Fourth Year

Fourth year consists entirely of elective clinical rotations and a four-week required Capstone course.

Philosophy of the electives program

The elective year allows students to develop a flexible, individualized program of study at a crucial time in the continuum of formal medical education. The elective year provides medical students the opportunity to:

  • Advance clinical skills
  • Refine educational and professional goals
  • Explore areas of personal and professional interest
  • Engage in one-on-one learning experiences with faculty mentors
  • Participate in extramural clinical rotations or research projects

The program is administered by the Electives Office, a division of the Office of Medical Student Education. Please contact the Electives Office for more information.

Current fourth-year students can find additional enrollment information in Canvas.

Electives courses

Anatomy and Neurobiology

Advanced Dissection
Teaching Assistant in Human Anatomy


Anesthesia for Neurosurgery
Cardiothoracic Anesthesiology
Cardiothoracic Critical Care
Critical Care
Obstetrical Anesthesia
Pain Management
Pediatric Anesthesia

Emergency Medicine

Clinical Emergency Medicine, Barnes-Jewish Hospital
Medical Toxicology
Emergency Ultrasound

Internal Medicine

Ambulatory Infectious Disease
Bone and Joint Infectious Disease Consult
Bone and Mineral Diseases
Cardiac Arrhythmias and Electrophysiology
Clinical Cardiology – VA Hospital
Clinical Cardiovascular Medicine
Clinical Gastroenterology and Hepatology
Clinical Internal Medicine – Hospitalist
Clinical Mentoring
Clinical Nephrology
Endocrinology, Diabetes and Metabolism
General Inpatient Infectious Disease
Geriatric Medicine
Heart Failure/Cardiac Transplantation
Hematology and Hemostasis
Honors Medicine – Cardiology
Honors Medicine – General Medicine
Honors Medicine – VA Hospital
Hyperbaric Medicine & Problem Wound Management
Infectious Disease: Care of HIV-Infected Patients
Inpatient Cardiology
Inpatient Internal Medicine/Oncology-Firm
Intensive Care Medicine – BJ North
Intensive ECG Interpretation
Medical Intensive Care
Medicine Consult Service
Palliative Medicine
Transplant Infectious Disease Consult

Neurological Surgery



Adult and Pediatric Epilepsy
Clinical Aspects of Aging and Dementia
Clinical Neuroimmunology and Multiple Sclerosis
MS Center/Outpatient
Neonatal Neurology
Neurology Subinternship
Neurology/Neurosurgery ICU
Pediatric Neurology
Physical Medicine and Rehabilitation

Obstetrics and Gynecology

GYN Oncology Subinternship
Maternal-Fetal Medicine Outpatient Care Subinternship
Maternal-Fetal Medicine Inpatient (Antepartum) Subinternship
Obstetrical Anesthesia
OB/GYN Endocrinology-Infertility Subinternship
OB/GYN Ultrasound-Genetics
Special Topics in Reproductive Health

Ophthalmology and Visual Sciences


Orthopaedic Surgery

Orthopaedic Hand and Upper Extremity Surgery
Orthopaedic Oncology
Orthopaedic Pediatric Surgery
Orthopaedic Spine Surgery in Adult Patients
Orthopaedic Sports Medicine
Orthopaedic Surgery – Foot/Ankle Surgery
Orthopaedic Surgery – Shoulder/Elbow Surgery
Orthopaedic Trauma
Pediatric Orthopaedics – Spine and Sports Surgery
Reconstructive and Joint Preservation Surgery


Ambulatory Otolaryngology for the Primary Care Physician
General Otolarnygology
Pediatric Otolaryngology
Practicum in Adult Clinical Audiology


Autopsy Pathology
Clinical Laboratory Medicine – Barnes/Jewish Hospital
Diagnostic Hematopathology
General Cytopathology
Introduction to Neuropathology
OB-GYN Pathology Subinternship
Surgical Pathology – Barnes/Jewish Hospital


Clinical Pediatric Pulmonary Medicine
General Pediatrics Subinternship – St. Louis Children’s Hospital
Genetics and Genomic Medicine
Newborn Medicine
Pediatric Asthma and Allergy
Pediatric Cardiac Catheterization
Pediatric Cardiology-Outpatient Service
Pediatric Critical Care Medicine
Pediatric Emergency Medicine
Pediatric Endocrinology and Diabetes
Pediatric Gastroenterology, Hepatology and Nutrition
Pediatric Infectious Diseases
Pediatric Lung Transplantation
Pediatric Pulmonary Subinternship
Pediatric Renal Disease
Pediatric Rheumatology
Special Topics in Reproductive Health
Subinternship in Pediatric Hematology and Oncology


Child Psychiatry
Clinical Psychiatry-Inpatient Psychiatric Service
Interventional Psychiatry
Introduction to Eating Disorders
Outpatient Community Psychiatry
Psychiatric Oncology
Psychiatry Consult Service
Schizophrenia Precursors and Prodromal States

Radiation Oncology

Clinical Radiation Oncology


Clinical Nuclear Medicine
General Radiology
Interventional Radiology


Acting Internship, Colon and Rectal Surgery
Acting Internship, Hepatobiliary Pancreatic Surgery
Acting Internship, Minimally Invasive Surgery
Acting Internship, Surgical Oncology and Endocrine Surgery
Acting Internship, Trauma Service
Acting Internship, Vascular Surgery
Cardiothoracic Surgery
Critical Care
Organ Transplantation
Pediatric Surgery
Plastic Reconstructive Surgery
Surgical Night Float and ER Subinternship

Additional Elective

Business of Medicine


The 4th year Medical Student Capstone course is designed to complete the student’s preparation for internship. The course was created to provide the high value, practical knowledge and experiences required for a successful transition from medical student to intern. To accomplish this goal, we’ve created a curriculum that focuses on interactive didactic sessions in the morning which cover a broad spectrum of medicine and afternoon sessions which concentrate on procedural skills, acute care simulation, and intern skills workshops. Besides the general knowledge and skills that are covered in the main sessions, specialty-specific sessions are included which focus on giving students in specific career paths knowledge and skills particular to that specialty.

It is our hope that after this month rotation, the student will feel less anxious about beginning a career in medicine and will feel more prepared to face the challenges and thrills of patient care.