M4 Clinical Electives

• MED MD 405: Anesthesiology
  The Anesthesiology Elective is a 4-week clinical experience. In this elective, students will learn the principles and concepts of the practice of anesthesiology and the multiple roles the anesthesiology plays both in and outside of the operative room. Students will participate in the management of patients undergoing general surgery, head and neck surgery, neurosurgery, thoracic and cardiac surgery, obstetrics and gynecology procedures, orthopedic surgery, pediatric surgery, urologic procedures, and vascular surgery. Educational sites include the Boston Medical Center operating rooms, the pain clinic, off site imaging locations (CT/MRI), labor and delivery, and the gyncelogy procedure unit. Learning will primarily occur in the Boston Medical Center operating rooms, where medical students will be paired with residents and attending faculty. The experience will involve the perioperative evaluation and care of the surgical patient. Students will participate in the management of patients undergoing general surgery, head and neck surgery, neurosurgery, thoracic and cardiac surgery, obstetrics and gynecology procedures, orthopedic surgery, pediatric surgery, urologic procedures and vascular surgery. Additional educational sites include the pain clinic, off site imaging locations (CT/MRI), labor and delivery and the gynecology procedure unit. On their first day students will receive an orientation from the rotation director. During the elective, medical students will attend a series of lectures and case conferences. These will serve to enhance their knowledge, skills and understanding of the field. Students will also attend Departmental Grand Rounds, held most Fridays. Logistics: 1- Students will receive a packet of information via e-mail prior to the start of the rotation. 2- Students must report to the Anesthesiology Office at 6:30 AM on the first day (or when otherwise specified) for orientation. (Location: Powerplant Building, 750 Albany St., Floor 2R) 3- Students are expected to be present for all departmental academic activities. 4- There are no call responsibilities for this rotation.
• MED MD 410: Clinical Cardiology
  The Clinical Cardiology Elective is a 4-week clinical experience at Boston Medical Center. In this elective, students will become a member of the Cardiology Consult team comprised of a staff cardiology, a cardiology fellow, and one to three PGY-2s. Students will be exposed to a wide variety of cardiac patients and share in the responsibilities for patient evaluation, management, and disposition. This elective emphasizes the fundamentals of the cardiac examination and therapeutics. Students will learn the significance, usefulness and manner of performing special diagnostic studies including electrocardiograms, echocardiograms, exercise stress tests, holter monitors, nuclear scans and cardiac catheterizations and will apply these to patient care. Teaching activities include daily rounds with staff cardiologist, EKG reading, Cardiology Grand Rounds, and Conferences. Students are expected to develop competency in EKG reading during the rotation. By special arrangement, additional elective time can be provided for certain students with a special interest in arrhythmia, cardiomyopathy, echocardiography, stress testing or clinical research." All students and residents are expected to develop competency in EKG reading offered during the rotation. By special arrangement, additional elective time can be provided for certain students with a special interest in arrhythmia, cardiomyopathy, echocardiography, stress testing or clinical research. Teaching activities include: 1. Daily rounds with Staff Cardiologist 2. EKG reading 3. Cardiology Grand Rounds 4. Medical/Surgical Conference 5. Arrhythmia Conference 6. Imaging Conference 7. Research Conference 8. Cardiomyopathy Conference 9. Core Curriculum Conference
• MED MD 411: Clinical Cardiology - Kaiser San Jose
  The Cardiology Elective will expose the medical student to the field of Cardiology as practiced within an integrated multispecialty group. The rotation takes place in the Cardiology Department at Kaiser San Jose with rotations both in the clinic and hospital setting. The student will learn about the most common Cardiology conditions such as coronary artery disease, valvular heart disease, arrhythmias, congestive heart failure, hypertension and congenital heart disease. Learning about various diagnostic modalities in the evaluation of various cardiac conditions such as stress testing, coronary angiography and other imaging modalities such as echocardiography, CT angiography and cardiac MRI are also part of the experience. Acquiring a general understanding of the various management options for patients with cardiac conditions, such as appropriate medical therapy, coronary percutaneous interventions, and coronary, valvular or other structural heart surgery will be imparted. Students will work closely with a faculty member to evaluate patients, perform some procedures under direct supervision and be exposed to a broad spectrum of cardiac conditions presenting to a community hospital and medical center setting. They will be assigned to one of seven attendings during the weekday hours of 8:30-5:30 pm, who will supervise them while evaluating consultations both in the outpatient and inpatient settings.
• MED MD 412: Clinical Cardiology - Santa Clara
  The Cardiology Elective will expose the medical student to the field of Cardiology as practiced within an integrated multispecialty group. The rotation takes place in the Cardiology Department at Kaiser San Jose with rotations both in the clinic and hospital setting. The student will learn about the most common Cardiology conditions such as coronary artery disease, valvular heart disease, arrhythmias, congestive heart failure, hypertension and congenital heart disease. Learning about various diagnostic modalities in the evaluation of various cardiac conditions such as stress testing, coronary angiography and other imaging modalities such as echocardiography, CT angiography and cardiac MRI are also part of the experience. Acquiring a general understanding of the various management options for patients with cardiac conditions, such as appropriate medical therapy, coronary percutaneous interventions, and coronary, valvular or other structural heart surgery will be imparted.
• MED MD 415: Dermatology
  The Dermatology Elective is a 4-week clinical experience. In this elective, students will develop fundamental dermatology skills and be exposed to general dermatology, pediatric dermatology, dermatology specialty clinics, and dermatologic procedures. Students will attend ambulatory clinics, inpatient consultations, grand rounds, and didactics. Our group is comprised of attending dermatologists, dermatopathologists, procedural dermatologists, doctorate scientists, dermatology residents, international trainees, dermatopathology fellows and a skin oncology fellow. Boston University is a center of excellence in basic cutaneous biology research, skin oncology, wound healing, psoriasis, connective tissue disease, photomedicine, hair disorders, dermatologic surgery/oncology, dermatopathology and dermatology education. COMPETENCY BASED GOALS AND OBJECTIVES The purpose of the dermatology elective is to provide BUSM IV students the content, functional knowledge and practical skills needed to identify, evaluate, manage and prevent common and important disorders of the integumentary system.
• MED MD 416: Dermatology (Kaiser)
  The General Dermatology Elective takes place in the Dermatology Department at Kaiser Santa Clara, Kaiser San Jose, and Kaiser Milpitas with rotations both in the clinic and hospital setting. The goal is to expose the medical student to the field of Dermatology as practiced within an integrated multispecialty group. Students will have the opportunity to work closely with a faculty member to evaluate patients, perform procedures under direct supervision including Mohs surgery, contact Dermatology, pediatric Dermatology, and complex medical Dermatology and be exposed to a broad spectrum of dermatologic conditions presenting to a community hospital and medical center setting. Medical students will learn how to perform dermatology focused history and physicals, develop a methodical assessment and plan and perform supervised procedures for diagnostic testing and/or treatment of some of these patients.
• MED MD 420: Emergency Ultrasound
  The Emergency Ultrasound Elective is a 4-week clinical experience. In this elective, students will develop their ultrasound skills and gain additional exposure to patient care in the Emergency Department. The elective will provide students with the tim eand mentorship to develop advanced skills in bedside emergency ultrasound. All students will participate in designated instructional hands on sessions with an ultrasound faculty member. They will have assigned 4-hour scanning shifts where they will scan patients in the emergency department. Students will deliver a final presentation and take a final examination. Enrollment is limited to 2 students per block.
• MED MD 422: Emergency Medicine - Kaiser
  
• MED MD 426: Ambulatory Family Medicine
  Students who are entering the field of family medicine are the target for this elective. Students will see ambulatory patients at one or two of the affiliated residency sites, including South Boston Community Health Center, East Boston Neighborhood Health Center and Codman Square Health Center. The student will work with a variety of Family Medicine residents and preceptors, and as such will not likely have opportunity for significant summative assessments and advanced accolades from faculty. With appropriate supervision, students will be expected to have first contact with patients and to do the initial work-up. Students will advance their skills in the diagnosis of the undifferentiated patient, and the assessment and management of acute and chronic problems which commonly present in family medicine. Instruction in patient education and preventive medicine in the family contMAS will be emphasized. Students will participate in staff conferences and may attend rounds, conferences and lectures that are part of the BMC Family Medicine Residency Program. This elective is also available through the Boston Medical Center Minority Recruitment Program.
• MED MD 428: Family Medicine 360°
  The Family Medicine 360° is an opportunity for fourth year medical students to delve into the many roles of a family doctor. This elective is designed for medical students strongly considering a career in Family Medicine who would like additional exposure to outpatient, inpatient, maternal child health and specialty care provided by family doctors. The elective experience will take place at Boston Medical Center, at Family Medicine affiliated community health centers, and at the Ryan Center (Sports Medicine). The student will have a clinical home throughout their rotation at a community health center. Each student will be paired with a resident, and will participate in that resident's continuity clinic 2 sessions/week on their inpatient and mom-baby weeks and 5 sessions/week on the outpatient week. These supervising residents will receive Resident as Teacher training and will get teaching support and mentoring during the rotation from Dr. Cohen-Osher. The student will see a subset of patients on the resident's schedule. The clinical care provided by the student-resident pair will be supervised by the attending physician who is precepting in resident clinic. The student will also work with additional clinicians at the community health center to understand the comprehensive services available for the care of patients such as integrated behavioral health and nutrition counseling. The inpatient experience during the elective will include 2 weeks on the Family Medicine inpatient service caring for hospitalized adults. During the week of nights, the student will work directly with the Family Medicine intern and attending physician to admit new patients and cross-cover patients on the Family Medicine resident teams. During the week of days, the student will follow their own assigned patients with supervision from the resident team and attending physician. The maternal child health week gives students a true Family Medicine-centered experience to include prenatal/perinatal care (including labor and delivery), inpatient postpartum care for women, as well as newborn nursery care for their infants. The student will spend mornings on the postpartum floor caring for women and their infants- focusing on issues such as breastfeeding (including spending time with a lactation consultants), the newborn exam, routine postpartum care, maternal counseling and anticipatory guidance. During the outpatient/specialties week the student will have an opportunity to tailor their clinical experiences to their individual interests. All students will have the opportunity to spend clinical time with the Sports Medicine fellowship trained Family Medicine faculty and fellows. Students will also be able to experience other areas of focus in Family Medicine such as integrative medicine, transitions of care, office based substance use treatment, geriatrics, and student health and these will be tailored (as much as possible) to the student's clinical interests.
• MED MD 429: Family Planning and Reproductive Health
  
• MED MD 442: Adolescent Medicine
  The Adolescent Medicine elective will take place at Boston Medical Center's outpatient Adolescent Center, as well as at a handful of community sites. It will be an opportunity for one 4th year medical student per rotation to gain experience caring for adolescents in the outpatient setting. Students will interview and examine adolescent patients with attending physician supervision, and come up with plans for diagnostic evaluation and treatment. Students are expected to work at least 40 hours per week and have various opportunities to interact with attending physicians, mid-level providers, nurses, social workers, and other community providers. This elective will give medical student valuable exposure to common psychosocial and medical health concerns in adolescents such as sexual and reproductive health, disordered eating, reproductive endocrinology, depression and anxiety, substance use, as well as pubertal growth and development. Students will also attend teaching conferences in the Department of Pediatrics at Boston Medical Center when this does not conflict with clinical experiences. This may include, but is not limited to: Noon Conference, Case of the Week, and Grand Rounds - in addition to adolescent specific education sessions as part of the BCRP Keystone block. Students will receive timely feedback from providers as well as formative feed back at the mid-clerkship evaluation to assess their progress in developing the below skills. At the end of the elective, the student will be expected to complete an evidence-based presentation as outlined below, and will have gained the following skills: - To conduct an age and developmentally appropriate interview - To council adolescents regarding common psychosocial concerns, including but not limited to reproductive health, substance use and mental health - To come up with appropriate treatment plans for common adolescent concerns.
• MED MD 443: Ambulatory Medicine
  Advanced Internal Medicine, Medicine II Block: All Students will complete a required four week Ambulatory Medicine rotation in the fourth year. For the 4 week ambulatory medicine rotation, students will be assigned to one of the following sites: Jamaica Plain/West Roxbury VA, Bedford VA, Roger Williams Medical Center, Neighborhood Health Centers, Private Practices or BMC. BUSM is exploring additional possible clinical venues for training in Ambulatory Internal Medicine and may add new venues in the coming year.
• MED MD 445: Addiction Medicine
  The Addiction Medicine elective will take place at Boston Medical Center’s inpatient wards, as well as various community sites, including but not limited to: HCRC Methadone Clinic, Fast Path Clinic, Envision, and SMART Recovery Meetings. This is an opportunity for a 4th year medical student to understand addiction as a chronic medical condition, and SUD as an important and prevalent public health issue. Students will engage in care of persons with SUD in a professional, health-oriented, responsible and proactive manner, in order to reduce substance-related harm, promote health and address co-existing medical problems. Students will interview and examine patients with attending physician supervision and be involved in the patient's treatment planning. Students are expected to participate, Monday through Friday, at least 40 hours/week. Students will attend teaching conferences that are scheduled during the elective time. Students will receive timely, formative feedback from the attending preceptors including a mid-clerkship evaluation to assess their progress in developing the skills needed to treat patients with SUD.
• MED MD 446: Vascular Medicine
  This is designed to be a comprehensive rotation in cardiovascular disorders with emphasis on vascular problems. Students will gain an exposure to the evaluation and management of vascular disorders affecting the arterial, venous, and lymphatic systems, as well as vasospastic disorders. Emphasis will be placed on learning the presentation, physical findings, diagnostics, and therapeutics. The indications, techniques, and interpretation of vascular studies will be taught. Students will be expected to fully participate in the clinical and educational activities including: - Inpatient vascular medical consultations including cardiac consultation for vascular surgery - Outpatient clinic, which includes new consultation and longitudinal care of patients with vascular disease - Non-invasive vascular laboratory and peripheral interventional laboratory - Vascular conferences including an interdisciplinary vascular conference and a vascular laboratory journal club As mentioned above, there is heavy emphasis placed on a comprehensive cardiovascular approach to the vascular disease patient. Students can expect to be exposed to and provide care for many cardiac disorders, including coronary artery disease, heart failure, valvular heart disease, and arrhythmias, especially during the perioperative evaluation and management. This will include an understanding and application of the diagnostic cardiac studies, including electrocardiograms, echocardiograms, exercise and pharmacologic stress test, and cardiac catheterization.
• MED MD 447: Obesity Medicine and Nutrition Support
  This elective provides "hands on" exposure to the problems of obesity and malnutrition in both inpatients and outpatients. The Obesity Medicine and Nutrition Support rotation at Boston Medical Center is a 4 week rotation. The students will gain experience managing individuals with morbid obesity by working in the Nutrition and Weight Management Clinic with nutrition physicians and dietitians. The students will get an overview of the medical management and surgical treatment options available for the morbidly obese patient. This includes an introduction to the comprehensive pre and post-operative management of these patients via clinic experience and inpatient follow-up where applicable. The option is available, based on student interest, to observe Culinary Nutrition Medicine classes in BMC's Nutrition Resource Kitchen with a professional chef/dietitian. The student will work closely with members of the multidisciplinary Nutrition Support Team. This includes an attending physician, clinical fellows, dietitians, pharmacists and research staff. Participation in daily patient and teaching rounds will be expected. Consultations will be undertaken with the supervision of a fellow or the Nutrition Support attending on service.
• MED MD 448: Gender Care Rotation
  This elective is for the BUSM student to learn the multi-disciplinary approach to appropriate care for transgender and gender nonbinary individuals. The transgender medicine elective will provide an introduction to the full spectrum of care for transgender and nonbinary individuals including establishing initial care, continuing primary care as well gender affirming hormone and surgical options. Students will interact with patients who are exploring gender identity, who identify as transgender and nonbinary, and who are pursuing hormonal or surgical gender affirmation. They will learn the endocrinological mechanisms of puberty as these parallel the hormonal and pharmacological interventions used in transgender medicines. Students will participate in clinical sessions and are expected to treat patients with respect and sensitivity. Students attend various clinical sessions during their elective including: endocrinology, primary care, adolescent medicine, and surgery clinics. Self-study of social work, pediatrics, psychiatry, ob/gyn and surgery aspects of transgender medicine is required. Students will be graded on interactions with patients in clinical session, knowledge of the subject from outside reading and a final 15 minute presentation in the 4th week of the rotation.
• MED MD 449: Pulmonary Medicine-Consultation Service
  The student will be an integral part of an active in patient clinical pulmonary consultation service. They will be responsible for the initial consultation in patients with a variety of respiratory disorders. The student's evaluation and plan of management will then be discussed with the pulmonary fellow and at daily staff attending rounds. The elective will provide an opportunity to evaluate chest roentgenograms, interpret arterial blood gases and pulmonary function tests, and discuss the role of and participate in such diagnostic procedures as fiberoptic bronchoscopy, pleural biopsy and thoracentesis. The student will participate in a full program of teaching conferences including work rounds, chest x-ray conferences, formal interhospital chest conferences, physiology seminars and research conferences, and a special weekly student case discussion conference.
• MED MD 455: Inpatient Clinical Neurology: General
  This elective is for the BUSM student to provide students with a broad exposure to the field of general inpatient neurology. Students will learn how to approach the diagnosis and management of patients with non-stroke neurological disorders. In addition, students will learn to work in multi-disciplinary teams to participate in the care of complex patients.
• MED MD 456: Inpatient Clinical Neurology: Stroke
  This elective is for the BUSM student to provide students with a broad exposure to the field of inpatient Stroke Neurology. Students will learn how to approach the diagnosis and management of patients with different forms of strokes and stroke risk factors. In addition, students will learn to work in multi-disciplinary teams to participate in the care of complex patients.