No, during the 3rd and 4th year of medical school, you pay the school. In most cases, the school also pays the hospital. Be careful of some schools, because they make you pay out of pocket twice, once for the school, and again to the hospital you work at.

At IAU, tuition per semester includes all of the clinical rotations at ACGME hospitals, which is often critical in many states to obtain licensure.

After clinical rotations, and step 2, you can compete for residency, which pays.