This study examined the impact of a rigorous third year clerkship (rotation) affects simulated surgical skill and declarative memory retention in medical students. In this study the OB/GYN clerkship was targeted because it is one of the more difficult clerkships, with increased student responsibilities usually occurring toward the end of the clerkship (weeks 5 and 6). We assessed declarative memory retention and virtual surgical skill using the a laparoscopic simulation device (LapSim) immediately following the completion of the OB/GYN clerkship (Rotation group) or a 2-week interval between rotations (Rested group). Twenty-six 3rd year medical students (24.6 ± 0.9yo; 12 males) completed the study. Orientation and acclimation to the tasks occurred at least 2 weeks prior to their Test day (post-Rotation (n=14) or post-Rest (n=12)). On the morning of the Test day students learned a declarative memory task (picture pairs) and trained on two LapSim skills (Clip Applying and vessel Cutting). Students returned approximately 10hrs later to retest on the same tasks. Sleep and wake activity data were collected via actigraphy the week preceding the Test day. On the morning of testing, subjective measures of alertness were similar (p values> 0.25), as were PVT reaction times (p=0.49). Despite sleeping, on average, ~30min more per night, students in the Rested condition, overall, did not perform better than students in the Rotation condition on the VPA task (p=0.81) or on core measures of simulated laparoscopic surgical skills (p values for the six tasks > 0.41). Following the cumulative effects of a rigorous 3rd year obstetrics rotation, abilities important in the practice of medicine (declarative memory recall and simulated surgical skills) did not suffer when compared to students who rested the two weeks prior to testing. This finding may suggest that medical students have the capacity to tap into a deep cognitive reserve under challenging conditions. However, further analysis of waking activity patterns/activity logs prior to testing need to be conducted to better understand these performance similarities.