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8025 - Curriculum Development - Arranged (Building Not Needed)

Course Prerequisites: N/A

Description: This is a directed student course in which students engage in individualized projects that are designed to reflect their self-directed learning skills that they have developed while at Wayne State University School of Medicine.

Objectives: Identify and define an area of curriculum improvement. In consultation with the course director, develop a curriculum related project. Implement the curriculum. Evaluate the effectiveness of the curriculum utilizing appropriate evaluation methodologies.

Methods: Given the individualized nature of the course, methodologies/activities vary by student and project. Common activities include small group instruction, individual instruction, and simulation.

8035 - Students Teaching & Educating Peers - Arranged (Building Not Needed)

Course Prerequisites: Served as a near-peer learning coach (formerly SIL) in the M2 year.

Description: Students will learn and apply techniques to prepare medical students for the Step 1 examination, as well as lead Step 1 preparation sessions. The goal of this course is to foster an opportunity for physicians-in-training to develop a fundamental knowledge of evidence-based teaching practices and to provide them with a platform to hone their skills delivery as reflective, innovative, medical professionals.

Objectives:

Engage in the role of a near-peer learning coach as an empowered decision maker; articulate rationale for decision-making and impact on junior students and their learning.
Exhibit professionalism and ethical behavior when interacting with junior students, and University faculty and staff.
Design, enact, and critically reflect upon teaching and learning in order to improve your own personal practice and positively impact student learning.
Design, enact, and critically reflect upon teaching and learning that provides access to rigorous learning for junior students, including those with unique learning needs.
Develop and maintain a positive relationship with junior students that is rooted in respect
Design, implement, and critically reflect upon instruction that engages junior students in problem-solving, critical and creative thinking, as well as metacognitive practices.
Communicate and collaborate with junior students, University faculty, and staff to enhance the overall near-peer teaching and learning experience
Use technology as a tool to enhance instructional planning, record-keeping, and communication.

Methods: Master Adaptive Learner Framework. Andragogy. Evidence-based teaching and coaching practices

Recommended Reading: The Master Adaptive Learning; Coaching in Medical Education; The Science of Learning; Make It Stick

Length: Longitudinal beginning in the M2 year, suspending service in the M3 year, and continuing service in the M4 year . Hours/ Week: Varies; Days/Week: Varies; Night Calls/ Month: N/A.

Additional Locations: Asynchronous online learning modules, Synchronous virtual training sessions.

Evaluation: Stakeholder surveys

Preceptor(s): N/A

Category: Non-Clinical

Recommended/Attire: Business Casual

EMR System: N/A

Director: Dr. Tara M. Reid

Coordinator: Ms. LaToya Sherman

Email: olt@med.wayne.edu

Website: https://www.med.wayne.edu/olt

8041 - Gross Anatomy Teaching Lab - Gordon H Scott Hall

Course Prerequisite: This course is open to M4 students who have previously participated in the prosector program following successful completion of M1 gross anatomy course. Prior Approval from the gross anatomy director is required to register.

Objectives: Teach dissection skills and provide mentorship to M1 students.

Methods: M4 students teach freshman medical students dissection skills in the anatomy labs. Students taking this elective will gain teaching and mentorship experience as well as provide an opportunity to practice dissection skills and review anatomy prior to residency training. M1 students will benefit from the experience of upperclassmen who possess advanced clinical knowledge.

Recommended Reading Material: Anatomy lecture notes, text, atlas, and dissection guide.

Length: 8 laboratory sessions total during the following 3 blocks: September (musculoskeletal), October-December (visceral), or January ( head/neck). All 8 laboratory sessions selected must be in a single block. Work days/week: consult laboratory schedule; Hours/Day: consult laboratory schedule; Hours/Week:6-9; Days/Week: 2/3; Night Calls/Month: None

Evaluation: A written evaluation is completed based on attendance, review of M1 materials, preparation of relevant clinical correlations based on the laboratory basic science and effectiveness/ease of student interactions. All activities observed by preceptors during laboratory periods.

Preceptor(s): Dr. Mark Ireland, Dr. Paul Walker

Category: Non-Clinical

Recommended Attire: Scrubs

EMR System: N/A

8045 - Medical Ethics - Detroit Medical Center

Course Prerequisites: None - students entering any clinical specialty would benefit from this elective.

Objectives: Students will: 1) Have a solid grasp of the fundamental principles of modern clinical (bio)-ethics. 2) Understand the distinction of Bio-ethics and morality as well as the intersection, and possible conflict with, of these and laws, 3) Be exposed to a variety of scenarios that give rise to requests for hospital Ethics Committee consultations, 4) Understand larger ethical issues in society and their intersection with clinical practice as well societal norms, expectations and controversies, 5) Become more confident and comfortable discussing ethical issues with their colleagues, patients and the patients' families, 6) Be able to analyze and present an ethics case.

Method: The Medical Ethics Elective will consist of a mixture of clinical experience and independent study as detailed below:

Clinical Experience: ICU rounds, PICU rounds. Students will be observers on ICU rounds engaging with the ICU team in discussions of potential ethics-related conflicts that arise. Students may also interact with patients and families where appropriate. Observations and cases will be discussed with other students and the Ethics faculty in weekly meetings.
Ethics Committee: Attend monthly Ethics Committee meetings when available.
Discussion of case studies, which will be included in the course pack, at weekly meetings
Independent Study: Create a presentation on a medical ethics topic of the student's choice and present it at the end of the rotation. Write a short paper summarizing the presentation.

1. Clinical Experience: ICU rounds, PICU rounds. Students will be assigned a patient, whose family and health care providers they will interview with regards to the ethical issues of their condition/treatment. At the end of each week the student will present the ethical issues of their patient's case to the ICU team. 2. Ethics Committee: Attend monthly Ethics Committee meetings. 3. Independent Study: Create a presentation on a medical ethics topic of the student's choice and present it as a lunchtime lecture open to all medical students. Write a five-page paper summarizing the presentation. 4. Weekly meetings with other students in elective, going over progress in their independent research. Discussion of case studies, which will be included in the course pack.

Length: 1 month (only offered April and October)

Recommended Reading/Resources: Syllanbus, resources, and reading material will be provided at the beginning of the elective.

Evaluation: Formative evaluation and feedback (mid-way) and final evaluation in New Innovations.

Course Director: Michael Stellini, M.D.

Category: Non-Clinical

Notes: Students should contact the Course Director, Michael Stellini, M.D. one week before the start of the rotation to obtain the course pack and information on logistics. (See Elective Course Coordinator Spreadsheet for contact details.)

8046 - Street Medicine: Detroit - Henry Ford Health Service

You must be an active or former board member and pre-approval is required to register for this course by: Dr. Bryce, rbryce1@hfhs.org

Objectives: This course provides students with knowledge and skills necessary to promote health, prevent illness, and manage the common chronic, and minor acute primary care needs of adults who are experiencing homelessness in Detroit.

Category: Non-Clinical, Community Service

8050 - General Anesthesiology - Henry Ford Health Service

Course Prerequisites: None.

Description: Each student works with a resident and staff anesthesiologist to provide anesthetic care for patients. Students participate in the preoperative assessment of their patients, I.V. and invasive line placement, airway management and intraoperative and postoperative patient care. The students' responsibilities advance as proficiency is demonstrated and culminates with the student fulfilling the role of an anesthesia resident.

Students will be exposed to anesthesia subspecialties, including cardiothoracic, neurological, obstetrical, pediatric, vascular and critical care medicine and pain management.

The clerkship includes active participation in a didactic program which consists of morning reports, grand rounds, morbidity and mortality conferences and core curriculum lectures.

Objectives: To provide exposure to the broad scope of anesthesia practice. Learn the pharmacologic and physiologic basis of anesthesia; the principles of preoperative patient assessment and devising an anesthetic plan which accommodates pre-existing disease; the basics of airway management; the indications and techniques for the placement of invasive hemodynamic monitors (including arterial lines, central venous lines and swan-ganz catheters) and to interpret the data which they provide; the indications and techniques for the performance of regional anesthetic techniques (i.e. spinal, epidural, and other blocks) Enhance knowledge and skills in the intraoperative and postoperative management of patients.

Methods: Each student works with a resident and staff anesthesiologist to provide anesthetic care for patients. Students participate in the preoperative assessment of their patients, I.V. and invasive line placement, airway management and intraoperative and postoperative patient care. The students' responsibilities advance as proficiency is demonstrated and culminates with the student fulfilling the role of an anesthesia resident. Students will be exposed to anesthesia subspecialties, including cardiothoracic, neurological, obstetrical, pediatric, vascular and critical care medicine and pain management.

The clerkship includes active participation in a didactic program which consists of morning report, grand rounds, morbidity and mortality conferences and core curriculum lectures.

Recommended Reading Material: To be assigned.

Length: 1 month; Days/Week: 5; Night Calls/Month: 1 optional

Distribution of student's time: 40% inpatient care, 40% outpatient care, 20% conferences/lectures

Hours/Week: 40; Night Call/Month: 1 (optional)

Evaluation: Observation of performance by faculty and house officers looking at quality of care given, level of knowledge, and level of skills and interpersonal relationships.

Category: Specialty Subinternship

8050 - General Anesthesiology - Harper Hospital

Course Prerequisite: None, although medicine and surgery are recommended

Objectives: 1. Learn what information must be elicited in the preoperative interview and appreciate the importance of this contact in the preparation of the patient for surgery. 2. Demonstrate the ability to adhere to a routine in the delivery of general anesthesia including equipment checks, institution of monitoring, induction and maintenance of surgical anesthesia. 3. Learn the principles and techniques of airway management including endotracheal intubation. Learn the management of use of airway equipment to ensure airway patency and ventilate a patient. At the end of the rotation, the medical student should be able: A. To state the signs of a non-patent airway and state steps to be taken to manage the obstructed airway; B. To demonstrate the proper use of the bag valve mask set-ups on the patient as well as choose the proper size equipment to be used both for ventilation and intubation; C. To assess the patient during ventilation to determine that ventilation is adequate both by physical criteria and use of pulse oximetry/capnography. 4. Learn how to select proper anesthetic agents. At the end of the rotation, the medical student should be able: A. To state what physical conditions would complicate giving anesthesia to a patient including: Physical deformities, underlying illness, prior use of anesthetic agents, current surgical procedures necessitating anesthesia; B. To have basic understanding of the pharmacology of agents used for anesthesia; C. To discuss the pharmacology, indications, contraindications, and complications of: 1. Drugs used for inhalation anesthesia; 2. Drugs used for IV anesthesia 3. Neuromuscular blocking agents. 5. Learn how to monitor a patient under anesthesia. At the end of the rotation, the medical student should be able to state what parameters to monitor during anesthesia. 6. Become familiar with the more common regional blocks and develop basic skills needed to produce regional anesthesia (such as spinal and epidural blocks). 7. Learn how to insert central lines and arterial lines, and become familiar with the basics of invasive monitoring. 8. Learn the methods of pain relief during labor and delivery, and understand the basics of anesthetic management in patients with obstetric complications. 9. Become acquainted with the modalities available to treat acute and chronic pain problems. 10. Develop an appreciation for the expanding role of the anesthesiologist as a problem solver in the hospital and outpatient settings.

Methods: The medical student will be assigned to a senior anesthesiology resident every day. Schedules will be prepared and distributed at the beginning of the rotation. The medical student should expect to spend time (in 4-5 day rotation periods) on a variety of services (e.g. cardiac anesthesia, neuroanesthesia, pain management, obstetrical anesthesia, thoracic/vascular anesthesia, preop and postoperative evaluations). The medical student will be required to attend weekly didactic lectures sponsored by the WSU Department of Anesthesiology. Voluntary participation in special lectures offered to anesthesiology residents available.

Recommended Reading Material: Basics of Anesthesia, Stoelting and Miller, (eds.) Introduction to Anesthesia, Dripps, (ed.)

Length: 1 month; Days/Week: 5; Hours/Week: 6:30 a.m. - 3:30 p.m. daily, (approximately 8-10 hours per day)

Evaluation: Written evaluation, final examination

Category: Specialty Subinternship

8050 - General Anesthesiology - Beaumont Dearborn

Students will be exposed to anesthesia subspecialties, including cardiothoracic, neurological, obstetrical, pediatric, vascular and critical care medicine and pain management.

The clerkship includes active participation in a didactic program which consists of morning reports, grand rounds, morbidity and mortality conferences and core curriculum lectures.

Objectives: Basic understanding of principles of airway, regional anesthesia, perioperative medicine. Students will spend time with anesthesiologists to observe and learn anesthesia management of simple and complex patients. Required reading: TBD

Work days/week: 5

Category: Specialty Subinternship

8050 - General Anesthesiology - Sinai Hospital

Students will be exposed to anesthesia subspecialties, including cardiothoracic, neurological, obstetrical, pediatric, vascular and critical care medicine and pain management.

The clerkship includes active participation in a didactic program which consists of morning reports, grand rounds, morbidity and mortality conferences and core curriculum lectures.

Objectives: To become familiar with the practice of anesthesia, including preoperative assessment, delivery of general and regional anesthesia, equipment use, and monitoring techniques.

Category: Specialty Subinternship

8050 - General Anesthesiology - St Joseph Pontiac

Course Prerequisites: None

Description: The student will have the opportunity to electively rotate for one month within the Dept of Anesthesia at one of the participating hospital locations. Students will work closely with staff anesthesiologists and when possible anesthesia residents. Students will learn about the preanesthetic evaluation, the selection of anesthetic techniques, the pharmacology of commonly used anesthetic agents, the physiological effects of the various methods of anesthesia, and postoperative care.

Objectives: 1. Introduction to the principles and techniques of general and regional anesthesia. 2. Airway management (mask ventilation, endotracheal intubation, laryngeal mask airway, alternative airways, etc). 3. Establishment of intravenous access and placement of invasive patient monitors. 4. Intraoperative fluid management 5. Pharmacology of anesthetic agents (induction agents, inhalationals, muscle relaxants, etc). 6. Opiate and pain management. 7. Post-operative recovery room management. 8. Have the opportunity to undergo training at one of the University Associates Stimulation Centers on specific anesthesia

Methods: During the rotation the student will be exposed to multiple subspecialty areas in the field of Anesthesia. These areas will include: cardiac, neurosurgical, pediatric, pain management, vascular, obstetrical, intensive care and research. After completing the basic medical elective, the student may wish to experience a more advanced exposure to the field of Anesthesia. Related Modules. (intubation, difficult intubation, fiberoptic use, central line placement, ACLS protocol, etc).

Recommended Reading/Resources: Clinical Anesthesia by Morgan and Mikhail

Length: 1 month

Additional Locations: Trinity Health Oakland - This site is the approved Wayne State University and Physicians Group course. Students will have an opportunity to rotate at Trinity Health Oakland (formerly St. Joseph Mercy Oakland) in Pontiac, which is the homebase for the Wayne State University residency program.

Evaluation: There will be a final exam at the end of the month-both written and mock oral.

Preceptor(s): Steven Landau, MD

EMR System: EPIC

Category: Specialty Subinternship

8050 - General Anesthesiology - St John Hospital

Objectives: To learn the basic principles and techniques in anesthesiology.

The curriculum will include preoperative evaluation, general anesthesia, regional anesthesia and invasive monitoring. Emphasis will be on anesthetic risks and complications.

Method: Students will be required to make pre-anesthetic rounds; which includes, the obtaining of a complete medical and anesthetic, history, the evaluation of patients physical status, the ordering of pertinent diagnostic tests, the discussion (with patients) of the anesthetic procedure and risks entailed, and the ordering of pre-anesthetic medication. Students pre-anesthetic notes, evaluations and orders will be reviewed and evaluated by an attending anesthesiologist.

Recommended Reading Material: Clinical Anesthesia Procedures of the Massachusetts General Hospital, (2002) by Massachusetts General Hospital Dept of Anesthesia and Critical Care, William E., M.D. Hurford, Michael T., M.D. Bailn, J. Kenneth Davison, Kenneth L. Haspel, Carl, M.D. Rosow, Susan A. Vassallo

Length: 1 month; Days/Week: 5; Hours/Week: 30-40; Night Calls/Month: none

Category: Specialty Subinternship

8060 - Pain Management - Veterans Admin Hospital

Course Prerequisite: All VA electives require U.S. citizenship. Do not register for this elective without being able to provide your U.S. social security number for onboarding purposes.

Description: This is a pain management and complimentary/integrative health rotation. Students will develop an appreciation of the diagnosis, treatment and management of both acute and chronic pain syndromes, malignant and nonmalignant.

Objectives: To learn the up-to-date pain management approaches that places opioids last but adapts more of interventional, physical, and complimentary and integrative modalities such as chiropractic care, acupuncture, yoga, massage, spinal rehab, and other opioid-free approaches.

Methods: Students will shadow pain specialists in all of the above areas. Students will work with trained and certified physicians in an auricular acupuncture modality called BFA where student will practice it, along with somatic acupuncture on real patients, which will expose students to the gratification of immediate responses of pain. The student will assist in patient evaluation and treatment plan formulation in both the clinic and inpatient consultations setting. Also, the opportunity to perform invasive pain procedures will be provided.

Formal weekly core curriculum lectures and journal club participation is expected.

Recommended Reading Material: Decision Making in Pain Management - Ramamurthy Rogers. Other articles will be provided upon signing in.

Length: 1 month; Days/Week: 2-4; Hours/Week: 30-40; Night Calls/Month: None

Evaluation: Participation and performance in clinics.

Preceptor(s): Various pain specialists, physiatrists, chiropractors, and acupuncturists

Category: Inpatient Consult Service

Recommended Attire: Scrubs, business professional, casual, white coat

EMR System: CPRS (Cerner coming in June 2023)

8060 - Pain Management - Henry Ford Health Service

Course Prerequisites: None

Description: An elective to give an introduction to chronic pain management. This program offers a comprehensive overview of pain medicine problems in adults in an ambulatory setting. At the end of the rotation, the student is able to identify common pain pathologies and devise a treatment plan. When opioids are indicated, the student will know the key elements of management. Each student works with a resident/fellow and senior staff to provide for and care for their patients.

The clerkship includes active participation in a didactic program which consists of grand rounds, morbidity and mortality conferences, and core curriculum lectures.

Objectives: To introduce the fourth year student to the field of pain management. The student will develop an appreciation of the diagnosis, treatment and management of both acute and chronic pain syndromes, malignant and nonmalignant. To provide exposure to the broad scope of pain medicine, including responsible opioid management. Enhance knowledge and skills pertaining to interviewing, physical examination, patient interactions, interpretation of data, clinical judgment, and observation of procedures (i.e., epidurals, rhizotomies, and spinal cord stimulation). Learn the pharmacologic and physiologic basis of pain medicine; the principles of assessment and devising a plan for the patient with acute, chronic, or cancer pain; the basics of opioid management; the indications and techniques available for interventions.

Methods: The student will assist in patient evaluation and treatment plan formulation in both the clinic and inpatient consultations setting. Also, the opportunity to perform invasive pain procedures will be provided. Formal weekly core curriculum lectures and journal club participation is expected. 85% outpatient care. 10% conferences/lectures. 5% inpatient care.

Recommended Reading Material: Decision Making in Pain Management - Ramamurthy Rogers. Other articles will be provided. Sladen library and website at HFH Detroit campus

Length: 1 month; Days/Week: 5 week days, 0 weekends; Hours/Week: 40; Night Calls/Month: None

Evaluation: Presentation, clinical evaluation, participation, and performance on rounds. Quality of care given. Level of knowledge. Level of skills and interpersonal relationships. Observation of performance by faculty and house officers.

Preceptor(s): Dr. Murali Patri

Category: Inpatient Consult Service

Recommended Attire: Scrubs, white coat

EMR System: EPIC

8070 - Pediat Anesthesiol - Childrens Hospital

Objectives: To gain experience in the management of infants and children undergoing anesthesia, including airway management, intubation, IV skills and fluid resuscitation.

Methods: Daily participation in preparation of children scheduled for elective or emergency operative or diagnostic procedures needing anesthesia. Daily discussion sessions on anesthetic principles and priorities for a variety of surgical procedures. Daily participation in administering general anesthesia, including establishment of IV's and secured airway control by tracheal intubation. Concurrent discussion of potential complications and management. Daily evaluation and management of post-anesthesia sequelae in patients and their families. Reading assignments regarding differences between adult and pediatric responses to stresses of surgery and anesthesia. Attend bi-weekly lecture series. An interview review of the student's progress in relation to the knowledge, skills and behavior appropriate to pediatric anesthesia care is held with the Director of Residency Education at the end of the rotation. All staff members contribute to the final grade given the student.

Recommended Reading Material: Textbook & required reading provided.

Length: Evaluation: Clinical evaluation and written

Category: Inpatient Consult Service

8090 - Military Officer Training - Arranged (Building Not Needed)

The course will develop critical thinking in decision making processes that incorporate medical decisions within both a battlefield scenario as well as in a hospital setting. This course will emphasize how an officer fits within the TEAMSTEP concept of medical management which enforces medical excellence, team building within a hospital.

This course is only available to students in the HPSP program.

Category: Non-Clinical

8100 - Law and Medicine - Multiple Locations

Course Prerequisites: Please contact Ms. Lisa Blackwell to submit your request for this course. 313-577-0878 or lblackwe@med.wayne.edu.

Objectives: To provide an opportunity for students to obtain first hand experience with law firms that are directly involved with various legal issues related to clinical medicine. The goal is to help students develop practice and habits to help them from being sued for medical malpractice in the future.

Methods: The student will be assigned to legal firms where they will be involved in researching, preparing and observing court cases.

Assignment: The student will be required to keep a daily journal chronicling his/her elective experiences. The journal will describe the student's observations, impressions, interviews and a summary of the periodic meetings with the preceptor. Each student will also be expected to write a 4-5 page paper on a medical-legal issue on a subject related to the student's intended residency/specialty. The typed journal will be turned in to the Department of Family Medicine, c/o Miss Lisa Blackwell, 3939 Woodward upon completion of the rotation.

Length: 1 month

Additional Locations: The assignment will be one student per location, first come, first assigned.

Meyers Law - 3200 Greenfield Rd #260, Dearborn, MI 48120; (313) 961-0130
Sommers Schwartz, P.C. - 1 Towne Square #1700, Southfield, MI 48076; (248) 355-0300

Evaluation: Oral and Written; New Innovations Evaluation

Coordinator(s): Lisa Blackwell

Category: Non-Clinical

EMR System: N/A

8110 - Healthcare: Systems, Quality, Safety and Social Determinants - Arranged (Building Not Needed)

Course Prerequisites: None.

Description: The goal of every health care provider and organization is to provide safe, timely, equitable, effective, efficient, and patient- and family-centered care. In order to do this, students need foundational knowledge and skills related to safety, quality, leadership and the business of medicine. Students electing this course will join the WSUSOM chapter of the Institute of Healthcare Improvement (IHI) and complete 13 modules from the IHI Open School earning a Basic Certificate in Safety and Quality. Students will then create a quality improvement project proposal suitable for implementation during internship. Students will also complete Caring with Compassion online learning modules to better understand how to provide care to underserved and disadvantaged patients. Students will complete additional modules related to health systems, insurance, coding, and documentation. Students will post reflections on required readings.

Objectives: To provide foundational knowledge and skills in patient safety, quality, leadership and the business of medicine, to prepare students to deliver high quality safe care and participate in quality improvement necessary for internship. To provide students with knowledge, skills and attitudes necessary to provide care for socioeconomically disadvantaged populations: homeless, uninsured, and underserved patients. To provide students with knowledge and skills to participate as physician members of the health systems. To provide students with knowledge and skills in documentation and coding of health encounters.

Methods: Students are required to attend the synchronous online orientation. Students will learn using online educational modules, and reflection. Students are required to present their quality improvement project proposals at the synchronous online conference at the end of the month.

Recommended Reading/Resources:

IHI Open School http://www.ihi.org/education/ihiopenschool/Pages/default.aspx

Business of Medicine https://www.udemy.com/wsusom-business-of-medicine/

Caring with Compassion: https://caringwithcompassion.org/

Current and timely additional readings and resources will be posted on Canvas

Length: 1 month; Days/Week: 4; Hours/Week: 30-40; Night Calls/Month: None

Additional Locations: Online.

Evaluation: Course grade will be determined by submission of certificates demonstrating successful completion of all modules, the quality improvement project proposal and presentations, and assigned reflections. Attendance at orientation and at the end of the month’s quality improvement proposal conference is required. All assignments are due at the end of the rotation.

Preceptor(s): Dr. Diane Levine

Category: Non-Clinical, Online

Recommended Attire: N/A

EMR System: N/A

8115 - Special Topics: Interprofessional Education - Arranged (Building Not Needed)

Course Prerequisites: None.

Description: This interprofessional education (IPE) course is for health professional student learners in the areas of advanced practice (i.e., medicine, nursing, pharmacy, social work, and physician assistant). The course allows health professional students to learn about, from and with each other, how each discipline contributes to the healthcare team, the importance of effective communication, the role of team collaboration and preparing health care professionals for collaborative practice with a focus on clinical decision making in interdisciplinary teams. This course is helpful in preparing students for the reality of the working environment of the residency programs they will begin after graduation.

Objectives: At the end of this course, students will be able to:

1. Describe and analyze the unique roles and skills that health care providers from medicine, nursing, pharmacy, physician assistant, and social work bring to the healthcare team.
2. Apply knowledge of one’s own role and those of other professions to appropriately assess and address the health care needs of patients and to promote and advance the health of populations.
3. Explain how viewpoints derived from the knowledge base and values of different health care professions can affect patient-care decisions and outcomes.
4. Demonstrate personal and team attributes that improve or compromise team effectiveness.
5. Create team-based care plans for healthcare situations that synthesize available evidence and incorporate multiple perspectives (individual, family, providers); Analyze the strengths and weaknesses of the plan and modify with input from team members.
6. Demonstrate attitudes, behaviors, and competencies that support communicating effectively when performing interprofessional work in healthcare.

Methods: Team taught, online modules (flipped classroom), active learning; small group discussions and activities; virtual meetings; team-based debriefing and case-based learning. Each student will be assigned to one of the different IPE course groups with students from each discipline evenly divided between the four groups in order to allow for each group to have interprofessional teams. Students will move through the semester in fixed interdisciplinary teams assigned at the beginning of the semester.

The class will operate in seven modules. The first and last modules will be virtual classroom sessions, covering the same content. Each of the other five modules is an online standalone unit (one is not dependent on another). The order in which these five modules are completed will vary by group. Students will rotate through modules taught by interdisciplinary pairs of faculty located at each of the four schools.

During each virtual in-class session, the student will be expected to actively engage with the experience. This involvement will be graded by the faculty leader using a standardized IPE Assessment Rubric. The rubric will appraise the student’s preparation, participation, communication skills, quality of work and professionalism. All rubric grading is final and there are no make-ups days.

A large part of this class focuses on students working on an interprofessional team. These team interactions provide learning opportunities for teamwork skill development for future professional employment. Students will be accountable to their teammates through a peer evaluation system.

Recommended Reading/Resources: There will not be a printed course pack. All materials and weblinks will be posted to Canvas. It is the responsibility of the student to routinely check Canvas and their WSU emails for updates, uploaded assignments and required readings posted by individual faculty. Students must complete required pre-work and will be assessed on acquisition of this knowledge. Pre-work is essential to ensure readiness to participate in class discussion. Accountability for completion of pre-work will be done through quizzes and assignments. Required readings will be available through the Canvas lesson builder pages.

Length: 3 months

Class Meeting Days/Time: Every Tuesday 5:30-7:30 P.M. (synchronous)

Additional Locations: Synchronous via Zoom and certain Asynchronous modules.

Evaluation: There will be no specific testing over materials presented in this Interprofessional education (IPE) course. Instead, there will be four modules to successfully complete synchronously and asynchronously, two collaborative in-person assignments, and one final team presentation. During the in-person class sessions, faculty will assess students using the standardized IPE assessment rubric posted on Canvas. Grading for in-class assignments will be based on quality and completion. More assignments may be created as the semester progresses. As a result, the weighted percentage of the assignments may change. Students will be notified of any such amendments.

Preceptor(s): Program-specific Course Instructors:

Medical School:
- Dr. Dennis Tsilimingras*
- Dr. Diane Levine
- Dr. Jennifer Mendez
- Dr. Sarkis Kouyoumjian
College of Nursing:
- Ramona Benkert*
- Katherine Balint
- Susan Wiers
College of Pharmacy & Physician Assistant Studies:
- Aline Saad
- Jamie McQueen*
School of Social Work:
- Joy Swanson Ernst*

*Faculty leads for each school.

Director: Dr. Dennis Tsilimingras (Medicine)

Category: Non-Clinical

Recommended Attire: Appropriate for Zoom

EMR System: None

Notes: This is a 4-month elective only offered in the Fall Term. The course meets every Tuesday evening during all four months (September, October, November, December). Students who register for this class will be required to attend every session (even in September before the course officially shows up on their schedules) in order to receive credit. Medical students will need to email records at records@med.wayne.edu to enroll in this 2-credit course in addition to their main 6 credit electives. This course can be taken with an online and/or vacation month. This course does not provide enough credits to take alone as its own elective in any given month unless it is taken during the term the student's vacation month is also being taken. The students who take this course will receive 2 additional credits over the span of the Fall Term (not 2 credits each month) and graduate with extra credits on their transcripts.

Special highlight: This class will show up as a fall term class. Medical students will be expected to attend all of the sessions, including those in the last month of the summer term. Students will have synchronous sessions in September, October, November, and December.

8120 - General Dermatology - Multiple Locations

Description: Students will rotate between three locations: 1575 Big Beaver Rd #C-12 &Harper Prof Bldg Weds PM & 34555 Levan Rd #202 Review Website for Dr. Moiin's Schedule: www.abetterskin.com.

Objectives: 1. To learn the fundamentals of making a specific dermatologic diagnoses and recognize cutaneous morphology. 2. To acquire basic knowledge in the management of common skin disorders in an ambulatory care setting. 3. To be able to perform and interpret diagnostic dermatologic tests including KOH preparations, Tzanck preparations, and patch tests. 4. To understand the role and evaluation of dermatologic treatments including surgery, photo therapy, cryotherapy in the management of benign and malignant disorders. 5. Enhance knowledge and skills pertaining to dermatologic terminology and detection of potentially serious lesions or conditions. 6. Interviewing skills, physical examination, patient interactions, interpretation of data and clinical judgment will also be addressed. 7. Increase ability to review medical literature both for clinical management and scientificc pursuits.

Methods: 1. Outpatient clinical experience supervised by Ali Moiin, M.D. 2. This elective is designed for the student who desires significant patient experience in Dermatology. 3. Learning is derived from direct patient care in the ambulatory setting. 4. Arrangements for reviewing basic biochemistry, physiology, mycology clinical dermatology, histopathology of the skin, and allergy are included in the clerkship.

Recommended Reading Material: Andrews' Diseases of the Skin: Clinical Dermatology, 10th Edition

Length: 1 month; Days/Week: 5 and Sat Mornings; Grand Rounds, Weds. mornings. Hours/Day: 8-10; Friday afternoons are free. Number of patient visits about 1000; Night calls/Month: none

LOCATIONS: 1575 BIG BEAVER RD #C-12 & HARPER PROF BLDG WEDS PM & 34555 LEVAN RD #202 SAT AM

Evaluation: Clinical evaluations, observation of performance, assessment of write-ups/reports. Paper and case reports are strongly encouraged.

Course Director: Ali Moiin, MD

Course Coordinator: Tammy Mitchell

Category: Specialty Subinternship

Recommended Attire: Professional with white coat

EMR System: None

8120 - General Dermatology - Henry Ford Health Service

Course Prerequisites: N/A.

Description: This elective is designed for the student who desires significant patient experience in Dermatology. A high proportion of learning is derived from direct patient care in both inpatient and clinical situations. This training is supplemented by daily conferences, lectures and programmed audiovisual study.

Objectives: Enhance knowledge and skills pertaining to basic dermatology with emphasis on dermatologic terminology, diagnosis and therapy of common conditions and detection of potentially serious lesions or conditions. The course will also focus on interviewing skills, physical examination, patient interactions, interpretation of data and clinical judgment. Students will be expected to attend daily didactic lectures with the residents. Increase student involvement in conferences, journal clubs. Increase ability to use and review medical literature both for clinical management and scientific pursuits. This elective is designed for the student who wished to increase their knowledge and clinical experience in Dermatology. A high proportion of learning is derived from direct patient care in both inpatient and clinical situations. This training is supplemented by daily conferences, lectures and programmed audiovisual study.

Methods:2% laboratory work, 88% outpatient care, 10% conferences/lectures. Students will see an average of 40 patients each week.

Length: 1 month; Days/Week: 5; Hours/Week: 50; Night Call/Month: none

Evaluation: Quality of care given. Participation and performance in conferences. Level of knowledge. Level of skills. Professionalism, interaction with staff, house officers, and support staff. Enthusiasm to learn, attitude, response to constructive criticism. Observation of performance by faculty and house officers, assessment of write-ups/reports, written/oral tests possible. Final evaluation will be based on input from all the staff and residents with whom the student has interacted.

Category: Specialty Subinternship

EMR System: EPIC

8120 - General Dermatology - Michigan Healthcare Professionals

Course Prerequisites: None.

Description: This rotation will focus on medical dermatology as well as procedural dermatology in an ambulatory setting. Students will not have an inpatient or hospital component to this elective, but will learn the fundamentals of diagnosing, treating, and managing patients with common dermatologic disorders.

Objectives: To learn medical dermatology while intermixing Internal Medicine concepts and broadening the student’s awareness of what dermatology is and how to visually recognize and treat diseases of the skin.

Methods: Students will have direct observation as well as personal interaction with patients in the clinical setting.

Recommended Reading/Resources: DermNetNZ.org

Length: 1 month; Days/Week: 4; Hours/Week: 30-40; Night Calls/Month: None

Typical Day: 8 AM - 4 PM (arrival no later than 7:45 AM)

Additional Locations: Oakland Dermatology Institute – 633 E. South Boulevard, Suite 1200, Rochester Hills, MI 48307; 27301 Dequindre Road, Suite 209, Madison Heights, MI 48071

Evaluation: New Innovations evaluation

Preceptor(s): Dr. Alexander Ernst

Category: Specialty Subinternship, Ambulatory

Recommended Attire: Comfortable shoes and scrubs

EMR System: Webchart

8120 - General Dermatology - Department of Dermatology

Course Prerequisite: This elective rotates in part at the John Dingell Detroit VA. All VA electives require U.S. citizenship. Do not register for this elective without being able to provide your U.S. social security number for onboarding purposes.

Description: This is the WSU Department of Dermatology course. The senior student will attend outpatient clinics at WSU Dearborn and Troy Clinic, Harper Professional Building, University Health Center, and VA Hospitals. Year 3 students will not rotate at the VA.

Objectives: 1. To learn the fundamentals of making specific dermatologic diagnoses and recognize cutaneous morphology. 2. To acquire basic knowledge in the management of common skin disorders in a variety of ambulatory care settings including University outpatient clinics, and private office practices. 3. To be able to perform and interpret diagnostic dermatologic tests including KOH preparations, Tzanck preparations, and patch tests. 4. To understand the role and evaluation of dermatologic treatments including surgery, photo therapy, cryotherapy in the management of benign and malignant disorders. 5. To recognize the role and necessity of an inpatient dermatology service in treating specific disorders.

Methods: 1. Didactic lectures from the faculty that will review basic dermatology principles. 2. Outpatient clinical experience supervised by WSU attending physicians. 3. Outpatient clinics in a private practice office at Harper Professional Building. 4. Inpatient rounds/consults at DMC Hospitals and Karmanos. 5. Take home exam. 6. Student presentations. Students are responsible for a 10-15 minute presentation on an appropriate dermatology topic, which will be presented to the rotating students and Chief Resident in Dermatology.

The one-month elective program in dermatology is predominantly clinical. The senior student will attend outpatient clinics at Wayne Health Dearborn, Monroe, and Troy Clinics, John Dingell VA Hospital, University Health Center 7A, and Harper Professional Building. Up to four half days will be spent in the private office of an attending staff member. Arrangements for reviewing basic biochemistry, physiology, mycology clinical dermatology, histopathology of the skin, and allergy are included in the program. This elective requires a considerable amount of driving from one site to another. Distances are great and it is strongly recommended that the students have their own transportation to take full advantage of the elective.

Recommended Reading/Resources: 1) Lookingbill & Marks: Principles of Dermatology 2) Fitzpatrick TB et al: Color Atlas and Synopsis of Clinical Dermatology 3) Arndt: Manual of Dermatologic Therapeutics; VisualDx online resource highly recommended as are the AAD Basic Dermatology Curriculum https://learning.aad.org/Listing/Basic-Dermatology-Curriculum-4-Week-Rotation-5406

Length: 1 month; Days/Week: 5; Hours/Day: 8; Night Calls/Month: None

Additional Locations: WSU Dearborn and Troy Clinic, Harper Professional Building, University Health Center, and VA Hospitals

As of February 1, 2024, the dermatology clinic will move from Oakwood to Wayne Health Dermatology Clinic at 5250 Auto Club Drive, Dearborn, MI 48126.

Evaluation: Clinical eval and exam presentation The exam will be given during the residents Fitzpatrick's book session. The medical students will give a 5-min presentation on the last Wednesday of their rotation to the residency program. The subject of the presentation will be arranged at least a week in advance. The presentation should be approximately 5 mins in duration.

Preceptor(s): Geoffrey Potts MD, Steven Daveluy MD, Darius Mehregan MD, Meena Moossavi MD, Aliya Hines MD PhD, Tina Pickett Baisden MD, Danita Peoples MD, Alan Fligiel MD, Lindsay Sklar MD, Leonard Kerwin MD, Ali Moiin MD

Course Director: Geoffrey Potts, MD

Course Coordinator: Emma Reaves

Category: Specialty Subinternship

Recommended Attire: Scrubs are acceptable for VA site and Wayne Health Dearborn or Troy sites. Professional attire advised for Grand Rounds days. Clean white coat.

EMR System: Athena EHR for Wayne Health sites, paper charts UHC 7A and Harper Professional, DMC or Karmanos Cerner, VA CPRS transitioning to Cerner in 2023

Notes: The 1st day of the rotation students report their scheduled rotation location for that day based on rotation schedule sent by Emma Reaves. Contact Ms. Emma Reaves or email Dr. Geoffrey Potts with questions and for needed days off or interviews in advance of rotation. See Elective Course Coordinator Spreadsheet for contact information. Students rotate at multiple locations.

8130 - Dermatology Research - Henry Ford Health Service

Description: Knowledge and experience in dermatology research.

Director: Angie Miller

Category: Research, Non-Clinical

8140 - General Emergency Medicine - Henry Ford Health Service

Course Prerequisites: Must be a fourth year medical student, with successful completion of all third year clerkships.

Description: This rotation is designed to introduce the student to the field of Emergency Medicine. The student assumes primary care for Emergency Department patients under the supervision of senior residents. The students perform the initial history and physical exam, develop and discuss a differential diagnosis and accompanying diagnostic and therapeutic plan, and perform any procedures needed to implement such plans. Assessment and management of critically ill patients occurs with the supervising resident's evaluation of the patient. Students participate in medical and surgical resuscitation. Attendance at weekly grand rounds is expected.

Objectives: 1. Students will gain familiarity with the approach to common emergency chief complaints, including chest pain, abdominal pain, and shortness of breath. 2. Students will garner experience obtaining a focused history and physical exam of critically ill patient. 3. Students will improve their development of differential diagnoses based on chief complaint/history/physical exam of the critically ill patient. 4. Students will have the opportunity to assist and perform emergency procedures in the care of their patients.

Methods: The formal curriculum is tailored for the senior medical student. There are 14 mandatory assigned clinical shifts. There are mandatory facilitated didactics on Thursday afternoons. Attendance at grand round conferences at the assigned hospital site is strongly suggested. All students must take a pre-test at orientation, and pass a written final exam at the end of the rotation.

Recommended Reading: TBD

Length: 1 month; Days/Week: 6; Hours/Week: 50; Night Calls/Month: At least two night shifts per month. No call, but shifts can occur during the day, afternoon, overnights, and on weekends.

Evaluation: Clinical attendance. Participation and performance in conferences. Level of knowledge. Level of skills. Professional conduct. Observation of performance by faculty. Observation of performance by house officers. Assessment of write-ups/reports. Lecture and clinical attendance. Written clinical evaluations by emergency medicine residents and attending physicians, OSCE and a final exam at the end of the month.

Preceptor(s): The Clerkship Site Director is Dr Daniel Axelson.

Category: Specialty Subinternship

Recommended Attire: Scrubs, white coat

EMR System: EPIC

8140 - General Emergency Medicine - Veterans Admin Hospital

Course Prerequisite: All VA electives require U.S. citizenship. Do not register for this elective without being able to provide your U.S. social security number for onboarding purposes.

Description: Available to Year 4 students this elective will be beneficial if you are interested in emergency medicine, family or internal medicine.

Objectives: To introduce students to the basics of Emergency Medicine and Urgent Care. Description of Educational Experience: Evaluate patients with several emergency and urgent conditions. Plan care with Emergency and Internal Medicine Attendings.

Category: Specialty Subinternship

8140 - General Emergency Medicine - Detroit Receiving Hospital

Initial evaluation, stabilization, and management of patients in the emergency department.

Category: Specialty Subinternship

8140 - General Emergency Medicine - St John Hospital

Ascension - St. John Hospital. This elective is for students interested in pursuing Emergency Medicine as a career. No previous EM rotation required.

Description: The student will become familiar with the initial evaluation, assessment, and stabilization of patients who present with urgent and emergent medical problems and trauma. They will play an active role in managing acutely ill, injured patients and critical cases. Students will become exposed to a variety of invasive and non-invasive procedures that are performed in the emergency department, i.e. arterial lines, arterial punctures, central lines, suturing, chest tubes, resuscitation skills, lumbar punctures, IV lines, nasogastric tubes, Foley catheters and airway management.

Orientation/Shifts/scheduling: Students taking this elective must attend a mandatory orientation the first weekday of the month the rotation begins. You will be scheduled for 15, 8-hour shifts. Shifts will span the entire month and include days, afternoons, nights, adults and pediatrics, with one guaranteed weekend off at some point during the month. You may request up to 3 dates off in advance of the schedule being made. You will be contacted by the student coordinator asking for any requests. 75% attendance at St. John resident lectures is required, typically held between 10a-3p on Thursdays. SLOE's: Students successfully completing this elective will be eligible to receive a Student Letter of Evaluation for their residency application, upon request.

About St. John Hospital Emergency Department Ascension St John Hospital Emergency Department is a major tertiary care and trauma center on the eastside of Detroit. Located in a large metropolitan area, our department treats an underserved urban population but we are also situated next to affluent inner ring suburbs. Therefore we have a unique combined urban and community hospital setting. We are an ACS verified State of Michigan designated level 1 trauma center, treating >100,000 total patients annually, including a significant number of trauma cases. Seventeen percent of our trauma cases are penetrating injuries. St. John has a dedicated Pediatric Emergency Department which services approx. 20,000 children per year in addition to an inpatient Children's Hospital/Pediatric Center. We have an ACGME accredited residency program, training 36 EM residents annually (PGY 1-3, 12 per class).

Category: Specialty Subinternship

8140 - General Emergency Medicine - Sinai Hospital

Must have completed Emergency Medicine Sub I course first. The elective cannot accommodate a student if there is a scheduled Sub I student.

Category: Specialty Subinternship

8140 - General Emergency Medicine - St Joseph Pontiac

Course Prerequisites: N/A

Recommended Reading: TBD

Length: 1 month; Days/Week: 6; Hours/Week: 50; Night Calls/Month: At least two night shifts per month. No call, but shifts can occur during the day, afternoon, overnights, and on weekends.

Preceptor(s): Rahul Metha, MD

Category: Specialty Subinternship

Recommended Attire: Scrubs, white coat

8140 - General Emergency Medicine - Providence Hospital

Course Prerequisites: N/A

Methods: The formal curriculum is tailored for the senior medical student. Attendance at grand round conferences at the assigned hospital site is strongly suggested.

Recommended Reading/Resources: To be assigned.

Length: 1 month; Days/Week: 6; Hours/Week: 50; Night Calls/Month: At least two night shifts per month. No call, but shifts can occur during the day, afternoon, overnights, and on weekends.

Preceptor(s): Dr. Denise Shuttie

Category: Specialty Subinternship

Recommended Attire: Scrubs, white coat

8145 - ER Ultrasound - St John Hospital

Course Prerequisites: This elective is geared towards fourth year students interested in pursuing emergency medicine as a career.

Description: Emergency medicine ultrasound elective designed to provide fourth year medical students the opportunity to expand basic POCUS skills as well as more advanced skills working with fellows and residents. Weekdays only, no nights, no holidays.

Objectives:

Scan three days a week at St John Emergency Department semi-independently to expand Pocus skills. 15/hrs/week.
Scan weekly at ultrasound sessions with the ultrasound faculty/fellows and residents at all four WSU home emergency centers. 5/hrs/week
Virtual training modules with embedded quizzes. 8/hrs/week
Weekly ultrasound Director or fellow to review progress and do some scanning. 1-2 hr/week
Attend weekly resident teaching lectures/didactics at St John on Thursdays. 5/hrs/week
Present an ultrasound topic or case at the end of the month during resident lecture didactics. 10 minutes.

Methods: Orientation at beginning of the month. Weekly meetings with ultrasound faculty. Independent scan shifts in emergency department at St John. Scanning with weekly teaching shifts with ultrasound faculty and fellows. Self-independent study virtual online weekly. Weekly didactics. Final presentation. No exam.

Required Reading: Virtual curriculum eight hours per week with recommended reading imbedded in the curriculum.

Length: One month. Total Hours/Week: 35-40 hrs. Weekdays. No nights, weekends or holidays. See objectives for details.

Evaluation: Weekly meetings with ultrasound faculty. Direct observation of skills. Progress with virtual curriculum which includes quizzes. 10-minute presentation at end of month resident didactics. No exam.

Course Director: Elizabeth Bascom, MD, FACEP

Preceptor(s): Ultrasound faculty at St John: Andrew Butki DO, Douglas Stayer MD

Coordinator: Erica Dobson

Category: Inpatient Consult Service

Recommended Attire: Scrubs

EMR System: Cerner

8145 - ER Ultrasound - Sinai Hospital

Course Prerequisites: Third year core rotations, preferably general emergency medicine rotation

Description: This rotation will introduce students to point-of-care ultrasound (POCUS) examinations, with a focus on indications for scanning, image acquisition and image interpretation.

Objectives: To develop skills in applications of emergency ultrasound, specifically focused on cardiac & abdomen, vascular access & procedures & transabdominal OB. Enhance skills in evaluation & management of critically ill ED patients using
ultrasound as a tool to evaluate hemodynamics. On 1 day, 5 day week of time spent in the ED performing U/S exams supervised by residents, fellows & faculty. 2-3 hours a week small group discussion, 2-3 hours a week of image review and
evaluation.

Methods: Time on rotation is a combination of scanning with residents/fellows/attendings, self-study, and weekly image review sessions and didactics with faculty. All images acquired during the month will be reviewed for quality by an US-fellowship trained attending.

Recommended Reading/Resources: Electronic book co-written by preceptor, Access Emsono, online tutorial, image book & exam qx's, Itunes lectures

Length: 1 month; Hours/Week: 40; Days/Week: 5; Night Calls/Month: None

Additional Locations: The primary location of this elective is at Sinai Hospital Detroit. Monday scanning sessions at Detroit Receiving and St. John’s Hospital in Detroit

Evaluation: Clinical evaluation based on image acquisition and interpretation skills; Written exam in Emsono blocks: FAST, Cardiac, OB

Preceptor(s): Brian Haber, MD, FACEP

Category: Inpatient Consult Service

Recommended Attire: Scrubs +/- white coat if desired

EMR System: Cerner

Director(s): Brian Haber, MD, FACEP

Coordinator(s): Jordan Anderson

8145 - ER Ultrasound - Detroit Receiving Hospital

Objectives: To develop skills in Emergency Ultrasound and Procedural Applications.

Method: Education will focus on specific skillsets in emergency ultrasound, specifically cardiac, abdominal, transabdominal OB, US guided procedures and hypotension & shock, and learn how to apply those skills.

Required Reading: Asynchronous Curriculum

Evaluation: Subjective clinical evaluation and test

Category: Inpatient Consult Service

8145 - ER Ultrasound - Henry Ford Health Service

Course Prerequisites: Students must have prior approval from Dr. Amponsah dampons1@hfhs.org. Prefer to have students interested in pursuing residency training in Emergency Medicine or other specialties that emphasize the use of POCUS

Description: The EM POCUS elective is designed to provide senior medical students a unique opportunity to enhance their ultrasound imaging and interpretation skills, and its application in the clinical setting during the assessment and management of patients presenting with urgent and emergent complaints.

Objectives: 1. Demonstration of ultrasound image acquisition skills for the core applications for EM practice. 2. Discuss the role of ultrasound in the evaluation of patients with urgent and emergent complaints in the ED. 3.Participate in QA and image review sessions with residents, fellows and core ultrasound faculty. 4. Review assigned articles and present a 10min summary of any ultrasound topic of interest. 5.Participate in WSUSOm ultrasound teaching sessions serving in the ccapacity as Teaching Assistant

Methods: Orientation. Scan shifts in the ED with ultrasound faculty and fellows. Attend EM grand rounds. Participate in self learning opportunities with literature review, web-based learning. Complete multiple choice test at the end of the rotation.

Required Reading: Ultrasound Review Articles that will be sent to students at the beginning of the rotation

Length: Work Days/Week: 5 days with no weekends; Approx Hours/Day: maximum of 6. Includes time to review articles, QA, and teaching activities; Night Calls/Month: None

Evaluation:10 minute presentation and multiple choice exam at the end of the rotation. Direct observation of ultrasound image acquisition and interpretation skills at the bedside with direct formative feedback.

Preceptor(s): David Amponsah MD

Category: Inpatient Consult Service

Recommended Attire: Scrubs, white coat

EMR System: EPIC

8160 - Emergency Medicine Core Clerkship - Sinai Hospital

Course Prerequisites: N/A

Description: The Emergency Medicine core rotation is designed to introduce students to the principles of acute care medicine. Students have the opportunity to evaluate patients as well as formulate effective testing and treatment strategies. Active participation in patient care and procedural skills are emphasized. The course consists of experiences in patient care, assigned readings from emergency medicine references, weekly conferences, and a final exam at the end of the rotation.

Objectives: The student will become familiar with the initial evaluation and stabilization of patients who present to the emergency department with urgent and emergent medical illnesses and traumatic injuries. The student will gain experience managing acutely ill and injured patients in a timely fashion. He/she will follow the patient's emergency department course, and provide an appropriate disposition. The student will become familiar with a variety of invasive and noninvasive techniques that are routinely used in the treatment of patients in the emergency department. The required procedures are suturing, peripheral IV placement, performing ABG’s and Foley catheter insertion. Students are expected to participate in all aspects of patient care including resuscitations.

Methods: The formal curriculum is well designed for the senior medical student. There are mandatory assigned clinical shifts. There are mandatory facilitated discussions on Thursday afternoons. Attendance at grand round conferences at the assigned hospital site is strongly suggested. An Emergency Medicine Student Manual is distributed to students at orientation. Students will participate in High Fidelity simulation. All students will be assigned and Interprofessional nursing shift during the month. All students must perform and OSCE and pass a written final exam at the end of the rotation.

Recommended Reading Material: WSU Emergency Medicine Student Manual. CDEM Clerkship Primer. CDEM Year 4 curriculum.

Length: 1 month; Days/Week: 6; Hours/Week: 50; Night Calls/Month: rotating shifts - days, afternoons, and midnights. The student is required to be present for this rotation during the entire month in which he/she is assigned. All students must attend a mandatory orientation session at WSU on the first weekday of the month of the rotation. This will be followed by a mandatory orientation at the assigned site. The final examination will be on the last weekday of the rotation. The exam is an NBME shelf. The student is allowed 2 days off for interviewing, with prior approval. All missed shifts, including days off for interviews, are expected to be made up. Contact the Department of Emergency Medicine at (313) 993-2530 for any questions or concerns.

Evaluation: Written clinical evaluations by emergency medicine residents and attending physicians, OSCE and a final exam at the end of the month.

Course/Clerkship Director: Sarkis Kouyoumjian, MD

Site Director: Brian Haber MD

Site Coordinator: Jordan Anderson

Category: Specialty Subinternship

Recommended Attire: Scrubs are recommended. For those that don’t want to wear scrubs other professional attire is required.

EMR System: Hospital dependent.

8160 - Emergency Medicine Core Clerkship - Henry Ford Health Service

Course Prerequisites: N/A

Recommended Reading Material: WSU Emergency Medicine Student Manual. CDEM Clerkship Primer. CDEM Year 4 curriculum.

Evaluation: Written clinical evaluations by emergency medicine residents and attending physicians, OSCE and a final exam at the end of the month.

Course/Clerkship Director: Sarkis Kouyoumjian, MD

Site Director: Daniel Axelson MD

Site Coordinator: Tina Gaines

Category: Specialty Subinternship

Recommended Attire: Scrubs are recommended. For those that don’t want to wear scrubs other professional attire is required.

EMR System: EPIC

8160 - Emergency Medicine Core Clerkship - Detroit Receiving Hospital

Course Prerequisites: N/A

Recommended Reading Material: WSU Emergency Medicine Student Manual. CDEM Clerkship Primer. CDEM Year 4 curriculum.

Evaluation: Written clinical evaluations by emergency medicine residents and attending physicians, OSCE and a final exam at the end of the month.

Course/Clerkship Director: Sarkis Kouyoumjian, MD

Assistant Clerkship Director/Site Director: Dr Dimitrijevski MD.

Site Coordinator: Shazzandra Doze

Category: Specialty Subinternship

Recommended Attire: Scrubs are recommended. For those that don’t want to wear scrubs other professional attire is required.

EMR System: Hospital dependent.

8160 - Emergency Medicine Core Clerkship - St John Hospital

Course Prerequisites: N/A

Recommended Reading Material: WSU Emergency Medicine Student Manual. CDEM Clerkship Primer. CDEM Year 4 curriculum.

Evaluation: Written clinical evaluations by emergency medicine residents and attending physicians, OSCE and a final exam at the end of the month.

Course/Clerkship Director: Sarkis Kouyoumjian, MD

Site Director: Elizabeth Bascom MD

Site Coordinator: Lynn Huber

Category: Specialty Subinternship

Recommended Attire: Scrubs are recommended. For those that don’t want to wear scrubs other professional attire is required.

EMR System: Hospital dependent.

8165 - Advanced Emergency Medicine - St John Hospital

Course Prerequisite: Students may register for the Advanced EM Elective, if they meet the following criteria: 1. Intend to apply for an Emergency Medicine residency 2. Successful completion of a prior EM rotation 3. Must be in the final year of medical school education

Description: The Advanced Elective in Emergency Medicine with ultrasound is a critical care and ultrasound experience for students applying for an Emergency Medicine residency. There is an emphasis on critical care management, "resuscitation" shifts, and ultrasound with opportunities to participate in the following:

Medical Critical Care Cases
Pediatric Critical Care Cases
Trauma Cases
Ultrasound shifts with a resident (5)
Scheduled to work “Resuscitation” shifts when available
Priority scheduling in areas that cover medical and trauma codes
Advanced Procedures such as:
- CPR
- ABG
- Ultrasound Guided-IV
- Ultrasound FAST exam
- Intubation
- Ultrasound Guided Central Line placement
- Trauma Code procedures
- Chest Tube Insertion
- Central Line placement

This Elective will expose the student to the diverse spectrum of clinical problems encountered in the Emergency Department. The student will gain experience in the evaluation and treatment of various acute medical and surgical and traumatic disorders and gai experience in ultrasound skills. The student will work closely with the senior residents and faculty of the Emergency Department in developing expanded differential diagnosis and management of both critically and non-critically ill patients. In addition to the patient care responsibilities, there are opportunities to participate in some of the following: didactic lectures, workshops, conferences.

Objectives:

Development of critical thinking and patient care management skills in a large urban Emergency Department setting.
The ability to function effectively within the context of complexity and uncertainty in medical care.
Management of more than one patient simultaneously, devise and implement expanded differential diagnosis and management of critically ill patients, and see them through to disposition.
The student will learn advanced procedures and ultrasound
The student will gain experience with End-of-life care and decisions, bereavement and family stress management.
Content Theme Integration\
1. Critical Decision Making
2. Ethics
3. Violence/Abuse
4. Geriatrics
5. Pain Management
6. Substance Abuse
7. Effective communication under stress conditions

Key Responsibilities of the student while on Elective: Students will have direct patient management responsibility under close supervision by the attending faculty and senior residents. Mandatory attendance for all activities, including clinical shifts in Emergency Department and all available didactic lectures, ultrasound workshops, SIM sessions and conferences. Students will be scheduled for 14-15, 8-hour shifts. Shifts will span the entire month and include days, afternoons, nights, adults and pediatrics, in order to experience the full range of case types that are typical of each shift. You will be guaranteed one weekend off at some point during the month.

Method of Evaluation: The final evaluation will be completed by the SJH EM Clerkship Director, using the format provided by the student's school and based upon: Successful completion of a minimum of 14 eight-hour required shifts. A minimum of 8 shift evaluations must be returned to the Clerkship Director by month end. 75% Participation in available conferences and lectures

Scheduling Information Months Offered: May-February, space is limited. Mandatory Orientation attendance on the first weekday of the elective month. Month runs from the first weekday to the last calendar day. Prior to orientation you will receive orientation details and rotation guidelines via email. You may request up to 3 dates off in advance of the schedule being made. You will be contacted by the student coordinator asking for any requests.

Category: Specialty Subinternship

Notes: About Ascension St. John Hospital Emergency Department: Ascension St John Hospital Emergency Department is a major tertiary care and trauma center on the eastside of Detroit. Located in a large metropolitan area, our department treats an underserved urban population, but we are also situated next to affluent inner ring suburbs. Therefore, we have a unique combined urban and community hospital setting. We are an ACS verified State of Michigan designated level 1 trauma center, treating >100,000 total patients annually, including a significant number of trauma cases. Seventeen percent of our trauma cases are penetrating injuries. St. John has a dedicated Pediatric Emergency Department which services approx. 20,000 children per year in addition to an inpatient Children’s Hospital/Pediatric Center. We have an ACGME accredited residency program, training 36 EM residents annually (PGY 1-3, 12 per class).

8165 - Advanced Emergency Medicine - Sinai Hospital

Course Prerequisite: Students may register for the Advanced EM Elective, if they meet the following criteria:

1. Intend to apply for an Emergency Medicine residency. 2. Successful completion of a prior EM rotation. 3. Must be in the final year of medical school education Description The Advanced Elective in Emergency Medicine is a critical care experience for students applying for an Emergency Medicine residency. There is an emphasis on critical care "resuscitation" shifts, and opportunities to participate in the following: Medical Critical Care Cases, Pediatric Critical Care Cases, Trauma Cases, Advanced Procedures such as ABG Ultrasound Guided-IV Ultrasound FAST exam Intubation Central Line placement Trauma Code procedures Chest Tube Insertion

This Elective will expose the student to the diverse spectrum of clinical problems encountered in the Emergency Department. The student will gain experience in the evaluation and treatment of various acute medical and surgical and traumatic disorders. The student will work closely with the senior residents and faculty of the Emergency Department in developing expanded differential diagnosis and management of both critically and non-critically ill patients. In addition to the patient care responsibilities, there are opportunities to participate in some of the following: didactic lectures, workshops, conferences.

Objectives: Development of critical thinking and patient care management skills in a large urban Emergency Department setting. The ability to function effectively within the context of complexity and uncertainty in medical care. Management of more than one patient simultaneously, devise and implement expanded differential diagnosis and management of critically ill patients, and see them through to disposition. The student will learn advanced procedures. The student will gain experience with End-of-life care and decisions, bereavement and family stress management. Content Theme Integration: Critical Decision Making, Ethics, Violence/Abuse, Geriatrics, Pain Management, Substance Abuse, Effective communication under stress conditions

Key Responsibilities of the student while on Elective: Students will have direct patient management responsibility under close supervision by the attending faculty and senior residents. Mandatory attendance for all activities, including clinical shifts in Emergency Department and all available didactic lectures, ultrasound workshops, SIM sessions and conferences. Students will be scheduled for 15, 8-hour shifts. Shifts will span the entire month and include days, afternoons, nights, adults and pediatrics, in order to experience the full range of case types that are typical of each shift. You will be guaranteed one weekend off at some point during the month.

Method of Evaluation: The final evaluation will be completed by the SJH EM Clerkship Director, using the format provided by the student's school and based upon: Successful completion of a minimum of 15 eight-hour required shifts. A minimum of 8 shift evaluations must be returned to the Clerkship Director by month end. 100% Participation in available conferences and lectures

Scheduling Information Months Offered: June-January, space is limited Mandatory Orientation attendance on the first weekday of the elective month Month runs from the first weekday to the last calendar day Prior to orientation you will receive orientation details and rotation guidelines via email. You may request up to 3 dates off in advance of the schedule being made. You will be contacted by the student coordinator asking for any requests.

Category: Specialty Subinternship

8166 - Student Run Free Clinic - Underserved Populations - Detroit Central City

Course Prerequisites: 50+ hours volunteered at Cass Clinic prior to the start of M4.

Description: Students are involved in supervision of day-to-day operations of a Student Run Free Clinic. Students will have clinical experience interacting with patients. Additionally, as a senior member of the Cass team, students will be expected to keep up with clinic organization, clinic resources, clinic improvement, and participate in ongoing research projects at the Cass clinic. Students will act as mentors to the preclinical leadership teams, sitting in on team meetings and providing 5–10-minute lessons to the M1/2 students about a medical/social aspect of underserved communities and how to better address it as a future physician. Students will also coordinate with RNs and social workers to support and advocate for patients during medical appointments.

Objectives: To understand the unique rewards and obstacles to treating underserved communities in Detroit. To learn to compassionately interact with patients of all backgrounds without making assumptions or judgments. To understand the challenges to receiving care for underserved communities in Detroit and witness the effects these gaps in medical care can have on a person's health. To become familiar with local and community resources and referrals aimed to bridge the gaps in healthcare. To work alongside teams of medical students, doctors, nurses, and social workers to learn about interdisciplinary care that supplements medical care. To home in on your teaching skills as you mentor preclinical medical students and teach them clinical skills early in their medical education.

Methods: Students will experience clinic-based learning. Students will participate in patient care with the Cass Clinic team at both of our locations under the guidance of a medical preceptor and offer support to the Cass Clinic Coordinators (Second year medical students) as needed. As a senior medical student participating in the Cass Clinic Elective, students are in a position to build trust with regular patients and offer them comprehensive medical care. Students will also have weekly required Didactics session with Dr. Sherwin. Topics will relate to common medical conditions/treatments seen at clinic, Clinic improvements, and career development sessions. At the end of each shift students should provide a debrief session to the first- and second-year medical students on all of the patients seen that day by the team and walk through the clinical reasoning for management and treatment. Students will be expected to submit a sample case and debrief session to Canvas. Students will also be expected to complete learning modules on Canvas and summarize their learning.

Recommended Reading/Resources: Medical Management of Vulnerable and Underserved Patients: Principles, Practice and Populations. Contact the coordinators to pick up a copy of the book for the month. Will be provided by Cass Clinic.

Hourly Breakdown (need to get to 120 hours): Clinic (clinic, presentations): 10 per week – 40 total; Offsite (EMR, patient follow up, meetings, pamphlets, med cards): 10 per week – 40 total; Readings (readings, presentation prep): 5 hours/week - 20 total; Modules: 12 total; Mentorship: 2 hours/week - 8 total; Weekly Didactics session with Dr. Sherwin: 1 hour/week

Additional Locations: Cass Clinic - Cass Community United Methodist Church - 3901 Cass Ave, Detroit, MI 48201

Preceptor(s): Dr. Robert Sherwin

EMR System: You will be given access to our EMR, which we expect you to use daily to ensure that our patient notes and charting written by our underclassmen are properly documented. In the case that you notice a preclinical medical student that does not meet our standards for note writing, you should reach out to that individual and offer some mentorship sessions to help them build their skills as they approach their clinical years. Please contact the Cass Clinic Senior Directors or the EMR Coordinator if you have any questions.

Category: Non-Clinical, Community Service

8170 - General Family Medicine - Providence Hospital

Course Prerequisites: N/A

Description: The enhancement of knowledge and skills in conducting a history/physical, diagnosing/managing patients, and participation in common office procedures in the outpatient setting.

Objectives: To introduce students to Family Practice in the office setting. To develop skills necessary for diagnosis and management of common medical problems. To gain exposure to procedures (sigmoidoscopy, coloscopy, vasectomy, minor skin lesions).

Methods: Students will examine and care for patients completing their care under supervision from senior family practice residents or faculty. They will be exposed to evidence-based medicine and management principles. Students will have the opportunity for hands on learning.

Recommended Reading Material: To be assigned.

Length: 1 month

Evaluation: Clinical Evaluation

Category: Specialty Subinternship

8170 - General Family Medicine - Beaumont Wayne

Objectives: To introduce students to Family Practice in either Belleville or Westland Family Practice Office settings. To develop skills necessary for diagnosis and management of common medical problems. To gain exposure to procedures (sigmoidoscopy, coloscopy, vasectomy, minor skin lesions).

Methods: Students will examine and care for patients completing their care under supervision from senior family practice residents or faculty. They will be exposed to evidence based medicine and management principles. Students will have opportunity for hands on learning.

Recommended Reading Material: Taylor, Robert B. Family Medicine. Principles and Practice.

Length: 1 month; Days/Week: 5; Hours/Week: 40; Night Calls/Month: none

Evaluation: Clinical Evaluation

Category: Specialty Subinternship

8172 - Family Medicine Student Run Free Clinic - Alexandrine

Course Prerequisites: Students must have previously served on the board of the Student Run Free Clinic. Students are required to get prior approval from Dr. Ralph Williams.

Description: The fourth year elective student for Robert Frank SRFC will serve as the Junior medical director of the clinic. They will be responsible for the entirety of clinic operations under the supervision of the medical director.

Objective: Learn principles for managing a student-run free clinic (SRFC). The students will be involved in supervising day-to-day operations of the WSU SRFC. Review problems and progress of clinic operations. Oversee scheduling and other practice management activities. At the conclusion of this elective, students will be able to:

Demonstrate enhanced knowledge of the operations of the SRFC.
Discuss the impact of Social Determinants of Health in health care delivery for the underserved in the city of Detroit.
Develop an appropriate treatment plan for primacy care services for uninsured patients.
Demonstrate leadership skills necessary to mobilize student and physician volunteers in the daily operations of the free clinic.
Implement Quality improvement and Quality assessment activities in an outpatient clinic.
Develop strategy for clinic growth
Facilitate interprofessional networks for enhanced clinical services
Demonstrate entrustability in the direct care of patients
Develop and implement research projects among the SRFC patient population

Methods: The fourth year elective student will be responsible for the following tasks:

Meet with Dr. Williams the week prior to the first clinic day to discuss elective month.
Attend all Chart Reviews and Saturday clinics during the month in which he/she is registered for the elective.
Provide direct management and oversight of all urgent and emergent patient issues. This includes phoning emergency transport service, accompanying patient
Ensure that student clinic EMR is maintained and updated following each clinic session. This includes monitoring and follow up of uncompleted charts, i. e., missing signatures, etc.
Organize and deliver a short (approximately 10-15 minutes) presentation in reference to a particular patient who was seen in the clinic that morning.
1. Presentations should focus on patient presentation, pertinent positives and negatives, differential diagnosis, and treatment/management.
2. Include at end of presentation a question to all care teams about any concerns or improvements that can be made.
3. Role model the expression of any feelings regarding situations that arose, particular patient reactions, etc.
Assist SRFC student leaders with current To-Do List tasks.
Meet with Dr. Williams weekly to review labs, patient issues, etc.
Meets and/or speaks with the succeeding 4^th Year elective student.
Review all charts in EMR following clinic sessions including following up with patient lab values, referrals, hospitalizations, etc.
Manages all clinic chart reviews. Provide clinical feedback and education to SRFC student volunteers on the day or two preceding each clinic.
Work at Family Medicine offices in the provided cubicle to enter charts for EMR, review labs, implementation of other projects. Keep cubicle orderly. Keep desk drawers free from patient files, etc.
Complete post-elective self-evaluation and send to Dr. Binienda.

8173 - Patient Centered Medical Home and Quality Curriculum - Crittenton Hospital

Course Prerequisites: Completion of outpatient family medicine rotation and sub-internship (either in FM or IM).

Description: The Patient Centered Medical Home (PCMH) and Quality rotation exposes students to the concepts of the Patient Centered Medical Home and quality metrics as they pertain to current practices in family medicine. They may also engage in a hospital-based Quality Improvement project aimed towards addressing Joint Commission and NIH requirements.

Objectives: By the end of the rotation, students will be able to:

Define and understand what a PCMH is.
1. List at least 3 PCMH benefits to the patient
2. List at least 3 PCMH benefits to the clinic/provider
Define and understand core quality metrics and how they pertain to reimbursements through major commercial insurance carriers. Including but not limited to:
1. Breast cancer screening
2. Cervical cancer screening
3. Colorectal cancer screening
4. Osteoporosis screening
5. Hypertension blood pressure control
6. Asthma management
7. COPD management
8. Diabetic control
  1. A1c goals
  2. Microalbumin
  3. Diabetic Eye exams
  4. Diabetic foot exams
Define and know the key components of Medicare Wellness Exams
1. Know the indication for “Welcome To”, “Initial” and “Subsequent” medicare annual exams
Understand the USPSTF recommendations for screening frequency for the following:
1. Mammograms
2. Pap smears
3. Colon cancer screening
  1. Cologuard vs. Colonoscopy
4. Osteoporosis screening
5. Diabetes screening
6. Hyperlipidemia screening
7. Prostate cancer screening
Understand the difference between ICD10 Codes, E&M codes, CPT codes, CPTII codes and medication “J Codes”
Understand how insurance companies utilize coding for reimbursement and quality measurements.

Methods: Students will focus on a quality improvement project in an outpatient family medicine residency clinic and/or in within the hospital family medicine department. That project will be determined by the course director and is dependent upon what initiative current Family Medicine residents are already working on.

Students will partner with the course director and FM residents on one of these initiatives during a 4 week rotation. The schedule will vary but will not exceed 40 hours per week. Examples of past initiatives:

Collecting data on hand-hygiene in the hospital setting to reduce c. diff transmission via widespread hospital initiatives
Sending letters with educational materials to women in need of pap smears to improve rates of pap smear completion
Developing patient educational materials on alternative ways to screen for colon cancer

During this month, students will also complete several on-line assignments to learn more about the PCMH model and Quality Metrics in Primary Care.

Required Reading/Resources:

Joint Principles of the Patient-Centered Medical Home 2007, AAFP
Lecture “PCMH & Quality Measures” 2018, Eleanor R. King
During the month the resident will attend any Clinical Operation or Practice Management lecture series hosted at the site

Length: 1 month; Days/Week: 4-6; Hours/Week: >= 40 hrs; Night Calls/Week: None

Additional Locations:

Rochester Academic Family Medicine, 1135 W. University Drive Ste 250, Rochester, MI 48307
Ascension Providence Rochester Hospital, 1105 W. University Drive, Rochester, MI 48307

Evaluation: Written Evaluation and Verbal Feedback

Preceptor(s): Director and PGY3 family medicine residents.

Director: Dr. Eleanor King

Coordinator: Lisa Blackwell

Category: Ambulatory

Recommended Attire: Scrubs +/- white coat, Badge or jacket with name visible

EMR System: Athena and Cerner (depending on the project these may or may not be used. If utilized, access will be provided).

8175 - MPH Master's Project - Arranged (Building Not Needed)

This course is only available to students enrolled in the MD/MPH program.

Course Description: The Master's Project is the MPH Program's culminating experience, in which students apply the knowledge and skills gained from classroom and field experiences to a scholarly project of their own design and execution. The final products are a written and an oral presentation.

Objectives: The objective of the Master's Project course is for the student to demonstrate MPH Program competencies. Master's Projects may take a variety of directions, depending on student interest and career objectives. The required written report and oral presentation will reflect the culmination, integration and application of the student's public health knowledge.

Method of Instruction: A Project Orientation session is held at the beginning of each semester. Students are required to attend the Orientation at least one time. At the orientation, course directors will review all aspects of the MPH project, including guidelines, important dates and deadlines. FPH 8990 operates similarly to an independent directed study; after a Project idea is formulated, students must recruit a Project Advisor and fill out the Project Proposal form.

Required and Recommended Reading Materials: Posted on the MPH Program website, under FPH 8990 course materials: Boardage G. Considerations on preparing a paper for publication. Teaching and Learning in Medicine: An International Journal. 1989; 1(1): 47-52. Watts, E, Peacock O, Liyanage S, Elsey E, Lund J. Presentation skills amongst surgical trainees at a national conference: an observational study. Journal of the Royal Society of Medicine Short Reports. 2012;3(5): 30 2) Recommended Text: Cottrell S. Dissertations and Project Reports: A Step by Step Guide. New York: Palgrave Macmillan, St. Martin's Press, LLC, 2014. ISBN: 978-1-137-36426-5

Notes on Acceptable Projects: The Project idea and plan may grow out of Practicum, but it must be distinct. If a project is identified from the student's current employment, it is permissible to develop a Master's Project distinct from work duties. Specifically, the Project must be conducted outside of normal work responsibilities.

Category: Non-Clinical

8176 - Public Health&Clinical Med - Arranged (Building Not Needed)

Students will complete a set of activities that introduce students to various aspects of public health and its role in clinical patient care.

Category: Online, Non-Clinical

8210 - Acting Internship: Family Medicine - Crittenton Hospital

Required for Year 4.

Objectives:

I. Communication Skills - Interns play a key role in communicating aspects of patient care to patients, families and healthcare providers. A. Communicate effectively with patients and family members B. Recognize verbal and non-verbal clues of a patients' mental and physical health. C. Summarize for the patient and/or family the reason for admission and rationale for clinical plan. D. Initiate a conversation with a patient about advance directives. E. Demonstrate the ability to clearly and concisely present oral and written patient summaries to members of the health care team.

II. Coordination of Care - Interns play a central role in coordinating patient care. This involves communication between the patient and his/her family, colleagues, and other hospital personnel. Appropriate; management and coordination is essential to ensure optimal patient care. A. Prioritize tasks for daily patient care in order to effectively utilize time. B. Appropriately utilize consultants C. Effectively coordinate with physician and non-physician members of the health care team D. Identify on-call housestaff and cross-coverage schedules among housestaff E. Communicate oral and written transfer of patient care responsibilities to other housestaff F. Demonstrate proficiency in coordinating a comprehensive, longitudinal patient care plan. G Communicate the plan with outpatient health care provider; arranging for follow-up when appropriate. H. Coordinate care plan utilizing community resources when necessary.

III. Information Management - Interns face an extraordinary challenge in managing large amounts of clinical information relevant to a patients hospital admission. Accurate and timely acquisition, documentation and transfer of clinical information are necessary for safe and efficient hospital practice. A. Be able to access the clinical information system in use at their hospital. B. Understand how panic values are communicated from the hospital laboratory to the responsible team member C. Use a systematic method to track clinical/laboratory/radiologic data. D. Be aware of patient confidentiality regulations governing medical records and clinical information. E. Understand the importance of precision and clarity when prescribing medications. F. Document in an organized and efficient manner G. Use electronic or paper reference to access evident based medicine to solve clinical problems

IV. Procedures - The subinternship presents an opportunity to gain experience with procedures that are commonly performed by interns and residents. The subintern should be able to: A. Describe indications, contraindications, risks and benefits of each of the following procedures: Venipuncture, Intravenous catheter insertion, Intravenous catheter insertion, Arterial blood sampling, Nasogastric tube placement, Lumbar puncture, Urethral catheter insertion, Intramuscular and subcutaneous injections, Bag and Mask placement and utilization, Other procedures that are service appropriate B. Recognize clinical situations where one or more procedures are indicated. C. Effectively explain the rational, risks and benefits for the procedure in language that is understandable by the patient and/or his/her family. D. Obtain and document informed consent, if necessary E. Recognize limitations of skill or proficiency in performing one of the above procedures. F. Recognize potential procedure related risks for the operator and the need for universal precautions. G. Personally perform, with direct supervision, the above procedures, when possible. H. Write a procedure note. I. Ensure that samples obtained are properly prepared for laboratory processing. J. Teach procedure skills to a third year medical student, when appropriate.

Recommended Reading Material: To be provided

Length: 1 Month

Evaluation: Written

Category: Acting Internship

EMR System: Hospital Dependent

8210 - Acting Internship: Family Medicine - Beaumont Wayne

Required for Year 4.

Objectives:

Recommended Reading Material: To be provided

Length: 1 Month

Evaluation: Written

Category: Acting Internship

EMR System: Hospital Dependent

8210 - Acting Internship: Family Medicine - St Mary Mercy Hospital/Livonia

Required for Year 4.

Objectives:

Recommended Reading Material: To be provided

Length: 1 Month

Evaluation: Written

Category: Acting Internship

EMR System: EPIC

8210 - Acting Internship: Family Medicine - Henry Ford Health Service

Required for Year 4.

Objectives:

Recommended Reading Material: To be provided

Length: 1 Month

Evaluation: Written

Category: Acting Internship

EMR System: EPIC

8230 - Maternal and Child Health - Beaumont Wayne

The rotation is at Oakwood-Westland

Objectives: To help a student gain experience in an aggressive family medicine OB service. The student will work with family medicine attendings and a family medicine OB fellow to perform deliveries, evaluate patients in triage, and see prenatal patients in an outpatient setting. The student will get good experience with c-sections and vacuum extractions as well.

Work days/week: 5-6; Approx hours/day: 8-10; Night call/month: 5-7

Category: Inpatient Consult Service

8250 - Sports Medicine - Detroit Medical Center

Knowledge and skills to assess the fitness and health risks of athletes.

Category: Inpatient Consult Service

8250 - Sports Medicine - Henry Ford Health Service

Course Prerequisite: Must be an M4. Pre-approval necessary.

Description: Students explore the practice of sports medicine on the amateur level from screening the athlete in a pre-participation exam to assessing an acute injury and rehabilitation. Students spend most of their time at the Center for Athletic Medicine with family physicians trained in sports medicine experience and certified trainers working with local high school teams. Didactics add to this clinical experience.

Objectives: To introduce the student to knowledge and skills pertaining to assessing an athlete's fitness and risk potential. To instruct a student in skills to assess the extent of an injury and appropriate therapeutic responses. To familiarize the students on general guidelines of sport participation, exclusion & rehabilitation and the medical literature pertaining to sports medicine.

Enhance knowledge and skills pertaining to muscuskeletal evaluations.
Become familiar with particular problems common to various sports and with history-taking of athletes.
Develop the ability to complete the pre-participation exam and to assess acute injury.
Develop ability to interpret data and use clinical judgment in providing therapy and advice to the athlete.
Increase student presentation skills.
Increase student use/review of medical literature.

Methods: To explore the practice of sports medicine including assessment and treatment of sports injuries in the clinic setting. They will work with the staff in the sports medicine clinics to better understand the role of the sports medicine physician in the health maintenance and treatment of athletic teams. Didactics are integrated to enhance this clinical experience. 80% patient care. 10% amateur athletic events. 10% operating room.

8260 - Allergy and Clinical Immunology - Henry Ford Health Service

Course Prerequisites: None.

Description: The majority of the elective time will involve providing care to patients in the outpatient clinic with a team consisting of an attending physician, fellows, residents and other students. There may be residents who also rotate on the service.

Objectives: Enhance knowledge and skills pertaining to interviewing, physical examination, or patient interactions, interpretation of data, clinical judgment and procedures (i.e., observational, allergy testing, therapy and advice to patients). Increase student involvement in conferences, journal clubs. Increase student use/review of the medical literature.

Methods: Direct supervised patient contact with staff. Patients with asthma, allergic and non-allergic rhinitis/rhinosinusitis, allergic conjunctivitis, atopic dermatitis, food allergy and/or intolerance, hymenoptera venom sting allergy, drug allergy, anaphylaxis, urticaria and angioedema. Patients with various immunodeficiency problems. Patients who require allergen immunotherapy and immunomodulation for allergic and immunologic diseases.

Distribution of students time: 85% outpatient care, 10% conferences, 5% inpatient care

Recommended Reading Material: To be provided

Length: 1 month; Days/Week: 5; Hours/Week: 36; Night Calls/Month: none

Additional Locations: Henry Ford Sterling Heights (3500 Fifteen Mile Rd. Sterling Heights), Henry Ford Columbus (39450 West 12 Mile Rd. Novi), Henry Ford Fairlane (1900 Hubbard Dr. Dearborn)

Evaluation: Clinical evaluation

Preceptor(s): Christian Nageotte; Edward Zoratti; Rana Misiak; David Coleman; Haejin Kim; Erica Ridley; Amy Eapen

Category: Inpatient Consult Service

Recommended Attire: Business professional

EMR System: EPIC

8270 - Ambulatory Med - Michigan Healthcare Professionals

Course Prerequisites: N/A

Description: There is an increased role of ambulatory medicine in all specialties. By selecting this course, the student will gain valuable experience at an advanced level in an ambulatory setting based on the specialty of their choosing.

Objectives: This course will expose the student to the patient’s needs as they differ in the outpatient environment, giving the student a more complete picture of longitudinal patient care outside hospitalization. Students who take this course will gain an appreciation and thorough expert understanding of how medical care is delivered in the clinic, while simultaneously exposing themselves to their planned specialty in the setting in which they will most likely be responsible for patient care after graduation.

Methods: Students will select their top three sites/specialties in which to further develop their skills and be assigned a spot at a Michigan Healthcare Professionals (MHP) location based upon those selections. The student will function as a valued team member to experience daily outpatient care under the guidance of MHP physicians and receive feedback for their work, both medically and surgically depending on the specialty assigned.

Additional Locations: Available MHP specialties and sites are subject to change. Please refer to your class's Canvas Resources page for an updated list.

Recommended Reading Materials/Resources: N/A

Length: 1 month; Days/Week: 5; Hours/Day: 8; Night Calls/Month: none

Evaluation: The student is evaluated throughout the course based on their EPA (Entrustable Professional Activities) performance to help determine whether or not the student is sufficiently prepared for residency.

Category: Ambulatory

Notes: This rotation is part of the two-week pilot program. Rotations participating in the pilot program are only available when taken in the same month or with a 2-week away rotation also in the same month.

8270 - Ambulatory Medicine - Veterans Admin Hospital

Course Prerequisite: All VA electives require U.S. citizenship. Do not register for this elective without being able to provide your U.S. social security number for onboarding purposes.

Description: This will be an ambulatory specialty elective, known as the potpourri or the smorgasbord elective. By selecting this course, the student will gain valuable experience at an advanced level in an ambulatory setting based on the specialty of their choosing. This course will expose the student to the patient’s needs as they differ in the outpatient clinic environment, giving the student a more complete picture of longitudinal patient care outside hospitalization in a select patient population of American Veterans. Students who take this course should not expect to spend time in the operating room. Students will gain an appreciation and thorough expert understanding of how medical care is delivered in the clinic, while simultaneously exposing themselves to their planned specialty in the setting in which they will most likely be responsible for patient care after graduation.

Objectives: To provide a variety of outpatient management experiences for students entering primary care and family medicine residencies. To gain recognition, working knowledge and management of common outpatient conditions that often prompt referral from primary care practices.

Methods: Students will spend one week in one of five different surgical and/or clinical clinics.

Urology
Otolaryngology (ENT)
Podiatry
Dermatology
Ophthalmology

Students will develop a schedule of a week or more experiences in 4 specialties. Contact Dr. Kakish for rotation order.

Recommended Reading/Resources: Family Practice Review Articles, www.aafp.org/pubs/afp/topics.html

Length: 1 month; Hours/Week: 40; Days/Week: 5; Night Calls/Month: 0

Additional Location(s) Address(es): Contact Dr. Bhavana Bhaya for additional locations.

Evaluation: Clinical performance.

Director(s): Dr. Bhavana Bhaya

Coordinator(s): Corey Johnson

Preceptor(s):

Ophthalmology: Dr. Bret Hughes
ENT: Dr. Michael
Urology: Dr. Alaa Hamada
Podiatry: Dr. Philip Homes
Ortho: Dr. Henri Pierre-Jacques

Category: Ambulatory

Recommended Attire: Clinic professional, white coat

EMR System: VA

Notes: This course is part of the two-week pilot program for students whose schedule, along with the VA schedule, permits.

8280 - Cardiology - St John Hospital

Objectives: 1. To develop the basic clinical skills, through history and physical examination, EKG and x-ray studies in the diagnosis of cardiovascular diseases. 2. To formulate a cost effective approach in the diagnosis of cardiovascular disease. 3. To understand the risk-benefit ratio of various procedures in the diagnosis and management of cardiovascular disease. 4. To maintain an awareness of all the patient's physical, psychological and social problems that the cardiovascular patients present and integrating this information for appropriate care for the individual patient. 5. Exposure to various invasive intervention, such as mean arterial line, Swan Ganz catheter and temporary pacemaker insertion. 6. Interpretation of common data generated from various invasive procedures.

Methods: 1. The fourth year student is to function at an intern level. 2. The fourth year student will be assigned new patient evaluations, will write the initial orders and provide continuing care. 3. The fourth year student will work under the direct supervision of the assigned senior medical resident and fellow - 2 weeks in ICU and 2 weeks on step down unit. 4. Daily bedside clinical rounds will be held in ICU and the step-down unit by Dr. Christensen, to insure review of patient evaluations and work-up. 5. Bedside teaching rounds by an assigned board certified cardiologists occur three times per week for l 1/2 hours per session. 6. The student is to attend the cardiology and medical conferences which include: a. Management Conferences in Cardiology by Dr. Giraldo b.Selected Medical Conferences 7.

Final evaluations will be made by the program coordinator after continuing and direct observation of the student's performance. This will also take into consideration input by the head nurses, residents and fellow staff, assigned at that time.

Recommended Reading Material: 1. The Practice of Cardiology. Robert Johnson, MD 2. Selected assignments from the literature.

Length: 1 month; Days/Week: 5. 1/2; Hours/Week: 50; Night Calls/Month: 4

Evaluation: Clinical Evaluation & Written

Category: Specialty Subinternship

8280 - Cardiology - Multiple Locations

Course Prerequisites: N/A.

Description: The Cardiology Rotation is designed to provide 4th-year medical students with a comprehensive and hands-on experience in the field of cardiology. Under the guidance of experienced cardiologists, students will gain nvaluable insights into the diagnosis, treatment, and management of cardiovascular diseases.

Objectives: By the end of this rotation, students will be expected to:

Understand Cardiovascular Anatomy and Physiology: Develop a solid foundation in the structure and function of the heart and blood vessels.
Perform Cardiac Assessments: Learn to perform comprehensive cardiac assessments, including history-taking, physical examinations, and interpreting diagnostic tests.
Diagnose Cardiovascular Diseases: Gain proficiency in diagnosing a range
of cardiovascular conditions, including coronary artery disease, heart failure, arrhythmias, and valvular diseases.
Participate in Patient Care: Collaborate with healthcare teams to provide patient-centered care, including creating treatment plans, prescribing medications, and monitoring patient progress.
Develop Effective Communication Skills: Enhance communication skills by effectively conveying medical information to patients and their families.
Utilize Diagnostic Tools: Learn to interpret ECGs, echocardiograms, stress tests, and other diagnostic tools commonly used in cardiology.
Stay Current with Cardiology Research: Stay updated with the latest developments in cardiology through literature reviews and participation in journal clubs.

Methods: N/A

8280 - Cardiology - Veterans Admin Hospital

Course Prerequisite: All VA electives require U.S. citizenship. Do not register for this elective without being able to provide your U.S. social security number for onboarding purposes.

Objectives: To familiarize oneself with the pathophysiology of common cardiac disorders. 2. To gain experience in learning to diagnose, treat and clinically evaluate patients with cardiac disease. 3. To learn indications for noninvasive tests including echocardiography, exercise stress testing, nuclear cardiology, and Holter monitoring. 4. To learn indications for cardiac catheterization and insertion of Swan Ganz catheters. 5. To gain familiarity with indications for pacemaker insertion and follow-up of pacemaker patients. 6. To gain experience in basic ECG interpretation.

Methods: No more than 2 students will be assigned each month to this rotation. Students will obtain a history and physical examination on patients where inpatient cardiology consultations have been requested and presented to the assigned cardiology staff at the bedside where appropriate diagnostic measures and treatment will be discussed. He/she will also examine patients in the Cardiology Clinic under staff supervision. The students will observe diagnostic procedures in the noninvasive laboratories, and participate in weekly noninvasive and vascular hemodynamic conferences. The students will also interpret ECG's daily under direct staff supervision.

Recommended Reading Material: Harrison's. Principles of Internal Medicine. 13th Edition, 1994.

Length: 1 month; Days/Week: 5; Hours/Week: 40; Night Calls/Month: none

Evaluation: Clinical evaluation

Category: Specialty Subinternship

8280 - Cardiology - Providence Hospital

Methods: 1. The fourth year student is to function at an intern level. 2. The fourth year student will be assigned new patient evaluations, will write the initial orders and provide continuing care. 3. The fourth year student will work under the direct supervision of the assigned senior medical resident and fellow - 2 weeks in ICU and 2 weeks on step down unit. 4. Daily bedside clinical rounds will be held in ICU and the step-down unit, to insure review of patient evaluations and work-up. 5. Bedside teaching rounds by an assigned board certified cardiologists occur three times per week for l 1/2 hours per session. 6. The student is to attend the cardiology and medical conferences which include: a. Management Conferences in Cardiology b.Selected Medical Conferences

Recommended Reading Material/Resources: To be assigned.

Length: 1 month; Days/Week: 5. 1/2; Hours/Week: 50; Night Calls/Month: 4

Evaluation: Clinical Evaluation & Written. Final evaluations will be made by the program coordinator after continuing and direct observation of the student's performance. This will also take into consideration input by the head nurses, residents and fellow staff, assigned at that time.

Preceptor(s): Dr. Delano Small

Category: Specialty Subinternship

8280 - Cardiology - Michigan Healthcare Professionals

Course Prerequisites: Students should have a working background in Internal and Emergency Medicine.

Description: Students will rotate in the inpatient and outpatient setting where they will experience direct patient care in common cardiological cases. Students will learn to take a basic history/physical, fulfill diagnostics, develop a treatment plan, and improve their management skills associated with common cardiac problems.

Objectives: To understand the details of what a cardiology specialty entails from the whole spectrum of the field, including acute to stable patients in an outpatient and inpatient setting.

Methods: Students will gain experience in observation, patient care, and rounding on patients in the office and/or the hospital. Students will scrub into and assist in procedures. Students will be involved with imaging, stress testing, echocardiograms, angiograms, heart catheterization, myocardial infarctions, and other common inpatient and outpatient procedures.

Recommended Reading: Rapid Interpretation of EKG’s by Dr. Dale Dubin; Basic Cardiovascular Physiology: From Molecules to Translational Medical Science” 1^st Edition. Students should have first aid resources available to them and a basic knowledge of cardiovascular physiology learned in school. Students will be expected to stay up to date with specific topics on uptodate.com.

Length: 1 month; Days/Week: 3.5-5; Hours/Week: 25-40; Night Calls/Month: None

Additional Locations: Millennium Cardiology at 32255 Northwestern Highway, Suite 115, Farmington Hills, MI 48334; Oakland Cardiology at 27483 Dequindre Road, Suite 210, Madison Heights, MI 48071; Ascension Providence Hospital

Evaluation: New Innovations evaluation

Preceptor(s): Dr. Herman Kado, Dr. Dustin Feldman, Dr. Eric Greenberg, Dr. Justin Trivax, and Dr. George Dirani

Category: Specialty Subinternship

Recommended Attire: Scrubs

EMR System: EPIC, Cerner, and Webchart

8290 - Cardiology Consultation - Detroit Receiving Hospital

Objectives: To teach medical students the pathophysiology, diagnosis and general therapeutic approaches to various cardiac diseases. You will experience interactions with other disciplines in designing combined modality therapies. An emphasis is placed on the approach to patient care of these diseases and to enhance knowledge, skills and attitude associated with cardiac consultation in an inpatient setting.

Methods: Daily patient care, daily attending rounds, conferences and didactics

Recommended Reading Material: To be assigned

Evaluation: The student is evaluated throughout the course based on quality of care, participation, attendance and performance in conferences (if applicable).

Category: Inpatient Consult Service

8290 - Cardiology Consultation - Henry Ford Health Service

Course Prerequisites: N/A

Description: On this rotation students will be a part of the inpatient cardiology consultation team that provides recommendations to the telemetry ward as well as non-cardiology services including the emergency room and intensive care units. Students will learn the fundamentals of the pathophysiology, diagnosis, and treatment of cardiovascular disease.

Methods: Daily patient care, daily attending rounds, conferences and didactics.

Recommended Reading Material: To be assigned

Length: 1 month; Hours/Week: about 50; Days/Week: 5; Night Calls/Month: None

Evaluation: Medical students will be evaluated on their physical examination, oral presentations, written consultations and progress notes, engagement and contribution to the consult team, attendance and availability, professionalism, and interactions with requesting services.

Preceptor(s): Dr. Bob Rabbani is the course director and individual supervising cardiology attending physicians will rotate on a weekly basis.

Category: Inpatient Consult Service

Recommended Attire: Business professional, white coat

EMR System: EPIC

Notes: Any absences should be approved in advance by the student emailing Dr. Rabbani and cc'ing their counselor.

8310 - Coronary Care Unit - Beaumont Dearborn

Course Prerequisite: N/A

Course Description: Each student will be supervised directly by the Medical Director of the Coronary Care Unit, Cardiology Attendings, the Cardiology Fellow and a Senior Medical Resident assigned to the CCU.

Objectives: To provide an intensive, comprehensive and state-of-the-art training experience in Critical Care Cardiology in a CCU with a high patient volume, diversity and acuity.

The following will be emphasized:

1. Clinical assessment skills & evidence-based, state-of-the-art and cost effective/efficient management. 2. Critical judgment, decision analysis and pathophysiological deduction. 3. Acquisition, review and interpretation of clinically aligned and applied data. 4. Acute intervention and follow-up. 5. Laboratory diagnosis and treatment of acute and critical heart disease; daily review of ECG's, Echocardiograms, Imaging Studies and Cardiac Catherizations. 6. Train the student to think in pathophysiological terms and apply evidence-based and cost-effective strategies to improve clinical outcomes. 7. Perform the basic procedural skills as applied in the CCU. 8. Review, interpret and understand the indications, results, utility and limitations of diagnostic studies as obtained in the CCU and of medical and interventional therapies. 9. Gain the experience, skills and understanding to be an independent, confident and insightful CCU subintern and to function in the capacity of a first year resident.

Recommended Reading Material: ACC/AHA Practice Guidelines on ACS/STEMI/CHF/Arrhythmiasm, Attitude and professional behavior; interest and enthusiasmm Participation and performance/presentation on rounds, Patient Satisfaction.

Evaluation: Quality, intensity and engagement of care provided. 2. Participation and performance on rounds. 3. Level of knowledge including clinical applications of new knowledge. 4. Level of skills. 5. Clinical Competency applied including clinical assessment skills, medical care, clinical judgment and patient outcome.

Category: Intensive Care Subinternship

8310 - Coronary Care Unit - Henry Ford Health Service

Course Prerequisites: Students must complete 8280 - Cardiology at any hospital before taking this course.

Description: This course introduces students to the care of patients in the cardiac intensive care unit. Students with learn about the evaluation and treatment for patients including severe coronary artery disease, cardiogenic shock and arrhythmias. This may include vasopressors, mechanical ventilation, mechanical circulatory support. equipment and tools used in the intensive care unit, There is a focus on, communication and teamwork to ensure the best outcomes for the critically ill patient.

Objectives: Increase student understanding of the pathophysiology, clinical manifestations and management of acute ischemic syndromes, congestive heart failure, arrhythmias. There is a strong focus on guideline based evaluation and therapy. Understand and manage post procedural care. Increase student involvement in conferences, journal clubs; increases student use/review of the medical literature.

Methods: Direct Patient care, weekly conferences, and core didactic series

Recommended Reading Material: To be assigned

Length: 1 month; Days/Week: 6; Hours/Week: 40-60; Night Calls/Month: Up to 7 nights.

Evaluation: Presentation, exam, clinical evaluation, participation, communication, documentation

Preceptor(s): Rounding attending. Please contact Gillian Grafton.

Category: Intensive Care Subinternship

Recommended Attire: Scrubs, white coat

EMR System: EPIC

8310 - Coronary Care Unit - Providence Hospital

Course Prerequisites: None.

Methods: Direct Patient care, weekly conferences, and core didactic series

Recommended Reading Material: To be assigned

Length: 1 month; Days/Week: 6; Hours/Week: 40-60; Night Calls/Month: Up to 7 nights.

Evaluation: Presentation, exam, clinical evaluation, participation, communication, documentation. 1. Quality, intensity and engagement of care provided. 2. Participation and performance on rounds. 3. Level of knowledge including clinical applications of new knowledge. 4. Level of skills. 5. Clinical Competency applied including clinical assessment skills, medical care, clinical judgment and patient outcome.

Preceptor(s): Dr. Delano Small

Category: Intensive Care Subinternship

Recommended Attire: Scrubs, white coat

8320 - Critical Care Medicine - Veterans Admin Hospital

Course Prerequisites: All VA electives require U.S. citizenship. Do not register for this elective without being able to provide your U.S. social security number for onboarding purposes.

Description: Under supervision, students take on the responsibility of first year residents for a limited number of patients with acute ICU/level problems

Objectives: To acquire a basic knowledge of life-threatening fluid and electrolyte problems, acute respiratory failure, shock, arterial blood gases, acid-based physiology, acute metabolic crises. To understand the principles of volume loading, mechanical ventilation, vasoactive drug administration. To acquire clinical experience in the management of critically ill patients. To develop a rational approach in assessment, problem solving and prioritization in critically ill patients, develop an understanding of the inter-relationship among organ systems, Learn the pathophysiology of disorders of perfusion, respiration, ventilation, acid-base equilibrium, Acquire experience in the management of critically ill patents, hemodynamic monitoring and ventilator management

Methods: The student will participate in the care of patients admitted to the intensive care unit under direct supervision of critical care medicine fellows and faculty. The student will gain "hands on" experience in hemodynamics, mechanical ventilation, respiratory failure, shock, coagulopathies, and multi-organ system failure. The student will work up and present patients at daily teaching and work rounds. Additional educational experience is obtained through didactic sessions and divisional conferences. Students will participate in morning teaching rounds, afternoon "X-ray" rounds, lectures covering basic issues in critical care medicine and other didactic sessions, as well as evening "sign out" rounds. History taking and physical exams will be performed on selected ICU patients under resident/fellow/staff guidance. The student will be allowed to present cases on morning rounds. He/she will follow one or two patients. Daily teaching and clinical rounds will be conducted by full-time University faculty who are recognized authorities in critical care medicine. A syllabus will be provided to each student. Students will be evaluated on their fund of knowledge, clinical skills, oral and written presentations, their ability to perform a competent physical exam and integrate hemodynamic, metabolic, and respiratory variables.

Recommended Reading/Resources: TBA—Given on first day of rotation

Length: 1 month; Days/Week: 5-7; Hours/Week: 60; Night Calls/Month: 4-6

Additional Locations: N/A

Evaluation: Clinical evaluation based on the quality, intensity, and engagement of care provided, participation and performance on rounds, level of knowledge including clinical applications of new knowledge, level of skills, clinical competency applied including clinical assessment skills, medical care, clinical judgment and patient outcome.

Preceptor(s): Dr. Hiba Hadid (Site director for the Pul/CC fellows)

Course Director: Dr. Hiba Hadid (Site director for the Pul/CC fellows)

Course Coordinator: Dr. Hiba Hadid

Category: Intensive Care Subinternship

Recommended Attire: Scrubs

EMR System: CPRS

8320 - Critical Care Medicine - Harper Hospital

Objectives: Develop a rational approach in assessment, problem solving and prioritization in critically ill patients, Develop an understanding of the inter-relationship among organ systems, Learn the pathophysiology of disorders of perfusion, respiration, ventilation, acid-base equilibrium, Acquire experience in the management of critically ill patents, hemodynamic monitoring and ventilator management,

Methods: The student will participate in the care of patients ts admitted to the intensive Care Unit of Harper Hospital under direct supervision of Critical care Medicine Fellows and Faculty. The student will gain "hands on" experience in hemodynamics, mechanical ventilation, respiratory failure, shock, coagulopathies, and multi-organ system failure. The student will work up and present patients at daily teaching and work rounds. Additional educational experience is obtained through didactic sessions and divisional conferences.

Recommended Reading Material: Assigned readings, manual distributed during rotation.

Length: 1 month; Days/Week; 6; Hours/Week 9/day; Night Calls/Month: 4-5

Evaluation: Performance

Category: Intensive Care Subinternship

8320 - Critical Care Medicine - Detroit Receiving Hospital

Course Prerequisites: N/A

Objectives: To acquire a basic knowledge of life-threatening fluid and electrolyte problems, acute respiratory failure, shock, arterial blood gases, acid-base physiology, acute metabolic crises. To understand the principles of volume loading, mechanical ventilation, vasoactive drug administration. To acquire clinical experience in the management of critically ill patients.

Methods: The student will participate in morning teaching rounds, afternoon "X-ray" rounds, lectures covering basic issues in critical care medicine and other didactic sessions, as well as evening "sign out" rounds. History taking and physical exams will be performed on selected ICU patients under resident/fellow/staff guidance. The student will be allowed to present cases on morning rounds. He/she will follow one or two patients. Daily teaching and clinical rounds will be conducted by full time University faculty who are recognized authorities in critical care medicine. A syllabus will be provided to each student. Students will be evaluated on their fund of knowledge, clinical skills, oral and written presentations, their ability to perform a competent physical exam and integrate hemodynamic, metabolic, and respiratory variables.

Recommended Reading Material: Cecil Textbook of Medicine-Critical Care Medicine, 19th Edition, 459-476.

Length: Length: 1 month; Days/Week: 5-7; Hours/Week: 60; Night Calls/Month: 7-8 - DRH, None-VAMC

Evaluation: Clinical evaluation and written

s/Month: 7-8 - DRH, None-VAMC

Category: Intensive Care Subinternship

8320 - Critical Care Medicine - Beaumont Dearborn

Course Prerequisite: N/A

Description: Students will learn about the management of critically ill patients to improve diagnostic, problem solving, assessment, and treatment skills.

Methods: The student will participate in rounds. History taking and physical exams will be performed on selected ICU patients under resident/fellow/staff guidance. The student will be allowed to present cases on morning rounds. They will follow one or two patients. Daily teaching and clinical rounds will be conducted by full time University faculty who are recognized authorities in critical care medicine.

Recommended Reading/Resources: To be assigned

Length: 1 month

Evaluation: Students will be evaluated on their fund of knowledge, clinical skills, oral and written presentations, their ability to perform a competent physical exam and integrate hemodynamic, metabolic, and respiratory variables. Quality, intensity and engagement of care provided, Participation and performance on rounds, level of knowledge including clinical applications of new knowledge, Level of skills, Clinical Competency applied including clinical assessment skills, medical care, clinical judgment and patient outcome.

Category: Intensive Care Subinternship

8320 - Critical Care Medicine - Henry Ford Health Service

Objectives: Increase student use/review of the medical literature as part of patient care (report to attending), Enhance the student's knowledge and skills pertaining to interviewing, physical examination, other patient interactions, interpretation of data, clinical judgment, and procedures (i.e., L.P., thoracentesis, paracentesis and central line insertion) swan-ganz catheter placement, placement monitoring and intraarterial line placement.

Methods: Direct patient care (daily attending rounds), weekly curriculum and didactic series

Recommended Reading Material: To be assigned.

Length: 1 month; Days/Week: 6; Hours/Week: 60; Night Call/Month: 4

Evaluation: Standard WSU Year 4 evaluation form with frequent feedback from rounding physician

U YR 4 evaluation form with frequent feedback from rounding physician

Category: Intensive Care Subinternship

8360 - Endocrine/Metabolism - Detroit Medical Center

Description:This is an outpatient rotation for the medical student to learn the pathophysiology, clinical presentations, diagnostic findings and treatment for common endocrine conditions. Students will learn the techniques of conducting a history and physical; diagnostic, therapeutic, and laboratory approaches to endocrine disorders.

Objectives: The objective of this course is to teach medical students the pathophysiology, diagnosis and general therapeutic approaches to diseases of endocrinology, diabetes and bone and mineral metabolism. An emphasis is on the consultative approach to patient care of these diseases and disorders. The content of the curriculum emphasizes diabetes mellitus, thyroid disease, lipid disorders, osteoporosis, calcium disorders, and adrenal and pituitary disorders.

Methods: This course offers to the medical student an opportunity to learn the pathophysiology, diagnosis, and general therapeutic approaches to endocrine and metabolic disorders. It is conducted in the outpatient setting. One student would be taught per block of time. The student spends at least one half day every day with senior staff in the Endocrinology and Metabolism Clinic observing them conduct evaluations of general endocrinology patients. Depending on the maturity and medical knowledge by the student, the student may advance to evaluating patients and presenting them to the senior staff. Didactic sessions: The student attends and participates in didactic sessions daily given by senior staff, endocrinology fellows, or outside staff. Didactics include lectures on general endocrinology topics, journal clubs, case conferences and endocrinology grand rounds. Recommended Reading Material: Reading material will be recommended by senior staff during clinic.

Didactic sessions: The student attends, participates in and contributes to reviews of current literature in Endocrinology and Metabolism, seminars in the Science of Endocrinology and Metabolism and clinical case conferences in Bone and Mineral Metabolism and in Endocrinology.

Recommended Reading Material: Reading material will be recommended by senior staff during clinic and in the rotation syllabus. Clinical practice guidelines from Endocrine Society, AACE (American Association of Clinical Endocrinology), American Thyroid Association and American Diabetes Association are recommended.

Length: 1 month; Days/Week: 5; Hours/Week: 35-40; Night Calls/Month: none

Evaluation: The student is evaluated at the end of the course by the staff with whom the student has worked during the month.

Category: Inpatient Consult Service

Recommended Attire: Business professional, white coat

8360 - Endocrine/Metabolism - Henry Ford Health Service

Course Prerequisites: N/A

Description:This is an outpatient rotation for the medical student to learn the pathophysiology, clinical presentations, diagnostic findings and treatment for common endocrine conditions.

Length: 1 month; Days/Week: 5; Hours/Week: 35-40; Night Calls/Month: none

Evaluation: The student is evaluated at the end of the course by the staff with whom the student has worked during the month.

Preceptor(s): Sharon Lahiri, MD Endocrinology fellowship program director and Rebecca Simon, DO associate program director

Category: Inpatient Consult Service

Recommended Attire: Business professional, white coat

EMR System: EPIC

8370 - Gastroenterology - St Joseph Pontiac

Objectives: 1. To become familiar with the pathophysiology of common gastrointestinal diseases and to gain experience in developing approaches to their diagnosis and treatment. 2. To gain an appreciation of the application and limitations of the entire range of diagnostic and therapeutic gastrointestinal endoscopy. EGD, colonoscopy, ERCP, EUS, and capsule endoscopy will all be covered. 3. To gain experience in the conduct and interpretation of commonly applied tests of gastrointestinal function, such as tests of absorptive function and esophageal and anorectal motility. 4. To observe the activity of the consultant in gastroenterology and develop an appreciation of the interaction between the requesting service and the consultant. 5. To acquire some familiarity with GI and liver histopathology.

Methods: Inpatient and outpatient evaluation of GI patients followed by discussion/instruction with/by GI faculty and fellows. Lectures, seminars, journal clubs, procedure observation.

Recommended Reading Material: Latest Harrison Internal Medicine

Length: 1 month; Days/Week: 5; Hours/Day: 8; Night Calls/Month: none

Evaluation: Subjective clinical evaluation, exam.

Preceptor(s): Brian Markle, MD

Category: Inpatient Consult Service

8370 - Gastroenterology - Detroit Medical Center

Methods: Inpatient and outpatient evaluation of GI patients followed by discussion/instruction with/by GI faculty and fellows. Lectures, seminars, journal clubs, procedure observation.

Recommended Reading Material: Latest Harrison Internal Medicine

Length: 1 month; Days/Week: 5; Hours/Day: 8; Night Calls/Month: none

Evaluation: Subjective clinical evaluation, exam.

Category: Inpatient Consult Service

8370 - Gastroenterology - Henry Ford Health Service

Course Prerequisite: Completion of core clerkship in Medicine.

Course Description: Gastroenterology & Hepatology. The student rotating in Gastroenterology/Hepatology will spend 2 weeks on the inpatient Gastroenterology consultative service, 1 week on the Hepatology inpatient consultation service, and 1 week in the outpatient Gastroenterology clinic. During the inpatient component, the student will see 1-2 consultations per day. He/she completes the evaluation and develops a differential diagnosis with management recommendations. A fellow and senior staff gastroenterologist or hepatologist reviews the student’s evaluation and findings and makes the final recommendations. During the outpatient component, the student sees 1-2 outpatient consults per week in a similar fashion. It is at the discretion of the staff whether the student shadows in clinic or sees the patient independently first. The student attends all teaching conferences. A core curriculum of 8-10 lectures per month is presented by GI fellows or staff. At the end of the rotation, students will provide evaluations to be completed.

Objectives: 40%-70% inpatient care. 20%-40% outpatient care. 10%-20% conferences/lectures

Methods: The student sees inpatient consultations during the day. He/she completes the initial evaluation and develops a differential diagnosis with therapeutic recommendations. A senior staff gastroenterologist reviews the student's evaluation and findings and makes the final recommendation. The student follows the patients while they are in the hospital. The student sees outpatient clinic consultations per week in a similar fashion. The student attends all conferences. A core curriculum of 8-10 lectures per month is presented by GI Fellows to the students and residents. Emphasis is on pathophysiology and clinical presentation.

Recommended Reading Material: Cecil Essentials of Medicine, sections on Gastroenterology and Hepatology

Length: 1 month; Days/Week: 5; Hours/Week: 40; Night Call/Month: none

Evaluation: Medical students are evaluated by the physicians they work with during the rotation.

Preceptor(s): Adarsh Varma, M.D.; Reena Salgia, M.D.

Category: Inpatient Consult Service

Recommended Attire: Business professional, white coat

EMR System: EPIC

8390 - General Internal Medicine Inpatient - Providence Hospital

Course Prerequisites: N/A

Description: An "internship" experience emphasizing primary responsibility for acutely ill patients on inpatient services. The M4 will act an intern, independently evaluating and following primary admissions until discharge. The student will work one-on-one with the attending physician. This rotation should provide an excellent opportunity to learn how to manage general medical patients who are covered by a "hospitalist" service. Most time will be spent in direct patient contact. There will be educational discussions and presentations as well as daily departmental noon conference and weekly grand rounds.

Objectives: To increase student involvement in conferences, etc. by having students present patients and/or patient data. Students will also participate as a member of the audience. To increase student use/review of the medical literature as part of patient care (report to attending) as part of a conference or journal club.

Evaluation: Quality of care given (including clinical judgment). Participation and performance in conferences. Level of knowledge (including new knowledge). Level of skills. Professional behavior. Methods to Evaluate Student Performance Observation of performance by faculty. Observation of performance by house officers. Assessment of write-ups/reports. Student presentation.

Preceptor(s): Dr. Madeleine Capatina-Rata

Category: Specialty Subinternship

8393 - Teaching, Learning, and Clinical Reasoning - Arranged (Building Not Needed)

Course Prerequisites: N/A

Description: This course is designed to provide fourth year students with the opportunity to cultivate their teaching skills in order to better prepare them for residency. Students will participate in workshops on how to refine their teaching skills, with topics such as creating a positive teaching environment, how to prepare an effective lecture, and how to give and receive feedback. Students will teach sessions for junior medical students to help practice their improved skills and will also provide feedback to junior students. The course has reading requirements. Students will be evaluated by chief residents/faculty and junior students. In addition, students will refine their clinical reasoning through review of evidenced based clinical skills as well as advanced clinical reasoning.

Students will participate in Teach the Teacher and Clinical Reasoning sessions provided by the faculty. Complete reading assignments on learning. In addition, students will participate in several sessions to assess junior students' oral presentations, patient note, procedural skills, and clinical reasoning through case discussions. Also, students will participate in the new CRISP course working with Year 3 students on multiple aspects of clinical skills. Students also may have an opportunity to teach in P4 and Bootcamp for off track students.

Presentations, particularly medical presentations suck, according to Garr Reynolds in Presentation Zen. Students will read and apply the principles in Presentation Zen to re-create and re-present to your peers a medical presentation.

To advance your own clinical reasoning, students will read and assess their knowledge through the series JAMA Rational Clinical Examination. Students will read Thinking, Fast and Slow by Daniel Kahneman and apply system 1 and 2 thinking to complex cases.

Objectives: Summarize the essential components of the learning cycle:

Apply Presentation Zen to prepare an effective and engaging lecture about a clinical topic
Model effective teaching strategies
Describe the role of feedback in teaching and learning
Describe the components of effective feedback
Implement best practices in feedback during evaluation of junior students
Explain core tenets of clinical reasoning to junior students in the context of standardized clinical encounters
Summarize knowledge of Advanced Physical Diagnosis
Apply System 1 and System 2 thinking to Complex Cases

Methods: Active learning sessions on how to teach, providing feedback, and clinical reasoning. Participate in teaching sessions with junior students. Complete online modules and assignments. Students will receive instruction on the fundamentals of adult learning theory, skills training, feedback and evaluation through a mini Stanford Faculty Development program.

Recommended Reading/Resources: JAMA Rational Clinical Exam, Presentation Zen, Thinking Fast and Slow

Length: Segment 4 Longitudinal

Additional Locations: Various (Kado, Maz, Scott Hall, Virtual)

Evaluation: Required participation in Teach the Teacher, Feedback, and Clinical Reasoning sessions. Required participation in an adequate number of teaching sessions (preliminarily 5-6 sessions of which at least 3 must be in person sessions) Teaching must also be done 2 sessions every quarter throughout the year. Demonstrate competency in teaching junior students. Prepare and present an effective presentation on a clinical topic. Demonstrate knowledge of advanced physical diagnosis.

Preceptor(s): Dr. Chih Chuang

Category: Non-clinical

Recommended Attire: business

EMR System: N/A

8395 - Clinical Pharmacology - Arranged (Building Not Needed)

Course Prerequisites: None.

Description: The course is a four-week elective that is conducted completely online using Canvas. A total of 4 case studies are posted at the beginning of the course, each assigned for a specific week. Students choose 3 of the 4 cases to review and address a set of questions. During the assigned week for each selected case, students may ask questions on the Discussion Board on Canvas. At the end of the week, the students will submit their analysis and written comments for evaluation. Besides addressing questions, the Discussion Board will also be used for comments and discussion of issues related to each case. To encourage this, questions or issues for comment are posted by faculty on Day-2, Day-4, and Day-6 during each weekly case review period. Students are expected to post responses or comments to at least some of the posts. Comments can be responses to the questions or issues, new questions that arise from comments made by other students, or affirmations of comments made by other students with elaborations. Supporting references (e.g., web sites, literature) should be cited where appropriate.

Objectives: 1) Analyze clinical pharmacology cases. 2) Use appropriate literature resources to answer questions about the cases. 3) Write weekly reports that address questions focusing on pharmacology principles. 4) Participate in Discussion Board, answering questions related to the weekly case or posing new questions.

Methods: Online course involving reading cases, answering questions on weekly Discussion Board, submitting written reports that address questions focusing on pharmacology principles.

Recommended Reading: Cases are posted on Canvas, Students then perform PubMed, UpToDate, Google searches to find relevant information to address questions and issues.

Length: 1 month; Hours/Week: 10-20 for 3/4 weeks; Days/Week: Course in online so required to participate in 3/4 weekly cases; Night Calls/Month: N/A.

Additional Locations: Online course

Evaluation: 75% of the grade is based on the quality of the weekly written reports (U, S, or H) and 25% is based on participation in the Discussion Board.

Preceptor(s): Dr. Lawrence H. Lash, Professor, Department of Pharmacology

Category: Non-Clinical, Online

Recommended Attire: Nothing specific as this is an online course.

EMR System: N/A

Notes: Note that this is a one-month, online elective offered in the months of November, December, and January. The course has been offered since December 2014.

8420 - Geriatric Medicine - Michigan Healthcare Professionals

Course Prerequisites: None.

Description: Students will learn to conduct a comprehensive assessment and treatment of internal medicine and geriatric patients, including factors affecting the health of the elderly in an office-based practice. Students will see primarily elderly patients (about 60-70%) and some younger patients as well. Students will gain experience with medically complex older adults seen in the office, at nursing homes, and in the hospital.

Objectives: To teach students about different aspects of geriatric care so they can confidently and appropriately care for older adults. To give students the ability to conduct a comprehensive treatment of older adults.

Methods: Students will learn to conduct fall risk assessments, depression screenings, and mental status screenings in the office and nursing home setting. Students will spend 5 half days/week in the office seeing elderly patients with acute and longitudinal problems. Students will spend 3-4 days/week with midlevel patients in nursing homes. Students will see long-term nursing home residents and short-term rehabilitation residents. Students will also visit the hospital every day to see patients in the hospital setting where there are often older, sicker patients seeking care. Students will work closely with nurse practitioners and physician assistants to develop an inter-professional working relationship that best helps the patient.

Recommended Reading: Varies based on patient population and cases.

Length: 1 month; Days/Week: 5; Hours/Week: 40; Night Calls/Month: None

Additional Locations: 27483 Dequindre Road, Suite 302, Madison Heights, MI 48071

Evaluation: Presentations, New Innovations evaluation

Preceptor(s): Dr. Gary Langnas

Category: Ambulatory

Recommended Attire: Scrubs, white coat

EMR System: Webchart

Notes: Students should bring a laptop to this rotation.

8420 - Geriatric Medicine - Detroit Medical Center

Objectives: To Learn the physiologic and psychosocial aspects of aging in the absence of disease. To recognize how disease may interact with the changes of aging. To understand the pathophysiology, diagnosis, and management of common geriatric syndromes. To function as a member of an interdisciplinary team and perform functional assessment. To identify the components of the health care continuum (including home care, nursing home care, hospice care), how they interface, and their function in the care of the geriatric patient.

Methods: Students will rotate through various types of clinical environments to achieve the objectives. At each clinical experience, faculty preceptors focus on bedside teaching, physical diagnosis, and discussions of the pathophysiologic, clinical diagnostic, and therapeutic aspects of each case. Detroit Receiving Hospital provides an inpatient consultation experience based on the acute care geriatric unit. Students will manage their patients as consultants by performing a complete consultation, presenting the patient to the faculty preceptor, and continuing management on daily rounds with the preceptor. At the ambulatory outpatient facilities of the Harper University Hospital and Huron Valley Hospital, students will perform outpatient geriatric assessment as a member of an interdisciplinary team.

This involves working with other health care professionals including geriatric nurse specialists and social workers in addition to the faculty preceptor, as well as using specific assessment instruments. Students will also accompany the faclty preceptor to sessions at a nursing home. A series of one hour didactic conferences presented by the geriatric faculty three times each week, discusses the common geriatric syndromes, and supplements the clinical experience. In many of these activities a geriatric fellow and rotating internal medicine resident will add to the instruction of the faculty preceptor.

Recommended Reading Material: Patient related, assigned by Fellow/Attending Staff

Length: One month;Days/week: 5 Hours/week: 40 Night Calls/month: Not required

Evaluation: Clinical evaluation and written.

Category: Inpatient Consult Service

8430 - Hematology - Veterans Admin Hospital

Course Prerequisite: All VA electives require U.S. citizenship. Do not register for this elective without being able to provide your U.S. social security number for onboarding purposes.

Objectives: To develop clinical expertise in diagnosing common hematological problems. To develop rationale for ordering laboratory tests related to hematological problems. To acquire proficiency in interpreting peripheral blood films. To become familiar with indications of bone marrow examination. To develop experience in bone marrow interpretation.

Methods: The one or two months will be spent seeing hematology patients in outpatient clinics, and answering inpatients occurrence. Patients with a wide variety of hematologic disorders are seen, including patients being followed for hematologic malignancies. There is an emphasis on laboratory and blood and bone marrow morphology. Seminars and conferences, bringing together staff, fellows and students from the entire program of the Division of Hematology are held weekly. Elective is offered at VA Hospital, or DRH/Harper/Hutzel.

Recommended Reading Material: Various hematology texts, on-line materials.

Length: 1 month; Days/Week: 5; Hours/Week: 45; Night Calls/Month: none

Evaluation: Clinical evaluation

Category: Inpatient Consult Service

8430 - Hematology - Henry Ford Health Service

Course Prerequisite: Completion of core clerkship in Medicine.

Description: Students participate in both inpatient and outpatient consultation with senior staff and didactic conferences and teaching rounds on inpatient floors. Students are expected to read hematology literature prior to their case presentations in hematology conferences. At the end of the rotation, students are expected to be able to interpret peripheral blood films, diagnose common anemias, leukopenia and thrombocytopenia, recognize hematologic malignancies and diagnose and treat coagulopathies.

Objectives: Enhance knowledge and skills pertaining to clinical judgment. Increase student involvement in conferences, journal clubs.

Methods: Students participate in both inpatient and outpatient consultation with senior staff and didactic conferences and teaching rounds on inpatient floors. Students are expected to read hematology literature prior to their case presentations in hematology conferences. At the end of the rotation, students are expected to be able to interpret peripheral blood films, diagnose common anemias, leukopenia and thrombocytopenia, recognize hematologic malignancies and diagnose and treat coagulopathies. 40% inpatient care. 50% outpatient care. 10% conferences/lectures.

Recommended Reading Material: To be provided.

Length: 1 month; Days/Week: 5; Hours/Week: 40; Night Call/Month: none

Evaluation: Quality of care given. Number of patients cared for. Participation and performance in conferences. Level of knowledge. Level of skill. Observation of performance by faculty. Observation of performance by house officers. Logbook entries. Assessment of write-ups/reports.

Category: Inpatient Consult Service

8430 - Hematology - Providence Hospital

Course Prerequisite: N/A

Description: This is a Hematology/Oncology rotation.

Students work closely with senior staff oncologists in morning and afternoon clinics. New outpatient consultations, as well as interesting follow up patients, are seen by students and discussed with staff. Students are expected to read hematology literature prior to their case presentations in hematology conferences. At the end of the rotation, students are expected to be able to interpret peripheral blood films, diagnose common anemias, leukopenia and thrombocytopenia, recognize hematologic malignancies and diagnose and treat coagulopathies. Students are expected to participate in journal clubs and weekly interdisciplinary case conferences.

Objectives: Enhance knowledge and skills pertaining to clinical judgment and hematologic/oncologic care. Increase student involvement in conferences, journal clubs.

Recommended Reading Material: To be provided.

Length: 1 month; Days/Week: 5; Hours/Week: 40; Night Call/Month: none

Preceptor(s): Dr. Howard Terebelo

Category: Inpatient Consult Service

8440 - HIV/AIDS - Tolan Park Medical Building

Course Prerequisites: N/A

Description: The goal of this course is to provide experience to 4th year medical students in the care of HIV and Hepatitis C positive persons in an outpatient setting using the multidisciplinary primary care model. The WSU Adult HIV Program with clinic at Tolan Park is the largest provider of HIV care in the state of Michigan. WSU AHP receives federal, state and local grant funding through comprehensive Ryan White funding.

Objectives:

The student will demonstrate the ability to elicit an orderly, thorough history and physical examination pertinent to the HIV-positive patient and use laboratory and radiographic data to synthesize a differential diagnosis.
The student will describe the pathogenesis and natural history of HIV infection.
The student will develop and state their rationale for ordering laboratory tests and radiographic studies and demonstrate an ability to interpret the results.
The student will verbalize understanding of the complex psychosocial, personal, and societal barriers to and facilitators of care experienced by PWH.
The student will develop an approach to initiating HIV treatment with ART as well as treating common side effects and resistance patterns.
The student will be able to evaluate a patient positive for Hepatitis C and make informed decisions regarding treatment.
The student will develop problem-oriented medical record keeping skills.

Methods:

The student will follow with attending physician or fellow during clinic hours and see patients independently and together.
On Monday mornings, students will work with a Hepatitis C specialist.
Be present at and participate in all assigned conferences, rounds and meetings.

Recommended Reading/Resources:

National HIV Curriculum
Screening and Diagnosis Lessons 1-4
Basic HIV Primary Care Lessons 1-5
Antiretroviral Therapy Lessons 1-3
- Co-Occurring Conditions Lessons 2-6
- Prevention of HIV Lessons 2 and 5
- Key Populations: pick 1 lesson of interest

Length: 1 month; Days/Week: 5; Hours/Day: 8; Hours/Week: 40; Night Calls/Month: None

Additional Locations: Tolan Park Adult HIV Clinic

Evaluation: Clinical evaluation and written

Directors: Dr. Gretchen Newman (main), Dr. Lauren Touleyrou

Preceptors: Dr. Gretchen Newman, Dr. Lauren Touleyrou, Mario Singleton (Clinic Manager)

Category: Inpatient Consult Service

Recommended Attire: Business casual with white coat

EMR System: Athena (Access to Athena can take 2-4 weeks to get, so students should contact the coordinator for the rotation about 1 month in advance of the rotation to ensure access is provided in time.)

8450 - Infectious Disease - Detroit Medical Center

Objectives: To acquire experience in the diagnosis and management of common infectious disease problems. To acquire an understanding of the rationale behind laboratory tests and ancillary procedures used to work up infectious disease problems. To acquire proficiency in interpreting serologic tests, and microbiologic studies (cultures, susceptibility tests, and synergy studies.). To understand the principles of antimicrobial therapy and the rationale behind selection of appropriate antimicrobial agents for common infections.

Methods: The Infectious Disease Service is primarily a consultation service. Patients are assigned to the student by the Fellow/Attending Staff on service. The student is expected to do a complete consultation which includes a complete history and physical examination, review of x-rays, pathology slides, smears and stains on every patient assigned to him/her. Considerable emphasis is placed upon bed-side teaching, physical diagnosis and in-depth discussion of the clinical, diagnostic and therapeutic aspects of each case. Differential diagnosis and recommendations are then discussed with the Fellow/Attending Staff before they are officially placed on the chart. Patients are seen daily, or more frequently in critical cases.

The student is expected to read about cases assigned. There are regularly scheduled lectures on microbiology, pharmacology and antibiotics, and selected infectious diseases subjects, in addition to a weekly Infectious Diseases Grand Rounds. Students will also attend a monthly Research Conference dealing with the research activities of the Division of Infectious Diseases. Apart from the clinical elective in Infectious Disease, senior students are invited to spend 1-2 months participating in selected research projects. The research elective will provide the student with an opportunity to gain insight into basic scientific infectious diseases research, as well as the possibility of authorship of research manuscripts.

Recommended Reading Material: Patient related, assigned by Fellow/Attending Staff

Length: 1 month; Days/Week: 6; Hours/Week: 55; Night Calls/Month: not required

Evaluation: Clinical evaluation and written

Category: Inpatient Consult Service

8450 - Infectious Disease - Henry Ford Health Service

Course Prerequisite: Completion of core clerkship in Medicine

Description: The student functions as a member of the Infectious Diseases team, and sees patients with senior staff. The student is expected to review infectious disease literature prior to his/her case presentation.

Objectives: Improve understanding of the evaluation of patients with infection, antimicrobial usage and microbiology tests upon completion of this rotation.

Methods: The student functions as a member of the Infectious Diseases team, and sees patients with senior staff. The student is expected to review infectious disease literature prior to his/her case presentation. 80% inpatient care. 15% conferences/lectures. 5% laboratory work.

Recommended Reading Material: To be provided.

Length: 1 month; Days/Week: 5; Hours/Week: 40; Night Call/Month: none

EMR System: EPIC

Category: Inpatient Consult Service

8450 - Infectious Disease - Providence Hospital

Course Prerequisites: N/A

Description: Students will rotate with the inpatient Adult Infectious Diseases service. A diverse range of cases will be seen. Students will do consultations and provide daily progress notes on their patients. They will attend team rounds which includes other medical students, Infectious Diseases fellows and their assigned attending physician. The students will also attend 3-4 conferences per week which include case conferences, seminars, didactics, and journal clubs. Students may be asked to provide case presentations at the weekly case conference.

The I.D. rotation is an inpatient consultative service. Case load is moderate with an excellent mixture of clinical problems. Adequate time for self-study is usually available. Students will be expected to assume a significant degree of responsibility. Students are encouraged to attend other Internal Medicine conferences and are expected to attend the weekly Infectious Disease conference. Close interaction with the Resident on the elective and the instructor.

Objectives: To expand knowledge in the discipline of infectious diseases and microbiology to gain experience in the management of patients with diversified infections in various services. To develop solid understanding of the principles of antibiotics and antiviral therapy. To enhance knowledge and skills pertaining to: Interviewing, physical examination and other patient interactions. Interpretation of data. Clinical judgment. Therapy and advice to patients. To increase student use/review of the medical literature: As part of patient care (report to attending).

Methods: Bedside teaching, daily rounds, conferences. 1. Daily teaching rounds with Infectious Disease Faculty, Infectious Disease Fellows, and rotating house officers. 2. Assignment of a number of new consultations and follow up with emphasis on balanced education and experience. 3. Participating in discussion of all new cases on the teaching service to assure broad clinical exposure. 4. Participating with residents, fellows and faculty in infectious disease journal club. 5. Presentation of selected cases during infectious diseases grand rounds. 6. Spending 1/2 day/week in the office of the Infectious Disease faculty or travel clinic. Weekly CORE and Clinical lectures/seminars to cover a predetermined wide curriculum of topics in infectious diseases.

Recommended Reading Material: To be assigned.

Length: 1 month; Days/Week: 5; Hours/Week: 40; Night Calls/Month: None

Evaluation: Students are assessed by the attending physician at the end of the rotation. There will be a written evaluation provided to WSU and a verbal evaluation directly to the student. Students will be evaluated on each of the following: Quality of care given (including clinical judgment). The number of patients given care. Level of knowledge (including new knowledge). Brief review of a topic in infectious diseases. Methods to be used in student evaluation include: Observation of performance by faculty. Assessment of write-ups/reports.

Preceptor(s): Dr. Tania Little

Category: Inpatient Consult Service

Recommended Attire: Business Professional

8450 - Infectious Disease - St John Hospital

Course Prerequisites: Internal Medicine rotation.

Description: Students will rotate with the inpatient Adult Infectious Diseases service for four weeks. A diverse range of cases will be seen. Students will do consultations and provide daily progress notes on their patients. They will be attend team rounds which includes other medical students, Infectious Diseases fellows and their assigned attending physician. The students will also attend 3-4 conferences per week which include case conferences, seminars, didactics, and journal clubs. Students may be asked to provide case presentations at the weekly case conference.

Recommended Reading Material: Mandell Principles and Practices of Infectious Disease

Length: 1 month; Days/Week: 5; Hours/Week: 40; Night Calls/Month: None

Preceptor(s): Leonard Johnson, MD

Category: Inpatient Consult Service

Recommended Attire: Business Professional

EMR System: Cerner

8460 - Infectious Disease Research - Detroit Medical Center

Objectives: To participate in a research project. To participate in several of the following: Formulation of a hypothesis and of a formal research proposal. Execution of a study including record keeping and Evaluation of research data. Reporting of the results. Integration of newly generated data with existing information in the literature. Formulation of alternate hypotheses and proposal of follow-up studies.

Methods: Student will contact a faculty member under whose supervision he/she wishes to work 60 days in advance of the first day of the intended rotation. Student's project or share of a project will be approved by the Division Chief or the course coordinator. Projects qualifying for this elective include (but are not limited to): laboratory or clinical studies which can be completed during 1-2 months, projects initiated previously by the student that can be completed within this period, suitable components of ongoing division projects that would insure achievement of at least 3 subsidiary objectives listed above [2(a)-(e)]. The students will be encouraged to write a brief report at the end of the elective or present their work in a seminar setting.

Recommended Reading Material: To be assigned Length:

Length: 1 or 2 months; Days/Week: 5; Hours/Week: 40; Night Calls/Month: none

Evaluation: Clinical evaluation

Category: Research, Non-Clinical

8470 - Acting Internship: Internal Medicine - Detroit Receiving Hospital

Course Prerequisites: Must be an M4 student in good standing who has completed a 3rd year clerkship in Internal Medicine.

Description: Students will expand on their Year 3 internal medicine clerkship experience with more intensive involvement in patients experiencing common internal medicine ailments in the hospital setting.

Rationale: While the time period between medical school graduation and the start of graduate medical training (internship) may be short, the transformation from medical student to intern is a significant one. New interns are expected to assume higher levels of responsibility and workload in the setting of challenging clinical, social, and emotional contexts. Surveys of residency program directors and empirical studies have noted gaps and variability in knowledge and skills among new interns. These gaps have prompted medical educators to turn their attention to the fourth year of medical school in an effort to strengthen students’ preparedness for internship. Among the wide array of fourth-year courses, the subinternship (also known as acting internship) is commonly viewed as one of the most important clinical experiences in helping senior medical students prepare for internship. This view has been shared by both faculty and residents.

The origin of the subinternship can be traced back to World War II, a time when the national shortage of interns necessitated the creation of “acting internships” for senior medical students. Seen as a logical extension of the “progressive graded responsibility” concept already in place for residency programs, this new rotation for senior medical students became widely adopted after the war. Over time, this popular course has evolved into an integral component of undergraduate medical training and is now required at 90% of U.S. allopathic medical schools. Despite its longstanding tenure, medical educators have only begun to establish some standardized structure and content for the subinternship in the past two decades. In 1998, Fagan and colleagues began this process by outlining specific recommendations for the internal medicine (IM) subinternship’s structure and experience. In 2002, the Clerkship Directors in Internal Medicine (CDIM) Subinternship Task Force developed a core curriculum for the IM subinternship. This curriculum was based upon a needs assessment survey of IM residency program directors, subinternship directors, and interns.

The landscape of graduate medical education (GME) and medical practice has changed significantly since the turn of this century, prompting national organizations to call for reforms to the medical school curriculum so that medical students are more adequately prepared for post-graduate training. The Association of Program Directors in Internal Medicine (APDIM) surveyed its members in 2010 and put forth four core skills all IM interns should possess at the start of residency training. Soon thereafter, the Alliance for Academic Internal Medicine (AAIM) formed a joint CDIM-APDIM Committee on Transition to Internship (CACTI) to examine the fourth year of medical school with the aim of making evidence-based recommendations to help students optimize their preparation for internship. The Association of American Medical Colleges (AAMC) also established thirteen core entrustable professional activities for entering residency (EPA) that define a set of foundational skills and behaviors expected of all medical school graduates. The core EPAs were created as a practical approach to assess the Accreditation Council for Graduate Medical Education (ACGME) six core competencies in real-world settings. Over this same time period the medical education community became increasingly aware of the distress and burnout problem among residents and medical students, resulting in calls for interventions to improve medical students’ well-being and resilience in hopes of getting them better prepared for their next phase of clinical training.

Objectives: To become familiar with and graded upon the 13 Core Entrustable Professional Activities (EPAs) throughout the subinternship. 1. To gather a history and perform a physical examination. 2. To prioritize a differential diagnosis following a clinical encounter. 3. To recommend and interpret common diagnostic and screening tests. 4. To enter and discuss orders and prescriptions. 5. To document a clinical encounter in the patient record. 6. To provide an oral presentation of a clinical encounter. 7. To form clinical questions and retrieve evidence to advance patient care. 8. To give or receive a patient handover to transition care responsibility. 9. To collaborate as a member of an interprofessional team. 10. To recognize a patient requiring urgent or emergent care and initiate evaluation and management. 11. To obtain informed consent for tests and/or procedures. 12. To perform general procedures of a physician. 13. To identify system failures and contribute to a culture of safety and improvement. Methods: Hospital-based clinical training with supervision from both senior residents and hospitalists/preceptors. Complimented by hospital-based didactics including case conferences, morning reports, and grand rounds.

Recommended Reading/Resources: The Subinternship Curriculum Version 2.0 along with online material as needed/directed based on the patient population.

Length: 1 month; Hours/Week: team and hospital variable, 40-60 hours without violation of duty hours; Days/Week: 5-6 with hospital and team-based variation; Night Calls/Month: Hospital and team-based dependent

Evaluation: New Innovations evaluation, evaluations by senior resident and attending physician.

Category: Acting Internship

Recommended Attire: professional, white coat, scrubs when on call

EMR System: Hospital dependent.

8470 - Acting Internship: Internal Medicine - Barbara A Karmanos Cancer Inst

Course Prerequisites: Must be an M4 student in good standing who has completed a 3rd year clerkship in Internal Medicine.

Recommended Reading/Resources: The Subinternship Curriculum Version 2.0 along with online material as needed/directed based on the patient population.

Evaluation: New Innovations evaluation, evaluations by senior resident and attending physician.

Category: Acting Internship

Recommended Attire: professional, white coat, scrubs when on call

EMR System: Hospital dependent.

8470 - Acting Internship: Internal Medicine - Sinai Hospital

Course Prerequisites: Must be an M4 student in good standing who has completed a 3rd year clerkship in Internal Medicine.

Recommended Reading/Resources: The Subinternship Curriculum Version 2.0 along with online material as needed/directed based on the patient population.

Evaluation: New Innovations evaluation, evaluations by senior resident and attending physician.

Category: Acting Internship

Recommended Attire: professional, white coat, scrubs when on call

EMR System: Hospital dependent.

8470 - Acting Internship: Internal Medicine - Veterans Admin Hospital

Course Prerequisite: All VA electives require U.S. citizenship. Do not register for this elective without being able to provide your U.S. social security number for onboarding purposes. Must be an M4 student in good standing who has completed a 3rd year clerkship in Internal Medicine.

Recommended Reading/Resources: The Subinternship Curriculum Version 2.0 along with online material as needed/directed based on the patient population.

Evaluation: New Innovations evaluation, evaluations by senior resident and attending physician.

Category: Acting Internship

Recommended Attire: professional, white coat, scrubs when on call

EMR System: CPRS

8470 - Acting Internship: Internal Medicine - Harper Hospital

Course Prerequisites: Must be an M4 student in good standing who has completed a 3rd year clerkship in Internal Medicine.

Recommended Reading/Resources: The Subinternship Curriculum Version 2.0 along with online material as needed/directed based on the patient population.

Evaluation: New Innovations evaluation, evaluations by senior resident and attending physician.

Category: Acting Internship

Recommended Attire: professional, white coat, scrubs when on call

EMR System: Hospital dependent.

8470 - Acting Internship: Internal Medicine - Beaumont Dearborn

Course Prerequisites: Must be an M4 student in good standing who has completed a 3rd year clerkship in Internal Medicine.

Recommended Reading/Resources: The Subinternship Curriculum Version 2.0 along with online material as needed/directed based on the patient population.

Evaluation: New Innovations evaluation, evaluations by senior resident and attending physician.

Category: Acting Internship

Recommended Attire: professional, white coat, scrubs when on call

EMR System: Hospital dependent.

8470 - Acting Internship: Internal Medicine - St John Hospital

Course Prerequisites: Must be an M4 student in good standing who has completed a 3rd year clerkship in Internal Medicine.

Recommended Reading/Resources: The Subinternship Curriculum Version 2.0 along with online material as needed/directed based on the patient population.

Evaluation: New Innovations evaluation, evaluations by senior resident and attending physician.

Category: Acting Internship

Recommended Attire: professional, white coat, scrubs when on call

EMR System: Hospital dependent.

8470 - Acting Internship: Internal Medicine - Henry Ford Health Service

Course Prerequisites: Must be an M4 student in good standing who has completed a 3rd year clerkship in Internal Medicine.

Recommended Reading/Resources: The Subinternship Curriculum Version 2.0 along with online material as needed/directed based on the patient population.

Additional Locations: Main Campus on W. Grand Blvd.

Evaluation: New Innovations evaluation, evaluations by senior resident and attending physician.

Category: Acting Internship

Recommended Attire: professional, white coat, scrubs when on call

EMR System: EPIC

8470 - Acting Internship: Internal Medicine - St Joseph Pontiac

Course Prerequisites: Must be an M4 student in good standing who has completed a 3rd year clerkship in Internal Medicine.

Recommended Reading/Resources: The Subinternship Curriculum Version 2.0 along with online material as needed/directed based on the patient population.

Evaluation: New Innovations evaluation, evaluations by senior resident and attending physician.

Preceptor(s): Geetha Krishnamoorthi, MD

Category: Acting Internship

Recommended Attire: professional, white coat, scrubs when on call

EMR System: EPIC

8470 - Acting Internship: Internal Medicine - St Mary Mercy Hospital/Livonia

Course Prerequisites: Must be an M4 student in good standing who has completed a 3rd year clerkship in Internal Medicine.

Recommended Reading/Resources: The Subinternship Curriculum Version 2.0 along with online material as needed/directed based on the patient population.

Evaluation: New Innovations evaluation, evaluations by senior resident and attending physician.

Category: Acting Internship

Recommended Attire: professional, white coat, scrubs when on call

EMR System: EPIC

8480 - Medicine/Pediatrics - University Health Center

Objectives: To orient the student to the day and practice of a Medicine/Pediatrics physician. The student will work in an academic along with a community setting with a staff physician. There will be weekly didactic teaching sessions.

Methods: Student will be enlightened and exposed to what a Medicine/Pediatric Physician is confronted with on a demanding practice.

Recommended Reading Material: Harrison's, Cecil's, Oski, Nelson's, Textbook of Adolescent Medicine

Length: 1 month; Days/Week: 5; Hours/Week: 40; Night Calls/Month: none

Evaluation: Written

Category: Ambulatory

8480 Medicine/Pediatrics - Michigan Healthcare Professionals

Course Prerequisites: None.

Description: Students will learn the aspects of the day-to-day practice of a physician specializing in an internal medicine/pediatric private practice. Students will rotate primarily in the outpatient setting with a large portion of patient care being done as virtual care over telemedicine. Students will gain an appreciation of the general running of a high-volume private practice and how to successfully run a future private practice if that is their goal.

Objectives: To get an overview of how to do outpatient and longitudinal care and what it means to take care of patients and develop family relationships over a long period of time. To help students understand and see interesting, common, and more unique cases to develop a deeper understanding of what it means to specialize in internal medicine and pediatrics.

Methods: Students will participate in out of office procedures including injections, biopsies, wart freezing, medical and pediatric wellness exams, and general physicals. In their first week, students will learn by following and discussions for understanding. After this time, students will be able to see patients independently with physician review and present to the preceptor on every third or fourth patient. Students can expect to see about 30-50 patients each day.

8490 - Nephrology - St John Hospital

Objectives: To gain exposure to common acute and chronic nephrologic disease states. To gain experience with acid-base disorders, acute and chronic dialysis, and transplant nephrology. Develop experience in physical diagnosis as it applies to uremia and various volume states. Special attention to diabetes as it applies to ESRD. Exposure to hypertension-urgency, emergencies, and its treatments. Understand and be able to evaluate UA's.

Methods: The fourth year student will function at an intern level. He/She will rotate on either the consult or Nephrology floor service. He/She will be responsible for initial patients assessment and will generate a working diagnosis. Daily bedside teaching rounds will be made. Daily didactic lectures will be held. Written evaluations will be provided by the nephrology staff.

8490 - Nephrology - Harper Hospital

Course Prerequisite: N/A

Objectives: To correlate renal renal pathophysiology with clinical medicine. To develop skills in diagnosing and managing common nephrologic problems, i.e. acute and chronic kidney injury, glomerulonephritis, interstitial nephritis, nephrotic syndrome, fluid, electrolyte, acid base abnormalities and hypertensive diseases. To learn how to perform and interpret urinalysis. To develop the rationale behind laboratory and diagnostic tests utilized in patients with renal disease and their interpretations. To expose the student to various therapeutic modalities used in the treatment of the patient with renal disease and the indications for their use.

Methods: Students will have the opportunity to see a variety of consultative nephrologic problems in the hospital. The student will have the opportunity to observe hemodialysis, peritoneal dialysis, renal biopsy and transplantation. The student will be the first to see patients referred to the nephrology division. Patients will be discussed with the renal fellow/faculty daily and presented to the faculty during bedside teaching rounds. Normal basic science will be reviewed in these sessions so as to encourage students to view disease as aberrations thereof. Abnormal urines will be reviewed with staff. Students will attend and participate in divisional conferences consisting of weekly basic science, nephrology grand rounds, renal pathology. Students will also attend morning lectures together with the residents on service.

Recommended Reading Material: Harrison's. Principles of Internal Medicine. Most recent edition. Section on Nephrology. Schrier, Robert W, MD. Renal & electrolyte Disorders. 6th edition. Up-To-Date 4. Reading list containing pertinent articles distributed.

Length: 1 month; Days/Week: 6; Hours/Week: 44; Night Calls/Month: none

Evaluation: Clinical evaluation, there is an exit written examination for internal quality control and is not used for grading purposes.

Category: Inpatient Consult Service

8490 - Nephrology - St Joseph Pontiac

Course Prerequisite: N/A

Descriptions: Students work primarily on consult service, which sees a broad range of nephrologic and hypertension problems. Patients are seen by the medical student, reviewed with the nephrology fellow and discussed in detail by the Nephrology/Hypertension senior staff. Participation in the Nephrology/Transplantation ward rounds is encouraged. Students also work with residents, fellows and faculty, seeing outpatient consults. Weekly conferences include two journal clubs, renal grand rounds, fluid-electrolyte and biopsy sessions.

Objectives: Students work primarily on consult service, which sees a broad range of nephrologic and hypertension problems. Patients are seen by the medical student, reviewed with the nephrology fellow and discussed in detail by the Nephrology/Hypertension senior staff. Students also work with residents, fellows and faculty, seeing outpatient consults. Weekly conferences include journal club, renal grand rounds, fluid-electrolyte, and biopsy sessions.

Methods: 65% inpatient care. 15% outpatient care. 20% conference/lectures.

Recommended Reading Material: To be provided.

Length: 1 month; Days/Week: 5-6; Hours/Week: 40-50 Night Calls/Month: None

Preceptor(s): Ghadeer Hannoudi, MD

Category: Inpatient Consult Service

8490 - Nephrology - Henry Ford Health Service

Course Prerequisite: Completion of core clerkship in Medicine.

Methods: 65% inpatient care. 15% outpatient care. 20% conference/lectures.

Recommended Reading Material: To be provided.

Length: 1 month; Days/Week: 5-6; Hours/Week: 40-50 Night Calls/Month: None

EMR System: EPIC

Category: Inpatient Consult Service

8490 - Nephrology - Providence Hospital

Course Prerequisite: N/A

Methods: Students work primarily on consult service, which sees a broad range of nephrologic and hypertension problems. Patients are seen by the medical student, reviewed with the nephrology fellow and discussed in detail by the Nephrology/Hypertension senior staff. Students also work with residents, fellows and faculty, seeing outpatient consults.

Recommended Reading Material: To be provided.

Length: 1 month; Days/Week: 5-6; Hours/Week: 40-50 Night Calls/Month: None

Evaluation: Clinical Evaluation

Preceptor(s): Dr. Fawaz Al-Ejel

Category: Inpatient Consult Service

8510 - Oncology: Medical - St Joseph Pontiac

Course Prerequisites: N/A

Description: This is a hematology/oncology service. Students work closely with senior staff oncologists in morning and afternoon clinics. New outpatient consultations, as well as interesting follow up patients, are seen by students and discussed with staff. Students are expected to participate in journal clubs and weekly interdisciplinary case conferences.

Objectives: Enhance knowledge and skills pertaining to interviewing, physical examination, or patient interactions, interpretation of data, clinical judgment, therapy, and advice to patients. Increase students involvement in conferences, journal club. Increase student use/review of the medical literature; rational use of analgesics. Understand how medical oncologist interacts with other disciplines in designing combined modality therapies. Understand scientific and ethical issues, which should govern use of antineoplastic therapies.

Recommended Reading Material: To be assigned

Length: 1 month; Days/Week: 5; Hours/Week: 40; Night Call/Month: none

Evaluation: Quality of care given, participation & performance in conferences, level of knowledge, level of skills. Observation of performance by faculty. Assessment of write-ups/reports.

Preceptor(s): Judie Goodman, DO

Category: Inpatient Consult Service

8510 - Oncology: Medical - Henry Ford Health Service

Course Prerequisites: N/A

Description: This is strictly an outpatient rotation. Students work closely with senior staff oncologists in morning and afternoon clinics. New outpatient consultations, as well as interesting follow up patients, are seen by students and discussed with staff. Students are expected to participate in journal clubs and weekly interdisciplinary case conferences.

Methods: This is strictly an outpatient rotation. Students work closely with senior staff oncologists in morning and afternoon clinics. New outpatient consultations, as well as interesting follow up patients, are seen by students and discussed with staff. Students are expected to participate in journal clubs and weekly interdisciplinary case conferences.80% outpatient care. 20% conferences/lectures.

Recommended Reading Material: To be assigned

Length: 1 month; Days/Week: 5; Hours/Week: 40; Night Call/Month: none

Evaluation: Quality of care given, participation & performance in conferences, level of knowledge, level of skills. Observation of performance by faculty. Assessment of write-ups/reports.

EMR System: EPIC

Category: Inpatient Consult Service

8520 - Oncology: Outpatient - Barbara A Karmanos Cancer Inst

Objectives: To develop an experience in the initial evaluation of cancer patients in an outpatient setting. To become familiar with a wide range of malignant diseases and their complications. To develop an appreciation of the role of staging in the workup and management of a cancer patient. To learn to conduct a focused follow up office visit of a cancer patient. To develop an appreciation of psychosocial problems of oncological patients who are in remission or overtly disease-free.

Methods: Students will spend a minimum of 6 half days a week in the oncology outpatient offices at the Karmanos Cancer Institute. They will work, one on one, with selected faculty and will see both new and old patients, i.e. do initial evaluations and provide follow up care under the supervision of a faculty member. The student will have a tutor who will keep himself/herself apprised of the student's everyday activities and progress and will be responsible for the student's evaluation and, together with the coordinator, for assignment of the student's grade. Optional activities will include attendance at multidisciplinary conferences, Oncology Grand Rounds, resident didactic sessions and special conferences recommended by the tutor or the coordinator. Pre and post tests will be available for self-assessment purposes but will not be used for grading.

Recommended Reading Material: D.A. Casciato: Manuel of Clinical Oncology, 3rd Edition.

Length: 1 month; Days/Week: 5; Hours/Week: 40; Night Calls/Month: none

Evaluation: Clinical evaluation

Category: Ambulatory

8520 Oncology: Outpatient - Michigan Healthcare Professionals

Course Prerequisites: None.

Description: Students will gain an appreciation of hematologic and oncologic care in an outpatient setting. Students will conduct initial evaluations, see a variety of types of malignant diseases, understand the role of staging, and conduct a focused follow-up of cancer patients. This is a heme/onc rotation.

Objectives: Students will learn internal medicine and the ability to work up common heme/onc-related diagnoses such as anemia, leukemia, lymphomas, myelomas, breast cancer, colon cancer, lung cancer, etc. Students will learn how to be patient and express empathy, especially in the cases of very sick patients, to be better, more understanding doctors. Physicians will teach to the level of the student, always attempting to elevate the student’s understanding of the topic at hand and challenge the student.

Methods: Students will first be given a tour of the office. Then, students can expect to be very hands on in their patient care. Students will always see oncology patients on Mondays, Wednesdays, and Fridays. Students will review the chart and go into the room as a first encounter before the attending physician to examine the patient with a total H&P, history, medication review, etc. and share their impressions with the physician in the hallways. Students and the physician will have a discussion, and then students will follow the physician into the room to see the same patient. They will then have a repeated discussion to ensure students understand the care plan and students will document the patient interaction with their notes. Students can expect to do hematology care on Tuesdays and Wednesdays following the same process. On Monday mornings, students will watch bone marrows. There will be private lectures called “coffee lectures” two days a week. If a physician has an interesting case, students will always be asked to join the case to get greater experience on the subject. Students can expect to see an average of 5-10 new patients each day. Students can expect to see a large volume of patients very quickly, while still giving each patient the time they need to ask questions, get answers to every problem/question, and feel like they’ve been given complete care.

Recommended Reading: Varies based on students on service, relevant topics, and patients. Assignments are based on patient population.

Length: 1 month; Days/Week: 5; Hours/Week: 40-60; Night Calls/Month: None

Additional Locations: 27900 Grand River Avenue, Suite 220, Farmington Hills, MI 48336; 27301 Dequindre Road, Suite 314, Madison Heights, MI 48071; 3577 W. Thirteen Mile Road, Suite 204, Royal Oak, MI 48073; 32255 Northwestern Highway, Suite 150, Farmington Hills, MI 48334

Evaluation: Presentations, New Innovations evaluation.

Preceptor(s): Dr. Harold Margolis, Dr. Jeffrey Margolis, Dr. Richard Zekman, Dr. Lynette Sutkowi

Category: Ambulatory

Recommended Attire: White coat

EMR System: Webchart

8540 - Otolaryngology - University Health Center

Course Prerequisites: Surgery rotation

Description: Provide a comprehensive experience with the surgical specialty of Otolaryngology - Head and Neck Surgery for students.

Methods: The electives objectives will be accomplished by: 1) enhancing the students history taking skills pertaining to otolaryngologic pathologies, 2) improving the students head and neck physical examination skills, 3) providing exposure to the audiology, vestibular and laryngology laboratories, 4) teaching the student about various head and neck pathologies through exposure to both in-hospital and clinic patients, 5) teaching the student how to initiate the work-up and provide treatment for various otolaryngologic emergencies, and 6) providing exposure to surgical aspects of otolaryngology with emphasis on both outpatient and inpatient procedures.

Objectives: During this clinical elective the student will become familiar with the specialty of Otolaryngology - Head and Neck Surgery. Special goals of the elective are to perfect the student's skills in performing a specialized head and neck examination. To aid the student in choosing and interpreting specialized diagnostic studies. To teach the student how to initiate and carry out a treatment plan for otolaryngologic - head and neck disorders.

Methods: Clinical activities and teaching will take place at Karmanos Cancer Institute, Harper Hospital, and Beaumont Dearborn. A portion of the elective may also be spent at the Children's Hospital of Michigan in accordance with a student's individual goals. The clinical experience will encompass the spectrum of this specialty including outpatient clinical activities, inpatient bedside rounds, and operating room procedures, all under the supervision of resident and attending staff. In addition, the student will participate in teaching rounds and Otolaryngology conferences.

Recommended Reading/Resources: ENT Secrets by Melissa Scholes and Vijay Ramakrishnan or Otolaryngology-Head and Neck Surgery: Clinical Reference Guide by Raza Pasha and Justin Golub

Length: 1 month or 2 weeks; Hours/week: Average 50 hours per week; Days/week: Monday-Friday; Night Calls/month: No required call. Optional weekend rounding

Additional Locations: Karmanos Cancer Institute/Beaumont Dearborn/Childrens

Evaluation: Clinical evaluation with Honors/High Pass/Pass/Fail

Preceptor(s): John Cramer, MD; Ho-Sheng Lin, MD; George Yoo, MD; Eleanor Chan, MD

Director: John Cramer, MD

Coordinator: Rita Florkey

Category: Specialty Subinternship

Recommended Attire: Scrubs for OR

EMR System: Cerner (DMC/KCI) or Epic (Beaumont)

8540 - Otolaryngology - Henry Ford Health Service

Course Prerequisites: N/A.

Description: 4-week elective geared toward medical students interested in otolaryngology as a career. The senior surgical clerkship in Otolaryngology is an opportunity to learn the techniques of thorough examination of the head and neck. Students manage outpatient problems under direct supervision of the senior staff physicians. Inpatient, outpatient, research and operative exposures suit students' individual interests. Continuously updated lectures and exposures include neck masses, head and neck cancer, airway obstruction, facial trauma, ear disease and sinus disease. Students are taught otolaryngologic concepts both in the operating room and in clinical outpatient areas.

Objectives: Enhance knowledge and skills pertaining to interviewing, physical examination, or patient interactions, interpretation of data, clinical judgment and procedures (i.e., therapy and advice to patients). Increase student involvement in conferences, journal clubs. Increase student use/review of the medical literature

Methods: Primarily clinical (5 days a week, 1 optional weekend over the course of the rotation). A 10 minute presentation is required at the end of the course. 20% inpatient care. 40% outpatient care. 30% operating room. 5% laboratory work. 5% research.

Recommended Reading Material: To be assigned.

Length: 1 month; Days/Week: 5 (M-f) plus 1 optional weekend during the four weeks; Hours/Week: 50-60; Night Calls/Month: None

Additional Locations: Henry Ford Health Service, Henry Ford West Bloomfield

Evaluation: Oral presentation at the end of the course. Evaluations are solicited from faculty and residents based on clinical experience, participation in clinic/OR/rounds. Quality of care given. Participation and performance in conferences. Level of knowledge. Level of skills. Interest in the rotation. Observation of performance by faculty and house officers. Written/oral tests.

Preceptor(s): Suhael Momin

Category: Specialty Subinternship

Recommended Attire: Scrubs, business professional, white coat

EMR System: EPIC

8540 - Otolaryngology - St Joseph Pontiac

Description: 4 week elective geared toward medical students interested in otolaryngology as a career. The senior surgical clerkship in Otolaryngology is an opportunity to learn the techniques of thorough examination of the head and neck. Students manage outpatient problems under direct supervision of the senior staff physicians. Inpatient, outpatient, research and operative exposures suit students' individual interests. Continuously updated lectures and exposures include neck masses, head and neck cancer, airway obstruction, facial trauma, ear disease and sinus disease. Students are taught otolaryngologic concepts both in the operating room and in clinical outpatient areas.

Objectives: Enhance knowledge and skills pertaining to interviewing, physical examination, or patient interactions, interpretation of data, clinical judgment and procedures (i.e., therapy and advice to patients). Increase student involvement in conferences, journal clubs. Increase student use/review of the medical literature

Recommended Reading Material: To be assigned.

Length: 1 month; Days/Week: 5 (M-f) plus 1 optional weekend during the four weeks; Hours/Week: 50-60; Night Calls/Month: None

Preceptor(s): Dr. Eric Succar

Category: Specialty Subinternship

Recommended Attire: Scrubs, business professional, white coat

8570 - Palliative Medicine - Multiple Locations

Course Prerequisite: All VA electives require U.S. citizenship. Do not register for this elective without being able to provide your U.S. social security number for onboarding purposes. Students entering any clinical specialty would benefit from this elective clerkship

This location includes the VA. This elective is available for pediatric and adult palliative medicine.

Description: Understanding of and skills in palliative medicine: communication, cultural issues, psycho-emotional and spiritual aspects of end of life care and death and dying.

Objectives: Students will have improved skills and understanding of: 1) recognition of life limiting illness, 2) appropriate timing for Palliative Medicine consultation, 3) communication skills in end of life care, 5) cultural variations in death and dying, 6) the evidence base for end of life care, 7) inter-disciplinary team approach to patient care, 8) psycho-emotional and spiritual aspects of death and dying, 9) Pain and other symptoms management, 10) Safe use of opioids

Methods: Students will work directly with faculty providing care of terminally ill patients in hospital, ambulatory and residential hospice settings. Initial consultations for palliative care will be provided in the hospital and in clinic settings. Students will be responsible for evaluating patients, performing history and physical examinations and participating with the team in decision-making. Students will follow patients seen in consultation. Case based small group teaching and didactics will be provided by the faculty. One or two short presentations will be made by the student during the month. A syllabus with core information and recent and classic literature in palliative medicine will be provided to each student.

Recommended Reading/Resources: Syllabus and reading material to be provided at orientation on the first ay of the rotation.

Length: 1 month; no call

Evaluation: Formative evaluation and feedback (mid-way) and Final evaluation in New Innovations.

Location(s): This elective rotation takes place at the Detroit Medical Center and Karmanos Cancer Center with an opportunity to observe the Hospice Unit at the Detroit VA Medical Center.

Students may rotate at other hospitals if specifically arranged by the student with the hospital.
Students wishing to rotate with Pediatric Palliative Care at Children’s Hospital of Michigan need to get approval from Dr. Nadia Tremonti, Director of Palliative Care at CHM. (See Elective Course Coordinator Spreadsheet for contact details.)

Course Director: Niren Naidoo, MD - Students should contact the course director one week before the start of the rotation for information on logistics.

Category: Inpatient Consult Service

Notes: Students entering any clinical specialty would benefit from this elective.

8580 - Primary Care Medicine - University Health Center

Objectives: Expose the 4th year medical student to common problems encountered in a outpatient clinical setting.

Methods: One-One staff with faculty/medical students.

Recommended Reading Material: Harrison's, Cecil's

Length: 1 month; Days/Week: 5; Hours/Week: 40; Night Calls/Month: none

Evaluation: Written

Category: Ambulatory

8590 - Pulmonary Medicine - Providence Hospital

Course Prerequisites: N/A

Description: This rotation offers the student interested in pulmonary and critical care medicine exposure to all aspects of modern pulmonary medicine.

Methods: In addition to pulmonary and critical care inpatient consultations, the student will acquire basic skills in interpreting chest x-rays, reading pulmonary function tests, and blood gas analysis. A comprehensive bibliography of suggested readings on a multitude of pulmonary and critical care topics is provided.

Objectives: Increase skill at performing the respiratory system history and examination. Discuss patients one on one with faculty to understand disease pathophysiology and therapeutics. Learn to interpret of Pulmonary Function Testing, chest xrays and CT scans.

Recommended Reading Material: To be assigned.

Length: 1 month

Evaluation: Composite evaluation of clinical skills by faculty involved with the student. Possible short multiple choice exam covering common respiratory diseases.

Preceptor(s): Dr. Wasseem Farra

Category: Inpatient Consult Service

8590 - Pulmonary Medicine - Detroit Medical Center

Course Prerequisites: Completion of Internal Medicine rotation

Description: During this rotation, students will learn more about common disorders of the respiratory system that are seen in both inpatients and outpatients. These disorders can include asthma, COPD, lung nodules, sarcoidosis/interstitial lung disorders, pulmonary hypertension, hypoxic and hypercapnic respiratory failure and sleep apnea. Students will evaluate patients in both the inpatient and outpatient settings.

Methods: 1. Half day rounding on the Pulmonary consult service that covers Harper University Hospital, Detroit Receiving Hospital and Karmanos Cancer Institute. Students will be expected to see 1-2 patients each day on their own, present patients to resident/fellow and then to attending. 2. Each week, student expected to attend one half day clinic; these clinics will rotate between the various specialty areas within the division including: general pulmonary, pulmonary hypertension, sleep, thoracic oncology, cystic fibrosis, sarcoidosis. 3. Didactics: Pulmonary Grand Rounds, Pulmonary Case Conference.

Recommended Reading/Resources: 1. Respiratory section of your general medicine textbook.

Length: 1 month; Hours/week: 30; Days/week: 5; Night Calls/month: None

Additional Locations: N/A

Evaluation: Composite evaluation of clinical skills by faculty involved with the student. Short multiple choice exam covering common respiratory diseases.

Preceptor(s): Ayman Soubani, MD; Ghulam Saydain, MD; Zahia Esber, MD; Amina Pervaiz, MD; Zubin Mukadam, MD

Category: Inpatient Consult Service

Recommended Attire: Standard hospital attire

EMR System: Cerner for inpatient; Athena for outpatient

Director: James Rowley, MD

Coordinator: Lashonda Butler

8610 - Pulmonary Consultation - Henry Ford Health Service

Course Prerequisites: N/A

Description: The student works with a senior staff member, pulmonary fellow and two medical residents on the inpatient consultation service which performs 4-6 consults daily, including a variety of conditions and diagnostic problems. Attendance at division conferences (4 per week) is expected.

Objectives: Enhance knowledge, skills and attitude associated with Pulmonary Consultation in an In patient setting. Enhance knowledge and skills pertaining to interviewing, physical examination, or patient interactions, interpretation of data, clinical judgment, therapy, and advice to patients. Increase student involvement in conferences, journal clubs. Increase student use/review of the medical literature.

Methods: Case-based practice, where the student independently evaluates patients prior to staffing the patient with the attending Pulmonary faculty. Attendance at Pulmonary conferences. Assigned reading. 85% inpatient care. 15% conferences/lectures. Students will see an average of 5 patients each week.

Recommended Reading Material: To be assigned.

Length: 1 month; Days/Week: 5; Hours/Week: 8; Night Call/Month: none

Evaluation: Subjective Clinical Evaluation. Quality of care given. Level of knowledge. Level of skills. Observation of performance by faculty. Assessment of write-ups/reports.

EMR System: EPIC

Category: Inpatient Consult Service

8620 - Rheumatology - University Health Center

Diagnosis and management of common rheumatologic problems; understanding ancillary procedures and lab tests.

Category: Inpatient Consult Service

8620 - Rheumatology - Henry Ford Health Service

Course Prerequisite: Completion of core clerkship in Medicine.

Description: Provide medical students an exposure to systemic rheumatic autoimmune diseases. Students gain broad experience in evaluation of the musculoskeletal symptoms ranging from patients with Lupus, Rheumatoid arthritis and Scleroderma. Students are thoroughly exposed to history-taking and physical evaluation of joint disease and are closely involved in the management of these rheumatic disorders.

Objectives: Enhance knowledge and kills pertaining to interviewing, physical examination, and interpretation of data, clinical judgment, procedures and therapies. Increase student involvement in conferences, journal clubs. Increase student use/review of the medical literature.

Methods: Students gain broad experience in evaluation of systemic rheumatic autoimmune diseases. Students are thoroughly exposed to history-taking and physical evaluation and are closely involved to the management of these rheumatic disorders. Students will see an average of 10-12 patients each month. 85% outpatient care. 15% conferences/lectures.

Recommended Reading Material: To be provided.

Length: 1 month; Days/Week: 5; Hours/Week: 50; Night Calls/Month: None

Additional Locations: Henry Ford Hospital - Main

Evaluation: Quality of care given. Participation and performance in conference.Observation of performance by faculty

Preceptor(s): Amita Bishnoi, MD

Category: Inpatient Consult Service

Recommended Attire: Business Professional, White Coat

EMR System: EPIC

8630 - Sleep Disorders - Henry Ford Health Service

Course Prerequisites: N/A

Description: This course offers to the medical student the opportunity to learn the pathophysiology, diagnosis and general therapeutic approaches to Sleep Disorders. It is conducted in the outpatient.

Objectives: Provide sufficient exposure and experience in the field of sleep medicine to understand how to approach, work up and treat the patient with sleep disorders. This rotation exposes you to the most common sleep disorders including sleep apnea, restless legs syndrome, narcolepsy and insomnia. It will also help you to have basic understanding of in-laboratory and portable polysomnography. Enhance knowledge and skills pertaining to interviewing, physical examination, interpretation of data, clinical diagnosis of polysomnograms and therapy. Increase knowledge base on sleep medicine. Increase student involvement in conferences, journal clubs.

Methods: Daily supervised contact in Clinical setting. 80% outpatient care. 20% conferences/lectures.

Recommended Reading Material: To be provided.

Length: 1 month; Days/Week: 5; Hours/Week: 40; Night Call/Month: none

Evaluation: Quality of care given. Participation and performance in conferences. Level of knowledge. Level of skills. Observation of performance by faculty. Assessment of write-ups/reports.

EMR System: EPIC

Category: Inpatient Consult Service

8640 - Molecular Medicine - Multiple Locations

Course Prerequisites: Student will contact Dr. Krawetz (skrawetz@med.wayne.edu) at least 60 days in advance of the first day of the intended rotation. Students can arrange to work with faculty at the C.S. Mott Center for Human Growth and Development, the Department of Obstetrics and Gynecology, or the Center for Molecular Genetics and Genomics.

Description: A rotation to familiarize students with aspects of Precision Medicine as outlined in the objectives.

Objectives: 1. Develop an awareness of the scope and future of Precision Medicine by appreciating the genetic and genomic mechanism(s). 2. Enhance knowledge of the opportunities to use available technologies to guide personalized and precise care and recognize how this can modify health. 3. Gain an appreciation of how the patient's current health status informs both patient and offspring disease risk. 4. Become acquainted with how the environment can impact one's reproductive future and pathways to remediation.

Methods: Students participate in ongoing research projects. This includes opportunities to become familiar with various procedures and analytical techniques that can span sample collection isolation to analysis and diagnosis. The project may include but is not limited to high throughput cellular, genomic, and RNA sequencing and analysis. Students are introduced to state-of-the-art data analytics to identify current health status and possible health outcomes. Individuals with prior experience in statistics, R and/or Python are guided and encouraged to implement and develop new analytical tools.

Recommended Reading Material: Project specific/To be assigned.

Length: 1 or 2 months; Days/Week: 5; Hours/Week: 40; Night Call/Month: none

Evaluation: Assessment of objectives met by direct observation of the student's performance and participation in daily activities, including hands-on procedures and analyses, and contribution in laboratory meetings, seminars, and group discussions toward the end goal of the research project.

Category: Research, Non-Clinical

8650 - General Neurology - Michigan Healthcare Professionals

Course Prerequisites: None.

Description: Students will evaluate, diagnose, treat, and manage patients with an array of general neurologic conditions in a mostly/entirely outpatient setting.

Objectives: To get a better understanding of neurological care in an office and hospital setting. To become proficient in neurology examinations and learn how to develop a differential diagnosis.

Methods: Students will experience a hands-on learning rotation. Students will have time to evaluate patients on their own. Students will then present their patients for review and the preceptor will discuss the patient's case with the student. Students can rotate at Troy Beaumont only with special permissions and additional paperwork. Dr. Young is in the office 3 days/week (Monday, Tuesday, and Wednesday). Students will split their time between 6 physicians in the office. Dr. Young sees her first patient at 6:30 a.m., though students do not need to be there then unless Dr. Young specifically states otherwise. Students can expect to see their last patient at 4 p.m. so students can expect to go home around 4:30-5p.m.

Recommended Reading/Resources: Varies based on patient population and cases. Readings are assigned based on daily neurologic cases.

Length: 1 month; Days/Week: 5; Hours/Week: 40-60; Night Calls/Month: None

Additional Locations: Rochester Medical Group / Oakland Neurology 633 E. South Boulevard, Suite 1300 Rochester Hills, MI 48307 and Troy Beaumont if students fill out additional permissions paperwork.

Evaluation: New Innovations evaluation

Preceptor(s): Dr. Esther Young, Dr. Norman Burns, Dr. Steven Hardy, Dr. Jodi Kresch, Dr. Andrea Rossi, and Dr. Olivia Ryder

Category: Ambulatory

Recommended Attire: Scrubs, white coat, can also dress up if desired

EMR System: Webchart

8650 - General Neurology - Detroit Medical Center

Evaluation, diagnosis, treatment and management of patients with an array of general neurologic conditions.

Category: Specialty Subinternship

8650 - General Neurology - Tri-County Neurological Associates

Course Prerequisites: N/A

Description: Students will evaluate, diagnose, treat, and manage patients with an array of general neurologic conditions.

Objectives: 1. To develop neurologic history and physical examination skills. 2. To develop the ability to identify and react appropriately to neurologic emergencies. 3. To develop a rationale in managing common neurological problems. 4. To develop skills in performing bedside diagnostic procedures such as lumbar puncture. 5. To develop a rationale for ordering neurophysiological and neuroradiological tests and the ability to interpret them.

Methods: 1. Students will follow patients within a busy private neurologic suburban practice under the supervision of two neurologists. 2. Students will be required to evaluate new patients and present their findings on rounds. 3. Students will be supervised by Dr. Jay Kaner.

Additional Locations: Patients will be seen both in an outpatient setting in the office and on rounds at St. Joseph's Hospital, East and West, and at Mt. Clemens General

Recommended Reading Material: Principles of Neurology. Adams and Victor. Merritt's Textbook of Neurology. Rowland.

Length: 1 month or 2 months; Days/Week: 5; Hours/Week: 40; Night Calls/Month: none

Evaluation: Clinical Evaluation

Preceptor(s): Dr. Jay Kaner

Category: Ambulatory

8650 - General Neurology - Providence Hospital

Course Prerequisites: N/A

Description: Students will evaluate, diagnose, treat, and manage patients with an array of general neurologic conditions.

Methods: 1. Students will follow patients within a busy private neurologic practice under the supervision of neurologists. 2. Students will be required to evaluate new patients and present their findings on rounds.

Recommended Reading Material: To be assigned

Length: 1 month; Days/Week: 5; Hours/Week: 40; Night Calls/Month: none

Evaluation: Clinical Evaluation

Preceptor(s): Dr. Bruce Kole

Category: Ambulatory

8650 - General Neurology - Multiple Locations

Course Prerequisites: N/A

Description: Students will be able to evaluate, generate differential diagnosis, diagnose, treat and manage patients with wide variety of neurological disorders in an outpatient setting

Objectives: To develop competence in:

Neurological history and physical exam
Generating differential diagnosis
Ability to develop a plan of care
Ability to effectively present the patient to supervising attending physician

Methods: Students will be able to evaluate new and established patients and present their findings to attending physician. 45-60 minutes of didactic lecture/ interesting case discussion every day.

Recommended Reading Material: Blueprints Neurology, Case Files Neurology

Length: 1 month; Days/Week: 5; Hours/Day: 8; Hours/Week: 40; Night Calls/Month: none

Additional Locations: Lakeside Neurology, PC; 28573 Schoenherr Rd, Warren, MI 48088; (586) 777-3370

Evaluation: Clinical Evaluation

Preceptor(s): Shyam S. Moudgil, MD, FAAN

Coordinator(s): Tracey Martin

Recommended Attire: Casual with white coat

EMR System: EPIC

Category: Ambulatory

8660 - Neurology Consult - Henry Ford Health Service

Course Prerequisites: M4 only. Completion of course in physical diagnosis and at least one medical clerkship. Prefer basic neurology rotation or competence with general neurology exam.

Description: This Neurology rotation is a 1 month rotation on the neurology services available at Henry Ford Hospital. The experience is tailored to the needs of the rotating student and includes opportunities to round on the Inpatient Neurology service, the Consult Neurology Service, The NeuroIntensive Care Unit, The West Bloomfield Neurology Consult Service and time in the Neurology Clinic if desired. Students will work with neurology residents/fellows, neurology attendings, APPs, and rotating residents. Students will evaluate, discuss/present and document on a variety of neurologic presentations in various clinical settings.

Objectives: Students are meant to explore and experience areas of neurological practice to become better accustomed to the wide field of neurology. Students are meant to develop a broad understanding of the approach to evaluating and managing a neurologic patient presentation. Students will also have the opportunity to practice and develop their note writing skills in the EHR setting and produce billable documentation with the use of a variety of neurology templates.

A. Identify the clinical symptoms and signs of degenerative dementias and cognitive impairments associated with other neurological and medical disorders. B. Be able to develop a differential diagnosis and investigational plan for disorders of cognition. C. Learn to administer and interpret office-based tests for dementia and cognitive impairment: CERAD; Neuropsychiatric Inventory; Clinical Dementia Rating Scale. D. Be able to appropriately identify and prescribe treatments for the cognitive, motor & behavioral symptoms of dementias: Acetylcholinesterase inhibitors; Antipsychotics; Antidepressants; Sleep impairment/REM sleep disorders; Aggression & oppositional behavior; Wandering & restlessness; Hallucinations and delusions/delirium; Aphasia & communication difficulties; activities of daily living/instrumental activities of daily living; Impaired driving; Apraxia; Parkinsonism/tremors/chorea; Spasticity; Falls Identify community resources to support caregivers & patients

Methods: Students will round with their instructional teams, evaluate and document on patient encounters, discuss cases in group settings and attend neurology lectures.

Educational Experience: On Monday & Tuesday mornings, new patients with cognitive disorders are evaluated in a traditional clinic setting. Residents will be able to administer cognitive tests under supervision and learn how to interpret results, develop differential diagnoses, and plan appropriate imaging, laboratory, PET, EEG, and spinal tap investigations. On Tuesday afternoons, residents will participate in the shared medical visit clinic, a new model for dementia care that involves 10 patients and 10-20 caregivers in a group visit. In addition to providing medical examinations and administering cognitive tests, the shared medical visit is an opportunity for residents to learn along with and from caregivers and Alzheimer's Assn professionals. In this setting, emphasis is on gaining expertise in dementia treatments & interventions. The rotation also includes participation in monthly behavioral neurology journal club, opportunities for participating in NIH & clinical research projects and independent projects.

Recommended Reading Material: Reading material for the rotation will be given on the first day of the rotation

Length: 1 month; Hours/Week: 40-50 max; Days/Week: 5; Night Calls/Month: None

Additional Locations: Henry Ford Health Service, Henry Ford West Bloomfield

Evaluation: Students will receive formal written evaluation as per WSU requirements. Students may expect to be evaluated on general knowledge, history and presentation skills, formulation and assessment, as well as general enthusiasm for learning and engagement in the educational process.

Preceptor(s): Daniel J. Miller, MD

Category: Inpatient Consult Service

Recommended Attire: Scrubs, Business Professional, Casual, White Coat

EMR System: EPIC

8690 - Movement Disorders - Detroit Receiving Hospital

Year 4 only.

Course Prerequisite: Prefer basic neurology rotation or competence with general neurology exam

This elective is 100% consult service. Students will see patients from all over the hospital and function as a consultant, not a primary service. There will be no exposure to the inpatient service or outpatient clinic.

Objectives: Identify the clinical symptoms and signs of degenerative dementias and cognitive impairments associated with other neurological and medical disorders. Be able to develop a differential diagnosis and investigational plan for disorders of cognition. Learn to administer and interpret office-based tests for dementia and cognitive impairment: CERAD; Neuropsychiatric Inventory; Clinical Dementia Rating Scale. Be able to appropriately identify and prescribe treatments for the cognitive, motor & behavioral symptoms of dementias: Acetylcholinesterase inhibitors; Antipsychotics; Antidepressants; Sleep impairment/REM sleep disorders; Aggression & oppositional behavior; Wandering & restlessness; Hallucinations and delusions/delirium; Aphasia & communication difficulties; activities of daily living/instrumental activities of daily living; Impaired driving; Apraxia; Parkinsonism/tremors/chorea; Spasticity; Falls Identify community resources to support caregivers & patients

Recommended Reading Material: Reading material for the rotation will be given on the first day of the rotation.

Evaluation: Administration of a complete mental status exam under supervision and written interpretation, differential diagnosis, and treatment plan to be presented to clinic staff Presentation to shared medical group on at least one topic Journal club case presentation or article review.

Length: Hours 8-6 Mon & Tues; Wed-Fri to be determined weekly, No Night Call Maximum number of students: 1/month; none in June & July

Category: Inpatient Consult Service

8710 - Neurologic Sleep Disorders - Veterans Admin Hospital

Course Prerequisite: All VA electives require U.S. citizenship. Do not register for this elective without being able to provide your U.S. social security number for onboarding purposes.

Objectives: The elective is offered in order to enable the student to gather experience in a field which is touched on only briefly, or not at all, in other portions of the curriculum. This is a rapidly expanding field which is truly interdisciplinary. The student will gain some familiarity with the evaluation of sleep disorder patients, particularly those with obstructive sleep apnea. In addition, the student will obtain some knowledge of sleep lab procedures and scoring and interpretation of polysomnographic and multiple sleep latency test recordings.

Methods: 1. Work-ups of sleep disorder patients in the hospital (4-5 per week). 2. Presentation of these patients at the weekly sleep-wake disorder case conferences. 3. Attending the Sleep-Wake Disorders Clinics under the supervision of the staff. 4. Participating with the technical and professional staff in preparing patients for sleep recordings. 5. Participation in the scoring and interpretation of recordings in the sleep lab under the supervision of technicians and staff. 6. Follow-up and management of sleep disorder patients together with the staff and discussion of the patients with the Pulmonary, ENT, Psychiatry and Oral Surgery services. 7. Directed readings and attendance at the Sleep-Wake Disorders Teaching Conferences in order to gain familiarity with sleep physiology.

Recommended Reading Material: 1. Thorpy, M. J. (ed). Handbook of Sleep Disorders . New York: Marcel Dekker, Inc., 1990. Kryger, MH, et al (eds). 2. Kryger, MH, et al (eds.). Principles and Practice of Sleep Medicine. 3rd edition. Philadelphia: Harcourt Brace Jovanovich, 1999.

Length: 1 month; Days/Week: 5; Hours/Day: 8; Night Calls/Month: none

Evaluation: Clinical evaluation, including presentation of a topic.

Category: Inpatient Consult Service

8730 - Neurology Pediatrics - Childrens Hospital

Objectives: 1. To expose the student to a variety of neurologic disorders of infancy and childhood requiring hospital management. 2. Attend specialized clinics to evaluate and treat common neurologic disorders. 3. The above will also permit the student to know the community resources available and which resource is most appropriate for a given problem. 4. Develop skills in diagnosis and management of the above population of children.

Methods: Students will attend Neurology Clinics on Monday mornings and Friday afternoons, and formal lecture daily from noon to 1. The student will be assigned inpatients for consultation management under the supervision of Neurology Fellows and Attending Staff such as infants and children with muscle disorders, mental retardation, epilepsy, attention deficit disorders, and genetic neurologic diseases.

Recommended Reading Material: 1. Chapter I - Pediatric Neurology, Swaiman. 2. Clinical Pediatric Neurology, Fenichel 5th edition 3. Neurology Section in Nelson's 4. Neurological examination made easy, G. Fuller 5th edition 5. Develop bedside neuro diagnostic skills for assessment of pediatric patients

Length: 1, 2, or 3 months; Days/Week: 5; Hours/Week: 45; Night Calls/Month: none

Evaluation: Clinical evaluation.

Category: Inpatient Consult Service

8750 - General Neurosurgery - Childrens Hospital

Course Prerequisite: N/A

Objectives: This clinical rotation is designed to provide an in-depth clinical understanding of pediatric neurosurgical clinical and surgical care and exposure to both routine and complex disorders and disease processes in clinical pediatric neurosurgery. The student is expected to participate in daily rounds, clinics, surgical procedures, and multidisciplinary conferences that focus on epilepsy, neuro-oncology, and pediatric neuroradiology. The students will work directly with pediatric neurosurgery faculty, rotating neurosurgical residents, and also with advanced practice providers to learn the art of providing complex and technical care. Students are expected to learn and develop diagnostic and management skills for the care of pediatric neurosurgical patients in the areas of hydrocephalus, spina bifida, neurotrauma, epilepsy, spasticity/cerebral palsy, brain/spinal cord tumors, neurovascular diseases, and spine. Opportunities for participation in clinical research may be available based on student's interest but not a requirement for the rotation.

Recommended Reading Material: 1) Handbook of Pediatric Neurosurgery (Jallo, Kothbauer, Recinos). 2) Principle and Practice of Pediatric Neurosurgery (Albright).

Length: 1 month; Days/Week: 5 (M-F); Hours/Day: 8 to 12 hours each day (~7am to 5pm daily); Night Call/Month: No call.

Evaluation: Quality of care given. The number of patients given care. Participation and performance in rounds, clinics, operating room, and conferences. Level of knowledge & skills.

Category: Specialty Subinternship

8750 - General Neurosurgery - St Joseph Pontiac

Course Prerequisite: N/A

Objectives: This elective is designed to initiate the student into the neurosurgical mileu by rapid and total immersion in the activities of a busy urban neurosurgical practice.

Methods: The subintern will take regular calls every third/fourth night (weekends excluded) with our house staff, providing a unique opportunity to participate in the primary diagnosis and treatment of subarachnoid hemorrhage, intracranial trauma, spine trauma and other neurosurgical conditions which present to an emergency room. Active participation is further broadened by the acquisition under direction of a variety of neurosurgical procedures. These include ICP bolt placement, halo placement, burr holes for chronic subdurals and other biopsy procedures in addition to the standard procedures of ICU management. This subintern rotates through the subspecialty services, including neuro-oncology, vascular and spine and functional.

Recommended Reading Material: To be provided.

Length: 1 month; Days/Week: 5; Hours/Day: 50; Night Call/Month: Every 3-4 days (weekends excluded)

Evaluation: Quality of care given. The number of patients given care. Participation and performance in conferences. Level of knowledge & skills

Preceptor(s): Todd Francis, MD

Category: Specialty Subinternship

8750 - General Neurosurgery - Henry Ford Health Service

Course Prerequisite: N/A

Objectives: This elective is designed to initiate the student into the neurosurgical mileu by rapid and total immersion in the activities of a busy urban neurosurgical practice.

Recommended Reading Material: To be provided.

Length: 1 month; Days/Week: 5; Hours/Day: 50; Night Call/Month: Every 3-4 days (weekends excluded)

Evaluation: Quality of care given. The number of patients given care. Participation and performance in conferences. Level of knowledge & skills

Category: Specialty Subinternship

8780 - General Gynecology - Hutzel Hospital

Course Prerequisites: Successful completion of the core rotation in Ob/Gyn Clerkship

Description: Signs, symptoms, and management of both surgical and nonsurgical gynecologic disease.

Objectives: 1. To develop skills in routine gynecologic examination and family planning services. 2. To develop skills in medical management of common gynecological problems. 3. To further develop technical skills needed for operative gynecology. 4. To be able to recognize gynecologic emergencies.

Methods: Students will participate in 7:00am morning rounds, operative schedule, gynecologic clinic, and attend grand round and evening rounds. When possible, assignment for private gynecologist office will be arranged.

Recommended Reading/Resources: Comprehensive Gynecology by Droegemuller. Comprehensive Gynecology, Herbst, 6^th edition. Other assigned reading as indicated.

Length: 1 month; Hours/Week: 40; Hours/Day: 8-10; Days/Week: 5; Night Calls/Month: None

Additional Locations: None

Evaluation: Submitted on New Innovations to be completed by faculty and residents matched by the student

Preceptor(s): N/A

Course Director: Dr. Rebecca Jameson

Course Coordinator: Cathy Rutkowski

Category: Specialty Subinternship

Recommended Attire: Scrubs

EMR System: N/A

8781 - Family Planning & Abortion - Hutzel Hospital

Course Prerequisites: Successful completion of the core rotation in Ob/Gyn Clerkship

Description: Students will learn the principles and counseling techniques for contraceptive management and abortion.

Objectives: Learn principles of contraceptive management and abortion. If a student is interested, they will learn to perform D & C.

Methods: Learn to counsel patients in all forms of contraception. Learn counseling for women undergoing abortions.

Reading Reading/Resources: Supplied

Length: 1 month; Hours/Week: 40; Approx Hours/Day: 8; Days/Week: 5; Work Days/Week: 5; Night Calls/Month: None

Additional Locations: Students will rotate between Hutzel and UHC.

Evaluation: Submitted on New Innovations to be completed by faculty and residents matched by the student. Presentation, clinical evaluation.

Preceptor(s): N/A

Course Director: Rebecca Jameson, MD

Course Coordinator: Cathy Rutkowski

Category: Specialty Subinternship

Recommended Attire: Scrubs

EMR System: N/A

8790 - Gynecologic Oncology - Henry Ford Health Service

Course Prerequisites: Previous completion of Core Ob/Gyn rotation.

Description: One month general clinical experience on Gynecologic Oncology service.

Objectives: To learn how to evaluate and treat patients presented with a range of gynecologic malignancies.

Methods: This service will include hospital rounding, OR, and clinic.

Recommended Reading/Resources: To be assigned.

Length: 1 month; Daytime M-F (may need to round on weekends). Day usually starts at about 6 A.M. with rounds.

Additional Locations: HFH (may be asked to go to other sites on an as needed basis.)

Category: Specialty Subinternship

Recommended Attire: Office attire for clinic, scrubs for OR.

EMR System: EPIC

Division Head: Dr. Thomas Beukers

Course Director: Dr. Robert Goldfarb

Coordinator: None at this time.

Contact person: Senior resident on the service (changes periodically). You will be notified who this is before you begin.

8790 - Gynecologic Oncology - Hutzel Hospital

Course Prerequisites: Successful completion of the core third year Ob/Gyn clerkship

Description: Evaluation and treatment of patients presenting with a range of gynecologic malignancies.

Objectives: The goal of this elective is to familiarize the student with the evaluation and treatment of patients presented with a range of gynecologic malignancies. This elective is intended for the student who may be considering a residency in one of the surgical specialties, especially dealing with the seriously/terminally ill patient.

Methods: This is a clinical elective of 1 month duration in which the student works in the field of gynecologic oncology. This will include active participation in gyn onc clinics, operating room, inpatient rounds, colposcopy, radical surgery, pathology, chemotherapy, genetics and palliative care. Research projects, may be initiated depending upon the student's background and interest. The student will be asked to presents on a topic of their choice at the end of the rotation.

Recommended Reading/Resources: 1. DiSaia P, Creasman W: Clinical Gynecologic Oncology. 2nd Edition. 2. DiSaia P, Morrow C P, Townsend P: Synopsis of Gynecologic Oncology 3. Barber HRK: Manual of Gynecologic Oncology. 4. Gusberg SB, Shingleton HM, Deppe G: Female Genital Cancer, Churchill Livingstone, New York 5. Priver: Manual of Gynecologic Oncology and Gynecology.

Length: 1 month; Hours/Week: 40-50; Hours/Day: 8-10; Days/Week: 5, 1 weekend AM rounding; Night Calls/Month: None unless requested

Additional Locations: N/A

Evaluation: Subjective clinical evaluation at the end of the rotation on New Innovations.

Preceptor(s): N/A

Course Director: Radhika Gogoi, MD

Course Coordinator: Cathy Rutkowski

Category: Specialty Subinternship

Recommended Attire: scrubs/business attire in clinic

EMR System: N/A

8790 - Gynecologic Oncology - Beaumont Dearborn

Course Prerequisite: N/A.

Objectives: To form a basis of the diagnosis and treatment of most gynecologic malignancies.

Methods: Participants will become a part of the gynecologic oncology service in the Department of Ob/Gyn at Oakwood Hospital. Patients are seen in the Cancer Center with clinical exposure to new patients recently diagnosed with gynecologic malignancy in the office setting as well as the operating room exposure to radical surgery to correct gynecologic malignancy. Three attendings are primarily on the service as well as a resident. Students will be expected to perform rounds with the resident on the Gyn Oncology service. They will also be expected to present patients to the attending of the week, and to present patients in the clinic.

Recommended Reading Material: To be provided.

Length: 1 month; Days/week: M-F; Hours/day: 6-8; Night call/month: optional

Evaluation: Subjective clinical evaluation.

Category: Specialty Subinternship

8800 - Obstetrics - Hutzel Hospital

Course Prerequisites: Successful completion of the core rotation in Ob/Gyn Clerkship

Description: Signs, symptoms and management of normal/abnormal labor, and experience patients with intrapartum high risk conditions and intrapartum/postpartum complications.

Objectives: 1. To gain further experience in supervised, primary management of normal labor and delivery. 2. To develop skills in accurate risk assessment during the antepartum, intrapartum and postpartum periods. 3. To gain experience in managing common intrapartum and postpartum complications.

Methods: A one-month rotation of the general obstetric service is offered. During the rotation, students will participate in both inpatient and outpatient care settings, and have a limited amount of night call. Each student will function as an integral member of an obstetric team under the preceptorship of faculty and senior residents.

Recommended Reading/Resources: Beckman and Ling’s, Obstetrics & Gyneccology 8^th edition; Williams Obstetrics 25^th edition

Length: 1 month; Hours/Week: 40; Days/Week: 5; Night Calls/Month: None

Additional Locations: N/A

Evaluation: Clinical evaluation submitted on New Innovations to be completed by faculty and residents matched by the student.

Preceptor(s): N/A

Course Director: Susan Berman, MD

Course Coordinator: Cathy Rutkowski

Category: Specialty Subinternship

Recommended Attire: Scrubs

EMR System: N/A

8810 - Obstetrics/Gynecology - St Joseph Pontiac

Objectives: The student will spend time with each of a three-person core faculty group. He/she will be exposed to the responsibilities and duties of a teaching physician, including rounds with residents, private office setting, and operating room experience.

Methods: This course is designed to help the student learn about general obstetrics and gynecology via direct contact with each of three faculty physicians. The student will be able to spend time on labor and delivery, in the operating room, and in the private and resident clinics. He/she will participate in resident teaching rounds. Also, the student will directly observe the work schedule and responsibilities of a teaching faculty member and learn about differences in practice opportunities available in this specialty. The course is very malleable, and emphasis on any of the above areas can be adjusted based on the student's desire.

Recommended Reading Material: General Ob/Gyn reference books

Length: 1 month, Work days/week: 5 Hours/day: 6-8, Night call/month: optional

Evaluation: Subjective clinical evaluation.

Preceptor(s): Anan Abdelrahman, MD

Category: Specialty Subinternship

8810 - Obstetrics/Gynecology - Hutzel Hospital

Course Prerequisites: N/A

Description: This course is part of the core experience for students entering the obstetrics/gynecology specialty. The purpose is to have the student perform, within limits and under strict supervision, the duties of a PGY1 resident on an inpatient service. This includes day to day care of inpatients and some outpatient experience as would be performed by the first year residents. The student would be an integral part of an inpatient team of senior, junior residents and yr 3 medical students. They are assigned primary patients and are assigned duties and responsibilities above what were expected of M3 clerkship students. Evaluation is done by residents and faculty and involves feedback based on EPA readiness.

The subinternship is also somewhat specialty specific in resident preparation, but has expected EPA tasks that are common to all specialties.

The student Subintern will be assigned to an inpatient/outpatient core obstetrics gynecology service at affiliated hospitals identified at the beginning of the registration process.

The subinterns are expected to be capable of providing billable documentation per the limits of MMS federal guidance of 2018, as allowed by institutional and physician policy (this is being piloted for our subI students at one institution as of 2018-19 academic year).

Objectives:

Taking on primary responsibility for the patient.
Focusing histories, physicals, and oral and written communication appropriately.
Sharing information effectively with a patient and family.
Prioritizing and organizing work effectively.
Anticipating what a patient will need during the course of hospitalization (i.e. when they need to be reexamined, when a lab needs to be repeated, when additional therapy is necessary, when additional history needs to be obtained, discharge criteria) and communicating this information effectively in handovers.
Re-evaluating a patient when you take on their care (i.e. the assessment and plan, as well as the clinical status) and looking further when the clinical picture does not fit.
Continuing to think about and re-assess the patient during the course of the day.
Coping with uncertainty in patient care issues (i.e. knowing what you know and what you don’t know, accessing best resources, and knowing when and how to get help).
Functioning as a "team player" with residents, attendings, nurses, ancillary staff and all others involved in the care of the patient.
Coordinating the care of your patient during hospitalization and in planning for discharge.

Methods: Students will provide patient care that is compassionate, appropriate and effective with attention to the patients’ perspectives, needs, values and comfort. Students will demonstrate communication and interpersonal skills and strategies that result in respectful, compassionate and effective information exchange and decision making with patients, families, members of the healthcare team and other colleagues. Students will demonstrate sufficient knowledge to provide patient care with appropriate supervision. Students will use evidence based medicine and self-directed learning in the care of patients and education of others. Students will strive to provide high-quality health care and advocate for patients within the context of the health care system. Students will demonstrate a commitment to accountability, excellence in practice, adherence to ethical principles, humanism, altruism, and sensitivity to diversity. Students will demonstrate a commitment to professional responsibilities and behavior as well as the ability to understand, reflect upon and integrate ethical and moral dimensions of healthcare. Students will demonstrate knowledge of community factors that influence individual, community and public health and gain perspective and experience through service-learning activities within local or global community settings.

Recommended Reading/Resources: To be assigned.

Length: 1 month

Evaluation: Clinical evaluation based on achievement of EPA (Entrustable professional activities)

Category: Specialty Subinternship

EMR System: Hospital Dependent

8810 - Obstetrics/Gynecology - St John Hospital

Objectives: Care of inpatient and outpatient obstetric and gynecologic patients, and participation in obstetric and gynecological procedures.

Category: Specialty Subinternship

8810 - Obstetrics/Gynecology - Henry Ford Health Service

Course Prerequisites: N/A

Description: The electrive is one is part of the core experience for students entering the obstetrics/gynecology specialty. The purpose is to have the student perform, within limits and under strict supervision, the duties of a PGY1 resident on an inpatient service. This includes day to day care of inpatients and some outpatient experience as would be performed by the first year residents. The student would be an integral part of an inpatient team of senior, junior residents and yr 3 medical students. They are assigned primary patients and are assigned duties and responsibilities above what were expected of M3 clerkship students. Evaluation is done by residents and faculty and involves feedback based on EPA readiness.

The subinternship is also somewhat specialty specific in resident preparation, but has expected EPA tasks that are common to all specialties.

The student Subintern will be assigned to an inpatient/outpatient core obstetrics gynecology service at affiliated hospitals identified at the beginning of the registration process.

Objectives:

Taking on primary responsibility for the patient.
Focusing histories, physicals, and oral and written communication appropriately.
Sharing information effectively with a patient and family.
Prioritizing and organizing work effectively.
Anticipating what a patient will need during the course of hospitalization (i.e. when they need to be reexamined, when a lab needs to be repeated, when additional therapy is necessary, when additional history needs to be obtained, discharge criteria) and communicating this information effectively in handovers.
Re-evaluating a patient when you take on their care (i.e. the assessment and plan, as well as the clinical status) and looking further when the clinical picture does not fit.
Continuing to think about and re-assess the patient during the course of the day.
Coping with uncertainty in patient care issues (i.e. knowing what you know and what you don’t know, accessing best resources, and knowing when and how to get help).
Functioning as a "team player" with residents, attendings, nurses, ancillary staff and all others involved in the care of the patient.
Coordinating the care of your patient during hospitalization and in planning for discharge.

Recommended Reading/Resources: To be assigned.

Length: 1 month

Evaluation: Clinical evaluation based on achievement of EPA (Entrustable professional activities)

Category: Specialty Subinternship

EMR System: EPIC

8810 - Obstetrics/Gynecology - Michigan Healthcare Professionals

Course Prerequisites: N/A

Description: Students will gain experience in recognizing the signs, symptoms, and management of both surgical and nonsurgical obstetrics and gynecologic disease in the outpatient setting.

Objectives: To develop skills in routine gynecologic examination and family planning services. To develop skills in medical management of common oncologic/gynecological problems. To further develop technical skills needed for operative gynecology and gynecologic and oncologic procedures. To be able to recognize oncologic/gynecologic emergencies.

Methods: Students will provide patient care under the supervision of various physicians at the practice to better develop their obstetrics and gynecologic skills, including taking histories and physicals, learning how to chart common obstetric and gynecologic cases, assisting with procedures and routine check-ups and pap smears, and practicing sharing information compassionately and effectively with the patient and family. Students will use evidence-based medicine and self-directed learning in the care of patients and education of others. Students will strive to provide high-quality health care and advocate for patients within the context of the health care system. Students will demonstrate a commitment to accountability, excellence in practice, adherence to ethical principles, humanism, altruism, and sensitivity to diversity. Students will demonstrate a commitment to professional responsibilities and behavior as well as the ability to understand, reflect upon and integrate ethical and moral dimensions of healthcare. Students will demonstrate knowledge of community factors that influence individual, community and public health and gain perspective and experience through service-learning activities within local or global community settings.

Recommended Reading/Resources: To be assigned.

Length: 1 month; Hours/Week: 35-40h; Days/Week: 5 (9 A.M.-5 P.M.) (Fridays by 3 usually); Night Calls/Month: None

Additional Locations: Every Woman Ob/Gyn, 633 E. South Boulevard, Suite 2300, Rochester Hills, MI 48307, (248) 659-1150, Trinity Pontiac, Beaumont (with additional forms and permissions)

Evaluation: New Innovations evaluation

Preceptors: Dr. Julie Masters, Dr. Stacy Paye, Dr. Sarah Shook, Dr. Aabeen Hagroo, Dr. Cara Smith, Dr. Usha Ram

Category: Ambulatory

Recommended Attire: Scrubs, white coat, and badge

EMR System: Webchart

8810 - Obstetrics/Gynecology - Beaumont Dearborn

Recommended Reading Material: General Ob/Gyn reference books

Length: 1 month, Work days/week: 5 Hours/day: 6-8, Night call/month: optional

Evaluation: Subjective clinical evaluation.

Category: Specialty Subinternship

8830 - Maternal Fetal Medicine - Beaumont Dearborn

Objectives: To develop competence in the sub-specialty of Maternal Fetal Medicine and Fetal Ultrasound.

Methods: Participants will become part of the High Risk team in the Department of OB/Gyn with in-patient experience at Oakwood Hospital and out-patient at the resident High Risk OB clinic as well as the ultrasound unit, perinatal diagnostic unit. Under preceptorship of the MFM service, students receive patients in the clinic and follow a number of patients in the antenatal setting. The procedure exposure would include that of amniocentesis and surgical cerclage and cesarean sections. Participants will attend Grand Rounds and a weekly perinatal conference to discuss patient care. Student's responsibilities will be to round with the MFM resident on patients, to present patients to the MFM rounder, and to actively manage some patients during the rotation.

Recommended Reading Material: Maternal-Fetal Medicine, Principles and Practices, Gabbe's book on MFM.

Length: 1 month, Work days/week M-F, Hours/days 6-8 hrs., Night call/month optional

Evaluation: Subjective Clinical Evaluation

Category: Specialty Subinternship

8830 - Maternal Fetal Medicine - Hutzel Hospital

Course Prerequisites: N/A

Description: Join a team caring for patients with high acuity pregnancies. Experience patients with common medical and obstetrical complications; development of skills in fetal assessment and evaluation of high risk pregnancies.

Objectives: 1) Participate with MFM Attendings, Fellows and Residents in a team approach to the management of medical complications in pregnancy. 2) Learn about the fetal environment and monitoring fetal growth, Doppler flow, amniotic fluid and placental assessment. 3) Participate in two full-day High-Risk pregnancy clinics with an option to join one or two full-day sessions at the Fetal Care Center at Children’s Hospital. 4) Round daily on the antepartum High-Risk Floor at Hutzel Women's Hospital. 5) Attend OB/GYN Grand Rounds, OB/Peds conferences and resident learning conferences pertinent to obstetric management.

Methods: Student will be asked to present a short talk on a topic of interest to the team. Students responsibilities during the rotation may be tailored to accommodate existing research projects.

Recommended Reading/Resources: ACOG technical bulletins and literature pertinent to patient's conditions as they present themselves.

Length: 1 month; Hours/Week: 40 - 8 a.m. to 5 p.m.; Days/Week: 5 - Monday through Friday; Night Calls/Month: None

Additional Locations: N/A

Evaluation: 360 Evaluation

Preceptor(s): Various

Course Director: David R. Bryant, Jr, MD

Coure Coordinator: Cathy Rutkowski

Category: Specialty Subinternship

Recommended Attire: Business Casual

EMR System: Power Chart

8860 - Reproductive Endocrine and Infertility - Hutzel Hospital

Course Prerequisites: Successful completion of the core third year Ob/Gyn Clerkship

Description: Diagnosis and treatment of couples with infertility and reproductive endocrine disorders.

Objectives: 1.. Provide an introduction to the diagnosis and treatment of couples with Infertility. 2. Provide an introduction to the evaluation and treatment of reproductive endocrine disorders.

Methods: 1. Observation and participation in office practice and operating room activities. 2. Participation in regular conferences in division and departmental grand rounds. 3. Completion of assigned reading from recommended text.

Recommended Reading/Resources: Speroff, Clinical Gynecologic Endocrinology and Infertility.

Length: 1 month; Hours/Week: 40; Days/Week: 5; Night Calls/Month: None

Additional Locations: Kindbody Fertility, 26400 West 12 Mile Road, Ste 145, Southfield, MI 48034

Evaluation: Subjective evaluation of clinical performance. Submitted on New Innovations to be completed by faculty and residents matched by students.

Preceptor(s): N/A

Course Director: Awoniyi Awonuga, MD

Course Coordinator: Cathy Rutkowski

Category: Inpatient Consult Service

Recommended Attire: Business attire/white lab coat

EMR System: N/A

8890 - Ophthalmology - Henry Ford Health Service

Course Prerequisites: N/A

Description: The student is introduced to medical and surgical ophthalmology. He/she should learn basic terminology. The student is taught to recognize common diseases and approaches to management. The student will become familiar with examination and diagnostic techniques and be taught a systematic approach to an ophthalmological history and physical. The student will also have the option to observe surgery.

Objectives: Participation in the diagnosis and treatment of medical and surgical ocular disease. Enhance knowledge and skills pertaining to interviewing, physical examination, or patient interactions, clinical judgment and procedures (i.e., physical exam techniques, therapy and advice to patients). Enhancement of knowledge and skills through outpatient examinations, inpatient surgery, and subspecialty consultations. Obtain familiarity with physical examination techniques/instruments, clinical judgement, and procedures. Introduction to ophthalmic photography procedures. Optional interaction with research faculty. Increase student involvement in conferences, journal clubs. Increase student use/review of the medical literature.

Methods: Daily didactic lectures by faculty on a variety of ophthalmic topics, weekly Grand Rounds conference, and exposure to patient care in the clinical setting as well as the operating rooms for the following subspecialties: cornea/refractive and external disease, vitreoretinal disease, neuro-ophthalmology, glaucoma, oculoplastics, pediatrics, and comprehensive ophthalmology. Participation and observation of regular house staff activities and duties.100% outpatient/specialty. Students will see an average of 40 patients each week.

Recommended Reading Material: To be provided.

Length: 1 month; Days/Week: 5; Hours/Week: 40; Night Call/Month: 1

Evaluation: Quality of care given. Participation and performance in conferences, in clinics, and with house staff. Level of knowledge & skills obtained. Student presentation. Observation of performance by faculty and house officers. Assessment of write-ups/reports. Conference presentations.

Category: Specialty Subinternship

EMR System: EPIC

Notes: This course is offered April-October.

8890 - Ophthalmology - Kresge Eye Institute

Objectives: 1. To become familiar with ophthalmology as a medical and surgical specialty and with the many subspecialties of ophthalmology. 2. To become familiar with outpatient eye care. 3. To become familiar with the surgical care of eye patients. 4. To become familiar with diagnostic and therapeutic applications of lasers, applications of ultrasound and fluoresce in angiography. 5. To become familiar with ophthalmic emergencies.

Methods: 1. Daily encounters with outpatients and inpatients under the faculty and resident supervision at the Kresge Eye Institute, the Children's Hospital of Michigan Eye Clinic, the Veteran's Administration Hospital Eye Clinic, and Detroit Receiving Hospital Emergency Room. 2. Opportunity to interact with ophthalmology faculty members and attending ophthalmologists of different subspecialty interests. 3. Observation of ophthalmic surgical procedures at Kresge Eye Inst/Hutzel Hospital operating rooms under faculty supervision. 4. Observation of laser procedures under faculty supervision and diagnostic ultrasonography and fluorescein angiography.

Recommended Reading Material: 1. Basic Ophthalmology for Medical Students and Primary Care Residents, edited by Cynthia Bradford, MD(8th Ed) American Academy of Ophthalmology, San Francisco, 2004. 2. Vaughn & Asbury's General Ophthalmology, edited by Paul Riordan-Eva, F.R.C.S. and John P. Whitcher, MD(16th Ed) Lange Medical Books/McGraw-Hill, New York 2004

Length: 1 month; Days/Week: 5; Hours/Week: 40; Night Calls/Month: None

Evaluation: Written exam and assessment by the staff.

Category: Specialty Subinternship

8890 - Ophthalmology - Michigan Healthcare Professionals

Course Prerequisites: Good Internal Medicine and Neurology background. The American Academy Basic Book for students is pretty standard and easy to get ahold of and a great way to familiarize yourself with everything before the rotation. Take a look at the most recent edition before starting your elective.

Description: The student is introduced to medical and surgical ophthalmology, including an understanding of basic terminology, recognition of common diseases and management. The student will learn examination and diagnostic techniques, and be taught a systematic approach to an ophthalmologic history and physical. The student will also be exposed to ophthalmic surgery.

Objectives: To provide the student with a fundamental knowledge base in Ophthalmology. Introduce the student to basic procedures relevant to the practice of Ophthalmology. Facilitate an understanding of the approach to clinical problem solving in Ophthalmology. Promote the acquisition of simple basic skills for the diagnosis, management, and prevention of common simple emergencies. Encourage the continued development of the student’s professional attitude and behavior.

Methods: Students will see patients in the clinic Monday through Thursday and be in the operating room on Tuesday. Topics of study include eye anatomy; diseases of the cornea; diseases of the anterior chamber; diseases of the lens; diseases of the retina and vitreous; diseases of the nasolacrimal system, eyelids, and orbit; diseases of the extraocular muscles; and ocular disorders.

Recommended Reading/Resources: Basic Ophthalmology for Medical Students and Primary Care Physicians, American Academy of Ophthalmology publication (Recommended to read or be familiar with this PRIOR to the start of the rotation.)

Length: 1 month; Days/Week: 4; Hours/Week: 35-50; Night Calls/Month: None (voluntary)

Schedule: Open 7 a.m. - 5 p.m. Monday through Thursday. Surgical days are Tuesdays.

Additional Locations: Affiliated Eye Surgeons (MHP) - 1421 E. 12 Mile Road, Building A, Madison Heights, MI 48071, (248) 547-6656; Straith Hospital for Specialty Surgery - 23901 Lahser Rd, Southfield, MI 48033; Ascension Macomb Oakland Hospital, Madison Heights Campus, 27351 Dequindre Rd, Madison Heights, MI 48071

Evaluation: The student will be continually evaluated during the rotation by attending physicians, office staff and patients of the practice. Students will be assigned various reading topics and will have the opportunity to engage in one-on-one discussions with attending physicians. At the end of the rotation, the student will be asked to give a 10-15 minute presentation to Dr. Simonian, Dr. Rubin and staff. The ophthalmic topic may be of personal interest, or a topic from an evidence based journal article. The presentation may be a PowerPoint presentation or demonstration. It should be of interest to the audience and demonstrate a working knowledge of the subject presented. The student should be prepared to answer questions regarding the presentation. New Innovations evaluation.

Preceptor(s): Sidney K.Simonian, D.O., F.A.O.C.O; Lindsay R. Rubin, D.O., F.A.O.C.O

Category: Specialty Subinternship, Ambulatory

Recommended Attire: Business Professional with Short White Coat with name clearly displayed.

EMR System: Nextech Intellichart Pro

8900 - Ophthalmic Research - Kresge Eye Institute

Objectives: 1. To engage in an ongoing productive ophthalmic research project under the direct supervision of faculty members and their research associates. 2. To become familiar with the daily activities of a full time academic faculty member. 3. To have the opportunity to interact with the clinical as well as the research faculty members of the Department of Ophthalmology.

Methods: During the period of one or two months, highly motivated Year III & IV students will be able to participate in an ongoing productive research project under the supervision of a clinical or research faculty member and his/her research associates. Some of the results and observations made by the students taking the Ophthalmology Research elective in the past were worthy of presentation at national or international ophthalmic meetings and publication in medical or scientific journals.

Recommended Reading Material: Appropriate journal articles and references will be assigned.

Length: 1 or 2 months; Days/Week: 5; Approx hours/day: 8; Night Calls/Month: none

Evaluation: Assessment by the supervising faculty

Category: Research, Non-Clinical

8910 - General Orthopedic Surgery - St Joseph Pontiac

Coures Prerequisites: None

Description: There will be four-week-long rotations in different sections of the Orthopedic Department, including Arthritis Surgery, Hand Surgery, Foot and Ankle Surgery, Pediatric Orthopedic Surgery, Spine Surgery, Sports Medicine and Surgery and Orthopedic Trauma Surgery. Courses are appropriate for those considering careers in Orthopedic or other surgery specialties.

Objectives: Increase student knowledge of orthopedic diagnosis and treatment.

Methods: There will be four-week-long rotations in different sections of the Orthopedic Department, including Arthritis Surgery, Hand Surgery, Foot and Ankle Surgery, Pediatric Orthopedic Surgery, Spine Surgery, Sports Medicine and Surgery and Orthopedic Trauma Surgery. Courses are appropriate for those considering careers in Orthopaedic or other surgery specialties. 40% inpatient care. 50% outpatient care. 10% conferences/lectures. Students will see an average of 10-15 patients each week.

Recommended Reading Material: To be assigned.

Length: 1 month; Days/Week: 5; Hours/Day: 40-60; Night Call/Month: Every 3 days

Evaluation: Quality of care given. Participation and performance in conferences. Level of knowledge. Ability to participate in patient care clinics and in operating room. Observation of performance by faculty

Preceptor(s): Safa Kassab, MD

Category: Specialty Subinternship

8910 - General Orthopedic Surgery - Providence Hospital

Course Prerequisites: N/A

Description: This is an opportunity to gain exposure to the field of orthopedic surgery in both the operative and clinical setting.

Objectives: This course offers medical students an early and exceptional hands-on experience in Orthopedic Surgery. Students will rotate for 1 month. You will be exposed to Orthopedic Trauma, Sports Medicine and the Total Joint Services. Each medical student will spend time in the operating room and outpatient clinic. You will be invited to all resident events, such as journal clubs, weekly conferences, and hands on lab demonstrations. Students will work with faculty of all specialties and backgrounds. .

Methods: We encourage rotators to show us your knowledge and abilities. The residents are there to help you learn casting, splinting, reductions, and a good orthopedic physical exam. Students will present a small interesting case or lecture topic at the end of the rotation during our grand rounds.

Recommended Reading: TBD

Length: 1 month; Days/Week: 5; Hours/Week: 40-60 hours; Occasional Weekend Call; Night Calls/Month: 0

Evaluation: Quality of care given. Participation and performance in conferences. Level of knowledge. Ability to participate in patient care clinics and in operating room

Preceptor(s): Dr William Kesto

Category: Specialty Subinternship

Recommended Attire: Scrubs, business professional, white coat

EMR System: Athena, Citrix

8910 - General Orthopedic Surgery - Detroit Medical Center

Students may rotate at the DMC which includes DRH, Harper Hospital, CVI and CHM.

Objectives: This course offers medical students an early and exceptional hands-on experience in Orthopedic Surgery. Students will rotate for 1 month and have the opportunity to spend time at all of our facilities. You will be exposed to Orthopedic Trauma, Pediatric Orthopedics, Sports Medicine and the Total Joint Services. Each medical student will spend 2 weeks on 2 of the 4 services offered, taking a total of between 4-6 calls with our Trauma team. The rotation at our program is comprehensive and involves you working with nearly the entire faculty and all of the residents. You will be invited to all resident events, such as journal clubs and the new Bioskills lab. Wednesday nights, you will get to work with the Sports Medicine staff and get early hands-on experience doing arthoscopy.

Methods: The main point of the rotation is to show us your skills while also interacting with our residents. Much time has been spent developing the rotation so that you spend as much time as possible with the residents. The residents are going to go out of their way to make sure you get ample experience learning how to cast, split and do reductions on your own.

Category: Specialty Subinternship

8910 - General Orthopedic Surgery - Henry Ford Health Service

Coures Prerequisites: None

Objectives: Increase student knowledge of orthopedic diagnosis and treatment.

Recommended Reading Material: To be assigned.

Length: 1 month; Days/Week: 5; Hours/Day: 40-60; Night Call/Month: Every 3 days

EMR System: EPIC

Category: Specialty Subinternship

8914 - Orthopaedic Surgery Research - Detroit Medical Center

Course Prerequisites: WSU CITI IRB training completed

Description: This is a 2-week or 4-week course that gets you prepared and involved in Orthopaedic Research: Clinical, Biomechanical, Experimental, and population health.

Objectives: To work on an Orthopaedics problem or question to solve: 1. study a problem that needs a solution/purpose or question with literature review. 2. Define methods to solve your question/problem/how will you measure it. 3. to understand the limitations of your methods. 4. To execute your study.

Methods: Students will contact a faculty member under whose supervision he/she wishes to work 60 days in advance of the first day of the intended rotation. Students will have the opportunity to study experimental biomechanics, prospective clinical trials, retrospective chart review, systemic literature review, anatomic dissections, technique papers.

Recommended Reading/Resources:

One hundred orthopaedic conditions every doctor should understand Roy Meals second edition.
CITI training
AO Peer course

Length: 1 month; Hours/week: 40; Days/week: 5; Night Calls/Month: None

Additional Locations: Detroit Receiving/Harper Hospital, Michigan Children's Hospital, Sinai Grace Hospital, Huron Valley Hospital

Evaluation: New Innovations evaluation (and any other relevant evaluation methods)

Preceptor(s):

Traumatology:
1. Dr. Vaidya
2. Dr. Nasr
3. Dr. Oliphant
4. Dr. Gheraibeh
Sports Medicine:
1. Dr. Henry Goitz
2. Chris Cooke
3. Dr. Todd Frush
Total Joints
1. Dr. Hussein Darwiche
2. Dr. Brian Little
Pediatric Orthopaedic Surgery
1. Dr. Wallid Yassir
Tumor /Karmanos
1. Dr. Aysia Kemp
Hand Surgery
1. Dr. Andrew Tsai
Spine
1. Dr. A Sethi Dr. Vaidya Dr McCarty

Category: Research, Non-Clinical

Recommended Attire: Business Casual

EMR System: CITRIX CERNER DMC

Director: Dr. Rahul Vaidya

Coordinator: Dr. Andrea Geamanu

8940 - General Pathology - St Joseph Pontiac

Objectives: 1. Develop an understanding of the scope of pathology and laboratory medicine services 2. Enhance the student's understanding and knowledge of the pathology of disease processes through direct laboratory experiences and didactic conferences 3. Improve the student's understanding of the appropriate application of laboratory services and laboratory information for patient care

Methods: The student will have scheduled time in all of the sections of pathology and laboratory medicine(Surgical pathology, autopsy pathology, cytopathology, electron microscopy, molecular pathology, clinical chemistry, hematopathology and coagulation, microbiology, serology, transfusion medicine/blood banking, urinalysis). Supervision and teaching in each section will be provided by subspecialist faculty members, pathology residents and medical technologists. Schedules may be modified upon request to enhance the educational experience for students with a particular interest in an Anatomic or Clinical Pathology subspecialty.

Recommended Reading Material: To be assigned.

Length: 1 month; Days/Week: 5; Hours/Week: 40; Night Call/Month: none

Evaluation: Direct observation of the student's performance and participation in daily activities.

Category: Specialty Subinternship

8940 - General Pathology - St John Hospital

Objectives: This rotation will expose the student to the functions of the clinical laboratory, provide experience in laboratory test interpretation, diagnostic interpretation of surgical pathology and cytopathology material, and autopsy technique.

Methods: The student will spend time in each section of the laboratory, including time with residents and pathologist staff, and attending teaching conferences. The student will give a 45 minute presentation on the topic of his/her choice.

Recommended Reading Material: 1. Henry J B, Clinical Diagnosis and Management by Laboratory Methods. 2. Robbins, Pathologic Basis of Disease 3. Sternberg, Diagnostic Surgical Pathology

Length: 1 month; Days/Week: 5; Hours/Week: 40; Night Calls/Month: none

Evaluation: Subjective and presentation

Category: Specialty Subinternship

8940 - General Pathology - Henry Ford Health Service

Course Prerequisites: Interest in histology, anatomy, biochemistry, microbiology, transfusion medicine

Description: During the rotation medical students will work with current post-graduate trainees, laboratory technicians, PhD scientists and pathologists (MDs). The rotation will involve all divisions (e.g., histopathology, clinical chemistry, microbiology and transfusion medicine).

Objectives: Develop an understanding of the scope of pathology and laboratory medicine services. Enhance the student's understanding and knowledge of the pathology of disease processes through direct laboratory experiences and didactic conferences. Improve the student's understanding of the appropriate application of laboratory services and laboratory information for patient care.

Recommended Reading/Resources: Kumar, V., Abbas, A. K., Aster, J. C., & Deyrup, A. T. (Eds.). (2022). Robbins & Kumar Basic Pathology (11th ed.). Elsevier - Health Sciences Division.

Length: 1 month; Days/Week: Monday-Friday; Hours/Week: 40; Night Calls/Month: None

Additional Locations: None (HFH Main Hospital)

Evaluation: Medical school template and/or written recommendation letter upon request

Preceptor(s): Dr. Robert Tibbetts

Category: Specialty Subinternship

Recommended Attire: Scrubs or street clothes (PPE gear available for use)

EMR System: EPIC, CoPath, Sunquest

8950 - Anatomic Pathology - Harper Hospital

The location of this course is primarily in the Harper Professional Bldg, 8th floor.

Objectives: The elective rotation in pathology is designed to expose the student to aspects of pathology in clinical practice, including anatomic pathology and clinical pathology. The rotation can be tailored to the needs of the individual student, such as exclusive anatomic pathology, exclusive neuropathology, or the specific areas of interest.

Methods: 1. Anatomic: by the end of the rotation, the student should participate in at least one postmortem examination, observe frozen section diagnosis, adequacy and procedure of fine needle aspiration, perform and dictate at least five gross and microscopic examinations of surgical specimens, be able to define basic pathology terms.

2. Clinical: by the end of the rotation, the student should dictate microscopic examinations of bone marrow or lymph node specimens, understand the clinical indications and utilization of laboratory tests in the diagnosis and management of disease, familiarize different analytical methods and instruments and understand the basic principles, understand the importance of quality control measures, understand the importance of interpreting test results within the clinical context.

Length: 1 or 2 months; Days/Week: 5; Hours/day: 9 (8am until 6pm); Night Calls/Month: none

Evaluation: A written evaluation with a grade of Honors, Satisfactory or Unsatisfactory, is based on daily attendance and performance, as assessed by residents and staff with whom you work, completion of presentation and worksheet, and quality of presentation.

Category: Specialty Subinternship

8970 - Forensic Pathology - Wayne County Medical Examiners

Course Prerequisites: None.

Description: This is elective course exposes rotators to the medicolegal investigation of death. They are to learn what constitutes a medicolegal case, what are the components of a medicolegal death investigation, how to perform a medicolegal autopsy, how to complete a death certificate, and the basic patterns of injuries (forensic pathology). This course also allows rotators to review basic anatomy and bridge their clinical medicine knowledge with pathology.

Objectives: 1. Perform autopsies under direct supervision of the pathology staff. 2. Gather essential and accurate information and appropriately apply it in cause of death determinations, 3. Understand what constitutes a medicolegal case and which cases must be reported to the medical examiner prior to autopsy. 4. Learn basic patterns of injury, decomposition, natural disease, and basic forensic histopathology 5. Learn the differences between cause of death, manner of death, and mechanism of death. 6. Draft a concise, thorough, accurate, and understandable postmortem report that includes an opinion as to the cause and manner of death. 7. Demonstrate knowledge of evidence-based medicine and apply its principles in practice. 8. Demonstrate adherence to ethical principles, sensitivity to diversity and nature of cases, and confidentiality requirements.

Methods: Rotation activities include: performing autopsies under direct supervision of the pathology staff; drafting concise, thorough, accurate, and understandable postmortem reports; learning basic forensic histopathology through a histology slide review session; give a presentation on a topic in forensic pathology with previous agreement to subject and participation of pathology staff; and attending lectures/rounds for forensic education. If permitted, they may also have the opportunity to observe the staff in court giving expert testimony in forensic pathology and attend scenes with our investigators to understand the importance of scene investigation.

Recommended Reading Material: 1. Medicolegal Investigation of Death. Spitz, W., Thomas Publishers, 1993. 2. Forensic Pathology. Knight. Oxford Univ. Press, 1991. 3. Forensic Pathology. DiMaio. Elsevier, 1989.

Length: 1 or 2 months; Days/Week: 5; Hours/Week: 35; Night Calls/Month: None

Additional Locations: Wayne County Medical Examiners Office 1300 E. Warren, Detroit, MI.

Evaluation: presentation and written

Preceptor(s): Dr. Teresa Nguyen

Category: Non-Clinical

Recommended Attire: Scrubs

EMR System: N/A

Notes: Must report to the Wayne County Medical Examiners Office on the first day of the rotation at 8:30 a.m. Rotators cannot be absent for the first two days of the month rotation.Rotators cannot be absent for the first two days of the month rotation; these are mandatory orientation days.

8980 - Tumor Genetics - Detroit Medical Center

Course Prerequisites: Department Approval Required - Records and Registration will request approval.

Attendees: 4th year Medical Student focusing on Genetics.

Number of attendees: 2 per month.

Objectives: Senior Clinical Tumor Genetic Elective - Course Director - Provide four weeks training of individual clinical teaching, training in FISH, chromosomes, and array CGH.

Category: Non-Clinical

8990 - General Pediatrics - Multiple Locations

Course Prerequisites: N/A

Description: One month ambulatory rotation at Wayne Pediatrics, a multi-specialty pediatric clinic located south of the DMC medical campus.

Objectives: To know the elements of a health maintenance visit for newborns, infants, children, and adolescents including taking a history and performing a physical exam, developmental surveillance, screening, and anticipatory guidance. To become familiar with common problems of the newborn in the ambulatory setting such as Jaundice, feeding difficulties, poor weight gain, and maternal depression. To learn how to obtain a confidential history in adolescents. To learn how to counsel adolescents about high-risk behaviors. To learn how to provide realistic anticipatory guidance that is congruent with the family structure, health beliefs and culture. To learn how to effectively educate parents whose health beliefs differ from what is medically recommended/indicated. To learn which common medical conditions should be referred to a pediatric specialist. To demonstrate how to gather a basic history and perform a physical exam. To demonstrate the ability to assess a patient’s development based both on parental history and on the physical exam. To learn how to interpret common lab results in the outpatient setting including cbc with differential, lead, urinalysis, hemoglobin A1c, total and direct bilirubin, transcutaneous bilirubin, and cholesterol profile. To know the elements of a pre-participation sports physical.

Methods: Spend 7-8 half-days per week at Wayne Pediatrics performing clinical duties. Students will see patients independently and present to an attending physician. Students will gain experience in well and acute care visits, develop an assessment plan for each patient, provide anticipatory guidance as indicated for each visit, provide instructions for home care for any acute illnesses, and document the clinical visit in the Electronic Medical Record. Students will give at least 2 presentations to the Wayne Pediatrics Department on a topic relevant to the practice. Students will assist M1-M3 students with Pediatric Exam Skills. Students will spend 1-2 half-days per week working on independent study or a research project and spend 1-2 hours/week with various support staff to learn their roles in the outpatient setting.

Clinical Instruction:
- First Day
  - general orientation to the clinic
  - observed history and physical exams with immediate feedback after the visit
- Subsequent Days
  - Gradual advancement to indirect supervision
  - Oral presentations to the attending after each patient encounter with feedback
  - Written documentation: write notes on all patients seen and submit for feedback

8992 - Pediatric Pulmonary - Childrens Hospital

Course Prerequisites: N/A

Objectives: Learn evaluation & treatment of pediatric patients with acute & chronic respiratory diseases.

Methods: Participation in all clinical activities of the pediatric pulmonologists, including pulmonary, cystic fibrosis and sleep disorders clinic, daily inpatient rounds, consultations and procedures. They will learn to: 1. appreciate the wide range of phenotypes in patients with cystic fibrosis & the importance of specialized team care for this population 2. develop differential diagnoses & management plans for pediatric patients with cough, wheeze stridor, pulmonary infiltrates and sleep disturbances 3. become familiar with indications for diagnostic methods in pediatric pulmonology including radiographic, bronchoscopic & pulmonary function testing 4. appreciate the role of the pediatric pulmonologist and the importance of referral and consultation

Length: Work days/week: 5; Approx hours/day: 8; Night call/month: None

Evaluation: Completion of worksheet & review with coordinator

Category: Specialty Subinternship

9000 - Adolescent Pediatrics - Childrens Hospital

Students will first see patient on their own and then have direct supervision by the attending physician. Participation in weekly didactic sessions.

Objectives: 1. To become familiar with normal physical, cognitive and psychosocial development in young people. 2. To become familiar with the interviewing skills required for effective interaction with adolescents. 3. To gain expertise in the physical examination of adolescent patients.

Methods: 1. Participation in the Adolescent Clinic at CHM. The student will have the opportunity to evaluate new and established patients under faculty supervision. 2. Participation in weekly didactic sessions addressing common gynecologic problems and sexually transmitted diseases, adolescent development and physician-patient interactions.

Recommended Reading Material: 1. Selected readings are provided. 2. Neinstian. Adolescent Health Care A Practical Guide. 5th Edition.

Length: 1, 2, or 3 months; Days/Week: 5; Hours/Week: 8; Night Calls/Month: none

Evaluation: Clinical evaluation and written

Category: Specialty Subinternship

9010 - Allergy, Immunology, and Rheumatology - Childrens Hospital

Objectives: 1. To acquire experience in day-to-day care of patients (adult and pediatric) with asthma, allergic rhinitis, urticaria, atopic dermatitis, drug reactions, and conditions mimicking atopy. 2. To acquire experience in day to day care of pediatric and adolescent patients with perinatal HIV infection and primary immune deficiencies (DiGeorge syndrome, common variable immune deficiency, ataxia telangiectasia, Bruton's agammaglobulinemia, etc.). To become familiar with the use of intravenous immunoglobulin and with the use of antiretroviral medications, and with the use of prophylactic antibiotics in immune deficient patients. 3. To acquire experience in day to day care of patients with juvenile rheumatoid arthritis, juvenile dermatomyositis, systemic lupus, and other pediatric rheumatological problems. 4. To acquire experience in diagnosing immune deficiencies, and to develop familiarity with immunological tests designed to detect abnormalities of immune function (mitogen proliferation, pre and post vaccination antibody titers, lymphocyte markers, etc.).

Methods: 1. The student will be supervised by full time faculty. 2. Students will attend clinics in pediatric and adult allergy/asthma, primary immune deficiency, HIV, and pediatric rheumatology. 3. Students will do allergy consults with the sub-specialty fellows and supervising attendings. 4. Students will attend all division lectures for the month of the rotation (1-2 per week), and may be asked to do a brief presentation on a topic of interest to her/him in this field.

Recommended Reading Material: Students are referred to the American Academy of Allergy and Immunology (AAAAI) website for up to date information on suggested reading for student and resident rotations in allergy and immunology, and to the Primary Immune Deficiency Foundation website for information on all of the primary immune deficiencies.

Length: 1 month; Days/Week: 5; Hours/Week: 40; Night Calls/Month: none

Evaluation: An open book exam will be given on the first day of the rotation to be turned in by the end of the rotation, and written evaluations will be made on clinical performance for all students.

Category: Specialty Subinternship

9045 - Pediatric Community Partnership - Arranged (Building Not Needed)

Course Prerequisites: N/A

Description:

Objectives:

Students will recognize how historic injustices and systemic racism are key drivers of food insecurity.
Students will explain the intersectionality of food insecurity and early childhood development and education.
Students will examine how current interventions directed at addressing food insecurity and early childhood education impact on families.
Students will collaborate with community members to propose an alternate approach to interventions directed at addressing the impact of food insecurity and early childhood development and education.

Methods: Students will focus on each objective in one-week increments using in-class activities like lectures and/or videos and working with the group in large group activities. Students will have coursework outside of in-person work with pre-reading assignments and homework assignments. Students will work in the community at a variety of community locations.

Recommended Reading/Resources: Syllabus with readings and resources will be provided.

Length: 1 month; In person 3 days/week - Monday, Tuesday, and Thursday; Hours/Week: ; Night Calls/Month:

Additional Locations: Community locations TBD

Evaluation:

Participation and engagement in class discussions, reflections, and activities
Quality of alternate intervention proposal
Presentation of alternate intervention proposal
Course reflection and self-assessment

Preceptor(s): Dr. Lynn Smitherman, Dr. Nakia Allen, Dr. Meghan Dwaihy

Director(s): Dr. Lynn Smitherman, Dr. Nakia Allen

Notes: Medical students will work in partnernship with public health students in this elective.

Category: Community Service, Non-Clinical

9050 - Pediatric Genetics - Childrens Hospital

Objectives: 1. To obtain and correctly document a multigeneration family history. 2. To become familiar with abnormal morphology of children and its significance to diseases. 3. To develop diagnostic skills in various inherited diseases and inborn errors of metabolism and to understand the rationale for the use of diagnostic tests. 4. To become familiar with various aspects of Genetic Counseling.

Methods: Students will perform genetic consultations along with the staff of Genetic and Metabolic Disorders Division in an inpatient and outpatient setting. Students will have an opportunity to learn to obtain a thorough history and perform a complete physical examination to arrive at differential diagnoses of genetic disorders. They will participate in genetic counseling cases of different types. They will be asked to interpret results of various laboratory tests and will be taught to arrive at a definitive diagnosis. They will learn effective management of various genetic disorders. They will be assigned relevant reading materials.

Recommended Reading Material: To be assigned.

Length: 1 month; Days/Week: 5; Hours/Week: 40; Night Calls/Month: none

Evaluation: Clinical evaluation & Written.

Category: Specialty Subinternship

9070 - Neonatology - Childrens Hospital

Course Prerequisites: Offered every term.

Description: Management of critically ill newborns, both term and pre-term in the inpatient setting of level III and IV Neonatal Intensive Care Units. Evaluation of healthy newborns; common newborn conditions; care of high risk infants and their mothers. Students who wish to experience caring for healthy newborns can discuss their goals with the resident to secure additional educational experiences at an affiliated hospital when possible.

Objectives:

Describe the transition from the intrauterine to the extrauterine environment, including temperature regulation, cardiovascular/respiratory adjustment, glucose regulation, and initiation of feeding.
List the information from the history of pregnancy, labor, and delivery obtained from the parents or medical record that has implications for the health of the newborn.
Describe how gestational age can be assessed with an instrument such as the Ballard scale and identify key indications of gestational maturity.
Describe the challenges for parents adjusting to a new infant in the home.
List the differential diagnosis and complications for the following common problems that may occur in the newborn including: Jaundice; Respiratory distress; Poor feeding; Large and small for gestation infants; Abnormalities which includes tremulousness, irritability, lethargy from causes such as drug withdrawal, hypoglycemia, sepsis; Prematurity
Describe how gestational age affects risks of morbidity or mortality in the newborn period (for example lung disease, hypothermia, and glucose homeostasis).
Population and Community Health: Socioeconomic risk factors in high risk pregnancies; Limitations to prenatal care and impact on deliveries and neonatal management.

Methods: Participate in daily rounds. Attend educational activities such as Grand Rounds and Noon Lecture. Participate in signout of patients. Function as a Junior member of the team with graded responsibility for patient care consistent with skills and senior student status. Perform a complete physical examination of the newborn infant. Give parents of a newborn anticipatory guidance for the following issues: The benefits of breast-feeding vs. Formula for the newborn and mother; Normal bowel and urinary elimination patterns; Normal neonatal sleep patterns; Newborn screening tests to include screens for metabolic and infectious conditions and hearing loss; Appropriate car seat use; Prevention of sids (“back to sleep”); Immunizations (e.g. Hbv); Medications (e.g. Eye prophylaxis, vitamin K, and vitamin D). Primary responsibility for several patients, 2-5 depending on student level of comfort, skill, and service capacity. Independent student and presentation of topics to the team when time allows.

Recommended Reading: TBD

Length: 1 month

Evaluation:

Practice-Based Learning and Improvement - Students must investigate and evaluate their patient care practices, appraise and assimilate scientific evidence, and improve their patient care practices.
System-Based Knowledge - Students must demonstrate an awareness of and responsiveness to the larger context and system of healthcare and the ability to effectively call on system resources to provide care that is of the optimal value.
Interpersonal and Communication Skills - Students must be able to demonstrate interpersonal and communication skills that result in effective information exchange and collaboration with patients and those important to patients (spouses, caregivers, family, trusted friends, significant others, etc.) and with professional associates.

Category: Specialty Subinternship

9080 - Pediatric Cardiology - St Joseph Pontiac

Objectives: A. The student will become more proficient in the cardiovascular examination of children. B. This will include characterization of heart sounds, murmurs, precordial impulses, pulses and blood pressure. C. The student will become very familiar with congenital and acquired heart disease in children in relationship to its diagnosis and treatment. D. The student will gain a better understanding of cardiovascular physiology as it pertains to pediatrics by attending cardiology clinic. E. The students who are on the elective for longer than 1 month may participate in retrospective and prospective clinical research. F. The student will become more proficient in the cardiovascular examination of children. G. This will include characterization of heart sounds, murmurs, precordial impulses, pulses and blood pressure. H. The student will become very familiar with congenital and acquired heart disease in children in relationship to its diagnosis and treatment. I. The student will gain a better understanding of cardiovascular physiology as it pertains to pediatrics by attending cardiology clinic. J. The students who are on the elective for longer than 1 month may participate in retrospective and prospective clinical research.

Preceptor(s): Daniel Turner, MD

Category: Specialty Subinternship

9080 - Pediatric Cardiology - Childrens Hospital

Category: Specialty Subinternship

9090 - Pediatric Ear, Nose & Throat - Childrens Hospital

Objective: To familiarize students with entire scope of Pediatric Otolaryngology.

Methods: Will accompany residents, fellow and staff in clinic, OR and rounds. Will work up clinic and inpatients. Each student is expected to make one oral presentation on assigned topic towards end of rotation.

Category: Specialty Subinternship

9100 - Pediatric Emergency Medicine - Childrens Hospital

Objectives: The student will have the opportunity to see large numbers of children on a "front-line" basis. The conditions evaluated will range from diaper rash to cardiac arrest. After seeing large numbers of children, the student should be able to distinguish normal from abnormal. He/she will acquire skills in various procedures such as sutures and spinal taps. Skills in history-taking, physical and differential diagnosis and decision making will be developed. Bedside manner by discussing patients condition and disposition will be attained. The student will be supervised directly by full-time attending staff with emphasis on diagnosis, management and disposition.

Category: Specialty Subinternship

9110 - Pediatric Endocrinology and Diabetes - Childrens Hospital

Offered Every Term.

Restriction(s): Enrollment limited to students with a class of Med Third Year or Med Fourth Year; enrollment is limited to students with a major in Medicine; enrollment is limited to Medical level students; enrollment limited to students in the School of Medicine.

Objectives: Evaluation of normal physical growth and development; recognition of common pediatric endocrine problems.

Category: Specialty Subinternship

9120 - Pediatric Gastroenterology, Hepatology, and Nutrition - Childrens Hospital

Objectives: To provide experience with common and uncommon problems in the Pediatric Gastroenterology, Hepatology & Nutrition. 2. To develop basic concepts regarding nutritional requirements and how to deliver these.

Methods: By doing inpatient consults, By participating in outpatient clinics, By attending divisional conferences, By observation of procedures

Recommended Reading Material: To be assigned.

Length: 1 month; Days/Week: 5; Hours/Week: 40; Night Calls/Month: none

Category: Specialty Subinternship

9130 - Pediatric Hematology/Oncology - Childrens Hospital

Objectives: 1. To improve the student's ability to interpret a peripheral blood smear, and to coordinate this interpretation with the patient's history and clinical presentation (and with other laboratory tests). 2. To improve the student's ability to perform and document a pediatric history and physical examination, and to formulate an appropriate differential diagnosis in the area of hematological and oncology problems. 3. Enhance the student's understanding of psychological, social and economic principles involved in chronic and/or serious, life threatening illnesses of childhood (ex: malignant disease, sickle cell anemia, hemophilia, etc.), including the impact of these on the entire family. 4. To enhance the student's understanding of the "team concept" of health care for serious and/or chronic illnesses (ex: malignant disease, hemophilia, sickle cell anemia), in which physicians, social workers, genetic counselors, physical therapists, specially trained nurses, etc., work together as a closely integrated, communicating team in an attempt to provide the best possible comprehensive care for the patient and his or her family. 5. To improve the student's ability to select the most appropriate current diagnostic tests which are necessary to establish the diagnosis of hematological disorders seen in children and adolescents (such as hemoglobinopathies, coagulation disorders, iron deficiency anemia, acute leukemia, solid malignancies), and to be able to interpret these tests. 6. To enhance the student's knowledge of transfusion medicine, in terms of indications for transfusions, selection of most appropriate product, risks associated with blood transfusions, and how to calculate amounts of blood components to be given to children.

Methods: The elective consists of full participation in all activities of the department, including daily ward rounds, seeing patients in the hematology out-patient clinic, slide quiz sessions, weekly hematology conferences and seminars,and weekly Tumor Board conference. Infants and children with a wide variety of blood diseases will be seen, including acute leukemia, hemophilia, sickle cell disease and other hemoglobinopathies, purpuras and aplastic anemia. In addition, children with neuroblastoma, Wilm's tumor, and other solid tumors will be seen. The student will be assigned certain patients and will work under the direct supervision of one of the full time staff Hematologists (Drs. Lusher, Ravi or one of their associates).

The student will be expected to evaluate, follow and discuss such patients, and to participate in "team" discussions. Each student will also be assigned a seminar topic for presentation near the end of the elective period. There will be an opportunity to perform procedures and also to see the preparation of blood components (platelet and leukocytecon centrates, frozen RBC's, cryoprecipitates, etc) at the nearby American Red Cross Blood Bank. The students will be able to observe laboratory techniques for determining the CBC and hemoglobin quantitation and coagulation tests.

Recommended Reading Material: 1. Reference texts for selected chapters: Pediatric Oncology, (Pizzo & Poplack, eds.). 4th edition, J. B. Lippincott, Pub. 2001 2. Blood Diseases of Infancy and Childhood. (Nathan,D & Oski, F, Eds.), 6th Edition, 2003, W B Saunders, Publ.

Length: 1 month; Days/Week: 5; Hours/Week: 40; Night Calls/Month: none

Evaluation: Written

Category: Specialty Subinternship

9140 - Pediatric Infectious Disease - Childrens Hospital

Objectives: Clinical experience in the diagnosis and management of infectious diseases in hospitalized infants and children. Acquisition of knowledge of the etiology, pathogenesis, treatment and epidemiology of common infectious illnesses in the pediatric age group.

Methods: The fourth year student will be assigned to the Infectious Diseases Ward (6NE) and will be responsible for the complete management (diagnostic work-up and treatment) of patients under his/her care. The student will act as a subintern and will be supervised by pediatric house staff and an Infectious Diseases attending on the ward. The attending physician makes daily bedside rounds. Night calls will be every 4th night with close supervision by a pediatric resident (Year III). The student will participate in regularly scheduled infectious diseases conferences and will attend other pediatric conferences.

Category: Specialty Subinternship

9150 - Pediatric Intensive Care - Childrens Hospital

Course Prerequisite: Recommend the student has demonstrated prior involvement and recommendation from Critical Care Medicine attending physician.

Objectives: 1. To develop a diagnostic and therapeutic approach to the care of a critically ill child. 2. To become familiar with commonly encountered life threatening disorders in pediatrics. 3. To learn how to apply pathophysiologic principles for bedside evaluation and management. 4. To learn how to deal with families with critically ill Children.

Methods: Students will be exposed to a number of critically ill children in the general ICU. Problems will be managed under direct faculty and fellow supervision in patients with such serious pediatric disorders as shock, fluid and electrolyte disturbances, cardiorespiratory failure, traumatic and metabolic encephalopathies, poisoning, and renal failure. Each student will be personally involved in the care of several critically ill children and will be responsible for the development of integrated summaries of pathophysiology and treatment progress on several patients each week. Emphasis will be upon the understanding of pathophysiological changes which occur in severe illness states, physical diagnosis, patient monitoring and appropriate record keeping. Students will have the opportunity to work closely with the team of highly skilled professionals in providing direct care to children and supportive care of families.

Recommended Reading Material: To be assigned.

Length: 1 month; Days/Week: 5; Hours/Week: 60; Night Calls/Month: 7-8

Category: Intensive Care Subinternship

9160 - Pediatric Nephrology - Childrens Hospital

Objectives: 1. Be able to demonstrate, by the process of obtaining a history and performing a physical examination, facility in the initial assessment of children with common renal diseases. 2. Be able to demonstrate familiarity with the usual laboratory procedures employed in the assessment of children with renal disease by suggesting their utilization in the further evaluation of patients. 3. Be able to demonstrate the ability to formulate treatment plans for common renal conditions, including gomerulonephritis, the nephrotic syndrome,and obstructive uropathy by presenting such to the attending nephrologist. 4. Be able to discuss the pathophysiology of disorders of fluid and electrolyte balance, acid-base balance, and complications of the uremic state. 5. Be able to demonstrate an understanding of the advantages and limitations of various forms of therapy for acute and chronic renal failure.

Methods: 1. Daily participation in rounds with the attending staff and house officers on the renal inpatient service. 2. Participation with the house staff in the initial assessment of inpatient consultations, and presentation of same to the attending staff. 3. Preparation of a report on a Nephrologic topic to be chosen jointly by the student and the attending physician. 4. Participation in regular renal teaching conference. 5. Ongoing and final detailed evaluation of performance by the attending physician.

Recommended Reading Material: 1. Nelson and/or Rudolph's. Textbook of Pediatrics-sections on Urinary Tract Disease. 2. Clinical Physiology of Acid -Base and Electrolyte Disorders. Burton David Rose, (Ed).

Length: 1 month; Days/Week: 5; Hours/Week: 40; Night Calls/Month: none

Evaluation: Written.

Category: Specialty Subinternship

9180 - Pediatric Pathology: Autopsy and Surgical - Childrens Hospital

Objectives: 1. Pediatric Pathology is the study of the changes in tissues and body fluids of children with clinical diseases. The student, having already experienced clinical pediatrics, will have an opportunity to correlate clinical and anatomical and laboratory findings. 2. To develop an awareness of the alteration of development and growth by factors such as hypoxia, nutrition, teratogens and mutagens, carcinogens, physical injury and abnormal genes. 3. To develop diagnostic skills of observation, supplementing clinical skills and expanding clinical acumen through the use of the techniques of gross and microscopic anatomy.

Methods: The student will be involved in all the departmental activities, including the daily flow of surgical specimen and autopsies. The student will attend the teaching conferences of the department and of the hospital as related to Laboratory Medicine. Collections of gross tissue, congenitally anomalous hearts and microscopic slides are available for review, with the appropriate attending pathologist. Areas of interest to the student may be concentrated upon during this short rotation involving literature review and in depth case write-ups.

Recommended Reading Material: Standard texts by Denher, Potter in the department

Length: 1 month; Days/Week: 5; Hours/Week: 7:30 -5:00, Night Calls/Month: none

Category: Specialty Subinternship

9190 - Pediatric Plastic Surgery/Craniofacial - Childrens Hospital

Course Prerequisites: Must have passed Year 3 PEDS clerkship.

Objectives: To recognize and plan treatment for congenital cleft/craniofacial anomalies, and vascular lesions.

Methods: Active participation in O.R. and clinic with independent reading.

Recommended Reading Material: Pediatric Plastic Surgery (Bentz) in Office

Length: 1 month; Days/Week: 5; Hours/Week: 50; Night Calls/Month: none

Category: Specialty Subinternship

9200 - Pediatric PMR - Childrens Hospital

Objectives: Introduce concepts of development. Expose student to childhood head injury, spinal cord injury, cerebral palsy, neuromuscular diseases, sports medicine, electromyography. Introduction to bracing/adaptive equipment. At end of rotation student should be able to identify functional impairments and develop rudimentary rehab plan.

Methods: In-patient assignment on 5th Floor (Rehab CHM) Outpatient Clinics. (PM & R, Cerebral Palsy, Myelo, Muscular Dystrophy Clinics, Chemodenervation Clinic).

Recommended Reading Material: To be assigned.

Length: 1 or 2 months; Days/Week: 5; Hours/Week: 40; Night Calls/Month: none

Evaluation: WSU form

Category: Specialty Subinternship

9210 - Acting Internship: Pediatric - Childrens Hospital

Course Prerequisites: N/A

Description: The Pediatric Sub-Internship serves as an opportunity for 4^th year medical students interested in pursuing a career in children’s health or other related fields to gain experience working with a pediatric inpatient team. The 4-week rotation is offered on one of the inpatient units at Children’s Hospital of Michigan and provides a hands-on experience where students function as interns on their assigned teams.

Objectives: Gain medical knowledge through direct clinical exposure and apply knowledge and skills to more autonomous patient care, with guidance from residents and staff.

A. Knowledge for Practice

Utilize appropriate resources to increase their understanding of pediatrics.
- This may be demonstrated through a formal topic presentation or by reading on a patient who they saw and additional learning opportunities were identified.
- It is the responsibility of the student to report back on their learning.
- Assessment: informal presentations on rounds
Develop the top 3 most likely differential diagnosis following a clinical encounter based on common pediatric signs and symptoms.
- Assessment: Written H&Ps; oral presentation; daily progress notes, transfer notes, discharge summaries

B. Patient Care

Demonstrate the ability to gather a pediatric history including the following components:
- Report on the source of the history and understand the importance of this information
- Obtain a pertinent HPI and review of systems
- Review core patient histories (birth, medical, surgical, family)
- Obtain neonatal, developmental, and age-appropriate social histories
- Assessment: oral presentations; direct observation; H&P and progress notes
Perform a physical exam
- Students should be able to interpret pediatric vitals, growth charts and BMI charts
- Students should be proficient in the following exam components and able to identify and describe abnormal findings: general appearance, vital signs, head, neck, heart, lungs, abdomen, neurologic, musculoskeletal, integumentary
- Students should be able to perform the following exam components and sometimes able to identify and describe abnormal findings: eyes, ENT
- Students should be able to perform a GU exam under supervision and be able to perform Tanner staging
- Assessment: oral presentations; direct observation; H&P and progress notes
Recognize a patient requiring urgent or emergent care, inform a senior team member, and explain initial steps to escalated care.
- Assessment: direct observation
Determine when to use basic screening tests and interpret the results.
- For sick patients, this includes BMP, CBC, urinalysis, blood and fluid cultures,
- Assessment: oral presentations; H&P and progress notes; direct observation
Develop basic management plans, including immunizations, medication and fluid management.
- Students should be able to perform weight-based calculations of bolus and maintenance fluids.
- Students should be able to select appropriate antibiotics and locate information about weight-based dosing.
- Students should understand the appropriate medications to treat common childhood diseases, such as otitis media, asthma or constipation.
- Students should be able to determine recognize the indication for standard procedures in pediatrics, including the risks and benefits for each procedure, including:
  - Lumbar puncture
  - Capillary or arterial blood gas
  - Urethral catherization
  - Central line access
  - Nasogastric tube insertion
  - Tracheal intubation
  - Total parenteral nutrition

C. Practice-based Learning and Improvement

Utilize appropriate resources to increase their understanding of pediatrics.
- This may be demonstrated through a formal topic presentation or by reading on a patient who they saw and additional learning opportunities were identified.
- It is the responsibility of the student to report back on their learning.
- Assessment: informal presentations/assignments

D. Interpersonal and Communication Skills

Write an encounter note, such as an H&P or a SOAP note, using appropriate clinical language and format. This may be done in EMR or a Word document.
- Assessment: H&P, progress notes, transfer notes, discharge summaries
Orally present an organized clinical encounter that includes all four “SOAP” components.
- Assessment: oral presentations

E. Professionalism

Demonstrate professional behavior at all times
- This includes behavior toward patients and families
- This includes behavior toward residents and attending physicians, and all members of the inter-professional team
- Attend all clinical and scheduled events as dictated in the syllabus and schedule
- Assessment: direct observation

D. Systems-based Practice

E. Interprofessional Collaboration

Understand the roles of support staff in the inpatient setting, including nurses, patient care associates, respiratory therapists, occupational and physical therapists, nutritionists, chaplains, patient advocates, etc.

F. Personal and Professional Development

Utilize appropriate resources to increase their understanding of pediatrics.
- This may be demonstrated through a formal topic presentation or by reading on a patient who they saw and additional learning opportunities were identified.
- It is the responsibility of the student to report back on their learning.

Methods: The Peds Sub-I is available every month for a limited number of students. Students are assigned to a pediatric in-patient service team, either on one of the general inpatient teams, an inpatient specialty team or one of the critical care units. Each team consists of an Attending Physician, 1-2 Senior Residents, interns, and third-year students. The sub-intern’s level of responsibility is on par with a PL-1 resident and as such involves direct patient care responsibility for hospitalized children. Under the supervision of pediatric senior residents and pediatric attendings, students learn by doing and by example. As a functioning member of the inpatient team, sub-interns participate in all ward rounds, direct patient care, documentation, procedures, consultations, clinical planning and didactic conferences. On call responsibilities during the sub-internship are the same as that of the pediatric interns on their respective teams, either a combination of short, long and night shifts or a standard overnight call. Sub-intern schedules adhere to the ACGME duty hour requirements. As this is an intensive, full-time commitment to patient care as an integral member of the inpatient team, this experience is not to be interrupted by vacations, residency interviews, or unexcused absences.

The sub-internship begins with an orientation in the afternoon of the first day to review the expectations of the rotation. Sub-interns will also meet with the Associate Clerkship Director and/or the chief residents midway through the month, and finally have an exit interview on the last day. They are expected to attend the educational sessions along with the pediatric residents and may have some informal teaching sessions with their teams or the sub-intern faculty.

Recommended Reading/Resources: Pediatrics In Review, Harriet Lane, Lexicomp, Nelson’s

Length: 1 month; combination of short shifts and long shifts with 2 calls/night shifts

Additional Locations: 5^th and 6^th floor CHM main hospital.

Evaluation: Sub-interns are evaluated by their senior residents and attending physicians. Evaluations are based on the competencies listed below and are aligned with Enstrustable Professional Activities as set forth by the LCME. New Innovations evaluation.

Preceptor(s): On-service/rounding attending physician

Category: Acting Internship

Recommended Attire: Scrubs or professional attire, white coat optional

EMR System: Cerner/PowerChart

9230 - Physical Medicine & Rehabilitation - Rehabilitation Institute

Course Prerequisites: This course is for students with a true interest in PM & R, Ortho or Neurology.

Description: Physical Medicine & Rehab is a branch of medicine that aims to enhance and restore functional ability and quality of life to those with physical impairments or disabilities. Through this rotation students will experience the various aspects of PM&R including spinal cord injury, stroke, traumatic brain injury, general rehab, and consults. Through this rotation, students will achieve a greater understanding of the musculoskeletal and neuromuscular systems. Typically one week is spent in each dept. Students will be integrated into the rehab team and work with the attending, residents, as well as physical and occupational therapists. In addition, the student will participate in rounds, team conferences, as well as weekly didactics.

Objectives: The goal of this rotation is to develop competencies in the student to allow him/her to provide optimal rehabilitative patient care. Rotators must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of patients seen in the outpatient setting. Students must demonstrate knowledge of established and evolving biomedical, clinical epidemiological and socio-behavioral sciences pertaining to the state of patients and the application of this knowledge to overall patient care. Spinal Cord Injury: Understand the management of spinal injury patients including bowel and bladder management, pain control, and spasticity management. Learn the basics of the ASIA exam. Traumatic Brain Injury, Stroke: Gain experience in the management of TBI and stroke patients including spasticity management, agitation, and seizure management. Learn the complete neurological exam required to assess the patients. Learn about the various stroke syndromes.

Methods: Teaching methods include direct patient care. Role modeling, and didactic conferences. Rotators are assigned patients and given progressive responsibility based on their level of training and knowledge. Students will need to demonstrate ability to obtain and document complete histories and perform thorough physical exams. They will define and prioritize realistic rehabilitation goals and treatment plans for patients with musculoskeletal, TBI, SCI and Stroke disorders. They will demonstrate ability to discriminate between treatment modalities (pharmacological, exercise) according to safety, mechanism of action, and contraindications. Students will also demonstrate ability to integrate medical knowledge to order appropriate consultations (including rheumatology, neurosurgery, and orthopedics), laboratory and imaging studies. They will also prescribe appropriate exercise, physical modalities, medical equipment and medications for people with musculoskeletal disorders through working with therapy staff.

General Rehab: Understand the management of hip and knee replacement patients, cancer rehab, burn patients, and cardiac rehab patients. Gain experience with the complete musculoskeletal examination.
Consults: Gain understanding of which types of patients are appropriate for inpatient rehab v. subacute rehab and outpatient rehab. Learn how to provide the appropriate care for patients in the acute care setting. Gain experience operating in a team environment with a multidisciplinary approach.

Recommended Reading/Resources: Braddom, Randall L. Physical Medicine and Rehabilitation. 3rd ed, Philadelphia: WB Saunders; 2007

Length: 1 month

Additional Locations: Stroke and TBI RIM 6th floor; Outpatient Clinic 1st floor; General Rehab 4th floor; SCI 3rd floor; and Peds PM&R CHM IP 5 East Charting Room.

Evaluation: Clinical Evaluations. Students will be evaluated based on their patient care, professionalism, interpersonal and communication skills, and medical knowledge. Students will receive ongoing feedback from the faculty during the rotation. There are no formal examinations. In the event of a failing performance, the attending will reach out to the sponsoring program office.

Preceptor(s): Michael Ajluni, MD (Director); Ali Bitar, MD; Tyler Williamson, MD; David Rustom, MD; Erin McCarty, MD; Pano Papalekas, MD; C Santia, MD; T Woehrlen, MD; Michael Bush-Arnold, MD; Charles Pelshaw, MD

Program Coordinator: Colleen Harbowy

Category: Specialty Subinternship

9230 - Physical Medicine & Rehabilitation - St Joseph Pontiac

This course is for students with a true interest in PM & R, Ortho or Neurology.

Objectives: Spinal Cord Injury: Understand the management of spinal injury patients including bowel and bladder management, pain control, and spasticity management. Learn the basics of the ASIA exam. Traumatic Brain Injury, Stroke: Gain experience in the management of TBI and stroke patients including spasticity management, agitation, and seizure management. Learn the complete neurological exam required to assess the patients. Learn about the various stroke syndromes.

Methods: 1. General Rehab: Understand the management of hip and knee replacement patients, cancer rehab, burn patients, and cardiac rehab patients. Gain experience with the complete musculoskeletal examination. 2. Consults: Gain understanding of which types of patients are appropriate for inpatient rehab v. subacute rehab and outpatient rehab. Learn how to provide the appropriate care for patients in the acute care setting. Gain experience operating in a team environment with a multidisciplinary approach.

Recommended Reading Material: Braddom, Randall L. Physical Medicine and Rehabilitation. 3rd ed, Philadelphia: WB Saunders; 2007

Evaluation: Written

Preceptor(s): Timothy Sesi, MD

Category: Specialty Subinternship

9261 - Emergent & Consult Liaison Psychiatry - Multiple Locations

Course Prerequisites: 1 student per month who has completed the core psychiatry clerkship and who is seriously interested in psychiatry.

Wayne State University students only.

Objectives: Assessment and disposition of psychiatric patients in acute settings and on consult service. Assessment and management of acute intoxication and withdrawal syndromes. Assessment and management of psychiatric patients with medical comorbidities.

Methods: One month clinical experience in an emergency psychiatric center (3 days per week) and inpatient consult service (2 days a week).

Recommended Reading Material: 1. Diagnostic & Statistical Manual of Mental Disorders, DSM-IV-TR. 2. Kaplan & Sadock’s Comprehensive Textbook of Psychiatry

Length; 1 month Days/Week: 5; Hours/Day: 8-10; Night Calls/Month; None

Additional Locations: Detroit Receiving Hospital Crisis Center & Sinai Grace Hospital

Evaluation: School of Medicine evaluation form.

Recommended Attire: In the Crisis Center at DRH scrubs are acceptable. During Consults at Sinai/Grace business attire is preferred. Business casual is acceptable. (No scrubs or jeans!)

Coordinators: Dr. Victor Ajluni and Dr. Gerald Shiener

Notes: Students are required to have DMC access. (Students must inform Ms. Betty Brown or onboard at least 4 weeks prior to the elective start date.)

Category: Specialty Subinternship

9261 - Emergent and Consult Liaison Psychiatry - Henry Ford Health Service

Course Prerequisites: This elective is designed for senior medical students who have plans of applying for residency training in Psychiatry.

Description: Students will learn to assess psychiatric patients, manage acute intoxication and withdrawal syndromes, manage psychiatric patients with medical comorbidities and learn basic managed care principals. Students will rotate with either the Consult Liaison service or at the inpatient psychiatric hospital.

Objectives: At the end of the rotation the student is expected to:

Conceptualize psychiatric illness using a biopsychosocial model.
Perform a basic psychiatric interview with formal mental status examination.
Detail risk factors associated with suicide / homicide / violence and describe appropriate interventions.
Be familiar with medical illnesses that commonly have psychiatric presentations, including delirium.
Be familiar with the role of the physician in assessing capacity.
Elicit diagnostic symptoms associated with common psychiatric disorders, including: depression, bipolar disorder, panic disorder, generalized anxiety disorder, psychoses, delirium and dementia.
Understand symptoms and sequelae of common drugs of abuse and dependence.
Formulate a bio-psycho-social treatment plan for common psychiatric illnesses.
Describe pharmacological treatment of common psychiatric illnesses.

Recommended Reading/Resources: To be assigned

Length: 1 month; Days/Week: 5; Hours/Week: 40; Night Calls/Month: N/A

Additional Locations: Henry Ford Main or at Kingswood, our inpatient psychiatric hospital in Ferndale, (which will be moving to West Bloomfield once new inpatient facility opens)

Evaluation: Clinical Evaluation

Preceptor(s): Varies

Director(s): Anjali Thakrar, MD

Category: Specialty Subinternship

Recommended Attire: Business professional

EMR System: Epic

9262 - Emergency Psychiatry - Sina Hosp Crisis Ctr

Objectives: The student will:

Learn how to evaluate psychiatric patients in an emergency setting.
Learn how to complete a thorough risk assessment.
Participate in the diagnosis of DSM–V Axis I and II disorders.
Learn about the use of psychotropic medications in an emergency setting.
Follow transition of care of psychiatric patient from Sinai Grace ED to inpatient hospitalization.

Methods: Students will participate closely with Dr. Shah in the evaluation of psychiatric crisis patients and will discuss different treatment options, and continue to evaluate and treat patients during their inpatient hospitalization.

Recommended Reading Material: To be determined by Dr. Shah during the clerkship. Reading will be tailored to the student’s particular interests.

Length: 1 month; Days/Week: 5; Hours/Day: 8; Night Call/Month: None

Additional Locations: Sinai Grace Hospital Crisis Clinic and Sinai Grace 5South Inpatient Unit

Evaluation: Direct observation.

Recommended Attire: The students can wear business casual attire. For men, that should include a tie. White coats are not required and all IDs should be worn above the waist.

Coordinator: Dr. Ashok Shah

Notes: Students are required to have DMC access. (Students must inform Ms. Betty Brown or onboard at least 4 weeks prior to the elective start date.)

Category: Specialty Subinternship

9264 - Psychiatry Research - Tolan Park Medical Building

Course Prerequisites: To register for this course the student must have written approval from Dr. Morreale. In addition, a scheduled meeting with Dr. Morreale to discuss a specific research focus is required at least 2 months prior to the elective starts. Available every month with prior approval. 1-2 students per month.

Description: The student will participate in a four-week course detailing psychiatric research modalities. The student will also complete a 1-page ‘research proposal’ that details a potential research study and which contains: 1) an introduction section describing available literature related to their research topic, 2) a description of the proposed methodology, and statistical analysis of any data that would be collected, and 3) a discussion of the expected results and how these findings relate to the current body of previously completed research, as well as a description of potential limitations of the proposed study, and directions for future research. The student will work with a psychiatry faculty mentor, who will be determined based on the student’s interest.

Objectives:

Become familiar with research techniques utilized in the study of psychiatric illness and/or medical education within the field of psychiatry
Become familiar with the research process including development of a research question, literature review, IRB approval, research methodology, and abstract or manuscript submission

Methods: One-month psychiatric research elective in the Department of Psychiatry and Behavioral Neurosciences at Wayne State University. This elective will involve both self-directed study/review and regular meetings with a senior level faculty member to discuss the materials covered during the course. The elective will have both remote and in person components.

Recommended Reading Material/Resources: Readings will be assigned related to the specific research interest.

Length: 1 month; Days/Week: 5; Hours/Day: 8; Night Calls/Month: None

Additional Locations: Tolan Park Medical Building, 3901 Chrysler Service Drive, Detroit, MI 48201

Evaluation: Clinical evaluation and written

Chairman: Dr. David Rosenberg

Elective Coordinator: Dr. Mary Morreale

Category: Research, Non-Clinical

Recommended Attire: Casual attire when remote and business casual when in-person.

EMR System: N/A

Notes: This elective is done remote or in-person.

9265 - Outpatient Psychiatry - Henry Ford Health Service

Objectives: Students will rotate between Kingswood Hospital in Royal Oak Township and Henry Ford Cottage Hospital in Grosse Pointe. This elective is for senior medical students with plans of applying for residency training in Psychiatry.

Students will rotate through the partial day-hospital, the ECT clinic, and an outpatient psychiatric clinic. Medical students will have the opportunity to learn about the private practice model of psychiatric care. The student will attend grand rounds and meet weekly.

Goals: To learn about the partial hospital program and an outpatient private practice model of care. This elective experience includes an opportunity to observe and learn more about electroconvulsive therapy (ECT), dialectical behavior therapy, and an outpatient practice.

Objectives: 1. Learn to conduct complete initial psychiatric evaluations 2. Participate in ongoing management including medication evaluations and therapy appointments 3. Participate in multidisciplinary treatment team meetings 4. Attend all scheduled dialectical behavioral therapy groups 5. Be empathic, respectful, curious, open, nonjudgmental and collaborative 6. Learn about approach to management and modalities such as combined therapy and medication management, ECT, and group therapy

Recommended Reading Material: The American Psychiatric Publishing Textbook, Sixth Edition. Free Access for Henry Ford Students at: http://psychiatryonline.org/doi/book/10.1176/appi.books.9781585625031

Category: Ambulatory

9267 - Brain Imaging Psychiatry Research - Tolan Park Medical Building

Course Prerequisites: N/A

Description: N/A

Objectives: The student will: 1. Be exposed to and participate in research studies pertaining to various neuropsychiatric disorders: Adult and/or Childhood onset. 2. Identify a neuroscience project related to neuroimaging. 3. Learn image acquisition approaches and image processing techniques for MRI, functional MRI and MR spectroscopy. 4. Participate in data analysis and interpretation of research results. 5. Orientation to human brain neuroanatomy and neurochemistry. 6. Observe and participate in the preparation of manuscripts and scientific presentations.

Methods: One month research elective in the Brain Imaging Research Division in the Department of Psychiatry and Behavioral Neurosciences at Wayne State University.

Recommended Reading Material/Resources: Readings will be selected based on the specific project.

Length: 1 month; Days/Week: 5; Hours/Day: 8; Night Calls/Month: None

Additional Locations: Suite 5B - Tolan Park Medical Building, 3901 Chrysler Service Drive, Detroit, MI 48201

Evaluation: Clinical evaluation and written

Coordinator(s): Drs. Jeffrey Stanley & Vaibhav Diwadkar

Category: Research, Non-Clinical

Recommended Attire: Casual attire when remote and business casual when in-person.

EMR System: N/A

Notes: This elective is done remote or in-person.

9270 - Child & Adolescent Psychiatry - Multiple Locations

Course Prerequisites: 1 student. Completion of core clerkship in psychiatry is required! Elective is open to visiting medical students, though WSU students receive preference when scheduling.

Objectives: Experience of a variety of children and adolescents with psychiatric disorders; evaluation of patients and provision of care.

Recognition of normal and abnormal social and emotional development in children and adolescents, as manifested by the clinical psychopathology of childhood.
Exposure to an array of child and adolescent treatment settings, services and interventions in the community.
Participation in outpatient interdisciplinary team assessment and discussion at multiple levels of community/ambulatory care, including general as well as specialty treatment teams.

Methods: One-month clinical experience incorporating didactics and seminars, clinical discussion, patient assessment and treatment; community agency, State Hospital and pediatric hospital observation; and self-directed reading.

Recommended Reading Material: (Purchase suggested) Stubbe, Dorothy, Child and Adolescent Psychiatry: A Practical Guide (Practical Guides in Psychiatry),

Lippincott, Williams and Wilkins

Length: 1 month; Days/Week: 5; Hours/Day: 8; Night Calls/Month: None

Additional Locations: University Psychiatric Center/Livonia

Evaluation: Attendance, Professionalism, Quality of clinical and discussion-based participation

Recommended Attire: Business professional (with flexibility when it is necessary to sit on the floor with a child) NO white coats!

Coordinator: Dr. Rebecca Klisz-Hulbert

Notes: Students missing more than 2 days on service during the month may be required to make up time missed at the discretion of the rotation director. Students will be required to complete Wayne Health paperwork 4 weeks prior to the elective start date.

Category: Inpatient Consult Service

9270 - Child & Adolescent Psychiatry - Henry Ford Health Service

Course Prerequisites: This elective is designed for senior medical students who have plans of applying for residency training in Psychiatry.

Description: Students will experience of a variety of children and adolescents with psychiatric disorders; evaluation of patients and provision of care. Students will primarily rotate in the child unit of our inpatient Psychiatry hospital (currently Kingswood in Ferndale, will be moving to our new inpatient facility in West Bloomfield once opened, date TBD). Based on faculty availability and student interest, opportunities to rotate in one of our outpatient child psychiatry clinics may be an option for part of the rotation.

Objectives: 1. Recognition of normal and abnormal social and emotional development in children and adolescents, as manifested by the clinical psychopathology of childhood. 2. Exposure to child and adolescent inpatient psychiatric treatment, services and interventions in the community. 3. Participation in interdisciplinary team assessment and discussion.

Recommended Reading/Resources: To be assigned.

Length: 1 month; Days/Week: 5; Hours/Week: 40; Night Calls/Month: N/A

Additional Locations: Henry Ford Dearborn Clinic, Kingswood Hospital Inpatient Child Psychiatry Hospital (will be moving to new inpatient facility in West Bloomfield once opened), possible outpatient experiences, sites TBD

Evaluation: Clinical evaluation

Preceptor(s): varies, Dr. Shehryar Khan

Director(s): Anjali Thakrar, MD

Recommended Attire: Business professional

EMR System: EPIC

Category: Inpatient Consult Service

9290 - Psychiatric Consultation - St Mary Mercy Hospital/Livonia

Course Prerequisites: None - Course Permissions

Description: This rotation is a clinical training experience designed to prepare medical students to promote advancement of basic psychiatric medical care and overall clinical care to provide the most effective patient treatment regardless of the students’ ultimate specialty choice. The rotation encourages self-reflection and challenges basic assumptions about the nature of human behavior and psychiatric illness. Students will also have the opportunity to observe, interview, examine, and manage, under appropriate supervision, a variety of patients with common neuropsychiatric disorders. The student will be given more patient responsibilities and have expectations to function at a sub-intern level.

Students will develop their knowledge and skills associated with the psychiatric interview; mental status examination; development of knowledge base in behavioral medicine and treatment of psychiatric illness.

Objectives:

Perform full-length psychiatric evaluation for multiple common psychiatric illnesses including depressive and anxiety disorders, bipolar disorder, psychotic disorders.
Be able to formulate an adequate differential diagnosis for common psychiatric presentations including behavioral disturbances.
Be able to provide an appropriate medical work up for psychiatric presentations.
Conduct and present a complete mental status exam.
Present team educational discussions regarding unique cases and/or learning points

Methods: Medical students will have opportunity to engage in multiple different psychiatric teams and settings including inpatient mental health unit (MHU), psychiatric consultation/liaison service (C/L), psychiatric emergency services (PES), and ambulatory psychiatric clinic (OPC). Rotations will be at least for a weekly basis minus excused medical school approved absences. If there is a particular preference to have a more in-depth experience on a particular service, then this request should be made well in advance and efforts will be made to accommodate these learning experiences as feasible.

9290 - Psychiatric Consultation - St Joseph Pontiac

Course Prerequisites: None - Course Permissions

Description: Knowledge and skills associated with the psychiatric interview; mental status examination; development of knowledge base in behavioral medicine and treatment of psychiatric illness.

Objectives: 1. Perform full-length psychiatric evaluation for multiple common psychiatric illnesses including depressive and anxiety disorders, bipolar disorder, psychotic disorders. 2. Be able to formulate an adequate differential diagnosis for common psychiatric presentations including behavioral disturbances. 3.Be able to provide an appropriate medical work up for psychiatric presentations. 4.Conduct and present a complete mental status exam.

Recommended Reading/Resources: To be assigned.

Length: 1 month; Hours/Week: 40; Days/Week: M-F; Night Calls/Month: None

Additional Locations: Trinity Health Oakland

Evaluation: New Innovations evaluation

Preceptor(s): Michelle Allison, MD

Category: Inpatient Consult Service

Recommended Attire: Professional

EMR System: EPIC

Director: Camelia Arsene, MD, PhD, MHS

Coordinator: Gayle Bellman

9300 - Psychiatry: Geriatrics - Henry Ford Health Service

Course Prerequisite: Completion of MS3, including core psychiatry clerkship. This course requires permission to enroll.

Description: This rotation will focus on Geriatric Psychiatry. Students will have the opportunity to explore clinical issues at the critical juncture in elderly care – the border between full autonomy and assisted living. The student will play an active role in the assessment and treatment of full spectrum of geriatric psychopathology in varied settings. The student will work with geriatric psychiatrist in the outpatient clinics. In these settings, they will participate in new assessments and ongoing evaluation of older adults and address issues relating to mood problems, memory, and functional ability among other geriatric psychiatric issues. Students will assess patients with memory problems and master the administration and interpretation of the MMSE and the MOCA. The student will have a maximum of 3 new patients, 3 follow-ups. Supervision is consistent and constant due to the nature of the clinic set up.

Objectives: Geriatric Psychiatry

The medical student will understand that the progression in longevity of the American population together with rising costs of disability has generated renewed interest in the area of Geriatric Psychiatry.
The medical student will appreciate and address the unique psychosocial issues in the elderly to optimize care.
The medical student will demonstrate competency in the diagnosis and treatment of medical and neurologic illness, psychiatric disorders in the elderly.

Methods:

Supervision: The student will have direct supervision and indirect supervision with a staff psychiatrist daily and direct supervision with a staff neuropsychologist daily. All cases will be discussed and reviewed. All documentation will be reviewed.
Didactics/Educational Conferences: All students will be expected to participate in scheduled didactics and conferences during the duration of the rotation.

Recommended Reading/Resources:

Length: 1 month; Hours/Week: 45; Days/Week: 5 (Monday-Friday, 8 AM-5PM) Night Calls/Month: No weekend or overnight calls.

Additional Locations: General guideline for the layout of the rotation:

Mondays: ALTERNATE in person at Henry Ford Plymouth and virtual with Dr. Boore-Clor (IN PERSON & VIRTUAL)
Tuesdays: Henry Ford Dearborn with Dr. Boore-Clor (IN PERSON)
Wednesdays: Psych at Henry Ford Dearborn with Dr. Boore-Clor (VIRTUAL)
Thursdays: Neuro at Henry Ford W Bloomfield with Dr. Boore-Clor (VIRTUAL)
Fridays: Psych at Henry Ford Dearborn with Dr. Boore-Clor (VIRTUAL)

Evaluation: Staff psychiatrists will observe and rate the student in a clinical skills examination to observe interviewing and case presentation skills. Supervisors will rate the student using the end of rotation evaluation. Students will also receive individual feedback on documentation and performance during the rotation. Each student will evaluate the Geriatric Psychiatry Rotation as well as the supervisory staff.

Preceptor(s) Name(s): Dr. Laurie Boore-Clor (Site Supervisor)

Director: Hayley Getzen, MD, MPH

Coordinator: Yolanda Pitts

Category: Inpatient Consult Service

Recommended Attire: Business casual unless otherwise noted

EMR System: EPIC

9345 - Psychiatric Care of Veterans - Veterans Admin Hospital

Course Prerequisite: All VA electives require U.S. citizenship. Do not register for this elective without being able to provide your U.S. social security number for onboarding purposes. This elective is available to senior (4^th year) medical students with plans of applying for residency training in psychiatry.

Description: Students will join the inpatient psychiatry team. Depending on student interest, availability, and educational goals, some rotation through consultation liaison or emergency psychiatry may be added. Medical students on this rotation may join DMC/Wayne State University Psychiatry Residents for case conferences, and will have the opportunity to work closely with clinical faculty.

Objectives: To learn about psychiatric care of Veterans. To learn about presentation of psychiatric symptoms in a Veteran patient with focus on knowledge and application of DSM 5 criteria. To understand the delivery of psychiatric care of the Veteran patient in an integrated health-care system.

Methods: Develop skills at taking a patient history, mental status exam, and documentation of findings as you work collaboratively in a multidisciplinary team with psychiatry faculty and residents from the Wayne State/DMC program.

Recommended Reading/Resources: To be determined.

Length: 1 month; Days/Week: 5; Hours/Day: 7-8; Night Calls/Month: None

Additional Locations: N/A

Evaluation: Clinical evaluation.

Preceptor(s): N/A

Director(s): N/A

Coordinator(s): Umair Daimee MD; Michael Maksimowski MD

Category: Inpatient Consult Service

Recommended Attire: N/A

EMR System: N/A

Notes: Those interested can e-mail the coordinators for more information. See contact information on the course coordinator spreadsheet.

9350 - General Diagnostic Radiology - St John Hospital

Students have the opportunity to learn both Diagnostic & Nuclear Medicine on this rotation.

Objectives: 1. To acquire a basic understanding of the investigative approach for imaging department. 2. To acquire a basic understanding of various techniques for obtaining imaging. 3. To acquire a basic understanding and technique for x-rays of the chest, abdomen, gastroenterology, genitourinary, and skeletal system including the head and neck. 4. To acquire a basic understanding of computerized tomography of the head, spine and abdomen. 5. To acquire a basic understanding of ultrasound of the abdomen, pelvis, carotid arteries of the neck and other superficial organs. 6. To acquire a basic understanding of techniques for neuroangiography and general visceral angiography, including angioplasty. 7. To acquire a basic understanding of the techniques in invasive radiology, such as biopsies of lung and abdominal masses and draining of abscesses. 8. To acquire a basic understanding of MRI(Magnetic Resonance Imaging). 9. To acquire a basic understanding of Nuclear Medicine. 10. To acquire a basic understanding of Radiation Therapy.

Methods: Emphasis is placed on a one-to-one relationship between the radiologist and students. The first week consists of general diagnostic radiology including gastroenterology, genitourinary and emergency medicine - skeletal system. The second week will be a rotation for computerized tomography of the head and spine and radiation therapy and MRI. The third week will be a rotation in Ultrasound and CT of the abdomen and Nuclear Medicine. The fourth week will be a rotation in neuroangiography and visceral angiography. This will include invasive radiology. Daily conferences from 12:00 to 1:00 are offered to the student which are related to radiology and general medicine. There are also one-hour radiology conferences with the departments of surgery, pediatrics, medicine, family practice and Obstetrics/Gynecology which are available for the student. There is an extensive radiology teaching ARC discs in the library available for the student's use.

Recommended Reading Material: 1. Squire, Lucy F. Exercises in Diagnostic Radiology. 2. Meschan. Roentgen Signs in Clinical Practice. 2 volumes. 3. Juhl and Paul. Essentials of Diagnostic Roentgenology. 4. Felson, Fundamentals of chest Roentgenology. 5. Wiesbeck and Nice. C.A.T. of the Head. 6. Lee and Rau. C.A.T. of the Head. 7. Sarti and Sample. Diagnostic Ultrasound 8. Babcock. Cranial Ultrasould 9. Haughten and William. C.T. of the Braun J. 10. Haaga. Computed Tomography of the Abdomen 11. Bradley. M.R.I. Reference Book - available in Library. 12. Kapans. Breast Imaging. 13. Tabar & Dean. Atlas of Breast Imaging/ACR Video discs/Website: www.learningradiology.com

Length: 1 month; Days/Week: 5; Hours/Week: 25; Night Calls/Month: none

Evaluation: Routine evaluation during rotation

Category: Inpatient Consult Service

9350 - General Diagnostic Radiology - Henry Ford Health Service

Course Prerequisites: N/A

Description: Diagnostic Radiology offers students a comprehensive, practical rotation designed to introduce them to the many facets of medical imaging. Interventional, Neuro-radiology, Ultrasound, Nuclear Medicine, MRI and Computed Tomography are included. Entry-level audiovisual programs and books are available to the student.

Objectives: 1. To become familiar with the cost of diagnostic radiology exams and appropriate clinical indications for ordering exams 2. Enhance knowledge and skills pertaining to interpretation of data, clinical judgment and procedures (i.e., angiography, and interventional radiology). To gain experience in interpretation of basic radiology exams (chest, abdominal and bone x-rays) 3. To learn about basic radiology physics and the spectrum of radiologic technology used today 4. To understand the role of the radiologist as a consultant. 5. To increase student involvement in conferences, journal clubs.

Methods: This 4-week rotation will introduce medial students to a variety of topics useful to the basic understanding of diagnostic imaging and its role in patient care. Students will achieve the course objectives through daily clinical work supervised by senior residents and faculty, computer/web-based instruction, required reading, mandatory weekly lectures for medical students and daily resident conferences and case presentation. 40% inpatient care. 30% outpatient care. 30% conferences/lectures.

Recommended Reading Material: 1. Radiology 101, 2nd edition (Evkonen, WE) 2. Felson's Principles of Chest Roentenology (Goodman, LR) 3. Lectures

Length: 1 month; Days/Week: 5; Hours/day: 8; Night Calls/Month: 0

Evaluation: Participation and performance in conferences. Level of knowledge. Teaching file contributions. Observation of performance by faculty. Observation of performance by house officers. Assessment of write-ups/reports.

EMR System: EPIC

Category: Inpatient Consult Service

9350 - General Diagnostic Radiology - Detroit Medical Center

Objectives: 1. to become familiar with the cost of diagnostic radiology exams and appropriate clinical indications for ordering exams 2. to gain experience in interpretation of basic radiology exams (chest, abdominal and bone x-rays) 3. to learn about basic radiology physics and the spectrum of radiologic technology used today 4. to understand the role of the radiologist as a consultant

Recommended Reading Material: 1. Radiology 101, 2nd edition (Evkonen, WE) 2. Felson's Principles of Chest Roentenology (Goodman, LR) 3. Lectures

Length: 1 month; Days/Week: 5; Hours/day: 8; Night Calls/Month: 0

Evaluation: 1. Subjective clinical evaluation 2. Case presentation 3. Written final exam

Category: Inpatient Consult Service

9350 - General Diagnostic Radiology - St Joseph Pontiac

Recommended Reading Material: 1. Radiology 101, 2nd edition (Evkonen, WE) 2. Felson's Principles of Chest Roentenology (Goodman, LR) 3. Lectures

Length: 1 month; Days/Week: 5; Hours/day: 8; Night Calls/Month: 0

Evaluation: 1. Subjective clinical evaluation 2. Case presentation 3. Written final exam

Preceptor(s): Bashir Hakim, MD

Category: Inpatient Consult Service

9350 - General Diagnostic Radiology - Providence Hospital

Course Prerequisites: N/A

Methods: This rotation will introduce medial students to a variety of topics useful to the basic understanding of diagnostic imaging and its role in patient care. Students will achieve the course objectives through daily clinical work supervised by senior residents and faculty, computer/web-based instruction, required reading, mandatory weekly lectures for medical students and daily resident conferences and case presentation.

Recommended Reading Material: 1To be assigned.

Length: 1 month; Days/Week: 5; Hours/day: 8; Night Calls/Month: 0

Preceptor(s): Sachit Malde

Category: Inpatient Consult Service

9350 - General Diagnostic Radiology - Beaumont Dearborn

Objectives: The training period is designed to provide a broad exposure to general diagnostic radiology, nuclear and cross-sectional imaging with emphasis on mode of radiologic work-up, clinical problems and an understanding of expectations and limitations of radiology.

Methods: During the month the student will be expected to review selected cases from American College of Radiology Learning File in the department.The student will rotate through the various specialty sections of the department including chest, GI, Nuclear Medicine, Body CT, Ultrasound, Angiography and Neuroradiology (MRI). The student also has the opportunity to observe emergency room film interpretations. In addition, the student will be expected to attend didactic sessions in the department as well as inter and intra departmental conferences. On the average, these will number 10 per week. At the conclusion of the month, there is an opportunity to prepare a short presentation on a topic in Radiology of interest to the student. This will be presented to the Radiology Residents and Rotation Coordinator.

Recommended Reading Material: 1. Brant and Helms. Fundamentals of Diagnostic Radiology. 2. Squire. Fundamentals of Radiology 3. Mettler: Essentials of Nuclear Medicine Imaging.

Length: 1 month; Days/Week: 5; Hours/Week: 40; Night Calls/Month: none

Evaluation: Clinical evaluation

Category: Inpatient Consult Service

9350 - General Diagnostic Radiology - Veterans Admin Hospital

Course Prerequisite: All VA electives require U.S. citizenship. Do not register for this elective without being able to provide your U.S. social security number for onboarding purposes.

Objectives: 1. To gain familiarity with indications for and complications of commonly ordered radiologic examinations. 2. To understand role different imaging examinations play in evaluation of patients with wide degree of symptoms and diseases. 3. To gain expertise in interpretations of chest films, abdominal examinations, GI studies and IVP's. 4. To gain basic knowledge of principles of interpretation of CT, MRI, ultrasound and angiography

Category: Inpatient Consult Service

9360 - Intervention Radiology - Henry Ford Health Service

Course Prerequisites: N/A

Description:

Participate in daily inpatient rounding with IR team (Staff, Fellows, Residents, MLPs).
Assist in patient workup, consents, and procedures
- Review relevant patient history, allergies, mediations, PMH, labs, and pertinent imaging studies. Understand indications for the requested procedure and how it is performed.
Observe and help radiology technologists and nurses as they set up the room, bring the patients in, position them and prep and drape the field. Understand techniques used to perform the procedure.
Practice suturing with instruments and one/two hands.
Attend all IR related conferences – IR didactic, M &M, journal club, Aorta, GI and liver tumor board

Objectives: 1. Explain how the listed imaging modalities are used to guide procedures and differentiate when each is used: ultrasonography, fluoroscopy, CT. 2. List the common indications and techniques of the following common IR procedures: central venous access fluid aspiration and drain placement, angiography, percutaneous nephrostomy, percutaneous transhepatic cholangiography, gastrostomy tube placement, percutaneous angioplasty and stent placement. 3. Describe to a patient the following procedures: vascular access, angiography, fluid aspiration and drainage tube placement in stomach (gastrostomy), kidney (nephrostomy). 4. Critically assess requests for IR procedures and explain the factors that go into determining if a procedure is necessary and indicated, safe, and able to be performed. 5. Explain and demonstrate the factors used to reduce radiation dose during fluoroscopic and CT interventions.

Methods: Participate in daily inpatient rounding with IR team (Staff, Fellows, Residents, MLP's). Assist in patient workup, consents, and procedures. Review relevant patient history, allergies, mediations, PMH, labs, and pertinent imaging studies. Understand indications for the requested procedure and how it is performed. Observe and help radiology technologists and nurses as they set up the room, bring the patients in, position them and prep and drape the field. Understand techniques used to perform the procedure. Practice suturing with instruments and one/two hands. Attend all IR related conferences - IR didactic, M&M, journal club, Aorta, GI and liver tumor board

Recommended Reading Material: Kessel, D. Interventional Radiology: A Survival Guide, 3rd Edition. Kandarpa, K. Handbook of Interventional Radiologic Procedures, 5th Edition. Valji, K. Vascular and Interventional Radiology, 2nd Edition

Additional Locations: Henry Ford Hospital, Detroit MI, K3 Interventional Radiology

Evaluation:

Quiz: Students will be given a quiz at the end of the elective. This will cover general aspects of Interventional Radiology such as anatomy, indications, management, etc. It will be both image and non-image based. This will usually take place on the last day of the rotation.
Presentation: Students are expected to give a 15-20 minute presentation on a topic of their choice during the weekly IR divisional conference. Topics can be anything related to the rotation that is of interest – an interesting case, patient, disease process, or review of new literature regarding a procedure, technique, or disease process.
Evaluation: A written evaluation will be completed on all elective students. Input is requested from all staff and residents in IR. Students will also be asked to evaluate the rotation.

Category: Specialty Subinternship

9380 - Radiation Oncology - Detroit Medical Center

The location of this rotation includes the DMC and Karmanos Cancer Institute.

Course Description: The student will experience the fundamentals of the field of radiation oncology: clinical care, physics and radiobiology. This will be accomplished through patient contact in the consultation and treatment setting, the treatment planning phase and daily treatments. Students may also have the opportunity to further improve the following skills: physical exam, medical history, documentation of the clinical encounter and pain management. Basic sciences of physics and biology, as well as fundamental radiobiology will be wed in the course and how they apply to the clinical setting. Rotating students will be assigned to a different attending physicians each week. The medical student will shadow an attending physician-resident team to gain knowledge of the basic discipline of radiation oncology, attend related multidisciplinary conferences, and participate in patient consultations, weekly treatment examinations and follow-ups.

Objectives: Students will spend time in the treatment area (dosimetry and physics) as well as at the treatment machines to understand the full spectrum of the field. Students are expected to attend all resident conferences and multidisciplinary tumor boards in which the attending physician participates. A schedule will be provided on the first day. Each student will present a seminar on one particular cancer and the role of radiation therapy for that cancer. The talk will be scheduled at the end of the rotation. The chief resident will need to be engaged to mentor the seminar subject and style.

Recommended Reading Material: Introduction to Clinical Radiation Oncology (Coia, Lawrence R. and Moyland, David J.)

Length: 1 month, five days a week from approximately 8 a.m. to 5 p.m.

Evaluation: Students will be evaluated on observed skills, including patient interaction, communication-with patients and their families, amongst peers and with members of the patient care team.

Category: Inpatient Consult Service

9380 - Radiation Oncology - Henry Ford Health Service

Course Prerequisites: Required General Medicine and Surgery core clerkships. Pre-approval required

Description: Radiation Oncology is a specialty involving the use of external beam radiation therapy, brachytherapy and radiosurgery in the treatment of diseases of various parts of the body, usually malignant tumors. The student is expected to become familiar with certain aspects of the natural history, diagnosis, treatment and follow-up of various malignancies.

Objectives: Understand the role of radiation therapy in a variety of adult and pediatric malignancies. Enhance knowledge and skills pertaining to interviewing, physical examination, or patient interactions, interpretation of data, clinical judgment, therapy and advice to patients. Increase student involvement in conferences, journal clubs. Increase student use/review of the medical literature.

Methods: 10% inpatient care. 50% outpatient care. 30% conferences/lectures. 10% research. Students will see an average of 10 patients each week.

Length: 1 month

Evaluation: Quality of care given. Participation and performance in conferences. Level of knowledge. Level of skills. Observation of performance by faculty and house officers.Assessment of write-ups/reports.

EMR System: EPIC

Category: Inpatient Consult Service

9380 – Radiation Oncology - Michigan Healthcare Professionals

Course Prerequisites: None, but an interest in oncology can be helpful.

Description: Radiation Oncology is a specialty involving the use of external beam radiation therapy, brachytherapy, radiopharmaceuticals, and radiosurgery in the treatment of diseases of various parts of the body, usually malignant tumors. The student is expected to become familiar with certain aspects of the natural history, diagnosis, treatment and follow-up of various malignancies.

Objectives: To enhance knowledge and skills pertaining to interviewing, physical examination, or patient interactions, interpretation of data, clinical judgment, therapy and advice to patients. To increase student involvement in conferences, journal clubs. To increase student use/review of the medical literature relating to the specialty of radiation oncology.

Methods: Student can expect to explore the role of radiation therapy in a variety of adult malignancies in a typical outpatient setting. Students will be involved in consultations, follow-ups, treatment planning, H&Ps, brachytherapy and radiopharmaceutical procedures, and the managing of radiation treatment. Students will go through simulations to better acquaint themselves with the radiation oncology field.

Recommended Reading/Resources: To be assigned.

Length: 1 month; Hours/week: 45 hours (students can expect to see patients on a typical day from 8 a.m.-5 p.m.); Days/week: 5 (Monday-Friday); Night calls/month: None

Additional Locations (some flexibility regarding office location based on student preference):

MHP Radiation Oncology Institute Clarkston – 6770 Dixie Highway, Suite 106, Clarkston, MI 48346, (248) 625-0300
MHP Radiation Oncology Institute Farmington Hills – 28595 Orchard Lake Rd., Suite 110, Farmington Hills, MI 48334, (248) 553-0606
MHP Radiation Oncology Institute Macomb – 17435 Hall Rd., Macomb, MI 48044, (586) 228-0299
MHP Radiation Oncology Institute Madison Heights – 30365 Dequindre Road, Madison Heights, MI 48071, (248) 589-5000
MHP Radiation Oncology Institute Pontiac – 70 Fulton Street, Pontiac, MI 48341, (248) 338-0300
MHP Radiation Oncology Institute Troy – 4550 Investment Drive, Suite B11, Troy, MI 48098, (248) 952-5019

Evaluation: New Innovations evaluation

Preceptor(s):

Vito Antonucci, MD
Larry Kestin, MD
Frank Vicini, MD
Thomas Boike, MD
Ahmed Ezz, MD
Kay Miller, MD
Michael Ghilezan, MD
Alvaro Martinez, MD

Category: Ambulatory

Recommended Attire: Business Casual

EMR Systems: Epic, Mosaiq

Coordinator: Amy Lemke

Director: Larry Kestin

9390 - General Surgery - St Joseph Pontiac

Objectives:1. To acquire experience in the treatment of a wide variety of general surgical problems, especially laparoscopic surgery. 2. To diagnose and treat urgent and emergency surgical problems such as perforated ulcer, acute appendicitis, upper and lower GI bleeding, bowel obstruction, etc. 3. To learn the appropriate roles of various diagnostic modalities in the work-up of surgical problems such as FAST, x-rays and C-T scanning, nuclear medicine tests, and clinical laboratory tests. 4. To develop skills in common procedures on surgical patients such as chest tube insertions, central line placements, arterial mean catheterization, etc. 5. To gain experience in the evaluation and outpatients care of surgical patients on an ambulatory basis as seen in the surgical clinics. 6. To learn the rapid assessment and operative and nonoperative treatment of a wide variety of trauma patients. 7. To be exposed to the latest laparoscopic surgical procedures.

Methods: 1. Students are assigned to one of three general surgical services. 2. Daily bedside rounds with chief surgical resident and junior resident on the service assigned. 3. Teaching rounds two hours weekly with board certified general surgeon and surgical residents. 4. Participation in all surgical conferences including subspecialty conferences and grand rounds and journal club on Saturday morning. 5. The student is not required to take any night call. 6. The student will have daily operative experience with senior resident and attending staff.

Recommended Reading Material: 1. Hardy. Critical Care for the Surgical Patient. 2. Swartz, Seymour. Principles of Surgery. 3. Slide tape program also available.

Length: 1 month; Days/Week: 5 1/2; Hours/Week: 50; Night Calls/Month: 4 recommended

Evaluation: Clinical evaluation

Preceptor(s): Amy Kirby, MD

Category: Specialty Subinternship

9390 - General Surgery - Henry Ford Hospital-Macomb

Cardiothoracic and Vascular surgery (Macomb) Staff : Dr. Alnajjar

Objectives: Students on the Henry Ford Macomb surgery service will participate in the care of elective thoracic and vascular and cardiac surgery cases as well as emergency thoracic and vascular cases including thoracic and vascular trauma, this will include evaluation and management of lung cancer, pneumothorax, pleural effusion, mediastinal masses, coronary artery disease, valvular heart disease, rib fractures and hemothorax, limb ischemia, aortic aneurysms and dissection. Also there will be a good amount of exposure to minimal invasive surgery including Robotics and VATS procedures. There will also be a great amount of exposure for bronchoscopic procedures. Students will have the opportunity to scrub and assist in all the above cases, to do thoracenteses under supervision and also see patients in the clinic.

Coordinator: Medical Education

Category: Specialty Subinternship

9390 - General Surgery - Sinai Hospital

Objectives: 1. Become proficient in the clinical evaluation and management of surgical diseases 2. Expose the student to a variety of elective and acute surgical cases 3. Acquire diagnostic and therapeutic skills (peritoneal lavages, chest tube insertion, CVP placement)

Methods: 1. The student will be part of the surgery residents' team and function as a "junior resident". 2. The student is expected to be current and write in each patient's clinical progress and participate in case presentations. 3. Daily - (one hour) rounds with clinical faculty members.

Recommended Reading Material: 1. Schwartz - Principles of Surgery - Latest Edition 2. Sabiston - Textbook of Surgery - Latest Edition

Length: 1 month; Days/Week: 6; Hours/Week: 50-60; Night Calls/Month: 5-6

Evaluation: Clinical evaluation

Instructor: Dr. K. Bland

Category: Specialty Subinternship

9390 - General Surgery - Henry Ford West Bloomfield

Course Description: Henry Ford – West Bloomfield. General and Acute Care Surgery

Staff: Dr. Puraj Patel Students on the West Bloomfield surgery service will participate in the care of elective general surgery as well as emergency general surgery patients. 

Description: Emergency general surgery includes the evaluation and management of patients with an acute abdomen, appendicitis, biliary tract disease, intestinal obstruction or perforation, and soft tissue abscesses. 

Objectives: Elective general surgery will include gall bladder, soft tissue, and various hernia repairs.  Additionally, there may also be some exposure to bariatric surgery and advanced minimally invasive surgery including robotics and complex abdominal wall reconstruction.  Students may also have the opportunity to see patients in the clinic setting and see the initial evaluation and workup of general surgery pathology.

Category: Specialty Subinternship

9390 - General Surgery - St John Hospital

Recommended Reading Material: 1. Hardy. Critical Care for the Surgical Patient. 2. Swartz, Seymour. Principles of Surgery. 3. Slide tape program also available.

Length: 1 month; Days/Week: 5 1/2; Hours/Week: 50; Night Calls/Month: 4 recommended

Evaluation: Clinical evaluation

Coordinator: Kathy Clancy

Instructor: Dr. Donn Schroder

Category: Specialty Subinternship

9390 - General Surgery - Beaumont Dearborn

Objectives: 1. To experience what surgical practice is like 2. To learn more about the field of surgery

Methods: The student could select or be assigned to, one or more practicing surgeons, and follow in their surgeries, consults, office, emergencies, etc. usually for a week or more at a time

Recommended Reading Material: Standard texts and journals

Length: 1 or 2 months; Days/Week: 5; Hours/Day: 8; Night Call/Month: usually 2 - 4

Evaluation: By coordinator, mentors and residents. Coordinator: Jill Balazsi

Category: Specialty Subinternship

9390 - General Surgery - Henry Ford Health Service

Course Prerequisites: N/A

Description: Students will gain experience in a variety of elective and acute surgical cases; diagnostic skills; basic surgical techniques and procedures. This rotation offers 4th-year students the opportunity to participate in evaluation and management of patients with benign and malignant breast disease, hernias, surgical diseases, melanoma and sarcoma problems, laparoscopic cholecystectomies and other laparoscopic surgical procedures and the entire range of abdominal and gastrointestinal surgery. Senior residents and surgeons participate in all educational activities and are on-call approximately every fourth night. This program pairs selected students with senior staff surgeon preceptors to provide a high quality clinical and research experience.

Objectives: To teach students basic surgical principles and the pathophysiology, diagnosis, management of a variety of surgical conditions. To increase student involvement in conferences, educational rounds. To increase student use/review of the medical literature. To appreciate surgical work style.

Methods: 50% inpatient, 45% outpatient, 5% conferences/lectures. Students will see an average of 3-5 patients per week.

Recommended Reading/Resources:

Length: 1 month; On-call responsibility: Every 4 days

Evaluation: Quality of care given. Interest, commitment, and stamina. Participation and performance in conferences. Level of knowledge. Level of skills and H&P's notes. Enthusiasm, willingness, ability to function as part of resident team. Methods of evaluation: Observation of performance by faculty and house officers; Assessment of write-ups/reports; Other structured skills testing; Preparatory for Operating Room Division.

Preceptor(s): Staff

Category: Specialty Subinternship

EMR System: EPIC

9390 - General Surgery - Detroit Medical Center

Course Prerequisites: None

Description: The student will be attached to the resident team, working up elective and emergency surgical patients. Will scrub a variety of surgical procedures, including surgical oncology, gastrointestinal surgery, minimally invasive surgery and inpatients consults. Outpatient clinic is once per week. Didactics consist of grand rounds, morbidity and mortality conference, and team rounds. The student may be asked to present a topic at weekly rounds.The student will work on accomplishing certain procedures, starting i.v's, foley placement, central venous catheter placement and arterial line placement via ultrasound guidance and possibly chest tube placement. Student should become more facile with imaging and laboratory test reading and interpretation and recommendation of management and differential diagnoses pertaining to full constellation of the patient.

Objectives: To become familiar with and develop house officer level skills in evaluation, management, extended differential diagnosis and procedural through inpatient , emergency department and the outpatient exposure and care of the surgical patient. To develop skills in preoperative and postoperative care as well as, to become more experienced in the operating suite in the acute care surgical and elective arenas.

Methods: This will be accomplished as part of the surgical team as daily activities of this surgical team directs the student to the variety of scenarios throughout the rotation. The student will round, see surgical consults, and go to the operating room with the assigned surgical team as well as take call about once per week.

Recommended Reading: Cameron Current Surgical Therapy

Length: 1 month; Hours/Week: 80; Days/Week: 6; Night Calls/Month: 4

Additional Locations: Detroit Medical Center, Harper Hospital, Detroit Receiving Hospital.

Evaluation: The evaluation will be filled out by faculty based on interaction on the service through office, rounds and the operating room.

Preceptor(s): Alfred Baylor, III MD, David Edelman MD, Steven Tennenberg

Category: Specialty Subinternship

Recommended Attire: Scrubs, Business Professional, White Coat

EMR System: Citrix

Coordinator: Nancy Linenger

9392 - Residency Preparation: Surgical - Gordon H Scott Hall

Description: Offered by the Wayne State University Department of Surgery. Students will learn advanced surgical skills in preparation for their surgery residency program.

Objectives: Participation in this course will leave the student much better prepared to start his or her residency which will begin in a few short months. The goal is to go beyond the basic surgical patient management skills that were learned in your third-year clerkship and in the fourth year sub-internship. We hope to introduce you to many techniques in open, laparoscopic and vascular surgery along with use of surgical ultrasound and care of the general surgical patient - focusing on problems that you will see as an intern - and looking at surgical anatomy from a surgeon’s point of view.

Methods: The activities will be centered on the following themes:

Pre and post elective testing. On the first and last day of the rotation, you will spend the day having your skills evaluated in both open and laparoscopic skills.
Surgical anatomy. The syllabus will be handed out the first day. There will be an exam at the end of the rotation. (limited in April)
Patient management problems, affectionately known as PMP. Much of the Resident Prep curriculum from the American College of Surgeons will be used for this instruction
Laparoscopic skills lab. The laparoscopic simulators are in the Mazurek Education Building and these will be used every day for instruction and practice.
Surgical techniques. A collection of modules and surgical techniques will be lead by the staff. There will be ample practice time and hands-on practice is required.
Ultrasound techniques
Electrosurgery principles
Additional sessions Probably the most unique and valuable part of this elective is the chance to sit and talk surgery with actual practicing surgeons on a daily basis. Please appreciate this golden opportunity and take advantage of it!

There will be no direct patient care involved in this rotation. This is a techniques and knowledge rotation.

Recommended Reading/Resources: The required texts for this course are as follows. (Each is available and in stock at Barnes/Noble or Amazon.com.) Possibly available as an eresource at Shiffman Library.

On Call Surgery, 4^th Edition, by Adams, Forrester, Rosenberg and Bresnick

Recommended texts

Netter’s Surgical Anatomy and Approaches by Delany (avail. on line through Shiffman Library and Henry Ford Library)
Surgical Anatomy and Techniques: A Pocket Manual, 3rd Edition, by Skandalakis
Surgery Boot Camp Manual: A Multimedia Guide for Surgical Training Jones and Gupta (optional)
Outliers, by Malcolm Gladwell, suggested reading before the course

Further resources are available at accesssurgery.com.

Length: 1 month; The hours will be from 8:00 A.M. to 4:00 P.M. daily. Extra time will be available for practice outside of these hours if needed. There will be no weekend sessions held except for robot training when available. Schedules will be distributed for the course on the first day of your rotation and will need to be frequently adjusted based on availability of the surgeon instructors.

Attendance: We expect and require no less than 100% from each student. There are no days off except for extenuating circumstances. If you are looking for an easy month off, this is not the course for you.

Additional Locations: Home base for this rotation will be in the Surgical Task Training Room, Room 230 in the Mazurek Education Building. We will try and do most sessions in person, but there will be a few here or there that will be on Zoom. Some sessions will also be held in the Henry Ford Hospital Skills Center and conference rooms.

Evaluation: Multiple tests and quizzes. Practical skills testing. Evaluation of improvement in skills.

Category: Non-Clinical, Residency Prep (TTR)

Recommended Attire: “non clinical”

9393 - Breast Surgery - Barbara A Karmanos Cancer Inst

Description: Students will gain exposure to the diagnosis and treatment of breast diseases at the Walt Comprehensive Breast Center.

Category: Specialty Subinternship

9393 - Breast Surgery - Henry Ford Health Service

Course Prerequisites: Core surgical clerkship

Description: Rotation with the Henry Ford surgical breast oncology team.

Objectives: Obtain thorough knowledge of breast examination, workup and management of a breast mass and mammographic lesions, and management of benign and malignant breast disease.

Methods: Participation with the Henry Ford Breast Oncology Program. This rotation focuses on surgical management and treatment, but experience with medical oncology, radiation oncology, and breast imaging will be possible at tumor board meetings.

Evaluation: subjective clinical evaluation Resources (required reading, etc) deVirgilio Surgery, Part II Breast Work

Recommended Reading: deVirgilio Surgery breast chapters

Length: 1 month; Hours/Week: 40-60; Days/Week: 5 (M-F) with possible weekend rounds if there are inpatients to see; Night Calls/Month: None

Additional Locations: Henry Ford Health Service, Henry Ford West Bloomfield.

Evaluation: Summative clinical evaluation

Preceptor(s): Lindsay Petersen

Category: Specialty Subinternship

Recommended Attire: Scrubs, Business Professional, White Coat

EMR System: EPIC

9400 - Acute Burn Care - Detroit Receiving Hospital

Objectives: Learn about acute burn care, learn about resuscitation management of complications and operative care of burns.

Methods: Students will be a member of burn team and participate in daily care of patients, daily OR's, see patients in clinic and participate in rounds

Recommended Reading Material: Articles and book chapters provided

Length: 1 month Days/week: 5; Hours/day: 8; Night/call month: 4 0

Evaluation: Subjective clinical evaluation.

Category: Specialty Subinternship

9410 - Cardiovascular Surgery - Detroit Medical Center

Course Prerequisites: N/A

Thoracic Surgery Description: Thoracic surgery elective available to 4^th year students. Motivated students with an interest in thoracic surgery will gain exposure to the full spectrum of tertiary level thoracic surgical disease including both benign and malignant diseased of the lung, esophagus, mediastinum, chest wall and diaphragm. Students will participate in activities in the operating room, ICU, surgical floor and clinic with senior staff, PAs and surgical residents. There is an emphasis on thoracic oncology and minimally invasive thoracic surgery, including thoracoscopic and robotic surgery. Students are required to perform a complete history and physical examination on at least two patients per week and follow their patients from the OR through discharge. The rotation can be customized to ensure adequate exposure to the student’s area of particular interest. Experience with cardiac surgery, including ischemic heart disease, structural heart, transplant and mechanical assist can be arranged if desired.

Cardiac Surgery Description: The student will be involved in all aspects of perioperative care of the cardiac surgery patient including preoperative assessment, surgical care, and postoperative management. The students will become familiar with treatments unique to cardiac surgery including cardiopulmonary bypass and postoperative care of the critically ill cardiovascular patient. Emphasis will be placed on time in the operating room for both scheduled and emergency cases.

Objectives: At the conclusion of the clerkship, the student should have familiarity with the major thoracic surgical disease prostheses. Each student is given a syllabus outlining the reading requirements. Didactic sessions cover most of the material outlined. Students are perform a complete history and physical examination on two patients per week. The students participate in both operative and ward activities with the cardiothoracic staff.

Methods: The student is exposed to the full spectrum of tertiary care cardiac and thoracic surgery. The clerkship can be individualized to the students interests so as to maximize exposure in the operating room, intensive care unit, outpatient clinic and wards or medical/surgical conferences. Students can focus specifically on thoracic or cardiac surgery for a more in-depth learning experience.

Recommended Reading/Resources:

Thoracic Surgery Track: Selected readings from: Adult Chest Surgery, Sugarbaker, et al.
Cardiac Surgery Track: To be provided.

Length: 1 month; Days/Week: 5-6; Hours/Week: 50-60; Night Call/Month: varies, no more than q4, home

Evaluation: Clinical performance, history and physical, daily activities

Preceptor(s):

Thoracic Surgery Track: Dr. Frank Baciewicz
Cardiac Surgery Track: Dr. Kenton Zehr

Category: Specialty Subinternship

Recommended Attire: N/A

EMR System: N/A

Notes: This is a course separated into two sections - cardiac and thoracic surgery. Please contact coordinator Nancy Linenger (nlinenge@med.wayne.edu) for more information about the course and to finalize section request.

9410 - Cardiovascular Surgery - Henry Ford Health Service

Course Prerequisites: N/A

Recommended Reading/Resources:

Thoracic Surgery Track: Selected readings from: Adult Chest Surgery, Sugarbaker, et al.
Cardiac Surgery Track: To be provided.

Length: 1 month; Days/Week: 5-6; Hours/Week: 50-60; Night Call/Month: varies, no more than q4, home

Evaluation: Clinical performance, history and physical, daily activities

Preceptor(s):

Thoracic Surgery Track: Dr. Andrew Popoff
Cardiac Surgery Track: Dr. Hassan Nemeh

Category: Specialty Subinternship

Recommended Attire: N/A

EMR System: EPIC

9440 - Pediatric Surgery - Childrens Hospital

Objectives: 1. To gain experience in the diagnosis and care of surgical disorders in children. 2. To improve skills in surgical ward procedures. 3. To be exposed to the cooperative multidisciplinary care required for children with multiple congenital anomalies. 4. To improve interpersonal communication skills by direct involvement inpatient care.

Methods: This course is appropriate for students planning careers in either pediatrics or surgery. The course emphasis is on clinical evaluation and management of congenital anomalies of surgical importance as well as acquired surgical disease. Student's responsibility is determined by individual knowledge and application, but will include history and physical examinations complete with formulation of a diagnostic evaluation and treatment plan. Regular attendance on ward rounds, assistance on operative procedures and presence at didactic teaching conferences will be required.

Recommended Reading Material: To be assigned.

Length: 1 month; Days/Week: 5; Hours/Week: 40-60; Night Calls/Month: none

Category: Specialty Subinternship

9470 - Plastic & Reconstructive Surgery - Harper Hospital

Course Prerequisites: All VA electives require U.S. citizenship. Do not register for this elective without being able to provide your U.S. social security number for onboarding purposes.

Description: Learn about the specialty of plastic and reconstructive surgery. It is more than what you see on television or social media. Students will be instructed in basic techniques of complex wound management within the general area of plastic surgery including hand, facial trauma, reconstructive, microvascular, and aesthetic surgery. At completion of the course, students will have obtained a better understanding and a balanced perspective of plastic surgery.

Objectives: 1. To acquire experience in day-to-day management of plastic and reconstructive surgery needs for functional, traumatic, congenital and oncologic conditions. 2. To evaluate and formulate a treatment plan for patients including participation in surgery and postop care for a variety of plastic surgery patients at DMC Hospitals (Harper University Hospital, Detroit Receiving and Children’s Hospital). 3. To learn techniques, principles and approaches of skin closure, wound healing, complex wound reconstruction including skin grafting and flaps. 4. To learn techniques, principles and approaches in general plastic surgery, breast reconstruction, burn reconstruction, hand surgery and pediatric craniofacial surgery.

Methods: Students will function as sub-interns and be an integral part of the team. They will learn from inpatient daily bedside rounding and inpatient/emergency room consults, assessment of patients in the outpatient clinic setting, participating in operative procedures, and participation in plastic and reconstructive surgery conferences.

Recommended Reading Material: Grabb and Smith’s Plastic Surgery is a good general text for most patients and surgeries that you will encounter. We always recommend asking the resident you will be working with what to read, and this is best done the day before surgery. Essentials for Students “Plastic Surgery” is a brief text that is good as well. PDF available

Length: 1 month; Days/Week: 5; Hours/Week: 40-50; Night Calls/Month: Optional

Additional Locations: Detroit Medical Center, Children's Hospital, Harper/Detroit Receiving Hospital, Veterans Admin Hospital

Evaluation: Evaluation process includes daily clinical evaluation with verbal feedback with a final written evaluation at the end of the rotation.

Preceptor(s): Guillermina Nava, M.D., Faisal Al-Mufarrej, M.D., Ahmed Hashem, M.D., Mihaela Rapolti, M.D., Arlene Rozzezelle, M.D. - all have med.wayne.edu email addresses

Category: Specialty Subinternship

Recommended Attire: Scrubs, for clinic-only days casual business attire is appropriate with a white coat or school issued track jacket

EMR System: Cerner- PowerChart

9470 - Plastic & Reconstructive Surgery - Henry Ford Health Service

Course Prerequisites: N/A.

Description: The student accompanies the residents and staff on inpatient rounds, in the clinic and operating room. The Plastic Surgery Division is set up for maximal involvement of residents and students in all aspects of inpatient and outpatient care. For students electing the eight-week rotation, participation in a "mini-research" clinical project is expected. The student also must attend a mandatory Hand Anatomy Dissection Course given by Plastic Surgery senior staff. For two month rotators -- a Micro surgery Course is optional.

Objectives: Enhanced knowledge and skills pertaining to interviewing, physical examination, patient interactions, interpretation of data, clinical judgment and procedures. (surgery techniques, therapy, and advice to patients.) Increase student involvement in conferences, journal clubs, etc. Increase student use/review of the medical literature.

Methods: The student accompanies the residents and staff in inpatient rounds, in the clinic and operating room. The Plastic Surgery Division is set up for maximal involvement of residents and students in all aspect of inpatient and outpatient care. For students electing the eight week rotation, participation in a written clinical research project is expected. The student must also attend a mandatory hand anatomy dissection course given by the Plastic Surgery senior staff. For the two-month rotators, an available microsurgery course is optional. 25% inpatient care. 50% outpatient care. 10% clinical rounds. 15% conferences/lectures.

Recommended Reading Material: To be provided.

Length: 1 or 2 months; Days/Week: 6; Hours/Week: 60; Night Calls/Month: None

Evaluation: Observation of performance by faculty and house officers. Assessment of write-up/reports. Written/oral tests. Other structured skills testing. Quality of care given. Participation and performance in conferences. Level of knowledge. Level of skills

EMR System: EPIC

Category: Specialty Subinternship

9480 - Surgical Intensive Care Unit - Harper Hospital

Objectives: 1) To learn the fundamental principles and practices of surgical critical care and its relation to the pathophysiology of surgical critical illness. 2) Develop critical care skills-arterial line, central venous line, pulmonary artery catheter, ventilator management, hemodynamic monitoring and support, nutritional support, ICU pharmacology, fluid and electrolyte therapy, organ failure support. 3) To learn teamwork in the multidisciplinary treatment of critically ill surgical patients.

Methods: 1) Daily rounds with SICU team consisting of attending intensivist, critical care fellow, surgery and anesthesia residents, nurse practitioner, pharmacist 2) Functioning as subintern and following several patients in SICU 3) Textbook and literature reading 4) Topic presentation 5) Lectures and journal club

Educational Experience: This rotation involves a one month rotation in the Surgical ICU of Harper Hospital which cares for surgical and surgical subspecialty (cardiothoracic, vascular, ENT, etc) patients. Students will serve as subinterns on the SICU team and follow several critically ill patients. Students will become members of the multidisciplinary critical care team and participate in daily teaching and work rounds. The rotation will provide teaching and experience in the practice and theory of surgical critical care, as well as procedure-oriented skills.

Category: Intensive Care Subinternship

9480 - Surgical Intensive Care Unit - Henry Ford Health Service

Course Prerequisites: Must have completed all core clerkships

Description: During this course, the student will function as a member of a busy surgical intensive care service, working closely with faculty, fellows, residents, and advanced practice providers. They will be exposed to a variety of critically ill patients with traumatic and acute pre and post-surgical conditions. They will have the opportunity to develop their knowledge and clinical decision-making skills with regards to the initial resuscitation, ongoing work-up, and definitive medical and surgical care of these critically ill patients.

Students will spend the rotation in the 40-bed Surgical Intensive Care Unit at Henry Ford Hospital, working alongside faculty, fellows, residents, and APPs throughout the month. They will attend the morning staff lectures along with the residents for additional education beyond the bedside teaching. Students will be assigned patients (with a house officer also assigned to the same patient for guidance), will pre-round on their assigned patients, and have an opportunity to present each of their patients on daily rounds to the fellow and staff rounder. This course offers exposure to a wide variety of complex pathology within the field of critical care and all general surgery and surgical subspecialties (including: trauma, acute care, vascular, transplant, thoracic, surgical oncology/HIPEC, general/endocrine, colorectal, plastic & reconstructive, ENT/head & neck cancer, urology, Ob/Gyn, and orthopedic surgery).

Objectives: This program provides exposure to a wide spectrum of complex pathophysiology, as well as the fundamental principles and practice of surgical critical care; identification and management of various disease processes and complications in critically ill patients; establishing priorities of treatment and assessment of changes in priority/type of treatment needed; multidisciplinary approach to patient care; resource utilization; and system/hospital coordination of care. Students will develop various skills within critical care including: arterial and central lines, hemodynamic monitoring, ventilator management, fluid & electrolyte management, organ failure support, nutritional support, and ICU pharmacology.

Methods: The student will participate as a team member on a busy surgical intensive care service seeing critically ill pre and post-surgical patients. The student will participate in rounds each day and present patients, observe and assist with minor invasive bedside procedures (a-lines), and major invasive bedside procedures (central lines, tracheostomy, endoscopy, and percutaneous gastrostomy). The student will spend time on the night shift with senior level residents, advance practice providers and fellows gradually increasing hands-on experience and have the opportunity to observe and assist with invasive bedside procedures (a-lines and central lines). 60% inpatient care. 30% clinical rounds. 10% conferences/lectures. Students will see an average of 10 patients each week.

Recommended Reading Material: "The ICU Book" - Paul Marino; any critical care textbook (Civetta, Fink, Parrillo, etc)

Length: 1 month; Hours/Week: 50-60; Days/Week: 5-6; Night Calls/Month: 0 required; Optional five to seven 12-hour shifts with a senior resident.

Additional Locations: N/A

Evaluation: Students will be observed by faculty, APPs, and house officers in the following domains: oral presentation of patients on daily rounds, progress notes/H&Ps, and presentation at end of clerkship on a topic of their choosing. Engagement as a team member with active participation on rounds. Evidence of self-directed learning and application of this in the interpretation of clinical data and care of patients. Participation in conferences. Observation of performance by faculty and house officers. Assessment of write-ups/reports.

Observation of student performance will be performed by faculty, APPs, and house officers, in addition to assessment of write-ups/reports. Presentation due at end of clerkship.

Preceptor(s): Dr. Arielle Hodari Gupta; Dionne Blyden; Dr. Erin Field

Category: Intensive Care Subinternship

Recommended Attire: Scrubs, Business Professional, White Coat

EMR System: EPIC

9495 - Advanced Maxillofacial Surgery - St John Hospital

Course Prerequisite: N/A

Objectives: The students will learn to perform a comprehensive head and neck exam with attention to distinguishing normal variation from pathology. Coordinate care plan utilizing community resources when necessary. Students will actively participate in the operating room and follow those patients post-op. Information Management - Interns face an extraordinary challenge in managing large amounts of clinical information relevant to a patients hospital admission. Accurate and timely acquisition, documentation and transfer of clinical information are necessary for safe and efficient hospital practice.

Methods: A. Be able to access the clinical information system in use at their hospital. B. Understand how panic values are communicated from the hospital laboratory to the responsible team member C. Use a systematic method to track clinical/laboratory/radiologic data. D. Be aware of patient confidentiality regulations governing medical records and clinical information. E. Understand the importance of precision and clarity when prescribing medications. F. Document in an organized and efficient manner G. Use electronic or paper reference to access evident based medicine to solve clinical problems

Procedures: The subinternship presents an opportunity to gain experience with procedures that are commonly performed by interns and residents. The subintern should be able to: A. Describe indications, contraindications, risks and benefits of each of the following procedures: Venipuncture, Intravenous catheter insertion, Intravenous catheter insertion, Arterial blood sampling, Nasogastric tube placement, Lumbar puncture, Urethral catheter insertion, Intramuscular and subcutaneous injections, Bag and Mask placement and utilization, Other procedures that are service appropriate B. Recognize clinical situations where one or more procedures are indicated. C. Effectively explain the rational, risks and benefits for the procedure in language that is understandable by the patient and/or his/her family. D. Obtain and document informed consent, if necessary E. Recognize limitations of skill or proficiency in performing one of the above procedures. F. Recognize potential procedure related risks for the operator and the need for universal precautions. G. Personally perform, with direct supervision, the above procedures, when possible. H. Write a procedure note. I. Ensure that samples obtained are properly prepared for laboratory processing. J. Teach procedure skills to a third year medical student, when appropriate.

Recommended Reading Material: To be provided

Length: 1 Month

Evaluation: Written

Category: Specialty Subinternship

9500 - Transplant Surgery - Henry Ford Health Service

Course Prerequisites: Required Surgery clerkship.

Description: The goal is to provide the student with a more in-depth understanding of the science and clinical practice of organ transplantation. The student spends time with residents and staff on inpatient rounds and at outpatient clinics where organ transplant recipients (kidney, liver, pancreas, and heart) are followed. The student participates in organ recovery procedures and organ transplant surgery. Opportunity for exposure to Tissue Typing Laboratory is available, as well as to Vascular Access Surgery (for hemodialysis patients).

Objectives: Teach students the basic surgical principles and the pathophysiology, diagnosis, management of a variety of surgical conditions. Increase student involvement in conferences, educational rounds. Increase student use/review of the medical literature. Appreciate surgical work style. Familiarize the student with all phases of kidney transplantation, including pretransplant evaluation of potential candidates; living and deceased donor organ procurement; intraoperative management and surgical technique, and postoperative medical and immunosuppressive management.

Method: Join all activities of combined transplant surgery/nephrology team(Drs. Gruber, Doshi, Singh and Menta; Surgery residents: Nephrology fellow; coordinators; pharmacist and social worker). Twice-daily rounds on inpatient transplant recipients; posttransplant outpatient clinic 3 mornings/week; pretransplant evaluation clinic one afternoon/week; transplant team meeting to review patients on the list 3 hours/week; didactic transplant lectures one hour/week; opportunity to scrub on all living-and cadaver-donor renal transplants, laparoscopic live-donor nephrectomies and multiorgan procurements. 40% inpatient care. 20% outpatient care. 20% conferences/lectures. 20% operating room.

Recommended Reading:: Transplant textbooks and key journal articles will be provided for study and reference.

Length: 1 month; Days/Week: 5; Hours/Day: 10; Night Call/Month: No schedule in-house call but expected to scrub on deceased donor transplants and multiorgan procurements.

Evaluation: Subjective clinical evaluation. Quality of care given. Interest, commitment, and stamina. Participation and performance in conferences. Level of knowledge. Level of skills and H&P's notes. Enthusiasm, willingness, ability to function as part of resident team. Observation of performance by faculty and house officers. Assessment of write-ups/reports. Other structured skills testing. Preparatory for Operating Room Division.

EMR System: EPIC

Category: Specialty Subinternship

9510 - Acute Care Surgery - Henry Ford Health Service

Course Prerequisites: Required Surgery clerkship.

Description: The student will function as a member of one of two acute care surgery teams, working closely with faculty, residents, and advanced practice providers. They will be exposed to a variety of patients with traumatic and acute surgical conditions. They will have the opportunity to develop their knowledge and clinical decision-making skills with regards to the diagnosis, resuscitation, work-up, and definitive care of these patients.

Objectives: The student will participate as a team member on a busy acute care surgery service seeing emergency room and inpatient consults. The student will participate in rounds each day and present patients, help with wound care and other minor bedside procedures (negative pressure wound therapy, drain, and line removal. The student will spend time in the operating room with gradually increasing hands-on experience and can observe and assist with invasive bedside procedures (lines, chest tubes, etc.)

Methods: The student will see an average of 10 patients per week. 85% inpatient care. 5% outpatient care. 10% conferences/lectures.

Recommended Readings/Resources: So You Want to Be a Surgeon, https://www.facs.org/for-medical-professionals/education/programs/so-you-want-to-be-a-surgeon/; Surgery: A Case Based Clinical Review, Second Edition, de Virgilio et al.

Length: 1 month; On-Call Responsibility: Not to exceed one every seven days.

Additional Locations: Henry Ford Detroit campus

Evaluation: Engagement as a team member with active participation on rounds and in the OR. Evidence of self-directed learning and application of this in the interpretation of clinical data and care of patients. Participation in conferences. Observation and assessment of performance by faculty and house officers using standard New Innovations M4 evaluation form.

Preceptor(s): Course Director: Dr. Erin Field, efield1@hfhs.org

Course Coordinator: Nancy Linenger, nlinenge@med.wayne.edu

Category: Specialty Subinternship

Recommended Attire: Business professional with white coat, scrubs for the operating room or bedside procedures.

EMR System: EPIC

9520 - Vascular Surgery - Harper Hospital

Objectives: A broad experience in the pre-operative assessment, perioperative and postoperative care of patients with arterial and venous disease.

Methods: Experience will include participation in daily inpatient care and rounds, operative procedures, perioperative care in ICU and hospital wards, outpatient vascular clinic and non-invasive vascular laboratory.

Recommended Reading Material: Current Vascular Surgery; Stanley/Ernst

Length: Work days/week 5-6, Approx hours/day 6-10, Night calls/month: 4

Category: Specialty Subinternship

9520 - Vascular Surgery - Henry Ford Health Service

Course Prerequisites: Completion of core clerkship in Surgery

Description: Each student accompanies the surgical team on ward activities where daily discussions of patients and vascular problems are conducted. The student is exposed to a broad spectrum of vascular disease. Rounds and conferences are integrated into the clerkship and basic pathophysiology of vascular disease is taught. The clerkship can be individualized to the student's interests. At the end of the rotation, students should be able to diagnose, work up, and initiate treatment on common and some complex vascular diseases. Opportunities for clinical research is available for interested students.

Objectives: Develop a foundation in the art and science of vascular disease through mentorship. Gain the ability to obtain a good vascular history and perform a physical examination. Teach the diagnosis and treatment of common vascular problems. Develop both open surgical and endovascular skills. Increase student involvement in conferences, journal clubs. Increase student use/review of the medical literature.

Methods: The Division of Vascular Surgery is active with a heavy patient load. The variety of vascular problems seen is wide. The student sees patients prior to operation. He/she will participate in conferences in which arteriogram, aortograms and special studies are reviewed. The student participates in the operative procedures and then observes the postoperative care. Rounds are made daily with staff participation and teaching. We expect the student to follow 1-2 inpatients while on the service. 70% inpatient care/operating room. 15% outpatient care. 15% conferences/lectures.

Recommended Reading Material: Greenfield's Surgery: Scientific Principles and Practice - Fourth Edition, (Chapters: 87; 89; 92-94; 96; and 98).

Length: 1 month; Days/Week: 6; Hours/Week: 60; Night Call/Month: varies

Evaluation: Observation of performance by faculty and house officers. Assessment of write-up/reports. Level of knowledge as well as skill is assessed. Participation and performance in conferences is encouraged. Ability to function as a team, interest, and quality of care given to patients.

Category: Specialty Subinternship

9528 - Maxillofacial Surgery - St John Hospital

Course Prerequisites: This course is only available to OMFS students.

Objectives: 1) The students will learn to perform a comprehensive head and neck exam with attention to distinguishing normal variation from pathology 2) The students will participate in a multidisciplinary head and neck tumor conference 3) Increase the students ability to communicate with a patient regarding the nature of their disease and the proposed treatment plan 4) Demonstrate knowledge of sterile technique, function safely in a sterile environment, and become aware of operating room routines 5) Know and demonstrate relevant anatomy for cases assigned

Methods: The elective is deisgned to provide the student with an in depth exposure to the field of maxillofacial surgery and its subspecialties of trauma, oncology, and micro-vascular reconstruction. The student will be expected to perform as a sub-intern working under the direct supervision of senior maxillofacial surgery residents and attending faculty. Students will actively participate in the operating room and follow those patients post-operatively. Students will perform consultations in the outpatient clinic setting of attending physicians who will provide ongoing feedback about student performance. There is a weekly didactic program for the medical students consisting of a core curriculum and facilitated discussions. The course begins on the first weekday of the month with a mandatory orientation and ends on the last weekday of the month with a meeting with the clerkship director. The grade is based on clinical evaluations, conference attendance and upon completion of all requirements in a timely manner.

Evaluation: Clinical, post-test

Length: Hours/week: 40, Students will work day, afternoon and take some call; Days/Week: 5 clinical, 1 didactic

Category: Specialty Subinternship

9530 - General Urology - Henry Ford Health Service

Course Prerequisite: None

Objectives: Enhance knowledge and skills pertaining to interviewing, physical examination, or patient interactions, interpretation of data, clinical judgment, and procedures (i.e., foley catheterization, cystoscopy, and minor surgical procedures). Increase student involvement in conferences, journal clubs. Increase student use/review of the medical literature. Student will gain familiarity with diagnosis and treatment of common urologic problems.

Methods: The student is exposed to the broad spectrum of urologic diseases, enabling him/her to recognize and treat most common urologic problems. The student will be exposed to our innovative robotic assisted laparoscopic Urology program. Participation in the full clinical service is offered, including diagnostic and operative procedures. Rounds and conferences are integrated into the clerkship, and basic pathophysiology of urologic disease is stressed. An opportunity for clinical research is available for interested students.

Recommended Reading Material: To be provided.

Length: 1 month; Days/Week: 5; Hours/Week: 60; Night Call/Month: none

Evaluation: Observation of performance by faculty & house officers. Assessment of write-ups/reports. Presentation at end of clerkship.

Category: Specialty Subinternship

9530 - General Urology - Michigan Healthcare Professionals

Course Prerequisites: General Surgery completed – really considered core and this is a sub-specialty. Must fulfill general surgery fundamentals first.

Description: Students will have the opportunity to learn about adult urologic systems and diseases in either a clinic-based, hospital-based, or hybrid learning environment based on the student’s interests. Uniquely, this elective will also allow interested students to rotate in the subspecialty of pediatric urology for 1-4 weeks of their rotation. Interested students will be able to see the difference between diseases and systems-based urology in adult versus pediatric urology. Students will meet with Dr. Kenneth Lim at the beginning of their rotation to determine a rotation schedule based on student interests, matching students to the different hospitals and clinics based on disease interests and suburban medicine. Students will have the opportunity to act in a clinical, operative, or pediatric urology clinic and/or hospital settings, or create a hybrid rotation that better suits their interests going forward. Students will be able to go through clinical cases and sit down weekly for topic review. Students will also have the opportunity for independent studying all while experiencing a fast and dynamic rotation.

Objectives: For students to gain a better understanding of how genital urinary systems such as the kidneys, bladder, prostate, and testicles work. For students to develop an understanding of the anatomy and physiology of each of the urinary systems and be able to pick up on disease states that would overlap with each of those areas such as aging, cancer, etc.

Methods: Students will take part in daily clinics where they will evaluate and manage patients for new urologic diagnoses and chronic disease states. They will also be involved in preoperative workups and postoperative visits. The students will observe office-based procedures such as prostate ultrasound, biopsies, cystoscopies and vasectomies. They will learn about shared decisions in treatment options for many Urological Diseases. This will also involve cancer patients with treatment plans based on evidence based NCCN guidelines. Students will also take part in didactic training from a list of key topics in urology curriculum developed for medical students wherein the students will select topics of interest and then with a mentor, review disease states, understand pathophysiology, and formulate a workshop and treatment plan.

Suggested topics: UTIs, kidney stones, BPH, Prostate Cancer, Hematuria, Infertility, and Urinary incontinence

Recommended Reading: Students will use the American Urological Association website’s dynamic database for medical students. Students will navigate to the AUA University tab under AUA Websites to be able to go through the site to see everything related to important clinical training on organ systems, disease entities, and more for home study, reference, patient care, and presentation purposes.

Length: 1 month; Days/Week: 5 (students will have the opportunity to create a more operative-based or clinic-based schedule based on their interested with the ability to have 2-5 days of operative experience, 5 days of clinic experience, or to create a hybrid schedule as approved by Dr. Lim); Hours/Week: 40; Night Calls/Month: None

Additional Locations: Oakland County Urologists at 3145 Dixie Highway, Waterford, MI 48328 and 39475 Lewis Drive, Suite 280, Novi, MI 48377; Detroit Receiving Hospital; Sinai Grace Hospital; Huron Valley Hospital; Children’s Hospital of Michigan; St. Joseph Mercy Oakland Hospital

Evaluation: New Innovations evaluation, Presentation based on a reading assignment and a topic of the student’s choice.

Preceptor(s): Dr. Kenneth Lim, Program Director Urological Surgery, Detroit Medical Center

Category: Specialty Subinternship, Ambulatory

Recommended Attire: Washable scrubs, white coat

EMR System: Varies based on clinic and hospital. Students will use the EMR system to look up tests.

9530 - General Urology - Barbara A Karmanos Cancer Inst

Course Prerequisite: This course rotates at the VA as well as the listed site. All VA electives require U.S. citizenship. Do not register for this elective without being able to provide your U.S. social security number for onboarding purposes.

Objectives: 1) To foster a basic understanding of the field of urology and familiarity with disease processes which occur commonly within this specialty. 2) To improve diagnostic skills. 3) To gain an understanding of common urological diseases. 4) To increase knowledge of the anatomy and function of the genitourinary tract through exposure to disease states which impact this organ system.

Methods: The students will be assigned to an adult urology rotation at the Karmanos Cancer Center. They will function similar to members of the house-staff by assisting in the operating room and by performing supervised history and physical examinations in the outpatient Karmanos Multidisciplinary clinics. The students will also participate in inpatient consultations at Karmanos and other hospitals of the central campus. They will participate on daily rounds and will attend didactic conferences and other educational activities which occur weekly within the department. Students will meet weekly with faculty mentors to ensure educational objectives are met and to facilitate a quality subspecialty experience.

Recommended Reading Material: 1. Handbook of Urology, latest edition 2. Smith's General Urology Tanagho-McAninch

Additional Locations: The location for this rotation is WSU/Karmanos Cancer Center, Veteran's Admin Hospital

Length: 1 month; Days/Week: 5; Hours/Week: 40; Night Calls/Month: none

Evaluation: Clinical Evaluation

Category: Specialty Subinternship

9545 - Step 2 Preparation - Arranged (Building Not Needed)

Objectives: Students will be introduced to methods for successfully passing the mandatory Step 2 CK United States Licensing Examination (USMLE).

Category: Non-Clinical

9545 - Step 2 Preparation - Multiple Locations

Description: This one credit course is required for Year 4.

Objectives: Students should register for the course in the month they plan to take Step 2. Students will have the option to opt out by submitting paperwork to Dr. Brennan in the Kado Clinical Skills Center.

Category: Non-Clinical

9600 - Residency Preparation: Nonsurgical - Multiple Locations

Description: This one month elective course will prepare finishing medical students to enter residency training with a superior degree of skill. Curricular elements will be both general for all specialties and specific to specialty.

Objectives: The sessions will be organized into 2 phases--those topics applicable to all specialties and those specific to specialties. The student will demonstrate:

Professional personal skills required of the resident in time and organization, finances, and career development
Knowledge of practical medical issues of legal medicine, coding and billing, health care systems as relates to patient management.
Skills in communication in dealing with difficult patients and families, medical errors , deaths, difficult prognosis and care decisions and conflict resolution
Practical resident patient management skills in team building and team management, writing orders, writing notes, working with the electronic medical record, and transitions of care.
Skills in physician consulting, interprofessional teamwork, common nurse calls and emergencies.
Skill in handling simulated phone calls of patient emergencies
Knowledge and situational mastery of specific in hospital emergencies and common on call problems, presented in simulated situations
Knowledge and practice of resident teaching skills important in future teaching of medical students
Skills in simulated environment of basic procedures including IV lines, blood gases, suturing, tube management.
Practical knowledge of common medications used in management of acute care and ambulatory patients.

Methods: Lecture, online exercises, small group discussions and simulation will be used as instructional modalities.

Part A will be didactic topics applicable to all specialties. For Part B, students will be grouped by their specialty areas for the small group and simulation exercises. Didactics and small group exercises with case simulations will be centered on the following topics:

Resident skills: time and organization, finances, legal issues, coding/billing, health care systems, career development.
Communication and professionalism: presentation, dealing with medical errors, deaths, difficult patients and families, prognosis and difficult discussions, conflict resolution
Hospital and team functioning: team building, orders, notes, EMR, consulting, transitions of care, patient safety, interprofessional teamwork, common nurse calls and emergencies.
Residents as educators, giving and receiving feedback.

Procedural skills will be specialty specific and include:

Surgical simulation for surgical subspecialties
Ultrasound
IV access, blood gas, suturing
Simulated call (answering phone calls with evaluation and orders).

Group Divisions (to be determined on day one of class):

Surgical subspecialties (Orthopedics, Urology, Otolarygology, Neurosurgery)
Ob/Gyn
Internal medicine (including those entering preliminary internship) Neurology, Dermatology, Physical Medicine, Psychiatry, Radiology
Family medicine
Emergency Medicine and Anesthsia
Pediatrics

Reading Materials/Resources:

The Washington Manual of Medical Therapeutics (Lippincott Manual Series) Thirty-Fifth Edition. Bhat et al.
WISE-MD On-call Program (online subscription through SOM) lms.wisemed.org
Kado clinical skills center for simulation and task training.

Length: 1 month

Notes: This is an in-person class. This class will only be offered in April 2024 for the graduating class of 2024.

Category: Non-Clinical, Residency Prep (TTR)

9610 - Teaching and Learning in Medical Education (TLMed) - Arranged (Building Not Needed)

Course Prerequisites: N/A

Description: This course is designed to provide fourth-year students with the opportunity to cultivate their teaching skills in order to better prepare them for residency. This course provides all students with the fundamentals of learning theory and evidence-based teaching to help medical students become effective educators. Students will apply educational principles as they work with first, second, third, and/or fourth-year students. The course includes two virtual workshops and a series of modular assignments that support teaching session preparation and encourage reflective analysis of teaching methods. Students are required to complete a minimum of eight teaching sessions, including six in-person, at WSUSOM designated classes or clinical sessions.

Educational skills are increasingly recognized as essential components of the education of future physicians, particularly in residency training when learners take on new teaching responsibilities for their teams. MD4 9610 provides students with the skills, strategies, and techniques to instruct medical students in classroom and clinical contexts. This course integrates a full range of educational experiences, including teaching placements, live virtual workshops, self-paced online learning modules, instructional design projects, and a final capstone project to develop M4 students into skillful teachers.

Students can choose to complete one of three separate teaching tracks to fulfill their teaching requirements: (1) general teaching, (2) clinical skills teaching, and (3) small group facilitation.

Objectives: This course is designed to provide fourth year students with the opportunity to cultivate their teaching skills in order to better prepare them for residency. Students will participate in workshops on how to refine their teaching skills, with topics such as creating a positive teaching environment, how to prepare an effective lecture, and how to give and receive feedback. Students will teach sessions for junior medical students to help practice their improved skills and will also provide feedback to junior students.

Upon completion of this course, students will gain mastery in the following competencies:

Giving constructive feedback
Precepting in clinical contexts
Small group teaching
Case-based teaching
Large-group teaching
Self-directed learning principles

By the end of the Teaching and Learning in Medical Education course, students will be able to:

Identify and apply principles of key adult learning theories to set and monitor one’s progress towards learning and teaching goals.
Explicitly track knowledge gaps and apply learning strategies, resources, and seek assistance to address learning gaps.
Apply principles of adult learning theory to evaluate and improve junior students' clinical reasoning abilities.
Create opportunities to demonstrate leadership and professionalism in a simulated clinical setting by providing constructive and effective feedback to junior students.
Identify and implement appropriate instructional strategies when giving feedback to junior students.
Identify and implement evidence-based teaching strategies that are rooted in the science of learning.
Identify and apply evidence-based leadership strategies to develop and facilitate small group active learning sessions.
Identify and apply evidence-based teaching strategies to facilitate large group active learning sessions.
Apply teaching and feedback strategies that promote junior students’ procedural and critical thinking skills during a simulated clinical encounter.
Compare and apply models of effective feedback to support junior students’ learning in classroom and clinical contexts.

Methods:

Teaching Sessions: Students are expected to complete a minimum of 8 teaching sessions, 6 of which must be in-person sessions. 2 teaching sessions must be completed per unit. Refer to the “Teaching Requirements” page on Canvas (Module 0: Orientation) for more information.
Teaching Workshops: Students are expected to attend 2 virtual sessions. These sessions will be held over Zoom and will be delivered in Unit 1 (April – June).
Final Teaching Portfolio: Students will complete a summative reflection project which will consistent of submitting a end-of-term course reflection and portfolio of instructional activities.
Self-Paced Learning Modules: Students will complete two self-paced learning modules per 3-month unit. Each module is organized into a self-paced sequence of instructional activities that take approximately 3-4 hours to complete. The module activities must be completed within the 3-month period for each unit.

Recommended Reading/Resources: JAMA Rational Clinical Exam, Presentation Zen, Thinking Fast and Slow

Length: Segment 4 Longitudinal

Additional Locations: Various (Kado, Maz, Scott Hall, Virtual)

Evaluation: A satisfactory (S) or unsatisfactory (U) grade for the course will be determined from the timely completion of the required activities and teaching sessions as outlined below:

Teaching sessions
Completion of learning modules
Workshop activities
Final project

Course Director(s): Chih Chuang, MD; Marissa Zhu, PHD

Preceptor(s): Dr. Chih Chuang

Category: Non-Clinical

Recommended Attire: business

EMR System: N/A

9620 - Clinical Reasoning Using Integrated Skills in Education (CRUISE) - Arranged (Building Not Needed)

Course Prerequisites: N/A

Description: CRUISE is a year-long longitudinal course completes the four-year Highways to Excellence © curriculum. WSU senior students will advance skills in areas common to all specialties while applying clinical reasoning to online assignments, in-person workshops, and asynchronous content.

Objectives: To enable a WSUSOM graduate to enter postgraduate training prepared to analyze patients to make clinically sound decisions while continuing to learn in areas common to all medical practice. Students will practice in areas such as professionalism, ethical and social responsibility, and critical thinking to enhance skills and knowledge best introduced in the post-clerkship setting.

Demonstrate knowledge and competency in areas common to all specialties of medical practice, including advanced patient care skills, professional practice, ethics and end of life issues, conflict resolution, advanced communication, and lifelong learning.
Demonstrate principles of care in geriatric medicine.
Demonstrate skills in end-of-life care.
Demonstrate mastery clinical, technical, and other patient-centered skills.
Demonstrate techniques in advanced communication skills with difficult patients and situations.
Demonstrate involvement in the care of our community by participating in student-run clinics and other volunteer opportunities.
Demonstrate advanced clinical reasoning skills.
Promote efficient and effective health care delivery supported by clinical reasoning strategies.
Demonstrate critical application of medical literature by application of evidence-based medicine principles.
Critically assess competence to improve performance.

Methods:

Professional Formation Modules: Using your log-in, you will review various modules on Drexel University's Center for Innovation in Healthcare Education and complete a reflection to submit on Canvas.
Aquifer Modules: Using your log-in, you will review various modules on AQUIFER and submit a screen shot of completion on Canvas.
Healthcare Communication: Using your log-in, you will review various modules on Drexel University's Center for Professionalism & Communication in Health Care. Completion of the modules are tracked within the portal.
EPA Reflection(s) Exercise: At the beginning of the term, you will use the EPA-based-Sub-I Evaluation form to complete a self-reflective assessment. At the end of the year, you will return to this exercise to monitor your performance and identify strengths and opportunities for growth.
Clinical Application Activities: Students will be assigned to various clinical sites in the Emergency Medicine Core Clerkship, a specialty-specific clinical elective, and a sub-internship with competency-based assessment of clinical skills.
Residency Preparation: To prepare for residency, students will be allotted to prepare for Step 2 Examination, residency interviews, and independent studies.
End of Life and Palliative Care Modules/Article: Students will review articles and videos posted on Canvas related to End of Life care and conversations. After the articles, students will submit a reflection to Canvas.

Course Structure: A majority of the course will be delivered asynchronously. Refer to Canvas to stay abreast with official due dates (typically the end of the term) and changes made to the curriculum. Canvas and your WSU email are the official means of communication, please check them regularly to stay up to date with the course. The CRUISE course will run in 4, 3-month blocks: April – June, July – September, October – December, January – March.

Recommended Reading/Resources: Available on course Canvas page.

Length: Segment 4, longitudinal Students are required to register in quarters. Enrollment reflects four, three-month long terms.

Additional Locations: N/A

Evaluation: CRUISE is a pass/fail course, meaning a satisfactory (S) or unsatisfactory (I) grade for the course will be determined upon the timely completion of the required activities.

Course Director: Erin Milled, MD

Coordinator: Michelle Hill

Preceptor(s): Dr. Chih Chuang

Category: Non-Clinical

Recommended Attire: business

EMR System: N/A