Registrar

Department Website: APG

Course #: ATR 4110 Neuroanatomy Clerkship

Duration: 4

Hours: 5

Grading: (Pass/Fail)

Course Description: Provide opportunity for student to carry out integrated review of head & neck anatomy with functional neuroanatomy. Practical application of anatomical knowledge in relation to clinical medicine is stressed. Students enrolled in clerkship can assist in teaching in the Clinical Head and Neck Anatomy and Functional Neuroscience course and participate in faculty reviews. Independent cadaver dissection of head & neck region, study of gross brain, slices & CNS myelin-stained slides. Utilize USU computer modules on head neck and CNS anatomy. Comments: Interactive software on head and neck modules, functional neuroscience and lesion localization & radiology support this process.

Course #: ATR 4140 Anatomy Teaching Elective

Course Type: C

Department: Surgery and or APG department 

Duration: 4 (One Block/Round) or 8 (Two Blocks/Rounds)

Hours: 4 (One Block/Round) or 8 (Two Blocks/Rounds)

Grading: (Pass/Fail)

Course Description: Students will assist Course Director and the Anatomy/Surgical Faculty members in teaching anatomy in the School of Medicine First-Year and Second-Year Gross Anatomy Courses.  The lectures are held in Lecture Hall E and the labs are held in the Anatomical Teaching Laboratory, USUHS (Ground Floor).  The senior student participates as a junior faculty member, teaching cadaver dissections to the first-year medical students, performing prosections, creating teaching material, leading small group reviews, and presenting prosections to the faculty members and their classmates – all under the supervision of the anatomy/surgical faculty members. 

Comments: Participation must be approved in advance by Mr. Edward Jones (Edward.Jones@USUHS.edu), Dr. David Mears (David.Mears@USUHS.edu), or Dr. Guinevere Granite (Guinevere.Granite@USUHS.edu). Early sign-up is recommended since the number of participants may be limited.

Site: Anatomical Teaching Laboratory (ATL), USUHS 

Course #: ATR 4150 Forensic Anthropology 

Department: Surgery 

Duration: (One Block/Round)

Grading: Pass/Fail

Course Description: This course is an introduction to the application of forensic anthropology. The aim is to understand how anthropologists apply scientific principles and processes to the collection and analysis of skeletal evidence. Topics include anthropology within the context of forensic investigations, human skeletal biology, and research methods, including analyzing bone trauma, pathology, and taphonomy. Anticipated initial course would be offered to up to 20 students during their fourth year. Potential student interest would include pathology, radiology, orthopedics, and any other students with an interest in forensics. This course can be beneficial to military surgeons and medical practitioners who are involved in disaster recovery and combat-related injuries/fatalities. It can provide them with a better understanding of osteology, bone trauma and pathology.

Course Introduction: Forensic anthropology, the analysis of human skeletal remains, has advanced significantly in recent history.

This course will focus on: 

The science of forensic anthropology and its applications to criminal and medico-legal investigation
Investigative methods
How forensic anthropologists work with medical examiners and pathologists during forensic cases
Research methods for identifying, examining, analyzing, and interpreting human skeletal remains
Human skeletal anatomy and dentition review
Anthropometric instruments and measurement
Reorientation with the standard anatomical position, anatomical planes, and terms of orientation
Students will study actual forensic anthropological cases, examine actual skeletal remains, and answer these 10 standard questions:

Are the bones human?
How many individuals are represented?
How long ago did death occur?
What was the person's age at death?
What was the person's sex?
What was the person's ethnicity/ancestry?
What was the person's height?
Are there any identifying characteristics to aid in personal/positive identification?
What was the cause of death?
What was the manner of death?

Course Outcomes:

After completing this course, students should be able to:

Apply scientific principles and processes to the collection and evaluation of evidence
Analyze evidence and case details and recommend solutions using appropriate quantitative and qualitative anthropological and statistical methods
Accurately and effectively communicate their findings using appropriate terminology and format

Grading: Pass/Fail

Credit Hours: 48 hours (4 hours, 3 times a week for 4 weeks)

Course Description:

This course focuses on anatomical variations encountered throughout the human body. Anatomical variations are frequently encountered by clinicians and surgeons. Knowledge of human anatomical variations is critical for patient treatment. The understanding of anatomical variations obtained from this course can assist in decreasing the risk of iatrogenic injuries during surgical intervention and improve diagnosis ability and accuracy. The aim of the course is to educate students on the common and uncommon anatomical variations associated with their anatomical area of interest, i.e. neuroanatomy, cardiovascular anatomy, gastrointestinal anatomy, reproductive anatomy, or musculoskeletal anatomy. Students will have different lecturers depending on their anatomical area of interest that will present anatomical variations and how diagnosis is normally obtained. Students will also dissect human cadavers in their anatomical area of interest. Dissection of the region may result in finding of variations covered in the course or at minimum, provide review the normal anatomy of the region. Anticipated initial course would be offered to up to 20 students during their fourth year. Potential student interest would include surgery, pathology, radiology, orthopedics, and any other students with an interest in anatomical variations.

Course Facility and Resource Needs:

• Location: ATL prosection room (dissection) and G-028 ATL Classroom (lectures)
• Cadavers: 2 students to each cadaver, depending on enrollment
• Number of Instructors: 1 to 4, depending on enrollment and anatomical area of interest; Clinician and anatomy lecturers recruited depending on anatomical area of interest

Course Outcomes:

After completing this course, students should be able to:

• Identify anatomical variations in their anatomical area of interest
• Diagnose any related symptomology caused by the anatomical variation(s)

Confidently dissect the anatomical area of interest, knowing normal vs. abnormal anatomy in that region

Comments: Please contact Dr. Guinevere Granite (Guinevere.Granite@usuhs.edu) with interest in the course. Early sign-up is recommended since the number of participants may be limited. 

Course #: ATR 4780 Advanced Anatomy - Cadaver Dissection Review

Course Type: S

Department: Dept of Anatomy, Physiology, and Genetics (APG)

Duration: 4 (One Block/Round) or 8 (Two Blocks/Rounds)

Hours: 8

Grading: (Honors/Pass/Fail)

Course Description: The student performs independent cadaver dissections on a preserved cadaver under the supervision of Professor Jones. The elective provides experiences that are appropriate for an upcoming internship or residency.  The goal is to review pertinent anatomy and other skills that are needed in PGY1.  The elective can be tailored to the individual student’s choice of specialty or subspecialty. 

Comments: Participation must be approved in advance by Professor Jones via email- edward.jones@usuhs.edu. Early sign-up is recommended since the number of participants is limited.

Site: Anatomical Teaching Laboratory (ATL), USUHS

Department Website: ANE

Course #: ANR 4200 Anesthesia Clerkship

Duration: 4

Hours: 5

Grading: (Honors/Pass/Fail)

Can be taken as an MS3 or an MS4.  Fulfills the graduation requirement

Experience: 2 wks ANE, 1 wk pain, 1 wk ICU.

Course Description:During this clerkship students interact with staff from several surgical and non-surgical specialties.  Students are introduced to and participate in pre-, peri-, and postoperative patient evaluations while accounting for co-existing diseases and conditions that affect the management of the surgical patient.  Students are taught critical technical skills required of all physicians, including airway management and intravenous catheter placement, along with the use of physiologic monitoring.  Students gain exposure to interventional procedures and the bio-psycho-social model of pain, and participate in multidisciplinary pain management for patients with acute, chronic, and cancer pain in the outpatient and inpatient setting.

5 sites:  WRNMMC, NMCSD, SAMMC, TAMC, and Fort Belvoir

Course #: ANR 4202 Anesthesia Selective

Duration: 4

Hours: 5

Grading: (Honors/Pass/Fail)

Can be taken as an MS3 or an MS4.  Fulfills the graduation requirement 

Experience: 4 wks in the OR.

Course Description: Students are involved in the perioperative care of patients undergoing anesthesia and surgery.  This selective will introduces students to a systematic approach of perioperative evaluation while high-lighting co-existing diseases of particular concern to the surgical patient.  Critical technical skills required of all physicians, including airway management and intravenous catheter placement, will be taught along with the use of physiologic monitoring that are used in many specialties. 

18 sites: Bremerton, Elin, Camp Lejeune, Fort Belvoir, Fort Bliss/WBAMC, Fort Bragg, Fort Hood, Jacksonville, Korea, MAMC, Nellis, Okinawa, Pensacola, Portsmouth, NMCSD, SAMMC, TAMC, WRNMMC

Course #: ANR 4220 Pain Selective

Duration: 4

Hours: 5

Grading: (Pass/Fail)

Must have passed ANR 4200 or ANR 4202 PRIOR to taking this rotation, and this course does not fulfill the graduation requirement (ANR 4200 or ANR 4202 must be taken)

Course Description: Students will be involved in the care of patients in the pain management clinic. They will be responsible for supervised evaluation of new/returning patients. They will participate in performing appropriate regional conduction blocks, and developing outpatient treatment regimens. They will participate in inpatient consult.

Prior approval is necessary before scheduling this rotation; please contact the Anesthesia Clerkship Coordinator with your rotation request.

Course #: ANR 4222 Expanded Anesthesia Experience- Anesthesia Clerkship

Duration: 4

Hours: 5

Grading: (Pass/Fail)

Prerequisite: Successful completion of ANR 4200 or ANR 4202 PRIOR to taking this rotation.  This rotation does not fulfill the graduation requirement (ANR 4200 or ANR 4202 must be taken)

Experience: 2 wks ANE, 1 wk pain, 1 wk ICU.

Course Description: This MS4 clerkship experience is designed to build upon students’ past Anesthesia clerkship experience(s), providing them with greater exposure to, and a stronger foundation in, Anesthesia.  This clerkship experience mirrors the ANR 4200 Clerkship experience and responsibilities, except there is no USUHS exam component at the end of the clerkship experience.

5 sites:  WRNMMC, NMCSD, SAMMC, TAMC, and Fort Belvoir

Course# ANR 4223 Expanded Anesthesia Experience- Anesthesia Selective 

Duration: 4

Hours: 5

Grading: (Pass/Fail)

Prerequisite: Successful completion of ANR 4200 or ANR 4202 PRIOR to taking this rotation.  This course does not fulfill the graduation requirement (ANR 4200 or ANR 4202 must be taken)

Experience: 4 wks in the OR.

Course Description: This MS4 clerkship experience is designed to build upon students’ past Anesthesia clerkship experience(s), providing them with greater exposure to, and a stronger foundation in, Anesthesia.  This clerkship experience mirrors the ANR 4202 Clerkship experience and responsibilities, except there is no USUHS exam component at the end of the clerkship experience.

18 sites: Bremerton, Eglin, Camp Lejeune, Fort Belvoir, Fort Bliss/WBAMC, Fort Bragg, Fort Hood, Jacksonville, Korea, MAMC, Nellis, Okinawa, Pensacola, Portsmouth, NMCSD, SAMMC, TAMC, WRNMMC

Department Website: DER

Course #: DMR 4100 Clinical Dermatology

Duration: 4 weeks

Hours: 5

Grading: (Pass/Fail)

Course Description: : Allow students to participate in the care and management of inpatient & outpatient dermatology patients through direct contact with patients under staff supervision. Specific educational techniques include didactic sessions, conferences led by staff and senior residents, lab demonstrations, audiovisual material, histopathology review, slide presentations, assisting in dermatologic surgery, and case presentations. Some teaching centers will offer additional specialized opportunities such as Mohs surgical procedures, consultant visits, city-wide Grand Rounds, and clinical research programs. Comments: Clerkship is designed to teach fundamental principles of pathophysiology, diagnosis, and treatment of skin diseases. Expectations include completing an end of rotation exam and giving a short presentation on a dermatological topic of interest. 

Department Website: FAM

Course # FPR 4017: Maternity Care/Reproductive Health (multiple sites)

Hours: 5
Grading: (Pass/Fail)

Course Description: Students will gain additional knowledge, skill and procedural expertise in the evaluation and management of patients and families with maternity care/reproductive health issues. Students will actively participate in rounds, lectures and conferences as appropriate

Course #: FPR 4018:  Metacognition- Thinking About How You Think  (Site: USUHS)

Duration: 4

Hours: 5
Grading: (Pass/Fail)
Course Description: This 4-week elective uses books from well-known authors to encourage students to examine ways to develop mindfulness in their evolving medical practices. Through reading selected texts, writing reflective papers, and facilitating small groups, the metacognition elective allows post-clerkship medical students to continue developing the habit of thought that is reflective practice.

Course #: FPR 4071:  Family Medicine Operational (multiple sites)

Duration: 4
Hours: 5
Grading: (Pass/Fail)
Course Description: Students work with family physicians assigned to operational units.  Students will gain experience in the clinical, administrative and leadership skills required of a medical officer to effectively function as part of an operational unit.
 

Course #: FPR 4076:  Family Medicine Comprehensive Clerkship (multiple sites)

Duration: 4
Hours: 5
Grading: (Pass/Fail)
Students will work closely with Family Physician faculty practicing full scope Family Medicine in a variety of settings. While there may be some site variation, students will gain experience with patient care in the outpatient, inpatient, labor & delivery and emergency department settings. A modest amount of overnight call may be a requirement. Students will participate in morning report and clinical conferences. Sites sponsoring these rotations are typically OCONUS or CONUS non-GME training sites.

Course #: FPR 4110:  Family Medicine Ambulatory (multiple sites)

Duration: 4
Hours: 5
Grading: (Pass/Fail)
Course Description: Students participate in the care of outpatients in the Family Medicine clinic, including acute and chronic and perform outpatient procedures. Students will participate in morning report, the Family Medicine lecture series and clinical conferences. Access to videotaping patient interviews may be available to focus on improving interviewing skills and learning family dynamics.
 

Course #: FPR 4130:  Family Medicine Sub-Internship (multiple sites)

Duration: 4
Hours: 5
Grading: (Honors/Pass/Fail)
Course Description: Students will function as an intern. The majority of the rotation will involve inpatient care with a lesser amount in the outpatient, labor and delivery and emergency department.  Students will evaluate, admit, work-up and follow inpatients w/various medical, surgical, pediatric & OB/GYN diagnoses.  Students will attend and participate in morning report, lecture series and conferences.
 

Course #: FPR 4140:  Sports Medicine (multiple sites)

Duration: 4
Hours: 5
Grading: (Pass/Fail)
Course Description: Students will evaluate, assess & formulate treatment plans for patients with a wide variety of musculoskeletal conditions. Students will master a sequential & thorough exam of the spine and extremities. Students will actively participate in conferences and lectures.
 

Course #: FPR 4141: Integrative Medicine (site: USUHS/ NCA)

Duration: 4
Hours: 5
Grading: (Pass/Fail)
Course Description:  Students will gain an exposure to Integrative Health  -the practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, healthcare professionals and disciplines to achieve optimal health and healing. Students will choose 2 to 4 areas of concentration from the following list that includes: Acupuncture, Yoga, Art Therapy, Mind-Body Practices, Chiropractic Care, Nutrition, Animal/Pet Therapy, Behavioral Health in Primary Care, Patient Education, Palliative Care, Sexual Health & Intimacy, Tobacco Cessation.
 

Course #: FPR 4150:  Family Medicine-Community Health Care (site: USUHS)

Duration: 4
Hours: 5
Grading: (Pass/Fail)
Course Description: Students works with staff at selected agencies/organizations providing community health and social services to underserved populations. Students gain experience in patient assessment, screening, health care education and the administrative challenges of providing basic health care to underserved populations.
 

Course #: FPR 4180: Complementary Medicine-Acupuncture  (Site: Malcolm Grow Medical Clinic, Andrews AFB MD)

Duration: 4
Hours: 5
Grading: (Pass/Fail)
Course Description: Students will gain a basic understanding of acupuncture; learn acupuncture techniques and indications for use in the management of acute and chronic pain conditions. Students will learn techniques that can be applied to selected patient problems in the outpatient and operational settings. Students will be active participants in conferences and lecture series.  
 

Course #: FPR 4192: Motivational Interviewing and Behavioral Change (site USUHS)

Duration: 4
Hours: 5
Grading: (Pass/Fail)
Course Description: Students will learn basic behavior change strategies and methods to improve motivation for behavioral change in a Family Medicine environment. Throughout the month, students will complete readings, observe behavior change groups, participate in weekly discussions, and develop a paper to synthesize learned information.

Course #: FPR 4201: Clinical Informatics (Site:  Madigan AMC, Joint Base Lewis-McCord, WA)

Duration: 4
Hours: 5
Grading: (Pass/Fail)
Course Description: During this 4 wk rotation students will work with the family physician director and will be exposed to clinical systems, business intelligence, development, IT hardware and training. By the end of the rotation students will understand the basics of Health IT systems and associated processes used by DoD and how to apply that knowledge to patient care.

 

 

Department Website: SOM

Course #: CAP4000, Capstone Research Project

Duration: 4, 8, or 12 week electives

Hours: 5

Description: The Capstone Program encompasses a diverse group of scholarly activities under 4 broad categories: laboratory research; clinical research; global health and military leadership scholarship, and educational research and scholarship. Students can enter the course code for up to 3 months. Each School of Medicine Class has a dedicated Capstone Sakai Website with appropriate descriptions and forms. Students should gain approval from OSA to take these elective months and coordinate submission of the 3202 scholarly planning form with the Capstone Program Director.

Contacts:

Martin Ottolini, MD, Colonel (ret) USAF, MC, Capstone Program Director

Phone Number: (301) 319-4023

martin.ottolini@usuhs.edu

Administrator: Roberta Mcintyre

Phone Number: (301) 295-9939

Roberta.mcintyre@usuhs.edu

Department Website: MED

As a fundamental prerequisite for performing any Advanced Clerkship, including Clinics and Consultation electives or Subinternship in the Department of Medicine, the student must have satisfactorily completed the third year core clerkship in internal medicine, unless otherwise so directed, arranged, and approved by the Department of Medicine. Students may contact the Director of Advanced Clerkship Programs who can be reached at (301) 295-9903. Dr. Ellen Im is not the scheduling POC however is available to provide guidance.

I. Clinics and Consultation (C&C) Objectives

Clinics and Consultation electives provide students with opportunities to expand their knowledge of particular subspecialties, work as consultants, and manage patients primarily in the outpatients setting. Much of a clinician's time is spent in office practice and consultation; these electives allow students to experience those aspects of practice as well as expose them to common diseases rarely seen on internal medicine wards. Students learn specialized history taking and examination skills of a particular subspecialty and learn how and when to use diagnostic tools of that specialty. Students are responsible for initial work-ups and notes as well as follow-up visits. After the initial evaluation of a patient, students present and discuss patients with fellow and staff attending. Each service is responsible for its own schedule of formal talks and rounds in which the students will participate.

Grading of clinics and consultative electives is Pass/Fail. The goal of these clerkships is to prepare the students for internship and enable students to serve as managers for their patients. Therefore using the RIME scheme (Reporter- Interpreter- Manager- Educator), students in the advanced clerkships are expected to be competent reporters and interpreters and making movement toward being managers for their assigned patients in order to receive a passing grade. In comparison, third year internal medicine clerks are expected to be competent reporters and making movement toward interpreters to receive a passing grade.

Objectives common to all clinics and consultation rotations include the abilities to:

Present cases (orally and written) that are organized, succinct, and factual
Longitudinally track patient data using available resources
Coordinate clinical care with supervising physicians and other health care workers
Use electronic health records
Appraise literature and apply it to their assigned patients (Evidence Based Medicine)
Demonstrates respect, compassion, integrity, and honesty in interactions with patients, family, and health care professionals 

Objectives unique to each subspecialty will be outlined under the individual clerkships. These electives are available throughout the year for students from USUHS (blocks 1-12) and other medical students unless otherwise specified.

Course List 

Course #: MDR4400, Cardiology C&C

Duration: 4 weeks
Hours: 5

Description: This rotation is designed to evaluate and develop management plans for both outpatients and inpatients with a wide range of cardiovascular disease including congestive heart failure, arrhythmias, valvular heart disease, coronary artery disease, and hypertension. The primary focuses are cardiac history and physical diagnosis; interpretation of EKGs, stress testing, and basic radiographic procedures; preoperative assessment; and outpatient consultation.

Goals: At the end of this elective, senior students will be able create differential diagnoses of common cardiac signs and symptoms, interpret common cardiac diagnostic testing, develop management plans for their assigned patients, and ultimately develop a rationale approach to caring for similar patients in the future (prior to referring patients to an internist or cardiologist).

Unique Objectives:
1) Correctly interpret EKGs on assigned patients
2) Identify common bradyarrhythmias, tachyarrhythmias, and myocardial ischemia/infarct on EKGs
3) Attain fund of knowledge and skills in order to enable the students to initiate care for patients who present with acute chest pain, hypertensive emergencies, and arrhythmias

Course #: MDR4490, Hematology/Oncology C&C

Duration: 4
Hours: 5
Description: Working closely with other members of the consult service, clerks will have responsibility for providing initial consultation as well as daily follow-up on their assigned patients. In addition, clerks will see both new and follow-up patients in the outpatient clinic. The focus of this elective is to expose the subintern to a wide variety of hematologic and sold malignancies, their consequences, and effects of therapy as well as the diagnosis, treatment, and management of non-malignant hematologic disorders such as anemia, cytopenias, and coagulation disorders.

 
Goals: At the end of this elective, senior students will be able create differential diagnoses of common presentations of malignant and hematologic disease, interpret common diagnostic testing (both laboratory and imaging), develop management plans for their assigned patients, and ultimately develop a rationale approach to caring for similar patients in the future (prior to referring patients to an internist or hematologist/oncologist).

Unique Objectives:
1) Correctly interpret findings on peripheral blood smears, other laboratory results, and radiographic procedures on their assigned patients
2) Development diagnostic and management plans for assigned patients who present with non-malignant hematologic disease (i.e. anemia, cytopenias, coagulation disorders, etc.)
3) Develop diagnostic and management plans for their patients who present with signs or symptoms suggestive of an underlying malignancy or have a known malignancy
4) Attain fund of knowledge and skills to enable the students to care for their patients with hematologic and malignant disease, including treatment options, management of treatment-induced complications (i.e. pancytopenia, fevers, etc.), and end-of-life issues

Course #: MDR4510, Gastroenterology C&C

Duration: 4
Hours: 5

Description: Working closely with other members of the consult service, clerks will have responsibility for providing initial consultation as well as daily follow-up on their assigned patients. In addition, clerks will see both new and follow-up patients in the outpatient clinic. The focus of this elective is to expose the clerk to a wide variety of important disease, such as cirrhosis, malabsorption, peptic ulcer disease, inflammatory bowel disease, pancreatitis, and esophageal dysfunction. The clerk will observe and/or participate in a variety of diagnostic procedures unique to the subspecialty.

Goals: At the end of this elective, senior students will be able create differential diagnoses for common signs and symptoms of gastrointestinal disorders, interpret common diagnostic testing (both laboratory and imaging), develop management plans for their assigned patients, and ultimately develop a rationale approach to caring for similar patients in the future (prior to referring patients to an internist or gastroenterologist).

Unique Objectives:
1) Correctly interpret laboratory results and radiographic procedures on their assigned patients
2) When possible, observe and/or participate in endoscopic procedures performed on their assigned patients
3) Attain fund of knowledge and skills to enable the students to work-up and care for their patients with gastrointestinal bleeding, abdominal pain, nausea and vomiting, and solid tumors of the gastrointestinal tract

Course #: MDR4540, Endocrinology C&C

Duration: 4
Hours: 5

Description: Working closely with other members of the consult service, clerks will have responsibility for providing initial consultation as well as daily follow-up on their assigned patients. In addition, clerks will see both new and follow-up patients in the outpatient clinic. The focus is to develop sophistication in history-taking and physical exam skills for recognizing endocrine diseases and become familiar with assaying hormones in the evaluation and management of important endocrine problems such as diabetes mellitus, osteoporosis, and thyroid disease. Opportunities to evaluate diseases of the pituitary, adrenal, and reproductive system are dependent on the availability of patients.

Goals: At the end of this elective, senior students will be able create differential diagnoses for common signs and symptoms of endocrinologic disorders, interpret common diagnostic testing (both laboratory and imaging), develop management plans for their assigned patients, and ultimately develop a rationale approach to caring for similar patients in the future (prior to referring patients to an internist or endocrinologist).

Unique Objectives:
1) Correctly interpret hormonal assays and other laboratory results on their assigned patients
2) Attain fund of knowledge and skills to enable the students to work-up and care for their patients with diabetes mellitus, thyroid disease, and osteoporosis

Course #: MDR4550, Infectious Disease C&C

Duration: 4
Hours: 5

Description: Working closely with other members of the consult service, clerks will have responsibility for providing initial consultation as well as daily follow-up on their assigned patients. In addition, clerks will see both new and follow-up patients in the outpatient clinic. Emphasis is placed on understanding basic pathogenic mechanisms as they relate to patient care and management, principles of antibiotic usage, HIV, and clinical microbiology.

Goals: At the end of this elective, senior students will be able create differential diagnoses for common signs and symptoms suggested of an infectious etiology, interpret common diagnostic testing (both laboratory and imaging), develop management plans for their assigned patients, and ultimately develop a rationale approach to caring for similar patients in the future (prior to referring patients to an internist or infectious diseases physician).

Unique Objectives:
1) Correctly interpret laboratory results, microbial cultures, and radiographic procedures to optimize care on their assigned patients
2) Develop a rationale use of available antibiotics considering drug cost, side effect profiles, and individual patient data
3) Attain fund of knowledge and skills to enable the students to work-up and care for patients with fevers who are immunocompromised or hospitalized, properly evaluate fevers in both the outpatient and inpatient settings, and develop a basic understanding of the use of antiviral agents in the setting of HIV

Course #: MDR4560, Nephrology C&C

Duration: 4
Hours: 5

Description: Working closely with other members of the consult service, clerks will have responsibility for providing initial consultation as well as daily follow-up on their assigned patients. In addition, clerks will see both new and follow-up patients in the outpatient clinic. Emphasis is placed on developing a basic understanding of acute renal failure, chronic renal diseases, electrolyte disorders, acid-base disorders, and hypertension as well as interpretation of urinalyses and other laboratory tests, pathology, and pathogenesis.

Goals: At the end of this elective, senior students will be able create differential diagnoses for common signs and symptoms of nephrologic disease, interpret common diagnostic testing (including urinalyses and other laboratory tests and imaging procedures), develop management plans for their assigned patients, and ultimately develop a rationale approach to caring for similar patients in the future (prior to referring patients to an internist or nephrologist).

Unique Objectives:
1) Correctly interpret laboratory results, urinalyses, and radiographic procedures in order to optimize care on their assigned patients
2) Develop a rationale use of available hypertensive agents considering drug cost, side effect profiles, and individual patient data
3) Attain fund of knowledge and skills to enable the students to work-up and care for patients with acute renal failure, electrolyte disorders, hypokalemia/hyperkalemia, chronic renal failure, and possible adverse drug effects

Course #: MDR4570, Pulmonary C&C

Duration: 4

Hours: 5

Description: Working closely with other members of the consult service, clerks will have responsibility for providing initial consultation as well as daily follow-up on their assigned patients. In addition, clerks will see both new and follow-up patients in the outpatient clinic. Emphasis is placed on gaining a more thorough understanding of the broad spectrum of pulmonary disease, chest radiograph interpretation, bronchoscopy observation, interpretation of pulmonary function tests, and management of acute and chronic respiratory disease.

Goals: At the end of this elective, senior students will be able create differential diagnoses of common respiratory signs and symptoms, interpret common laboratory, spirometric and imaging used to diagnose and treat pulmonary disease, develop management plans for their assigned patients, and ultimately develop a rationale approach to caring for similar patients in the future (prior to referring patients to an internist or pulmonologist).

Unique Objectives:
1) Correctly interpret laboratory results, microbial cultures, and radiographic procedures to optimize care on their assigned patients
2) Develop a rationale use of available medications to treat chronic lung conditions such as asthma and COPD considering drug cost, side effect profiles, and individual patient data
3) Attain fund of knowledge and skills to enable the students to work-up and care for patients with respiratory distress, acid-base disorders, lung cancers, pulmonary thromboembolism, and chronic lung disease

Course #: MDR4580, Rheumatology C&C

Duration: 4
Hours: 5

Description: Through evaluation of patients primarily in the outpatient setting, students will develop skills in history-taking, musculoskeletal examination, interpreting laboratory results, and radiographic interpretation in order to establish a rationale to approach patients with a wide variety of musculoskeletal complaints.

Goals: At the end of this elective, senior students will be able create differential diagnoses of common rheumatic signs and symptoms, interpret common serologic and immunologic testing used to diagnose and treat rheumatic disease, develop management plans for their assigned patients, and ultimately develop a rationale approach to caring for similar patients in the future (prior to referring patients to an internist or rheumatologist).

Unique Objectives:
1) Correctly interpret results of serologic and other laboratory tests and radiographic procedures to optimize care on their assigned patients
2) Develop a rationale use of available medications to treat pain and inflammation taking into account drug costs, patient demographics, underlying condition, and patient demographics
3) Attain fund of knowledge and skills to enable the students to work-up and provide initial care for patients with osteoarthritis, gout and other crystalline disorders, back pain, rheumatoid arthritis, fibromyalgia, soft tissue disorders, and the spondyloarthropathies

Course #: MDR4590, Allergy C&C

Duration: 4
Hours: 5

Description: Through direct observation and participation primarily in the outpatient setting, students will develop skills in history-taking and interpreting laboratory results in patients with allergic disorders in order to establish a rationale to approach patients with a wide variety of immunologic and allergic diseases.

Goals: At the end of this elective, senior students will be able create differential diagnoses of common allergic signs and symptoms, interpret common immunologic testing in adults and children, develop management plans for their assigned patients, and ultimately develop a rationale approach to caring for similar patients in the future (prior to referring patients to an internist or allergist).

Unique Objectives:
1) Correctly interpret diagnostic laboratory and other tests on assigned patients
2) Acquire an appreciation of the basic mechanisms of allergic disorders and asthma
3) Attain fund of knowledge and skills to enable the students to initiate a diagnostic work-up and management for patients who present with suspected immunodeficiency, apparent drug allergy, anaphylaxis, and asthma

Course #: MDR4591, Sleep Medicine C&C

Duration: 4
Hours: 5

Description:Working closely with other members of the consult service, clerks will have responsibility for providing initial consultation as well as daily follow-up on their assigned patients. Emphasis is placed on gaining a more thorough understanding of the broad spectrum of sleep medicine to include circadian rhythm disorders, sleep movement disorders, parasomnias, and hypersomnias. There will be an emphasis on proficiency in diagnosing and managing obstructive sleep apnea and insomnia. An introduction to polysomnogram interpretation (both in-lab and home types), actigraphy , overnight pulse oximetry will be provided as part of this rotation. Patients of all ages will be managed. Clinical research is an important part of sleep medicine, and clerks will be encouraged to participate in new or ongoing sleep medicine research.

 Goals:At the end of this elective, senior students will be able create differential diagnoses on patients that have common sleep-related symptoms, understand the importance of polysomnography findings, interpret common laboratory tests, and develop management plans for their assigned patients. Ultimately, senior students will be proficient in identifying sleep-related disease symptoms and be able to provide initial treatment of these problems.  They will also be able to develop a reasoned approach to caring for similar patients in the future (prior to referring patients to sleep medicine).

Unique Objectives:

1) Develop proficiency in identifying signs and symptoms of sleep-related disorders, particularly obstructive sleep apnea and insomnia.

2) Correctly interpret data from patients’ history, laboratory and radiologic evaluations, polysomnography and actigraphy and incorporate it in patient management decisions.

3)Develop skill in the initial management of sleep-related disorders. 

4) Participate in clinical research on a sleep medicine-related topic.

II. Subinternship (Descriptions, Goals and Objectives)

Subinternships in internal medicine are designed to provide senior students with an opportunity to manage acutely ill hospitalized patients under a high degree of supervision. Students will further develop their skills in history taking, physical examination, differential diagnosis, and the day-to-day management of both common and unusual illnesses. Advanced clerkship students will function with intern-like responsibilities under the direction of a resident and attending physician. In certain subinternships, the student may also work with fellows. Students will provide comprehensive care for their assigned patients including their initial work-up, daily progress notes, and performing procedures under close supervision. Students may take night and weekend calls. Students will carry the full responsibility for his/her patients and is expected to develop their initiative in identifying issues in patients care and in proposing daily plans for his/her patients.

A grade of Honors/Pass/Fail will be given for this rotation. The goals of the subinternship is two-fold: provide a forum in which students integrate internal medicine teaching from the entire four year curriculum and equip students with new knowledge, skills, and attitudes they will need to excel during internship. Therefore using the RIME scheme (Reporter- Interpreter- Manager- Educator), students on advanced clerkships are expected to be competent reporters and reasonable interpreters (most of the time) and making movement toward being managers for their assigned patients in order to receive a passing grade.  To receive an Honors grade, students must demonstrate the ability to be at the Manager/Educator level during the rotation.

Objectives common to all sub-internship rotations include the abilities to:

Present cases (orally and written) that are organized, succinct, and factual
Track patient data longitudinally using available resources
Coordinate clinical care with supervising physicians and other health care workers
Prioritize daily work to include sign-out lists
Assess patient decision-making capacity
Apply pharmacokinetics of common medication
Compose discharge summaries
Deliver bad news
Use electronic health record databases
Appraise literature and apply it to their assigned patients (Patient centered care)
Demonstrate respect, compassion, integrity, and honesty in interactions with patients, family, and health care professionals
Objectives unique to each subspecialty will be outlined under the individual clerkships. Subinternships are available throughout the year for students from USUHS and other medical schools unless otherwise specified.

Course List

Course #: MDR4420, Cardiology Coronary Care Unit S.I.

Duration: 4
Hours: 8

Description: This course is designed primarily to care for inpatients. Senior students will function as an intern on the inpatient cardiology team. They will provide comprehensive care for assigned patients including their initial work-up, daily progress notes, interpretation of EKGs and other diagnostic tests, and performing procedures under the supervision of senior members of the team. Senior students will take night and weekend call. The primary focuses recognition and management of arrhythmias, heart failure, and acute coronary artery syndromes.

Goals: At the end of this elective, senior students will be able create differential diagnoses of common cardiac signs and symptoms, interpret common cardiac diagnostic testing, develop diagnostic and management plans for their assigned patients, and ultimately develop a rationale initial approach to caring for similar patients in the future (prior to referring patients to an internist or cardiologist).

Unique Objectives:
1) Correctly interpret EKGs on assigned patients
2) Identify common bradyarrhythmias, tachyarrhythmias, and myocardial ischemia/infarct on EKGs
3) Attain fund of knowledge and skills to enable the students to initiate care for patients who present with acute chest pain, hypertensive emergencies, and arrhythmias

Course #: MDR4440, General Medicine S.I.

Duration: 4
Hours: 8

Description: This clerkship provides a supervised inpatient experience evaluating and managing major diseases encountered on an inpatient service. Students will serve as a member of the medicine ward team with "intern" level responsibility including taking call, writing initial orders, and providing daily care to their assigned patients. Emphasis will be placed on developing skills necessary to become successful interns.

Goals: At the end of this elective, senior students will be able create differential diagnoses of common adult signs and symptoms of disease, interpret diagnostic testing used in caring for their patients, develop diagnostic and management plans for their assigned patients, and ultimately develop a rationale initial approach to caring for similar patients in the future (prior to referring patients to an internist or other subspecialists).

Unique Objectives:
1) Correctly interpret diagnostic studies including laboratory and EKGs on assigned patients
2) Attain fund of knowledge and skills to enable the students to initiate care for patients who present with abdominal pain, acute gastrointestinal bleeding, acute pulmonary edema, acute renal failure, altered mental status, arrhythmias, chest pain, electrolyte disorders, fever, glycemic control, hypertensive emergencies, nausea and vomiting, pain management, respiratory distress, shock, and seizures

Course #: MDR4460, MICU S.I.

Duration: 4
Hours: 8

Description: This course is designed primarily to care for inpatients. Senior students will function as an intern on the Intensive Care Unit team. They will provide comprehensive care for assigned patients including their initial work-up, daily progress notes, interpretation of EKGs and other diagnostic tests, and performing procedures under the supervision of senior members of the team

Goals: At the end of this elective, senior students will be able create differential diagnoses of common signs and symptoms in critically ill patients, interpret common diagnostic testing in the ICU, develop management plans for their assigned patients, and ultimately recognize signs and symptoms of critical illness in future patients who require admission in ICUs.

Unique Objectives:
1) Correctly interpret diagnostic studies including laboratory and EKGs on assigned patients
2) Develop management plans for their patients who present with electrolyte, acid base, and fluid disturbances
3) Attain fund of knowledge and skills to enable the students to initiate care for patients who present with acute gastrointestinal bleeding, acute renal failure, arrhythmias, acute chest pain, electrolyte disorders, hypertensive emergencies, respiratory arrest, and shock

Course #: MDR4500, Hematology/Oncology S.I.

Duration: 4
Hours: 8

Description: Subinterns will have "intern" level responsibility for managing patients on the inpatient hematology/oncology service and will see both new and follow-up patients in the outpatient clinics. The focus of this elective is to expose the subintern to a wide variety of hematologic and sold malignancies, their consequences, and effects of therapy. The subintern will take night call with their team.

Goals: At the end of this elective, senior students will be able create differential diagnoses of common presentations of malignant and hematologic disease, interpret common diagnostic testing (both laboratory and imaging), develop management plans for their assigned patients, and ultimately develop a rationale approach to caring for similar patients in the future (prior to referring patients to an internist or hematologist/oncologist).

Unique Objectives:
1) Correctly interpret findings on peripheral blood smears, other laboratory results, and radiographic procedures on their assigned patients
2) Development diagnostic and management plans for assigned patients who present with non-malignant hematologic disease (i.e. anemia, cytopenias, coagulation disorders, etc.)
3) Develop diagnostic and management plans for their patients who present with signs or symptoms suggestive of an underlying malignancy or have a known malignancy
4) Attain fund of knowledge and skills to enable the students to care for their patients with hematologic and malignant disease, including treatment options, management of treatment-induced complications (i.e. pancytopenia, fevers, etc.), and end-of-life issues
III. Clerkships (Descriptions, Goals, and Objectives)

Clerkships in internal medicine offer similar experiences as subinternship, but are graded Pass/Fail. While they are four weeks in duration, they do not fulfill the School of Medicine’s requirement for a subinternship. However, the amount of primary patient management may be similar to the subinternships. The goals and objectives for clerkships is the same as those for the subinternships.  

Objectives unique to each subspecialty will be outlined under the individual clerkships. Clerkships are available throughout the year for students from USUHS and other medical schools unless otherwise specified.

Course #: MDR4390, Palliative Medicine

Duration: 4
Hours: 5

Description: Provide senior student with the opportunity to participate in home palliative care & pain control for terminally ill patients.

Goals: Provide multi-disciplined approach to palliative care. Encompasses nursing, social work, pastoral care, volunteers, home health aids and bereavement services. Focus is holistic, addressing medical, psychosocial, and spiritual needs of patients/families. Participates in home visits with the disciplines, attends lectures, observes output visits.

Site: DCVA

Course #: MDR4680, Clinical Pharmacology Consults

Duration: 4

Hours: 5

Description: Provide senior student with the opportunity to participate in the clinical pharmacology consultation services. Consultation experience frequently involves drug overdose, adverse drug reactions, and drug pharmacokinetics.

Goals: At the end of this elective, senior students will be able create differential diagnoses of common allergic signs and symptoms, interpret common immunologic testing in adults and children, develop management plans for their assigned patients, and ultimately develop a rationale approach to caring for similar patients in the future (prior to referring patients to an internist or allergist).

Unique Objectives:
1) Correctly interpret results of drug levels and other laboratory tests to optimize care on their assigned patients
2) Develop a rationale plan for treating common drug overdoses using available nomograms and knowledge of drug pharmacokinetics
3) Attain fund of knowledge and skills to enable the students to work-up and provide initial care for patients with drug-induced hepatitis, alcohol intoxication and withdrawal, recreational drug use, and drug poisoning

Comments: To schedule contact COL Thomas Oliver at thomas.oliver@usuhs.edu, (301) 295-0016 or (301) 295-3239.

Site: USUHS

Course #: MDR4690, Geriatric Medicine

Duration: 4
Hours: 5

Description: This rotation provides in-depth exposure to geriatric medicine and gerontology by working closely with faculty and residents. Students may take part in nursing home care, physician house call, and outpatient geriatric evaluation.

Goals: At the end of this elective, senior students will be able create differential diagnoses of common problems affecting the elderly, perform geriatric outpatient assessments, evaluate mental status alterations in the elderly, develop diagnostic and management plans for their assigned patients, and ultimately develop a rationale initial approach to caring for elderly patients in the future (prior to referring patients to geriatrics specialist).

Unique Objectives:
1) Correctly interpret laboratory results and radiographic procedures to optimize care on their assigned patients
2) Develop a rationale approach to prescribing drugs in the elderly
3) Attain fund of knowledge and skills to enable the students to work-up and care for elderly patients who present with dementia, depression, incontinence, falls, polypharmacy, end-of-life issues, and other common disease affecting the elderly

Course #: MDR4715, Women's Healh Clinic

Course Type: C

Department: MDR 

Duration: 4 weeks

Hours: 5 

(Letter/Pass/Fail): P

Description: 

Working closely with members of the DCVA Women’s Health clinic and under direction of a participating internist, clerks will have responsibility for evaluating follow-up and new patient care. Clerks will gain exposure to a multi-disciplinary view of women’s health care by participation in related psychiatry, gynecology, endocrinology and primary care aspects of women’s health outpatient care.  Students will attend breast tumor board and spend time in review of breast imaging with a radiologist as well as have potential for time in the OR observing gynecologic surgery. 

Goals: At the end of this elective, senior students will be able to describe issues in women’s health and illness prevention. 

Unique Objectives:

1) Identify signs and symptoms of women's health-related diagnoses such as vaginitis, dysfunctional uterine bleeding and pregnancy

2) Distinguish military service-specific effects' on female veterans' orthopedic, reproductive and mental health

3) Apply clinical practice guidelines in women's health-related diagnoses and preventive care

Site: DCVA (only)

Course #: MDR4720, General Medicine Clinics

Duration: 4
Hours: 5

Description: Clerks will see follow-up, walk-in, semi-urgent, and 72 hour consultations referred to the internal medicine clinic. While the bulk of the patients will be outpatients, consultations from inpatient services may also be seen while working together with a resident and faculty internist. Clerks are responsible for the complete evaluation and disposition for required follow-up procedures and other diagnostics.

Goals: At the end of this elective, senior students will be able create differential diagnoses of common cardiac signs and symptoms, interpret laboratory and other diagnostic testing, develop management plans for their assigned patients, and ultimately develop a rationale approach to caring for similar patients in the future (prior to referring patients to an internist).

Unique Objectives:
1) Correctly interpret diagnostic studies including laboratory and EKGs on assigned patients
2) Provide recommendations on surgical patients referred for preoperative assessment
3) Attain fund of knowledge and skills to enable the students evaluate patients who present with hypertension, headaches, abdominal pain, acute gastrointestinal bleeding, acute renal failure, altered mental status, arrhythmias, chest pain, electrolyte disorders, fever, glycemic control, nausea and vomiting, pain management, respiratory distress, and seizures

Course #: MDR4740, Safety and Quality

Duration: 4

Hours: 5

Description: This four-week elective, organized in two parts, will allow students to build their knowledge of safety and quality.  It is usually assumed that by learning how to assess the risk of disease, diagnose disease, and treat patients one intuitively learns how to practice safe, high quality medicine. Unfortunately, physicians make frequent, avoidable errors. Furthermore, they may not appreciate the vital role of the healthcare system in providing a safe medical environment and in promoting high quality care.  Students will receive mentorship from the Elective Director, meeting at the start of the elective and at the end of each week at USU, typically for one hour. Additionally, students will rotate at Defense Health Headquarters (DHHQ) in Falls Church, VA where they will work closely with the Defense Health Agency (DHA) safety and quality leadership. The mission of this course is to build knowledge of safety and quality, which will increase as learners progress through residency, graduate to independent practice. The ultimate purpose of this course is for the student to become a leader in improving safety and quality.

Goals: At the end of this course, the student will be familiar with key safety and quality issues, at the level of the physician and at the level of the healthcare system. Furthermore, at the end of this course, the student will understand the roles safety and quality play in the practice of medicine.

Unique Objectives:

1) In the first two weeks, the student will: (A) read seminal safety and quality articles, (B) learn the most common medical errors, where and when they occur, and how to avoid them, and (C) write a paper (no longer than five double-spaced pages) recommending a way that physicians can improve the safety and/or quality of their care.

2) In the second two weeks, the student will: (A) work closely with the Defense Health Agency Safety and Quality leadership in Falls Church, VA, (B) learn how the healthcare system detects and corrects safety problems and improves the quality of care, and (C) write a paper ( no longer than five double-spaced pages) recommending an improvement project.

Site: USU and DHHQ (only).  Enrollment is limited to one student per round.

IV. Research Opportunities

Course List

Course #: CAP4000, Cardiology Research

Duration: 4
Hours: 5
Grading: (Pass/Fail)

Description: Provide senior student with the opportunity to perform either basic science or clinical research that may include the development, performance, interpretation of results, and writing of a specific research project by working with investigators and/or technical staff to learn the techniques and the rationale behind the study plans.

Goals: While the specific goals will depend on the project and faculty advisor, the primary goal is to expose the student the research method: developing hypotheses, study design, data collection, data analysis, and results. Some students may be able to prepare a short article or abstract for a suitable journal or meeting.

Unique Objectives: To be determined by research supervisor

Comments: To schedule contact COL Thomas Oliver at thomas.oliver@usuhs.edu.

Course #: CAP4000, Clinical Pharmacology Research

Duration: 4
Hours: 5
Grading: (Pass/Fail)

Description: Provide senior student with the opportunity to perform either basic science or clinical research that may include the development, performance, interpretation of results, and writing of a specific research project by working with investigators and/or technical staff to learn the techniques and the rationale behind the study plans. Specifically, students are involved in a clinical research project involving experimental therapeutics in the Division of Clinical Pharmacology and Medical Toxicology's Clinical Research Unit.

Goals: While the specific goals will depend on the project and faculty advisor, the primary goal is to expose the student the research method: developing hypotheses, study design, data collection, data analysis, and results. Some students may be able to prepare a short article or abstract for a suitable journal or meeting.

Unique Objectives: To be determined by research supervisor

Comments: To schedule contact COL Thomas Oliver at (301) 295-0016 or (301) 295-3239.

Course #: CAP4000, Education Research

Duration: 4
Hours: 5
Grading: (Pass/Fail)

Description: Provide senior student with the opportunity to perform educational research that may include the development, performance, interpretation of results, and writing of a specific research project by working with investigators and/or technical staff to learn the techniques and the rationale behind the study plans. Typically, students may design their own project or participate in ongoing research related to the process of evaluation and modification of educational programs.

Goals: While the specific goals will depend on the project and faculty advisor, the primary goal is to expose the student the research method: developing hypotheses, study design, data collection, data analysis, and results. Some students may be able to prepare a short article or abstract for a suitable journal or meeting.

Unique Objectives: To be determined by research supervisor

Comments: To schedule contact Dr. Louis Pangaro (301) 295-2010 or Dr. Steve Durning (301) 295-3606

Course #: CAP4000, Infectious Disease Research

Course Type: C
Department: MDR
Duration: 4
Hours: 5
(Letter/Pass/Fail): P

Description: Provide senior student with the opportunity to perform either basic science or clinical research that may include the development, performance, interpretation of results, and writing of a specific research project by working with investigators and/or technical staff to learn the techniques and the rationale behind the study plans. Previous clinical trials have included investigational new drugs and biologics relating to infectious disease and biological warfare defense.

Goals: While the specific goals will depend on the project and faculty advisor, the primary goal is to expose the student the research method: developing hypotheses, study design, data collection, data analysis, and results. Some students may be able to prepare a short article or abstract for a suitable journal or meeting.

Unique Objectives: To be determined by research supervisor

Comments: To schedule contact Dr. Naomi Aronson at (301) 295-3621.

Course #: MDR4636, Medical Education Elective

Duration: 4

Hours: 5
Grading: (Pass/Fail)
Description: The Medical Education Elective provides MS4s with both formal education on teaching, evaluation and curriculum development as well as the opportunity to practice these skills under the mentorship of medical education experts. The course aims to help MS4s build a foundation of medical education knowledge before they embark on medical careers that require participation in education at all levels of training. Students will practice the skills they learn during expert-led, small group didactic sessions by assisting with teaching courses in the pre-clerkship curriculum. These courses include but are not limited to physical exam, medical interviewing, reflective practice, integrated clinical skills, integrated clinical reasoning and MEM curricula.

Goals: To develop senior medical students as medical educators by providing an opportunity to study the theory and methods of medical education and practice learned skills as educators in the underclass pre-clerkship curriculum. 

Unique Objectives: By the end of the 4-week curriculum, MS4s will demonstrate their ability to: 

a. Discuss key foundational theories in medical education
b. Employ learned teaching skills in each of the following settings at least weekly

i. One-on-one teaching 

ii. Small group sessions 

iii. Large group sessions

c. Identify underclass student needs and questions, and create at least two concise, clear, reusable resources that address these topics 

Comments: For any questions, please contact course directors, ENS Sophia Schermerhorn (sophia.schermerhorn@usuhs.edu) and ENS Zachary Monahan (zachary.monahan@usuhs.edu). Dr. Patrick O'Malley is the course's faculty supervisor (patrick.omalley@usuhs.edu).

Site: USUHS

Department Website: MEM

The department of Military and Emergency Medicine (MEM) lies within the Uniformed Services University of the Health Sciences (USU) F. Edward Hebert School of Medicine (SOM). Created to enhance students’ understanding and appreciation of military medicine, the Department of Military and Emergency Medicine is also what makes USU a unique learning environment and opportunity for students who would not otherwise practice and understand what makes the practice of Military Medicine unique and challenging. All students who graduate from the USU School of Medicine will not only be equipped with a breadth of excellent medical knowledge and skills, but they will be leaders in medicine. This commitment to Military Medicine, Practice and Leadership become the pillars for this one of a kind curriculum at the Uniformed Services University.

Contacts

Course List

Course #: MM0 4002, Military Emergency Medicine

Duration: 4 weeks

Hours: 5

Description: The Emergency Medicine Clerkship is a mandatory, 4-week, senior Clerkship designed to train 4th year medical students in the basic tenets of diagnosis and management of emergency medical conditions. During this clerkship, students will develop clinical skills to diagnose, manage, and rapidly understand undifferentiated, emergency medical and surgical conditions in patients of all ages and demographics. They will gain an understanding of the role of Emergency Medicine in our healthcare system and an appreciation of time constraints and resource utilization.

Course #: MMO 4033, Emergeny Medicine Elective

Duration: 4 weeks

Hours: 5

Description: The Emergency Medicine elective is a  4-week, senior elective designed to train 4th year medical students who wish for additional emergency medicine experience in the basic tenets of diagnosis and management of emergency medical conditions. The rotations consist of clinical shifts, in military and civilian emergency departments, combined with written reflective assignments.  The 4-week elective, located at sites around the country, affords students the chance to learn about the assessment and management of emergency patients while gaining insight into a potential EM career.

Course #: MM0 4150, Pediatric Emergency Medicine

Duration: 4 weeks

Hours: 5

Description: Students in Pediatric Emergency Medicine (PEM) will have the opportunity to evaluate multiple patients in a tertiary care Pediatric Emergency Department (ED) and Level 1 Pediatric Trauma Center.  Students will evaluate pediatric patients with a variety of complaints (infectious problems, congenital disorders, traumatic injuries, etc.) and levels of medical acuity.  Students will experience the busy nature of the ED setting and learn how to assess and manage patients efficiently and effectively.  Finally, students will be exposed to different areas of the specialty of Pediatric Emergency Medicine including direct patient care, ED nursing and technician roles, patient triage and the academic endeavors and commitments of the PEM staff.  

Department Website: MEM

Military Operational Medicine Electives

USUHS and the School of Medicine are dedicated to producing leaders for the Military Health System.  An integral part of leadership is understanding how the operational sides of our services function.  The Military Operational Medicine elective is a great way for students in the post-clerkship year to gain experience working with operational units of each service.  Over the years, the Department of Military and Emergency Medicine has sponsored students rotating in a wide array of operational units.  We value enabling students to go out into the services and to begin to understand how they fit in as medical officers.

Military Operational Medicine elective rotations are largely student initiated and driven.  While our staff is here to assist you in establishing a suitable elective experience, you will assume the lion’s share of the responsibility in contacting/establishing a primary POC/Sponsor, working with that sponsor to craft goals and objectives for the rotation, and obtaining ultimate approval from the MEM Operational Medicine Clerkship Director and OSA.

The Department of Military and Emergency Medicine will not assume responsibility for funding operational medicine electives.

MILITARY OPERATIONAL MEDICINE ELECTIVE COURSES IN EMPOWER

Note that Military Operational Medicine electives range in duration from 2 weeks to 6 weeks.  Please ensure that you register for the proper course/place-holder equivalent to that for which you have been ultimately approved (i.e., 2-week course experiences will register for MOR4110, MOR4120, and MOR4130 sequentially/respectively; 3-week course expereinces will register for MOR4155; 4-week course experiences will register for MOR4210, MOR4220, and MOR4230 sequentially/respectively; 6-week course experiences will register for MOR4110 and MOR4210).

Work with the Registrar to ensure your dates are aligned properly within Empower, as default date presets will not always align with your course choices/availability.

Additionally, you are solely responsible for supplementing the time allocated for each ACR Block/Rotation if/when an operational medicine course duration does not completely fill allocated block time (i.e., supplementing with research opportunities, approved leave/pass, etc.). Consult your chain of command in such cases.

Sample List of Military Operational Medicine Electives (including but not limited to)

Operational Medicine Electives vary widely.  The following are possible examples of Operational Medicine Electives, but others may be included (coordinate with the MEM Operational Medicine Electives  Director):

Military Mountain Medicine Course (M3C) in Vermont or Washington – 2 weeks – training by Wilderness Medicine Fellowship instructors (counts toward DiMM – Diploma in Mountain Medicine; USMC Mountain Medicine does NOT)

Cold Weather Mountain Medicine and Avalanche course in Vermont – 2 weeks – advanced mountain medicine in the cold and austere environment along with introduction to avalanche basics; must have completed M3C or USMC Mountain Medicine in Bridgeport, CA; training by Wilderness Medicine Fellowship instructors (counts toward DiMM – Diploma in Mountain Medicine)

Dive Medicine and Dive Rescue Course in Key West – 2 weeks – training in Dive & Marine medicine; will become Open Water, Advanced Open Water, and Water Rescue Dive certified

Navy Diving & Salvage Training Center in Panama City (2-4 weeks) – work alongside Navy UMOs; this is not a “course” but more of an operational clinical rotation

Naval Special Warfare Center in Coronado, CA (2-4 weeks) – this is where BUDS training occurs; work alongside Navy physicians that provide oversight of BUDS and other Special Forces training; not a true “course but more of an operational clinical rotation

Air Force Flight Surgeon Course (AMP 201/202) at WPAFB – 4 weeks – must have completed AMP 201 already; these 4 weeks will complete the flight surgeon training to earn wings; only students that are doing one year internships with plans to go into Flight Medicine as a GMO will be authorized 

 Army Flight Surgeon Course at Fort Rucker – 6 weeks – completion of this course leads to earning the Army FS wings

Special Operations Combat Medic at Fort Bragg – 2 to 4 weeks – work alongside the 18D students and Instructors at Fort Bragg in this Special Operations community

Other Course Notes/Responsibilities

For established Emergency Medicine Course electives such as Clinical Rotations in Emergency Medicine, Medical Toxicology, Pediatric Emergency Medicine, or Research in Emergency Medicine, see the previous 4^th-Year catalog tab (Military Emergency Medicine).

Military Operational Medicine Elective options do NOT include purely military training courses that are not medically academic nor clinical in any way (e.g. Airborne, Air Assault, etc.). Such Military Training Courses are coordinated by the Brigade and are NO LONGER credited as Military Operational Medicine electives – see the Commandant’s office for guidance and Brigade Operations for coordination (usuhs-bde-s3-operations-ggg@usuhs.edu or 301-295-9635, Rm C-1081). For purely military training/course options, you should prepare to assume sole responsibility for contacting the appropriate school, securing a slot, fulfilling any course prerequisites, and obtaining command (Commandant/Brigade) approval

For purely research-related elective options, please reach out to Dr. Martin Ottolini, Assistant Dean for Capstone Projects, at martin.ottolini@usuhs.edu or 301-319-4023, as his office handles ALL research elective approvals and monitoring.  Feel free to Courtesy Copy (cc) our office regarding research-related elective options in Operational or Military Emergency Medicine.  Our office can assist with suggesting an array of valuable research elective opportunities.

Forms

Operational Medicine Command Endorsement Form

USUFORM650 Evaluation Form

Military Operational Medicine Elective POCs

Col Tony Kim, 

Clerkship Director

Tony.Kim@usuhs.edu

C-1042, 301-295-1763

Mr. John Brown,

Clerkship Administrator

Johnnie.Brown@usuhs.edu

C-1046, 301-295-9656

Department Website: NEU

Course #: NE04100, Adult Neurology

Course Type: C
Department: NEO
Duration: 4
Hours: 6
Grading: (Honors/Pass/Fail)

Description:  The Neurology Clerkship is a combined inpatient and outpatient rotation where students evaluate and manage patients as part of a team consisting of other med students, residents, and Staff Members. Students participate in teaching rounds, conferences, and lectures/seminars conducted by their site. The objective is to teach students principles of neurologic diagnosis and management in preparation for internship. Students are required to see 9 Core Patients and submit a mini-case report on 5 of them.  Students must also pass a written examination and their end of month Clinical Performance Evaluation.  The clerkship is offered at multiple sites throughout CONUS. 

Course #: NE04110, Child Neurology

Course Type: C
Department: NEO
Duration: 4
Hours: 6
Grading: (Honors/Pass/Fail) 

Description: The Child Neurology Clerkship is a combination outpatientand consultation service where students evaluate and manage patients as part of a team consisting of other med students, residents, and Staff Members. The Child Neurology Clerkship is only offered at WRNMMC.  However students are required to attend clinic once per week at one of the satellite locations either at FBCH or Malcom Grow.  Students participate in teaching rounds, conferences, lectures/seminars. The objective is to teach students principles of neurologic diagnosis and management in preparation for internship. Student must satisfy all requirements of NEO 4100.  

Course #: NE04205, Neurology Elective

Duration: 4

Hours: 5

Grading: (Pass/Fail)

Description: Clinical electives are offered in a number of subspecialty areas including (but not restricted to) Child Neurology, Behavioral Neurology, Epilepsy, and Movement Disorders. Students may also chose an elective at any MTF where a military neurologist is available. Elective rotations are all unfunded and require prior authorization from the MTF and the Clerkship Director.

1. These are arranged directly with the Neurology 

2. All are pass/fail graded.

3. Grades are determined on the basis of a Performace Report by the Supervisor. 

Course #: NE04121, Neurology Sub-Internship

Duration: 4

Hours: 8

Grading: (Honors/Pass/Fail)

Description: The Neurology sub-internship experience is offered for those students who want additional exposure to neurology in preparation for residency application. This rotation is only offered at three MTF sites where a neurology residency exists (Madigan, San Antonio, and Walter Reed). The neurology ELECTIVE can be performed at any site where a staff neurologist is stationed, with pre-approval by the USUHS Clerkship Director. The neurology sub-internship cannot be used as a substitute for the required neurology clerkship.

 The sub-internship is designed to offer students increased responsibility in the care and management of patients, beyond what the required clerkship offers. This will be a predominantly inpatient experience with the following objectives:

Specify common neurologic complications of patients admitted with medical/surgical illness
Review the responsibilities of a PGY1 on a neurology service (patient assessments, writing orders for common neurologic tests, discharge planning)
Demonstrate oral communication skills necessary to present patient data to the attending physician and consulting providers in a logical manner
Illustrate the ability to work in interdisciplinary teams (awareness of roles and responsibilities of ancillary providers in care of neurology in-patients, engage PT/OT/SLP, and SWS when appropriate, incorporate recommendations from other services)           
The sub-internship student is required to:
Attend daily rounds (ward or consult service)
Present all data to include History & Physicals, labs, imaging, and consult results to the attending on rounds
Independently perform the initial evaluation on at least 6 NEW patients over the course of the 4 This can be done via ER consults, ward admissions, or consult service patients.
Maintain an average daily census of 3 patients (i.e., the sub-intern must be actively following (seeing daily, writing notes, oral presentations) at least 3 patients per day averaged over the course of the 4
Attend discharge planning meetings for the patients they are actively following
Write orders and enter consults requests in the electronic health record (after discussion with house staff) for patients they are actively following
Present a patient at morning report over the course of the 4 weeks. This must include presentation of the history and physical, localization, differential diagnosis, and evaluation/management plan
Take call at least 3 times over the course of the 4 week The Site Director can determine how best to implement for their location. For example, at those sites where call is from home the student could stay in hospital from 0700-1900 on a Saturday or Sunday. When the resident gets a call, (s)he can call/text the student who can get started on the evaluation prior to the resident arriving.
The sub-internship student will be evaluated on:
The ability to take a history and perform a neurologic exam
Oral communication skills in patient presentations
Ability to document information in the electronic health record
The ability to work in interprofessional/interdisciplinary teams Grades of Honors Pass, Pass, and Fail.

Department Website: OBG

I. Electives

Course #: OBR 4250, Maternal Fetal Medicine

Duration: 4 weeks
Hours: 5
Grading: (Pass/Fail)
Course Description: Students will be part of the MFM team composed of maternal fetal medicine specialists and OB/GYN residents. They will participate in the care of patients with high risk pregnancy concerns in the inpatient and outpatient settings. Additionally, the students will be exposed to fetal diagnosis and advanced ultrasonography. Other opportunities for education include morning rounds, departmental conferences, specialty clinics, and time on the Labor and Delivery Unit.
By the conclusion of the rotation the student should be able to:
1. Describe the impact of pregnancy on the medical problems and the impact of medical problems on pregnancy.
2. Describe and interpret common screening, diagnostic and evaluation tools employed to assess fetal status.
3. Work cooperatively with peers, residents, staff, nurses, patients, and all members of the healthcare team.

Course #: OBR 4330 Gynecologic Oncology

Duration: 4 weeks
Hours: 5
Grading: (Pass/Fail)
Course Description: Students will be part of the gyn oncology team made up of gynecology oncology staff and OB/GYN residents (and fellows). They will participate in the outpatient and inpatient care of patients with pre-cancer, cancer or complex surgical cases as well as familial syndromes. Students will round daily with the team and be assigned primary responsibility for individual patients. Students will provide concise patient presentations daily in standard format. Students will participate in other educational opportunities including morning report, departmental conferences, and tumor planning conferences. Students will attend and, when appropriate, scrub on operative cases.
By the conclusion of the rotation the student should be able to:
1. Demonstrate understanding of the anatomy of the female pelvis and basic surgical principles (sterile technique, basic suturing, knot tying).
2. Describe signs, symptoms, risk factors, and basic evaluation of ovarian, cervical, endometrial, vulvar and vaginal cancer.
3. Describe the spectrum of treatment options for gynecologic cancer patients including surgery, chemotherapy, radiation, and palliative care.
4. Function as a productive and contributing member of the gyn onc team.

Course #: OBR 4340 Urogynecology

Duration: 4 weeks
Hours: 5
Grading: (Pass/Fail)
Course Description: Students will be part of the UROGYN team made up of uro-gynecologists and OB/GYN resident (and fellows). They will participate in the outpatient and inpatient care of patients with pelvic floor disorders such as uterovaginal prolapse, urinary incontinence, and voiding dysfunction. Students will assist with diagnostic procedures, medical treatment, pre-operative and post-operative care of surgically managed patients. Students will participate in other educational opportunities including morning report, departmental conferences, and specialized uro-gynecology conferences. Students will attend and, when appropriate, scrub on operative cases. By the conclusion of the rotation the student should be able to:
1. List and describe main types of urinary incontinence (SUI, UUI, mixed UI) and basic management of each type.
2. Describe severity of pelvic organ prolapse.
3. List major risk factors for urinary incontinence and pelvic organ prolapse.

Course #: OBR 4230 Minimally Invasive Surgery (MIS) or GYN Surgery

Duration: 4 weeks
Hours: 5
Grading: (Pass/Fail)
Course Description: Students will be a part of the gynecology team made up of board certified obstetrician-gynecologist and OBGYN residents (and MIS fellows). They will participate in the outpatient and inpatient care of patients with surgical gynecologic disorders to include the preoperative assessment, surgical procedure and post-operative care. Where applicable, students will learn the basic foundation of minimally invasive surgery. Additional opportunities for education include morning report and departmental conferences. The students will attend and, when appropriate, scrub on operative cases. By the conclusion of the rotation the student should be able to:
1. Describe the pelvic anatomy, both internal and external with emphasis on blood supply, ureteral location, and retroperitoneal anatomy.
2. Describe the principal causes, diagnostic evaluation, surgical and non-surgical treatment options, and appropriate follow-up in the management of patients with abnormal uterine bleeding, pelvic masses, chronic pelvic pain, and endometriosis.
3. Describe common measures for the prevention of infection, deep venous thrombosis, and other peri-operative complications.
4. Describe when the use of laparoscopy versus open procedures is most appropriate.

Course #: OBR 4270 Reproductive Endocrinology & Infertility

Duration: 4 weeks
Hours: 5
Grading: (Pass/Fail)
Course Description: Students will be part of the REI team made up of board certified reproductive endocrinologists and OB/GYN residents (and fellows). They will participate in the outpatient and inpatient care of patients with infertility and other endocrine diagnoses. Students will, when appropriate, assist with specific procedures such as saline sonograms, hysterosalpingograms, and intrauterine inseminations. Students will participate with the team in the operating room, as well as, gain exposure to Assisted Reproductive Technologies (ART) such as in vitro fertilization. Other opportunities for education include morning report and departmental conferences. By the conclusion of the rotation the student should be able to:
1. Describe the hormonal changes in the normal and abnormal menstrual cycle and how these are impacted by other factors within the body and environment.
2. Demonstrate understanding of the basic infertility evaluation of both the male and female patient.
3. Develop a basic understanding of the evaluation and treatment options for polycystic ovarian syndrome, congenital uterine anomalies, amenorrhea, abnormal uterine bleeding, thyroid and prolactin issues, and endometriosis.

Course #: OBR 4220 General Obstetrics/Gynecology Clerkship

Duration: 4 weeks
Hours: 5
Grading: (Pass/Fail)
Course Description: Students will spend approximately 50% of their clerkship on the routine obstetrics service and the remaining time on the gynecology service. Their teams will be made up of OB/GYN residents at multiple levels of training and attending obstetrician/gynecologist. During this rotation, the students will participate in the care of patients in the inpatient and outpatient settings. While on L&D, they will participate in the evaluation of patients in triage, as well as, be involved in vaginal and cesarean deliveries. Other opportunities for education include morning rounds, departmental conferences, specialty clinics, dedicated time in the OR and time on the Labor and Delivery Unit. By the conclusion of the obstetrics portion of the rotation, the student should be able to:
1. Evaluate pregnant women presenting with common triage complaints including labor (term and preterm), third trimester bleeding, rupture of membranes (term and preterm), and hypertension.
2. Describe the normal course of labor, as well as, identify abnormalities that develop during labor.
3. Discuss the normal maternal physiologic changes of the postpartum period and counsel patients on post-partum care and contraception.
By the conclusion of the gynecology portion of the rotation, the student should be able to:
1. Evaluate women in clinic presenting for routine health maintenance and common gynecologic disorders.
2. Describe the key components of the pre-operative evaluation and planning, including history, physical examination, and informed consent.
3. Describe components of postoperative care, as well as, discuss common postoperative complications

Course #: OBR 4210 Labor and Delivery Days and Night Float

Duration: 4 weeks
Hours: 5
Grading: (Pass/Fail)
Course Description: Students will be an integral part of the Labor and Delivery Team. Their teams will be made up of OB/GYN residents at multiple levels of training and attending obstetrician/gynecologist. During this rotation, the students will participate in the care of patients in the inpatient and triage settings. While on L&D, they will participate in the evaluation of patients in triage, as well as, be involved in intrapartum and postpartum care. They will have the opportunity to participate in vaginal and cesarean deliveries. Other opportunities for education include morning rounds and departmental conferences. By the conclusion of the rotation, the student should be able to:
1. Evaluate pregnant women presenting with common triage complaints including labor (term and preterm), third trimester bleeding, rupture of membranes (term and preterm), and hypertension.
2. Describe the normal course of labor, as well as, identify abnormalities that develop during labor.
3. Discuss the normal maternal physiologic changes of the postpartum period and counsel patients on post-partum care and contraception.

Course #: OBR 4212 OB/GYN Subspecialty Combo

Duration: 4 weeks
Hours: 5
Grading: (Pass/Fail)
Course Description: This course code describes when students complete a rotation combining two subspecialties (e.g. Urogyn/Gyn Onc/MFM or any combination). 

II. Sub-Internships

Course #: OBR 4370 Gynecologic Oncology S.I.

Duration: 4 weeks
Hours: 8
Grading: (Honors/Pass/Fail)
Course Description: Students will be part of the gyn oncology team made up of gynecology oncology staff and OB/GYN residents (and fellows). They will participate in the outpatient and inpatient care of patients with pre-cancer, cancer or complex surgical cases as well as familial syndromes. Students will round daily with the team and be assigned primary responsibility for individual patients. Students will provide concise patient presentations daily in standard format. Students will participate in other educational opportunities including morning report, departmental conferences, and tumor planning conferences. Students will attend and, when appropriate, scrub on operative cases.
By the conclusion of the rotation the student should be able to:
1. Demonstrate understanding of the anatomy of the female pelvis and basic surgical principles (sterile technique, basic suturing, knot tying).
2. Describe signs, symptoms, risk factors, and basic evaluation of ovarian, cervical, endometrial, vulvar and vaginal cancer.
3. Describe the spectrum of treatment options for gynecologic cancer patients including surgery, chemotherapy, radiation, and palliative care.
4. Function as a productive and contributing member of the gyn onc team.

Course #: OBR 4375 Uro-Gynecology S.I.

Duration: 4 weeks
Hours: 8
Grading: (Honors/Pass/Fail)
Course Description: Students will be part of the UROGYN team made up of uro-gynecologists and OB/GYN resident (and fellows). They will participate in the outpatient and inpatient care of patients with pelvic floor disorders such as uterovaginal prolapse, urinary incontinence, and voiding dysfunction. Students will assist with diagnostic procedures, medical treatment, pre-operative and post-operative care of surgically managed patients. Students will participate in other educational opportunities including morning report, departmental conferences, and specialized uro-gynecology conferences. Students will attend and, when appropriate, scrub on operative cases. By the conclusion of the rotation the student should be able to:
1. List and describe main types of urinary incontinence (SUI, UUI, mixed UI) and basic management of each type.
2. Describe severity of pelvic organ prolapse.
3. List major risk factors for urinary incontinence and pelvic organ prolapse.

Course #: OBR 4310 Obstetrics/Gynecology S.I.

Duration: 4 weeks
Hours: 8
Grading: (Honors/Pass/Fail)
Course Description: Students will spend approximately 50% of their clerkship on the routine obstetrics service and the remaining time on the gynecology service. Their teams will be made up of OB/GYN residents at multiple levels of training and attending obstetrician/gynecologist. During this rotation, the students will participate in the care of patients in the inpatient and outpatient settings. While on L&D, they will participate in the evaluation of patients in triage, as well as, be involved in vaginal and cesarean deliveries. Other opportunities for education include morning rounds, departmental conferences, specialty clinics, dedicated time in the OR and time on the Labor and Delivery Unit. By the conclusion of the obstetrics portion of the rotation, the student should be able to:
1. Evaluate pregnant women presenting with common triage complaints including labor (term and preterm), third trimester bleeding, rupture of membranes (term and preterm), and hypertension.
2. Describe the normal course of labor, as well as, identify abnormalities that develop during labor.
3. Discuss the normal maternal physiologic changes of the postpartum period and counsel patients on post-partum care and contraception.
By the conclusion of the gynecology portion of the rotation, the student should be able to:
1. Evaluate women in clinic presenting for routine health maintenance and common gynecologic disorders.
2. Describe the key components of the pre-operative evaluation and planning, including history, physical examination, and informed consent.
3. Describe components of postoperative care, as well as, discuss common postoperative complications

Course #: OBR 4008 Minimally Invasive Surgery (MIS) or GYN Surgery S.I.

Duration: 4 weeks
Hours: 8
Grading: (Honors/Pass/Fail)
Course Description: Students will be a part of the gynecology team made up of board certified obstetrician-gynecologist and OBGYN residents (and MIS fellows). They will participate in the outpatient and inpatient care of patients with surgical gynecologic disorders to include the preoperative assessment, surgical procedure and post-operative care. Where applicable, students will learn the basic foundation of minimally invasive surgery. Additional opportunities for education include morning report and departmental conferences. The students will attend and, when appropriate, scrub on operative cases. By the conclusion of the rotation the student should be able to:
1. Describe the pelvic anatomy, both internal and external with emphasis on blood supply, ureteral location, and retroperitoneal anatomy.
2. Describe the principal causes, diagnostic evaluation, surgical and non-surgical treatment options, and appropriate follow-up in the management of patients with abnormal uterine bleeding, pelvic masses, chronic pelvic pain, and endometriosis.
3. Describe common measures for the prevention of infection, deep venous thrombosis, and other peri-operative complications.
4. Describe when the use of laparoscopy versus open procedures is most appropriate.

Course #: OBR 4006 Reproductive Endocrinology & Infertility S.I.

Duration: 4 weeks
Hours: 8
Grading: (Honors/Pass/Fail)
Course Description: Students will be part of the REI team made up of board certified reproductive endocrinologists and OB/GYN residents (and fellows). They will participate in the outpatient and inpatient care of patients with infertility and other endocrine diagnoses. Students will, when appropriate, assist with specific procedures such as saline sonograms, hysterosalpingograms, and intrauterine inseminations. Students will participate with the team in the operating room, as well as, gain exposure to Assisted Reproductive Technologies (ART) such as in vitro fertilization. Other opportunities for education include morning report and departmental conferences. By the conclusion of the rotation the student should be able to:
1. Describe the hormonal changes in the normal and abnormal menstrual cycle and how these are impacted by other factors within the body and environment.
2. Demonstrate understanding of the basic infertility evaluation of both the male and female patient.
3. Develop a basic understanding of the evaluation and treatment options for polycystic ovarian syndrome, congenital uterine anomalies, amenorrhea, abnormal uterine bleeding, thyroid and prolactin issues, and endometriosis.

Course #: OBR 4009 Labor and Delivery Days and Night Float S.I.

Duration: 4 weeks
Hours: 8
Grading: (Honors/Pass/Fail)
Course Description: Students will be an integral part of the Labor and Delivery Team. Their teams will be made up of OB/GYN residents at multiple levels of training and attending obstetrician/gynecologist. During this rotation, the students will participate in the care of patients in the inpatient and triage settings. While on L&D, they will participate in the evaluation of patients in triage, as well as, be involved in intrapartum and postpartum care. They will have the opportunity to participate in vaginal and cesarean deliveries. Other opportunities for education include morning rounds and departmental conferences. By the conclusion of the rotation, the student should be able to:
1. Evaluate pregnant women presenting with common triage complaints including labor (term and preterm), third trimester bleeding, rupture of membranes (term and preterm), and hypertension.
2. Describe the normal course of labor, as well as, identify abnormalities that develop during labor.
3. Discuss the normal maternal physiologic changes of the postpartum period and counsel patients on post-partum care and contraception.

Course #: OBR 4014 OB/GYN Subspecialty Combo  S.I. 

Duration: 4 weeks
Hours: 8
Grading: (Pass/Fail)
Course Description: This course code describes when students complete a rotation combining two subspecialties (e.g. Urogyn/Gyn Onc, REI/MIS, Gyn Onc/MFM or any combination). 

Department Website: PED

I. Sub-Internships

Course #: PDR 4632 Pediatric Ward S.I.

Duration: 4 weeks

Hours: 5

Grading: (Honors/Pass/Fail)

Sites:  Wright-Patterson, Madigan, San Diego, San Antonio (=SAMMC), Portsmouth, Tripler, NCC-WRNMMC

Course #: PDR 4381 Neonatal Intensive Care Unit (NICU) S.I.

Duration: 4 weeks Hours: 5

Grading: (Honors/Pass/Fail)

Sites:  Wright-Patterson, Madigan, San Diego, San Antonio, Portsmouth, Tripler, NCC-WRNMMC

Course #: PDR 4631 Pediatric Intensive Care Unit (PICU) S.I.

Duration: 4 weeks

Hours: 5

Grading: (Honors/Pass/Fail)

Sites:  Wright-Patterson, Madigan, San Diego, Portsmouth, Tripler, NCC-WRNMMC

Course #: PDR 4038 Newborn Service S.I.

Duration: 4 weeks Hours: 5

Grading: (Honors/Pass/Fail)

Site: Portsmouth

II. Electives

Course #: PDR 4670 Pediatric Ward

Duration: 4 weeks

Hours: 5

Grading: (Pass/Fail)

Sites: Wright-Patterson, Madigan, San Diego, San Antonio, Portsmouth, Tripler, NCC-WRNMMC

Course #: PDR 4380 Neonatal Intensive Care Unit

Duration: 4 weeks

Hours: 5

Grading: (Pass/Fail)

Sites:  Wright-Patterson, Madigan, San Diego, Portsmouth, Tripler, NCC-WRNMMC

Course #: PDR 4224 Pediatric Intensive Care Unit

Duration: 4 weeks

Hours: 5

Grading: (Pass/Fail)

Sites: Portsmouth, San Diego, Madigan

Course #: PDR 4300 Adolescent Medicine

Duration: 4 weeks

Hours: 5

Grading: (Pass/Fail)

Sites:  Wright-Patterson, Madigan, San Diego, San Antonio, Portsmouth, Tripler, NCC-WRNMMC

Course #: PDR 4310 Ambulatory Pediatric Clinic

Duration: 4 weeks

Hours: 5

Grading: (Pass/Fail)

Sites:  Wright-Patterson, Madigan, San Diego, San Antonio, Portsmouth, Tripler, NCC-WRNMMC

Course #: PDR 4238 Child Advocacy/Child Abuse and Neglect

Duration: 4 weeks

Hours: 5

Grading: (Pass/Fail)

Site:  NCC-WRNMMC

Course #: PDR 4330 Developmental Pediatrics

Duration: 4 weeks

Hours: 5

Grading: (Pass/Fail)

Sites: Madigan, San Diego, San Antonio, Portsmouth, Tripler, NCC-WRNMMC

Course #: PDR 4430 Pediatric Cardiology

Duration: 4 weeks

Hours: 5

Grading: (Pass/Fail)

Site: Wright-Patterson, Madigan, San Diego, San Antonio, Portsmouth, Tripler, NCC-WRNMMC

Course #: PDR 4450 Pediatric Endocrinology

Duration: 4 weeks

Hours: 5

Grading: (Pass/Fail)

Site: Wright-Patterson, Madigan, San Diego, San Antonio, Portsmouth, Tripler, NCC-WRNMMC

Course #: PDR 4802 Pediatric Dermatology

Duration: 4 weeks

Hours: 5

Grading: (Pass/Fail)

Sites: NCC-WRNMMC

Course #: PDR 4460 Pediatric Gastroenterology

Duration: 4 weeks

Hours: 5

Grading: (Pass/Fail)

Site: Wright-Patterson, Madigan, San Diego, San Antonio, Portsmouth, Tripler, NCC-WRNMMC

Course #: PDR 4470 Pediatric Genetics

Duration: 4 weeks

Hours: 5

Grading: (Pass/Fail)

Site: Wright-Patterson, Madigan, San Diego, San Antonio, Portsmouth, Tripler, NCC-WRNMMC

Course #: PDR 4480 Pediatric Hematology/Oncology

Duration: 4 weeks

Hours: 5

Grading: (Pass/Fail)

Site: Wright-Patterson, Madigan, San Diego, San Antonio, Portsmouth, Tripler, NCC-WRNMMC

Course #: PDR 4490 Pediatric Infectious Disease

Duration: 4 weeks

Hours: 5

Grading: (Pass/Fail)

Site: Wright-Patterson, Madigan, San Diego, San Antonio, Portsmouth, Tripler, NCC-WRNMMC

Course #: PDR 4510 Pediatric Nephrology

Duration: 4 weeks

Hours: 5

Grading: (Pass/Fail)

Site: Tripler, NCC-WRNMMC

Course #: PDR 4520 Pediatric Neurology

Duration: 4 weeks

Hours: 5

Grading: (Pass/Fail)

Site:  Madigan, San Diego, San Antonio, Portsmouth, Tripler, NCC-WRNMMC

Course #: PDR 4543 Introduction to Pediatric Residency

Duration: 4 weeks

Hours: 5

Grading: (Pass/Fail)

Site: SAMMC, MAMC, Tripler, Wright Patterson

Course #: PDR 4610 Pediatric Pulmonology

Duration: 4 weeks

Hours: 5

Grading: (Pass/Fail)

Site: Wright-Patterson, Madigan, San Diego, San Antonio, Portsmouth, Tripler, NCC-WRNMMC

Course #: PDR 4670 Pediatric Ward

Duration: 4 weeks

Hours: 5

Grading: (Pass/Fail)

Site: Wright-Patterson, Madigan, San Diego, San Antonio, Portsmouth, Tripler, NCC-WRNMMC

Course #: PDR 4660 Well Baby Nursery/Newborn Service

Duration: 4 weeks

Hours: 5

Grading: (Pass/Fail)

Site: Madigan, San Diego, San Antonio, Portsmouth, Tripler

III. Research

Course #: PDR 4127 Media Communication in Health Care

Duration: 4 weeks

Hours: 5

Grading: (Pass/Fail)

Description: During this four week elective, students will participate in ten (10) face to face 90 minute sessions to experience multiple methods of communication and media. The course is open to all USU students who will be responsible for up to 10 outside hours of preparation and reading per lesson. The inter-professional teaching staff will develop student media use and guide them in improving their communication skills.

Site: USUHS

Course #: PDR 4056 Pediatric Humanitarian Medicine

Duration: 4 weeks

Hours: 5

Grading: (Pass/Fail)

Description: Students will participate in a pediatric nutrional screening mission in Houduran villages with JTF-B. Rotation will include pre-mission brefings, review of previous mission data, force & medical protection assesssments, performing & analyzing nutrition assessments, and delivering a post-mission brief.

Site: USUHS

Department Website: PMR 

Course#: PMR4215 Physical Medicine And Rehabilitation 

Duration: 4

Hours: 5

Grading: (Pass/Fail) 

Description: Students will rotate on both outpatient/inpatient physical medicine consultation svcs. Evaluate & participate in mgmnt of common neurological, neurosurgical & musculoskeletal practice areas of physiatry, including stroke, spinal cord trauma & acute/chroni. 

Point of Contacts: 

Dr. Nelson Hager 

nelson.hager@usuhs.edu

Jacob Gylling 

jacob.gylling@usuhs.edu 

Department Website: PMB

Please submit all PMB 4^TH Year Elective Rotation Evaluations to the following person: 

Andy Chern
CPT, MC, USA
andy.chern@usuhs.edu

Course #: PMR4100, Aerospace Medicine

Duration: 2-4 Weeks
Hours: Variable
Grading: Pass/Fail

Aerospace medical practitioners serve flyers, passengers, space travelers, air traffic controllers, patients transported by air, maintenance crews, and even mountain climbers and undersea workers. The diverse and expanding opportunities in the field make a career in aerospace medicine attractive for health professionals.

The Army, Navy, and Air Force have aerospace medicine residency programs and offer opportunities for medical student training. NASA also offers medical student clerkships on a space available basis. To learn more about military aerospace medicine and current medical student opportunities, contact any of the individuals or resources below.

NOTE: This elective is separate from the service-specific flight surgeon courses. More information regarding the flight surgeon courses can be found through the Department of Military and Emergency Medicine and Operational Medicine course catalog.

Specific sites are listed below, but other sites are potentially available if student coordinated.

Army at Fort Rucker

John Venezia, DO, MPH, MA
MAJ, MC(SFS), USA
Program Director, Army Aerospace Medicine Residency
Fort Rucker, AL
john.j.venezia2.mil@mail.mil

Joe Pavelites, MD, PhD, MPH
MAJ, MC(SFS), USA
Associate Program Director, Army Aerospace Medicine Residency
Fort Rucker, AL
joseph.j.pavelites.mil@mail.mil

Navy at Pensacola

Kai Cheng, DO
LCDR, MC(FS), USN
Department Head, Internal Medicine
Naval Aerospace Medicine Institute
Pensacola, FL
Phone:  850-452-2941
Kai.y.cheng.mil@mail.mil

Air Force at Wright-Patterson Air Force Base

Doug Files, MD
Wright-Patterson Air Force Base, OH
Phone:  937-938-3222
douglas.files.3.ctr@us.af.mil

NASA at Houston

The NASA rotation is predominantly non-clinical. This specific rotation requires a formal application submission through the NASA organization. More information can be found here.

Course #: PMR4170, Occupational and Environmental Medicine

Duration: 2-4 weeks
Hours: 5
Grading: Pass/Fail
Student works at a major Military Treatment Facility. The student obtains hands-on experience in occupational & environmental medicine activities to include identification of hazards in the workplace through site visits, hazard specific medical surveillance exams, and the evaluation of persons with occupational illness or injury. The student will develop an understanding of the role of prevention in maintaining the health of the workforce.

Specific sites are listed below, but other sites are potentially available if student coordinated.

Walter Reed National Military Medical Center 

Michael D’Onofrio, MD, MPH
MAJ, MC, USA
Chief, Occupational Health
michael.j.donofrio.mil@mail.mil

Course #: PMR4180, Preventive Medicine

Duration: 2-4 weeks
Hours: 5
Grading: Pass/Fail
Description: Student participates directly in the practice of Preventive Medicine and obtain first-hand exposure to the diverse aspects of Preventive Medicine and Public Health in the military. Student joins the Preventive Medicine residency team at USU assisting on new or ongoing projects varying from outbreak investigations and epidemiologic research to healthy policy recommendations. Students may additionally evaluate patients in a Preventive Medicine and Public Health capacity.

Specific sites are listed below, but other sites are potentially available if student coordinated.

Walter Reed National Military Medical Center

Robert J. Lipsitz, MD, MPH, MA
CAPT, MC, USN
Chief, Direct Patient Care
robert.lipsitz@usuhs.edu
robert.j.lipsitz.mil@mail.mil

Course #: PMR4200, Tropical Medicine

Duration: Variable 
Hours: 5
Grading: Pass/Fail

Description: Laboratory, clinical, and/or fieldwork in Tropical Medicine/Tropical Public Health. Clinical experiences vary from outpatient services to inpatient rounds in collaborating hospitals and clinics. Laboratory experiences may be at USU or at collaborating overseas labs. Clinical emphasis is on diagnosis & treatment of tropical diseases endemic to elective location (locations vary). See PMB Division of Tropical Public Health for more details.

Comments: Clerkship must first be by approved six months in advance of desired date by Capstone Program Director. Potential student funding available but not guaranteed.

For additional information or potential interest in an elective site in our Department not specifically listed above, please contact the corresponding individual(s):

Occupational & Environmental Medicine

Pamela L. Krahl, MD, MPH
CAPT, MC, USN
Director & Assistant Professor

USU Occupational & Environmental Medicine Residency Program
Phone:  301-295-3718
pamela.krahl@usuhs.edu

Andy Chern, MD, MPH
CPT(P), MC, USA
Associate Director & Assistant Professor

USU Occupational & Environmental Medicine Residency Program
Phone:  301-295-9773
andy.chern@usuhs.edu

General Preventive Medicine

Catherine Takacs Witkop, MD, MPH
Col, USAF, MC
Director & Professor

USU General Preventive Medicine Residency Program
Phone:  301-295-3719
catherine.witkop@usuhs.edu

Tammy Servies, MD, MPH
CDR, MC, USN
Associate Director & Assistant Professor

USU General Preventive Medicine Residency Program
Phone:  301-295-0263
tammy.servies@usuhs.edu

Robert Lipsitz, MD, MPH, MA
CAPT, MC, USN
Chief, Direct Patient Care

USU General Preventive Medicine Residency Program
Phone 301-295-7945
robert.lipsitz@usuhs.edu
robert.j.lipsitz.mil@mail.mil

Kevin Taylor, MD, MPH
LTC, MC, USA
Assistant Professor

Uniformed Services University of the Health Sciences
Phone:  301-319-9218

kevin.m.taylor4.mil@mail.mil

Paul Faestel, MD, MPH
LTC, MC, USA
Director

Residency in Aerospace Medicine (RAM) Program
Fort Rucker, AL
john.j.venezia2.mil@mail.mil

Joe Pavelites, MD, PhD, MPH
MAJ, MC(SFS), USA
Director

Occupational & Environmental Medicine Residency Program (through RAM)
Fort Rucker, AL
joseph.j.pavelites.mil@mail.mil

Navy Aerospace Medicine
Nathan Almond
CAPT, MC(FS), USN
Director

Residency in Aerospace Medicine (RAM) Program
Pensacola, FL
nahaniel.b.almond.mil@mail.mil

Department Website: SUR

Advanced Clinical Rotations

Students are required to complete at least two 4 week patient care (clinical) rotations in a surgical specialty as a requirement for graduation. These rotations may be completed either under the auspices of the Department of Surgery or the Department of Obstetrics and Gynecology. One of the rotations is required to meet the requirements as a sub internship with inpatient care.

Advanced surgical clerkship and sub internship students are expected to expand on the general familiarity of the entire surgical experience gained during the core clerkship, and increase knowledge and independent practice skill sets in preparation to become a house officer. At a minimum, students should complete the surgical curriculum as an educated consumer of surgical resources. This includes membership on the "surgical team" with full participation in all activities of the team. These activities will include inpatient and outpatient evaluation, treatment planning, discussions concerning decision-making, preoperative evaluation, operative experience, post-operative care, surgical rounds, and surgical conferences. Students on surgical rotations must scrub and assist in procedures. Formal teaching will include grand rounds, daily lectures, journal clubs, teaching conferences, and bedside clinical instruction.

Surgical Sub internships

Sub internships differ from standard rotations in that the learning objectives fall under two separate but equally important categories 1) gaining knowledge, skills, and experience related to the clinical specialty and 2) developing competency in core practical skills required of a house officer (e.g. caring for inpatients, evaluating and admitting patients to the service, and taking call). Students on SUBI rotations are expected to perform as closely as possible to the level of a PGY 1. The rotation must include the daily care of inpatients, and call for the student at the same frequency as the most junior resident on the service who takes overnight call. Submission of a completed patient log is required.

Elective Courses (Courses with an * have a related SUBI listing)

All Elective courses are Duration: 4 weeks, Hours: 5, Grading: Pass/Fail

SUR 4400 General Surgery*

Participate as a member of a general surgical team, providing inpatient, outpatient, and emergency surgical care.

WRNMMC

SAMMC

FBCH

MGMC

Eisenhower Fort Gordon

Landstuhl

MAMC

TAMC

WBAMC (Fort Bliss)

WOMAC (Fort Bragg)

DGMC (Travis AFB)

Keesler

Wright Patterson

Nellis

NMCSan Diego

NMCPortsmouth

SUR 4420 Cardiothoracic Surgery*

Participate in surgical treatment of patients with a wide spectrum of heart and pulmonary diseases, including open heart surgery. Students will master the cardiac examination and clinical adjuncts.

WRNMMC

SAMMC

MAMC

TAMC

DGMC

NMCSD

NMCP

SUR 4440 Burn Intensive Care Unit*

Participate in total care of burn patients; involving invasive monitoring, fluid resuscitation, metabolic/nutritional support, and surgical therapy of wounds.

SAMMC

Washington Hospital Center

SUR 4460 Vascular Surgery*

Participate in the preoperative evaluation, diagnosis and management, and operative treatment of vascular disease. Students will master the vascular examination.

WRNMMC

SAMMC

MAMC      

TAMC

DGMC

NMCSD

NMCP

SUR 4480 Renal Transplantation Rotations

Participate as members of a multidisciplinary patient care team, including nephrologists, surgeons, transplant nurse, social workers, dialysis nurse, and immunologists. Includes exposure to transplantation immunology, histocompatibility, and immuno-suppression, as well as transplant harvest and surgical transplantation.

 WRNMMC

SUR 4510 Pediatric Surgery*

Exposure to various aspects of pediatric surgical care to include of neonatal surgical diseases.

WRNMMC

NMCSD

NMCP

Children’s National Medical Center

SUR 4530 Sports Orthopedics

Students master a thorough examination of extremities and the operative management of sports injuries; topics include response to soft tissue injury, fractures, and orthopedic traumatology.

USMA (Keller)

SUR 4550 Ophthalmology

Introduction to external eye examinations, visual acuity measuring techniques, intraocular pressure measurement, neuro-ophthalmologic examination, slit lamp examination, fundoscopy, and ocular examination in eye injuries.

WRNMMC

SAMMC

FBCH

LRMC

MAMC

TAMC

DGMC

NMCSD

NMCP

SUR 4570 ENT*

Exposure to infections and inflammatory diseases of the head and neck, head and neck oncology, traumatology, reconstructive surgery, and otologic diseases and rehabilitation thereof.

WRNMMC

SAMMC

FBCH

Eisenhower AMC (Fort Gordon)

LRMC

MAMC

TAMC

DGMC Travis

USAFA

NMCP

NMCSD

SUR 4620 Urology*

Evaluation, and medical and surgical management of the urinary tract and the male genital tract.

WRNMMC

SAMMC

FBCH

MAMC

TAMC

DGMC

NMCSD

NMCP

***UTHSCSA (University of Texas Health Science Center San Antonio (REQUIRES 114)

SUR 4640 Orthopedic Surgery*

Students master a thorough examination of extremities and the operative management of orthopedic conditions. 

WRNMMC

SAMMC

FBCH

EAMC (Fort Gordon)

LRMC

MAMC

TAMC

WBMC (Fort Bliss)

WOMAC ( Fort Bragg)

Martin ACH (Fort Benning)

Fort Mead (KACC)

DGMC (Travis)

Keesler

USAFA

NMCP

NMCSD

SUR 4660 Plastic Surgery*

Exposure to the field of aesthetic surgery with some experience in the management of ordinary minor surgical problems, reconstructive surgery of trauma and congenital anomalies, and tissue transplantation techniques.

WRNMMC

SAMMC

FBCH

EAMC (FORT GORDON)

TAMC

WBAMC (Fort BLISS)

DGMC

KEESLER

NMCP

NMCSD

SUR 4690 Trauma Surgery*

Member of a Trauma Team, with exposure to initial evaluation and resuscitation, and a wide perspective of trauma care/systems; from epidemiology of injury, to life-saving procedures.

WRNMMC

SAMMC

**SCRIPPS MERCY SAN DIEGO – REQUIRES 114 APPROVAL

UMD shock Trauma

Washington Hospital Center 

SUR 4720 Surgical ICU/Med SURG ICU*

Member of a Critical Care Team, with exposure to care issues such as ethical considerations, management of ventilators, ongoing resuscitations, drugs used in the ICU setting, and placement of invasive lines for monitoring.

WRNMMC

SAMMC

EAMC (FORT GORDON)

TAMC

WBAMC (FORT BLISS)

DGMC (TRAVIS)

NMCSD

Washington Hospital Center 

SUR 4750 Neurosurgery*

Exposure to evaluating patients with a variety of neurological complaints, in order to enhance skills in performing neurological exams, and in formulating/evaluating appropriate differential diagnostic possibilities.

WRNMMC

SAMMC

MAMC

TAMC

DGMC (TRAVIS)

NMCSD

NMCP

***UTHSCSA (University of Texas Health Science Center San Antonio (REQUIRES 114)

SUR 4755 Community Multi-Specialty Surgery (FORM 114 REQUIRED)

Students participate in treating patients in multiple surgical specialties in a small hospital setting, gaining exposure to a broad spectrum of procedures and techniques. Prior Department approval is necessary for this rotation.

AS SCHEUDLED VIA FORM 114

SUR 4758 International Surgery (FORM 114 REQUIRED)

Students gain surgical experience at an international location. This experience is often multispecialty, with students participating in a variety of patient care settings and procedures. Prior department approval is necessary for this rotation.

AS SCHEUDLED VIA FORM 114

SUBI Courses

SUBI courses are Duration: 4 weeks, Hours: 8, Grading: Honors/Pass/Fail
Goal: Gain experience in procedures appropriate for the students’ level of training, improve manual dexterity in surgical technical skills, and experience house officer responsibilities (including call). Students will be expected to perform at near intern level by the end of the rotation. See the corresponding elective course listing for a description of the targeted learning objectives and experiences.

SUR 4410 General Surgery SUBI

WRNMMC

SAMMC

FBCH

Eisenhower Fort Gordon

MAMC

TAMC

WBAMC (Fort Bliss)

WOMAC (Fort Bragg)

DGMC (Travis AFB)

Keesler

Wright Patterson

Nellis

NMCSan Diego

NMCPortsmouth

SUR 4430 Cardiothoracic Surgery SUBI

WRNMMC

SAMMC

MAMC

TAMC

DGMC

NMCSD

NMCP

SUR 4450 Burn Intensive Care Unit SUBI

SAMMC

Washington Hospital Center

SUR 4470 Vascular Surgery SUBI

 WRNMMC

SAMMC

MAMC

TAMC

DGMC

NMCSD

NMCP

SUR 4520 Pediatric Surgery SUBI

WRNMMC

NMCSD

NMCP

Children’s National Medical Center

SUR 4581 ENT SUBI

WRNMMC

SAMMC

MAMC

TAMC

NMCP

NMCSD

SUR 4630 Urology SUBI

WRNMMC

SAMMC

MAMC

TAMC

NMCP

NMCSD

***UTHSCSA (University of Texas Health Science Center San Antonio (REQUIRES 114)

SUR 4650 Orthopedic Surgery SUBI

WRNMMC

SAMMC

EAMC (Fort Gordon)

MAMC

TAMC

Martin ACH (Fort Benning)

NMCP

NMCSD

SUR 4670 Plastic Surgery SUBI

WRNMMC

SAMMC

NMCSD

NMCP

SUR 4700 Trauma Surgery SUBI

WRNMMC

SAMMC

***SCRIPPS MERCY SAN DIEGO – REQUIRES 114 APPROVAL

UMD shock Trauma

Washington Hospital Center 

SUR 4710 Surgical ICU/Med SURG ICU SUBI

WRNMMC

SAMMC

EAMC (FORT GORDON)

TAMC

NMCSD

Washington Hospital Center 

SUR 4760 Neurosurgery SUBI

WRNMMC

***UTHSCSA (University of Texas Health Science Center San Antonio (REQUIRES 114)