Elective Clerkships

It is recommended to conduct elective rotations once all core clerkships have been completed. At this time the student has a better insight of which specialty they prefer to excel in and can choose to do additional rotations in that specialty to gain more knowledge and experience. Elective rotations can be done in-between core rotations after at least one core rotation has been completed if the student prefers. Elective rotations either be 2 weeks, 4 weeks, or 6 weeks in duration; depending on the interest of the student for that specialty.

Anesthesiology

  • The Anesthesiology elective rotation is intended to allow students to observe and participate in the administration of inpatient and outpatient operative anesthesia, obstetrical anesthesia, and the diagnosis and management of chronic pain syndromes.
  • The student, under the close supervision of the attending physician, will participate in the administration of inhalation and conduction anesthesia and the use of diagnostic and therapeutic regional anesthetic techniques. The students gain knowledge in the preoperative evaluation, and the physiological and pharmacological management of the patient undergoing surgery. The students will pay close attention to airway management, monitoring techniques, interpretation of laboratory values obtained intraoperatively and the pharmacology of the anesthetic agents and other drugs used in patient management.

Cardiology

  • The objective of the cardiology elective is to improve student’s basic understandings of the cardiovascular system and diseases. Students will learn how to appropriately consult patients with cardiovascular health problems and perform a complete history and physical. Students are involved in following their cases through cardiac investigations including stress test, echocardiogram and cardiology catheterization.
  • Students should have an accurate understanding of electrocardiograms and be able to interpret them appropriately. Students will also be exposed to cases involving murmurs where they should be able to appreciate each heart sound and determine the cause of the murmur. Students will gain the ability to evaluate venous and arterial pulses and diseases that impact the cardiovascular system. Through the elective they should be able to determine the different types of arrhythmias and appropriate treatment for each.

Cardiovascular Surgery

  • During the cardiovascular surgery elective students will function as an integral member of the team in the work-up and management of patients with cardiac, vascular and thoracic diseases. They will be given the opportunity to go to the cardiac catheter lab, the respiratory lab, the vascular radiology lab, the intensive care unit as well as to the operating room where they will be part of the surgical team.
  • Students will be closely supervised by a member of the cardiac surgery department including the attending physician as well as the entire surgical team. The students will develop an in-depth understating for the cardiovascular anatomy and physiology and the impact disease has on the normal cardiovascular system. They will also develop an increasing awareness of the treatment and outcome for the most frequent cardiac diseases.

Colon and Rectal Surgery

  • During the colon and rectal elective importance is brought upon a through understanding of the anatomy of the colon and rectum as well as pathophysiology of colon and rectal diseases. Students should be able to identify different areas of the colon, important anatomical landmarks as well as any visible abnormalities during the surgeries.
  • Students will have the opportunity to be involved in patient consultations during which time a post-operative as well as pre-operative patient note needs to be taken. Students should learn how to properly perform a rectal examination using the appropriate methods. Ability to differentiate between an abnormal and normal rectum by rectal examination should be demonstrated as well as ability to diagnose the cause of the abnormality.

Dermatology

  • During the dermatology elective, the student will be exposed to the many aspects of dermatologic diagnosis and treatments. The students will become familiar with conventional therapy and diagnostic techniques including: KOH exam, gram stain, cosmetic surgery and dermatologic laser. Students will be able to conduct consultations in an in-patient setting.
  • At the end of the general dermatology elective, students will be able to properly perform a history and physical examination of patients with skin diseases, recognize and treat common skin conditions. Students will be exposed to patients of a variety of ages with various skin conditions including moderate to severe acne, SLE and rosacea.

ENT (Ear, Nose, Throat - Otolaryngology)

  • An ENT elective is more complex then the rest as it involves the ear, nose and throat with which there is a broad range of diseases. The students will be in a clinical setting where they will learn how to asses each patients chief complaint, be able to take a full history and rule out the specific cause.
  • The students should gain knowledge upon performing accurate head and neck exams, management of otolaryngologic emergencies including upper airway obstruction. They will also be exposed to cases involving facial fractures and rhinology. By the end of the elective they should be able to discuss and identity appropriate treatment plans.

Gastroenterology

  • The gastroenterology elective is usually based upon a clinical inpatient setting. During this elective students will be exposed to endoscopic procedures conducted by gastroenterologists allowing them to grasp concepts regarding the most commonly seen gastrointestinal diseases.
  • Through out the rotation students should develop clinical skills to assess patients with GI disorders. They should gain knowledge and demonstrate appropriate choice of labs to order, tests to be conducted and procedures needed to diagnose GI disorders. They should also be able to appropriately consult patients prior to a procedure as well as after regarding any diet restrictions and discharge instructions.

Hematology

  • During the hematology elective students will participate closely with the hematology consultation team. The student will have the opportunity to evaluate in-patients on the wards as well as out-patients in the clinics with a variety of hematologic problems. These problems include the evaluation and treatment of patients with anemia, thrombocytopenia, enlarged lymph nodes or spleen, bleeding and clotting disorders, and other abnormalities of the blood
  • Hematologists also manage chemotherapy for the treatment of hematologic malignancies. They prescribe blood product administration and removal of excess blood components as needed for a variety of blood disorders. The student is expected to be an active participant in patient evaluations and consultations, familiarize themselves with associated laboratory abnormalities, and assist in patient follow up.

Neonatology/Perinatolgy

  • During the neonatology elective the student will gain understanding of the most common diseases of newborn infants and the best possible treatments available. Students under the supervision of the attending neonatologist are to be involved in the care of premature low birth weight infants with their multiple complicating disease processes. Full term infants are also referred for care with complications such as: perinatal asphyxia, jaundice, neonatal sepsis, congenital heart disease or major congenital malformations requiring surgical repair.
  • Students can also attend daily patient care rounds to observe the many critical aspects involved in the comprehensive neonatal intensive care. Throughout the rotations students should grasp a thorough understanding of normal and abnormal fetal development as well as the transitions from intrauterine to extrauterine environment.

Nephrology

  • The nephrology elective can be based in both an inpatient as well as outpatient setting. Students will come across a variety of cases during their nephrology elective including patients with acid-base disorders, electrolyte and metabolic disorders as well as chronic and acute renal diseases.
  • During this time students should understand the importance and ability to communicate effectively with patients regarding their disorders. They should also be able to draw out a differential diagnosis, determine the best next step in management and discuss each case with their attending physician. Students may also be asked to compose presentations on some of the above-mentioned cases as well as any seen during the clerkship.

Neurology

  • The neurology elective is designed to provide students with a thorough insight regarding the most commonly seen neurological problems. The emphasis of this elective is on neurological localization, diagnosis and management. The student is expected to conduct a complete a thorough neurological examination on each patient seen both in an inpatient setting as well as outpatient. This will allow them to expand their knowledge regarding tests to order, imaging studies as well as newer treatments available.
  • The student is expected to present each case to the attending physician in detail along with any physical examination findings. By the end of the elective the student should have build upon their basic science knowledge and physical examination skills. The student is also expected to compile a detail oriented patient note.

Ophthalmology

  • The ophthalmology elective is a combined surgery/clinic elective. Emphasis is given to the clinical aspect of this elective. Students are expected to have a strong and thorough knowledge regarding the anatomy and physiology of the eye as well as eye movements. Students should grasp the concept of taking a good history, measuring the visual acuity, proficient use of the slit lamp and ophthalmoscope as well as physical examination of the eye.
  • Students are expected to observe any eye surgeries that take place during the elective, learn how to differentiate between various eye diseases as well as treatment plans for each.

Radiology

  • The radiology elective is structured to provide a detailed overview of diagnostic imaging, invasive radiology and fundamentals of radiology. Students will develop an understanding of the types of studies that are available. They will also gain an understanding of clinical indications for obtaining studies, the risks/benefits of radiological procedures and the technical aspect of how examinations are performed.
  • Prior to completion of the rotation students will gain an insight into the diagnostic limitations of imaging studies. They will learn to know the difference between each of the imaging specialties and the operation of these procedures.

Respirology

  • During the respirology elective students will gain experience in the assessment and management of acute and chronic respiratory diseases. Each student is required to have an understanding of the basic and more complex respiratory diseases. Students will be exposed to cases including acute bronchitis, asthma, chronic obstructive pulmonary disease, and respiratory distress syndrome.
  • Through the elective students will have direct patient care and consultations and increase their knowledge of respiratory diseases. They will also enhance their skills in pulmonary function tests and chest radiograph interpretation.

Rheumatology

  • The rheumatology elective allows the student to be exposed to a wide range of rheumatic disorders to improve their skills in history taking, musculoskeletal examination and differential diagnosis. Students will be exposed to common technical procedures such as joint aspiration and injection as well as crystal analysis by polarizing microscopy. Students will also be expected to participate in the patient consultation service for both inpatient and outpatient.
  • Throughout the elective the student should become more comfortable with the overall approach to the rheumatic patient with an emphasis on improved skills in the musculoskeletal exam.  Students should be better able to differentiate inflammatory from degenerative diseases, interpret laboratory tests and be able to generate differential diagnoses and management plans for patients suffering from a wide variety of rheumatic diseases. 

Trauma

  • The objective of the trauma elective is to provide the students with the opportunity to apply the basic physiology and pathology learned to the critically ill patient in a fast paced working environment. Some of the issues that will be addressed include: ventilator management, management of ARDS, electrolyte and acid base diseases, renal replacement therapy, pain management, spinal cord injury management and head injury management.
  • Students will participate in the Intensive care unit (ICU), multi-trauma ICU and neuro-trauma ICU. This gives students the opportunity to participate in procedures such as central lines, arterial lines, and pulmonary artery catheter insertion under the direct supervision of the attending physician.

Urgent Care

  • An urgent care elective is based upon emergency medical treatment in a clinical setting. Student will be exposed to large variety of cases spanning from urinary tract infections to bone fractures as well as common cough and cold treatment. During this time students should understand the pathology of each case, appropriate labs to be ordered and also being able to instantly identify when immediate emergency care is needed at which time the patient must be sent to the hospital.
  • Students will have the opportunity to learn how to accurately draw blood, perform urine analysis as well how to conduct an x-ray. Students will also be able to observe and grasp the appropriate techniques for suturing.

Urology

  • During the urology elective students will be exposed to a wide variety of adult male and female urological disorders. Students will participate in day-to-day investigation and management of patients and may attend cystoscopy, open and endoscopic surgical procedures. They will also be exposed to urodynamics, sexual dysfunction, biofeedback and lithotripsy.
  • In the urology out-patient setting the students will have the opportunity to learn about a variety of ambulatory urological conditions. Emphasis is placed on problem evaluation, and the orderly process of urological investigation. Students are taught the elementary skills of catheterization, the principles of modern catheter care and routine endoscopy.

Vascular Surgery

  • During the vascular surgery elective the student will gain sufficient understanding of the evaluation and management of patients with vascular diseases and the management of these conditions. The student will make relevant findings in obtaining the history and physical examination of patients with vascular disease. The student will draw out an appropriate differential diagnosis for patients with acute and chronic vascular conditions.
  • The student will be an integral member of the Vascular Surgery Team. The students will have the opportunity to attend operative, interventional and diagnostic procedures on patients on the service. The student will learn how to appropriately perform focused exams on patients who are seen in consultation. The student will develop differential diagnoses for these patients and will formulate a plan for further evaluation and management.
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