Your first year as a resident is basically your intern year, when you rotate through several different services, usually IM, ER, Gen Surg, etc. That's basically the same thing that other residents do that don't have a traditional year internship. As mentioned, traditional internship years aren't required for us because we choose a specialty right off the bat and our off-service rotations are built into our residency. It has nothing to do with how much we do/don't do during our 3rd/4th year.