Medical School Life

Top questions to help master life as a third-year medical student

This AMA FAQ helps medical students navigate the third year of training by offering insight on some common questions.

| 10 Min Read

As a third-year medical student, you are halfway home and have many meaningful patient-facing and learning experiences ahead. Throughout your journey as a medical student, some key questions are likely to arise. The AMA offers answers to questions medical students frequently ask during their undergraduate medical training.

Find leadership opportunities

The AMA offers local and national leadership opportunities to help medical students develop their leadership skills and advocate for patients and the profession.

The majority of medical students begin clerkship rotations during their third year of training. The move signifies a transition from classroom to clinic, making for a different type of learning environment. Tips from those who have gone through these key rotations include maintaining professionalism, remembering your patient experiences to help your learning and using the experience to hone your specialty choice options. 

Having recently completed his family medicine residency at United Health Services in Binghamton, New York, James Docherty, DO, is a few years removed from his own clinical rotations as a medical student at New York Institute of Technology College of Osteopathic Medicine. 

“If I could do it again, I'd definitely be more forthright with my thoughts,” Dr. Docherty said in an interview for the AMA’s “What I Wish I Knew in Medical School” series. “I'd be more confident with how I spoke and really put my thoughts out there.”

“What you are really learning is how to develop a concrete plan. It’s a different phase of medical school. In your first and second years you learn about individual diseases, and you learn how to treat individual diseases because they give you all the pharmacology knowledge, and now you have to combine all those different diseases in a real person. It's so rare that one person has one chronic disease.”

Dive deeper: 

This is likely going to be dictated by your institution. Traditionally, Step 2 of the United States Medical Licensing Examinations® (USMLE®) was taken between third and fourth year. 

And, historically, Step 2 was broken into two parts. Step 2 Clinical Knowledge (CK) is a multiple-choice exam that covers the application of the basic sciences highlighted in Step 1. Unlike Step 1, Step 2 test-takers are given a numerical score. The other half of Step 2—Step 2 Clinical Skills (CS), a simulated patient exam—was permanently canceled in 2020

The questions most students want to know is a simple one: What should I study?

“For Step 2 CK the dominant area is going to be internal medicine. Even for things like the surgery questions, a fair number of them have internal medicine principles,” said Christopher Cimino, MD, chief medical officer, Kaplan Medical.

“For example, things like nutrition are in the surgical domain. They are surgical principles, but because they don’t involve cutting, students tend to think of them as internal medicine. So the internal medicine aspects of all the disciplines are probably a good place to focus on in Step 2 CK.”

Dive deeper: 

Taking place during the summer following a medical student’s third year, away rotations are a clinical experience at an institution other than your own. Applications for away rotations are generally due during the spring of the third year of medical school. As far as their import, that is going to depend on one’s specialty aims.

“With respect to the importance of away rotation, it depends in part on the specialty itself,” said Mark Meyer, MD, senior associate dean for student affairs at University of Kansas School of Medicine. “Generally speaking, surgical subspecialties place greater emphasis on away rotations than, say, do some or most primary care specialties.

“For the competitive specialties, such as the surgical subspecialties, as well as, say, dermatology, away rotations are considered almost an essential component in the overall application strategy as programs place great value in these experiences in terms of gauging student interest, assessing their abilities and overall compatibility with the program.”

Dive deeper:

Get residency-ready with AMA benefits

  • Find your perfect match using full features of FREIDA™, the AMA Residency & Fellowship Database®
  • Distinguish yourself with AMA leadership opportunities

Supporting you today as a medical student. Protecting your future as a physician.

While precise data on the number of medical student parents is unavailable, a figure from the Association of American Medical Colleges’ 2023 Medical School Graduation Questionnaire sheds some light on the prevalence of parenthood among future doctors. When asked “How many dependents do you have (not including a spouse or partner)?” roughly 4% medical students said one, 2% said two and 0.4% said three. The word “dependent,” however, isn’t exclusive to children.

AMA member Rommel Cruz Morales, MD, entered medical school with one child and had another as he progressed in training. He highlighted the importance of flexibility in being an effective medical student parent. 

“Every month tends to be a different balance, as the expectation varies between my clinical schedule and [his wife] Kathryn’s professional projects,” said Cruz Morales, now an ob-gyn resident at Wright State University. “For example, right now I'm approaching my overnight shifts on my ob-gyn subinternship, and we're planning our week where she'll need to take on more of the evening childcare.

“At our busiest times, we prioritize things as they appear, using whatever free time to handle the most urgent things as quickly as possible. If I know my wife has had a rough day, I'll let her sleep while I handle all the shopping, food prep, housework, etc.—and she does the same for me.”

Dive deeper:

With residency applications for most students going out in the fall of year four, most students pick a specialty at the end of their third year of medical school.

For students who are still deciding, subinternships—advanced rotations that typically take place after the core clerkships have been completed at a hospital affiliated with your training institution—offer one last chance to get specialty exposure before sending out applications.

“Subinternships allow students to work in a more autonomous way,” said Lindia J. Willies-Jacobo, MD, senior associate dean for admissions and equity, inclusion and diversity at Kaiser Permanente Bernard J. Tyson School of Medicine. “Most subinterns will work similarly to the way an intern would work. They are fairly independent in their engagement with the stations. In that autonomy and being in that role in a pretty intense way is a way in which students can use that [experience] to settle on a specialty.”

Dive deeper: 

Medical students are more likely to experience burnout and depression than other similarly aged individuals pursuing different careers, and this elevated risk persists into residency training. Systemic solutions are generally considered the more effective method for preventing medical student burnout.

At the individual medical student level, however, one piece of advice to combat burnout is to try to get back to parts of your past wellness routine. That, of course, is easier said than done for the stretched-thin medical student. 

“At the end of my third year of medical school, I was a physical mess,” said Sandra A. Fryhofer, MD, immediate past chair of the AMA Board of Trustees and a practicing internal medicine physician in Atlanta. “I had no time to exercise. I was exhausted. I looked in the mirror and I said: What is happening? I'd always gone to dance classes for exercise, but as a third-year medical student there was no time. There was no schedule. But I then joined a health club, and I went to exercise every day. This health club was close to my home, so I had to change what I'd always done—and it helped.

“Knowing self-care strategies can be helpful. … Organized study groups can really be helpful. They can reduce stress, anxiety and depression.”

Dive deeper: 

Subscribe and succeed in medical school

Get tips and insider advice from the AMA on succeeding in medical school—delivered to your inbox.

Medical student sitting on a stack of textbooks

Medical students enter medical school with the goal of becoming well-rounded physicians. Much of the development toward that aim is done in the clinical arena. But the best physicians are not simply encyclopedias of medical knowledge.

Leadership is a key area of medical student development. Growing as a leader is often done outside formal curriculum of medical school and accomplished through extracurricular activities. 

Michael G. Kavan, PhD, is associate dean for student affairs at Creighton University School of Medicine in Omaha, Nebraska. He advised medical students to start gaining leadership experience through organizations on campus.

“One easy way to get involved with leadership early in medical school is to seek out lower-level student government positions,” Kavan said. “It doesn't have to be a vice president or president position. Instead, students could gain valuable leadership experience by becoming a class representative for the school’s advancement or promotions committee; still an important role but requiring a more limited time commitment.”

Dive deeper:

Where you will do your residency training becomes a focal point of your final year in medical school—though it’s key to stay on point with your studies

The final months of your third year of medical school and the ensuing summer should be spent making sure you have your ducks in a row. Some key tasks include: Finalizing letters of recommendation; crafting a personal statement and comprehensive CV; and obtaining your token for the Electronic Residency Application Service (ERAS), which transmits students’ residency program applications and key information from their designated dean's office to program directors. 

Dive deeper: 

Medical students may not have all the answers in a classroom or clinical setting. That knowledge comes over time. Still, what students may lack in know-how, they tend to make up for in passion.

Channeling that passion can take on many forms. One of them is advocating for changes to the modern health care industry that can better serve physicians and patients. 

Anyone can be an advocate. To do it effectively, past members of the AMA Medical Student Section Committee on Legislation & Advocacy say one should demonstrate creativity and resourcefulness to take ambitious motivation and channel it into something that truly makes an impact.

Dive deeper: 

The AMA’s Facilitating Effective Transitions Along the Medical Education Continuum handbook takes a deep dive into the needs of learners along the continuum of medical education—from the beginning of medical school through the final stage of residency. Download now.

Become a student leader

FEATURED STORIES FOR MEDICAL STUDENTS