I can't help much, since I'm not in 3rd year yet (I can chime in again come March
🙂), but I can tell you what I do know.
1)What is the 3rd year like and how is it structured?
Third year you spend at UVA affiliated centers (you can't do rotations outside those already worked out with the clerkship director). You do rotations in Psych, Neurology, Acute Care, Geriatrics, Surgery, Surgical subspecialties, Internal Medicine (inpatient and outpatient), Peds, OB, and Family Medicine. The rotations range in length from 2 weeks (surgical subspecialties, acute care, geriatrics), to 8 weeks (Surgery and Peds).
You are required to spend part of your year 'away' from UVA; we currently have sites in Richmond (Peds and OB), Fairfax (Peds), Western State (psych; though this site is not considered 'away'), Roanoke (Surgery, Psych, Peds-I think, Internal Medicine), and Salem (Surgery, Internal Medicine, Psych), though those will likely change in the next couple years as the VT people are being placed in the Roanoke sites for their rotations, so there's some pressure for space). Those sites are determined by a lottery you do at the beginning of second year.
Outpatient Medicine and Family medicine are also away, and are done at individual clinics throughout the state. Those are chosen at random, and everyone is considered away for them.
The schedule for the day will vary depending on what rotation you're on and where, but basically, you round on patients in the hospital, present to residents and attendings, and monitor their care throughout the day. You'll do some admitting, some consulting, etc, again, depending on your rotation.
2) Where do 3rd year evaluations come from?
Grades are determined by a combination of performance on the nationally standardized Shelf exams and preceptor evaluations. I'm not sure of the exact breakdown, and I think it varies from rotation to rotation.
4) How receptive is the administation to fixing problems and/or disciplining out of line behavior, espcially from residents?
Each class elects Student Advocacy representatives... 2 in first year (who serve 4 year terms) and 2 in third year (who serve 2 year terms). The SAC deals with complaints relating to abuse of medical students, and there are various ways to report this abuse. I haven't heard of any out of line behavior, so I'm not entirely sure how it's dealt with, but there is a system in place to deal with it.
5) how good is this school at focusing on the bread and butter?
We've had some concerns about the treatment of bread and butter things during the pre-clerkship time frame (one of the downsides of having specialists teach you most of the organ systems... hopefully the impact will be less for future years than it was for us), but as far as rotations go... UVA is a tertiary care center, so you will see people who have been referred for the zebras. However, UVA is also the place to go for anyone who does not have insurance in the entire state of Virginia, so there's a fair amount of bread and butter cases as well. I can't comment on the percentage because obviously I haven't seen it yet, beyond the few times I've interviewed patients in the ED or shadowed in the family medicine clinic.
You will also do two of your rotations (4 weeks each) at primary clinics throughout the state, so you'll see bread and butter cases there as well. If that isn't enough for you, there's also a number of electives you can do during 4th year to get better exposure to those bread and butter cases.