Students working in Skills Lab

Curriculum by Program Year

Mix of Clinical and Classroom Training, Right from the Start

The curriculum in the Elson S. Floyd College of Medicine prepares you to succeed in a wide range of health care environments. Partnerships with hospitals and clinics make possible a rich diversity of classroom and clinical experiences. Whether you practice in a large urban hospital or as the sole physician in a rural setting, you will know how to deliver health care that achieves outstanding outcomes for your patients and your community.

Years 1 and 2: Basic Science and Clinical Training

In the first two years of medical school, you will study the foundational sciences for medicine, integrated with the fundamentals of clinical practice. Through classroom lessons based on clinical cases, as well as your own clinical experiences, you will build the foundational knowledge you need to succeed as a clinician.

First Year

Intensive introductory training

Your medical education begins with an orientation program that will set the stage for your time in medical school. Orientation is capped by a moving White Coat Ceremony where your family and friends join with the College faculty and staff to welcome you to the medical profession. Your learning will begin with a variety of educational formats including a heavy emphasis on small group and case-based learning. Your course in leadership earning you a Certificate in Leadership by the time of graduation will also start. Each week includes sessions in the art and practice of medicine where basic clinical skills will be learned along with topics such as medical ethics and professionalism. Evidence-based medicine sessions will also be provided on a weekly basis to help you master an evidence-based approach to clinical practice, population health, biostatistics and career-long learning.

Clinical Experiences in the First Two Years

Before you arrive to start classes, you will have the opportunity to rank your preferences among the four campuses where you will complete most of your clinical training. At the beginning of the program, you receive your clinical campus assignment: Everett, Spokane, Tri-Cities or Vancouver.

During the first year you will have three week-long clinical sessions at your regional campus clinical sites working along-side seasoned physicians. This very early immersion in clinical settings brings classroom lessons to life. By the time you have completed your first two months of medical school, you will begin to understand how it feels to be a physician.

Summer Break

During the summer of your first year, you will enjoy a break from scheduled classes. During that time, you will have opportunities to complete electives in clinical or research settings. Your electives may take place at the College or elsewhere.

Second Year

Expect to broaden and deepen your knowledge of foundational medical sciences in second-year courses. At the same time, look to gain even more experience in clinical settings, with additional weeks at your regional clinical campus. You learn how to support your clinical decisions with the scientific principles you learned in classes.

Licensing Exam, Part 1 of 3

Near the end of your second year, you will be provided over four weeks of dedicated study time to allow focused final preparation just prior to taking the first part of a 3-part national test, the United States Medical Licensing Examination (USMLE). This part tests your fundamental knowledge in the medical sciences. You must pass all parts of the USMLE before you can practice medicine as an MD in the United States.

Years 3 and 4: Clinical Immersion

During the final two years of study, the focus of medical education shifts heavily to the clinical curriculum. You and your fellow students will move into ambulatory and in-patient hospital settings to function as junior members of the medical team. Closely supervised by practicing physicians and residents, you will diagnose and treat patients. You will put into practice the basic science knowledge and clinical skills learned during your first two years.

High Level of Interaction with Top Clinicians

In most medical education programs, third- and fourth-year students typically learn the most from residents—physicians-in-training who are only a year or two out of medical school. In Washington State University’s Elson S. Floyd College of Medicine, medical students train largely in community-based hospitals and clinics that do not have large residency programs. As a result, you will learn primarily from seasoned clinician faculty preceptors. Students in similar MD programs report that they develop a true “sense of companionship” with their preceptors*. They get more hands-on experience. They receive constant feedback from physicians with decades of experience and become trusted associates. Students become more confident and acquire the expertise of a resident long before they begin their residency.

Staying Close to Home

If you have roots in the State of Washington, you do not have to worry that you will be sent beyond the border for your clinical clerkships. Throughout your medical education, your clinical experiences will take place in Washington, although in the fourth year students may select doing elective experiences outside of the state and even at international sites.

*“Community-based medical education: Is success a result of meaningful personal learning experiences?” by Len Kelly, Lucie Walters, David Rosenthal, Education for Health, 2014, Volume 27, Issue 1, pages 47-50

Third Year

During your third year, you will experience all the key fields of medicine as part of your clinical clerkships. It is a chance to test drive career options and find the field that’s the best fit for you.

What You Do as a Clinical Clerk

  • Improve your history-taking and physical examination skills
  • Write orders on charts
  • Write progress notes
  • Present patients verbally to your medical team and faculty
  • Discuss issues with patients and their families
  • Perform procedures

Required Longitudinal Integrated Clerkship, Year 3

Unlike traditional clerkships, in which medical students may briefly visit with patients while shadowing a mentor, Longitudinal Integrated Clerkships (LICs) allow students to follow patient cases on a longitudinal basis. This model infuses the curriculum with meaning for students. It fosters bonds between the student and patient, as well as between the student and teacher.

New and Innovative Approach

LICs are a relatively new and innovative concept in clinical learning. In the year 2000, only 5 medical schools in the U.S. reported having LICs. But by 2014-15, LICs had been adopted at 44 LCME-accredited schools nationwide. The Elson S. Floyd College of Medicine faculty includes experts in the LIC model. The college is proud to be one of a handful of progressive U.S. medical schools that has adopted the LIC as its primary clinical training model for all students.

Advantages of LICs

  • Retaining empathy: Medical educators theorize that students who do LIC clerkships retain empathy to a greater degree than students who participate in traditional clerkships.
  • Improving recall: LICs allow students to interweave, or alternate between, topics and return to them at spaced intervals over weeks or months. According to learning theory, students better retain information learned in this context.
  • Building strong relationships with patients and preceptors: As a student in one of the College’s clinical learning communities that include Everett, Spokane, Tri-Cities or Vancouver and locations close by, you will experience continuity in your experiences with patients and preceptors. This ongoing interaction allows you to build meaningful relationships. You will find that it helps you to:
    • Build self-confidence
    • Take ownership of your own learning
    • Take initiative in patient care environments
    • Trust in your growing capabilities
    • Participate more fully in patient care

Licensing Exam, Part 2 of 3

At the end of your third year or during your fourth year, you will take the second part of the USMLE examination. This segment of the test assesses how well you can apply medical knowledge, skills and understanding of clinical science to care for patients while working in a supervised environment.

Fourth Year

In your final year, you will focus on advanced clinical work, zeroing in on your areas of interest. For example, if you want to become an orthopedic surgeon, you might choose an elective in orthopedic surgery and allow a few extra weeks for the clerkship. That way, you’ll have extra experience to showcase when you apply for residency.

Required Core Clerkships and Rotations, Year 4

You will receive training in emergency medicine and in the care for underserved populations in either the rural or urban environments, complete your leadership capstone and scholarly projects, and explore a range of other areas of medicine.

Elective Rotations

Elective rotations take the form of electives and sub-internships.


You will work in the hospital as an intern, but with more responsibilities than you had in your third year. You will be supervised more directly by a senior-level physician than before. You will be given more leeway in decision-making and charting. All students must complete one sub-internship but may do more than one depending on their personal preferences.

Applying to Residency Programs

During the first part of the fourth year, you will submit your applications through the National Residency Matching Program (NRMP). This organization is made up of key academic medical oversight agencies and medical student associations.

The steps are:

  • Applying: You send an application form, a personal statement, letters of recommendation, and USMLE test scores to the residency programs of your choice.
  • Interviewing: You go through a round of interviews.
  • Ranking: Both you and the residency programs to which you apply submit a ranking list.
  • Matching: You are matched with the highest-ranked residency program that has also lists you as desirable and acceptable.

Special Note

Licensing Exam, Part 3 of 3

Typically taken at the end of the first year of residency, the third and final USMLE examination assesses whether medical school graduates can apply medical knowledge and understanding of biomedical and clinical science essential for the unsupervised practice of medicine, with emphasis on patient management in ambulatory settings.  Again, you must pass all parts of the USMLE before you can practice medicine as an MD in the United States.