4th Year Curriculum Overview


Ambulatory Medicine:

Students are required to do one month in an Internal Medicine ambulatory setting. These rotations take place in the community as well as in hospital based clinics. The dates and locations for this clerkship are assigned by lottery in One45. Because of the fact that there are limited locations available for this rotation in a given month the rotation is generally full every month. Students are advised to give careful consideration to the consequences before dropping this rotation since it may be very difficult to get into another month prior to graduation. Many students have had to delay their graduation by a month to complete this rotation after dropping the course earlier in the year.

Emergency Medicine:

Students are required to do a one month rotation in Emergency Medicine. These rotations take place in a variety of hospitals throughout the states including hospitals on all of the regional campuses. Like Ambulatory Medicine, the dates and location of this rotation are assigned through the One45 lottery process. While not as limited as Ambulatory Medicine, this rotation too can fill up so students should again consider the consequences before dropping. Spots on the Augusta campus are limited to students declaring EM during the months of July, August, and September.


Critical Care:

Students must complete a rotation in Critical Care during their 4th year. Since this is a selective, students do have some choice about which course to take much like an elective. Unlike an elective, however, there are only a limited number of courses which will fulfill this requirement. For a complete list of the specific courses please refer to the elective bulletin, but currently Critical Care courses are offered in the Departments of Anesthesia, Medicine, Neurology, Pediatrics, and Surgery. Please note a change from previous years is that, while the Anesthesia Critical Care course will continue to count for Critical Care, the General Anesthesia course will not count. Signup for these courses follows the same signup process as electives. Students need to complete a Course Form and return it to the department sponsoring the course.


Students are required to take a one month sub-internship. Like the Critical Care course this course allows students to choose from a list. Currently the Sub-I is offered in the Departments of Family Medicine, Medicine, Neurology, Obstetrics and Gynecology, Pediatrics and Surgery. The complete list of qualifying courses is in the elective bulletin. Signup is done using the same process as electives


• Students are required to complete 4 elective months in Phase 3 prior to graduation – 1 in 3rd year and 3 in 4th year (or all 4 in 4th year for those who defer their 3rd year elective).
• These courses are offered in a variety of different departments and on all campuses. All courses are listed in the elective bulletin.
• Signup for these courses is done using the MCG Sponsored Course Form or the Extramural Course Form depending on the type of course. These forms are returned to the departments using email and then forwarded on after approval to the Curriculum Office.
• Students must complete all of the required paperwork and be registered in the course prior to the start date in order to receive credit for the course. Retroactive credit is not granted for paperwork that is late.
• Students may take more than the required number of courses as long as time permits, but they must be registered in all courses (even if they do not plan to get credit) in order for malpractice to cover them.
• Augusta based students must take at least one course on campus (two if they deferred their 3rd year elective to the 4th year). For the purpose of this distinction, on campus refers to MCG, the VA, University and Trinity. Regional campus students should check with their campus leadership for on campus requirements.
• Students may only count one research course and one international course toward graduation, regardless of length of the course and number of courses taken.
• Many students take courses at other medical schools – referred to as away electives, audition electives, or VSAS electives. In order to get credit toward graduation for more than one of these electives in the same department, they will need to complete an Application for Graduation Credit form and submit the form to the Curriculum Office for approval. As a part of this submission, students should turn in paperwork to demonstrate a sufficient difference in content of the two courses (Ex: adult patients one month and pediatric patients another). It is very rare for students to get credit for more than two of these courses in the same department.

Scheduling Process

The scheduling process for students starts in January of their 3rd year when they begin to declare a sponsoring department – the department in which they plan to pursue a residency. While it is not mandatory that a student declare a department until June those who wish to take advantage of the prelottery selection must do so by the end of the first week of January. The prelottery selection is a process by which the sponsoring department assigns all of the students for that department to a rotation within the department on the main campus for one of the first 3 months of the academic year. This allows the students to get letters from members of the academic faculty within their chosen field prior to the start of the academic year. After this, the lotteries for Ambulatory Medicine and Emergency Medicine are run at the beginning of February. Once this is complete and reviewed by the departments, the results are released to the students and the signup process for the remaining courses opens and remains open until the students have graduated.

Advisors Meetings

It is mandatory that students meet with advisors from their sponsoring department to discuss their schedule plan for the year. While this meeting can take place at any time, there is a worksheet that must be completed and signed by the advisor which includes information about the Ambulatory and EM lotteries. This is set up so that students know the timing of these courses as well as the course within their chosen field when they talk with their advisor. Students cannot be registered for any courses in the Curriculum Office before this meeting has occurred. Meetings can take place in person or via phone or other means of communication. Forms can be completed and turned in via email.


During the 4th year, students are allowed to change their schedule as many times as they wish by utilizing the drop/add system. Courses can be added to the schedule at any time up to the start of the course providing there is space in the course and the appropriate paperwork is submitted in time. In order to drop a course, students must first discuss with their advisor their plan to drop the course and get at least an email acknowledgement from the advisor of this discussion. This email along with the form indicating the plan to drop must then be submitted to the Curriculum Office. The deadline for paperwork to reach the Curriculum Office is 6 weeks prior to the start of the two clerkships (Ambulatory and EM) and 4 weeks prior to the start of all other courses. Without special permission, students who do not meet these deadlines will have to withdraw from the course and this will be noted on the transcript. They are also not permitted to register for another course during the month if they withdraw.


• Students must complete Step 2 CK and CS prior to December 15th of their 4th year
• Students must take a Phase 3 OSCE, arranged through the Clinical Skills Office, during the fall of their 4th year
• 3 days of excused absence are allowed from all 4th year rotations with the appropriate arrangements made with the course director to make up the missed days. Residency interviews, Step 2, and Phase 3 OSCE are considered excused absences for the purposes of this requirement.
• Students may postpone the shelf exam in one of the two clerkships (Ambulatory or EM) by up to one month as long as they provide one week’s notice and the reason would be considered an excused absence.

Please feel free to contact me if you have any questions or concerns about the 4th year curriculum in general or about a specific advisee.

Chris Fly, M.D.
Director of 4th Year Curriculum
GB 3355 706-721-1776