ICOM students spend their third and fourth years doing clinical clerkship rotations at core affiliated hospital and outpatient sites. These clinical rotations utilize both traditional and innovative educational options, including regularly-scheduled learning sessions, interactive computer based learning, simulation, with assessment of clinical knowledge and skills. All clinical rotations are with contracted, accredited physicians at clinical sites that offer significant diversity and numbers of patients to allow for excellent educational environments.  

Clinical rotations occur in a variety of settings, including hospitals (inpatient experiences), ambulatory practices, and long-term care facilities. Core hospital assignments will take place in the fall of the second year with significant efforts to place students at their core sites of choice. Each core site has a Regional Dean and Coordinator to facilitate a strong educational experience. ICOM continues to engage hospitals, clinics and physicians to offer new diverse training opportunities. Hands-on learning in osteopathic manipulative medicine will continue in student’s third and fourth years. Core and affiliated rotation sites are subject to change and ICOM cannot guarantee any specific site or state.

The goals of clinical clerkship rotations are based on the American Osteopathic Association’s (AOA) seven core competencies, as well as the 13 Entrustable Professional Activities (EPA’s) per the American Association of Colleges of Osteopathic Medicine (AACOM). The ICOM Office of Clinical Affairs will assist and educate students is scheduling their clinical rotations. All physician preceptors will be board-certified/board-eligible, and be credentialed and contracted with ICOM.


View the Clinical Clerkship Guide & Rotation Manual


Regional Site Placement

ICOM’s third- and fourth-year curriculum delivery occurs through the regional sites located in the states of Idaho, Montana, Wyoming, North and South Dakota and beyond. In the second year of the curriculum, students will be designated to a regional site. Regional site placement procedures are designed to support the mission of ICOM to recruit students to meet the health care workforce needs of the rural and medically-underserved areas that we serve. The Associate Dean of Clinical Education has the authority to assign a student to a rotation site and/or a regional site.

Students from the five mission states will be given every opportunity to return to core rotation sites in their home state.

Third Year

ICOM’s third-year osteopathic medical students are required to complete 12 core rotations. The required rotations for third year are listed below; all core rotations must be taken and completed at ICOM core rotation sites. Core rotations are clinical rotations involving patient care which are required to be completed at a ICOM-affiliated clinical site with ICOM faculty.

The third-year core rotations are family medicine, internal medicine, internal medicine subspecialty, women’s health, pediatrics, behavioral health, emergency medicine, general surgery and surgery-subspecialty. All third-year students will complete clinical preparations, a four-week course at the beginning of their third year, to prepare them for clerkships. Third-year students also must complete a four-week scholarly activity rotation. All third-year rotations must be successfully completed to progress to the fourth year. Third-year students receive four weeks of vacation in the academic year.

The internal medicine subspecialties include: allergy/immunology, cardiology, critical care medicine, endocrinology, gastroenterology, geriatric medicine, hematology/oncology, infectious disease, pulmonology, nephrology,  neurology, and rheumatology.

The surgical subspecialties include orthopedic surgery, cardiovascular surgery, urological surgery, otolaryngological surgery, anesthesiology, dermatology, neurosurgery, pediatric surgery, plastic and reconstructive surgery, and vascular surgery.

Fourth Year

The fourth year will consist of nine elective rotations, typically four weeks in length, to allow adequate time for audition rotations and to strengthen students’ clinical skills and knowledge in their favored specialty.  One required rotation in the fourth year assists students in readiness for COMLEX-USA Level 2 and preparedness for residency. One rotation in the fourth year must be in a primary care specialty. 


Core Affiliated Sites Location
Adventist Health and Rideout Marysville, CA
Allina Health System Minneapolis, MN
Ascension Health System Milwaukee, WI
Avera Health Aberdeen, SD
Benefis Health System Great Falls, MT
Bingham Healthcare Blackfoot, ID
Campbell County Memorial Hospital Gillette, WY
Eastern Idaho Regional Medical Center Idaho Falls, ID
Grande Ronde Hospital LaGrande, OR
Logan Regional Medical Center Logan, UT
Magic Valley Core Site Twin Falls, ID
Monument Health Rapid City, SD
Providence St. Joseph Hospital Eureka, CA
Stony Brook Southampton Long Island, NY
Treasure Valley Core Site | including St. Luke’s, St. Alphonsus, Boise VA, and West Valley Hospital Boise, ID
Trinity Health Minot, ND


Affiliate Sites Location
Benewah Wellness & Medical Center Plummer, ID
Black Hills Surgical Hospital Rapid City, SD
Black Hills VA Hospital Sturgis, SD
Caribou Memorial Hospital Soda Springs, ID
Cascade Medical Center Cascade, ID
Central Washington Family Medicine Residency Yakima, WA
CHI St. Alexius Health Bismarck, ND
Family Health Services Twin Falls, ID
Family Medicine Residency of Idaho (FMRI) Boise, ID
Franklin County Medical Center Preston, ID
Genesis Community Health Boise, ID
Haven Behavioral Services Meridian, ID
Health West Pocatello, ID
Idaho Falls Community Hospital Idaho Falls, ID
Idaho State University FM Residency Pocatello, ID
Idaho Urologic Institute Meridian, ID
Intermountain Psychiatric Hospital Boise, ID
Imaging Center of Idaho Caldwell, ID
Kalispell Regional Medical Center Kalispell, MT
Lost Rivers Medical Center Arco, ID
Madison Memorial Hospital Rexburg, ID
Minidoka Memorial Hospital Rupert, ID
Mountain View Hospital Idaho Falls, ID
North Canyon Medical Center Gooding, ID
Primary Health Medical Group Garden City, ID
Portneuf Medical Center Pocatello, ID
Power County Hospital American Falls, ID
Riverstone Health Billings, MT
Salt Lake City VA Salt Lake City, UT
Saltzer Health Meridian, ID
Sisters of Charity of Leavenworth Health System, St. Vincent’s Billings, MT
St. John’s Medical Center Jackson, WY
St. Josephs Regional Medical Center Lewiston, ID
Star Valley Medical Center Afton, WY
State Hospital North Orofino, ID
State Hospital South Blackfoot, ID
Steele Memorial Medical Center Salmon, ID
Syringa Hospital District Grangeville, ID
Terry Reilly Health Services Nampa, ID
Treasure Valley Hospital Boise, ID
Valor Health Emmett, ID
Veterans Affairs Boise, ID
Vibra Hospital Boise, ID
Weiser Memorial Hospital Weiser, ID
Wellness Tree Twin Falls, ID
West Valley Medical Center Caldwell, ID
Wyoming Medical Center Casper, WY


Framework of Clinical Years

Third Year (13 Blocks) Fourth Year (11 Blocks)
Clinical Preparation Electives (9)
Emergency Medicine Residency Planning
Family Medicine Vacation
Internal Medicine
Internal Medicine Subspecialty
General Surgery
Surgical Subspecialty
Women’s Health
Scholarly Activity


Clinical Clerkship Experience at ICOM