An individual student's fourth year schedule is determined by the rank order requests submitted in the spring of third year. Electives offer fourth year students an opportunity to fill some educational gaps or explore some new interests. Elective grades are not factored into the school' s internal ranking order. Electives may be taken in any pre-approved medically reputable facility in any part of this country or abroad. Each spring, most American medical schools produce a book listing electives available at their institution for visiting students.
Many hospitals also send brochures describing electives.
Students have gone abroad for work in Asia, Europe, Latin America and Africa. Additionally, the American Medical Student Association publishes booklets listing opportunities abroad. Fourth year students must take Step II of the United States Medical Licensing Examination and have a score reported to the school as a prerequisite for graduation. Any student who had difficulty with or was marginal in Step I, should schedule an elective block of independent or formal study to prepare adequately for the examination. Students also engage in intensive counseling and preparation for residency applications in various specialties for the Match.