M4 Clinical Electives

• MED MD 503: Pediatric Cardiology
  One student will be a member of the cardiology consult team, and will assist in the evaluation, screening and management of patients with known or potential cardiac disease. The student will write initial consult and follow-up notes. Students may explore specialty consult services (e.g., adults with congenital heart disease, cardiac transplantation) for a portion of their rotation. Students are expected to improve ones consultation skills, read pediatric EKGs, and attend an array of didactic sessions covering a wide range of topics in pediatric cardiology. No call is required.
• MED MD 504: Pediatric Nutrition
  The U.S. Preventive Services Task Force recommends that physicians provide nutrition counseling and referral as a standard part of their practice and as a strategy for primary prevention of disease. The Pediatric Department at Boston Medical Center serves a diverse and underserved inner city population with high rates of nutritional related diseases including vitamin D and iron deficiencies, failure to thrive, failure to initiate or continue breastfeeding, and overweight / obesity. The purpose of this evidence-based elective is to increase the nutrition knowledge, attitudes and counseling skills of medical students through hands-on, case-based training in pediatric nutrition and weight management, as well as participation in pediatric nutrition conferences and projects. Students will have the opportunity to work with dietitians, physicians, mental health providers, and lactation consultants, individually and within multidisciplinary teams. They will be exposed to the nutritional management of patients who are enrolled in a variety of programs including the Pediatric Nutrition Support Service, the Nutrition and Fitness for Life (NFL) program, the Grow clinic, Baby Steps, the Pediatric Preventive Cardiology clinic, the Pediatric Endocrine clinic and the Pediatric GI clinic. Students will also have access to other programs based on their specific interests including the Baby Cafe, the Preventive Food Pantry, and the Teaching Kitchen. While a majority of their time will be spent in clinic, students will also have outside reading and web-based modules, complete a project, receive 1-on-1 lectures based on their interests, and attend case series, grand rounds and nutrition seminars.
• MED MD 505: Pediatric Latino Patients: Language, Sensitivity and Cultural Immersion
  This pediatric-focused elective is an opportunity for students to improve their medical knowledge of pediatric medical issues, deliver pediatric primary, and improve their medical Spanish knowledge in this population. The majority of the student's time will be spent seeing patients in the outpatient pediatric clinic at BMC with attendings who are Spanish-speaking and/or Spanish-speaking Latino origin that have a significant proportion of patients whose primary language, either for them or their parents, is Spanish. These clinics may include, but are not limited to the following pediatric settings: Gastroenterology, Neurology, Infectious Disease, Endocrinology, and Primary Care. The student will learn the initial approach for new patients as well as long-term management of chronic illnesses in the designated clinical settings. Discussions with faculty around patient care will focus both on medical management in general, but also with specific attention to elements of the social and cultural influences that affect the quality of medical services and treatment and that can enhance health outcomes for the patient and family. As a clinician, the student will develop skills of more culturally sensitive care both through observation of the approach of the experienced physicians and through active practice and feedback. Complementing the clinic experience and exposure to medical Spanish, the course will have a series of literature discussions developed to cover diverse elements of Spanish-speaking patients and Latino health, cultural awareness and sensitivity, as well as care of patients with limited English proficiency. Students interested in the elective should have a working proficiency of spoken Spanish with capability of, at a minimum, interviewing the patient, gathering pertinent information and performing a pertinent physical exam. Students lacking this level of fluency may enroll in the elective, but should have comprehension of spoken Spanish sufficient to follow the interview and interaction in Spanish between the care provider and the patient. For those interested in receiving attestation of their language proficiency to adequately interview patients in Spanish through the Hospital Interpreter Services an evaluation can be arranged beforehand for such attestation.
• MED MD 506: Pediatric Neurology
  The student will be immersed fully into the Pediatric Neurology team, constituted by Pediatric Neurology and Adult Neurology residents, rotating Pediatrics residents, and one of the staff physicians. This elective provides an opportunity to participate in all inpatient and outpatient activities of the Division of Pediatric Neurology. Students will obtain histories and examine patients seen in clinics, on the wards and in the nurseries, and will then present the case to staff. The staff will provide "hands on" instruction in neurological examination and in clinical management. Additionally, there are weekly Neuroradiology rounds at which cranial and spinal magnetic resonance imaging, cranial computerized tomography, and cranial ultrasound imaging studies are reviewed. EEG rounds are held bi-weekly. Each Friday, 2 hour-long academic sessions are held. The first portion of these Pediatric Neurology Grand Rounds include, on a rotational basis, Journal club, research topics, didactic presentations, case reviews with attending physicians, and topics in psychopharmacology. A live patient presentation and discussion of the child's neurological disorder by a member of the Pediatric Neurology Division occurs during the second hour as the case of the week. In the course of the month, the student is expected to identify a topic to research in-depth and to present the topic as a 20 minute presentation near the end of the elective. The elective is ideally suited for the student who is interested in pediatrics. Prior completion of the BUSM rotation in adult neurology is not required.
• MED MD 507: Child Abuse Pediatrics
  The Child Abuse Pediatrics Elective is an opportunity for a 4th year medical student to gain exposure to child physical abuse, child sexual abuse, and child neglect in the Emergency Department, Primary Care, and Pediatric Inpatient settings. The elective will take place primarily at Boston Medical Center, but the student will also have various placements throughout Boston and the surrounding areas. Students are expected to work at least 40 hours per week, with most of that time being one-on-one with attending physicians, social workers, and other members of the multidisciplinary team as dictated by case load and availability during the rotation. Students will spend at least 20 hours per week in clinical placements with a minimum of two 8-hour ED shifts and one 4-hour well child clinic per week. Students will learn to communicate effectively with families regarding the sensitive issues surrounding child abuse pediatrics, while maintaining a high ethical standard, compassion, and respect for all members of the family. Students will work directly with CPT staff during 51A filings and during weekly case review so as to educate the student about the information required, the basic ethical and legal frameworks, and the specific process of filling. The student will also attend standing case review and multidisciplinary meetings throughout the month and will participate in other related activities outside Boston Medical Center. It is expected at the conclusion of this elective that the student will have an understanding of the variety of ways in which child maltreatment can present in pediatric settings, and begin to develop a repertoire of skills for approaching clinical situations in which child maltreatment is suspected.
• MED MD 512: Pediatric Radiology
  The Radiology Elective is for the BUSM student to gain a deeper experience in a limited number of areas in radiology, based on their particular interests. This could include a variety of imaging modalities such as general radiology, CT, MRI, or ultrasound. Elective students will build upon the fundamental knowledge obtained in the general radiology Selective to better understand radiology's role in the care of patients and to practice with image and radiologic report interpretation in their selected areas. In addition, elective students will become familiar with radiologic study selection to best answer specific clinical questions and imaging study acquisition from both the technical and patient perspectives. Course Electives include: Neuroradiology, Pediatric Radiology, Body Imaging, Breast Imaging, Musculoskeletal Imaging The elective takes place in the Department of Radiology at Boston University Medical Center. At the beginning of the elective, the student will identify an attending radiologist with whom they plan to spend the majority of their elective time with as their mentor. This radiology attending will also be responsible for completing the student's evaluation at the end of the elective rotation. Elective students are expected to follow the Radiology Elective daily schedule which will be distributed and available on Blackboard. Through clinical observation in the imaging suites and radiology reading room, elective students will interact with patients, radiology technologists, residents, fellows and attending. Through required readings within each subspecialty, students will focus on studying on the subspecialty-specific Required Diagnoses that are assigned to each subspecialty within the Radiology elective.
• MED MD 513: Pediatric Surgery
  This elective on the Pediatric Surgical Service will provide a broad experience in the evaluation and operative management of a wide range of surgical disorders of infants and children (abdominal, thoracic, genital, transplant, trauma, endocrine). It is geared toward those with an interest in surgery, pediatrics, or both. The student's time is split between the BMC and BCH campuses. This will allow the student to see two different practice settings at two different institutions. The BMC experience is heavily weighted towards a busy outpatient elective surgery experience, including pediatric urology, with some inpatient emergency surgery of common pediatric surgical conditions such as appendicitis, pyloric stenosis, incarcerated hernias, and intussusception. Elective operative cases are held at BMC on Mondays and Pediatric General Surgery Clinic is held at BMC on Tuesdays. Wednesdays through Fridays are then spent at Children's in the ORs, clinics, and rounding on the floors. During the clinics, children who are seen for surgical conditions are discussed and scheduled for surgery; follow-up is provided for those who have recently undergone surgery. At Children's, the medical student will be part of a large team, including interns, residents, fellows, nurse practitioners and faculty, that provides general and specialized surgical services to infants, children, and adolescents presenting with a wide range of congenital and acquired conditions. The students' activities include patient evaluation, assisting in the operating room, and participating in teaching conferences and rounds. An MASensive number of conferences are held per week including grand rounds, morbidity and mortality, vascular anomalies, fetal surgery, oncology, clinical teaching rounds and several didactic lectures. Students will be exposed to and may participate in multidisciplinary patient care programs of the Department of Surgery which include: trauma, surgical critical care including MASracorporeal membrane oxygenation, vascular malformations, solid organ transplantation, fetal surgery and minimally invasive surgery. The medical student will receive teaching and supervision on the wards, in the operating room and in the pediatric emergency room. The student will assist in the operating room depending on his/her technical skills, and may be permitted to first assist or perform minor procedures with the attending. During your rotation, the fellows may assign you a case to present at Professor Rounds with Dr. Robert Shamberger, Chief of Surgery and Dr. Craig Lillehei. The purpose of this is for you to practice presenting an "unknown" to an audience while leading them through an initial presentation, differential diagnosis, lab tests, etc. Wednesday through Friday, students are encouraged to join morning sign out and rounds with the team. Morning Sign Out with the entire team starts early at 5:45am and is led by the Pediatric Surgery Chief Fellow, and all senior residents, nurs
• MED MD 515: Pediatric Complex Care
  Pediatric Complex Care
• MED MD 516: Caring for Pediatric Patients with Disabilities
  Current estimates place the number of children with disabilities at 1 in 6, with this proportion rising to upwards of 1 in 4 in adulthood and 3 in 4 by the time a patient is considered geriatric. Nonetheless, a recent national survey found that only 40% of physicians were very confident about their ability to provide quality care to patients with a disability, and only 56% strongly agreed that they welcome disabled patients into their practice. Several groups of advocates have developed practice guidelines to help address this bias both in medical education and in direct patient care. The goal of this elective is to increase medical students’ respect for and awareness of patients with disabilities across numerous specialties and to support them in understanding the complexity of care for individuals with disabilities across the lifespan.
• MED MD 520: Acute Psychiatry in Managed Care
  Bournewood Hospital, a private psychiatric hospital in the community, is a core adult inpatient training site for the residency program. This elective provides students with the opportunity to learn acute inpatient psychiatry, including patient evaluation, diagnosis, and treatment in a multidisciplinary setting. Students will learn about psychopharmacology and short-term psychotherapy management of patients with psychiatric disorders. Many patients are enrolled in managed care programs allowing students to also learn about systems of care, managed care approaches to psychiatric and substance use disorders.
• MED MD 521: Adolescent Psychiatry
  Bournewood Hospital, a private psychiatric hospital in the community, is a core inpatient adolescent training site for the residency program. This elective is an excellent opportunity to work with adolescents with psychiatric and dual diagnosis disorders in a managed care environment. Students will be members of a multidisciplinary team learning about psychopharmacology, psychotherapy, family therapy, and other treatment modalities. Students will learn about systems of care and the interface between social and educational services for adolescents.
• MED MD 524: Consultation-Liaison Psychiatry
  This four week elective in Psychosomatic Medicine with Dr. Wilensky is a core training site for the residency program and the psychosomatic fellowship program. This course offers a consultation-liaison experience, with a focus on clinical work designed to enhance student's ability to understand and appreciate the psychosocial aspects of medical illness. Emphasis will be placed on the development of interviewing techniques and differential diagnostic styles and increased responsibility for the development of brief treatment strategies. Interested students may choose to focus their clinical work in a particular area of the hospital or with a specific service. In addition, the student will be required to do research in an area of interest involving psychosomatic medicine with the development of a paper and presentation to members of the Psychosomatic Medicine team at the end of the rotation. This course is not intended solely for those interested in psychiatry as a specialty, but especially for those interested in the areas of general medicine and primary care.
• MED MD 525: Consultation-Liaison Psychiatry - VABHC West Roxbury
  Under close supervision, students in this elective will work as integral members of the consultation-liaison psychiatry service at the VA Boston Healthcare System, West Roxbury Campus. Students will evaluate and treat patients in the emergency room and acute medical setting for whom psychiatry consultation is requested. Common consultation requests include suicidality, substance intoxication or withdrawal, psychosis, delirium, depression, and capacity to make medical decisions. Students will work closely with attending psychiatrists as well as psychiatry residents, consultation-liaison psychiatry fellows, and addictions psychiatry fellows. Students will participate in daily teaching rounds and will receive additional teaching through formal didactic sessions. Students will receive individual supervision both at the bedside and in formal sessions. Students will carry up to four patients at any given time and will actively participate in daily patient care. Duty hours will be Monday through Friday, without night or weekend requirements. In addition to daily patient care, students will complete two brief, informal presentations on clinical questions related to their patients, as well as a thirty-minute formal presentation at the end of the rotation on a topic relevant to consultation-liaison psychiatry. The elective will expose students to a wide variety of psychiatric diagnoses, with a focus on how psychiatric issues interact with acute medical illness. By the end of the elective, students will show a nuanced understanding of how to perform a psychiatric consultation in the emergency room or acute medical setting and how psychiatric and medical issues affect one another, along with advanced skill in patient interviewing, oral presentations, and clinical documentation.
• MED MD 526: Outpatient Psychiatry
  Outpatient Psychiatry is a 4-week clinical elective. Students will have the opportunity to work closely with faculty who have expertise in collaborative care, severe psychosis, HIV psychiatry, addiction psychiatry, refugee mental health, adult psychiatry, child/adolescent psychiatry, and women's mental health. There will be an opportunity to rotate through Healthcare for the Homeless as part of their HIV psychiatry experience. Students will have the opportunity to improve their knowledge of psychopharmacology and brief psychotherapy, as well as participate in patient evaluation, diagnosis, treatment, and management of side effects.
• MED MD 528: Inpatient Psychiatric Management
  Inpatient Psychiatric Management
• MED MD 529: Emergency Psychiatry and Crisis Intervention
  This elective is for the BU medical student to actively engage in and learn more about emergency psychiatric care and crisis intervention. Students will improve their understanding of the mental health system and resources for patients who are experiencing psychiatric emergencies and crises. This elective provides an opportunity for the student to clinically manage patients presenting for acute psychiatric care and to experience some of the changes that are being made to the field of community crisis intervention to improve health equity in accessing high-quality psychiatric care. Students will learn about the range of services and resources that are available to support the acute psychiatric needs of patients, from the level of the Emergency Department to community focused interventions, with a particular focus on services for patients experiencing significant psychosocial stressors and health inequities. This elective takes place in the Emergency Department at Boston Medical Center and associated community crises centers. Students will work approximately three 10-hour shifts a week in the Psychiatric Emergency Department and two 8-hour shifts in associated community sites, all under the supervision of psychiatry attendings. In addition, students will work closely with psychiatry residents and social work staff. Students will have opportunities to interview patients, obtain collateral information, participate in disposition determinations, complete safety assessments, develop treatment plans, and write notes for the patients they treat in the Emergency Department and crisis intervention settings. Teaching will occur on a case-by-case basis. By the end of the rotation, students will have developed skills in managing acute agitation, utilizing verbal de-escalation techniques for patients in crisis, conducting in-depth suicide assessments, assessing patients with altered mental status, recognizing and treating emergent psychiatric conditions, and assessing psychiatric disposition needs. In addition to the three days per week managing patients in the Psychiatric Emergency Department, students will have the opportunity to spend two days each week working in select associated psychiatric crisis settings. Students will be able to select among sites including, the BMC Community Behavioral Health Center (CBHC), the Community Crisis Stabilization (CCS) unit at the Solomon Carter Fuller Building, Faster Paths, the ED Addiction Service, the Addiction Psychiatry Treatment Program (APTP), the Mobile Crisis Team, the Mental Health Court team, the Wellness and Recovery After Psychosis (WRAP) Program, and the Multi Visit Patient Program (MVPP). This elective will allow students to gain a better understanding of the full continuum of care and understanding of alternative levels of care for acute psychiatric crises.
• MED MD 530: Radiology Core
  Required Boston University course: The Department of Radiology offers a clinical 4-week rotation based at Boston Medical Center. The course is comprised of didactic lectures, departmental conferences, small group sessions on evidence-based imaging, case review sessions, and clinical observations in general radiology, pediatric imaging, musculoskeletal imaging, neuroradiology, abdominal and pelvic imaging, thoracic imaging, breast imaging and nuclear imaging. The course culminates in a student-facilitated departmental radiology-pathology correlation conference.
• MED MD 531: Radiation Oncology
  This elective is designed to provide an introduction to radiation oncology in the management of patients with cancer. Students will participate in the evaluation, radiation treatment planning, treatment evaluation and follow-up of patients with cancer. The role of radiation oncology in the multi-modality management of patients with cancer will be emphasized.
• MED MD 532: Interventional Radiology Elective
  The Interventional Radiology (IR) Elective is for the BUSM student to gain an immersive experience in IR. The student will be a fully-functioning member of the Interventional Radiology team. This rotation is designed for fourth-year students who have completed the Radiology Selective or Core Elective. Students will build on fundamental knowledge obtained in the radiology Selective as well as draw upon clinical skills developed in other third-year rotations such as Internal Medicine and Surgery. Students will be exposed to a variety of procedures that treat disease processes from nearly every organ system. This is meant to be hands-on rotation modeled after a surgical sub-internship, and will include responsibilities such as seeing consults, rounding on inpatients, and writing H&Ps and post-procedure notes. Students will be gradually given autonomy until they can function as an independent team member and handle a small patient load (2-3 patients). The elective takes place in the Department of Radiology at Boston University Medical Center. The student will identify an attending radiologist with whom they plan to spend the majority of their elective time with as their mentor. This radiology attending will also be responsible for completing the student's evaluation at the end of the elective rotation. Students will interact with patients, radiology technologists, residents, fellows and attendings. Through required readings within each subspecialty, students will focus on studying on the subspecialty-specific Required Diagnoses that are assigned to each subspecialty within the Radiology elective.
• MED MD 535: Body Imaging
  The Radiology Elective is for the BUSM student to gain a deeper experience in a limited number of areas in radiology, based on their particular interests. This could include a variety of imaging modalities such as general radiology, CT, MRI, or ultrasound. Elective students will build upon the fundamental knowledge obtained in the general radiology Selective to better understand radiology's role in the care of patients and to practice with image and radiologic report interpretation in their selected areas. In addition, elective students will become familiar with radiologic study selection to best answer specific clinical questions and imaging study acquisition from both the technical and patient perspectives. Course Electives include: Neuroradiology, Pediatric Radiology, Body Imaging, Breast Imaging, Musculoskeletal Imaging The elective takes place in the Department of Radiology at Boston University Medical Center. At the beginning of the elective, the student will identify an attending radiologist with whom they plan to spend the majority of their elective time with as their mentor. This radiology attending will also be responsible for completing the student's evaluation at the end of the elective rotation. Elective students are expected to follow the Radiology Elective daily schedule which will be distributed and available on Blackboard. Through clinical observation in the imaging suites and radiology reading room, elective students will interact with patients, radiology technologists, residents, fellows and attending. Through required readings within each subspecialty, students will focus on studying on the subspecialty-specific Required Diagnoses that are assigned to each subspecialty within the Radiology elective.