Students use the time in Year Four to complete core rotations and the following requirements:

• A sub-internship in a core discipline. Every clinical department offers sub-internships, during which students assume the role of the intern on a hospital-based team, usually with fewer patients and more direct supervision.
• Advanced Critical Care Clerkship. Students have a core didactic and simulation curriculum for this rotation, and choose from nine different intensive care units for the clinical experience.
• Transition to Residency and Internship and Preparation for Life (TRIPLE). This two-week capstone course is offered twice in April of Year Four.

The remainder of time during Year Four is often used for residency interviews and additional clinical electives.