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Undergraduate Medical Education: Fourth Year

The fourth year is composed of six 4-week clerkships, one week of PCM, and four 4-week electives. These clerkships allow for increased responsibility in patient care as well as the opportunity to pursue areas of individual interest. The electives provide students with the opportunity to select the clinical or basic science experiences to best meet their particular career goals.

M4 Year

Course Name


Credit Hours

Principles of Clinical Medicine VI



Ambulatory Medicine

4 weeks


Surgery Specialties

4 weeks


Specialty Clerkship

4 weeks


Senior Clerkship in Medicine

4 weeks


Senior Clerkship in any of the required M3 Clerkships

4 weeks


Longitudinal Scholars’ Project (M1, M2, M3, & M4 years)



Capstone Course

4 weeks


Required Electives

16 weeks

28 (7 each)


12 weeks





* Elective Programs: 16 weeks of half-time/full-time electives are required. Electives are available in Memphis, Chattanooga, Jackson, Knoxville, and Nashville.

M4 Course Descriptions


PCM-3002/F Principles of Clinical Medicine VI (1 credit hour).

Designed as a continuing medical education (CME) model. The goal is to provide direction for students in developing the skills necessary to become life-long learners and the ability to share their learning as effective teachers in both the academic as well as the community setting.

Successful completion of the curriculum includes both required and optional didactic and experiential components. Workshops include interdisciplinary topics such as HIV/AIDS, hospital nutrition, end-of-life/palliative care, smoking cessation, integrative medicine, and medical disabilities. The course is graded pass/fail. 


MED1-3002/F - Senior Clerkship in Medicine (7 credit hours).

The Senior Clerkship in Medicine places the student in a more direct role in patient care similar to an internship, but closely supervised and directed. The senior clerkship student will record the principal database (with resident or faculty review and counter signature), develop an evaluation and treatment plan, and write orders on patients (to be reviewed, altered if necessary, and signed by the resident or faculty prior to implementation).

The student is introduced to responsibility for inpatient care in a setting in which the student is the initial evaluator of the patient's problems as outlined in the general instructions. The student develops conceptual and manual skills for evaluation and care of internal medicine patients and becomes more familiar in dealing directly with hospital and other paramedical personnel with an appreciation for the team approach to patient care. The student participates in two-hour rounds at least four days per week with the attending physician assigned to the service and consults daily with the resident house staff on each assigned patient. This clerkship also is offered in Knoxville (MED2-3002/F), Chattanooga (MED3-3002/F), and Nashville (MED4-3002/F).


MED1-3003/F - Ambulatory Care (7 credit hours).

The objectives of the ambulatory clerkship are to provide: 1) an in-depth orientation to the evaluation, management and long-term clinical course of common medical problems which are handled by internists; 2) guidelines for recognizing common clinical problems which may be cared for in an ambulatory setting versus those which require hospitalization and/or referral for specialty or subspecialty care; 3) instruction in the unique principles of successfully providing medical care in the ambulatory setting; and, 4) instruction in health maintenance, disease prevention, and relevant clinical epidemiology.

The student will work in a variety of clinical areas including general medicine clinics at the Regional One Health and Veterans Affairs Medical Center. There are also opportunities to participate in the Adult Special Care Clinic, Sickle Cell Clinic, Hypertension Clinic, and many of the subspecialty clinics such as Cardiology and Endocrinology. The student may spend some time with an internist in private practice. This clerkship also is offered in Knoxville (MED2-3003/F), and Chattanooga (MED3-3003/F).

SUR1-3002/F - Surgery Specialties (7 credit hours). This clerkship exposes the student to the Surgery Specialties of Orthopedics, Ophthalmology, Otolaryngology and Urology. The clerkship is available in Knoxville (SUR2-3002/F), and in Chattanooga (SUR3-3002/F). The clerkship is graded pass/fail.
Senior Clerkship 

Senior Clerkship (FME, MED, OB/GYN, PED, PSY/NEURO, URO, OTO, SUR) (3010/F to 3012/F) (7 credit hours).

Students are required to take a 4-week experience in any one of the core clerkships.


SPE1-3001/F - Specialty Clerkship (7 credit hours).

This clerkship is offered in each block throughout the calendar year. Students will have a week each in Anesthesiology and ICU unless either has been taken in a previous block. Then students may substitute Infectious Disease or Cardiology. The students will have a two week rotation in Palliative Care. The clerkship is graded pass/fail. This clerkship is available in Knoxville (SPE2-3001/F) and Chattanooga (SPE3-3001/F).


IDE1-4040/F - Capstone Course (7 credit hours.)

This is a face-to-face clinical rotation offered in Block 5, Block 8, Block 10, and Block 2. The course includes opportunities to review basic science concepts in the framework of clinical cases, Legal Issues in Medicine, and TBL’s focusing on the business of medicine using the HealthCare Handbook written by medical students Askin and Moore. Guest faculty will discuss health care reform, insurance, regulatory agencies and being a member of a hospital staff. An EBM component will help improve student skills in searching the literature to answer clinical questions. Intern school will focus on skills to prepare students for life as a house officer, including radiology review, ECG review, on-call emergencies, line placement and intubation skills, and the opportunity for ACLS certification. A teaching academy component will review teaching and learning techniques for residency and beyond; the five-minute preceptor, how to give feedback, and other teaching techniques. The course is graded pass/fail. This clerkship will be available in Knoxville (IDE2-4040/F) and Chattanooga (IDE3-4040/F) in Block 2.


Electives (7 or 3.5 credit hours each).

Sixteen weeks of two-week (half-time) or four-week (full-time) elective work are required and normally taken during the senior year. Both basic science and clinical electives of varying lengths are offered in a variety of settings with maximal learning opportunities. During this time, each student has the opportunity to: 1) select experiences that meet individual career goals, 2) study in depth in a clinical or basic science area, and 3) have increased responsibility in patient care under the direct supervision of the faculty. Electives are offered by the University of Tennessee, UT-affiliated hospitals, and (with approval) at other accredited medical schools.

For more information, view the Electives Catalog.

LSP1 3004

LSP1 3004 – Longitudinal Scholar’s Project (1 credit hour), longitudinal course for the Fall and Spring term of year four.

The Longitudinal Scholar's Project (LSP) clerkship is a longitudinal clerkship spanning the four years of medical school. The course will introduce medical students to three basic areas: health research, patient safety and quality improvement (PSQI) and community and global health.

The clerkship involves a longitudinal project in one of the three areas and culminates in a graded poster presentation. Rather than have every student participate in each category, the clerkship provides the students with a foundation of basic understanding in research, patient safety and quality improvement and community/global health, while requiring each student to do a project in one area to be presented at any time during medical school. The poster may be presented at a committee approved poster venue.

May 26, 2022