4 Years of Medical School Timeline

You’ve finally gotten into medical school and there’s just four short years between you and earning your M.D. In this post, we’ll go over the timeline and what to expect during each year.


First year (MS1 or M1)

The first year will be the most radical transition for most students. Gone are the days of college, and now the rigors of medical school are thrust upon you. The first few weeks to months are challenging for this reason, however you’ll soon get in the groove and soon learn that your first year offers you the most free time.


I go over how to make the adjustment as painless as possible in my Adjusting to Medical School 101 post, which goes in great depth with actionable advice.


During this time, you should reassess and hone your study strategies, figure out your routines, and work to optimize your efficiency in preparation for the upcoming stages of medical school. Find your group of friends and figure out whether or not they are people that you can actually study with. Sometimes studying with your closest friends is more distracting than motivating.


You’ll remember the middle and end of your first year as some of the best times in medical school. The stress is comparatively low to the later stages, you have more free time, and you are bonding with new people and solidifying life long friendships. You’ll be amazed by your classmates, as medical students are some of the most impressive and diverse people you’ll come across.


Second Year (MS2 or M2)

MS2 starts with an uneasy tension that will grow and expand for the rest of the year. That tension is for one thing and one thing only – Step 1. Step 1 is the first of the three United States Medical Licensing Exams, or USMLEs, that you’ll be taking prior to obtaining your medical license. Step 1 and Step 2 are taken during medical school. Step 1 is considered more important for matching into residency, hence the high stress building to a climax at the end of your second year.


In the second year, you should have honed your study strategies, time management, and be ready to increase the intensity of your studying. In the first couple months, you may be solidifying your plan on how to study for USMLE Step 1. There are two stages: leading up to the dedicated period, and the dedicated period. I go over how I achieved a top score in my USMLE Step 1 Dedicated Period study post.


Step 1 is a beast unlike any other test. For the MCAT, you can put in 2 months and achieve a 99th percentile score. But Step 1 is a different animal – it’s the culmination of your entire first two years of medical school, and you’ll spend most of your second year utilizing resources to adequately prepare for it.


Most students take Step 1 in the spring at the end of their second year. In the fall and winter of your second year, you’ll hermit up and spend more time studying and less time socializing. The end of winter and spring is when you’ll have your dedicated period and really go all out in studying. Right after you take Step 1, you’ll begin third year.


Third Year (MS3 or M3)

Most students love it, some students hate it. It’s an adjustment for everyone. Third year marks the beginning of your clinical years. While the first two years were focused in the classroom, the latter two years are primarily in the hospital or clinic. This is what you came to medical school for – to become a doctor and take care of patients.


Clinical rotations are particularly challenging, because for the first time in your life, you’re not just studying out of books and taking tests. Rather, you still have to do that, but now most of your waking hours are spent in the hospital or clinic, and your evaluations from your seniors hold tremendous weight in your overall grade. It’s a different game entirely.


Every medical student has to take a series of core rotations before graduating. During your third year, you’ll likely be rotating on internal medicine, family medicine, general surgery, psychiatry, neurology, pediatrics, ob/gyn, and emergency medicine.


At the end of third year, you’ll be preparing for Step 2CK. Step 2 is similar to Step 1, except now it’s testing the culmination of knowledge from your third year of medical school – most heavily concepts from your internal medicine rotation. You won’t be studying nearly as hard as you did for Step 1. One month for Step 2 will usually suffice.


Fourth Year (MS4 or M4)

Finally, MS4, the promise land! Hold your horses. Everyone told me that fourth year was the dream, and that everything would be smooth sailing. Not so fast. The first half of fourth year is arguably the hardest part of the entire medical training process, at least if you go into a competitive surgical subspecialty. The first half of your fourth year is challenging for two main reasons: sub-internships and preparing your residency application.


Sub-internships, also known as audition rotations, are rotations you perform at other institutions anywhere in the country. You’re essentially performing a month long interview, and you have to be on your best behavior. If you’re going into a specialty with a suboptimal lifestyle, like surgery, expect long hours and high stress.


You know how you apply to medical school using AMCAS? Medical students apply to residency using ERAS, which stands for Electronic Residency Application Service. I know, very creative. The application usually opens around September 15th. It’s a single common application, just like AMCAS, and you submit a personal statement, letters of recommendation, and a work and activities section. It’s very similar to AMCAS, but thankfully you don’t have any secondaries to complete.


The timing of interviews vary by specialty, occurring anywhere between October to February. At the end of February, you submit your rank list. You don’t get accepted by programs in the traditional sense. Instead, both applicants and programs submit a rank list via the NRMP. An algorithm runs and a month later, around the middle of March, is Match Day. You open your envelope with the rest of your classmates during a grand ceremony, and your fate is sealed. Inside that envelope is the program you’ll be training at for the next 3 to 7 years.


After March, it’s smooth sailing. Residency starts on July 1st. Between Match and starting residency, most students take this opportunity to travel or spend time with loved ones, because residency is going to be a rough ride.



And that’s it! The four years of medical school are no joke. You’ll be tested, you’ll have your lows, but you may also remember medical school as some of the best years of your life – the bonds you make with your newfound friends, the amount of knowledge you gain, and the sense of accomplishment from completing the most rigorous professional degree in the world.


If you’re a pre-med, we’ve created a course just for you. It’s the Pre-Med Roadmap to Medical School Acceptance. We go in painstaking detail through each year of college and outline the most important  items to focus on during each stage. It’s an adaptable blueprint that will help maximize your chances of getting into a top medical school. We have several videos, written content, and exclusive access to a mentorship group where you can get your personal questions answered by me or other doctors.


Let me know in the comments what part of medical school are you looking forward to. I personally loved anatomy during my first year, but fourth year was the highlight for me.

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