OMS Years III & IV


The OMS-III year is based at one of ARCOM core clinical sites and each student follows a COM directed curriculum that includes patient care as well as didactics, independent learning assignments, interactive computer case-based learning, simulation scenarios, and hands- on OMM labs to ensure that the foundational competencies for each discipline are provided for each student. The students will complete core clinical rotations, occurring both in the hospital and in community settings. Each rotation has designated learning objectives for the accompanying curriculum, integrated osteopathic learning objectives and requirements, as well as an end-of-rotation evaluation. Each student has dedicated time during the year for review and board preparation. Each student must successfully pass the OMS-III clinical examination, the COMSAE and COMLEX examinations by the end of the OMS-III year in order to move on to the OMS-IV year.

Hospital Core Rotations

This six block course during the OMS-III year is supervised by COM appointed faculty at one of the COM affiliated core hospitals and is integral to the development of physicians. The course is designed to allow the student to convert facts and information accumulated during their preclinical years into the application of that knowledge for the benefit of the patient, develop confidence in themselves as professionals and expose areas of need for further learning.  Included are rotations in internal medicine and medical subspecialties, general surgery and surgical subspecialties, obstetrics and women’s health, pediatrics and psychiatry.  While the students are not primarily responsible for the care or outcome of the patient during their rotations, the patient remains the primary concern of all members of the health care team, including the student. Students are challenged to demonstrate they have acquired and can utilize a foundation of basic clinical skills, medical knowledge, and competencies to move into graduate medical education.

Community Core Rotations

Based in a community and outpatient setting, this portion of the core education of the OMS-III student is designed to expose the student to the practice of medicine originating outside of the hospital and academic settings. With an emphasis on public health, preventive medicine, wellness, primary and secondary care of acute and chronic illness, and emphasizing a holistic approach to the patient, the student will have opportunity to follow the physician from the clinic to the hospital and back, which provides an opportunity to participate in the total care of the patient regardless of where the care originated. All students will spend one block during their OMS-III year with a family physician in office-based practices. In addition, they will have opportunities for a selective rotation in surgery and medicine. OMS-III students will also have two electives and one Non-Clinical Elective. Some students may have a portion of their rotation during family medicine, psychiatry, and pediatrics rotations on hospital services.

Procedures for OMS-III Students

OMS-III students that are within four hours driving time from the campus will return to campus the last Friday/Saturday of each block for end-of-rotation examinations. Students whose core site is more than four hours from the main campus will obtain the experiences and fulfill the educational requirements at a regional core site under the direction of college appointed faculty and staff.

At the end of each semester, students will return to campus for Days at the Fort where they will complete sessions in: OMM, Career Counseling, Simulation Lab, and Standardized Patient Lab.

Clinical students are to follow the work schedule and calendar governing the clinical service they are assigned to each block and not strictly the COM calendar. For the sake of continuity, quality clinical education and patient care requirements, the student may be required to work on holidays or other days differing from postings on general COM calendar. The normal workweek while on clinical service is 60-72 hours. Students normally will not be assigned to work more than 12 hours each day nor more than 12 out of 14 days unless patient care conditions dictate otherwise. Students are to have two consecutive days off every two weeks, but they are not required to be weekend days.

See the Clinical Medicine Handbook for a more detailed description of each of the clinical rotations, objectives, evaluations and expected outcomes.


The OMS-IV year provides for two blocks of rural hospital, one block of emergency medicine, selective rotations and three electives. During core rotations, each student has integrated osteopathic principles and practices requirements in addition to the requirement for OMM application. All students must pass both components of COMLEX Level 2 (CE and PE) in addition to all clinical rotations (both faculty evaluations and end of rotations examinations when given) to be eligible for graduation.

Selective Rotations

Each student must take and pass one block of an approved hospital-based medicine selective, one block of an approved hospital-based surgical selective, and one additional selective of their choosing during the OMS-IV year to fulfill the requirements of the curriculum and to advance their preparation for residency responsibilities.

The student’s selective may be with a COM faculty member at one of the ARCOM core hospitals or may be taken at a hospital with an osteopathic residency program that is approved by the COM.

Medical selective options include: Allergy/Immunology, Cardiology, Critical Care Medicine, Endocrinology, Gastroenterology, Geriatrics, Hematology/Oncology, Hospitalist service, Infectious Disease, Nephrology, Neurology, Pulmonology, and Rheumatology.

Surgery selective options include: Anesthesia, General Surgery, Gynecological Surgery, Neurological Surgery, Oncological Surgery, Ophthalmology, Orthopedics, Otolaryngology, Transplant Surgery, Trauma Surgery, Vascular Surgery, and Urological Surgery.

Rural Hospital Rotation

Each student, during the OMS-IV year, must complete a two-block rotation in a rural/underserved hospital with COM appointed faculty. Sites approved include Critical Access or Rural Hospitals, FQHC in rural or urban areas that provide service to underserved populations, correctional facilities, Native American facilities, etc.


Each student has three electives. A student may not take more than two blocks of rotations at the same site or with the same preceptor in the same discipline. An elective rotation may be completed by the student with COM appointed faculty, at COM approved sites or at other sites arranged by the student if the policy and procedures established in the clinical manual are followed.

The clinical curriculum course descriptions and syllabus, objectives, requirements, and rotations schedules are updated yearly and are posted online for the students of the COM.