D&I Planning

Preparing for D&I

During the Major Clinical Year (MCY), students begin a series of decisions culminating in a particular residency program for postgraduate education. In October, November, and December of their MCY, students plan their Differentiation and Integration (D&I) curriculum, which includes electives and a scholarly project, and participate in preliminary registration in January after MCY. To make the best choices, students must consider their interests and then decide what to study, at which institution, and at which point in the year. Program directors, chairs, residency advisers, advisory deans, senior students, the associate dean for student affairs, support & services, and the associate dean for student career development and the  provide information regarding suitable electives for each career choice.

D&I Structure and Requirements

Electives are offered year-round unless otherwise noted in the OASIS catalog. All electives run from the beginning to the end of the month and are a minimum of four weeks in length. First-day reporting is coordinated by each elective director and/or coordinator.

General D&I Requirements - 14 months total

Electives (8 months), including:
  • Medicine, Pediatrics, or Surgical Sub-Internship (less than 1 month)
  • Ready 4 Residency (R4R)
Scholarly Project (4 months)
Interviews/Vacation (2 months)


Students in the Scholarly Projects Plus program who wish to complete more than six months of full-time scholarly work must meet with the senior associate dean for student affairs and the associate dean for curricular affairs to develop an individualized learning plan (ILP) as part of their project review process. Students in other tracks/programs will have modified requirements.

Elective Types

Columbia University Vagelos College of Physicians and Surgeons (VP&S) students have the opportunity to participate in a wide variety of electives during their D&I phase. There are also options for global health electives and self-arranged preceptorships, as well as self-arranged research electives. Please review UserVoice for more information about how to register for these types of electives:

  • Sub-internship (clinical): Often referred to as a "sub-I," this elective allows students to function as part of a team on a teaching service, with responsibilities closely mirroring those of an intern. Students will have primary responsibility for patient care and may be required to take night calls. The most common sub-internships are in medicine, pediatrics, surgery, neurosurgery, orthopedic surgery, otolaryngology, urology, neurology, emergency medicine, and psychiatry.
  • Consult (clinical): The student will be under the direct supervision of house staff and attendings and will provide consultation to other in-hospital services. Students present cases and are responsible for follow-up of their patients.
  • Preceptorship (clinical): The student will work directly with one faculty member during the course of the elective, performing or observing all the duties of that faculty member.
  • Research (nonclinical): Research electives are self-arranged opportunities for dedicated study on a topic agreed upon with a research supervisor. They are not available to visiting students except where listed in the elective catalog.

Away Electives

VP&S students may receive credit for up to three electives that are full-time, four weeks in duration, and supervised by an MD at a Liaison Committee on Medical Education–accredited school or a Columbia University international exchange program. All other away electives must be approved by the senior associate dean for student affairs prior to the start date of the rotation. Please see D&I Policies and Course Registration for more information on away electives.

Evaluations and Grading

All electives are graded and evaluated through OASIS. VP&S students are required to complete a course evaluation before a student performance evaluation will appear on their schedule. All electives will be graded as Honors/High Pass/Pass/Low Pass/Fail, except for R4R, away electives, and global health electives, which are all graded as Pass/Fail.

Graduation Requirements and D&I Policies

Career Planning

To increase student awareness of upcoming decisions and available options, the senior associate dean for student affairs provides information in the form of memorandums and class meetings beginning in the middle of the MCY and throughout the D&I period. Advisory deans and residency advisers also provide numerous opportunities for students to meet with them and learn about different specialties. Please reference the Career Planning section of the VP&S website for more information.

Columbia University Vagelos College of Physicians and Surgeons Affiliated Hospitals/Sites*

The Allen Hospital*
5141 Broadway
New York, New York 10034
Indian Health Service
PHS Indian Hospital, PO Box 467
Zuni, New Mexico 87327
Basset Healthcare/Cooperstown
One Atwell Road
Cooperstown, New York 13326
Northern Navajo Medical Center
PO Box 160
Shiprock, New Mexico 87420
Harlem Hospital
135th Street and Lenox Avenue
New York, New York 10037
NewYork-Presbyterian Hospital
622 West 168th Street
New York, New York 10032
Helen Hayes Hospital
Route 9W
West Haverstraw, New York 10993
Milstein Hospital Building
177 Ft. Washington Avenue
New York, New York 10032
Indian Health Service
PHS Indian Hospital, PO Box 860
Whiteriver, Arizona 85941
Stamford Hospital
Shelburne Road at West Broad Street
PO Box 9317
Stamford, Connecticut 06902


*The Allen Hospital of NewYork-Presbyterian Hospital is located at 5141 Broadway (near West 220th Street). It is not at the main NewYork-Presbyterian Hospital site.