The third and fourth years of med school are spent in the clinic or hospital. The 3rd year is one of the hardest but most fulfilling times in a physician's training, as this is the first real experience with direct patient care. Rounding consists of taking vital signs, asking the patient how he or she is doing, examining the patient, then writing a progress note in the chart. After rounds and teaching, it's off to the clinic, operating room, labor and delivery unit, or library. While students are allowed to do some procedures, surgeries are conducted by residents with the attending physician supervising and assisting.
Call can be brutal.
Some schools have gotten away from 36-hour call, but others have not. Although much of the third year is hard, some rotations during the third year are less demanding than others, with hours ranging from 40-50 per week and only a few days of call per month. The fourth year is spent in many elective rotations and is much easier than the third year. There is almost always much less call, less stress, and more time to concentrate on selecting a specialty to practice. Some students actually spend a month or two at another hospital or city.