Osteopathic Clinical Medicine IV (OCM IV) is a fourth-year transition to residency (TTR) course designed to align with consensus-derived recommendations for knowledge and skills needed in the transition to residency. The course will prepare students for different aspects of the residency application, match and post-match as well, including interview preparation, learner self-assessment and reflection, and the development of individualized learning plans for residency. Didactic sessions focus on preparing students for increased patient care responsibilities, and patient-centered, population-based & interdisciplinary team-based care that factors in the understanding of systems and healthcare policies. The course includes hands-on osteopathic skills lab concentrating on manipulative treatment for hospitalized patients.