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. McManamon 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 #: MDR4126, Internal Medicine Consult and Triage Rotation ("Phoenix")
Department: Internal Medicine
Duration: 4 weeks
Hours: 8
(Letter/Pass/Fail): P
Description: Clerks will see follow-up, walk-in, semi-urgent, and 72 hour consultations referred to the internal medicine clinic and inpatient internal medicine consultations, working together with a resident and faculty internist. Clerks will also work with an internal medicine resident under the supervision of a faculty general internist to help to evaluate and triage inpatient admission/transfers to the internal medicine ward teams from 0800-1200. 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 medical problems, interpret laboratory and other diagnostic testing, develop management plans for their assigned patients, and ultimately develop a rational approach to caring for similar patients in the future.
Unique Objectives:
1) Correctly interpret diagnostic studies including laboratory studies, radiographic images 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 diagnoses such as hypertension, headaches, abdominal pain, acute gastrointestinal bleeding, acute renal failure, altered mental status, arrhythmias, chest pain, electrolyte disorders, fever, poor glycemic control, gastrointestinal symptoms, pain management, respiratory distress, and seizures
Site: WRNMMC
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, Pallative 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.
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.
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 #: 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 #: MDR4799, Medicine Clinic (Pentagon)
Duration: 4
Hours: 5
Description: DiLorenzo TRICARE Health Clinic (DTHC) is a multi-specialty clinic at the Pentagon that serves the health and wellness of over 23,000 personnel including the highest ranking echelons of the Department of Defense. Clerks will have the opportunity to see patients in a standard Patient Centered Medical Home (PCMH) as well as working with subspecialties including cardiology, flight medicine, and travel medicine. In addition, DTHC has some unique opportunities including an Acute Care Clinic and the Emergency Response Team (ERT)-- responding to all medical emergencies within the Pentagon Reservation. Finally, students may participate in Mass Casualty training and exercises. 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.
Unique Objectives:
1) 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 evaluation of patients presenting 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, seizures, and basic musculoskeletal injuries.
4) Understand basics of an emergency response and procedures to initiate patient transfer to higher level of care.
5) Gain exposure to planning and implementation of a Mass Casualty Response as well as to the principles of Medical Readiness and deployability within the military.
IV. Research Opportunities
Course List
Course #: MDR4610, 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 #: MDR4620, 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 #: MDR4630, 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 #: MDR4660, 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).
