Medical Electives and Acting Internships

Electives and Acting internships at MetroHealth are offered to 4th year medical students as 4-week rotations only.

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Anesthesiology

ACCM 4000B: Anesthesia Acting Internship

Prerequisites

At least two weeks of an Anesthesia elective anywhere in the U.S.

Description

This 4-week Acting Internship is designed for student applying to an Anesthesia residency program. It is meant to simulate as accurately as possible the day of an anesthesiology resident. As such, participants will be required to take two overnight weekday calls and one overnight weekend call. Students will be assigned a room with a resident and attending for the day and will help manage patients pre-operatively, intra-operatively, and post-operatively. This is not a rotation where students will go room to room in an attempt to get as many intubations as possible. Students are expected to stay with their assigned cases until completion. Students will participate in didactic sessions with the residents and conferences with the department. 

Goals & Objectives

We expect students to be able to obtain these goals by the end of their internship:

1. To experience the role of a CA-1 anesthesia resident by taking care of patients in the perioperative environment (e.g., initial pre-operative H & P, formulation and execution of an anesthetic plan, intraoperative airway management, postoperative pain control).
2. To improve procedural skills in airway management, vascular access, and pain management.
3. To experience management of unstable trauma patients in the call environment.
4. To learn to work as a contributing member of the anesthesia care team.

At the completion of this Acting Internship, participants should be able to:

1. Perform a focused anesthesia history and physical and formulate an appropriate anesthetic plan.
2. Explain the advantages/disadvantages of various types of anesthesia (e.g local, MAC, neuraxial, regional, general)
3. Provide an accurate, concise, and well-organized presentation.
4. Recommend and interpret laboratory or additional testing for patients in the perioperative setting.
5. Gain knowledge of commonly used medications by an anesthesiologist
6. Perform basic airway examination and gain knowledge of the ASA difficult airway algorithm.
7. Apply principles of fluid management and blood resuscitation to the perioperative setting
8. Describe indications, risks, benefits, alternatives, and complications of the common procedures performed by anesthesiologists.
9. Demonstrate technical skills in airway management and vascular access.
10. Describe the role of medical management of systemic illnesses in changing anesthetic risk.
11. Learn various strategies at mitigating acute post-operative pain.
12. Identify the roles and contributions of each member of the Peri operative team.

 

ACCM 4001B: Clinical Anesthesia

Description

This elective will provide the student with a broad and comprehensive experience in the area of anesthesiology. The student will gain an understanding of the physiology, pharmacology, and coexisting diseases that affect the perioperative management of patients. Students will become practiced in various techniques of airway management and IV access throughout the rotation. Each student will be involved with preoperative evaluation, induction, intubation, monitoring, emergence, and recovery of patients undergoing surgical procedures; all under close resident and attending supervision.

The student will spend the first 2 weeks of the rotation in the main OR, learning the basic principles and techniques of anesthesia. In the 3rd week, the student will spend time rotating on the Obstetrical Anesthesia team, the Acute Pain Service, and in the Pre-Surgical Evaluation Clinic. The 4th week is designed as an elective week where the student can choose where they would like to spend their time. It is during this week that a student can rotate at the Chronic Pain Management Clinic or Ambulatory Surgical Center.

Students will be expected to attend all resident lectures in addition to special lectures provided by the anesthesia attendings. They will also have an aggressive reading schedule; therefore, daily duties will end early to allow for this study. At the end of the rotation, students will take an examination.

Goals & Objectives

• Gain knowledge of the commonly used drugs in anesthesia
• Describe the role of medical management of systemic illnesses in changing anesthetic risk
• Compare and contrast various anesthetic techniques and formulate a basic anesthesia plan
• Evaluation of airways and demonstration of basic airway techniques
• Describe how the physiologic changes during pregnancy affect anesthetic management
• Gain exposure to ultrasound guided upper and lower extremity peripheral nerve blocks

 

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Cardiology

CARD 4001B: Clinical Cardiology

Description

During this elective, the student will see and evaluate patients on the Cardiology consult service as part of a team that includes the cardiology attending, fellow and residents from various fields - including Internal Medicine, Emergency Medicine and Anesthesia. Students will be expected to closely follow their assigned patients and to be able to discuss the active, pertinent issues with the attending physician on daily rounds. The student will participate in scheduled daily conferences (pre-arranged didactic conferences) and a daily one-hour ECG reading session. The student will observe cardiac diagnostic procedures (including heart catheterization, electrophysiologic testing, echocardiography and stress testing) during a scheduled half day session in each of these areas.

The student will be expected to perform a history and physical exam on cardiac consultation patients and then formulate diagnostic and therapeutic plans dependent on the results of that evaluation. The student will present his/her patients as part of daily rounds with the supervising attending physician. The student will interpret electrocardiograms on a daily basis with a cardiology attending.

Goals & Objectives

To introduce the student to patients with acute and chronic cardiac diseases. He/she will develop skills in performing the cardiovascular physical exam and in the interpretation of electrocardiograms. The student will become well versed in the evaluation of patients with chest pain, the management of patients with heart failure, coronary and/or peripheral vascular disease, the diagnosis and treatment of patients with cardiac arrhythmias, and the basic evaluation of patients undergoing non-cardiac surgery. He/she will learn the indications for cardiac procedures (echo, stress testing, nuclear cardiology, electrophysiology testing, and cardiac catheterization).

 

CARD 4002B: Acute Cardiac Care

Description

During this elective, the student will see and evaluate patients in the Cardiac Intensive Care Unit - under the close supervision of the house staff, fellow and attending physician on the CICU team. Students will be expected to actively participate during daily rounds in the unit. They will attend daily conferences and ECG reading sessions. They will learn the indications for, and be given an opportunity to observe, various diagnostic procedures and therapeutic interventions used in the field of cardiology.

The student will be expected to perform a history and physical exam on patients admitted to the Cardiac Intensive Care Unit in conjunction with and under the supervision of a resident, fellow and attending. The student will present his/her patients as part of daily rounds with the supervising attending physician. He/she will formulate and implement the patient's daily plan with the help of the CICU team. He/she will be encouraged to participate in night call during the month - in association with the CICU house staff.

Goals & Objectives

To immerse the student in the dynamic world of acute cardiovascular intensive care. The student will gain knowledge in the management of patients with acute myocardial infarction, unstable angina, congestive heart failure and both stable and unstable cardiac arrhythmias. He/she will work in a closely supervised setting with a resident, cardiology fellow and cardiology attending to evaluate and acutely intervene in the treatment of patients with both acute and chronic cardiovascular diseases. He/she will be taught extensively in the areas of the cardiovascular physical exam and electrocardiography.

 

CARD 4003B: Electrophysiology

Description

This elective is intended for students who are interested in a career in either Internal Medicine or Cardiology. Students will participate in Inpatient consults with the Cardiology fellow and the EP attending. They will also attend Outpatient EP clinic. They will have to option of assisting in Electrophysiology research as well. There will also be weekly didactics during this elective rotation. This course will provide a strong arrhythmia and cardiac device foundation to support effective application in clinical practice and interpretation of the various electrical abnormalities of the heart. 

Objectives

The student will be able to recognize the various common electrical abnormalities of the heart in the inpatient and outpatient adult population, the most up-to-date methods of treatment, within the one-month span of the course.

Additionally, the student will learn the interpretation of electrical abnormalities in ECGs, cardiac device interrogations, and holters. Students will be assessed based on team participation and basic knowledge of Cardiology.

 

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Dermatology

DERM 4001B: Clinical Dermatology

Description

Teaching during this elective is based on the patient material available in both the outpatient and inpatient dermatology services at MetroHealth Medical Center, including the inpatient consultation services, and at the Clement Center for Family Health. Participation in twice weekly didactic sessions is expected: journal club, basic science and clinical conferences and city-wide grand rounds. For students that have a particular interest in dermatopathology, additional experience in histopathology is available. Several subspecialty exposures can be arranged (Dermatologic and MOHS micrographic cancer surgery, laser surgery and contact dermatitis patch testing. Students on the UH/VAMC and on the MetroHealth electives attend the same didactic conferences and can exchange clinic sessions with each other as staffing permits. The student will be evaluated on the basis of his/her acquisition of basic dermatologic descriptive and diagnostic skills and his/her participation in other clinical and education sessions each day. Students do not take night call. Toward the end of the rotation the students may evaluate and follow their own patients or do consultations if they desire.

Objectives

To be able to describe, recognize and treat the common dermatologic problems of adults and children. 

 

DERM 4002B: Pediatric Dermatology

Description

This elective will include time in the MetroHealth resident continuity clinics and time in the private clinic of our pediatric dermatologist. The goal of the rotation is to become familiar with the diagnosis and treatment of common pediatric dermatological conditions. Students are expected to act professionally, be punctual and involved in their learning.

Goals & Objectives

Become familiar with a full skin examination in the pediatric population. Become familiar with the diagnosis and management of common skin conditions in pediatric patients. Learn appropriate steps for counseling and compliance monitoring in pediatric patients. Learn resources available for patients/parents/regarding etiology and treatment of common pediatric dermatological conditions. Maintain open communication with referring physicians and interact with all clinical and non-clinical personnel in a professional and respectful manner.

 

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Emergency Medicine

EMMD 4000B: Emergency Medicine Acting Internship

Description

Our goal is to not only prepare you for applications to emergency medicine, but to make you the best Emergency Medicine physician you can be. We believe that starts during your clerkship. You will be treated as close as possible as a resident to best prepare you for residency. You will work alongside both attending and resident physicians. We believe this gives our students a great look into not only what life is like as a resident at our program but also an attending physician.

Students will “own their patients.” We will teach you and expect you to independently evaluate, formulate a plan, reevaluate, manage, and appropriately disposition under the guidance of an attending or resident physician. This may seem like a daunting task to new students, but we promise we will get you there. As a student you will have full access to our EMR (Epic) and imaging services, ability to document, and place orders.

Our four-week rotation encompasses both clinical and academic activities. Your clinic shifts will take place at the following locations:

• MetroHealth Main Campus Medical Center: County Level 1 Trauma/Burn center
• MetroHealth Community Emergency Departments (Parma, Cleveland Heights, Brecksville): Stand-alone ED’s to Level 3 Trauma departments.
• Cleveland Clinic Foundation Main Campus Emergency Department: World renowned quaternary care and referral center.
• Metro Life Flight: Ride along in our helicopters as an observer with our Metro Life Flight team for a day! (This experience is not a mandatory part of the rotation, we would be happy to replace this shift with another experience that better aligns with your interests including ground EMS, US, Critical Care, etc.)

Academic Activities will include:

• Attend our weekly resident didactics
• Ultrasound day with our Ultrasound Faculty to get you hands on experience with our machines to better prepare you for use in the department
• CCF Cadaver lab: hands on experience with faculty to prepare you for any ED procedure from intubations to thoracotomies
• EKG/Airway lab: Master EKG interpretation, the ED way! Understand the nuances of airway management from preparation, resuscitation, equipment, and more!
• AI Simulation: show off the skills you’ve acquired at end of your rotation with high fidelity simulations.

 

EMMD 4001B: Emergency Medicine Elective

Description

This elective offers the student the opportunity to make critical decisions while participating in the emergency management of patients. The student will work in close association with emergency medicine residents and faculty. The student will learn to evaluate, diagnose and treat emergency medicine patients. We are a Level 1 Trauma Center, regional burn and pediatric/neonatal referral center and have one of the largest helicopter transport program in the country. Our emergency medicine residency is active, as is our faculty participation in SAEM and ACEP.

The student will function as an integral part of the ED health care team. He/she will see patients primarily and be supervised by the emergency medicine senior resident and attending staff. Ample opportunity to perform supervised splinting, laceration repair, abscess drainage, medical resuscitation, and bedside ultrasound is the norm each month.

The student will work in the ED an average of 40 hours/week and attend the Department of Emergency Medicine conferences. An opportunity to ride along with Cleveland EMS is available, as is a paramedic-shadowing shift to gain proficiency in 12-lead EKG acquisition, phlebotomy & IV canulation.

 

EMMD 4012B: Medical Simulation

Description

MetroHealth Simulation Center (MHSC) conducts simulation programs involving healthcare providers from various disciplines. During this elective, the student with an interest in healthcare simulation will participate in the programs and activities of the MHSC under the direction of Thomas Noeller, MD. The student will have the opportunity to work with MHSC utilizing all facets of simulation including high-fidelity mannequins, procedural task trainers, and standardized patients.

Examples of educational opportunities include but are not limited to the following:

• Models and theories related to the use of simulation for evaluation, training, patient safety and disaster preparedness
• Programming and operation of high-fidelity mannequins (adult, pediatric, obstetrical, and neonatal)
• Effective use of procedural task trainers for education and evaluation
• Design and implementation of standardized patient programs (including education and evaluation principles, selection and training of standardized patients
• Design and implementation of multi-faceted/hybrid simulation programs
• Simulation center administration - The student will be responsible for helping to design and execute a simulation program. The student will be provided with appropriate references to augment the practical experience

 

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Family Medicine

FAMD 4000B: Family Medicine Acting Internship

Description

This 4-week rotation provides experience in Family Medicine-centered team-based inpatient care. The acting intern will function as part of the inpatient team and will have a similar schedule to the interns. This will include caring for about 2-3 patients at a time under the direct supervision of Family Medicine residents and faculty. They will be exposed to a wide variety of medical diagnoses, patient ages and demographics as they participate directly in daily rounds. Additionally, the acting intern may choose to rotate on night float with a senior resident for the full inpatient service experience. The acting intern will have a hands-on role in procedures for their patients, attend all resident didactic experiences and will have the opportunity to prepare teaching topics for the team. The Family Medicine Acting Internship is appropriate for students interested in advanced inpatient management skills, team-based care and will provide an excellent foundation for the residency experience.

Objective

To practice advanced inpatient management skills

 

FAMD 4001B: Innovative Primary Care for the Urban Underserved

Description

This is an Urban Underserved Innovative Primary Care experience focused on Integrated team based care. The student will spend four weeks with the team working with patients in the urban underserved population. Each half day would be spent with various team members, including but not limited to physicians, nurse practitioners, care coordinators, social workers, psychologists, and others. During the rotation, the student will spend time at MetroHealth and off-site at various locations in the neighboring community. These sites could include, but are not limited to, school-based health, county jail, recovery center, clinic for homeless patients, home visits, trauma survivors’ clinic, and a community hospice experience. This is a one-of-a-kind experience for a student interested in exploring urban underserved primary care.

Objectives

• Increase understanding of providing (innovative) care to underserved population
• Gain exposure to each component of the health care delivery system that the patient has to experience
• Improve understanding of the importance of the doctor-patient health care team relationship
• Understand how good primary care improves outcomes and efficiency
• Experience a unique type of interdisciplinary team-based health care delivery (i.e. home visits, group visits, etc.)
• Participate in behavioral health delivery and understand how it integrates with primary care

 

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Gastroenterology

GAST 4001B: Gastroenterology/Heptatology

Description

The student will become a full member of a team consisting of faculty and G.I. fellows; as such she/he will become familiar with the pathophysiology and clinical management of a wide variety of gastrointestinal problems. She/he will have similar responsibilities as the residents for inpatient and outpatient consultations and practical procedures. Students will also actively participate in regularly scheduled clinical management, radiologic, pathologic and surgical G.I. conferences. Duties will be similar to second year residents rotating through service with the exception that comprehensive teaching and observation will be employed.

Objective

To gain insight into the diagnosis and management of patients with liver, pancreatic and gastrointestinal diseases.

 

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Internal Medicine

IMED 4000B: Internal Medicine Acting Internship

Description

Fourth year students will be assigned to a ward where they will work with one or two interns and a supervising medical resident. The students will take regular night call and will assume direct responsibility for the care of 4-6 patients under the supervision of the senior resident and ward attending physician. The acting intern will be expected to take part in regular Attending Rounds and teaching conferences. Consultation with subspecialty services will be routinely available either for educational purposes or for assistance in the management of patients with complex medical problems. Medical students function identical to interns, except Acting interns are paired with each other or an intern.

Objective

To expand knowledge of and competency in internal medicine by assuming direct responsibility for care of hospitalized patients.

 

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Medicine-Pediatrics

IMED 4002B: Medicine-Pediatrics Ambulatory elective

Description

Medical students will see patients as first contact and work side by side with residents and attendings. The practice of Med- Peds is learned in both urban hospital and community settings with preventative aspects emphasized. The student participates in hospital rounding on the group practice's inpatients. Other duties include outpatient history and physicals, presentation of patients, cost-effective test ordering, use of evidence-based medicine, and documentation/reimbursement issues. Mornings are spent at MetroHealth in conference attendance and in the ambulatory clinics of the core disciplines.

Afternoons are spent at the combined medicine/pediatrics practices of the MetroHealth satellite system.

 

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Infectious Disease

IMMU 4001B: Clinical Infectious Disease

Description

This elective is a general experience on an active consultation service in infectious diseases at a large general hospital. Students will be assigned 3-5 new patients each week. With the help of the infectious disease fellows, each student will work up and follow new patients. The student will be expected to participate in daily attending rounds. The student will also be expected to participate at the weekly case conference by presenting patients he/she is following.

It is anticipated that students will acquire facility in examination and differential diagnosis of patients with various infectious diseases. The approach to the management of these patients and the rational selection of antimicrobial agents will be stressed. In addition, experience in the handling of clinical specimens and the interpretation of cultural results and a general exposure to clinical microbiology will be provided.

Student will follow his/her own patients under the supervision of both the Infectious Disease fellow and the attending physician. The level of responsibility will be variable and dependent on the student's willingness to participate. There are no night calls. Saturday morning rounds.

 

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Informatics

MEDS 4001B: Clinical Informatics

Description

Medical Informatics is a rapidly growing field in healthcare which involves the use of computer technology to improve healthcare. Medical informatics encompasses several fields. After a brief introduction to the overall field of medical informatics, this elective rotation will focus primarily on clinical informatics. Clinical informatics is the sub-field of medical informatics concerned with how computer technology affects clinical care. Examples of clinical informatics topics include electronic medical records, clinical decision support, and personal health records, among many other topics. The medical informatics elective will include review of medical informatics articles, presentations on medical informatics topics, shadowing the Chief Medical Informatics Office of the MetroHealth System, and developing a medical informatics project.

Medical students interested in the medical informatics elective should contact Dr. David Kaelber (david.kaelber@case.edu) at least 6 weeks before they would like to start the rotation.

 

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Neurosurgery

NEUS 4001B: Neurosurgery

Description

During this elective, the student attends daily rounds with the team. The student will spend time in the Operating Room for selected patients. He/she will also spend approximately three evenings per month on late call to get an idea of the complete management of the neurological surgical patient. The main responsibility of participants in this elective is to learn to examine the neurological patient. The secondary responsibility is to obtain an understanding of the surgical management of neurological disease. The student is required to have two written write-ups. The student is also required to make a short, five-to-seven-minute presentation towards the end of the clerkship on the topic of neurosurgical interests.

 

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Ophthalmology

OPTH 4001B: Ophthalmology

Description

During this elective, the student will attend clinic both in the morning and in the afternoon, and is available for attendance in the operating room on all surgical procedures. The student will have the opportunity of following patients from the initial examination in the eye clinic to its resolution, whether by medical or surgical means. The student may be able to see patients independently depending on interest and level of knowledge.

Objective

Presentation of the basic knowledge of examination and diseases of the eye, the changes that take place with disease, and the available modes of therapy, both medical and surgical.

 

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Pathology

PATH 4001B: Anatomic Pathology

Description

During this 4-week elective, the student will rotate for 2 weeks in anatomic pathology (surgical pathology, cytopathology and autopsy service) and for another 2 weeks in clinical pathology (hematopathology, transfusion medicine, chemistry, microbiology and immunology).

In anatomic pathology the student will observe, examine and help dissect, under guidance, autopsy and surgical pathology material. The student will evaluate the microscopic slides with residents and attending staff. In clinical pathology, the student will rotate through different disciplines and get familiar with laboratory methods and testing. The student is also expected to attend departmental conferences, review the available teaching sets, and make a short presentation on a topic of his or her choice. Students will work with the fellow or senior resident, under guidance of the faculty, who will teach them gross pathology examination, frozen section examination, correct tissue sampling, and final microscopic and interpretations.

Objectives

To introduce medical students to the practice of anatomic pathology (autopsy, surgical pathology and cytopathology) in a major hospital setting. To observe and study the effect of disease process on tissue. To understand structural and functional relationships of diseased organs, and to make anatomic and clinical correlations

 

PATH 4002B: Perinatal & Gynecological Pathology

Description

The primary goal of this elective is clinical pathologic correlation of various pathology specimens, including perinatal autopsy, placentas, products of conceptions, cervical biopsies and gynecologic malignancies with their corresponding clinical presentation and subsequent patients' management and treatment.

Another goal is the introduction of additional ancillary pathological disciplines, such as the Pap smear, serology for HPV detection and cytogenetics and the understanding of their contribution to patients' management. The primary objective of this elective is to offer the student a "hands on approach" of handling and examination of perinatal and GYN pathology specimens and correlation of the pathology findings with the clinical presentation and management of these cases.

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Pediatrics

PEDS 4001B: Children with Disabilities

Description

During this elective, students will participate in outpatient and inpatient programs including case conferences, rounds and seminars. The student will see the evolution of medical, educational, and social prescriptions for individual children and their families. Areas of emphasis include the diagnostic approach to the handicapped child, syndrome identification in pediatric practice, medical genetics (including cytogenetics) and the psycho-social assessment of the family. Visits to community agencies serving children with disabilities will be arranged.

The elective will be of particular interest to students interested in Pediatrics, Family Practice, Neurology, Orthopaedics, Child Psychiatry, and Physical Medicine and Rehabilitation.

Objectives

• To enable the student to participate in an inter-disciplinary program serving children with disabilities and their families.
• To demonstrate coordination required to manage complex medical problems.

 

PEDS 4006B: Pediatric Hispanic Health

Prerequisites

Student must be at an intermediate to advanced level of Spanish prior to taking this elective

Description

Students will work one-on-one with the attending at the Pediatric Hispanic Clinic (Pediatrics outpatient setting) for the day. Students will learn to function at an intern level throughout the rotation. Students will interview patients in Spanish, devise a differential diagnosis and treatment plan, and present to the attending physician and discuss plans with the patients in Spanish. Students will be responsible for performing outpatient procedures on their respective patients. Students are encouraged to draw blood or administer vaccinations to children when possible. Patients visiting the Clinic are scheduled for 20-minute appointments.

This elective is offered as a 4-week rotation. Attending each clinic counts as 1 clinical session. Example: Attending morning, afternoon, and evening clinic on Mondays counts for 3 clinical sessions. Medical students who take this elective are required to attend ten (10) clinical sessions and complete a scholarly activity that addresses some aspect of Hispanic health. This scholarly activity must be approved by the attending physician. The scholarly activity can be, but is not limited to: 1) A formal presentation about a patient care issue related to Hispanic health, 2) A formal presentation about an aspect of Hispanic health disparities, 3) A formal presentation regarding any global health related topic of your choosing that involves Spanish-speaking groups, 4) A project involving a health education that can be implemented with the Clinic to help better serve this population.

 

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Psychiatry

PSYY 4002B: Psychiatry Acting Internship

Description

Students will work with attendings and residents caring for inpatients at the Behavioral Health Hospital. They will actively participate in daily report, team meetings and teaching rounds. Students will be expected to lead discussions on certain topics during clinical rounds. They will interview and examine patients, present findings to the treatment team, and report information through writing notes in the electronic medical record. Students will also be required to research topics relating to patients and present their findings using evidenced-based medicine. One-half day each week is devoted to formal didactics.

Goals & Objectives

This AI will prepare the fourth-year student to enter residency better prepared to handle clinical problems and day-to-day issues that confront a first-year resident.

1. Perform a psychiatric evaluation and thorough mental status exam
2. Describe the indications and contraindications of pharmacological and various psychotherapy modalities
3. Effectively manage acute psychiatric presentations
4. Function effectively as a member of the inter-professional healthcare team, including receiving and giving patient hand-offs during transitions of care.

 

PSYY 4001B: Consultation-Liaison Psychiatry

Description

The student will work with interdisciplinary CL Psychiatry team of attendings, residents and social workers caring for patients who are admitted to the Glick Center from the MH Emergency Department. These patients will remain under the care of the CL team for psychiatric management at Glick due to medical co-morbidities that are too acute for management at the Behavioral Health Hospital.

The student will participate in daily report, team meetings and teaching rounds. They will interview and examine patients, present findings to the CL team, learn to effectively communicate to different team members and report information through writing notes in the electronic medical record. One-half day each week is devoted to formal didactics. 

Objectives

1. Demonstrate proper evaluation and management of psychiatric disorders in the medically ill, psychiatric manifestations of medical illness, and psychological distress in the medically ill.
2. Develop skills in communicating with non-psychiatric physicians, nurses, social workers and other staff. 
3. Identify the triage and discharge/disposition challenges of medically complicated patients with psychiatric disorders 
4. Demonstrate an ongoing effort to maintain and expand their knowledge and skills to optimize evaluation and treatment of psychiatric disorders. 
5. Demonstrate adherence to ethical principles of autonomy, justice, beneficence, and non-maleficence while caring for a diverse patient population. 
6. Describe how to work effectively with other healthcare providers, payers, case managers, and other agencies and professionals to ensure coordinated patient care.

 

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Pulmonary Medicine

PULM 4001B: Pulmonary Consult Service 

Description

The consultation service is involved with the diagnosis and management of patients with pulmonary disorders on medical and surgical wards, coronary care unit and surgical intensive care unit. During this elective, students will work under the direct supervision of a pulmonary medicine fellow. The interpretation of chest radiographs and the evaluation of pulmonary function tests will be emphasized. The principles and practice of antimicrobial therapy for pulmonary infections, including pulmonary tuberculosis, will be stressed. Students will also be introduced to specialized procedures including thoracentesis, pleural biopsy and bronchoscopy and will be familiarized with respiratory therapy devices including mechanical ventilators. This is a full-time commitment with no night-call.

Objective

• To provide clinical experience in the diagnosis and management of patients with respiratory disorders.
• To provide further understanding of the basic pathological and physiological abnormalities underlying lung diseases and respiratory disorders.

 

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Radiology

RADI 4001B: Introduction to Radiology

Description

The student will be assigned to individual staff members throughout the elective and will participate in a representative sample of basic diagnostic situations. He/she will assist in the planning and interpretation of various radiologic investigations (for both inpatients and outpatients), which include plain film, intervention, pediatric, as well as ultrasound, CT, nuclear medicine and mammography. The student will compare gross and radiological anatomy with the intention of identifying those radiologic modifications produced by disease. Weekday attendance, 8:00 a.m. - 5:00 p.m. No call assignment. Orientation is on the first day of rotation and is mandatory.

Objectives

• Gain familiarity with choice and selection of appropriate examinations and their expected accuracy
• Develop an understanding of contemporary practice of radiology, its methodology, and its limitations

 

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Obstetrics & Gynecology

RBIO 4002B: Gynecologic Oncology Acting Internship

Description

This AI will allow the student to partake in the educational rounds of the GYN/Oncology service. The student will attend to the Operative suites to observe and assist with the surgeries of this area of Gynecology. The student will partake in several colposcopy clinics to learn about pap smear and cervical pathology. The student will attend Tumor board conferences to discuss diagnoses and management of complex GYN tumors/diseases. The student will attend GYN/Oncology clinic with the residents and GYN Oncologist.

Objectives

• Participate in diagnosis, management and treatment of gynecologic oncology patients (daily clinical rounds & outpatient clinics)
• Observe surgical procedures
• Attend conferences in gynecologic oncology, pathology and cytology
• Improve clinical competence in diagnosing, managing and treating gynecologic oncology patients

 

RBIO 4003B: Urogynecology Acting Internship

Description

During this AI, the student will have the opportunity to be in the operating room with the Urogynecologists and/or the Minimally Invasive GYN surgical specialist (laparoscopist). The student will also shadow the Urogynecologist in their outpatient clinic.

Objectives

• Learn the office evaluation of the incontinent female patient
• Gain exposure to advanced benign gynecologic surgery
• Learn indications for referral to a Urogynecologist

 

RBIO 4004B: Maternal-Fetal Medicine Acting Internship

Description

The student will partake in management of the High-Risk obstetric antepartum service. The student will be involved in the activities on Labor and Delivery including vaginal deliveries, cesarean sections, triage and management of the high-risk patients who are being monitored. The student will participate in the obstetric High-Risk Clinic and Diabetic Clinic. The student will shadow private Maternal-Fetal Medicine attendings in their offices, participating in examinations and observing the many medical complications of pregnancy. The student will also participate in ultrasound evaluation of pregnant patients.

Objectives

• To improve skills and prepare the medical student to become a resident in OB/GYN
• To improve skills in organization and presentation of high-risk complications affecting high-risk OB patients
• To improve skills in vaginal delivery as well as surgery
• To obtain hands on skills in performing basic ultrasounds

 

RBIO 4010B: General OB/GYN Acting Internship

Description

Each student will participate in a mixture of outpatient clinic, operating room procedures and labor and delivery. While in the outpatient clinics, the student will obtain a pertinent history and physical exam, create an assessment and plan, and participate in clinic procedures. While in the operating room, they will be expected to scrub in, and participate in surgery. On labor and delivery, they are expected to follow laboring patients, and participate in all aspects of their care.

Objectives

Clinic days

1. Formulate an appropriate assessment, diagnosis, management and treatment of a whole spectrum of OBGYN patients
2. Perform office procedure (IUD insertions and removals, contraceptive implant insertions and removals, endometrial biopsies) 
3. Participate and perform colposcopies

OR days

1. Scrub in and participate in surgical cases 
2. Be able to explain the indications for each procedure and alternative managements

Labor and Delivery/Call Shifts

1. Act at the level of an intern in intrapartum care, vaginal deliveries, c sections, and obstetric triage, including obstetrical management and plans

 

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Physical Medicine & Rehab

REHA 4000B: Rehabilitation Acting Internship

Description

This acting internship consists of a 4-week primarily inpatient rotation with intermittent outpatient exposure. The inpatient time will be spent on one of the following rehabilitation areas: Stroke, Traumatic Brain Injury, or Spinal Cord Injury. Attendance is required 5 days weekly, with the student responsible for 2-4 inpatients under the supervision of an attending physician. The student will lead daily rounds and present information regarding their patients at team and family meetings.

Students will participate in the initial evaluation and the care of rehabilitation inpatients including daily progress notes and family meetings. Outpatient clinics will be 2-3 half days per week and include a variety of sub-specialties clinic such as Stroke, Brain Injury, Spinal Cord Injury, Botulism Toxin, Musculoskeletal clinic, EMG, Intrathecal Pump Management, Ultrasound guided injections, Lymphedema, Amputee clinic, and Urodynamic studies.

Students are expected to complete a 10-minute topic presentation to the inpatient team. Night call is not required.

At the end of the rotation, the student will be able to perform a physiatric History and Physical Exam, with its emphasis on functional status and rehabilitation program goals. Lastly, the student will gain an appreciation for the medical management of persons with disabilities and the interdisciplinary approach unique to Physical Medicine and Rehabilitation.

Prior PM&R rotation highly recommended.

 

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Renal/Nephrology

RENL 4001B: Nephrology & Hypertension

Description

This elective is designed to allow the student the opportunity to provide care to both hospitalized and ambulatory patients through its consultation service, Hypertension and Nephrology Outpatient Clinics and Renal Dialysis Center.
The student will assess and manage hospitalized patients with acute renal failure from all causes, with fluid and electrolyte abnormalities and with hypertension. In addition, the student will encounter hospitalized End Stage Renal Disease patients and learn unique aspects of the care of common medical problems in these patients. The student will attend an outpatient nephrology clinic and learn the outpatient evaluation, diagnosis and management of patients with chronic renal insufficiency, patients with hypertension and patients with stable acidbase and electrolyte disorders. Patients requiring dialysis are not generally seen at this time. At the end of the rotation, the student should be able to interpret a urinalysis, appropriately order urine electrolytes and initiate a diagnostic work-up for acute and chronic renal insufficiency and sodium, potassium and acid- base disorders.

Students will be responsible for the primary evaluation of no more than five inpatients per week who have been referred to the Nephrology Consult service. After preliminary discussions with the nephrology fellow, the case will be presented to the attending. The goal of these presentations is not only to suggest appropriate management of the patient to the primary service, but also to use the case material for didactic teaching. The student, if time allows, will be expected to have accomplished some background reading about the case prior to the presentation. After the initial discussions, the student will be responsible for primary follow-up of the patient. Specifically, the student will collect pertinent data to devise a subsequent management plan and present this information on rounds with the attending nephrologists.

The daily schedule starts with morning work rounds with the fellow and any Medicine residents rotating on the elective. Attending rounds generally begin in the afternoon. No night or weekend call is required, although students are welcome to participate in weekend rounds or after hour emergent patient management as they desire. The students will attend a weekly afternoon nephrology clinic. Limited exposure to an outpatient Dialysis clinic is also possible. Conferences include weekly clinical Nephrology Conferences and a monthly discussion of renal biopsies with Metro nephrology and renal pathology faculty. Appropriate text, journal and internet resources are available within the Divisional offices and should provide adequate material for any necessary background reading. In addition, a collection of basic core articles is provided by the Division at the beginning of the rotation.

 

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Rheumatology

RHEU 4001B: Rheumatology

Description

During this elective, students are instructed in the recognition, diagnosis and treatment of various arthritic disorders. The appropriate use of diagnostic tests, physical and rehabilitation therapy, rheumatology referral, and surgical treatment are emphasized. Acute and chronic conditions affecting joints, muscles, tendons and bursitis are managed in outpatient clinics, which are held daily Monday through Friday. Musculoskeletal procedures are carried out in these clinics. Daily rheumatology consultation rounds are conducted on the inpatient services. A range of conferences are provided weekly.

Objective

To enable the student to acquire skill and confidence in her/his ability to evaluate, diagnosis, and manage acute and chronic
musculoskeletal disorders

 

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Surgery

SURG 4000B: General Surgery Acting Internship

Description

This opportunity is provided for the student who is particularly interested in surgery and anticipates ultimately entering a surgical discipline. It will best serve the student who wants to gain a head start in this direction. The student will in all respects serve (except from a legal standpoint) as a full-fledged first year house officer. He/she will be a member of the surgical team and by doing so will be given far more responsibility than is possible for a clerkship student. This AI will be a full time, intensive commitment. Being an integral part of the team means that the student takes on significant responsibility for patients on the wards, in the OPD and in the operating room. It is anticipated that the student will have an abundance of experience in all settings. To provide an opportunity for students particularly interested in surgery to assume significant responsibility for the care of surgical patients. The responsibilities will be equivalent to those of a first year surgical House Officer, under the supervision of the attending staff.

 

SURG 4004B: Trauma Surgery Acting Internship

Description

This AI is designed for students who are interested in pursuing advanced training in the care of trauma patients. Students will function as acting interns on the Trauma Service. Two weeks of this four-week rotation will be spent on the day team (6AM-6PM), and two weeks will be spent on the night team. The student will be given greater responsibility than a junior clerkship student and is designed for the student who plans a career in a surgical discipline. The student will be involved in the care of patients injured by a number of mechanisms, including falls, car crashes, motorcycle crashes, assaults, gunshot wounds, and stab wounds. Students will respond to all trauma activations and actively participate in the Trauma Resuscitation Unit, the operating room, the Trauma Intensive Care Unit, and the regular nursing floor. They will be expected to be comfortable actively participating with basic procedures. Students will present cases on daily rounds and at the weekly trauma educational conference. This acting internship involves management of a large number of patients on a busy trauma service and is structured to provide development of clinical judgment and technical skills, all while under direct supervision.

 

SURG 4005B: Plastic Surgery Acting Internship

Description

During this AI, students will gain an understanding of the basic principles and techniques available in plastic surgery, including management of traumatic, oncologic, and congenital problems. Students will learn the principles of wound healing and options available for management of difficult wound situations. They will develop their surgical skills, including dissection and suturing, while scrubbed in the operating room and emergency ward. These individuals will have the opportunity to practice and enhance their diagnostic capabilities during a twice-weekly clinic experience encompassing both general plastic surgery, facial trauma, and hand surgery. The students are considered an integral part of the Plastic Surgical Team and will actively participate in the conferences, rounds, and operating room.

 

SURG 4010B: Surgical Intensive Care Unit Acting Internship

Description

During this AI, the student will be involved in the management of critically ill surgical patients as a member of a multidisciplinary SICU service. Patients seen include those on the General, Trauma, Vascular, Neurosurgical, Thoracic, and subspecialty services. Emphasis is placed on hemodynamic and respiratory management, placement of arterial, central venous and right heart catheters, and nutritional/metabolic problems in the critically ill.

Objective

To learn the basic principles and skills required for care of the critically ill surgical patient

 

SURG 4017B: Burn Unit Acting Internship

Description

The Burn Unit is, in effect, a physiology laboratory in which the student can learn in-depth the interrelationships between fluid and electrolyte balance, shock, infection, sepsis, nutrition, wound healing, antibody host-responses as well as the management of respiratory insufficiency, cardiac failure, renal failure, hepatic failure and the clinical approach to their treatment. In addition, the student will have an opportunity to learn techniques of wound isolation, debridement, skin grafting, cosmetic and functional reconstruction and the important role that the supportive medical and paramedical services offer in achieving these objectives. This rotation will provide for the inquisitive student an opportunity to integrate the multiple aspects of surgical-patho-physiology encountered in severe acute and prolonged life-threatening illness.