School of Medicine

Wayne State University School of Medicine

Year Three


Career Planning Goals in Year 3:

1)   Adjust to the Year 3 curriculum, balancing clinical learning with preparation for NBME subject exams  
2)   Meet with your Class Counselor each semester to discuss specialty interests
4)   Continue to complete Self-Assessment exercises and explore specialties on the Careers in Medicine website
5)   Consider participating in the School of Medicine's Mentoring Program as a peer mentor
6)   Participate in Specialty Interest Groups to explore fields of medicine you are considering
7)   Consult with SOM faculty advisors in your areas of interest
8)   Set up observerships with faculty members in the specialties you are considering that are not part of core clerkships
9)   Update your Curriculum Vitae (CV)


 Year 3 Orientation

 Year 3 Orientation is conducted prior to the beginning of your first clerkship in July.  You will be introduced to clinical learning and given many tools to assist you to achieve success in Year 3. You will also attend a one time Site Orientation for your clinical campus on the 1st day of Year 3 Orientation.  Attendance is mandatory at both events.  On the first day of your clerkships you will attend clerkship orientation, which is also mandatory.

 Clerkship Evaluation

 During your Year 3 required clerkships you can earn a grade of Satisfactory (S), Satisfactory with Commendation (S+) or Honors (H).  Your evaluation is based on several components but most importantly your academic performance (the score on your NBME shelf exam) and your overall clinical performance.  To earn Honors you must receive an outstanding rating in both of these factors, along with other criteria as set by the each clerkship’s department.  You may earn Satisfactory with Commendation by achieving an outstanding rating in either your academic performance or your clinical performance.  To achieve a Year 3 Comprehensive Grade of Honors, you must earn Honors for a minimum of six months, not including the Continuity of Care Clerkship or elective month.  For more information about the Year 3 curriculum and grading policies, please consult the Year 3 Curriculum Guide.

 Year 3 Elective

 You are required to take one elective month during Year 3.  This can be a very important month for your medical specialty decision if you are applying to a field other than the required clerkships (Family Medicine, Internal Medicine, Neurology, Obstetrics/Gynecology, Pediatrics, Psychiatry & Surgery).  You will be contacted at the appropriate time to register for this elective directly with a representative of the Office of Records & Registration.  You will be given a list that details the electives you are allowed to take as Year 3 student and how to make your selections.  In many cases, you cannot take an elective until you have completed the required clerkship in that specialty.  You are allowed to take the Year 3 elective month off  if you choose, but you will then will need to take the Year 3 elective during Year 4.  This will result in only 2 vacation months in Year 4, rather than the usual 3 months.  For those who have co-curricular credit and choose to use it, you will have 4 months off in Year 4, but only 3 months of vacation if you postpone your Year 3 elective.

 Year 3 OSCE

 You will participate in an Observed Structured Clinical Exam during Year 3.  These will be scheduled through the Clinical Skills Training Center and occur at various times during Year 3.  Many students find the OSCE is excellent preparation for the USMLE Step 2 CS exam.  For more information regarding the OSCE please consult the Year 3 Curriculum Guide.

Overall Medical School Performance (Ranking)

 At the end of your Year 3, your Overall Medical School Performance will be determined and included in your Medical School Performance Evaluation (MSPE).  Separate ratings will be determined regarding both your academic performance and your clinical skills.  Students are divided into one of these six categories:

Overall Comparative Performance in Medical School

Performance Descriptor

Approximate Percentage


Level of Academic Performance and Clinical Skills



Outstanding academic performance and Superb clinical performance

PLUS Comprehensive Honors for all 3 Years




Outstanding academic performance and Superb clinical performance




Outstanding academic performance and Proficient clinical performance
OR Very Good academic performance and Superb clinical performance

Very Good



Very Good academic performance and Proficient clinical performance
OR Good academic performance and Superb clinical performance




Good academic performance and Proficient clinical performance

ACADEMIC PERFORMANCE BASIC SCIENCE (Average Standardized score over Years 1-2)    [(Year 1 Standardized score plus Year 2 Standardized score divided by 2]
Outstanding Academic Performance ≥ 485 (approximately 60%)
Very Good Academic Performance = 431 to 484 (approximately 20%)
Good Academic Performance ≤ 430 (approximately 20%)


CLINICAL PERFORMANCE (Year 3 Grades Converted to Scores)
Superb Clinical Performance ≥ 35 points (approximately 25%)
Proficient Clinical Performance = 14 to 34 points (approximately 74%)
Competent Clinical Performance ≤ 13 points (approximately 1%)



 Toward the end of your Year 3 you will meet with a member of the administration who will discuss with you the development of your Medical School Performance Evaluation (MSPE).  The MSPE gives an overview of your work during medical school with the greatest emphasis placed on your Year 3 performance.  The MSPE is one component of your residency application and is posted to the Electronic Residency Application Service on October 1st of your Year 4.


 Posting a passing score for Step 2 CS is a graduation requirement.  Many students will want to take the NBME clinical skills exam in the free time you have between the end of Year 3 (mid to late June) and July 1st.  The NBME only conducts these exams in 5 locations with Chicago, IL being the closest to Wayne State University.  Due to the limited exam appointments, it is important to schedule your Step 2 CS exam early in the fall of your Year 3.  For more information, please refer to the NBME website. The School of Medicine deadline for taking Step 2 CS for the first time is October 31 of Year 4.

 USMLE Step 2 CK

 Posting a passing score for Step 2CK is a graduation requirement.  Many students will want to take the NBME Clinical Knowledge (CK) exam in either July or August of Year 4, just after completing all of the Year 3 NBME subject exams.  Most programs want to see the Step 2 CK score early in the application process.  This will require you to register for and select a test date in late winter/early spring of your Year 3. The School of Medicine deadline for taking Step 2 CK for the first time is December 31 of Year 4.


 You will need to attach 3 or 4 Letters of Recommendation to your residency applications through the Electronic Residency Application Service (ERAS) and to non-ERAS Matching Programs.  Such letters are best written in the second half of your Year 3 after you have developed your clinical skills.  Your best LORs will come out of Year 4 Sub-Internships or electives in the field to which you will apply.  In many cases, one of your 4 LORs will be a Chairman’s Letter, written by the WSUSOM Department Chair in the field to which you will apply.  You will request these letters through the ERAS Electronic Portal where you will be waiving your right to read the letter.  ERAS does allow you to collect more than 4 LORs, but you can only attach 4 to each application.

Year 4 Required Clerkship Lottery

 In early spring of your Year 3, you will participate in a lottery for the 3 Year 4 required clerkships:  an Ambulatory Medicine clerkship, Emergency Medicine clerkship and a Sub-Internship in either Family Medicine, Internal Medicine, Pediatrics or Surgery.  The lottery is for the time for which are able to access and register for the courses through the WSU Banner System.  Registration will remain open for one week to allow to you to make adjustments.

 Year 4 Elective Lottery

 Subsequent to the Year 4 Required Clerkship Lottery, another lottery will be held for your register for your remaining Year 4 electives.  Again, the lottery is for the time that you are able to access the Banner System.

 As you begin your clinical clerkships, you are encouraged to use the CiM to assist you in gathering your thoughts, feelings, and reflections on each specialty. Throughout your third year, review the Charting Outcomes in the Match report to assess qualifications and competitiveness for different specialties.  Additionally, begin conducting informational interviews with our clinical faculty advisors and participate in activities and events.  You will be notified periodically of several School of Medicine events including the Residency Recruitment Fair, Specialty Dinners with Program Directors, the Year 4 Schedule Approvathon, Alumni Career Night, and the CV and Personal Statement Workshop all of which will help your career planning stay focused and current. 

 At least by midway of Year 3, you should meet with your faculty advisor(s) to discuss your top specialty choices.  If you are having difficulty making a specialty decision, you can complete the CiM Specialty Indecision Scale and discuss the results with your advisor and/or counselor.  You are also advised to complete the other self-assessment exercises.   If you are interested in more than one specialty late into Year 3, don’t fret.  You will be able to schedule additional electives in Year 4 to help clarify your top specialty choice.  It is permissible and recommended that you apply to more than one specialty if you are undecided or are applying to extremely competitive specialties.

The Office of Student Affairs staff and the SOM Faculty Advisors look forward to working with you during this exciting phase of your career development.