Year 4 Medical Students

Planning Guide

Welcome to your final year of medical school! This year is a time to decide upon a specialty, choose to take elective courses in the medicine you are interested in exploring, travel to other medical schools or out of the country for learning experiences, interview for residency, learn where you'll be for the rest of your training and finally, graduate. The 4th Year Class page has links to many of the resources you will need in preparation for residency and graduation.

Competetive Specialties

Be in close communication with your clinical advisor and clinical mentor to set up your Year 4 schedule.

Plan a home school sub-internship in your specialty choice early in Year 4.

Timing of USMLE Step 2:

  • Most students should plan to take Step 2 early in year 4. You are most prepared for the content at the end of Year 3.
  • If your Step 1 score was above 250, students can postpone USMLE Step 2 until later in the fall. You won't need it to get interview invitations. Remember, programs must have this exam score well before ranking lists are determined. Time your test so your score is reported no later than January 1. USMLE Step 2 scores usually are reported within three weeks of your test date, but are not guaranteed to be reported in this time.
  • Talk with your clinical advisor and Student Affairs for more information and advising based upon your academic record.

Away electives are required for competitive specialties. Plan two away electives, possibly three, depending upon your competitiveness for your chosen specialty.Prioritize programs for your away applications.

  • Strength of program
  • Faculty/alumni connections
  • Academic versus community based
  • Geographic considerations:  Students applying to competitive specialties will need to apply nationally. Geographic bias can impact students. Plan at least one away elective outside of the Western region to show programs you are serious about relocation.
  • Make sure you'll have exposure to chief resident or program director at your away
  • Call or email program to make sure you meet with elective screening criteria - usually USMLE Step 1 scores.
  • Be confident in your preparation from UNR Med. Most UNR Med students "shine" and perform very well while on away electives, which is why our Match looks so good each year!

Remain in constant contact with Student Affairs regarding your application strategy, interview preparation, rank order lists and parallel planning. When applying to a competitive specialty, it is imperative that you are aware of your match risk and are open to discussions regarding a parallel plan.


Strategies for Success

  • Metrics aligned with specialty
  • Interview preparation
  • Proactive communication with advisors and Student Affairs
  • High level of professionalism
  • Leadership
  • Open to feedback
  • Seeks out feedback
  • Seeks information and diverse viewpoints

Presentations and Resources

Nuts & Bolts for Applying to Residency Presentation PPT 

Class of 2020 Nuts & Bolts for Applying to Residency Presentation Recorded (begin at 13:00 minutes)

Financial Exit Interviews - debt management workshops are required for all senior medical students who took out federal loans during medical school. These workshops are held each March or April of senior year.


January - March 2019

January 30, 2019

Attend Specialty Advising Workshops
Schedule 1st  meeting with Career Advisor to discuss specialty choice and fourth year schedule
Explore options for away electives, if desired
Attend Year 4 Elective Planning Workshop
March - May 2019  Rural rotations finalized by March 15, 2018
Begin applying for away electives through VSLO 
Plan Step 2CK and CS exam dates
April 9, 2019 Electronic Residency Application Workshop & Tutorial 
May-June Schedule MSPE meeting 
Work on your personal statement and CV
Ask for LoRs
Complete assessments for MSPE meeting
Finalize Year 4 Away Elective Decisions
Finalize Step 2 CK and CS exam dates
July -September Schedule 2nd meeting with Career Advisor to review program selection, application strategy, and personal statement prior to MSPE meeting
Work on ERAS application, finalize program selection
Check-in with LoR writers
Order transcripts from UNR and USMLE
Register for NRMP
June - October Monthly Interview Preparation Workshops
August 15, 2019 ERAS Q&A - online chat
September 15, 2019 Submit ERAS application
September 25-30 Review draft MSPE prior to release on October 1
October - December Respond to Residency Interview Survey Requests #1 and #2
November 30 = Deadline to Register for NRMP
December 1 - Deadline to change 4th year schedule for Fall
December 15, 2019 Deadline to take Step 2 CK and CS
January- February Schedule 3rd meeting with Career Advisor to discuss Rank List
January 10, 2020 - SF Match Results Released
February 1 - Deadline to change 4th year schedule for Spring
February TBD Preparing your Rank List Workshop
February 28, 2020 Submit Rank List
March 20, 2020 Match Day!