M4 Surgery & Surgical Subspecialties

• MED MD 461: Neurosurgery
  Fourth year students electing Neurosurgery will have an opportunity to make daily ward rounds with an attending neurosurgeon, perform clinical examinations, discuss differential diagnosis and diagnostic procedures. Under direct supervision, the student may participate in patient management and follow up. The student will also have the opportunity to review and learn about the interpretation of different diagnostic tests, such as angiograms, CT and MRI of the central nervous system. The student will be able to attend and participate in weekly neurosurgical teaching conferences. Ongoing research projects within the department are available to stimulate the student's academic interest. In the operating room, the student will be instructed about the duties of a surgical assistant and will be exposed to the surgical anatomy of the brain and spine. The student will also be encouraged to evaluate the patients post-operatively, especially in the setting of the intensive care unit.
• MED MD 467: Sub-Internship: Neurosurgery
  The neurosurgery sub-internship is designed to immerse the student in neurological surgery, a specialty focused on the identification and treatment of neurological disorders managed surgically. The student will be an integral part of the neurosurgery team at Boston Medical Center (BMC) working in the operating room, inpatient unit, surgical ICU, emergency department and outpatient clinics during this 4-week sub-internship experience under the direct supervision and mentorship of neurosurgery faculty, residents, NPPs and fellows. All students are welcome to take this course and those who plan to apply for Neurosurgery residency should prioritize this course over other Neurosurgery electives.
• MED MD 480: Multidisciplinary Breast Cancer Care
  This elective is based at Boston Medical Center and the Boston University Chobanian & Avedisian School of Medicine. The student will participate in outpatient activities of the core faculty members including surgical oncology, medical oncology, and radiation oncology clinics. Students will also participate in the operative management of breast cancer patients as assistants in the operating room. Exposure to breast imaging technology and interpretation, breast cancer pathology interpretation, and genetics will be incorporated through sessions in those disciplines. In addition, select newly diagnosed patients will be identified at the beginning of the elective and the student will follow those patients to all consultations and treatments. Students will be expected to participate in weekly multidisciplinary breast tumor board including preparing and presenting case presentations for discussion with direct faculty guidance. Students will be exposed to early breast cancer, locoregionally advanced breast cancer, and metastatic breast cancer, gaining an appreciation for the full spectrum of presentation. Integration of expertise from all disciplines will be emphasized. Landmark clinical trials in breast cancer will be reviewed and discussed through a program of assigned reading and discussion with faculty. This is primarily an outpatient elective with rare select inpatient activities. The student will be expected to participate in clinical activities on all weekdays during the elective. There will be no weekend responsibilities.
• MED MD 485: Sub-Internship: Otolaryngology-Head and Neck Surgery
  This elective provides an intense learning experience for students interested in a career in Otolaryngology - Head and Neck Surgery, and for others with specific interest in head and neck cancer, facial plastic and reconstructive surgery, allergy involving the nose and sinuses, and the auditory system. Students observe and work with faculty and residents in the Department of Otolaryngology - Head and Neck Surgery at the Boston Medical Center. Approximately half of the time is devoted to learning how to evaluate and treat ambulatory outpatients with otolaryngologic disorders. The other half of the time is spent observing and assisting in the operating room and evaluating hospitalized patients. Students are expected to attend weekly teaching conferences including Friday morning case conference, Pathology conference, Radiology conference, Audiology conference, Tumor Board conference, and structured Wednesday afternoon didactic lectures. Student Responsibilities - Fourth year medical students are required to do the following: 1. Be present and on time for clinics, rounds, surgeries, conferences 2. Acquire specified knowledge and skills (as delineated in "Otolaryngology Student Knowledge/ Skills Checklist") 3. Assist residents in providing patient care 4. Prepare and present an eight minute PowerPoint presentation on a chosen topic. Participation, Expectations of Performance, and Grading The Department of Otolaryngology uses elements adapted from the ACGME Residency Review Committee Guidelines for General Competencies in Medical Education as a basis for student evaluations. Because the clinical rotation can be considered an opportunity to begin learning skills that a medical school graduate will be expected to acquire, we shall judge student performance in the categories of the six ACGME1 competencies listed below: 1. Patient care that is compassionate, appropriate, and effective for the treatment of health programs and the promotion of health 2. Medical Knowledge about established and evolving biomedical, clinical, and cognate sciences, as well as the application of this knowledge to patient care 3. Practice-based learning and improvement that involves the investigation and evaluation of care for their patients, the appraisal and assimilation of scientific evidence, and improvements in patient care 4. Interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and other health professionals; 5. Professionalism, as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to patients of diverse backgrounds; 6. Systems-based practice, as manifested by actions that demonstrate an awareness of and responsiveness to the larger contMAS and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care.
• MED MD 486: Research Elective in Otolaryngology-Head and Neck Surgery
  This elective is designed for students willing to take the initiative and devote time to planning, investigating, and implementing an independent study that will culminate in preparation of a manuscript for publication in a peer reviewed medical journal. The student is required to meet with Dr. Levi two months prior to beginning the elective to review potential projects and arrange a mentor. Although most projects should be designed for completion within the four week elective, students may need to devote additional time to complete the independent study project after conclusion of the one month elective rotation. Students who have taken this elective have had high success at having completed projects presented at a national Otolaryngology meeting and subsequently published.
• MED MD 487: Advanced Otolaryngology
  This elective provides an intense learning experience for students interested in a career in Otolaryngology - Head and Neck Surgery, and for others with specific interest in head and neck cancer, facial plastic and reconstructive surgery, allergy involving the nose and sinuses, and the auditory system. Students observe and work with faculty and residents in the Department of Otolaryngology - Head and Neck Surgery at the Boston Medical Center. Approximately half of the time is devoted to learning how to evaluate and treat ambulatory outpatients with otolaryngologic disorders. The other half of the time is spent observing and assisting in the operating room and evaluating hospitalized patients. Students are expected to attend weekly teaching conferences including Friday morning case conference, Pathology conference, Radiology conference, Audiology conference, Tumor Board conference, and structured Wednesday afternoon didactic lectures.
• MED MD 488: Otolaryngology Multi-Site Elective
  This Otolaryngology-Head and Neck Surgery elective is designed to immerse Boston University Chobanian & Avedisian School of Medicine students in Otolaryngology, which includes head and neck cancer, facial plastic and reconstructive surgery, allergy involving the nose and sinuses, and the auditory system, as well as introduce them to two of our resident rotation sites. The student will be an integral part of the Otolaryngology-Head and Neck Surgery team in the ambulatory outpatient clinic, with hospitalized patients, and in the operating room at Boston Medical Center, Lahey Hospital and Medical Center, and the Veterans Affair Boston Health Care System (VA Boston) during this 4-week 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 546: Sub-Internship: Surgical Intensive Care Unit
  Fourth year medical students are eligible to participate in the Surgical Intensive Care Unit elective at Boston Medical Center. This can be a one or two month elective which will be spent at the Menino Pavilion surgical intensive care unit. Students will be active members of the team and will participate in daily rounds and will be responsible for presenting in detail, all patients whom they have called on previously. He/she will defend the therapy initiated and propose a comprehensive treatment plan. Additionally, the student will participate in all procedures performed in the surgical intensive care unit. The Section on Critical Care offers daily teaching rounds as well as didactic lectures. It is hoped at the conclusion of this elective the student will have an appreciation of the problems and care of the critically ill patient.
• MED MD 547: Surgery Internship Prep Course
  In this elective, 4th year medical students are given the opportunity to delve deeper into the surgical management of patients. This rotation is for individuals who are going into general surgery or a surgical subspecialty, and is designed to prepare them for their internship. This rotation will expose students to crucial concrete knowledge and technical skills important for a surgical internship as well as for a surgical career. It includes focused didactic lectures, hands-on skills laboratory, a mock pager experience, and focused rotations; these activities are all designed to augment a student's exposure to real-life scenarios one would expect in a surgical internship and beyond.
• MED MD 548: Sub-Internship: Plastic & Reconstructive Surgery
  The elective in Plastic and Reconstructive Surgery will consist of a two week period with exposure to general plastic surgery with an emphasis on the aesthetic aspects of the field. This will provide the student with a broad basis in the area of elective plastic surgery. All arrangements for electives must be made through the Medical Student Coordinator at Boston Medical Center.
• MED MD 549: Sub-Internship: Colon and Rectal Surgery
  The Fourth Year Sub-internship is a 4 week course in Colon and Rectal Surgery designed to immerse the 4th year student in all aspects of Colon and Rectal Surgery at Boston Medical Center. This rotation will provide students with the basic components of colon and rectal disorders and surgeries and the care of patients with these disorders. The student will be an integral part of the surgical team in the inpatient unit, the operating room, and the surgical clinic. The acquisition of knowledge and skills in the care of the colorectal patient will be conducted in the following setting and activities. Colon and Rectal surgery clinic - Shapiro 6th floor 1. evaluation of new and established patients 2. follow-up of medically and surgically treated patients 3. assist in basic endoscopy including anoscopy and proctoscopy 4. assist in office procedures such as drainage of abscesses, excision of thrombosed MASernal hemorrhoids and tags, rubber band ligation 5. assist in wound care 6. assist in ostomy care Emergency department - as above Surgical inpatient service - comprehensive perioperative management The 4th year student will be an integral part of the surgery team on the inpatient units, outpatient clinic, and in the operating room during the 4-week sub-internship. The student will function as acting interns responsible for the evaluation and continued management of their own patients, under the direct supervision of the attending physicians, residents and physician assistants. Specifically, the student will take on the management of at least three new patients each week, and will assume primary responsibility for the care of these patients, with appropriate supervision. In addition, the student will be expected to do the following: perform initial history and physicals, write orders, assist in coordinating care, assist with or perform supervised procedures as applicable and appropriate for the sub-intern, present cases, use evidence-based medicine principles to help guide patient care, participate in teaching sessions, and take at least 2 weekend calls during the 4 week rotation alongside residents and attending physicians. With supervision, the student will also perform or assist procedures as appropriate to educational level and patient safety including venipuncture, IV line placement, arterial blood gas, foley catheter placement, nasogastric tube insertion, preparing and draping for surgery, assisting with surgery, and closure of surgical wounds. All Sub-I activities will be performed under appropriate supervision which can include attendings, residents, APPs or other qualified individuals on the Service.
• MED MD 550: Sub-Internship: Minimally Invasive Surgery
  The minimally invasive surgery elective at Boston University Medical Center is a combined clinical and research program with a strong focus in laparoscopic bariatric surgery and additional experience in laparoscopic foregut, endoscopic and robotic surgery. The elective is four weeks in duration and is designed to develop the surgical, educational and research skills of the medical student. The goals of the elective include: 1. Provide exceptional care for surgical patients 2. Learn pre-operative and post-operative management of bariatric surgery 3. Obtain introductory training in minimally invasive surgery with special focus in bariatric surgery
• MED MD 551: Sub-Internship: Orthopaedic Surgery
  The Orthopaedic Sub-I will take place at the Boston Medical Center at both the inpatient and outpatient setting that comprises of six total subspecialties: - Orthopaedic Trauma - Fracture Care - Hand and Elbow Surgery - Sports Medicine and Shoulder Surgery - Foot and Ankle The Sub-I will have the option to choose which subspecialty will fit their clinical interest and career goals. Please go to https://www.bumc.bu.edu/orthopaedics/ to read about the description of each specific subspecialty. The Sub-I on the Orthopaedic service will be responsible for the following: 1. Assist in the care for patients in the emergency room, clinics and operating room whom have orthopedic injuries. 2. Learn the preoperative and postoperative management of patients undergoing orthopedic procedures. 3. Learn how to evaluate patients in the clinic setting including taking pertinent orthopaedic history and performing an appropriate physical examination. 4. Obtain introductory training in orthopedic procedures such as casting, splinting, joint aspirations, wound closure, wound management, management of wound vacs, management of MASernal fixation devices, principles of surgical stabilization of fractures and basics in arthroplasty and spine fixation. 5. Function as a Acting-Intern with responsibilities commensurate with this educational requirement: 1. Function as acting intern responsible for the evaluation and continued anagement of patients under supervision of residents and attendings. 2. As part of the care team, will perform initial H&Ps, assist in coordinating care, assist with or perform supervised procedures appropriate for the sub-intern, present cases, use evidence-based medicine principles to help guide patient care, etc. 3. All Sub-I will be required to present a 12 min talk on the 3rd weds of the month during grand rounds on a case or topic of interest. 3 mins for questions at the end. 4. It is expected that the Sub-I will prepare for every single OR case by obtaining the patient history, indications for surgery, anatomy, surgical approach, steps to the procedure, and read two pertinent articles related to each case. 5. It is expected that the Sub-I will read daily, on the consults seen in the ED, patients seen in clinic the OR cases. Sub-I will meet with their respective supervisor and the senior resident on service for the subspecialty at the beginning, 2 weeks, and at the end of the month for formal feedback
• MED MD 552: Sub-Internship: Cardiac Surgery
  The rotation takes place at Boston Medical Center. Student will be part of the cardiac surgery team and expected to be involved in the day-to-day clinical care. Student will be working directly with the cardiac surgeons and physician assistants with goal to gain gradual comfort and supervised independency with basic surgical skills and management of cardiac surgery in the preoperative and postoperative setting as well as in the clinic.
• MED MD 554: Sub-Internship: Thoracic Surgery
  The thoracic surgery service sees a high volume of patients with chest disease, and performs a broad range of procedures related to the thoracic cavity including, but not limited to thoracotomy, thoracoscopy, bronchoscopy, mediastinoscopy, pulmonary wedge resection, lobectomy, pneumonectomy, endoscopy, esophageal stenting, esophageal myotomy, esophagectomy, hiatal hernia repair, antireflux surgery, etc. The service cares for a number of postoperative patients, and frequently consults on patients with complex needs on other services. Due to the nature of thoracic disease, patients can be quite ill during the perioperative and postoperative period. The sub-intern student will be an integral part of the thoracic surgery team in the operating room, inpatient unit, and outpatient clinic at Boston Medical Center during this 4-week sub-internship experience. Students will be responsible for evaluation and management of their own patients under the direct supervision of attending surgeons and residents, and will care for at least three new patients per week, performing histories and physicals, coordinating care, etc. They will perform procedures as appropriate, including venipuncture, IV placement, arterial blood gas, foley catheter placement, nasogastric tube insertion, bronchoscopy, thoracostomy, and closure of surgical wounds, all under appropriate supervision. The sub-intern will also take call with the surgical team on a regular schedule. As Boston University is a teaching program, students will also have the opportunity to enhance their teaching skills by assisting in the education of clerkship students in the operating room as well as the inpatient and outpatient settings. The goals for the rotation include: · Assist in the care for acute and chronic disease seen in these surgical patients, as evaluated and managed by the service · Learn pre-operative and post-operative management of patients undergoing thoracic procedures · Obtain introductory training in thoracic surgery procedures such as bronchoscopy, endoscopy, thoracentesis, chest tube placement/management/removal, etc · Function as a sub-intern with responsibilities commensurate with this educational requirement: o Function as acting interns responsible for the evaluation and continued management of their own patients, under the direct supervision of the attending physicians and residents. o Care for at least three new patients per week, and possibly more depending on the opportunities for patient care. o As part of patient care you will be expected to do the following: perform initial history and physicals, write orders, assist in coordinating care, assist with or perform supervised procedures as applicable and appropriate for the sub-intern, present cases, use evidence-based medicine principles to help guide patient care, participate in teaching sessions, and take call alongside residents and attending physicians. Students should report to morning rounds at the thoracic surgery workro
• MED MD 555: Sub-Internship: Acute Care and Trauma Surgery
  The Trauma and Acute Care surgery elective at Boston Medical Center is clinical program with a strong focus on management of acute general surgical disease and the multimodal and multidisciplinary management of traumatic injury. The elective is four weeks in duration and is designed to develop the complex peri-, intra-, and post-operative decision making and basic open and laparoscopic surgical skills of the medical student. The goals of the elective include: 1. Provide exceptional care for surgical patients 2. Develop pre-operative, intra-operative, and post-operative management strategies in acute general surgical and traumatic surgical maladies 3. Develop an understanding of co-morbid medical conditions that can influence surgical decision making.
• MED MD 557: Sub-Internship: Surgical Oncology
  
• MED MD 558: Sub-Internship: Vascular Surgery
  
• MED MD 573: Ophthalmology
  Students will work with residents and faculty at BMC. Activities will involve examining patients in the outpatient clinic and the in-patient consultation service. A clinic work sheet will be used to guide the student in the development of examination skills and to ensure that the student participates with faculty, fellows and residents in a discussion of selected ophthalmic topics. Students will spend time on subspecialty services such as triage, consults, neuro-ophthalmology, retina, glaucoma, pediatric ophthalmology, cornea, and oculoplastics. Students will also have the opportunity to attend ophthalmic procedures in the office and surgical procedures in the operating room. Students will be required to prepare a short (10 minute) slide presentation on a case encountered during their rotation, including a discussion of the differential diagnosis and main clinical teaching points. Students will be required to prepare a short (10 minute) slide presentation on a case encountered during their rotation, including a discussion of the differential diagnosis and main clinical teaching points.