University of Missouri School of Medicine MU Health School of Medicine


The fourth year consists of three one-month advanced clinical selectives (sub-internships), in the core disciplines, four one-month general electives, and a one-month Advanced Biomedical Sciences (ABS) course. One of the advanced selectives must be in a surgical area and one must be in a medical area. A minimum of four fourth-year courses (including 2 advanced selectives) must be taken under the supervision of Columbia-based School of Medicine faculty (refer to page 49 of the Student Handbook).

The fourth year consists of two groups of advanced selectives and general electives.

Advanced clinical selectives

Three advanced clinical selectives from the core disciplines of child health, family medicine, internal medicine, neurology, obstetrics and gynecology, psychiatry and surgery are required. Each selective is four weeks in length. One must be in a surgical area and one must be in a medical area. Advanced clinical selectives build on the knowledge and skills acquired during third-year core clerkships. Students are expected to assume more responsibility for patient care than in the core blocks.

Advanced basic science selectives

Advanced basic science selectives revisit the biomedical sciences in the context of a patient, disease, diagnosis or problem. Four options are available. Students may

  • Search and analyze the literature, integrate and evaluate data, produce a paper or presentation
  • Conduct original research with mentors from the basic or clinical sciences.
  • Attend a series of graduate-level lectures and discussions of current literature.
  • Function as co-tutors for PBL, attend tutor preparation sessions and write a PBL case.

General electives

Sixteen weeks of general electives are required. Off-site experiences are available but must be approved by the appropriate department.

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