There seem to be some students who do not feel the need for structured learning during the third and fourth year. I posted the following message in the "NOVA" post and felt that it would be nice to post it here as well for more input from other people: Although, I believe that "AdrianShoe" is exaggerating a bit, his comments about lack of affiliation are absolutely correct. I speak from experience when I say, you want to go to a medical school with strong hospital affiliations. Your education during your third and fourth year will depend on it. You are right that you do not need to do a rotation at a site to obtain a residency spot there, but you will not get a good education if all you are doing is setting up your own rotations at various hospitals. This is kind of like going to the library and studying on your own for the first two years and not going to any of your classes and not following any of the outlines. Even though, you might be able to cover all the necessary topics, the structured and organized learning will not be there. You have to be in a teaching hospital that the preceptors are familiar with YOUR school and are PAID by your school and feel obligated to teach students from YOUR school and the hospital feels the need to create a structured learning atmosphere for students from YOUR school. After all this is why you keep paying the same tuition during your third and fourth year of medical school. As a first-second year or a premed, you might feel this is not that big of a deal because you can just set up your own rotations at X hospital that has 1800 beds and you will get to see everything and learn a lot. This is NOT TRUE. You want to be in a place with organized lectures and paid FACULTY as your instructors. Sure all hospitals have organized lectures, if they have a residency program, but you want them to have organized lectures with organized outlines for each of your rotaions made specifically for med students from your school with some of the same faculty members you have seen during your first and second year as your instructors. This is very important for your education. Again I am not talking about getting into a residency program. I am talking about your education.