4th year will surprise you. Assuming everything is scheduled on time, you will truly only have a few months until residency applications are already due. By September and October,  rotations will become less meaningful and more of a requirement for hours rather than experiences as the priority transitions over to interviews for residency.

The first few months, likely on sub internships, the goal is to impress and show residents and attendings that you would fit in at their program as a resident next year. It is very important to push yourself in every way and go out of your way to adapt to any situation that is thrown at you. These are important qualities program directors look for.

Also, it might be beneficial to start forming your identity. Students come and go, try to come up with something that you will be remembered for or remembered as, in a positive light. Besides all the hard work, try to build and form bonds with the residents and attendings and tell them things about yourself outside of medicine. Read about my experience with common interview topics to see why 

At some programs, residents will have a say in the interview and application process and some may even interview you. If they have positive experiences with you, the interview day will go smoothly as well.

If you work with an attending that will later possibly interview you, again, you’ll have good experiences to fall back on and you will come across as being more genuine about wanting to be at that program.

After applications are in, your attention should be shifted to researching and knowing about the programs you applied to. Early on, try to follow up on programs high on your list to make sure you get an interview. It may also be beneficial to gently remind anyone you know at the programs that you did apply and are genuinely interested in their program. If you are currently rotating in the hospital to which you applied and did not receive an interview, I would even consider stopping by the office and showing your face and showing that you really enjoy your current experience at the hospital and follow up on the status of their interview invitations. Use this method at your discretion and based on what the residents and students there have heard in the past. Some programs are less open to this approach than others however it does work. And at the end of the day, what do you have to lose. You are walking in without an interview, you can only gain from there.