The CNU College of Medicine MD program

In Phase A, clinical faculty lead each clinical presentation, walking you through its algorithm and the key decision points. Basic science faculty then teach the relevant anatomy, biochemistry, genetics, microbiology, pathology, pharmacology and physiology, in health and disease. The week's Clinical Case lets you apply that science.

You learn through a mix of lectures, small groups, Clinical Cases, case-based learning and self-directed study. The 2026-27 handbook names team learning and interprofessional experiences with CNU pharmacy and health sciences students as a theme in all four years. You bring a TurningPoint clicker, issued at orientation, to every class.

In Phase B, teaching moves to hospitals and clinics, where a preceptor (a supervising physician) guides your daily work and gives you formal feedback at mid-clerkship. You also log required patient encounters and procedures.

In Phase A you must attend Clinical Cases, case-based learning sessions, Medical Skills and the Colloquium; attendance at other classes is strongly encouraged. The 2026-27 student handbook caps scheduled contact time at an average of 25 hours a week over each course, including exam week; the school's 2021 scheduling policy gives 24. Lunch is noon to 1 p.m., with 10-minute breaks between classes. You are expected to stay in the area until each semester ends, in case you need a retest.

On clerkships the clinical team sets your hours, within limits. You work at most 80 hours a week averaged over four weeks and 24 hours in a row, with 10 hours off between shifts and one day in seven free. Internal medicine, neurology and psychiatry involve no overnight call. You can miss at most one day of a four-week clerkship and two of an eight-week one.

Each clerkship keeps a weekly teaching slot. Family medicine meets online on Friday mornings, obstetrics and gynecology on Thursday mornings, pediatrics on Monday evenings, psychiatry on Friday afternoons and surgery on Wednesday afternoons. Internal medicine keeps Monday afternoons for teaching and study. Each clerkship ends with a National Board of Medical Examiners (NBME) shelf exam, a national multiple-choice test in the specialty, usually on the last Friday.

Anatomy is taught within the organ-system courses rather than as a separate course, so you meet each region's structure alongside its function and disease. In Integumentary and Musculoskeletal Systems, in the fall of year 1, you dissect human donors in the anatomy lab. You also review X-rays, CT scans and MRIs of normal and abnormal structures.

In Neuroscience, in the spring of year 1, you carry out cadaver dissection and review prosected specimens, already dissected to display structures, again with imaging. The Gastrointestinal System course in year 2 includes a cadaveric dissection lab, and Medical Skills adds surface anatomy taught with body painting.

The gross anatomy lab is run by a Director of Gross Anatomy, whose permission visitors need. Dress rules ban shorts and skirts and require clothing or protective equipment over any body part that could touch the cadaver or chemical fluids.

Your first patient skills come through Medical Skills. You practice on classmates, standardized patients, simulators and partial task trainers, with real patients when appropriate and available. Before clerkships you receive at least 130 hours of teaching in history taking and physical examination.

Sessions follow the classroom topics. During the cardiovascular and pulmonary course you learn to check blood pressure, record electrocardiograms, run spirometry and do Gram stains. In the reproductive course you practice Pap smears and pelvic, rectal and breast exams on standardized patients and models. Medical Skills also covers nutrition and runs a journal club.

Optional student-run clinics add real patients. At Clínica Tepati, where places are limited, you work with UC Davis medical students and University of the Pacific pharmacy students, caring for the underserved Latinx community. Shifa Clinic runs weekend clinics where you take histories and examine patients. Sacramento Street Medicine volunteers typically join one 3- to 5-hour outreach visit a month to people without housing. Through Anatomy Academy, student volunteers teach local elementary school children one organ system a week during the neuroscience course.

Full-time clinical work starts in mid-May at the start of year 3, after a week-long Clerkship Symposium (May 4 to 8 in 2026). Preceptors are encouraged to let you present one complete history and examination a day where feasible. In year 4, the surgery sub-internship gives you a patient load like a first-year resident's.

In Phase A every course ends with a summative exam that makes up a major part of your grade; earlier formative exams are practice and do not count. Questions are multiple-choice clinical vignettes in the style of Step 1. A course grade rests on at least two exams, and you need 70% or more on the final comprehensive exam to pass. Clinical skills are tested in OSCEs: Medical Skills has a practice mini-OSCE and a graded one, and year 3 has a required OSCE.

Organ-system courses and required clerkships are graded Honors, High Pass, Pass or Fail. For courses, the catalog's grading table puts Honors at 90% and above and High Pass at 80% to 89%, and below 70% is a fail. The Colloquium, the scholarly project and electives other than sub-internships are pass or fail, and no grade point average is calculated. Medical Skills, Colloquium and clerkship grades include a written narrative.

In each clerkship, your national percentile on the shelf exam sets a starting grade: Honors at the 75th percentile or above, High Pass at the 30th and Pass at the 5th. Your preceptor's ratings on a five-point scale and the clerkship director's grade for teaching sessions and assignments can then raise or lower it. Below the 5th percentile you may be allowed one retake; otherwise you receive a Y (remediation) grade, and the best result after remediation is Pass.

Two NBME comprehensive exams act as gates. You need a qualifying CBSE score, set by the Office of Medical Education, to sit Step 1, which has been reported only as pass or fail since January 2022. You must pass Step 1 before year 3 or be placed on a leave of absence. Near the end of year 3, a qualifying CCSE score lets you sit Step 2 CK, which is scored on a three-digit scale and must be passed before graduation.

In August 2026 the USMLE program announced a move to designated testing dates from January 2029, with Step exams offered less often each year. Its June 2026 announcement had named 2028. The USMLE has urged schools to review rules on when students must test, so CNU's Step deadlines could change.

On the current schedule, if you enter in July 2027, you would sit the CBSE in spring 2029 and need a passing Step 1 by about mid-May 2029. Designated testing dates are due to start before then. You could sit Step 2 CK once you have a qualifying CCSE score near the end of year 3, around spring 2030, and must pass it before graduation in about May 2031.

• In Phase A, Foundations of Clinical Medicine is the one course where you can retake a failed final exam before getting a Y grade. In other Phase A courses a failed final means a Y and one remediation attempt, which can fall in the winter or summer break.
• A failed remediation turns the Y into an F, and you repeat the course; a remediated course can earn no more than Pass.
• Failing the CBSE or the CCSE three times brings an academic warning, a non-disciplinary status that is not mentioned on your MSPE or transcript.
• Failing Step 1 or Step 2 CK more than once leads to disciplinary action, which can include dismissal, under the progression policy approved in December 2025.
• Time limits: Phase A, including Step 1, within four years; Phase B within three; the whole MD within seven years of starting.

The catalog places clerkships at community-based hospitals in the Sacramento area and the surrounding Central Valley, with affiliations in the Bay Area and Southern California. The 2026-27 handbook says most are in the Greater Sacramento Valley. The dean's message names Kaiser Permanente, Sutter Health and Dignity Health, plus private physicians' offices and clinics in underserved areas.

Clerkship tracks differ in the order of the specialty rotations. You rank them, a computerized lottery assigns them in rounds, and you then have 10 business days to swap with a classmate who agrees. A 2020 policy described six tracks and a map of sites for location preferences. You can request a different site or sequence for reasons such as where your partner or children live, a health condition such as pregnancy, or hardship.

Some neurology and surgery students work in private offices and follow those physicians' schedules. The obstetrics and gynecology syllabus places students at one of several sites across California. Psychiatry students sit their shelf exam at the College of Medicine or an approved Southern California testing site. Emergency medicine students at distant sites can join weekly teaching remotely.

CNU has no student housing, so you arrange your own. Before year 3 you need a second background check and a drug screen, and some sites set extra immunization requirements. CNU plans a teaching hospital in Natomas, on the former Sleep Train Arena site, but its website lists the construction start as to be decided.

Alongside the required curriculum, optional elective courses are open in every year. They include Global Health (COM 592), on tropical diseases and care in resource-poor settings. Another, Navigating the Doctor Patient Relationship (IND 850), uses Balint groups to discuss hard situations from the clinical years. A Phase A mindfulness course follows the Mindfulness-Based Stress Reduction model. Teaching assistant electives let you help teach Endocrinology, Cardiovascular and Pulmonary, Behavioral Medicine or Reproductive Systems.

Year 4 rules differ slightly between the university catalog and the 2026-27 handbook, with one week counting as one credit. The catalog requires at least 28 elective and sub-internship units, including one four-week core sub-internship in internal medicine, family medicine, surgery, psychiatry, pediatrics, obstetrics and gynecology or neurology. It also sets minimums of 8 units with inpatient work, 4 in your intended specialty and 12 outside it. At most 8 units can be virtual or non-clinical, and at most 4 credits each can come from research and teaching-assistant electives.

The 2026-27 handbook instead lists 30 elective and sub-internship credits, at most 12 in one discipline, at least 11 with CNU faculty and at most 20 away. Its list of core sub-internship specialties leaves out neurology. Both total 76 credits for years 3 and 4: the catalog counts the Extended Clinical Experience among 48 required year 3 units, while the handbook lists 46 required clerkship credits.

Under a policy approved in October 2021, you can take sub-internships only after completing the six core clerkships in family medicine, internal medicine, surgery, obstetrics and gynecology, pediatrics and psychiatry. The internal medicine sub-internship puts you on a ward team with an attending, a senior resident and two interns, managing three to five patients six days a week without overnight call. The catalog's year 4 elective list runs from allergy and anesthesia to urology, including palliative medicine, neurosurgery, sports medicine and wilderness medicine.

Away rotations at other schools go mainly through the Visiting Student Learning Opportunities (VSLO) service of the Association of American Medical Colleges (AAMC). Under the same 2021 policy you need good academic standing and your own travel funds, and you must submit your request at least 90 days ahead. The college does not award credit for international electives.

Research is required in years 1 and 2 through the Self-Directed Student Scholarly Project, which runs for 18 months from the fall of year 1 to the fall of year 2. It opens with teaching in biostatistics, research design and methods. In the spring of year 1 your group chooses a project and faculty mentor, sets a hypothesis and methods, and submits a proposal for approval.

Projects can be translational, clinical or basic research, or in global health, medical education, epidemiology, public and environmental health or the history of medicine, with safety or research ethics training where needed. In the fall of year 2 you analyze your data, write an abstract and present a poster or talk at Research Day, typically in December. The project is graded pass or fail. In February 2024 the showcase featured 10 podium talks and 40 posters by second-year students.

In years 3 and 4 you can add a research elective of 2 or 4 weeks with any principal investigator, with a CNU faculty advisor if the investigator is external. The Office of Research also funds faculty projects with students through seed grants.

All of Phase A is taught at 9700 West Taron Drive in Elk Grove. The first floor holds classrooms, quiet study rooms and college rooms with lockers for first- and second-year students. Medical students get booking priority there from 8 a.m. to 5 p.m.

Hands-on teaching uses the gross anatomy laboratory and the College of Medicine's Clinical Skills and Simulation Center. The center offers standardized patient encounters, computer-based and mannequin simulation and part-task trainers such as a lumbar puncture model. Since the LCME's 2021 survey visit, the school says it has invested in cell biology, virology, translational research, 3-D printing, animal facilities, simulation and anatomy.

The Learning Resource Center has a full-time health sciences librarian, space for individual, group and quiet study, more than 10,000 electronic journals and interlibrary loan through the DOCLINE network.

Your College Mentor is your first advisor. You must meet at least once a semester to review your academic performance and career plans, and you can ask to change mentors. Each first-year student is also paired with a second-year student through the Big/Little peer mentoring program.

Academic Counselors, who play no part in grading or promotion, help with study skills, test-taking and time management. If you score below 70% on a summative exam, you and your College Mentor are told and you meet an Academic Counselor. School-funded peer tutoring is available on request or referral; tutors need 80% or more on their latest summative exam and tutor up to eight hours a week.

Career advising starts at orientation with the AAMC's Careers in Medicine resources. At the start of year 3 you are assigned a Career Advisor, and specialty advisors from the faculty and community are available. A Residency Advisory Council of faculty, staff and two elected students helps fourth-year students with the Electronic Residency Application Service (ERAS), interviews, rank lists and, if needed, the Supplemental Offer and Acceptance Program (SOAP).

The Wellness Committee of faculty, staff and students meets monthly and runs student-led subcommittees and a Wellness Day each semester. Counseling options include TimelyCare, a free virtual service available 24/7, and a free clinic run by CNU's College of Psychology in Rancho Cordova. The clinic is staffed by psychology doctoral students and has no session limit. There are more than fifty student interest groups.