South Dakota has one medical school, the public University of South Dakota Sanford School of Medicine, founded in 1907 (school list) and accredited by LCME since before 1942, with its next full survey due in 2033-34 (LCME). It teaches at Sioux Falls, Vermillion, Rapid City, Yankton, Spearfish and Pierre (school list).
In 2025-26 it had 1,076 applications for 71 first-year places, and 78.9% of the entering class came from South Dakota (AAMC FACTS). The CMS list counts three teaching hospitals: Avera McKennan and Sanford USD Medical Center in Sioux Falls, and Monument Health Rapid City Hospital in Rapid City (CMS list).
Medical schools in South Dakota
| School | City | Degree | Founded | Type | Exam series |
|---|
| University of South Dakota Sanford School of Medicine | Vermillion | MD | 1907 | Public | USMLE |
Several of these schools teach students at more than one site: University of South Dakota Sanford School of Medicine also lists Sioux Falls, South Dakota, Rapid City, South Dakota, Yankton, South Dakota, Spearfish, South Dakota, Pierre, South Dakota.
School list: LCME and COCA accreditation lists, via the list of medical schools in the United States, checked October 2026.
Teaching hospitals in South Dakota by city
- Sioux Falls: Avera Mckennan; Sanford USD Medical Center
- Rapid City: Monument Health Rapid City Hospital
Facts about South Dakota
| School | City | LCME accreditation | Next full survey | 2025-26 applications | First-year places | Entering class from South Dakota |
|---|
| University of South Dakota Sanford School of Medicine | Vermillion | Full, since before 1942 | 2033-34 | 1,076 | 71 | 78.9% |
Accreditation: LCME directory; applications, places and in-state share: AAMC FACTS, Table A-1.
| City | Internal medicine residency program | First-time takers, 2023-2025 | Passed |
|---|
| Sioux Falls | University of South Dakota Program | 23 | 100% |
ABIM internal medicine certification exam by residency program: ABIM residency program pass rates; ABIM says to read rates from under 25 takers with caution.
- The Sanford School of Medicine teaches in three pillars; Pillar 1, before the clerkships, is 10 integrated science blocks over 3 semesters, each running beside a clinical foundations course and graded satisfactory/unsatisfactory. (USD Sanford School of Medicine)
- In Pillar 2, over 12 months, Sanford students complete seven core clerkships as a longitudinal integrated clerkship on one of three clinical campuses, Rapid City, Sioux Falls or Yankton, or in rural communities through the Frontier And Rural Medicine (FARM) program; the first semester is pass-fail and the second brings letter grades. (USD Sanford School of Medicine)
- Pillar 3 lasts 16 months and requires two surgery subspecialty experiences, an emergency medicine rotation, an acting internship (sub-internship) and a capstone rural family medicine experience, with the rest left for electives, research and away rotations. (USD Sanford School of Medicine)
- The school's curriculum chart places a break for Step 1 prep in the second year, after the last Pillar 1 system blocks and before the Pillar 2 longitudinal integrated clerkship begins. (USD Sanford School of Medicine)
- The Pillar 2 calendar for the February Class of 2027 schedules NBME midterm exams in weeks 24 and 25, a CCSE exam in week 21 and another in week 39, and NBME final exams at the end of the clerkship year. (USD Sanford School of Medicine)
- FARM, a selective nine-month rural track for students in Pillar 2, began in 2014 with six students in five communities; in its seventh year 11 students trained at seven sites: Milbank, Mobridge, Parkston, Pierre, Spearfish, Vermillion and Winner. (USD)
- USD reports that 34 FARM students had matched into residencies, twenty-three of them in primary care and fifteen in family medicine. (USD)
- In the 2025 Main Residency Match, programs in South Dakota offered 60 residency positions in 8 specialties, the most in family medicine (19), internal medicine (9), and psychiatry (9). (NRMP)
Sources: LCME, directory of accredited U.S. programs (checked October 29, 2026); AAMC FACTS, Table A-1, 2025-2026 (checked October 29, 2026); USD Sanford School of Medicine, Office of Medical Education (checked November 1, 2026); USD Sanford School of Medicine, Three Pillar Curriculum chart (checked November 1, 2026); USD Sanford School of Medicine, Pillar 2 calendar 2025-2026 (checked November 1, 2026); USD, Unique Program Develops Physicians for South Dakota's Rural Communities (checked November 1, 2026); NRMP, 2025 Main Residency Match by state and specialty (checked October 29, 2026); ABIM, residency program pass rates 2023-2025 (checked October 29, 2026).
Where Step 1 falls in the three pillars
Sanford students sit Step 1 at the seam between the first two pillars. The school's curriculum chart shows a break for Step 1 prep in the second year, once the last Pillar 1 system blocks (cardiovascular, renal-urinary, respiratory and endocrine-reproductive) are done and before the longitudinal integrated clerkship starts.
Pillar 1 is graded satisfactory/unsatisfactory and Step 1 is pass/fail, so neither one ranks a student; what the break has to deliver is a safe pass on the first try in a state whose board counts every attempt (Sanford curriculum; FSMB). We plan that break backward from the test date: question-bank work begins inside the second-year system blocks, a baseline NBME self-assessment comes before the break, and the break itself is for closing the gaps that self-assessment shows, not for first reads of the material.
Shelf exams in a longitudinal clerkship
Most schools run clerkships in blocks and end each one with its own NBME subject exam. Sanford's Pillar 2 interleaves seven disciplines over 12 months instead, so the exams come in sets: the 2025-2026 calendar for the February Class of 2027 puts NBME midterm exams in weeks 24 and 25, CCSE exams (the NBME Comprehensive Clinical Science Examination) in weeks 21 and 39, and NBME final exams at the end of the year (Pillar 2 calendar).
That layout changes how to study. Seven subjects stay open at once, so we rotate question blocks across all of them each week rather than finishing one discipline and moving on. The first semester is pass-fail and the second brings letter grades, which makes the final NBME set the one that shows on a residency application, and the two CCSE sittings double as checkpoints for Step 2 CK, the scored exam ahead (Sanford curriculum).
FARM: nine months in a rural town
Students picked for FARM spend their Pillar 2 year living and training in a small South Dakota community for nine months. The program started in 2014 with six students in five communities; in its seventh year it had 11 students at seven sites, in Milbank, Mobridge, Parkston, Pierre, Spearfish, Vermillion and Winner (USD on FARM).
FARM students sit the same NBME exams as students in Rapid City, Sioux Falls and Yankton, but often with fewer classmates nearby to study with. Online tutoring fits that: sessions run by live video (Zoom or Google Meet) from wherever the student is placed, so the plan does not change when the rotation town does.
Residency in South Dakota
In the 2025 Main Residency Match, South Dakota programs offered 60 positions in 8 specialties: 19 in family medicine, 9 in internal medicine, 9 in psychiatry, and 6 each in pediatrics and the transitional year (NRMP). Most residents train in Sioux Falls and Rapid City, home to the state's three hospitals on the CMS teaching hospital list (CMS teaching hospital list).
A South Dakota license waits until residency is complete, and the board's attempt and time limits apply to Step 3 as much as to Step 1, so a resident planning Step 3 here should sit it with the same care (FSMB).
Which board exams South Dakota students take
South Dakota students follow the USMLE sequence because the state's only school, the University of South Dakota Sanford School of Medicine, grants the MD. Step 1 has been reported pass/fail since January 26, 2022 (USMLE). Step 2 CK comes next and, after graduation, Step 3 follows.
The state's list shows no DO school. DO students from out of state who train in South Dakota hospitals sit COMLEX-USA, and FSMB's South Dakota rule applies its three-attempt limit to the USMLE or COMLEX alike (FSMB).
Internal medicine residents in Sioux Falls can go on to the ABIM internal medicine exam. In 2023-2025, 100% of 23 first-time takers from the University of South Dakota program passed it; ABIM says to read rates from fewer than 25 takers with caution (ABIM).
South Dakota licensing rules that affect your exam plan
South Dakota's line in FSMB's licensing summary asks for successful completion of residency before a first license, allows 3 attempts with a pass required on the third, and sets 7 years to complete the USMLE or COMLEX, or 10 years for dual-degree MD-PhD applicants (FSMB). The table below shows each line in FSMB's words.
| Rule | What South Dakota requires |
|---|
| Training before first license | Successful completion of residency program |
| Exam attempts | Allowed 3 attempts, must pass on third, for the USMLE or COMLEX examination |
| Time limit | 7 years to complete USMLE or COMLEX; 10 years for Dual Program Degree MD-PhD Applicant |
Source: FSMB state licensure requirements, checked October 2026; confirm with the board before relying on them.
What South Dakota's rules mean for how you study
- South Dakota allows 3 attempts and you must pass on the third; the USMLE program's own cap is four. The state's number is the lower one, so plan around it (FSMB, USMLE eligibility rules).
- The 7-year window to complete the USMLE or COMLEX is the plan's hard edge. A research year, leave of absence or postponed Step 3 all draw on it, so ask the board when the clock starts (FSMB).
- FSMB gives dual-degree MD-PhD applicants 10 years instead of 7. A student on that track should plan against the longer window and confirm with the board that the category applies (FSMB).
- South Dakota asks for successful completion of residency before a first license, so a South Dakota license sits at the end of training (FSMB).
Many South Dakota students rotate, interview or match next door. South Dakota's neighbors on our list: Iowa (1 MD, 1 DO), Minnesota (2 MD, 0 DO), Montana (0 MD, 1 DO), Nebraska (2 MD, 0 DO), North Dakota (1 MD, 0 DO), Wyoming (0 MD, 0 DO).
How much South Dakota searches for board prep
South Dakota sits at the low end of Google Trends' ranking of the 50 states and DC on every exam term: 40th of 51 for “USMLE” and for “USMLE Step 2”, 42nd for “COMLEX” and for “Shelf exam”, and 50th for “USMLE Step 1” (Google Trends, five years to October 2026). Step 1 is the outlier, one place from last.
| Search term | South Dakota rank of 51 |
|---|
| USMLE | 40 |
| USMLE Step 1 | 50 |
| USMLE Step 2 | 40 |
| COMLEX | 42 |
| Shelf exam | 42 |
Source: Google Trends, United States, past 5 years, retrieved October 2026; ranks show relative interest, not student numbers.
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