Students working in Skills Lab

Curriculum by Program Year

Integrating Clinical Training with Classroom Learning from the Start

At Washington State University’s Elson S. Floyd College of Medicine, the MD program curriculum integrates classroom learning and community-based clinical training beginning in the first year to prepare future physicians to succeed in a range of health care environments and achieve outstanding outcomes for their patients.

In the pre-clerkship years, Years 1 and 2, students study the fundamental medical sciences and are introduced to clinical practice and their regional medical campuses. In the clerkship years, Years 3 and 4, students transition to their clinical campuses and are immersed in clinical experiences through a third-year Longitudinal Integrated Clerkship (LIC) and fourth-year required rotations (12 weeks) and elective rotations (24 weeks).

“We have designed our curriculum to expose students to patients in clinical settings from the first term of medical school until graduation. Our goal is exposure to care in common health care environments and exposure to areas of highest need in our state.”

Kimberly Beine, MD, Interim Associate Dean for Curriculum

Pre-clerkship Years: Foundational Sciences and Clinical Training

In the first two years of medical school, the focus of the program is classroom learning, with integrated exposure to clinical settings. You will study the foundational sciences of medicine and the fundamentals of clinical practice to develop the essential knowledge and skills you need to succeed as a physician.

Clinical Experiences in Years 1 and 2

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

During the pre-clerkship years, you will visit your assigned campus for one week per term to become familiar with the community’s health care infrastructure and to train with experienced health care professionals. You will also spend one half day per term in a clinical setting in Spokane. This early exposure to clinical settings enables students to put classroom lessons into practice.

Year 1

Your medical education begins with a week of orientation that introduces you to the program, your peers and instructors, and the range of resources available to support your learning and well-being during your time in medical school. Orientation week concludes with a moving White Coat Ceremony where your family and friends join the college faculty and staff to welcome you to the medical profession.

Intensive Introductory Training

First-year students complete intensive course work in fundamental medical sciences including anatomy, physiology, pathology, pharmacology, and more, learning about human body systems and the prevention and treatment of associated health conditions. Your coursework will include the art and practice of medicine, where you learn clinical skills, medical ethics, professionalism, and about health equity and other topics.

Course work employs a variety of educational formats: large-group classroom learning, case-based small-group learning, and simulation-based clinical skills training at the Virtual Clinical Center. Courses for the leadership curriculum and scholarship and discovery curriculum also begin in Year 1.

Summer Break Elective and Research Opportunities

During the summer of your first year, you will enjoy a break from scheduled classes and will have the opportunity to take an optional elective or engage in your scholarly research.

Year 2

Second-year students broaden and deepen their knowledge of foundational medical sciences through course work that explores more body systems and applies concepts at a deeper level. You continually review prior content and apply it in new contexts as your medical knowledge grows. Additionally, you continue to develop your competence in medical and scientific knowledge, patient care and health promotion, professionalism and self-awareness, practice-based and lifelong learning, systems-based and interprofessional practice, and interpersonal and communication skills.

Licensing Exam, Part 1 of 3

Near the end of your second year, you will have seven weeks of dedicated study time to prepare for the first part of a three-part national exam, the United States Medical Licensing Examination (USMLE). This part tests your knowledge of fundamental medical sciences. You must pass all parts of the USMLE before you can practice medicine as an MD in the U.S.

Clerkship Years: Clinical Immersion and Specialization

In the final two years of medical school, the primary focus of the program shifts from classroom learning to learning in the clinical setting. You and your fellow students will relocate to your respective regional clinical campuses for the Year 3 Longitudinal Integrated Clerkship followed by Year 4 which includes required rotations (e.g., a sub-internship of choice) and 24 weeks of elective rotations. As a junior member of health care teams in outpatient and inpatient settings, you will put your foundational medical science knowledge and clinical training into practice diagnosing and treating patients, closely supervised by practicing physicians.

Work Closely with Top Clinicians in the Community

In the community-based medical education model, our students complete most of their clinical training in community clinics and hospitals throughout Washington and beyond, primarily learning from practicing physicians and other health care professionals.

This contrasts to most medical education programs where third- and fourth-year students learn primarily from residents, physicians in training who have only recently finished medical school. Our training sites do not generally have large residency programs, providing more opportunities for our students to learn from professionals with decades of experience who serve as faculty preceptors.

Students who receive community-based training report numerous benefits, including increased hands-on experience, frequent feedback, and a true sense of companionship with preceptors. Through the community-based model, you will acquire the confidence and expertise of a resident long before beginning your residency.

Year 3

The third year consists of a Longitudinal Integrated Clerkship (LIC) at your regional medical campus. Clerkships expose students to various aspects of patient care, allowing them to develop their clinical skills through hands-on experiences. You will increase your competency in clinical skills including taking histories, conducting physical examinations, formulating diagnoses, documenting encounters, writing orders, performing procedures, and communicating with patients, families, and colleagues.

Students gain clinical experience in six clinical care domains during the LIC

  • Care of the Ambulatory Adult Patient
  • Care of the Hospitalized Patient
  • Care of the Patient with Obstetric or Gynecologic Needs
  • Care of the Patient with Psychiatric Needs
  • Care of the Pediatric Patient
  • Care of the Surgical Patient

A New and Innovative Approach to Clinical Training

Longitudinal Integrated Clerkships have numerous advantages compared to traditional block clerkships. While a block clerkship focuses on one clinical domain for a set period before rotating to another, the LIC incorporates multiple clinical domains over the course of a year, allowing students to form deeper relationships with patients and preceptors and hone clinical skills over a longer period of time.

Year 4

In the final year of the program, students continue immersive and increasingly personalized clinical experiences through a sub-internship, required rotations, and elective rotations, learning more advanced clinical skills and focusing their attention on a particular primary care domain or specialty of interest.

Students choose a sub-internship and elective rotations to suit their educational and professional goals. For example, if you want to become a pediatrician, you may choose a pediatrics sub-internship and electives in neonatology, adolescent medicine, and pediatric emergency medicine.

Required Sub-Internship and Rotations in Core Disciplines

A sub-internship is a clinical experience similar to a traditional block clerkship rotation, but with additional responsibilities for students as they practice under the supervision of a physician. The sub-internship helps prepare students for their internship, which is the first year of residency.

All students are required to choose one of six disciplines for their four-week sub-internship
  • Family Medicine
  • Pediatrics
  • Internal Medicine
  • General Surgery
  • Obstetrics and Gynecology
  • Psychiatry

Students also complete a four-week rotation in emergency medicine and a four-week rotation in the care of underserved populations in either a rural or urban environment.

Elective Rotations in Patient Care, Research, or other Learning Experiences

In addition to the sub-internship and two required rotations, students choose additional elective rotations (2-week or 4-week) for a total of 24 weeks of electives in Year 4. Students choose electives from more than 100 options, including rotations in most medical specialties and varied health care settings, domestic and international away rotations, research activities, and virtual courses. Students may design their own rotation to take with administrative approval.

Applying to Residency Programs

During the first part of the fourth year, students submit residency program applications through the National Residency Matching Program to continue training in their clinical domain of interest after earning their medical degree. You are allocated time during Year 4 to travel for residency interviews.

Licensing Exam, Part 2 of 3

During the fourth year, students also take the second part of the USMLE. This part of the exam tests your understanding of clinical knowledge. The third part of the exam, which tests your ability to practice unsupervised, is typically taken during the first year of residency.