The medical school timeline can be confusing and understanding all the important extracurricular requirements medical students need to meet can be intimidating. Not every US medical school has the same curriculum, but the general timeline is the same. We break it down below:
The Ultimate Medical School Timeline Breakdown
The 4-Year Overview
Every medical school has its own curriculum and its own approach to teaching the essential foundations of medicine. But all medical students must take the USMLE (US medical licensing examinations), broken into 3 separate exams (Step 1 after year two of medical school, Step 2 after third year of medical school, and Step 3 after the first year of residency training).
Because of this, all students must learn the same material and clinical skills at similar points in their medical school timeline (before the scheduled USMLE exams). The general breakdown of this timeline is highlighted below.
Year One
The first two years of medical school consist primarily of lectures and course material with little clinical exposure. The idea is to cover the “foundational sciences” of medicine before students begin seeing patients and focusing on clinical skills. The first year is often the most challenging year for medical students as they struggle to adjust to the rapid pace of the medical school curriculum.
Because of this, many students will choose to focus exclusively on their academics and do not pursue extracurricular research or shadowing opportunities. This is perfectly okay. But for those who adjust well to medical school in their first year, connecting with physicians and professors at your university can be a great way to find opportunities for research and shadowing outside of class.
The summer before the first year of medical school and the summer after the first year of medical school are the only summers students will have during the medical school (and residency) experience. So many students use this time to gain extracurricular research or clinical experience.
Year Two
In the second year of medical school, students will complete their basic clinical sciences course material and begin to study for USMLE Step 1, the first of three exams required to attain US medical licensing. USMLE Step 1 is a written exam that will generally cover all the material students should have learned in these first two years of medical school.
Many medical schools set aside “dedicated” time at the end of the year for students to prepare for Step 1, but many students find it not enough time to adequately prepare. Therefore, most students will get a head start on studying for the USMLE Step 1 exam in January, alongside their last few modules of coursework. Students will then take the exam between February-April.
While it is possible to retake the exam if a student does not pass their first attempt, most medical schools will require students to have received a passing score before beginning third year clinical rotations.
Year Three
The last two years of medical school consist primarily of 4-8 week clinical rotations, with an exam following each rotation in each department. This is to give students the opportunity to gain the clinical skills needed to apply what they learned the first two years of medical school to real-life patient cases.
Having completed all the “core” rotations in each department, students should start considering which medical specialty they may be interested in pursuing by the end of their third year. Read more about choosing a medical specialty here.
Students will also take the second of the three exams required for US medical licensing, USMLE Step 2. Again, schools often set aside “designated” study time for students to prepare for this exam. But many students will begin preparing early.
The fourth and final year of medical school generally consists of “elective” rotations. This is an opportunity for students to gain more clinical experience and to explore areas of medicine that may not have been covered in their core rotations third year. For example, after rotating in pediatrics third year, a student may decide they want to pursue an elective rotation in neonatology their fourth year (a pediatric subspecialty).
In addition to continuing clinical rotations, fourth year also involves residency program applications. Read more about choosing a residency program here.
Having decided which specialty (or specialties) they are interested in, students can begin researching residency programs in the summer entering their final year. Students may begin submitting applications in September through the centralizing residency application service, ERAS.
Interviews are scheduled from fall through the spring. Students then submit their program rank list by early March, and The Match is released approximately 2 weeks later.
Final Thoughts
The medical school timeline can vary slightly from school to school, but important events like USMLE Step exams and residency applications are standard for all US medical students. But in addition to coursework and exams, students should use their medical school years to explore their clinical interests, find a specialty they’re passionate about, and connect with physicians and researchers doing work they admire.
