The Bridges Phase is the final phase of the Three Rivers Curriculum at the University of Pittsburgh School of Medicine, encompassing the 15-month period from February following the Clerkship year through May of the graduation year.
What does the Bridges Phase include?
Variable Required Components –
- Remaining clerkships – Adult Outpatient Medicine Clerkship
- Anesthesiology Rotation
- One Acting Internship – four week selective
- Electives – 36 weeks of variable experiences
- Acute Care Course – four week selective
- Vacation/Interviewing – Eight weeks across both Clerkships and Bridges Phase
Scheduled Cohort Components
Longitudinal Components:
Acting Internship
A four-week Acting Internship (AI) is required during the senior year. An AI is a clinical rotation offered on an inpatient service in which one or more attending physicians hold overall responsibility for coordinated patient care.
Acting internships require students to take coordinated responsibility for all aspects of patient care including assessment, differential diagnosis, test ordering and interpretation, and treatment and discharge planning, while collaborating as part of an interprofessional team. Students participate in all documentation such as admission notes, progress notes, and discharge summaries, and gain experience with cross-coverage, patient handoffs, and regular communication with patients and families. The overall goal is to provide a level of independence and patient ownership that goes beyond standard electives and clerkships, closely simulating the responsibilities of a PGY-1 resident.
Acting internships are offered in the following specialties:
- Cardiothoracic Surgery
- Family Medicine
- Internal Medicine
- Medical Intensive Care Unit (MICU)
- Neonatal Intensive Care Unit (NICU)
- Pediatric
- Physical Medicine and Rehabilitation
- Surgery
Please search the Course Catalog for more information on Acting internships.
Rotations in other departments or institutions will not fulfill the AI requirement.
Acute Care Month
The Acute Care Month is a required four-week selective designed to provide students with experience and skill development in caring for acutely and critically ill patients. Students will participate in the initial stabilization and management of life-threatening conditions, including treatment of shock, respiratory failure, and cardiac and neurological emergencies. Students may enroll in one of the following:
- Adult Critical Care Medicine
- Adult Emergency Medicine
- Pediatric Emergency Medicine
Diagnostics Course
The Diagnostics Course is a required, longitudinal course consisting of six sessions spanning the first 12 months of the Bridges Phase. This course reinforces the knowledge and skills necessary to evaluate the appropriateness, value, utilization, interpretation, and limitations of common diagnostic tests, and to apply test results to personalize patient care. Students will also develop clinical acumen to establish appropriate thresholds for specialist consultation and deepen their understanding of value as it applies to health care.
Discovery Weeks Course
The Discovery Weeks Course is a longitudinal in-person intersession course designed to support students during the Clerkship and Bridges phases, which are periods marked by rapid professional transition, increased clinical responsibility, and dispersion across multiple sites. These five weeks provide structured opportunities to complete required educational experiences, support professional identity formation, and promote a positive learning environment. These sessions reconvene the cohort to address content not easily delivered within rotations, facilitate advising and near-peer mentorship, and integrate wellness and reflective practices that sustain student development and well-being throughout the transition to clinical practice.
The organization of topics across the five Discovery Weeks is deliberately progressive, grounded in students' real-world clinical environments, evolving career and life demands, and advancing professional identities. Content is designed to build over time, enabling students to integrate prior experiences, apply new insights, and refine skills as they progress from early clerkships through Acting Internships, the residency application process, and preparation for graduation. Collectively, these experiences are intended to support a cohesive developmental trajectory that fosters learner growth, resilience, and readiness for the role of physician.
Longitudinal Alliance Program content will be integrated into the Discovery Weeks course in the Bridges Phase.
Integrated Life Science Course
The Integrated Life Science (ILS) course reinforces the relevance of foundational basic and translational science in the context of emerging and evolving clinical practices, building on the years of clinical experience students have accumulated by this stage in their medical education. Students will integrate molecular, cellular, and physiologic principles with clinical care including contemporary therapies, diagnostics, and procedures, and will strengthen their skills in presenting scientific and clinical information clearly to peers and faculty.
Boot Camp
Getting Ready for Residency Boot Camp is a required rotation intensive preparation for students who are about to enter residency. Students will be provided with a combination of general and specialty-specific, clinically relevant content in a variety of modalities. The focus will be on practical content that will prepare the student to function at the starting level of an intern after graduation. The Boot Camp course has seven tracks from which students can choose to enroll in.
- Anesthesiology
- Emergency Medicine
- Internal Medicine
- Obstetrics & Gynecology
- Pediatrics
- Psychiatry
- Surgery
Electives
The UPSOM Course Catalog offers more than 250 elective options across clinical and non-clinical disciplines, including two-week, four-week, and longitudinal experiences. Two-week electives are generally best suited for exploration, allowing students to gain exposure to a particular field, while four-week electives offer the opportunity for a more in-depth experience with more rigorous assessment. Longitudinal electives provide sustained, immersive clinical and educational experiences that foster deeper content mastery, enhance critical reasoning, and support professional identity formation through ongoing engagement with faculty mentors and patient populations. The Course Catalog is searchable here.
Please refer to the Program Director's Recommendations for the Bridges Phase document for specialty-specific guidance. In general, students should consider electives in the following categories:
- Medicine or Neurology
- Pediatrics, Pediatric Neurology, Pediatric Pathology, or Pediatric Surgery
- Surgery or Surgical Subspecialties, Obstetrics and Gynecology
- Ambulatory Care, Community Medicine, or Psychiatry