Medical School Timeline

We recognize that schools have varying curricula, with some taking the more traditional approach of starting clerkships after two years of preclinical study, and others initiating clerkship rotations after a year of preclinical work. For clarity, we will refer to the clinical training year, or traditional third year, as the clerkship year, regardless of when it begins at your institution.

Third Year/Clerkship Year

Beginning of Year: Start clinical rotations!

This is an exciting year where you finally gain experience in a clinical setting. Be a sponge and learn as much as you can in every specialty, as this will be your last chance to do many exciting things in medicine: deliver a baby, work through a differential on teaching rounds, or perform a well-child exam. You never know how these experiences can help inform your future practice.
The keys to this year are simple: work hard, have a good attitude, show up on time, be respectful, and do everything that you can to contribute fully to your team and patient care.
If you're considering surgery, the standard recommendation is to schedule your surgical rotation in the middle of the year—early enough to leave time for research but late enough to have some clinical experience. That said, many schools don't offer scheduling flexibility, and attitude and effort matter far more than timing.

Mid- to Late Year

Begin narrowing down your specialty of interest, choose a specialty-specific advisor, and consider what sub-internships you may want to do in your final year of medical school.
Explore opportunities for research projects with surgical attendings and start to identify potential letter writers. You will need three letters, and while you can obtain a letter from a surgical attending in your clerkship rotation, you will also have opportunities to get letters in your final year from sub-internships or surgical research advisors.
Consider whether you might want to do an away rotation at another institution and apply if interested.

Late Year

Plan your fourth year accordingly (see section on electives) and set up any surgery sub-internships early in your final year (May through August) so attendings can write your letters of recommendation before application deadlines.

Electives

Value of Electives During Medical School

After completing your required clerkships, you will have the opportunity to take electives. While the beginning of your final year will focus on surgical sub-internships, including building knowledge and skills while obtaining letters of recommendation, you will have remaining time to pursue additional electives.

Most program directors agree that this remaining time should be spent gaining exposure to areas you will not encounter during surgical residency. Frequently recommended electives include anesthesia, radiology, intensive care, pathology, emergency medicine, and cardiology. Consult the American College of Surgeons' Prerequisite Objectives for Graduate Surgical Education to identify your gaps and arrange your electives accordingly.

An increasing number of medical schools conclude with a capstone experience or a preparatory curriculum for intern year, some tailored specifically to surgical interns. If your school offers one of these programs, take advantage of it.

"Away" or Audition Electives

Most general surgery programs do not require an away rotation, but many surgical subspecialties strongly recommend completing at least one audition rotation at an institution other than your home program. Talk with your advisor and mentors about whether this makes sense for you. Deadlines vary by institution, so explore opportunities early and apply where appropriate.

Audition rotations can be valuable for assessing whether a program is a good fit, but they come with real challenges. It is tough to learn a new system quickly, integrate into an unfamiliar team and culture, and perform at your best, often without established support structures. As with any rotation, your attitude and work ethic will be important components of your success.

Fourth/Final Year

May–August: This is the primary time for your surgery sub-internships.

Apply the same principles: work hard, maintain a great attitude, and aim to perform at the level of a surgical intern—that will be your job next year!
Ask identified surgical mentors for letters of recommendation.
Seek program recommendations from attendings and advisors.

June: The residency application process opens, and you can log on to familiarize yourself with the interface.

Begin drafting your personal statement. This will be important to share with attendings who will be writing your letters of recommendation.
Start identifying and writing about your most important experiences so that you are prepared to submit your application in the fall.
Begin building your program list with guidance from mentors.

September: The residency application submission begins!

Pay attention to deadlines because it is very important that you submit on time!
Remind your letter writers of the deadline.

October-November: Interview invites are sent and the first interviews begin.

It is important that you respond to interview invites promptly and keep a detailed calendar of dates to avoid conflicts. This can be challenging because you will also be completing other rotations at this time.
Talk to your mentors about other rotations that might be useful for your career in surgery. Typical considerations include anesthesiology, radiology, pathology, and cardiology.

November–January: Peak interview season.

Consider blocking one month for interviews, or schedule lighter rotations or research electives during this window.

January–February: Rank list season.

Start making your rank list and take part in second-look visit opportunities at programs that you are seriously considering in the match.
Submit your rank list by the late February/early March deadline—watch for the exact date each year!

March-April: Match Day comes in March!

Continue completing your electives so that you can graduate on time.
Complete all onboarding paperwork for your new program promptly.
Begin planning your move if relocating for residency.
Complete your final medical school rotations for graduation.

May-June: Graduation!