Updated
Medical School Curriculum: What Classes You Take, Year by Year
In medical school you first take the basic sciences (anatomy, physiology, biochemistry, pathology, pharmacology, microbiology and immunology), usually in organ-system blocks over one to two years. Then you rotate through core clerkships such as internal medicine, surgery, pediatrics, OB-GYN, psychiatry and neurology, and finish with sub-internships and electives.
Schools arrange those pieces differently. We use real curricula from Duke, Vanderbilt and NYU (MD) and WesternU and IUP (DO), taken from the schools' own pages and checked on November 3, 2026, as examples. For the classes you need before you apply, see required classes for medical school.
Medical school curriculum by year
| Year | What you take | One school's version |
|---|---|---|
| Year 1 | What you take: Basic sciences: anatomy (with cadaver lab), histology, biochemistry, physiology, neuroscience, plus a clinical skills course | One school's version: Duke teaches gross anatomy, physiology and brain science in one integrated first-year course |
| Year 2 | What you take: Disease and treatment: pathology, pharmacology, microbiology, immunology, often taught organ system by organ system, then board study | One school's version: IUP's DO students move through cardiology, neurology, gastroenterology and other systems, then take COMLEX Level 1 |
| Year 3 | What you take: Core clerkships: internal medicine, surgery, pediatrics, OB-GYN, psychiatry, neurology, family medicine | One school's version: Vanderbilt runs six core clerkships of four to eight weeks each, starting in the second year |
| Year 4 | What you take: Sub-internships, electives, away rotations, residency applications and interviews | One school's version: Duke's four-week Sub-I puts students in the role of an intern |
Years 1 and 2: what classes do you take?
The science years cover how the healthy body works, then how disease and drugs change it. At Duke, a single 10-month course, Foundations of Patient Care, integrates histology, gross anatomy, neuroscience, physiology, microbiology, immunology, pathology and pharmacology, with small-group labs that include cadaver dissection.
Many schools teach these subjects by organ system (heart, lungs, kidneys, brain) instead of as separate courses. IUP's DO program calls its model "clinical systems-based," and its second year moves through neurology, cardiology, gastroenterology, pediatrics and OB-GYN. Vanderbilt runs six foundational science courses of 6 to 12 weeks each in the first year.
You also learn to be a clinician from the start. Duke opens with a two-week clinical skills immersion, then a clinical skills course that meets 4 hours a week all year: history-taking, physical exams and talking with patients.
Grading is often pass/fail early on. Vanderbilt's first year is pass/fail, with pass/fail exams at the end of each block.
Year 3: clinical rotations (clerkships)
In the clinical year you join hospital and clinic teams, one specialty at a time. Each clerkship lasts a few weeks. Here is how Duke sets the lengths of its core inpatient rotations:
| Clerkship | Weeks |
|---|---|
| Medicine | Weeks: 6 |
| Surgery | Weeks: 7 |
| Obstetrics and Gynecology | Weeks: 6 |
| Pediatrics | Weeks: 4 |
| Psychiatry | Weeks: 4 |
| Neurology | Weeks: 2 |
| Radiology | Weeks: 2 |
| Anesthesia | Weeks: 1 |
Duke adds outpatient time on top: PIONEER, a 12-week course with a weekly clinic in internal medicine, neurology and pediatrics, plus emergency medicine shifts. Vanderbilt runs six core clerkships of four to eight weeks each. DO students also take subject-specific COMAT exams through their rotations, per the AOA.
Year 4: sub-internships, electives and residency
The last year is mostly yours to shape around the specialty you want. At Duke, the four-week sub-internship ("Sub-I") puts you in the role of an intern, clinical electives last 1 to 4 weeks, and a Capstone course in March prepares you for residency. Vanderbilt calls its final two years the Immersion Phase, with acting internships and research.
Many students also do away rotations at other schools through VSLO, then apply to residency through ERAS and interview through the winter.
Board exams along the way
- USMLE Step 1 (MD). A one-day exam in one 8-hour session. From May 14, 2026, it is split into fourteen 30-minute blocks, per USMLE. Each school sets where it falls.
- USMLE Step 2 CK. Sixteen 30-minute blocks in a 9-hour session, per USMLE. USMLE says examinees typically need about 60% of items right to pass.
- COMLEX Level 1 and Level 2-CE (DO). The AOA says DO students take Level 1 in their second year, between May and July, and Level 2-CE between the third and fourth years. WesternU gives students 9 weeks to prepare for Level 1.
Not every school runs the classic 2 plus 2
The traditional plan is two years of science and two of clinical work, and the AOA describes DO school that way. Many MD schools now compress the science:
- One year of science. Duke teaches the core sciences in the first year and clerkships in the second, then gives students 9 to 12 months for research. Vanderbilt also starts clinical training right after the first year.
- Three years in all. NYU offers a three-year MD pathway.
Whatever the shape, MD programs are accredited by the LCME, which is sponsored by the AAMC and the AMA.
How DO school classes differ
DO students take the same sciences and rotations, plus osteopathic manipulative medicine (OMM). WesternU lists OMM among its foundational topics and clinical skills in both preclinical years, and IUP runs a longitudinal course in osteopathic principles and practice. Our MD vs DO guide compares the two paths.
How to use a curriculum when you pick schools
Every school posts its curriculum. When you compare them, look at (our checklist):
- How long the science phase is, and when you first work on a clinical team.
- Whether the early years are pass/fail.
- When Step 1 or COMLEX Level 1 falls, and how much study time the school builds in.
- Protected time for research or a dual degree.
- Where clerkships happen: one big hospital, community sites, rural clinics.
Write down one curriculum detail per school you could talk about. Interviewers ask about it, and our why this medical school guide shows how to use it.
What about the classes before medical school?
Prerequisites are a separate list: the college courses schools want before you apply, such as biology, general and organic chemistry, physics and biochemistry. Our required classes for medical school guide covers them school by school.
Practice the curriculum question
Have one specific reason ready for each school, tied to how you learn.
“What about our curriculum appeals to you?”
Interviewers ask it to see whether you read past the brochure. Name one feature of the school's curriculum, why it fits how you learn and what you would do with it.
Example answer written by Confetto (the applicant is invented)
Your clerkships start in the second year, after one year of integrated science. I learn best when I can attach a fact to a patient. In my research job I understood heart failure far better after I sat in on the cardiology clinic than after any lecture.
I also like that your third year is open for a research project. I'd use it to keep studying how patients with heart failure manage their medicines at home, which is the question that got me interested in medicine in the first place.
Sources: the curriculum pages of Duke, Vanderbilt, NYU, WesternU and IUP, USMLE's Step 1, Step 2 CK and scoring pages, the AOA's osteopathic medical school timeline and the LCME, linked throughout and checked as of November 3, 2026. The year-by-year summary and the checklist are ours.
Frequently asked questions
What classes do you take in medical school?
Two kinds. First the basic sciences, such as anatomy, physiology, biochemistry, pathology, pharmacology, microbiology and immunology, usually taught in organ-system blocks. Then clinical rotations in internal medicine, surgery, pediatrics, OB-GYN, psychiatry, neurology and family medicine. See Duke's first-year course.
Is medical school four years?
Usually. NYU offers an accelerated three-year MD pathway. Others keep four years but change the order: Duke packs the basic sciences into one year and clerkships into the second, then gives students 9 to 12 months for research. See NYU's three-year MD.
Are medical school classes pass/fail?
Many are in the first years. Vanderbilt, for example, runs a pass/fail first-year curriculum with pass/fail block exams. Grading in the clinical years varies, so check each school's policy. See Vanderbilt's first year.
When do you take Step 1 and COMLEX Level 1?
Usually after the preclinical years. The AOA says DO students take COMLEX Level 1 in the second year and Level 2-CE between the third and fourth years. For MD students, each school sets where USMLE Step 1 falls in its curriculum. See the AOA's timeline.
How is the DO curriculum different from MD?
The science and rotations are much the same. DO students also learn osteopathic manipulative medicine (OMM) through the first two years, as WesternU's and IUP's curricula show. Compare MD and DO.
What classes do you need before medical school?
That's a different list: the prerequisites, such as biology, general and organic chemistry, physics and biochemistry. Our required classes guide covers them. See the required classes.