M4 Advance Training
The goal of the Phase 3/ Post-Clerkship fourth year of medical school is to solidify clinical competence, complete career preparation, foster personal growth, and prepare for transition from medical student to resident physician.
Objectives and Requirements
- Refine Clinical Skills
- Apply advanced diagnostic reasoning, management, and communication skills in real-world settings.
- Function more independently with greater clinical responsibility
- Prepare for Residency
- Explore specialties through electives and away rotations.
- Opportunity to finalize career path
- Demonstrate Readiness for Internship
- Prepare for transition from student to resident physician.
- Develop professionalism, time management, and team communication.
- Grow Personally and Professionally
- Reflect back on your journey and ahead to new roles.
- Gain exposure beyond chosen specialty to broaden and balance the overall educational experience.
Students must complete a total of 32 weeks of credit during their fourth year
- A total of 4 weeks of Internal Medicine Acting Internship
- A total of 4 weeks of a Specialty Acting Internship
- A total of 12 weeks of Intensive Clinical Experience
- A total of 12 weeks of General Electives
- An additional 20 weeks is considered unscheduled or flex time, which is time to be used for interviews, vacations, or other personal use.
Students must complete a total of 36 weeks of credit during their fourth year.
- A total of 4 weeks of Internal Medicine Acting Internship
- A total of 4 weeks of an Acute Care Experience
- A total of 4 weeks of the Transition to Residency Course
- A total of 12 weeks of Intensive Clinical Experience
- A total of 12 weeks of General Electives
- An additional 20 weeks is considered unscheduled or flex time, which is time to be used for interviews, vacations, or other personal use.
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Core Components of 4th Year
Students mimic the role of an intern under the careful supervision of an attending physician and senior level resident physician. Acting Interns (AI) are the primary caregiver for patients, performing the history and physical, creating a differential, writing the orders, and managing the patient’s care. The AI also participates in call, cross coverage, and patient care transitions. Students are required to take an acting internship in Internal Medicine as well as taking a second acting internship from a specialty of their choice: anesthesiology, emergency medicine, family medicine, gynecology, internal medicine, neurology, obstetrics, pediatrics, psychiatry, or surgery. Beginning with the Class of 2028 only the AI in Internal Medicine will be required and a second specialty AI can be applied toward Intensive Clinical Experience credit.
Defined as intensive, direct patient care experience providing more than 20 hours/wk of direct clinical/patient care experience and responsibility. Designed to teach medical students the importance of actively participating in the care of a patient and the health care team. Students devote face-to-face patient interactions serving as a member of the medical team.
Students choose electives in various specialties that will support their interests as well as broaden and balance the overall educational experience.
Students can receive Phase 3 credit at other institutions by completing an away rotation (“audition”).
Defined as unscheduled time which students can apply toward interviews, vacation, etc.
- Provide students the opportunity to recognize a patient requiring urgent or emergent medical care.
- Learn how to evaluate and treat patients with potentially life-threatening and/or complex conditions under appropriate supervision with potential exposure to bedside procedures.
- Students will choose either medical/surgical Critical Care OR Emergency Medicine to achieve this four-week requirement.
- Equip graduating medical students with practical knowledge, clinical skills, and professional competencies needed to confidently and effectively transition from medical school to residency training
- Specialty-specific, just-in-time training to support the transition from the role of student to a physician ready to assume increased responsibility for patient care.
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M4 Advanced Training: Acting Internships
Clerkship Director:
Peirce Johnston, MD
Email: peirce.johnston@uc.edu
Clerkship Coordinator:
Sonya Kirkland
Email: kirklasy@ucmail.uc.edu
The student will provide clinical care to patients with psychiatric disorders (i.e. bipolar disorder, schizophrenia, anxiety disorders, etc.
Clerkship Director:
Thomas James, MD
Email: thomas.james@uc.edu
Clerkship Coordinator:
Julie Karpe
Office: Medical Sciences Building Room 3054
Phone: 513-558-2426
Email: karpeje@ucmail.uc.edu
Students are exposed to all aspects of general anesthesia, same day surgery, and PACU, including evaluation and management throughout the immediate perioperative period.
Clerkship Directors:
John Campbell, MD
Email: campbejb@UCMAIL.UC.EDU
Clerkship Coordinator:
Paula Klepper
Office: Medical Sciences Building Room 1654
Phone: 513-558-8996
Email: kleppepd@ucmail.uc.edu
Working one-on-one with faculty and senior residents, students will care for patients across the whole spectrum of acuity in the ED and simulation center and perform a variety of procedures. In this course, students learn how to approach the undifferentiated patient and build patient management skills by functioning as interns, formulating their own plans, placing orders, and documenting on all patient encounters.
Clerkship Director:
Anisasattara Shomo MD
Email: drshomo@gmail.com
Clerkship Coordinator:
Nancy Jamison
Office: Medical Sciences Building Room 4304
Phone: 513-558-1435
Email: nancy.jamison@uc.edu
The student will be an active team member of the Family Medicine Inpatient Service which cares for over 200 patients per month. Students will participate in general medicine inpatient care and consultations.
Clerkship Directors:
Jane Morris, MD
Email: morri4j9@ucmail.uc.edu
Clerkship Coordinator:
Natalie Cassady
Office: Medical Sciences Building Room 4461
Phone: 513-558-7653
Email: cassadnc@ucmail.uc.edu
The gynecology AI is a member of the Gynecology or Gynecologic Oncology team at UCMC or Bethesda North Hospital. The student participates in surgeries and follows patients postoperatively. Inpatient and emergency department consults are also provided. They participate in specialty clinics as well. Weekend rounding will be required.
Clerkship Directors:
Jane Morris, MD
Email: morri4j9@ucmail.uc.edu
Clerkship Coordinator:
Natalie Cassady
Office: Medical Sciences Building Room 4461
Phone: 513-558-7653
Email: cassadnc@ucmail.uc.edu
Working closely with faculty and senior residents, the student will care for patients across the whole spectrum of acuity and across the entire admission for patients on Labor & Delivery. In this course, the student will learn how to approach the undifferentiated obstetric patient and build patient management skills by functioning as an intern. The L&D AI will manage patients from admission to delivery and throughout the inpatient postpartum course while learning how to perform procedures such as a spontaneous vaginal delivery, cesarean section, OB laceration repair, etc.
Clerkship Directors:
John Quinlan, MD
Email: john.quinlan@uc.edu
Starla Wise, MD
EMail: wises3@ucmail.uc.edu
Clerkship Coordinator:
Angela Bustamante
Office: Stetson
Phone: 513-558-2968
Email: bustamam@ucmail.uc.edu
The student will function as the primary caregiver in the inpatient setting as part of a team of residents and faculty. The student will complete admission orders, history and physicals, diagnosis, follow-up care, and discharge planning under the supervision of attending faculty and senior residents. Will attend neurology resident conferences.
Clerkship Directors:
Jane Morris, MD
Email: morri4j9@ucmail.uc.edu
Clerkship Coordinator:
Natalie Cassady
Office: Medical Sciences Building Room 4461
Phone: 513-558-7653
Email: cassadnc@ucmail.uc.edu
The obstetrics AI is a member of the OB Specialist (low-risk OB) or Maternal Fetal Medicine (high-risk OB) services at UCMC or Good Samaritan Hospital. A gradual increase in responsibilities and complexity of postpartum, antepartum, and triage patients occurs over the 4 weeks. Students assist with preparing for Planned Procedures, which may include circumcisions. Students may also assist on vaginal deliveries and C-sections. The weeks may be divided between days and nights depending on the service and enrollment. Night or weekend rounding will be required.
Clerkship Director:
Corinne Lehmann, MD
Email: corinne.lehmann@uc.edu
Clerkship Coordinator:
Mimi Pence
Office: Kasota 553 (Cincinnati Children’s Burnet Campus)
Phone: 513-636-0339
Email: mimi.pence@cchmc.org
The student will function at the level of an intern on in inpatient pediatric team. The student will admit new patients, perform history and physical exam, input orders in EPIC, provide follow up care, cross cover patients, and discharge patients. The student will follow an intern schedule with regards to daily and overnight responsibilities as well as attend all resident conferences.
Clerkship Director:
Latifa Silski
Email: sagesila@ucmail.uc.edu
Clerkship Coordinator:
Nikki Norman
Office: Medical Sciences Building Room 1586
Phone: 513-558-2134
Email: normanno@ucmail.uc.edu
This course provides both inpatient and outpatient experience in general surgery at the acting internship level with preoperative, intra and postoperative exposure to a wide variety of patients.
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Amy Guiot, MD, MEd
Professor, Cincinnati Children’s Hospital Medical Center
Phase 3 Curriculum Director

Contact Us
Office of Curriculum Managementand Integration
Medical Sciences Building Room G453 - G456
231 Albert Sabin Way
PO Box 670520
Cincinnati, OH 45267-0520
Mail Location: 0520
Phone: 513-558-1795
Fax: 513-558-4949