Fourth-year students spend their entire year putting their clinical skills to use. ICO has more than 150 affiliated externship sites in 47 states and four countries (Australia, Canada, China and the United Arab Emirates). Besides choosing the location, students also can choose from a variety of practice settings, including OD/MD practices, private and group practices, military sites, Veterans Administration hospitals, community health centers, and clinics on Indian reservations. Students are required to spend one quarter at the Illinois Eye Institute and two quarters at externship sites. On average, students encounter 1,600 total patient visits during their experience at ICO.