Boston University School of Medicine (BUSM) Clerkships & Subinternships
MED MS 310: Medicine Clerkship (eight weeks)
The Medicine 1 Clerkship is an eight-week experience designed to enhance the student’s capacity to function as a caring, increasingly independent, but supervised, clinician on a multiprofessional team. During the clerkship, students learn clinical medicine while working side-by-side with residents and faculty in providing care to a cohort of inpatients. A key principle that guides student learning is to provide graduated responsibility with supervision. Medicine 1 introduces the clinical tools and perspectives of the internist that are appropriate regardless of the student’s career choice. This learning experience is complemented by a unique enrichment in which students also work closely in small groups with a clerkship director and hone essential clinical skills (including intermediate-level communications skills, physical diagnosis, and clinical reasoning). The clerkship is divided into two mini-blocks of four weeks each, and students learn at two of the following sites: Boston Medical Center, the West Roxbury VA Hospital, MetroWest Medical Center (Framingham), Beth Israel Deaconess–Plymouth (former Jordan Hospital), and Roger Williams Medical Center (Providence, RI). In addition, some students will take the entire eight-week clerkship at the Kaiser Health Care System in California.
MED MS 311: Surgery Clerkship (eight weeks)
During the eight-week Surgery Clerkship, students are assigned to a four-week rotation in general surgery at one of six sites: Boston Medical Center, the West Roxbury VA Hospital, Cape Cod Hospital, Roger Williams Medical Center, MetroWest, or Kaiser Santa Clara Medical Center. Students also do two rotations (two weeks each) of other surgical subspecialties such as vascular surgery, anesthesiology, minimally invasive surgery, or acute care/trauma surgery, and a limited number of slots in orthopedics, urology, and otolaryngology. Each of these rotations includes experience in the OR. All rotations except anesthesiology include experience as part of the surgical team caring for patients on the surgical wards, and outpatient care in surgical clinics. Students work directly with faculty in the OR, in the clinic, and in regular meetings with their preceptors. All students (except those at Kaiser) return to Boston Medical Center for didactics on Fridays, and they participate in educational conferences with the residents and attendings.
MED MS 312: Obstetrics and Gynecology Clerkship (six weeks)
An Obstetrics and Gynecology Clerkship is one of the core clinical rotations in the medical school curriculum due to its unique focus on female reproductive health and dysfunction. In addition, OB/GYN providers are Women’s Health advocates who promote education, safe pregnancy, health maintenance and prevention of sexually transmitted diseases, and reproductive cancers. This clerkship emphasizes the doctor-patient relationship, interviewing skills, mastery of the pelvic and breast examination, patient safety, and clinical problem solving in patient care. The foundation that students will gain—in obtaining skills and knowledge to become a comprehensive health provider for women—will be integral to their education in health care and policy, regardless of future specialty choice. For clerkship students interested in women’s health, there is ample opportunity to familiarize themselves with the wide variety of career choices available within the field of Obstetrics and Gynecology. This clerkship offers students opportunities to improve core skills in screening patients for lack of material resources, and anchors students in the context of safe care with workshops on learning from error. Nine locations of the clerkship are available: Boston Medical Center, BMC/Lahey Clinic (inpatient GYN), MetroWest Medical Center in Framingham (MWMC), Beverly Hospital in Beverly, Mt. Auburn Hospital in Cambridge, Lahey Medical Center in Burlington, and Beth Israel–Plymouth, Kaiser San Jose, and St. Elizabeth’s, Brighton.
MED MS 313: Pediatric Clerkship (six weeks)
During the six-week Pediatric Clerkship, students will gain experience in clinical pediatrics by rotating at one of the clerkship’s seven sites. At the clerkship sites, students may have the opportunity to participate in pediatric care on a number of clinical services, including: the inpatient ward, outpatient primary care and subspecialty clinics, emergency room, newborn nursery, and perhaps a NICU and/or PICU. Objectives of the clerkship are for students to learn to perform a pediatric-specific history and exam in both inpatient and outpatient settings for all ages (newborn, toddler, school-age, and adolescent), to learn child growth and development from birth through adolescence, to learn about common childhood illnesses/disorders, how to evaluate and how to treat them, and to become familiar and comfortable with patient/family-centered care.
Students at all clinical sites will participate in the core conference series held weekly at Boston Medical Center. During this busy clerkship, we expect students will learn a lot about the care of children and their distinct needs.
MED MS 314: Psychiatry Clerkship (six weeks)
In the Psychiatry Clerkship, medical students will be assigned to a site where they will see and interview patients who are suffering from many different types of mental health disorders. In addition, students will participate in a weekly, three-hour Wednesday afternoon seminar located at BUSM, where they will hear presentations covering important topics in psychiatry such as anxiety and mood disorders, schizophrenia, and substance use disorders. Medical students will learn how to diagnose various mental health disorders and will gain a greater understanding of evidence-based treatments for these disorders.
MED MS 315: Family Medicine Clerkship (six weeks)
In the Family Medicine Clerkship, students work in high-volume ambulatory care practices of family physicians and residency programs. Over the course of the clerkship, students learn to understand and promote a patient-centered model of care; to understand the Family Medicine approach to seeing and evaluating patients and families with undifferentiated problems, and develop the clinical reasoning that guides the definition and diagnosis of such problems; to develop skills in the diagnosis and management of frequently occurring acute and chronic problems; to understand the patient as part of a family and community; to understand and use a comprehensive and continuous approach to care; to understand and use the concepts of Information Mastery, including Patient-Oriented Evidence that Matters, the Usefulness Equation, and point-of-care EBM resources to guide patient care decisions; to understand and use techniques of evidence-based preventive medicine and health promotion; and to understand population health, health management, and the importance of primary care in the health care system.
MED MS 316: Neurology Clerkship (four weeks)
Students at Boston University School of Medicine are required to participate in a four-week Neurology Clerkship in the third year. The goal of the clerkship is to teach students how a neurologist thinks about disease, gaining a solid foundation in the neurological history and examination, and the interpretation and significance of, neurological examination findings. Much attention is devoted to clinical-anatomical correlation and refining the skills of “lesion localization.” Students spend their clinical time in both the inpatient/consultation service and the outpatient clinics. Students are expected to spend most of their time on the adult services, but there is also opportunity to spend time with the Pediatric Neurology group. There are weekly didactic sessions with a senior faculty member that concentrate on clinical problem solving. Clinically relevant reading material and the cases to be discussed in the didactic sessions are provided on the clerkship’s Blackboard site. Students utilize the lumbar puncture simulator to increase their technical proficiency.
MED MS 404.1: Surgery Clerkship Surgical Subspecialty (four weeks)
All fourth-year medical students, as part of the Selectives, will have a choice to rotate in the Surgical Subspecialties. The Surgical Education office offers a four-week rotation consisting of two subspecialty rotations (two weeks each). Students will have the opportunity to rank their preferences for the subspecialties, limited by capacity. Students’ choices may not be guaranteed. Options include: Anesthesia (BMC or VA), Neurosurgery (BMC), Thoracic (BMC), Ophthalmology (BMC or VA), Orthopedics (BMC or VA), Otolaryngology (BMC), Plastic Surgery (BMC), and Urology (BMC or VA). Of note, fourth-year medical students who rotated in Anesthesia during the Surgery Clerkship may not rotate in Anesthesia again as part of the Surgical Subspecialties.
MED MS 410: Geriatrics Clerkship (four weeks)
This clerkship teaches students basic geriatrics knowledge and skills to recognize and manage common geriatrics issues, such as dementia, delirium, falls, incontinence, and pressure ulcers. The students learn the presentation and management of common geriatric syndromes, practice interviewing and examining patients with multiple disabilities, and demonstrate the use of common geriatrics screening tools. They participate in a multidisciplinary approach to the care of the frail elderly in the community and in nursing homes, learning about community resources and the roles of the various team members. Students work under the direct supervision of geriatric attending and nurse practitioners in the home care and nursing home settings. The students are expected to demonstrate independent learning with an evidence-based paper and during independent home visits.
MED MS 412: Radiology Selective (four weeks)
The purpose of the Radiology Selective is to expose students to all common imaging modalities, their uses and limitations, and to develop a systematic approach to image interpretation. Students also have an opportunity to see radiology in action, watch patients undergo exams, see consultation between clinicians and radiologists, and gain an appreciation of the contribution of imaging to clinical care.
MED MS 030.1i: Subinternship in Family Medicine—Boston Medical Center
The students participating in this subinternship experience work as integral members of the Family Medicine Inpatient Service on the East Newton Campus. This service provides care for a wide variety of patients with acute and chronic medical conditions from the Boston HealthNet Community Health Center system. To allow students to enhance their capacity as increasingly independent, highly competent, and compassionate care providers, students will be acting interns responsible for the evaluation and continued management of their own patients under the direct supervision of the attending physicians and residents on the inpatient service. Students are also expected to attend educational conferences and participate in morning teaching sessions.
MED MS 050.3: Subinternship in Pediatric Emergency Medicine—Boston Medical Center (one month)
This subinternship in pediatric emergency medicine will provide students with experience in independent evaluation of pediatric patients, ages 0–21 years. The rotation will focus on clinical problem solving, and will emphasize skills in the differential diagnosis and treatment of acutely ill children as well as provide experience with selected emergency procedures when available. There is no mandatory overnight call, but students may elect to have some weekend shifts in addition to weekday shifts to complete the required complement of shifts during the rotation. Approximately half of the shifts will be during the evening hours of 3–10 p.m. Students will be acting interns, with a schedule that approximates that of our interns; therefore, during a 4-week block there are 19 required shifts and during the 3-week block (block 14) there are 16 required shifts—all absences must be made up to meet this minimum. Attendance at the Department of Pediatrics conferences and twice-monthly resident conferences is encouraged. At the end of their rotation, students will be required to present a case-based, evidence-based medicine session to evaluate their ability to interpret and incorporate the medical literature into their practice. Note that for July through December, priority will be given to students applying for internship in Pediatrics.
MED MS 051.3: Subinternship in Pediatric Inpatient Medicine—Boston Medical Center (one month)
This clinical subinternship is a busy experience during which the student will have supervised responsibilities in the pediatric inpatient ward at a level that the inpatient team judges to be commensurate with an individual student’s abilities. The objective of the acting internship is for students to challenge themselves to become increasingly independent and highly competent members of the inpatient pediatric team. The student will admit patients and have responsibility for his/her own patients under the direction of the faculty and house staff on the inpatient service. He/she will be an integral member of the inpatient team participating in all levels of activity, rotating with BCRP residents on both day and night shifts, and have the opportunity to attend residency conferences.
MED MS 052.3: Subinternship in Pediatric Intensive Care Unit—Boston Medical Center (one month)
The PICU is a multidisciplinary six-bed unit caring for children and adolescents from newborns to 22 years; the subintern will work closely on a team with a senior pediatric resident from the Boston Combined Residency Program in Pediatrics (BCRP) and the PICU attending. The subintern will act as the primary provider for their assigned patients. Major teaching objectives of the rotation are the pathophysiology of childhood critical illness, pediatric advanced life support (PALS), and the various types of intensive care support (i.e., forms of mechanical ventilation, critical care nutrition, and coordination of care), as well as psychological and social support for patients and their families. Call is every fourth night including weekends until 10 p.m.
MED MS 057.3: Subinternship in Neonatology—Boston Medical Center (one month)
The neonatal intensive care unit is a multidisciplinary 21-bed, level 3 unit caring for preterm and/or critically ill neonates. The subintern will work closely with the team and serve as the primary physician covering 1–2 infants during the first two weeks of the rotation and up to 3–4 infants during the last two weeks of the rotation, with support from the junior and senior resident. The subintern will participate in neonatal resuscitations in the delivery room, care of infants throughout the hospitalization, and discharge planning. Time is available for the student to read in depth about perinatal medicine and to participate in seminars with house staff and senior staff. Students will be expected to take three overnight calls during the week, and two weekend calls during the day only.
MED MS 100.1: Subinternship in Medicine—Boston Medical Center
The Subinternship in Medicine is designed to challenge and enhance the capacity of the student to work as an increasingly independent, highly competent, and compassionate caregiver and contributing team member. To achieve this goal, the subintern will work as an advanced care provider under the direct supervision of the inpatient team resident and assume increasing responsibility for the initial evaluation and integration of the total care of assigned patients. The student is expected to integrate medical knowledge with clinical and interpersonal skills in order to demonstrate independent thought and develop a plan of action. The student is expected to develop a balance between acting independently and acknowledging his/her limitations and seeking help as appropriate.
MED MS 100.11: Advanced Acting Internship in Medicine—Boston Medical Center
The Advanced Acting Internship (AAI) builds upon and is a more intensive version of the traditional subinternship. Three AAI students are paired on an inpatient team that has no interns, and together they work under the direct supervision of the team resident and assume care of assigned patients. The student is expected to integrate book knowledge with clinical and interpersonal skills in order to demonstrate independent thought and develop a plan of action. The student is expected to develop balance between acting independently and acknowledging his/her limitations and seeking help as appropriate. The clinical work is complemented by conferences offered by the Department of Medicine. Because of space limitations, the AAI cannot accommodate all students.
MED MS 101.1: Medical Intensive Care Unit Subinternship
The Medical Intensive Care Unit (MICU) subinternship is available to selected fourth-year medical students and is designed to provide an introduction to the diagnosis and management of critically ill patients with single and multisystem organ failure. Students participate on daily work and radiology rounds, and contribute to the management of patients by collecting and assimilating data for presentation to the attending, arranging consults and tests, and by placing orders and performing common procedures under direct supervision.
MED MS 201.3: Inpatient Gynecology
The student participates as a subintern in all aspects of the inpatient and ambulatory gynecology service, assisting in minor and major gynecologic surgical procedures and following patients postoperatively. The student will primarily work with the East Newton GYN service. Students will prepare a case-based presentation at a GYN noon conference and are expected to participate in educating the clerkship students. The student will be evaluated on his or her teaching skills as part of the final grade.
MED MS 202.3: Maternal Fetal Medicine
The student works with the Maternal Fetal Medicine faculty and resident staff caring for high-risk pregnant patients, in both ambulatory and inpatient settings. The student will function as an acting intern for patients on the antepartum service. The student will attend the high-risk prenatal clinics and spend one day per week on the labor floor. He or she will attend conferences run by the High Risk Department; additionally the student is expected to present at a MFM Thursday noon conference. To receive honors in the clerkship, the student will write a paper or create an enhanced resource or teaching tool for clerkship students.
The Department of Surgery offers fourth-year students the opportunity to be subinterns at a variety of our major teaching hospitals. The student will be assigned patients to admit and follow during their hospital course. The student will work with the resident and attending staff in managing the patient’s surgical problems in the operating room, on the inpatient wards, and in the ambulatory setting. Attendance at morning and afternoon rounds, morbidity and mortality conferences, and other teaching conferences is an important part of the rotation as well as being on call with residents. Instruction will focus on principles and pathophysiology of surgical disease, pre- and postoperative care, indication for surgical intervention, and procedural skills. This rotation is especially suitable for any student interested in more intensive training in surgery than is possible during the required third-year surgery clerkship.
- MED MS 400.00: General Surgery, Cape Cod
- MED MS 400.1a: General Surgery, Vascular Service
- MED MS 400.1b: Surgical Oncology Service
- MED MS 400.2: General Surgery and SICU, VA Boston Healthcare System
- MED MS 400.3: Acute Care Trauma Surgery, Menino Pavilion
- MED MS 403.1: Surgical Intensive Care Unit