Years 3 and 4

Third Year

Established in 2005, the FSU Rural Program in Marianna, Florida, offers third-year medical students an immersive educational experience within a rural medical community. Students learn alongside community-based physicians, care for patients across a variety of clinical settings, and gain firsthand experience with the opportunities and challenges of practicing medicine in a rural community.

A distinguishing feature of the Rural Program is its Longitudinal Integrated Clerkship (LIC) model, which uses continuity as a central principle of medical education. While students at FSU’s regional campuses traditionally complete their required third-year clerkships in individual six-week blocks, Rural Program students participate in their required clerkships concurrently throughout the academic year. The Rural Program welcomed its first LIC class in the summer of 2015.

The year begins with an intensive clinical “boot camp” designed to reinforce and build upon skills developed during the first two years of medical school. Students then begin their clerkships and continue working with patients and faculty across multiple specialties throughout the year.

This longitudinal approach allows students to participate in the comprehensive care of patients over time, providing a unique opportunity to follow patients through different stages of illness, treatment, recovery, and ongoing health management. Through these sustained interactions, students develop meaningful relationships with patients and gain a deeper understanding of the many factors that influence health, including patients’ values, families, communities, access to care, and social determinants of health.

The LIC model also fosters strong, lasting relationships between students and their clerkship faculty. Consistent mentorship and progressive clinical responsibility allow faculty to observe students’ growth over time while providing individualized guidance and feedback. Through these experiences, students strengthen their clinical reasoning, communication, and professional skills while developing a deeper understanding of rural and community-based medicine.

Sample LIC Rotation Schedule

Fall Semester

Monday	Tuesday	Wednesday	Thursday	Friday
Hospital 6:30 - 8AM	Hospital 6:30 - 8AM	Hospital 6:30 - 8AM	Hospital 6:30 - 8AM	Hospital 6:30 - 8AM
Internal Medicine 8AM - 12PM	Psychiatry 8AM - 12PM	OBGYN 8AM - 12PM	OBGYN 8AM - 12PM	Pediatrics 8AM - 12PM
Independent Learning 1 - 5PM	Family Medicine 1 - 5PM	D3	Independent Learning 1 - 5PM	Independent Learning 1 - 5PM

Spring Semester

Monday	Tuesday	Wednesday	Thursday	Friday
Hospital 6:30 - 8AM	Hospital 6:30 - 8AM	Hospital 6:30 - 8AM	Hospital 6:30 - 8AM	Hospital 6:30 - 8AM
Internal Medicine 8AM - 12PM	Psychiatry 8AM - 12PM	Surgery 8AM - 12PM	Surgery 8AM - 12PM	Pediatrics 8AM - 12PM
Independent Learning 1 - 5PM	Family Medicine 1 - 5PM	D3	Independent Learning 1 - 5PM	Independent Learning 1 - 5PM

*Please note: The schedules above are not a reflection of the current schedule.

The schedule shown represents a typical M3 year for a student participating in the Rural Program’s Longitudinal Integrated Clerkship (LIC).

Because both Surgery and Obstetrics and Gynecology (OB/GYN) require dedicated operative and outpatient clinical experiences, each clerkship is completed within a single semester. During their respective semesters, students have two half-days each week dedicated to that specialty.

Independent Learning provides students with the flexibility to pursue additional clinical experiences based on their individual interests and educational goals. Students may arrange time in areas throughout the hospital, including the Emergency Department, Laboratory, Radiology, or with subspecialty physicians. Following these experiences, students submit a reflection of their activities to the Rural Program Director for review.

Students also participate in D3 , a weekly standardized didactic session coordinated by the Clerkship Administrator. These sessions complement students’ clinical experiences and provide dedicated time for structured learning throughout the M3 year.

Fourth Year

During the M4 year , students have the flexibility to complete their final year of medical school at any of the FSU College of Medicine’s six regional campuses: Daytona Beach, Fort Pierce, Orlando, Pensacola, Sarasota, or Tallahassee . This flexibility allows students to pursue clinical experiences that align with their individual interests, career goals, and residency preparation.

Family Medicine Sub-Internship

During the M4 year , students complete a required four-week sub-internship in either Family Medicine or Internal Medicine. The Family Medicine Sub-Internship is a competency-based clerkship that provides students with an immersive experience in the care of hospitalized patients. Working alongside family physicians and other members of the health care team, students experience the broad scope of family medicine while caring for patients of all ages and with a wide range of medical conditions.

As acting interns, students assume an expanded level of clinical responsibility, actively participating in the evaluation, management, and ongoing care of hospitalized patients. Through collaboration with interprofessional health care teams , students strengthen their clinical decision-making, communication, and patient management skills while contributing to high-quality, patient-centered care.

Students also gain exposure to procedures commonly performed by family physicians and participate in educational activities such as morning report, noon conferences, and other available clinical learning opportunities .

The Family Medicine Sub-Internship takes place on the inpatient family medicine service of a residency program or hospital-based rural site . When appropriate, students may also participate in ambulatory patient care experiences, providing additional exposure to the comprehensive scope of family medicine and the continuity of care provided across inpatient and outpatient settings.

Through increased clinical responsibility, hands-on patient care, procedural experience, and interprofessional collaboration, the Family Medicine Sub-Internship helps prepare M4 students for the transition from medical school to residency training.