The Zucker School of Medicine at Hofstra/Northwell MD program

The school was designed around self-directed learning, favoring small-group work on cases and applying concepts over memorizing facts. A policy last updated in September 2021 caps required class and clinical time at an average of 22 hours a week, or 24 in the opening course, which includes EMT training. Classes run five days a week.

PEARLS (Patient-centered Explorations in Active Reasoning, Learning and Synthesis) is the core of years 1 and 2. The school calls it a hybrid of case-based and problem-based learning: the cases have learning objectives built in, but your group has to find and research them. You stay with eight or nine classmates and one faculty facilitator for a whole course.

At the first session of the week the group works through two patient cases and sets learning objectives. Everyone researches them, and at the second and third sessions you explain what you found and pull it together.

Each course has three components. Mechanisms of Health, Disease and Intervention covers physiology, pathophysiology, pharmacology and therapeutics. Structure joins anatomy, embryology, histology, pathology, imaging, physical diagnosis and ultrasound. Patient, Physician and Society covers social and behavioral science and clinical skills through twelve threads, such as health equity, ethics, patient safety and health care financing.

In years 3 and 4 learning moves onto clinical teams, with structured exercises that keep science tied to patient care and week-long Core Learning sessions back in the classroom.

Each week of the First 100 Weeks has a theme set by its PEARLS cases, with three PEARLS sessions anchoring it. Structure labs, physical diagnosis, large group sessions and Patient, Physician and Society small groups follow the same theme. Once ICE starts, one afternoon a week is spent in a preceptor's office.

The school's sample of the EMT course shows how it fits together. In week 2, To Breathe or Not to Breathe, the EMT side covers burns, inhalation injury, bag-valve-mask ventilation and oxygen delivery. The physician side adds lung physiology, chronic obstructive pulmonary disease (COPD), pneumonia and pharmacology principles, plus a hypothesis-driven lung exam with ultrasound of the diaphragm and pleura.

Anatomy is part of the Structure component of every course in years 1 and 2. The Structure lab puts gross anatomy, histology and embryology alongside pathology, imaging, ultrasound and physical diagnosis, and Northwell's hospital-based doctors join the sessions.

You meet your anatomical donors, given through the school's Anatomical Gift Program, in the first course. You then explore clinical cases through several focused dissections, each ending in a presentation to peers and faculty. Course descriptions place the pelvis in The Biologic Imperative, the abdomen in Fueling the Body, and the heart, lungs and kidneys in Homeostasis.

Year 2 covers the limbs in Interacting with the Environment, and neuroanatomy, the special senses and the head and neck in The Human Condition. Besides donors, the lab uses prosections (specimens already dissected to display key structures), pathology specimens, models, task trainers and 3D virtual anatomy programs.

You also practice procedures there with standard kits, surgical instruments, laparoscopy and endoscopy, and build suturing skills. An annual student-led memorial service thanks the donors and their families. In year 3 you return before each core clerkship for sessions on its key structures and procedures, and year 4 offers a four-week Structure elective.

Real patients arrive within weeks. The EMT part of the first course follows the New York State Department of Health curriculum, with physician-level science added. You ride ambulances with certified Northwell EMTs, help stabilize patients before they reach the hospital and follow patients through the emergency room, meeting medical, traumatic and behavioral emergencies.

EMT training culminates in Mass Casualty Incident Day at the Nassau County Fire Service Academy. In September 2026, first-years triaged and treated actors in staged disasters, from an active shooter to a Long Island Rail Road derailment. The school says roughly 1,500 students have trained as medical student EMTs.

ICE begins in the second course. Year 1 brings preceptors in general medicine (internal or family medicine), surgery, and obstetrics and gynecology, and year 2 adds pediatrics and psychiatry. You take an active part in patient care. Two flex sessions in year 1 and three in year 2 let you try settings such as the emergency room, house calls or eICU telemedicine.

The school's 2021-22 ICE student handbook describes afternoons of about four hours. You aim to take a full history and examination from at least one patient, see others for shorter visits, and follow longitudinal patients over the two years. Each ICE clerkship includes a written narrative assessment of your performance.

Outside the curriculum, students run a free clinic in Rego Park, Queens, with faculty physicians, offering physicals, sick visits, vaccines and blood work to patients in need.

Every First 100 Weeks course is graded pass/fail, with written narrative feedback. Under the grading policy posted in August 2026, parts of each course are rated Meets Expectations, Marginal Performance Without Remediation or Does Not Meet Expectations. Formative assessments and summative ones (which count) run through each course and come together in its RIA week.

A school news story from April 2026 says traditional multiple-choice exams were replaced with essay assessments and high-fidelity simulations. That applies to years 1 and 2, whose formats the June 2026 brochure lists as short-answer essay exams, clinical skills exams, lab practicals, project-based presentations and narrative feedback from faculty and preceptors. Clerkships in years 3 and 4 use NBME subject exams, covered below. School policies name a final essay exam and Structure exams, and you can review an exam by appointment twice a year.

Clinical skills are tested in objective structured clinical examinations (OSCEs), where you see standardized patients and are scored against checklists on skills such as communication, examination and interpreting results. You sit practice OSCEs as well as assessed ones, and some clinical skills assessments take place at Northwell's Center for Learning and Innovation.

In years 3 and 4, core clerkships and acting internships are graded Honors, High Pass, Pass or Fail; the Continuity Clinic, Core Learning, selectives and electives are pass/fail. Clerkships use NBME subject exams, often called shelf exams, which are national tests in each specialty. They also use short-answer essay exams in surgery, clinical skills exams, faculty and resident feedback, write-ups and professionalism.

Step 1 has been reported pass/fail since January 2022; Step 2 CK comes next. LCME accreditation is what makes the school's MD students eligible to sit the USMLE. To sit Step 1 you must have passed every First 100 Weeks course except Transitions, and you must take it before Transitions and pass it to stay in the Second 100 Weeks.

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 2027 entrant would study for Step 1 from about late March to early May 2029 and sit it before Transitions that May, a few months after the switch. Step 2 CK, required before graduation, falls after the switch.

• Final grades are posted within six weeks of the end of a course or clerkship.
• A first Step 1 failure means joining the school's independent-study Step 1 preparation course. Under the August 2026 Policy on Academic Standing, which covers the Class of 2029 onward, including 2027 entrants, it also puts you on Academic Warning, an internal support status, with a remediation plan.
• A second failure, or a first one while already on Warning or probation, goes to the Student Advancement Committee, which oversees student progression, and can lead to probation or dismissal.

In years 1 and 2 your base is the school building on Hofstra's North Campus in Hempstead, about 25 miles from Manhattan. You leave it for EMT shifts, ICE afternoons in community practices, and simulation at Northwell's training centers.

The school's Second 100 Weeks page says clinical training takes place across three tertiary campuses in New York City and on Long Island. They are Lenox Hill Hospital in Manhattan, North Shore University Hospital and Long Island Jewish Medical Center, which includes Cohen Children's Medical Center and Zucker Hillside Hospital. The third-year page also lists South Oaks Hospital, used with Zucker Hillside for psychiatry, and Southshore Hospital. The school's June 2026 brochure names one more, Katz Women's Hospital, among the Northwell hospitals where students train.

The school's Clinical Experiences Team assigns clinical sites. Under a policy last updated in June 2019, you can ask for a different site only on grounds of mistreatment, a conflict of interest or other exceptional circumstances. Otherwise you can look for a classmate willing to swap.

Getting around is your responsibility. The transportation policy, last updated in April 2018, says public transportation is limited, so you must have a valid driver's license and access to a car, with possible exceptions for recognized disabilities. Site assignments are not made around transportation preferences.

On clerkships you follow the work-hour rules of Northwell's residency programs, under a policy last updated in February 2019. These allow no more than 80 hours a week averaged over four weeks, with at least one day off in seven and in-house call no more often than every third night.

Selectives come in year 3: four weeks, as two 2-week rotations chosen from approved specialty options within Northwell. They let you explore careers outside the core clerkships before you plan year 4.

Year 4 has 20 weeks of electives, in two-week or four-week rotations, at Northwell or other LCME-accredited institutions; others need special committee approval. Options include research, external and global electives, an extra acting internship, and clinical preceptorships, where you find a mentor and design a two- or four-week experience that a committee approves.

The school encourages you to spend at least half of your elective time in areas related to, but distinct from, your main field. You can apply for away rotations, electives at other institutions, from January of year 3. The Office of Student Records helps through the Visiting Student Learning Opportunities service of the Association of American Medical Colleges (AAMC). You must submit each away rotation to the school for credit at least four weeks before it starts; later requests earn no credit except in extenuating circumstances.

Global electives run through Northwell's Center for Global Health. Its flagship site, Georgetown Public Hospital Corporation in Guyana, usually takes students for four weeks with free Northwell housing. Universidad San Francisco de Quito in Ecuador takes students fluent in Spanish. Through Nuvance Health, which joined Northwell in 2025, further partner sites range from Botswana and Uganda to Vietnam, usually for six weeks.

Some options start earlier. The Surgical Skills course for second-year students, accredited by the American College of Surgeons, takes 16 students per cohort. Over seven weeks, a one-hour discussion and a 90-minute lab each week cover suturing, laparoscopy, endoscopy and robotics, and the course ends with a day in the operating room with a Northwell surgeon.

In year 4 up to ten students a year can earn the SONICS certificate in point-of-care ultrasound. It combines a four-week ultrasound elective, a faculty-reviewed scan passport, an image portfolio, an exam, co-teaching and a capstone. Medical Spanish is offered as an elective and a certificate.

Research is optional but encouraged. The Medical Student Summer Research Program runs from June to August after year 1. Projects can be at Hofstra, Northwell, the Feinstein Institutes for Medical Research or Cold Spring Harbor Laboratory, under a faculty mentor, with stipends by application. The school's June 2026 brochure says at least 90% of students do research that summer.

Later you can take research electives of 4 to 12 weeks in year 4 or apply for a research year away from the MD. Students who complete a hypothesis-testing study and submit a manuscript to a peer-reviewed journal can be considered for Graduation with Distinction in Research.

Scholarly concentrations are optional tracks that run alongside the MD and end in a capstone project. Humanities in Medicine looks at medicine through the arts and humanities. IMPACcT trains you in primary care alongside nutrition, pharmacy, physician assistant, psychology and social work trainees. Medical Education covers teaching and educational research. Health Economics and Clinical Effectiveness places you in an outcomes research program at the Feinstein Institutes.

The Klar Leadership Development and Innovation Management program, which marked ten years in 2026, admits first-year students to a summer project inside Northwell, then mentoring and seminars. A May 2026 school news story says 31 fourth-year students completed a concentration that year, in leadership, medical education, humanities, interprofessional primary care or point-of-care ultrasound.

Joint degrees open to enrolled students include the MD/MPH with Hofstra's School of Health Sciences, the MD/MBA and the MD/MA in Clinical Bioethics. Most students take a one-year leave after year 3 for the graduate coursework, aiming to finish both degrees in five years. The MD/MS in Translational and Clinical Research is a one-year research program for students who have finished the First 100 Weeks and taken Step 1.

MD/PhD students are admitted during the application process. They earn a PhD in The Molecular Basis of Medicine at the Feinstein Institutes or Cold Spring Harbor Laboratory over seven to eight years; the brochure says four join each year. After the First 100 Weeks and Step 1, in May of year 2, they spend about four years on research before returning for the Second 100 Weeks.

• MD/PhD students must apply for a National Institutes of Health F30 grant and can stay clinically active during the PhD, for example with 16 hours a month in Northwell emergency departments.
• MD/OMS: a six-year oral and maxillofacial surgery residency pathway at Northwell for dentists with a DDS or DMD, including the MD.
• Hofstra 4+4 BS-BA/MD: high school seniors apply to Hofstra as first-time, full-time freshmen, and a class of 10 to 15 moves into the MD if they meet the program's grade and MCAT conditions.

The school building on Hofstra's North Campus has 113,000 square feet. It grew from a 48,000-square-foot building that, according to the school's 2024 fact sheet, was formerly the New York Jets football team's training facility. It has 25 small-group rooms for eight to ten students, two medical education theaters seating more than 200 with lecture capture, clinical skills rooms and a health sciences library.

The Structure Laboratory covers 7,300 square feet and holds more than 125 people, with built-in computers, large monitors and surgical lighting. The brochure says on-campus graduate housing and parking are available.

The Office of Academic Success helps with studying in a student-centered curriculum, board exam preparation, academic difficulty and disability accommodations. During the Step 1 study period it advises taking about three Comprehensive Basic Science Self-Assessments at roughly two-week intervals. In years 3 and 4 it helps with NBME subject exams, clinical skills exams and write-ups.

Career advising starts in the First 100 Weeks with the AAMC's Careers in Medicine tools, then adds career advisors and departmental advisors for residency applications and the Match. Your Patient, Physician and Society small groups also run as continuity groups led by faculty mentors, where you reflect on becoming a professional.

The Office of Student Affairs runs a wellness program with sessions for each year. Hofstra's Student Counseling Services, a five-minute walk away, offers free counseling and a 24/7 crisis line. Northwell's Behavioral Health College Partnership at Zucker Hillside Hospital gives access to psychologists and psychiatrists, and TimelyCare adds free 24/7 virtual care.

If you hit difficulty, the Learner Remediation Committee draws up a remediation plan. Academic Warning, which signals a pattern of difficulty, does not appear on your transcript or your Medical Student Performance Evaluation (MSPE), the school's letter for residency applications. A four-week Summer Pre-Matriculation Program before year 1 is open to all incoming students.