Background
In contrast to schools with a highly structured post-clerkship phase, we offer notable flexibility for students’ schedule creation. Required coursework during thirteen 4-week blocks includes one sub-internship, Transition to Residency, a basic science/humanities selective and a longitudinal health systems science course. Twenty-four weeks of elective credit are required during enrollment. Concerns about student time utilization and academic rigor in the post-clerkship period have been raised centered, prompting this analysis.

Methods
We obtained final year schedules for the graduating classes of 2023, 2024, and 2025. MATCH information was added. We analyzed schedules for (1) the number and types of electives (clinical, research, career development) including when in the year these were scheduled (2) away electives (3) unscheduled/vacation periods. Schedules were also analyzed by GME training discipline. Analysis used descriptive statistics.

Results
Data from 638 students (2023=207, 2024=213, 2025=218) were reviewed. Few students scheduled electives with direct patient contact in the last 5 periods. Almost all students doing away electives (n= 303, 47.5%) scheduled rotations early in the academic year (primarily surgical subspecialties, ophthalmology, dermatology). An increase in away rotations was observed for the 2025 graduates. The average unscheduled/vacation blocks was 5.15 (SD 1.22, range 1-7.5) notably in first (Step2 study) and lattermost (post-Match) periods of the academic year.

Discussion
Reviewing our student schedules revealed limited patient care experiences in the final half of the post-clerkship phase, raising concerns about readiness for internship. Post-clerkship requirement updates to date include the addition of a second sub-internship, and a required direct patient care elective within 5 months of graduation. Academic calendar adjustments are underway to allow earlier dedicated Step 2 study time and free time before internship.