediation of core clerkships must be completed no later than November 1 of the academic year of anticipated graduation.

Before graduation, students will be asked to complete the AAMC Graduation Questionnaire. Although it is a voluntary survey, student responses help RWJMS and are important for the accurate collection of local and national data.

→ Overview of the Fourth Year Requirements

 Academic Calendar 2019–2020

 Academic Calendar 2020–2021

→ 4th Year Electives

Advanced Cardiac Life Support

Advanced Cardiac Life Support (ACLS) is an intensive course that presents a systematic approach to dealing with patients experiencing a cardiopulmonary emergency or sudden death. It emphasizes a rapid and coordinated strategy for resuscitation providers regardless of the size of the team. The methods presented rely on a uniform set of protocols and guidelines based on the newest scientific evidence in cardiovascular medicine and resuscitation from the American Heart Association in collaboration with the International Liaison Committee on Resuscitation.

Current basic life support certification and familiarity with emergency pharmacology and basic ECG interpretation are firm prerequisites and essential for success in the course.

Successful completion of ACLS is a requirement for graduation. NOTE: 3rd Year Medicine Clerkship is a pre-requisite for taking ACLS.

Selective in Critical Care

The Selective in Critical Care is the culmination of the required experiences in both Surgery and Medicine, providing the student with the opportunity to apply the knowledge learned in the third year and gain additional experience in the direct clinical management of acutely ill patients in a critical care environment. This Selective is focused on the “acute” patient in the intensive care unit. The student will actively participate on a critical care team in a surgical or medical unit working with faculty and other care providers. The educational experience will include supervised clinical experiences, didactic lectures, case based learning and self-study.

Emergency Medicine Clerkship

The 4 week Emergency Medicine Clerkship is required during the fourth year. Students will develop diagnostic and therapeutic skills in an emergency department setting and will address: Medical Knowledge, Patient Care, Professionalism, Communication and Interpersonal Skills, Practice Based Learning and Improvement, and Systems Based Practice. Students will demonstrate skill in completing an appropriately tailored history and physical exam in the emergent setting, the ability to synthesize an appropriate differential diagnosis for some of the most common emergency department complaints (chest pain, shortness of breath, abdominal pain, blunt trauma, and altered mental status) and create an appropriate workup and treatment plan for these patients. Students must demonstrate a basic understanding of the role of emergency ultrasonography in patient care, the role of prehospital care in trauma and chest pain patients and use ED patient care experiences along with appropriate educational resources to improve their understanding of emergency medicine.

Neurology Clerkship

The Neurology clerkship is an exciting 3-week clinical experience, and is required during the fourth year, if not taken in third year. Recent advances in the understanding of diseases of the nervous system are expanding our ability to help patients. New technologies, particularly in neuroimaging, are enhancing our ability to localize and define neurological disorder and solve diagnostic challenges. An expanding array of treatment options allows neurologists to make a substantive impact in their patients' quality of life and longevity. It remains a discipline that requires detailed and accurate history taking and physical examination skills; a discipline in which a diagnosis can be made given enough knowledge of applied anatomy and pathology.

During this clerkship students will be taught the elements of a complete neurological history and physical examination. Students will learn to interpret findings and to develop a differential diagnosis based on these findings; the appropriate use of diagnostic testing to verify or clarify a diagnosis and the basics of neurological therapeutics. This will be accomplished by direct patient contact in clinics and hospital services, by informal teaching rounds, and by a series of didactic case-based conferences. 

Patient Centered Medicine IV

Developing the skills to be an effective teacher is essential for every physician. The goals of the PCM IV course are to prepare senior medical students for their role as teachers and to reinforce the attitudes, skills and knowledge accumulated to date as they teach patient-centered care to others. 


A four week Sub-Internship is required of all fourth year students. Sub-internships that satisfy this requirement must be designated as a "sub-internship or acting internship" in one of the following disciplines: Family Medicine, Medicine, Obstetrics and Gynecology, Pediatrics, Psychiatry or Surgery. Acceptable sub-internships provide a broad base of experience that is primarily inpatient and where the pathophysiology of disease is emphasized in teaching by attending physicians and residents. Students serve as true acting interns with one-on-one reporting to a resident and attending physician.

Transitions for Fourth Year

Transitions to the Fourth Year (Clinical Correlates) is a 5 day course designed to prepare medical students for the fourth year of medical school. Students are required to complete the Summative OSCE, EMR Training, FIT testing, PPD placement, and ACLS course during the week. Additionally, students are given the opportunity to provide feedback to improve their clinical sites

Boot Camps

Every fourth year student has a boot camp experience in the field that best prepares them for their internship year. This experience provides a great opportunity to learn practicalities and increase your comfort in transitioning from a fourth year student to a first year resident. The bootcamp curriculum focuses on preparing students for the tasks, procedures, and skills that their residency will expect them to perform. Boot camps are offered in block 9 and block 10.