Stage Four: Career Preparation | NYU Grossman School of Medicine | NYU Langone Health

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MD Curriculum Stage Four: Career Preparation

Stage Four: Career Preparation

In stage four of NYU Grossman School of Medicine’s curriculum, students spend 11 months on several career-preparation activities including the completion of required rotations in a critical care clerkship and a subinternship that offers vital experience in advanced patient care. 

Students also use this time to prepare for residency interviews; finish clinical electives, selectives, and scholarly concentrations; and take the U.S. Medical Licensing Examination® (USMLE®) Step 2.

Stage Four: Career Preparation Curriculum

Critical Care Clerkship

In a four-week critical care clerkship, you develop the knowledge, skills, and experience you need to care for critically ill patients. You are assigned to a specialty intensive care unit and become an active member of the care team. Responsibilities include daily teaching rounds and following, assessing, and treating critically ill patients. Grades include honors, high pass, pass, and fail.


Another component of stage four of the MD curriculum is a four-week subinternship in one of three areas—advanced medicine, advanced surgery, or advanced pediatrics. During the subinternship, you take on patient-care responsibilities that exceed those in your core clerkships. This helps you excel during the internship year of your upcoming residency. Subinternship responsibilities may include taking overnight calls, admitting patients, and entering orders. Grades include honors, high pass, pass, and fail.

Advanced Medicine Subinternship

The advanced medicine subinternship provides additional training and experience in managing the care of hospitalized patients on an internal medicine inpatient ward. It better prepares you for a residency in internal medicine or, if that is not your eventual destination, offers a final opportunity to study internal medicine before you complete residency training in another area. 

Advanced Surgery Subinternship

The advanced surgery subinternship provides additional training and experience in general surgery. It also fulfills the subinternship graduation requirement for students applying for a residency in general surgery or another surgical specialty. 

Advanced Pediatrics Subinternship

The advanced pediatrics subinternship is for students who have successfully completed their pediatrics clerkship and are interested in additional pediatrics training and experience. It also fulfills the subinternship graduation requirement for students applying for a residency in pediatrics. 

USMLE Step 2

The USMLE® Step 2, the second part of the three-step exam for medical licensure, is divided into two sections. The clinical knowledge section, the USMLE® Step 2 CK, assesses medical knowledge and scientific concepts as they are applied to patient diagnoses and care, health maintenance and management, and disease prevention. It is administered in eight one-hour blocks during a single day, with 45 minutes of break time and a 15-minute tutorial session. 

In the clinical skills section, or the USMLE® Step 2 CS, a series of standardized patient encounters tests your ability to gather information from patients, perform physical exams, and communicate findings to patients and other members of the healthcare team. It is similar to the comprehensive clinical skills exam