The Columbia University VP&S MD program

Fundamentals mixes large-group lectures with a lot of required small-group work: case-based discussions, team-based learning, problem-solving sessions and a journal club where students debate the data in classic papers.

Clerkships put you on clinical teams. On the medicine clerkship you work with residents, who are doctors in specialty training, and attending physicians, the fully trained doctors in charge. Together you admit patients and care for them. Two week-long Mechanisms and Practice intersessions bring the class back to small-group classroom teaching on themes that cross specialties, such as the patient-physician relationship.

In D&I you build your own schedule of electives, research and sub-internships. In a sub-internship, sometimes called an acting internship, you do much of the work of an intern, a first-year resident. Near the end, the four-week Ready for Residency course brings the class back together for case sessions, virtual patients and simulation.

School pages last updated between 2018 and 2021 describe four themes, or threads, taught to every student over the four years. Most sessions sit in Foundations of Clinical Medicine, the Mechanisms and Practice weeks and Ready for Residency. The threads are public health, medical decision-making, biomedical informatics (data and computing in patient care) and Systems, Leadership, Integration and Management (SLIM), on leading and improving health systems. Columbia-Bassett students take a deeper version of SLIM.

The work-hours policy approved in April 2024 shapes the Fundamentals week. Required work must average no more than 60 hours a week. The cap counts scheduled sessions plus assigned readings, write-ups, online modules and weekly questions, but not your own studying. You also get two afternoons a week free of required activities, though not the same afternoons for everyone.

Recorded lectures are optional under the July 2024 attendance policy. Small groups, labs, simulation, FCM seminars, patient sessions and exams are mandatory and logged, and a third unapproved absence brings a faculty committee review.

On clerkships you are expected in every weekday, and on weekends when on call. Duty hours are capped at 80 a week averaged over four weeks, with a full day off every seven days on average. Each core clerkship gives a half day for wellness and a half day for shelf study. The clerkship year's only protected holidays are Juneteenth, Independence Day, Thanksgiving and the day after.

The Columbia-Bassett pages publish an example week from the longitudinal clerkship year:

• Monday: outpatient cardiology, then outpatient neurology.
• Tuesday: outpatient surgery, then following your own patients, with emergency room call from 8 p.m.
• Wednesday: outpatient psychiatry, then teaching sessions.
• Thursday: systems improvement time, then outpatient pediatrics.
• Friday: school-based health care for children, then an operating room session.

Anatomy is taught by dissection in Clinical Gross Anatomy. According to Columbia Magazine (Fall 2024), the course runs from August to December. Dissection is part of the first year for Columbia's medical, dental and physical therapy students alike. You start with the chest, move to the arms and legs, return to the chest and abdomen, and finish with the head, which stays covered until then.

Because donated bodies are in short supply, two groups of students share each donor and dissect different parts, learning from each other's work. The lab is open at all hours, so you can return at night or on weekends to study other donors. The class keeps a moment of silence when the donors are first brought out and another before the head is uncovered.

The school's own course page dates from 2018. It describes teams of four learning through dissection, clinical cases, palpation (examining by touch) and prosections, specimens already dissected by experts. X-rays and cross-sectional images are used too, and clinicians link anatomy to radiology and surgery. The lab is on the fifth floor of the Vagelos Education Center.

You meet patients, real and simulated, from the start. Within the first month, FCM seminars bring standardized patients into small-group sessions in the Simulation Center. Faculty coach you closely as you learn to interview people of different ages and backgrounds. Patient-as-Professor sessions also bring patients into class in the first semester to share their stories.

From the second semester, FCM tutorials teach the full interview and physical examination with real patients, and simulation adds motivational interviewing, a counseling method for helping patients change behavior. Psychiatric Medicine includes small-group interviews with psychiatric patients. In the third semester, standardized patient cases turn to domestic violence, substance use and breaking bad news.

Full-time clinical work starts in January of year 2. Under the supervision policy in force since January 2024, you never provide care unsupervised, and a supervisor must be in the room for any procedure. Each core clerkship lists required clinical experiences, such as taking part in a vaginal delivery or placing an IV line. You log them in OASIS, the school's online scheduling and records system.

Every Fundamentals course is pass/fail, and you must pass each of its blocks or sections, which typically takes about 70 percent. Exams are taken on a laptop or iPad through the Examplify app. A failed exam gets a retest, usually the following weekend in the first semester and during a later break after that. In the first semester only, you get one more chance before the course is failed.

Practice exams give feedback without counting. You take customized NBME exams at the end of the first semester and the start of the third, and an NBME basic science self-assessment at the end of Fundamentals. FCM and Psychiatric Medicine add written narrative assessments, and the education center's 2023 FAQ says the FCM courses include a sequence of OSCEs before clerkships.

In the Major Clinical Year, core clerkships longer than two weeks are graded Honors, High Pass, Pass or Fail, and the one-week rotations are pass/fail. Seven core clerkships end with an NBME shelf exam, taken on your own laptop; your first score counts, but a failed shelf must be retaken and passed. Narrative comments from your clerkships feed the Medical Student Performance Evaluation (MSPE), the summary letter residency programs read.

You must pass every part of your clerkships, shelf exams included, before sitting Step 1. If you fail Step 1 you get a month off to study and must retake it within 90 days. Three failed attempts at either Step can lead to dismissal. From the Class of 2028 onward, Student Competency Committees track progress against eight program objectives, on dashboards shared with you and your coach.

• Neurology: an observed neurological history and exam, an OSCE and the shelf.
• Surgery: the shelf and an in-house Clinical Skills Exam.
• Pediatrics: a formative telemedicine OSCE, which is practice and does not count.
• Primary care: a formative OSCE and the NBME Ambulatory Care shelf.
• Every core clerkship: a temporary Conditional Pass until any missing required clinical experiences are logged.
• D&I: sub-internships and clinical electives are graded in tiers starting at Honors; research, away and global health electives are pass/fail.

The school and Presbyterian Hospital developed the Columbia-Presbyterian Medical Center together in 1928, and the hospital, now NewYork-Presbyterian (NYP), is the school's primary teaching hospital. Under the 2025 assignment policy, students in the lottery do medicine, neurology and six specialty rotations, including anesthesiology and emergency medicine, at NYP hospitals. Obstetrics and gynecology, psychiatry, pediatrics, surgery and primary care also use affiliated sites.

Sites come from a three-phase lottery in OASIS. You rank the groups that set your clerkship order, then a top-choice site for one clerkship, and a fill lottery assigns the rest. You can swap with classmates in your group after each round. Expect one to three overnight sites, too far to commute, with lodging provided; exemptions are possible for health, caregiving or major family events.

A Lyft account covers trips to local affiliates before 6 a.m. or after 7 or 8 p.m., depending on the season. Shuttles run to Harlem Hospital and the Allen Hospital, and Metro-North fares to Stamford are reimbursed. Cars are provided for some psychiatry and primary care sites, and airfare is reimbursed for primary care in Miami and at the Indian Health Service. Transportation is not provided for D&I electives.

Electives fill most of D&I. Clinical types include sub-internships, consult services, where you see patients referred by other teams, and preceptorships with one faculty member. Non-clinical types include self-arranged research and project-based courses. You rank choices month by month in OASIS, and some electives, such as those at Stamford and Bassett, are waitlist-only and need the site's approval.

Under the 2025 electives policy, each elective lasts at least two weeks. The final clinical elective must be at a home or affiliated site, with at least 80 percent of your time spent working up and managing patients. Between March and September, when demand peaks before residency applications, you can take at most one internal medicine and one pediatrics sub-internship at NYP or affiliated hospitals. Students applying in medicine or neurology get priority for the medicine places.

Away rotations at other schools are capped at 12 weeks unless a dean approves more. The school's student knowledge base says an away rotation must last four weeks to earn credit, or three in the University of California system. That is longer than the two-week minimum the 2025 policy sets for every elective, away rotations included. Many host schools take applications through Visiting Student Learning Opportunities (VSLO), a shared application platform.

Global health electives, arranged through Columbia's Global Health Exchange Program, other university programs or on your own, are pass/fail. Twelve students in the class of 2026 traveled for one. Columbia also has exchange agreements with more than 20 international medical schools, whose students take electives at VP&S.

The Scholarly Projects Program pairs you with a faculty mentor for at least 16 weeks of full-time work in D&I, finished by the end of March before graduation. You choose one of five tracks: basic and translational science, clinical research, global and population health, medical education, or narrative and social medicine. Your track director approves your proposal in the first month, and you finish with a written Capstone report and a poster.

The project can grow to five months in place of an elective month, or longer with an individualized learning plan. A 12-month research year or a second degree lets you waive it and take 11 electives instead of 7.

Research can start earlier. The three-credit Medical Scholars Seminar in Fundamentals helps you choose a mentor and plan a summer project. After year 1 you can apply for 11 weeks of funded summer research, with a stipend of at least $5,000. Programs include the VP&S Summer Research Program, backed by National Institutes of Health grants, and Global Pop, for global and population health projects at home or abroad.

About 37 percent of a recent graduating class took extra time for research or a dual degree, the school's FAQ says. A research year usually falls during D&I and can be funded by fellowships or sometimes departments. D&I also allows up to three months of research electives. Most dual degrees are applied for after you enroll; the MD-PhD and PhD-to-MD have their own entry routes.

• MD-PhD: Columbia's Medical Scientist Training Program aims for 12 to 15 students a year. You take Fundamentals and at least one clerkship, Step 1, three or four PhD years, then an 11-month clinical year. Most finish in 7 or 8 years.
• 3-Year PhD-to-MD, for people who already hold a PhD: 18 months of preclinical courses, a 12-month clinical year and six months of sub-internship and electives.
• MD-MPH with the Mailman School of Public Health: 42 extra credits in one of five concentrations, usually taken between the third and fourth years, making five years in all.
• MD-MBA with Columbia Business School: three consecutive terms, starting in January after the clerkship year or of your fourth year.
• Also offered: the MD-MS in Biomedical Sciences, a 30-credit research degree with a thesis, plus the MD-MS in Biomedical Engineering and the MD-MA in Biomedical Informatics. Master's degrees in bioethics, human nutrition and narrative medicine are open too.

The Roy and Diana Vagelos Education Center (VEC), a 14-floor teaching building on the CUIMC campus, holds the Fundamentals courses. You return for Mechanisms and Practice, shelf exams and OSCEs during the clinical year, and for Ready for Residency. It has an auditorium seating about 265, a 190-seat lecture hall, classrooms, the anatomy lab, a student commons, study balconies and a lounge.

The Mary & Michael Jaharis Simulation Center occupies the cellar and parts of floors 6 to 8. It has 14 OSCE rooms set up like doctors' offices, with observation glass and recording. Two simulation suites each hold a mock operating room and a mock patient room for manikin scenarios. A 20-station anatomy lab hosts advanced surgical skills courses and task training.

Many students live in CUIMC housing on the medical campus, from studios to multi-room apartments for groups of friends.

Advisory deans, part of a program running since 2003, give academic, career and personal guidance in group and individual meetings that you are expected to attend. In 2023 they hosted lunches every two weeks on transitions such as exam preparation and the clinical year, and met each first-year student one to one.

Since August 2022 every new student has also joined one of six houses, small communities named after Washington Heights streets. Each is made of two FCM seminar groups and led by an advisory dean with two faculty coaches and second-year peer advisors. Coaching itself dates from 2016: your coach stays with you for four years, meeting you every three months during clerkships to review your evaluations and reflective portfolio. Those conversations stay confidential and off your record.

The student-run Student Success Network holds review sessions for most blocks, led by second- and fourth-year students, with review sheets and practice questions. Learning specialists at the Center for Education Research and Evaluation (CERE) advise on study strategies. If a pattern of difficulty emerges, a team including the student affairs dean draws up a support plan.

Student Health on Haven provides primary care and counseling on campus, and Disability Services arranges accommodations. Career advising runs from shadowing and advisory dean lunches early on to a specialty advisor, personal statement workshops and mock interviews in D&I. Columbia-Bassett students also have Life Experiences faculty mentors, who take no part in grading.