This course begins in summer of third year. Course includes: 1) Objective structured clinical examinations (OSCEs) throughout the academic year to evaluate student’s history and physical examination, interpersonal and professionalism skills, and SOAP note writing documentation skills; 2) Asynchronous nutrition lectures; 3) One OMM workshop; 4) Online antibiotic stewardship course; 5) Online clinical Aquifer cases to assist in preparing for OSCE cases; 6) Required attendance at either an Arizona state medical board meeting, or an out-of-state medical board meeting; 7) Online medical Spanish modules; 8) Buprenorphine training; 9) Core Competency Capstone for DOs (C3DO). Students must pass their end-of-third year C3DO to progress to fourth year. Students must take a COMSAE Phase II examination and achieve a predetermined baseline score in order to progress to the fourth year.