How Long Is Medical School? M.D. Degree Timeline

Medical students smiling at the camera

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A typical medical school program takes roughly 4 years to complete. However, the timing can vary depending on the institution, if you elect to take additional courses or a leave of absence, or pursue additional training like a Master’s of Public Health (MPH) degree.

While obtaining an M.D. degree will take only 4 years, physicians are also required to complete training in a residency program, which can last up to 7 additional years, depending on the specialty. Even after completing a residency program, many also go into subspecialty fellowship training programs, which may take a couple of additional years to complete. With required continuing medical education courses and ongoing skill training, the educational journey of a doctor never really ends. The following information summarizes the M.D. degree timeline and what happens during each year of medical school. 

Years 1 and 2: Pre-Clinical Coursework

The first two years of medical school will be spent focused on science training. The time may be split between listening to lectures in the classroom and hands-on learning in the lab. During this time, in-depth education will explore the basic sciences, like anatomy, microbiology, chemistry, and pharmacology. Lectures will review the detailed knowledge of body structures, how functions manifest through physiology, and the interplay of different systems. Knowledge of medical concepts, diagnoses, and treatments for a wide variety of medical conditions will be built on this foundation. Much of the high-level knowledge obtained from these science and lab courses will be applied in practice patient interactions, like obtaining medical histories or conducting physical examinations. 

The structure of the medical school curriculum can look different depending on the specifics of the program. In some schools, there may be a singular focus on one topic for 4-6 weeks before moving on to the next. Other medical schools may arrange 4 to 5 different courses to occur all at once, extended over a longer period of time. The structure of the curriculum and personal learning styles and preferences may be important to consider when choosing a medical school

During the second year of medical school, students begin preparing for the United States Medical Licensing Examination (USMLE) Step 1. This exam is one of three tests that must be taken to demonstrate basic competence in the scientific disciplines and clinical practice of medicine. It is necessary to be well-prepared for questions on the concepts and mechanisms behind health, disease, and therapies. Most medical students take the Step 1 exam near the end of the second year, before starting clerkship rotations.

Aside from coursework, the first two years are spent getting accustomed to the new pace of medical school, developing friendships and study groups, and learning more about medicine and long-term professional interests.

The last official summer break for medical students, who ultimately spend decades in education and training, happens between the first and second years of medical school. Many students use this time to relax a bit and have fun. Some take vacations, get married, or even have children during this summer. It is also quite common for students to pursue research opportunities or volunteer work. This time may also be used as a preview to clinical rotations. Students may choose to seek out externships offered by the school, or they might reach out to faculty in a specialty of interest. Foreign language classes or other extracurricular interests may also be engaged.

Year 3: Clinical Rotations Begin

The hands-on training—called clinical rotations or clerkships—begins in the third year of medical school. This is when the real fun of medicine begins! Instead of spending most of the day in a lecture hall, classroom, or lab, the medical student transitions to time spent in the hospital or clinic. During these rotations, exposure to general patient care as well as a variety of specialties across a wide range of patient populations occurs. In most medical school programs, there are a core set of standard rotations required of every student. The following are some of these common basic or core clerkships: 

  • Family Medicine: Delivery of comprehensive, generalized healthcare, usually in a clinical setting, to men, women, and children.
  • Internal Medicine: Focused on disease prevention, diagnosis, and treatment among adults, possibly with both a clinical and hospital practice, often used by medical students and residents as a foundation to specialty training (cardiology, pulmonary, infectious disease, gastroenterology, etc.).
  • Pediatrics: Responsible for the delivery of comprehensive healthcare to infants, children, and teenagers, usually in a clinical or hospital setting.
  • Radiology: Specializes in using various modalities of medical imaging for the diagnosis of diseases and treatment planning.
  • Surgery: The application of surgical techniques in an operating room to treat or manage a variety of surgical conditions impacting any part of the body as well as post-operative care of hospitalized patients and those seen after discharge. 
  • Neurology: Specializes in the diagnosis and treatment of disorders of the brain and nervous system.
  • Psychiatry: Specializes in the diagnosis, treatment, and management of patients dealing with mental disorders.
  • Obstetrics and Gynecology: Specializes in delivering healthcare to women, diagnosis and treatment of conditions affecting the female reproductive organs, and managing pregnancies, deliveries, and postpartum care. 

Depending on the medical school, its location, and the surrounding hospitals and resources, there may be some very unique experiences and opportunities. For example, if you are in a more urban city, you may have rotations in emergency or trauma medicine. 

By the end of the third year, it is possible to find a niche and select a specialty area for ongoing training with rotations during fourth year. Clinical rotations are a good time to consider interests as well as values, and develop skills that will help to select the types of residency programs to pursue. It is also a great time to do things that may never be done again, but the memories and experiences shall persist.

During the third year of medical school, it is also important to prepare for the USMLE Step 2 exam which is usually taken at the end of the year or early in the fourth year. The test assesses the knowledge acquired during general internal medicine rotations, the understanding of the principles of clinical science, and basic clinical knowledge and interpersonal skills, like communicating with patients or conducting physical examinations. This exam is split into two categories: Step 2 CS (Clinical Sciences) and Step 2 CK (Clinical Knowledge).

Year 4: Final Year and Residency Matching 

Clinical rotations will continue during the fourth and final year of medical school. It is common to pursue electives that fit long-term career interests and strengthen an application to residency programs. This is a typical time to complete sub-internships, also called “audition rotations.” During these clinical rotations, performance in a preferred specialty may be scrutinized and evaluated. It may help to strengthen a future letter of recommendation or even secure a position in the specialty program for continued training after graduation. These rotations can also happen at any institution in the country, allowing for an audition to an outside program that may be appealing for residency training. 

While clinical rotations continue, it is also time to prepare the residency applications. Similar to how medical school applications are submitted through AMCAS, residency programs of interest are selected and applications are submitted through ERAS. The application typically opens around September 5, and residency programs can begin receiving applications around the 15th of September. In compiling the application, a medical student will choose residency programs of interest and rank them. After in-person interviews are completed, which usually occurs between October and February, these programs will submit their own ranking of desired applicants. 

Based on a computer algorithm that compares these two sets of rankings, it will be possible to determine the best match between a candidate and an open residency position. During the Match Day ceremony, which typically occurs in March, medical students across the country open an envelope to learn their residency match and where they will spend the next years of their lives completing the required medical training. 

After Medical School 

Most residency programs begin at the start of July, with orientation in late June. Newly minted medical doctors may have some time off to transition to their new programs. Many choose to take a little vacation time before starting the next phase of their education and training. 

During the first year of residency, time will be dedicated to prepare for the last USMLE exam, known as Step 3. This final exam must be passed in order to obtain an official medical license, useful to become recognized by a state medical board, and will grant the ability to practice medicine without supervision. Clinical medical knowledge, and how it is applied in an outpatient setting, is the last component of this required 3-step testing. This exam is the least difficult of the tests and is usually taken at the end of the first year, or during the second year, of the residency program.

Sources and Further Reading