Year 3

​4th Year Planning

During your third year

  • Familiarize yourself with the Specialties an​d Subspecialties list on our website.
  • Use the tools and resources available in the Exploring Options section of AAMC-CiM site.
  • ​Explore the AAMC-CiM “Specialty Pages” list for detailed information of the 128 specialties and subspecialties.
  • Visit UWSOM’s Departmental web​​sites and the list of UWSOM Department Medical Student Clerkship opportunities.
  • ​Ask our SOM Career Advisors and the Departmental Career Advisors listed in the Career Advisors FAQ in your identified specialty to give you an honest appraisal of your chances. Every year across the country there are students who don’t match because of a disconnect between their academic records and their career choice.


​​​​​​​​Consider specialties

Medical students explore many specialties during their clerkships. During each rotation, pay attention to what interests you. Do you enjoy continuity of care, certain procedures, certain types of illnesses, seeing immediate results, having long term relationships with patients, figuring out diagnostic puzzles, caring for people in the context of their community, addressing issues of mental well-being, prevention, working with the underserved, working with children, etc.? Continue to re-evaluate your interests as you go through each clerkship and get more data. Don’t be afraid to change your mind. Many students alter their earlier specialty choices during their 3rd year.


Before deciding on your fourth-year schedule

  • Check the Career Advisors FAQ document to see what each specialty recommends in terms of electives.
  • Talk to the departmental career advisors in your area of interest to get additional information on how you can be successful in the Match.


If you are undecided at the end of your third year

  • Schedule an appointment to meet with one of our UWSOM Career Advisors. It’s helpful to discuss this process as it can be stressful. Your college mentors are also available to provide guidance and support.
  • Use FRIEDA Online which is a database of over 8700 accredited graduate programs. It includes Physician Workforce information as reported by residents and practicing physicians in every specialty.
  • Write a personal statement for each specialty you are considering. See if one flows more easily and you feel more engaged in the process of writing it. This might offer you a clue about where your deeper interest lies.
  • Remind yourself that you can apply to programs in two different specialties which will give you until rank day to decide which one is your first choice. Be aware that this path may increase the number of interviews that you will have to do in your 4th year (unless you clarify your decision before interviews begin) and will increase the expense as you apply to more programs.
  • Use the following tools on AAMC’s Careers in Medicine website: Exploring Options, Choosing a Specialty, Getting into Residency, Specialty Indecision Scale


Study for the Step 2 Exams

Think ahead about letters of recommendation

On clerkships in which you have done well or that you have already identified as your specialty choice, stay in touch with the physicians who knew your work best. Ask them to write you a letter of recommendation while the clerkship experience is still fresh in their mind. Some faculty offer to write you a letter after you complete the clerkship. This is a good time to say yes!

Sub Internship:


In general, Sub I’s are a good way to show residencies that you can handle more independent medical decision-making.  They can be particularly significant for those who have not gotten Honors in their relevant clerkship. Talk to your departmental advisor about how important they are in your specialty of choice.

These rotations are unofficially called “audition electives” so choose to do one in a residency where you have a reasonable chance of matching. You aren’t maximizing the advantages of a this opportunity if you choose the most competitive residency in the country and you don’t have the academic record to be considered a residency candidate. In competitive specialties, you might talk to your UW classmates and consider signing up for different Sub I’s from one another, as that might increase your chances of matching.

Remember, you can make a negative impression as well as a positive one in a Sub I. At all Sub I’s, work hard, be congenial and friendly, be a great team member, be positive, treat everyone from physicians to the janitorial staff with respect, and show initiative. Residents are looking for future colleagues and practice partners, and they usually have considerable influence on the rank list. It’s essential to demonstrate that you are a great team player.

Should I do a Sub I at UW?

Competitive specialties will often expect you to do a Sub I at your home institution, no matter what grade you received in your clerkship. Talk to your departmental advisor to see what they advise given your Step 1 scores, your grades and specialty-specific expectations. You can also review the Career Advisors FAQ  to find out what is generally recommended in terms of Sub I’s for each discipline.

Should I do an “away Sub I”?

Again, please consult with your departmental advisor as you make this decision. There are pros and cons to all Sub I’s, although in highly competitive programs, there is often the expectation that you will do an away Sub I in addition to one at UW. Advantages include meeting faculty and residents in a residency that you are interested in matching at, learning about the program firsthand, and making yourself known to the program. Talk to departmental career counselors for advice on good Sub I’s outside the UW system. Remember to request that your most important elective/Sub I is scheduled early, in the summer through the fall. While your grade may not make it into the Dean’s letter, you will be able to update your ERAS application with your subsequent grades and you will expand the list of physicians from whom you can request a letter of recommendation.