Advanced hospital selectives provide the opportunity for students to assume greater responsibility for patient care of the hospitalized patient, with oversight from supervising residents and attending physicians. Students expand upon competencies they develop during the third year as they care for one to two patients at a time. Additional expectations include responsibility for developing management plans, writing orders, patient handovers and transfers of care, recognizing the policies that support patient safety, and developing competency in procedures that they will perform independently as residents. Fourth year students also assist in teaching third year students.

The advanced general surgery rotation is designed for students who are interested in a general surgery residency. They will manage patients as independently as possible with oversight from the general surgery chief resident and an attending surgeon. They will be assigned to the general surgery service at either Borgess or Bronson. Assistance with teaching 3rd year students will also be expected. They will gain operative experience as well as have increased responsibilities managing patients in the inpatient and outpatient setting.