Hey lilyb441 (Student) , I literally just finished Semester 5 in Portland a few months ago so this is fresh. Semester 5 is basically a full semester dedicated to clinical skills and Step prep before you set foot in a hospital for rotations. You are doing OSCE style practice, standardized patient encounters, physical exam skills, and a lot of integrated review. It is not just sitting in lectures, you are actually doing things with your hands. For me personally it was the semester where medicine started feeling real instead of just memorizing pathways. Portland itself is a really pleasant city, manageable size, good food scene, and people are friendly. Coming back to the US after St. Kitts also just felt like a mental reset.