The Geisel School of Medicine at Dartmouth MD program

Within each organ-system course you study the system's normal structure and function, the diseases that affect it, how they are diagnosed and the drugs used to treat them. Cardiovascular Medicine, for example, covers the heart's anatomy and embryology, reading a 12-lead electrocardiogram (ECG), cardiac imaging and the ethics of end-of-life care.

Ten curricular threads run through the courses and clerkships instead of being taught on their own. They are Anatomy and Embryology, Child and Adolescent Health, Ethics and Human Values, Health Equity, Histology, Imaging, Nutrition, Pathology, Pharmacology, and Research and Scholarship. Each has its own leader and objectives but no separate exam; its content is tested in course and clerkship assessments.

Health care delivery science is taught throughout the first two years, mainly in Population Health: study design, statistics, health disparities, the US health care system, patient safety and quality improvement. Medical Learning Science covers evidence-based study methods, a personal wellness plan and your own Step 1 study plan.

In 2026 a review of Phase 1 went to the Medical Education Committee (MEC), the faculty committee with student members that oversees the curriculum. It recommended easing the load in Block 3 and aligning teaching more closely with Step 1 topics. In July 2026 the MEC also heard that its Phase 1 subcommittee had voted to add artificial intelligence and digital health content to Phase 1.

From Phase 2 you learn on hospital and clinic teams, with seminars and written assignments. Every required clerkship except Acute Care Medicine ends with an NBME subject exam, a national multiple-choice test in that specialty from the National Board of Medical Examiners. Short Clinical Education Intersessions bring the class back together at the start, middle and end of Phase 2.

In Phase 1, a school policy last approved in May 2026 caps scheduled contact hours at 24 a week on average across a block, and 26 in any one week. Contact hours count lectures, labs, PBL and TBL sessions, small groups, simulation, preceptor visits, online modules and exams. Required activities outside courses add at most 4 hours a week, and each 40-hour week keeps at least 12 unscheduled hours for self-directed study and career exploration.

From Phase 2, a policy last approved in November 2025 limits you to 80 hours a week in the hospital or clinic and 30 hours in a row. Call comes no more than one night in three, and on average one full day a week is free of patient care and teaching.

Anatomy is taught through the Anatomy and Embryology thread rather than as a separate course. You meet the general layout of each body system in the opening Foundations course, then study each system's anatomy in more detail inside its organ-system course. The thread also covers human development, death and dying, and the ethics of learning from body donors.

Lab teaching takes place in the school's dissection laboratory, with bodies given through Geisel's own Anatomical Gifts Program, run by the Department of Medical Education. Donors are people in New Hampshire and Vermont who registered before they died, and the school says its studies may take up to two academic years. Communication and teamwork, practiced in the lab and in case-based sessions, are a major part of the thread.

Anatomy is tested in course exams and in anatomy lab practical exams. A pilot reported to the MEC in June 2026 required the Class of 2028 to score at least 70% across Phase 1's 313 anatomy and embryology questions, with multiple-choice and practical questions counted equally. The school found that the lab practicals, more than the threshold, drove students to study anatomy, and students below 70% took remedial sessions in Block 7.

Your first patient contact comes through On Doctoring. In year 1 it combines large and small group sessions, interviewing and examination practice with standardized patients, and work in a preceptor's office. Its Psychology of Illness portion meets mainly in two-hour blocks: an hour of panel discussion, then an hour of small groups led by mental health professionals.

In year 2, On Doctoring continues with interviewing, examination, case presentations and more preceptor work. The course also includes extensive note writing and two sessions on the electronic medical record. The Derm-Rheum-Ortho course adds a two-hour clinic session in which small groups see dermatology patients with a dermatologist or resident. Psychiatry runs weekly small groups where you observe and join patient interviews.

Students and faculty also volunteer at the Good Neighbor Health Clinic in White River Junction, which gives free care.

Phase 1 courses are graded pass/fail. Course exams use multiple-choice questions. For students entering from fall 2026, failing up to two of the year-1 foundational and organ-system courses earns an Incomplete, and passing a retest turns it into a Pass. The failure then leaves no record on your transcript or MSPE, the Medical Student Performance Evaluation sent with residency applications. This second chance ends after year one and does not cover On Doctoring, Population Health or Medical Learning Science.

Clinical skills are tested in Objective Structured Clinical Examinations (OSCEs), in which you move through timed stations, each with a task such as taking a history from a standardized patient. You sit several OSCEs in each of the first three years at the Patient Safety Training Center at DHMC. The Clinical Education Intersessions course is pass/fail, and you must pass it, including its year-end OSCEs, to progress through Phase 3.

The USMLE has three Steps, and MD students take the first two in medical school. Step 1, on the science behind medicine, has been pass/fail since January 2022; Step 2 Clinical Knowledge (CK) tests clinical medicine and is still scored. Because the program is LCME-accredited, its students are eligible to sit the USMLE. Geisel requires a passing Step 1 score to graduate, and its Step 2 policy, last approved on March 18, 2026, adds a passing Step 2 CK score from the Class of 2030.

Under Geisel's Step 1 policy, last approved on July 16, 2025, the calendar gives you a six-week dedicated study period at the end of Phase 1. You must take the exam by the last day of Phase 1, before clerkships, unless an exception is approved. On the 2026-27 and 2027-28 second-year calendars that period runs from mid-February to late March. You must also complete a school-sponsored NBME practice exam by December 1 of year 2.

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. On the current schedule, a student entering in 2027 would sit Step 1 around March 2029, shortly after the switch. Step 2 CK must be taken by January 31 of your final year: January 31, 2031 for a 2027 entrant on the current policy, well after the switch. You need a passing score by February 25 to enter the residency Match.

Core clerkships have been graded Honors, Pass or Fail since April 2025, replacing a four-tier scale that also had High Pass. A clerkship grading committee weighs your Student Performance Evaluation, the form supervisors complete, the clerkship's assignments and your NBME subject exam, often called the shelf exam. As the MEC heard in June 2026, the shelf now counts for 20 to 25% of the grade, and Honors requires at least the 50th percentile on it.

• If Geisel's review of your Phase 1 results and NBME practice tests finds you need more Step 1 time, your Phase 2 schedule opens with a six-week elective block. You must also enroll in an approved non-clinical elective. If you fail Step 1, you cannot start a clerkship or clinical elective until you pass.
• You must pass Step 1 before starting a dual-degree year such as the MBA or MPH, the PhD phase of the MD-PhD, or an Academic Scholar Year of research.
• To pass a clerkship you must score above the 5th percentile on its NBME exam; across all required clerkships you get one shelf retest without a transcript note.
• In 2025-26, the first year of the new system, Honors fell from 59% to 42% of core clerkship grades.
• Acute Care Medicine is pass/fail in 2026-27, since no NBME exam exists for it; it is assessed on clinical performance, case write-ups and simulation.
• Transition to Residency and SPIM are pass/fail. Sub-internships and clinical electives longer than two weeks are graded Honors, High Pass, Pass or Fail; shorter clinical electives are pass/fail.

Geisel calls DHMC and the White River Junction VA its two affiliated academic medical centers. DHMC, which describes itself as New Hampshire's only academic medical center and only Level I adult trauma center, the top tier of trauma care, also houses Golisano Children's Hospital. Surgery adds Concord Hospital and two Dartmouth Health community hospitals, Alice Peck Day in Lebanon and Mt. Ascutney in Windsor, Vermont.

Clerkship registration runs through a lottery in OASIS, the school's online scheduling system. The lottery sets your clerkship order and, together with site preference forms for some clerkships, your sites. Students placed at California Pacific Medical Center or Santa Clara Valley Medical Center for inpatient medicine spend all seven clinical weeks there. Those staying local rank VA general medicine, DHMC general medicine and DHMC cardiology, then rotate at two of them.

If you have dependent children or a child on the way, or health needs that require frequent appointments, the Office of Clinical Education gives special consideration to your site requests. Contact it before the lottery if you can. Not having a car or driver's license does not usually qualify, and neither do a partner, pets or research plans.

Family medicine practices across New Hampshire, Vermont and Massachusetts can be up to two and a half hours from the Upper Valley, the area around Hanover and Lebanon. Students placed more than an hour away are given housing. Distant sites, chosen through the lottery, can include Valdez, Alaska; Belfast, Stockton Springs and Waterville, Maine; Missoula, Montana; and Shiprock, New Mexico.

Some sub-internships also take you away. Family medicine sub-internships run at three sites: the New Hampshire Dartmouth Family Medicine Residency at Concord Hospital, the Maine-Dartmouth Family Medicine Residency in Augusta, Maine, and the Greater Lawrence Family Health Center in Massachusetts. Geisel provides or helps with housing for each, the Augusta and Lawrence options require a car, and travel costs are yours.

Optional M1 and M2 Enrichment Opportunities run alongside Phase 1. Examples include Deaf Health, Reproductive Choices, Introduction to Medical Device Innovation, an ophthalmology clinical experience in Keene, and Medical Care and the Corporation at the Tuck School of Business.

Phase 2 leaves room for up to six weeks of clinical electives, and Phase 3 holds most of the rest. Across the two phases you need a four-week sub-internship and 20 elective credits. Twelve must be clinical, eight can be clinical or non-clinical, and at least six must be outside the specialty you plan to enter.

The 2026-27 catalog lists 30 sub-internships, from neurology and pediatric intensive care to colorectal, plastic and thoracic surgery. On the DHMC medical sub-internship you are the primary caregiver for four to seven inpatients, supervised by a hospitalist, a doctor who looks after hospital inpatients. At California Pacific Medical Center it is four to six, on a five-day call cycle.

The same fourth-year catalog lists about 75 clinical electives (97 listings, counting separate two-week versions) and 27 non-clinical electives. Examples range from Street Medicine with Pittsburgh Mercy and forensic pathology at New Hampshire's Office of the Chief Medical Examiner to a radiology bootcamp and Tuck courses on health economics.

Away rotations, electives at other institutions, go through Visiting Student Learning Opportunities (VSLO), the national application service, with invitations to third-year students in December. Away and other non-catalog electives need approval and OASIS registration before they start, requested at least four weeks ahead. International ones also need travel registration.

Students in the optional Global Health Equity Pathway of Concentration can take four-week fourth-year exchange electives through the Center for Global Health Equity, each with travel funding. Options include inpatient care at Chongqing Medical University hospitals in China and a national tertiary care hospital in Kigali, Rwanda. In Dar es Salaam, Tanzania, you can work at Muhimbili National Hospital or join HIV and tuberculosis research.

Research is part of the MD for everyone. Population Health in year 1 includes launching a scholarly project and a workshop on the IRB, the board that reviews research involving people, and SPIM completes the work in Phase 3. You can also apply for funded summer research between years 1 and 2, though you may accept only one competitive program.

The MD Research Scholars program, named for Dean Emeritus Duane Compton, selects five students each September of year 2. Scholars attend monthly evening meetings, work with a formal research mentor, present at department grand rounds in year 4 and submit a manuscript to a fourth-year paper contest. The program fulfills the research requirement for graduation, and the designation appears on your transcript.

For more time, the Academic Scholar Year (ASY) adds at least nine months, usually a year, of approved research or scholarship, during which you remain a full-time student. Under the policy for the Class of 2028 onward, you must first finish the Phase 2 clerkships and pass Step 1, and the year starts no earlier than the first Phase 3 block. It earns pass/fail credit on your transcript and fulfills SPIM. Fellowships for it include the Stephen Marsh Tenney Fellowship and others in pathology, radiology and radiation oncology.

Dual degrees combine the MD with another Dartmouth degree. The MD/MBA with the Tuck School of Business takes five or six years; you apply in year 2 and take the MBA year between MD phases. An MD/MEng with Thayer School of Engineering, an MD/MHA, and one-year MD/MPH and MD/MS options are also offered, the last two often after the clerkships. In 2024-25, 11 students were in the MD-MBA and one in the MD-MPH.

The MD-PhD takes about seven to eight years and had 20 students in 2024-25. You complete years 1 and 2 of the MD, spend typically three to five years on the PhD through Guarini or Thayer, then return for the clinical years. Geisel notes it is not a Medical Scientist Training Program (MSTP), the MD-PhD training program funded by the National Institutes of Health, though its trainees get comparable benefits.

Pathways of Concentration are optional four-year programs alongside the MD in Rural Health, Urban Health, Medical Spanish and Global Health Equity; you apply in the fall and may join one. Each ends in a community-engaged scholarly project. The Rural Health Pathway, still being refined, steers you to clerkships at DHMC and community hospitals in places such as Keene and Rutland, then a rural elective, and its project fulfills SPIM.

The Patient Safety Training Center, also called the Sim Center, occupies 8,000 square feet on level two of DHMC. Besides standardized patients and OSCEs, it has lifelike computerized manikins that show vital signs on a bedside monitor, reproduce heart and lung sounds and can be intubated. They come in adult, birthing, child, infant and newborn versions. Makeup called moulage creates realistic wounds.

The Learning Collaboratives, launched in July 2025, are Geisel's learning communities. Each student joins one of four houses and stays in it from matriculation to graduation. Every house has elected student leaders and clinical mentors who guide you through all four years, teach clinical skills through On Doctoring, help you set goals and hold regular one-to-one check-ins. Community service now also runs through the houses.

Senior career advisors meet you one to one and in small groups from Phase 2, helping with residency applications, CVs, personal statements and dual-degree, couples and military matches. Specialty advisors run group sessions in every phase and meet you one to one in Phase 3 about specialty choice, away rotations and letters of recommendation.

The Office of Academic Advising and Accessibility has academic coaches for time management, study strategies, test-taking and the Step exams. It also runs free peer tutoring, usually from second-year students, and a weekly group review session for first-years. Preclinical and clinical Committees for Academic Advancement and Growth monitor performance and set up tailored support plans.

The Navigator Program offers voluntary, confidential coaching from coaches trained to International Coaching Federation standards: 30 to 45 minutes every two weeks for two to three months, with limited places. Geisel Counseling gives free, confidential mental health support at two Hanover locations and online, and the Counseling Center at Dick's House offers 24-hour crisis support.