The Fourth Year of Medical Education: A Literature Review

Despite representing a substantial proportion of the student experience, the fourth year has received significantly less attention than other phases of the curriculum. The authors conclude that goals for the year should be clarified, reflect the mission of the school, and be designed to both complete the medical school experience and facilitate the transition to residency. Schools should decide the types of courses and organization of the year based on these goals. Organizational strategies for the fourth year should incorporate the requirements of the United States Medical Licensing Examination examinations and the residency application process. Fourth-year curricula and their constituent courses should be well designed and stringently evaluated to ensure educational goals are met and appropriate grades awarded.