Visiting Medical Student Electives

Electives by Department

 

ALHSAllied Health SciencesOBGYObstetrics and Gynecology
ANESAnesthesiologyORTHOrthopaedic Surgery
BINFBiomedical InformaticsPATHPathology
BIOMBiomedical SciencesPEDSPediatric and Adolescent Medicine
EMEREmergency MedicinePROFProfession of Medicine
FMEDFamily and Community MedicinePSYCPsychiatry
INDIndependent StudyRADRadiology
MEHLMedical Ethics, Humanities, and LawRESResearch
MEDMedicineSIMMedical Simulation
MEDEMedical EngineeringSURGSurgery
MEDUMedical Education  

 

All Electives

ANES 9420 Pain Management
Credits:
2
Directors:
Chafty
Grading:
Pass/Fail
Description:

Pain is prevalent in treatment of patients. The students will receive primarily acute pain management training while doing their anesthesia elective in the hospital. The pain management program is in an outpatient program done through the Kalamazoo Anesthesiology Pain Consultants. The student will be part of a team that includes physicians, physician's assistants, psychologists, nurses, occupational therapists, and physical therapists. There may be the occasional inpatient pain consult that the student will attend with the physician, but the vast majority of the training is done in an outpatient pain center and primarily deal with chronic, nonmalignant pain. By the end, the student should understand some common chronic pain issues and develop a considerate and thoughtful approach to management of these pain problems.

Offered: Only open to one student per block. Prior approval required.

Objectives:
  • Obtain an accurate and comprehensive history from the patient.
  • Perform a rational and thorough physical examination.
  • Try to focus as appropriate the history and physical to the patient's active pain issue.
  • Use the information gathered from the history and physical, as well as appropriate radiologic studies and labs, to create a problem list.
  • Try to generate a differential diagnosis from the active problem list.
  • Begin to develop a plan based on the problem list.
  • Present that problem list and differential diagnosis to the pain team.
  • Integrate learning based upon reading and experiences in the pain clinic to broaden the student's understanding of chronic pain management.
  • Begin to learn some block techniques that the student will apply as a resident and physician.
  • Understand the use of the multi-disciplinary approach to pain management.
EMER 9710 Emergency Medicine
Credits:
4
Directors:
Kothari
Description:

Emergency Medicine Selective provides experiences with a diverse set of patients spanning all ages and experiencing many pathological conditions that present to the emergency department. Students are expected to perform the initial patient assessment, formulate a differential diagnosis and problem list, present the patient to a senior resident or attending physician, write orders, interpret diagnostic studies, discuss patients with consultants, perform or assist with procedures under supervision, write discharge instructions, and facilitate admissions and transfers.

Offered:  Not offered in July

Objectives:
  • Perform a directed medical history and physical examination appropriate to the patient’s presentation.
  • Develop an appropriate differential diagnosis based on the patients’ complaint, history and physical exam.
  • Develop an appropriate management plan to evaluate & treat the patient’s condition.
FMED 9710 Advanced Hospital Family Medicine
Credits:
2,4
Directors:
VanDerKolk
Grading:
Pass/Fail
Description:

Advanced hospital clerkships provide the opportunity for students to assume greater responsibility for patient care of the hospitalized patient, with oversight from supervising residents and attending physicians. Students expand upon competencies they develop during the third year as they care for one to two patients at a time. Additional expectations include responsibility for developing management plans, writing orders, patient handovers and transfers of care, recognizing the policies that support patient safety, and developing competency in procedures that they will perform independently as residents. Fourth year students also assist in teaching third year students.

Advanced Hospital Family Medicine is an opportunity for students to participate in a busy, family medicine oriented, academic inpatient service at Bronson Methodist Hospital. Students will act as a sub-intern on the Family Medicine Service (FMS), comprised of and supervised by residents and attendings from the Department of Family and Community Medicine.

Participants will have the opportunity to work both days and nights on the service. While on days, students can expect to be responsible for the review, evaluation and management of 1-2 admitted patients under direct supervision. They will participate in regular daily rounds, presenting each patient under their care to the attending physician with their plan for the day. Students will be expected to present regularly on medical topics pertinent to the patients under their care. On nights, students will review and evaluate admitted patients and have the opportunity to admit patients from the emergency department.

This course can be taken as a required clerkship or an elective.

Offered:  All weeks

Objectives:
  • Identify patients requiring hospitalization for management of their conditions.
  • Obtain a complete History and Physical for a patient being admitted to the hospital.
  • Synthesize information from various sources to develop an assessment of the patient’s condition, culminating in a complete problem list with differential diagnoses.
  • Propose an initial management plan for each of the patients’ diagnoses.
  • Document adequately and completely the history, physical, and assessment and plan for the hospitalized patient.
  • Describe the presentation and initial management of several common inpatient conditions including COPD exacerbations, cellulitis, pancreatitis and others.

Advanced Clerkship Goals:

  1. Demonstrate clinical reasoning in gathering focused information relevant to a patient's care.
  2. Demonstrate patient-centered interview skills
  3. Demonstrate patient-centered examination techniques.
  4. Articulate a management plan based on the well-reasoned differential and working diagnoses.
  5. Provide complete and succinct documentation so that other providers have evidence of your clinical reasoning to ensure continuity of care and patient safety.
  6. Recommend reliable, cost-effective tests when indicated for screening or evaluating patients with common acute or chronic conditions.
  7. Routinely reflect on how the results of a test will influence clinical decision making and, conversely, on the potential consequences of not doing a test.
  8. Articulate the risks and benefits of what you are ordering (e.g., drugs, tests).
  9. Consistently discuss diagnostic plans with the patient, and provide evidence that patient preferences have been solicited and factored into decision making.
  10. Distinguish common, insignificant abnormalities from clinically important abnormalities.
  11. Provides documentation that is comprehensive and contains important information without unnecessary details or redundancies.
  12. Filter, synthesize, and prioritize information and recognize patterns, resulting in a concise, well organized, and accurate presentation.
  13. Adjust oral presentations for the receiver of information (e.g., faculty, patient/family, team members) and for the context of the presentation (e.g., emergent versus stable).
  14. Routinely identify the need to ask for help or seek new information in the context of the clinical setting, based on awareness of one's own knowledge gaps and patient needs.
  15. Provide key aspects of the ideal handover to the recipient, including verbalizing the patient's illness severity and/or providing action planning and/or contingency planning.
  16. Demonstrates awareness of known threats to handover communication (e.g., interruptions and distractions) by paying attention to the timing and location of the handover communication.
  17. Acts as an active and integrate member of the team who in most situations prioritizes team goals over one's own professional goals.
  18. Understands the roles of other team members, seek their counsel, actively listen to their recommendations, and incorporate them into practice.
  19. Interpret common test results to anticipate and respond to early clinical deterioration.
  20. Adhere to institutional procedures and protocols regarding escalation of patient care.
  21. Understand the importance of informed consent to rapport building and shared decision making.
  22. Demonstrate an understanding of the elements of informed consent generally (indications, contraindications, risks, benefits, alternatives) and the specifics of these elements for the procedures for which consent is being sought.
  23. Demonstrate patient-centered skills in performing procedures:
    • Avoid medical jargon such that patients are able to verbalize understanding of the procedure.
    • Participate in shared decision making with patients about procedures
    • Have confidence commensurate with level of knowledge and skill that puts patients at ease.
    • Simultaneously pay attention to both the procedure and the patient's emotional response.
  24. Identify real potential errors.
  25. Perform common safety behaviors (e.g., universal precautions, hand washing).
  26. Understand the importance of error prevention both to individual patients and to systems.
FMED 9720 Advanced Ambulatory Family Medicine
Credits:
2,4
Directors:
VanDerKolk
Grading:
Pass/Fail
Description:

Advanced ambulatory clerkships provide the opportunity for students to assume initial responsibility for the evaluation of patients in the ambulatory setting. Supervision will be provided by faculty preceptors in the academic setting as well as community private practices. Students expand upon competencies they developed during the third year as they team with residents and/or preceptors to provide preventive health services as well as acute and chronic illness management. The faster pace of ambulatory care provides an environment that strengthens patient and family communication skills, rapport development, and oral presentations. The use of evidence to inform treatment and counseling of patients and their caregivers are additional competencies that are highlighted in the outpatient setting.

Advanced Ambulatory Family Medicine is an opportunity for students to participate in a busy, resident-based family medicine outpatient clinic at the Family Health Center, a Federally Qualified Health Center. Students will act as entry level residents with direct supervision by senior Family and Community Medicine residents or attending physicians. Participants will perform the initial evaluation of patients, review patient records, and assimilate the information they have gathered into a complete assessment of the patient’s presenting problems. Finally, students will be expected to develop a plan for each problem identified.  Patients will be regularly presented to supervising physicians to finalize plans and follow-up. This course can be taken as a required ambulatory clerkship or an elective.

Offered:  All weeks

Objectives:
  • Identify a chief complaint for any patient presenting to the office.
  • Obtain an adequate history and physical exam for common outpatient complaints.
  • Synthesize history, physical exam findings and other patient data to complete an assessment of the patient’s condition.
  • Propose a plan for each problem identified in the visit.
  • Present patients with common outpatient conditions in a complete and concise manner, including the assessment and plan.
  • Integrate evidence-based medicine and preventive care into acute outpatient visits.
  • Begin to reconcile differences between preventive care guidelines from various organizations.

Advanced Clerkship Goals:

  1. Demonstrate clinical reasoning in gathering focused information relevant to a patient's care.
  2. Demonstrate patient-centered interview skills.
  3. Demonstrate patient-centered examination techniques.
  4. Articulate a management plan based on the well-reasoned differential and working diagnoses.
  5. Provide complete and succinct documentation so that other providers have evidence of your clinical reasoning to ensure continuity of care and patient safety.
  6. Recommend reliable, cost-effective tests when indicated for screening or evaluating patients with common acute or chronic conditions.
  7. Routinely reflect on how the results of a test will influence clinical decision making and, conversely, on the potential consequences of not doing a test.
  8. Articulate the risks and benefits of what you are ordering (e.g., drugs tests).
  9. Consistently discuss diagnostic plans with the patient, and provide evidence that patient preferences have been solicited and factored into decision making.
  10. Distinguish common, insignificant abnormalities from clinically important abnormalities.
  11. Provides documentation that is comprehensive and contains important information without unnecessary details or redundancies.
  12. Filter, synthesize, and prioritize information and recognize patterns, resulting in a concise, well organized, and accurate presentation.
  13. Adjust oral presentations for the receiver of information (e.g., faculty, patient/family, team members) and for the context of the presentation (e.g., emergent versus stable).
  14. Routinely identify the need to ask for help or seek new information in the context of the clinical setting, based on awareness of one's own knowledge gaps and patient needs.
  15. Act as an active and integrated member of the team who in most situations prioritizes team goals over one's own professional goals.
  16. understand the roles of other team members, seek their counsel, actively listen to their recommendations, and incorporate them into practice.
  17. Maintains a professional demeanor in all but the most trying of circumstances.
  18. Interpret common test results to anticipate and respond to early clinical deterioration.
  19. Understand the importance of informed consent to rapport building and shared decision making.
  20. Demonstrate an understanding of the elements of informed consent generally (indications, contraindications, risks, benefits, alternatives) and the specifics of these elements for the procedures for which consent is being sought.
  21. Provides complete information to patients and families.
  22. Avoids medical jargon in communicating with patients and families.
  23. Demonstrate patient-centered skills in performing procedures:
    • Avoid medical jargon such that patients are able to verbalize understanding of the procedure.
    • Participate in shared decision making with patients about procedures.
    • Have confidence commensurate with level of knowledge and skill that puts patients at ease.
    • Simultaneously pay attention to both the procedure and the patient's emotional response.
  24. Identify real and potential errors.
  25. Perform common safety behaviors (e.g., universal precautions, handwashing).
  26. Understand the importance of error prevention both to individual patients and to systems.
MED 9710 Advanced Hospital Medicine
Credits:
2,4
Directors:
Olken
Grading:
Pass/Fail
Description:

Advanced hospital clerkships provide the opportunity for students to assume greater responsibility for patient care of the hospitalized patient, with oversight from supervising residents and attending physicians. Students expand upon competencies they develop during the third year as they care for one to two patients at a time. Additional expectations include responsibility for developing management plans, writing orders, patient handovers and transfers of care, recognizing the policies that support patient safety, and developing competency in procedures that they will perform independently as residents. Fourth year students also assist in teaching third year students.

Hospital medicine is a growing professional track for internal medicine physicians. The Society for Hospital Medicine defines a hospitalist as a physician “who engages in clinical care, teaching, research, or leadership in the field of general hospital medicine. In addition to their core expertise managing the clinical problems of acutely ill, hospitalized patients, hospital medicine practitioners work to enhance the performance of hospitals and healthcare systems.” The M4 clerkship in hospital medicine exposes the student to the medical problems commonly seen in hospitalized adult patients and permits the student to have a greater role in the evaluation and management of these patients than they had during the M3 clerkship.

Offered: All weeks

Objectives:
  • Recognize, evaluate and manage the presentations of common acute medical problems encountered in inpatient general internal medicine.
    • Abdominal pain
    • Acute gastrointestinal bleeding
    • Acute pulmonary edema
    • Acute renal failure/kidney injury
    • Altered mental status
    • Arrhythmias
    • Chest pain
    • Drug withdrawal
    • Electrolyte disorders
    • Fever
    • Glycemic control
    • Hypertensive emergencies
    • Nausea and vomiting
    • Pain management
    • Respiratory distress
    • Seizures
    • Sepsis
  • Obtain a complete history and physical appropriate to the patient’s presentation.
  • Develop complete problem lists with appropriate assessment and plan, including differential diagnosis and selection of appropriate diagnostic studies and management plans.
  • Develop professional and caring relationships with patients and families, including timely discussions regarding the patient’s illness, recommended testing, prognosis, and treatment options.
  • Use consultants when indicated.
  • Develop appropriate discharge planning and outpatient follow-up care, including communication with outpatient physicians, discharge planners, and community resources essential for transition home.
  • Accurately assess and make judgments regarding acuity of illness for determining necessity for hospital admission and for determining need for intensive care admission.
  • Determine appropriate patient monitoring, including cardiac monitoring, diabetic monitoring, fluid management, neurological assessments and vital signs.
  • Function as both a responsible referring physician and as a consultant in appropriate settings.
  • Know the indications and be able to interpret and act upon the results, in the context of individual patients, for common lab and imaging studies.
  • Use the electronic health record to review test results, physician and non-physician notes, document patient care and progress as well as beginning proficiency in writing admission, discharge orders, and daily orders.
ORTH 9710 Advanced Orthopaedic Surgery
Credits:
4
Directors:
Lackey, Bovid
Grading:
Honors/Pass/Fail
Description:

Advanced hospital clerkships provide the opportunity for students to assume greater responsibility for patient care of the hospitalized patient, with oversight from supervising residents and attending physicians. Students expand upon competencies they develop during the third year as they care for one to two patients at a time. Additional expectations include responsibility for developing management plans, writing orders, patient handovers and transfers of care, recognizing the policies that support patient safety, and developing competency in procedures that they will perform independently as residents. Fourth year students also assist in teaching third year students.

Designed for the 4th year medical student with a potentially strong interest in pursuing orthopaedic surgery as a career. Patient care involvement will be both in the outpatient clinics and operating room. There will also be opportunities to be involved with emergency department and in-patient consultations.  Students will be required to take evening call and will be paired with a resident. Students will have opportunities to work with a variety of faculty that are fellowship trained in the different subspecialties of orthopaedic surgery. There will also be opportunities to work closely with orthopaedic residents. Students will learn musculoskeletal history taking skills, the details of a musculoskeletal physical examination, interpretation of radiographs and advanced imaging techniques, treatment options including both nonoperative and operative management, surgical approaches to include both soft tissue and bone handling techniques, and implant specifics. There will be a lectureship series for students given by the faculty. A fundamental knowledge of musculoskeletal anatomy will be important. 

Offered:  All weeks

Objectives:
  • Apply advanced fundamental knowledge in musculoskeletal gross anatomy to physical examination, surgical approaches and techniques.
  • Demonstrate understanding in the basic science of soft tissue healing, fracture healing, tendinopathies, arthropathies, meniscal, ligament and tendon injury, and joint biomechanics and apply this knowledge to patient care.
  • Develop advanced knowledge of common musculoskeletal complaints and diseases that present to the orthopaedic surgeon and use critical thinking to apply this in patient care.
  • Gather essential and accurate information in a thorough musculoskeletal-focused history
  • Perform an appropriate musculoskeletal physical examination to include the spine and extremities.
  • Interpret common plain film radiographs at a beginning level.
  • Participate in surgical care of patients including basic suturing and other skills as determined appropriate by the attending surgeon.
  • Demonstrate professionalism and effective communication skills in patient care and interactions with other members of the health care team.

Advanced Clerkship Goals:

  1. Demonstrate clinical reasoning in gathering focused information relevant to a patient's care.
  2. Demonstrate patient-centered interview skills
  3. Demonstrate patient-centered examination techniques.
  4. Articulate a management plan based on the well-reasoned differential and working diagnoses.
  5. Provide complete and succinct documentation so that other providers have evidence of your clinical reasoning to ensure continuity of care and patient safety.
  6. Recommend reliable, cost-effective tests when indicated for screening or evaluating patients with common acute or chronic conditions.
  7. Routinely reflect on how the results of a test will influence clinical decision making and, conversely, on the potential consequences of not doing a test.
  8. Articulate the risks and benefits of what you are ordering (e.g., drugs, tests).
  9. Consistently discuss diagnostic plans with the patient, and provide evidence that patient preferences have been solicited and factored into decision making.
  10. Distinguish common, insignificant abnormalities from clinically important abnormalities.
  11. Provides documentation that is comprehensive and contains important information without unnecessary details or redundancies.
  12. Filter, synthesize, and prioritize information and recognize patterns, resulting in a concise, well organized, and accurate presentation.
  13. Adjust oral presentations for the receiver of information (e.g., faculty, patient/family, team members) and for the context of the presentation (e.g., emergent versus stable).
  14. Routinely identify the need to ask for help or seek new information in the context of the clinical setting, based on awareness of one's own knowledge gaps and patient needs.
  15. Provide key aspects of the ideal handover to the recipient, including verbalizing the patient's illness severity and/or providing action planning and/or contingency planning.
  16. Demonstrates awareness of known threats to handover communication (e.g., interruptions and distractions) by paying attention to the timing and location of the handover communication.
  17. Acts as an active and integrate member of the team who in most situations prioritizes team goals over one's own professional goals.
  18. Understands the roles of other team members, seek their counsel, actively listen to their recommendations, and incorporate them into practice.
  19. Interpret common test results to anticipate and respond to early clinical deterioration.
  20. Adhere to institutional procedures and protocols regarding escalation of patient care.
  21. Understand the importance of informed consent to rapport building and shared decision making.
  22. Demonstrate an understanding of the elements of informed consent generally (indications, contraindications, risks, benefits, alternatives) and the specifics of these elements for the procedures for which consent is being sought.
  23. Demonstrate patient-centered skills in performing procedures:
    • Avoid medical jargon such that patients are able to verbalize understanding of the procedure.
    • Participate in shared decision making with patients about procedures
    • Have confidence commensurate with level of knowledge and skill that puts patients at ease.
    • Simultaneously pay attention to both the procedure and the patient's emotional response.
  24. Identify real potential errors.
  25. Perform common safety behaviors (e.g., universal precautions, hand washing).
  26. Understand the importance of error prevention both to individual patients and to systems.
PATH 9410 Anatomic Pathology
Credits:
2
Directors:
DeJong
Grading:
Pass/Fail
Description:

The Anatomic Pathology elective is intended for medical students in their fourth year and provides broad experience in general diagnostic techniques. Students will have opportunities to participate in autopsy pathology, cytopathology and surgical pathology. A daily diagnostic conference is scheduled for students. In addition to direct responsibilities in autopsy and surgical pathology areas, the student will have the opportunities to participate in electron microscopy, immunohistochemistry, molecular diagnostics and flow cytometry techniques.

Offered:  All weeks

Objectives:
  • Gather the important information that is needed for the evaluation of specimens in anatomic pathology.
  • Complete a gross examination and dissection of at least 5-10 specimens per week. The student should demonstrate the ability to perform this gross dissection while being observed by at least one attending or resident.
  • Know about common pathologic conditions seen on the relevant subspecialty service (for example, GI pathology).
  • Perform Gross Dissection for the common specimens seen on the relevant subspecialty rotation.
  • Demonstrate professional responsibility in working as a team member with other members of the subspecialty service team, technical and support staff.
  • Career/context Know the training/career pathway for Anatomic Pathology.
PATH 9420 Forensic Pathology
Credits:
4
Directors:
DeJong
Grading:
Pass/Fail
Description:

By familiarizing the students with autopsies, to include clinical history, gross and microscopic findings, the forensic pathology rotation will enhance students' ability to establish clinicopathologic correlations. Emphasis will be placed on the student's development and use of observational and deductive skills, and on self-directed independent study. This elective will also provide an orientation to basic forensic medicine through observation of and active participation in forensic autopsies, death scene investigation, assigned readings, didactic instruction, observation of courtroom testimony and self-directed writing assignments. The student will receive focused instruction on Michigan Compiled Law as it pertains to physicians and the Medical Examiner’s Office in addition to training in proper death certification. The student will be exposed to the related and overlapping fields of anthropology, entomology, law enforcement, odontology and toxicology. The student’s mastery of the material will be assessed through daily teaching rounds and an open-book examination.

Offered: All weeks

Objectives:
  • Formulate a differential diagnosis based on a clinical history
  • Observe and describe gross findings in organs
  • Differentiate normal and abnormal gross findings at autopsy
  • Formulate a cause of death based on history, scene investigation and autopsy findings
  • Correlate clinical manifestations of the patient with morphologic findings at autopsy
  • Recognize the microscopic characteristics of frequent diseases
  • Describe the clinical and pathologic characteristics of common diseases and injuries
  • Outline the procedure of obtaining family consent for autopsy in hospital deaths
  • Define criteria for medical examiner’s case and apply the criteria to a variety of scenarios.
  • Exhibit conduct consistent with accepted standards of ethical and professional behavior.
PEDS 9410 Pediatric Endocrinology
Credits:
2,4
Directors:
Draznin
Grading:
Pass/Fail
Description:

Pediatric Endocrinology is a primarily ambulatory 4th year elective based at the WMed Pediatric Subspecialty Clinic on Oakland Drive. Students will also have the opportunity to participate in consultations at the Bronson Children’s Hospital in downtown Kalamazoo, MI. Students may spend two or four weeks in our active academic pediatric endocrinology program. The site available is WMed Pediatric Subspecialty Clinic.

Offered: All weeks

Objectives:

After completion of this elective, each student will be able to:

  • Describe processes of growth and their differences in infants children and adolescents.
  • List common growth disorders in all pediatric age groups
  • Give a basic explanation of the evaluation and management of common growth disorders in pediatric patients.
  • Describe the pathophysiology, clinical manifestations, diagnostic evaluation, and basic management principles of diabetes mellitus (types 1 and 2) in children and adolescents.
  • Describe the Michigan Newborn Endocrine Screening Program, the treatment and long term care of infants identified to have congenital adrenal hyperplasia or congenital hypothyroidism in plain language that would inform parents and children.
  • Participate in a multidisciplinary diabetes clinic and be able to explain the need for the different disciplines involved.
PEDS 9440 Pediatric Pulmonary Medicine
Credits:
2,4
Directors:
Dr. Gregiore-Bottex
Grading:
Pass/Fail
Description:

Pediatric Pulmonary Medicine is primarily an outpatient experience, but student will participate in all Pediatric activities including Morning report and resident block conferences. The student will have ample opportunity to interview patients, perform physical examinations and discuss management of the most common pulmonary disorders. The student will participate in inpatient rounds and consults on patient admitted at Bronson hospital. They will have opportunity to observe a multidisciplinary team during the Cystic Fibrosis and Ventilation clinics. The student will observe bronchoscopy and spirometry or other pulmonary function testing. Emphasis is also placed on general pediatric issues: growth, immunization, risk of smoking or exposure to tobacco smoke, and infection control, patient education, safety and planning of care. The sites available are WMed Pediatric Subspecialty Clinics.

Offered: All weeks

Objectives:

After completion of this elective, all students will be able to:

  • Demonstrate progress in obtaining a pediatric pulmonary history.
  • Demonstrate age appropriate pediatric pulmonary examination.
  • Discuss the genetics, pathophysiology and management of cystic fibrosis, including most common complications and other impairment of airway clearance.
  • Describe two types of airway clearance techniques or devices in cystic fibrosis.
  • Discuss the pathophysiology and classify severity of asthma.
  • Explain the difference between controller and rescue medications for asthma. 
  • Discuss asthma management using the NIH / EPR guidelines based on asthma severity and degree of control.
  • Discuss the basic interpretation of spirometry and other test of pulmonary function.
  • Discuss the general approach to management of chronic cough and stridor.
  • Understand the care of a child with chronic lung disease: including prematurity, aspiration and immunodeficiency.
  • Understand the role of a multidisciplinary team in planning the care for a patient with chronic lung disease.
  • Participate in the quality improvement projects in the Clinic.
PEDS 9470 Developmental Behavioral Pediatrics
Credits:
2,4
Directors:
Dr. Soares
Grading:
Pass/Fail
Description:

The purpose of this course is to provide students with an overview of Developmental-Behavioral Pediatrics through their participation in several outpatient clinics as well as attendance at some of our community sites.  Students will learn skills specific to interviewing parents, caregivers, and children as well as the common developmental assessments used in general pediatric clinics and assessments used to evaluate for more complex developmental and behavioral concerns.

Offered:  All weeks 

Objectives:

After completion of this elective, each student will be able to:

  • Recognize normal and abnormal child development and behavior from infancy through young adulthood; including cognitive, language, motor, social and emotional components.
  • Differentiate between problem behavior and intrinsic and extrinsic factors that influence those behaviors that warrant referrals to other specialists.
  • Describe the impact of family structure, adoption and foster care on growth and development.
  • Interview parents, care providers, and youth.
  • Identify psychosocial and developmental screening techniques.
  • Identify components of psychological evaluations.
  • Identify management strategies for children with developmental disabilities or special needs.
  • Recognize needs of children at risk from psychosocial adversity.
  • Recognize abuse and neglect.
  • Discuss the impact of chronic illness, terminal conditions and death on children and their families.
  • Discuss the impact of trauma (domestic violence, bullying, physical and sexual abuse) on youth growth and development (domestic violence, bullying, physical and sexual abuse).
  • Recognize and manage common mental health conditions (anxiety, depression).
  • Recognize and manage common childhood behavioral concerns.
  • Recognize and coordinate childhood and adolescent mental health problems that require referral for diagnosis and treatment.
PEDS 9520 Pediatric Allergy and Immunology
Credits:
2,4
Directors:
Barr
Grading:
Pass/Fail
Description:

This rotation is designed to provide individualized teaching in the management of outpatient medical problems for students interested in combined internal medicine and pediatrics practice experience.  The student will spend the majority of their outpatient clinical experience in a community combined internal medicine and pediatrics practice.  There may also be opportunities for other experiences such as sports medicine and transitions of care clinics.  The student will gain experience in the ambulatory setting including preventative medical services, assessment of growth and development in children and adolescents, diagnosis and treatment management of common adult and pediatric ambulatory problems, psychosocial issues affecting patient compliance, and the importance of multidisciplinary care.  There may also be opportunities for performing or observing procedures such as EKG, Pap, microscopic examination of wet mounts, throat cultures, and injections. Other activities include Internal Medicine grand rounds and block conference and Pediatrics grand rounds and block conference.  At the conclusion of the experience, the student will give a short presentation to the practice site of a topic of interest.

Objectives:

After completion of this elective, each student will be able to:

  1. EPAs
    • Obtain a medical history and perform a physical examination appropriate to the patients presentation (EPA 1a and EPA 1b)
    • Construct a logically thought out and prioritized differential diagnosis (EPA 2)
    • Provide oral presentation of a clinical encounter (EPA 6)
    • Collaborate as a member of an interprofessional team; Be responsive to whole patient and behave in a professional manner that embraces and respects diversity while exhibiting compassion, honesty, integrity, respect, and responsibility (EPA 9)
    • Recognize a patient requiring urgent/emergent care and discuss the appropriate evaluation and management (EPA 10)
  2. Competencies
  • Medical Knowledge
  • Awareness of evidence-based guidelines guiding the diagnosis, treatment, and management of common primary care internal medicine and pediatrics problems
    • Examples of common internal medicine problems include COPD, type 2 diabetes, essential hypertension, coronary artery disease, chronic pain
    • Examples of common pediatric problems include well child exams, viral illnesses, asthma, ear infections, abdominal pain
  • Self directed learning and reading
  • Patient Care
    • Basic clinical skills – obtain a patient history and physical exam in a logical, organized, and thorough manner while adapting to the urgency of the medical situation and time available.
    • Oral presentations
    • There may be opportunities to perform or observe procedures such as throat cultures, injections, PAP smears, wet mounts, dermatologic procedures (cryrosurgery, excision of skin lesions and moles), PFTs and EKGs.
    • Identify opportunity to improve health promotion through patient education such as smoking cessation
  • Systems Based Practice
    • Community resources
  • Practice Based Learning and Improvement
    • Self directed learning and reading
    • Presentation of common Med Ped disease
  • Interpersonal and Communication Skills
    • Effective communication – perform patient interviews and physical examinations, and enhance presentation skills.
  • Professionalism
    • The student demonstrates responsible, professional, and respectful behavior.
    • Accepts constructive criticism and receptive to receiving feedback
PEDS 9710 Advanced Hospital Pediatrics
Credits:
2,4
Directors:
Lane-Davies, Corpus
Grading:
Pass/Fail
Description:

Advanced hospital clerkships provide the opportunity for students to assume greater responsibility for patient care of the hospitalized patient, with oversight from supervising residents and attending physicians. Students expand upon competencies they develop during the third year as they care for one to two patients at a time. Additional expectations include responsibility for developing management plans, writing orders, patient handovers and transfers of care, recognizing the policies that support patient safety, and developing competency in procedures that they will perform independently as residents. Fourth year students also assist in teaching third year students.

Advanced Hospital Pediatrics is a hospital based pediatric rotation that utilizes Bronson Children’s Hospital as its clinical site. This center is the tertiary care referral center for pediatric disorders in Southwest Michigan. Fourth year students who have successfully completed all Year 3 required clerkships are eligible to register for this course.  During this rotation, students will focus on the development of patient management skills as they assume primary responsibility for patient care.

Faculty for this rotation are the Bronson Children's Hospital Pediatric Referral Service.

Offered:  All weeks

Objectives:
  • Take primary responsibility for their patients.
  • Perform focused histories, physicals, and communicate orally and in writing appropriately.
  • Share information effectively with patients and families.
  • Prioritize and organize work effectively.
  • Anticipate what patients will need during the course of hospitalization (i.e. when they need to be re-examined, 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 hand-overs.
  • Re-evaluate patients when taking on their care (i.e. the assessment and plan, as well as the clinical status and looking further when the clinical picture is not consistent with the expected course).
  • Coping with uncertainty in patient care issues (i.e. knowing what you know and what you do not know, accessing best resources, and knowing when and how to get help).
  • Function as a "team player" with families, residents, attendings, nurses, ancillary staff and all others involved in the care of the patient.
  • Coordinate the care of patients during hospitalization and in planning for discharge.

Advanced Clerkship Goals:

  1. Demonstrate clinical reasoning in gathering focused information relevant to a patient's care.
  2. Demonstrate patient-centered interview skills
  3. Demonstrate patient-centered examination techniques.
  4. Articulate a management plan based on the well-reasoned differential and working diagnoses.
  5. Provide complete and succinct documentation so that other providers have evidence of your clinical reasoning to ensure continuity of care and patient safety.
  6. Recommend reliable, cost-effective tests when indicated for screening or evaluating patients with common acute or chronic conditions.
  7. Routinely reflect on how the results of a test will influence clinical decision making and, conversely, on the potential consequences of not doing a test.
  8. Articulate the risks and benefits of what you are ordering (e.g., drugs, tests).
  9. Consistently discuss diagnostic plans with the patient, and provide evidence that patient preferences have been solicited and factored into decision making.
  10. Distinguish common, insignificant abnormalities from clinically important abnormalities.
  11. Provides documentation that is comprehensive and contains important information without unnecessary details or redundancies.
  12. Filter, synthesize, and prioritize information and recognize patterns, resulting in a concise, well organized, and accurate presentation.
  13. Adjust oral presentations for the receiver of information (e.g., faculty, patient/family, team members) and for the context of the presentation (e.g., emergent versus stable).
  14. Routinely identify the need to ask for help or seek new information in the context of the clinical setting, based on awareness of one's own knowledge gaps and patient needs.
  15. Provide key aspects of the ideal handover to the recipient, including verbalizing the patient's illness severity and/or providing action planning and/or contingency planning.
  16. Demonstrates awareness of known threats to handover communication (e.g., interruptions and distractions) by paying attention to the timing and location of the handover communication.
  17. Acts as an active and integrate member of the team who in most situations prioritizes team goals over one's own professional goals.
  18. Understands the roles of other team members, seek their counsel, actively listen to their recommendations, and incorporate them into practice.
  19. Interpret common test results to anticipate and respond to early clinical deterioration.
  20. Adhere to institutional procedures and protocols regarding escalation of patient care.
  21. Understand the importance of informed consent to rapport building and shared decision making.
  22. Demonstrate an understanding of the elements of informed consent generally (indications, contraindications, risks, benefits, alternatives) and the specifics of these elements for the procedures for which consent is being sought.
  23. Demonstrate patient-centered skills in performing procedures:
    • Avoid medical jargon such that patients are able to verbalize understanding of the procedure.
    • Participate in shared decision making with patients about procedures
    • Have confidence commensurate with level of knowledge and skill that puts patients at ease.
    • Simultaneously pay attention to both the procedure and the patient's emotional response.
  24. Identify real potential errors.
  25. Perform common safety behaviors (e.g., universal precautions, hand washing).
  26. Understand the importance of error prevention both to individual patients and to systems.
PEDS 9720 Advanced Ambulatory Pediatrics
Credits:
2,4
Directors:
Patel
Grading:
Pass/Fail
Description:

Advanced ambulatory clerkships provide the opportunity for students to assume initial responsibility for the evaluation of patients in the ambulatory setting. Supervision will be provided by faculty preceptors in the academic setting as well as community private practices. Students expand upon competencies they developed during the third year as they team with residents and/or preceptors to provide preventive health services as well as acute and chronic illness management. The faster pace of ambulatory care provides an environment that strengthens patient and family communication skills, rapport development, and oral presentations. The use of evidence to inform treatment and counseling of patients and their caregivers are additional competencies that are highlighted in the outpatient setting.

Advanced Ambulatory Pediatrics is a 4 week, outpatient pediatric rotation that utilizes the WMed Pediatric Clinic as well as a community pediatric office as potential clinical sites. Fourth year students who have successfully completed all Year 3 required clerkships are eligible to register for this course. During this rotation, students will focus on understanding the normal progression of growth and development from infancy through adolescence. Students will also develop their diagnostic and management skills of common acute pediatric complaints, with a focus on respiratory, abdominal and dermatologic problems, as well as common behavioral and mental health disorders. Faculty will all have appointments in the Department of Pediatric and Adolescent Medicine.

Offered:  All weeks

Objectives:
  • Assess normal and abnormal growth patterns in children and adolescents.
  • Understand Tanner staging in adolescents.
  • Recognize the normal developmental timeline from early infancy to adolescence with regard to the gross motor, fine motor, language, adaptive and personal-social domains.
  • Administer and interpret standardized developmental testing.
  • Discuss the referral patterns for children who present with concerns regarding growth and/or development.
  • Appreciate the importance of vision and hearing assessment.
  • Demonstrate an evaluation of the upper and lower respiratory system including but not limited to otologic examination with pneumatic otoscopy, and nasal passage examination.
  • Recognize, compare and contrast nasal obstruction, stridor, wheezing and alveolar congestion.
  • Demonstrate understanding of abdominal pain in children.Distinguish between benign abdominal pain and that requiring outside consultation.
  • Demonstrate knowledge of basic dermatologic problems in children, demonstrate the ability to describe skin lesions and develop a differential diagnosis based on history and physical findings.

Advanced Clerkship Goals:

  1. Demonstrate clinical reasoning in gathering focused information relevant to a patient's care.
  2. Demonstrate patient-centered interview skills.
  3. Demonstrate patient-centered examination techniques.
  4. Articulate a management plan based on the well-reasoned differential and working diagnoses.
  5. Provide complete and succinct documentation so that other providers have evidence of your clinical reasoning to ensure continuity of care and patient safety.
  6. Recommend reliable, cost-effective tests when indicated for screening or evaluating patients with common acute or chronic conditions.
  7. Routinely reflect on how the results of a test will influence clinical decision making and, conversely, on the potential consequences of not doing a test.
  8. Articulate the risks and benefits of what you are ordering (e.g., drugs tests).
  9. Consistently discuss diagnostic plans with the patient, and provide evidence that patient preferences have been solicited and factored into decision making.
  10. Distinguish common, insignificant abnormalities from clinically important abnormalities.
  11. Provides documentation that is comprehensive and contains important information without unnecessary details or redundancies.
  12. Filter, synthesize, and prioritize information and recognize patterns, resulting in a concise, well organized, and accurate presentation.
  13. Adjust oral presentations for the receiver of information (e.g., faculty, patient/family, team members) and for the context of the presentation (e.g., emergent versus stable).
  14. Routinely identify the need to ask for help or seek new information in the context of the clinical setting, based on awareness of one's own knowledge gaps and patient needs.
  15. Act as an active and integrated member of the team who in most situations prioritizes team goals over one's own professional goals.
  16. understand the roles of other team members, seek their counsel, actively listen to their recommendations, and incorporate them into practice.
  17. Maintains a professional demeanor in all but the most trying of circumstances.
  18. Interpret common test results to anticipate and respond to early clinical deterioration.
  19. Understand the importance of informed consent to rapport building and shared decision making.
  20. Demonstrate an understanding of the elements of informed consent generally (indications, contraindications, risks, benefits, alternatives) and the specifics of these elements for the procedures for which consent is being sought.
  21. Provides complete information to patients and families.
  22. Avoids medical jargon in communicating with patients and families.
  23. Demonstrate patient-centered skills in performing procedures:
    • Avoid medical jargon such that patients are able to verbalize understanding of the procedure.
    • Participate in shared decision making with patients about procedures.
    • Have confidence commensurate with level of knowledge and skill that puts patients at ease.
    • Simultaneously pay attention to both the procedure and the patient's emotional response.
  24. Identify real and potential errors.
  25. Perform common safety behaviors (e.g., universal precautions, handwashing).
  26. Understand the importance of error prevention both to individual patients and to systems.
PSYC 9710 Advanced Adult Psychiatry
Credits:
4
Directors:
Longstreet
Grading:
Pass/Fail
Description:

Advanced hospital clerkships provide the opportunity for students to assume greater responsibility for patient care of the hospitalized patient, with oversight from supervising residents and attending physicians. Students expand upon competencies they develop during the third year as they care for one to two patients at a time. Additional expectations include responsibility for developing management plans, writing orders, patient handovers and transfers of care, recognizing the policies that support patient safety, and developing competency in procedures that they will perform independently as residents. Fourth year students also assist in teaching third year students.

Students work directly with a faculty psychiatrist, usually a psychiatry resident, and a multi-disciplinary team in an inpatient setting with older adult patients. Students perform initial evaluations and help manage patients throughout their hospitalization (if desired, the student may participate in the ECT Service). The site available is Borgess Medical Center.

Not offered July and August

Objectives:

After completion of this elective, each student will be able to:

  • Demonstrate capacity to conduct comprehensive intake evaluations of inpatients
  • Discuss the diagnosis of a basic formulation, and provide a practical treatment plan for patients with a wide variety of psychopathologies.
  • Discuss basic pharmacology of psychotropic medications.
  • Manage their own inpatients with relative autonomy.
  • Provide supportive and or motivational therapies for inpatients when indicated.

Advanced Clerkship Goals:

  1. Demonstrate clinical reasoning in gathering focused information relevant to a patient's care.
  2. Demonstrate patient-centered interview skills
  3. Demonstrate patient-centered examination techniques.
  4. Articulate a management plan based on the well-reasoned differential and working diagnoses.
  5. Provide complete and succinct documentation so that other providers have evidence of your clinical reasoning to ensure continuity of care and patient safety.
  6. Recommend reliable, cost-effective tests when indicated for screening or evaluating patients with common acute or chronic conditions.
  7. Routinely reflect on how the results of a test will influence clinical decision making and, conversely, on the potential consequences of not doing a test.
  8. Articulate the risks and benefits of what you are ordering (e.g., drugs, tests).
  9. Consistently discuss diagnostic plans with the patient, and provide evidence that patient preferences have been solicited and factored into decision making.
  10. Distinguish common, insignificant abnormalities from clinically important abnormalities.
  11. Provides documentation that is comprehensive and contains important information without unnecessary details or redundancies.
  12. Filter, synthesize, and prioritize information and recognize patterns, resulting in a concise, well organized, and accurate presentation.
  13. Adjust oral presentations for the receiver of information (e.g., faculty, patient/family, team members) and for the context of the presentation (e.g., emergent versus stable).
  14. Routinely identify the need to ask for help or seek new information in the context of the clinical setting, based on awareness of one's own knowledge gaps and patient needs.
  15. Provide key aspects of the ideal handover to the recipient, including verbalizing the patient's illness severity and/or providing action planning and/or contingency planning.
  16. Demonstrates awareness of known threats to handover communication (e.g., interruptions and distractions) by paying attention to the timing and location of the handover communication.
  17. Acts as an active and integrate member of the team who in most situations prioritizes team goals over one's own professional goals.
  18. Understands the roles of other team members, seek their counsel, actively listen to their recommendations, and incorporate them into practice.
  19. Interpret common test results to anticipate and respond to early clinical deterioration.
  20. Adhere to institutional procedures and protocols regarding escalation of patient care.
  21. Understand the importance of informed consent to rapport building and shared decision making.
  22. Demonstrate an understanding of the elements of informed consent generally (indications, contraindications, risks, benefits, alternatives) and the specifics of these elements for the procedures for which consent is being sought.
  23. Demonstrate patient-centered skills in performing procedures:
    • Avoid medical jargon such that patients are able to verbalize understanding of the procedure.
    • Participate in shared decision making with patients about procedures
    • Have confidence commensurate with level of knowledge and skill that puts patients at ease.
    • Simultaneously pay attention to both the procedure and the patient's emotional response.
  24. Identify real potential errors.
  25. Perform common safety behaviors (e.g., universal precautions, hand washing).
  26. Understand the importance of error prevention both to individual patients and to systems.
PSYC 9712 Advanced Adolescent Psychiatry
Credits:
4
Directors:
Longstreet
Grading:
Pass/Fail
Description:

Advanced hospital clerkships provide the opportunity for students to assume greater responsibility for patient care of the hospitalized patient, with oversight from supervising residents and attending physicians. Students expand upon competencies they develop during the third year as they care for one to two patients at a time. Additional expectations include responsibility for developing management plans, writing orders, patient handovers and transfers of care, recognizing the policies that support patient safety, and developing competency in procedures that they will perform independently as residents. Fourth year students also assist in teaching third year students.

Advanced Adolescent Psychiatry is an experience during which time students work as part of a treatment team including an attending psychiatrist, resident, social worker and therapists. Students will engage with faculty and staff in the process of psychological testing, group therapy, individual therapy, family therapy, and activities therapy. The site available is Borgess Medical Center.

Not offered July and August

Objectives:

After completion of this elective, each student will be able to:

  • Demonstrate the capacity to perform a comprehensive intake evaluation on adolescents.
  • Assess and utilize family and community resources to better understand and manage patients.
  • Assess and manage the common psychiatric disorders in children and adolescents.
  • Utilize common psychotherapeutic and psycho-pharmacological treatment approaches.
  • Conduct observed individual and family therapy sessions.
  • Obtain collateral information from as well as provide comfort for the families and patients.

Advanced Clerkship Goals:

  1. Demonstrate clinical reasoning in gathering focused information relevant to a patient's care.
  2. Demonstrate patient-centered interview skills
  3. Demonstrate patient-centered examination techniques.
  4. Articulate a management plan based on the well-reasoned differential and working diagnoses.
  5. Provide complete and succinct documentation so that other providers have evidence of your clinical reasoning to ensure continuity of care and patient safety.
  6. Recommend reliable, cost-effective tests when indicated for screening or evaluating patients with common acute or chronic conditions.
  7. Routinely reflect on how the results of a test will influence clinical decision making and, conversely, on the potential consequences of not doing a test.
  8. Articulate the risks and benefits of what you are ordering (e.g., drugs, tests).
  9. Consistently discuss diagnostic plans with the patient, and provide evidence that patient preferences have been solicited and factored into decision making.
  10. Distinguish common, insignificant abnormalities from clinically important abnormalities.
  11. Provides documentation that is comprehensive and contains important information without unnecessary details or redundancies.
  12. Filter, synthesize, and prioritize information and recognize patterns, resulting in a concise, well organized, and accurate presentation.
  13. Adjust oral presentations for the receiver of information (e.g., faculty, patient/family, team members) and for the context of the presentation (e.g., emergent versus stable).
  14. Routinely identify the need to ask for help or seek new information in the context of the clinical setting, based on awareness of one's own knowledge gaps and patient needs.
  15. Provide key aspects of the ideal handover to the recipient, including verbalizing the patient's illness severity and/or providing action planning and/or contingency planning.
  16. Demonstrates awareness of known threats to handover communication (e.g., interruptions and distractions) by paying attention to the timing and location of the handover communication.
  17. Acts as an active and integrate member of the team who in most situations prioritizes team goals over one's own professional goals.
  18. Understands the roles of other team members, seek their counsel, actively listen to their recommendations, and incorporate them into practice.
  19. Interpret common test results to anticipate and respond to early clinical deterioration.
  20. Adhere to institutional procedures and protocols regarding escalation of patient care.
  21. Understand the importance of informed consent to rapport building and shared decision making.
  22. Demonstrate an understanding of the elements of informed consent generally (indications, contraindications, risks, benefits, alternatives) and the specifics of these elements for the procedures for which consent is being sought.
  23. Demonstrate patient-centered skills in performing procedures:
    • Avoid medical jargon such that patients are able to verbalize understanding of the procedure.
    • Participate in shared decision making with patients about procedures
    • Have confidence commensurate with level of knowledge and skill that puts patients at ease.
    • Simultaneously pay attention to both the procedure and the patient's emotional response.
  24. Identify real potential errors.
  25. Perform common safety behaviors (e.g., universal precautions, hand washing).
  26. Understand the importance of error prevention both to individual patients and to systems.
PSYC 9714 Advanced Geriatric Psychiatry
Credits:
4
Directors:
Longstreet
Grading:
Pass/Fail
Description:

Advanced hospital clerkships provide the opportunity for students to assume greater responsibility for patient care of the hospitalized patient, with oversight from supervising residents and attending physicians. Students expand upon competencies they develop during the third year as they care for one to two patients at a time. Additional expectations include responsibility for developing management plans, writing orders, patient handovers and transfers of care, recognizing the policies that support patient safety, and developing competency in procedures that they will perform independently as residents. Fourth year students also assist in teaching third year students.

Students work directly with a faculty psychiatrist, usually a psychiatry resident, and a multi-disciplinary team in an inpatient setting with older adult patients. Students perform initial evaluations and help manage patients throughout their hospitalization (if desired, the student may participate in the ECT Service). The site available is Borgess Medical Center.

Not offered July and August

Objectives:

After completion of this elective, each student will be able to:

  • Demonstrate the capacity to provide psychiatric evaluations on older adult patients.
  • Discuss the effects of medical illnesses and medications on the presentation of psychiatric illness.
  • Demonstrate the ability to appropriately use and interpret the results of various psychometric screening instruments.
  • Demonstrate the ability to assess and utilize family and community resources to better understand and manage patients.
  • Identify and assess common neuropsychiatric disorders.
  • Discuss pharmacologic and non-pharmacologic including treatment approaches to manage behavioral problems.
  • Explain the unique biomedical processes involved in the presentation of psychiatric symptoms in some medical conditions as well as the effect of medical illnesses on psychiatric disorders.

Advanced Clerkship Goals:

  1. Demonstrate clinical reasoning in gathering focused information relevant to a patient's care.
  2. Demonstrate patient-centered interview skills
  3. Demonstrate patient-centered examination techniques.
  4. Articulate a management plan based on the well-reasoned differential and working diagnoses.
  5. Provide complete and succinct documentation so that other providers have evidence of your clinical reasoning to ensure continuity of care and patient safety.
  6. Recommend reliable, cost-effective tests when indicated for screening or evaluating patients with common acute or chronic conditions.
  7. Routinely reflect on how the results of a test will influence clinical decision making and, conversely, on the potential consequences of not doing a test.
  8. Articulate the risks and benefits of what you are ordering (e.g., drugs, tests).
  9. Consistently discuss diagnostic plans with the patient, and provide evidence that patient preferences have been solicited and factored into decision making.
  10. Distinguish common, insignificant abnormalities from clinically important abnormalities.
  11. Provides documentation that is comprehensive and contains important information without unnecessary details or redundancies.
  12. Filter, synthesize, and prioritize information and recognize patterns, resulting in a concise, well organized, and accurate presentation.
  13. Adjust oral presentations for the receiver of information (e.g., faculty, patient/family, team members) and for the context of the presentation (e.g., emergent versus stable).
  14. Routinely identify the need to ask for help or seek new information in the context of the clinical setting, based on awareness of one's own knowledge gaps and patient needs.
  15. Provide key aspects of the ideal handover to the recipient, including verbalizing the patient's illness severity and/or providing action planning and/or contingency planning.
  16. Demonstrates awareness of known threats to handover communication (e.g., interruptions and distractions) by paying attention to the timing and location of the handover communication.
  17. Acts as an active and integrate member of the team who in most situations prioritizes team goals over one's own professional goals.
  18. Understands the roles of other team members, seek their counsel, actively listen to their recommendations, and incorporate them into practice.
  19. Interpret common test results to anticipate and respond to early clinical deterioration.
  20. Adhere to institutional procedures and protocols regarding escalation of patient care.
  21. Understand the importance of informed consent to rapport building and shared decision making.
  22. Demonstrate an understanding of the elements of informed consent generally (indications, contraindications, risks, benefits, alternatives) and the specifics of these elements for the procedures for which consent is being sought.
  23. Demonstrate patient-centered skills in performing procedures:
    • Avoid medical jargon such that patients are able to verbalize understanding of the procedure.
    • Participate in shared decision making with patients about procedures
    • Have confidence commensurate with level of knowledge and skill that puts patients at ease.
    • Simultaneously pay attention to both the procedure and the patient's emotional response.
  24. Identify real potential errors.
  25. Perform common safety behaviors (e.g., universal precautions, hand washing).
  26. Understand the importance of error prevention both to individual patients and to systems.
RAD 9410 Diagnostic Radiology
Credits:
2,4
Directors:
Tominna, Smullens
Grading:
Pass/Fail
Description:

This is an overview of diagnostic radiology. Students will rotate through general radiology and the different subspecialties (gastrointestinal, neuroradiology, mammography, interventional radiology, musculoskeletal, and emergency radiology). Students will participate in the daily reading of images and in the performance of procedures. They will operate during the rotation as part of a team consisting of physicians, physician assistants, radiology physician assistants, nurses, and technologists.

During the elective, the students will choose what rotations they would like to participate in. They will participate in interpretation of images and performing procedures with the staff radiologist. Students will be on the rotation for approximate ten hours per day, some of which may be night shifts. Students will be expected to present an interesting case at the end of the elective. Students will attend all departmental conferences.

Offered: All weeks

Objectives:

After completion of this elective, each student will be able to:

  • Develop and demonstrate an understanding of the imaging modalities of radiology (X-ray, Ultrasound, CT, MRI, Fluoroscopy, Nuclear Medicine, and Interventional Radiology).
  • Develop and demonstrate an understanding of the indications for imaging.
  • Develop and demonstrate an understanding of the anatomy on imaging
  • Develop an understanding of the pathology seen on imaging.
  • Maintain a professional and positive relationship with the radiology staff and referring clinicians (professional, interpersonal and communication skills).
  • Develop an understanding of the limitations of imaging.
  • Develop an understanding of the risks of radiation and contrast.
  • Develop an understanding of the terminology used in radiology.
RAD 9460 Interventional Radiology
Credits:
2,4
Directors:
Tominna, Smullens
Grading:
Pass/Fail
Description:

This is a 2 or 4-week elective in interventional radiology. Students will be expected to be involved in the initial work up of patients, participate in procedures, and in the follow-up care of patients. Students will be expected to understand the risks, benefits and alternatives to procedures. The will be expected to perform basic procedure (line placement, paracetesis and thoracetesis) by the end of the rotation. Students will also be expected to participate in ward rounds. They will operate during the rotation as part of a team consisting of physicians, physician assistants, radiology physician assistants, nurses, and technologists. Students will not be required to take call. Students will be expected to present an interesting case at the end of the elective. Students will attend all departmental conferences.

Offered: All weeks

Objectives:

After completion of this elective, each student will be able to:

  • Develop and demonstrate an understanding of the different imaging modalities used in interventional radiology (X-ray, Ultrasound, CT, MRI, and Fluoroscopy).
  • Develop and demonstrate an understanding of the indications, alternatives, and risks for intervention.
  • Develop and demonstrate an understanding of the anatomy on imaging.
  • Develop the skill to be able to perform basic procedures (image guided line placement, paracentesis and thoracentesis).
  • Participate in more complex procedures and understand the equipment used.
  • Maintain professional and positive relationships with interventional radiology staff and referral clinicians (Professionalism, Interpersonal and Communication Skills).
  • Attend clinic once a week with the interventional radiologist.
  • Develop an understanding of the risks of radiation and contrast.
  • Develop an understanding of the terminology used in interventional radiology.
SURG 9710 Advanced General Surgery
Credits:
4
Directors:
Miller
Grading:
Pass/Fail
Description:

Advanced hospital clerkships provide the opportunity for students to assume greater responsibility for patient care of the hospitalized patient, with oversight from supervising residents and attending physicians. Students expand upon competencies they develop during the third year as they care for one to two patients at a time. Additional expectations include responsibility for developing management plans, writing orders, patient handovers and transfers of care, recognizing the policies that support patient safety, and developing competency in procedures that they will perform independently as residents. Fourth year students also assist in teaching third year students.

The advanced general surgery rotation is designed for students who are interested in a general surgery residency. They will manage patients as independently as possible with oversight from the general surgery chief resident and an attending surgeon. They will be assigned to the general surgery service at either Borgess or Bronson. Assistance with teaching 3rd year students will also be expected. They will gain operative experience as well as have increased responsibilities managing patients in the inpatient and outpatient setting. They will be assigned a faculty mentor/preceptor at their assigned hospital.

Offered:  Not offered in July

Objectives:

Upon completion of this course, each student will be able to:

  • Obtain a complete and accurate history in an organized fashion.
    • Demonstrate patient-centered interview skills (attentive to patient verbal and nonverbal cues, patient/family culture, need for interpretive services, demonstrates active listening skills).
    • Identify pertinent history elements in common presenting situations.
    • Obtain focused, pertinent histories in urgent, emergent and consultative setting.
    • Demonstrate clinical reasoning in gathering focused information relevant to patient’s care.
  • Perform a complete and accurate physical exam in logical and fluid sequence.
    • Perform a clinically relevant, focused physical exam pertinent to the setting and purpose of patient visit.
    • Identify, describe and document abnormal physical exam findings.
    • Demonstrate patient-centered examination techniques that reflect respect for patient privacy, comfort and safety.
  • Prioritize a differential diagnosis following a clinical encounter.
    • Synthesize essential information from the previous records, history, physical exam and initial diagnostic evaluations.
    • Integrate information as it emerges to continuously update the differential diagnosis
    • Integrate the scientific foundations of medicine with clinical reasoning skills to develop a differential diagnosis and a working diagnosis.
    • Engage with supervisors and team members for endorsement and verification of the working diagnosis in developing a management plan.
  • Recommend and interpret common diagnostic and screening tests.
    • Recommend first-line, cost-effective diagnostic evaluation for a patient with an acute or chronic common disorder.
    • Provide rationale for decision to order the test.
    • Interpret the results of basic diagnostic studies (both lab and imaging); know common lab values.
  • Enter and discuss orders and prescriptions.
    • Demonstrate
    • Demonstrate working knowledge of the protocol by which orders will be processed in the environment in which they are placing the orders.
    • Compose orders efficiently and effectively, such as by identifying the correct admission order set, selecting the correct fluid and electrolyte replacement orders, and recognizing the needs for deviations from standard order sets.
  • Document a clinical encounter in the patient record.
    • Filter, organize, and prioritize information.
    • Synthesize information into a cogent narrative.
    • Record a problem list, working and differential diagnosis and plan.
    • Verify the authenticity and origin of the information recorded in the documentation (e.g., avoids blind copying and pasting).
  • Provide an oral presentation of a clinical encounter.
    • Present information that has been personally gathered or verified, acknowledging any areas of uncertainty.
    • Provide an accurate, concise, and well-organized oral presentation.
  • Give or receive a patient handover to transition care responsibly.
    • Conduct handover communication that minimizes known threats to transitions of care (e.g., by ensuring you engage the listener, avoiding distractions).
    • Document—and update—an electronic handover tool.
    • Provide succinct verbal communication that conveys, at a minimum, illness severity, situation awareness, action planning, and contingency planning.
  • Recognize a patient requiring urgent or emergent care and initiate evaluation and management.
    • Recognize normal vital signs and variations that might be expected based on patient- and disease-specific factors.
    • Recognize severity of a patient’s illness and indications for escalating care.
    • Identify potential underlying etiologies of the patient’s decompensation.
    • Communicate the situation to responding team members.
  • Obtain informed consent for tests and/or procedures.
    • Describes the indications, risks, benefits, alternatives and potential complications of basic procedures.
  • Perform basic procedures such as assisting in surgery, suturing wounds, debridements, wound VAC changes, incision and drainage of abscesses.
    • Demonstrate the technical (motor) skills required for the procedure.
    • Understand and explain the anatomy, physiology, indications, risks, contraindications, benefits, alternatives, and potential complications of the procedure.

Advanced Clerkship Goals:

  1. Demonstrate clinical reasoning in gathering focused information relevant to a patient's care.
  2. Demonstrate patient-centered interview skills
  3. Demonstrate patient-centered examination techniques.
  4. Articulate a management plan based on the well-reasoned differential and working diagnoses.
  5. Provide complete and succinct documentation so that other providers have evidence of your clinical reasoning to ensure continuity of care and patient safety.
  6. Recommend reliable, cost-effective tests when indicated for screening or evaluating patients with common acute or chronic conditions.
  7. Routinely reflect on how the results of a test will influence clinical decision making and, conversely, on the potential consequences of not doing a test.
  8. Articulate the risks and benefits of what you are ordering (e.g., drugs, tests).
  9. Consistently discuss diagnostic plans with the patient, and provide evidence that patient preferences have been solicited and factored into decision making.
  10. Distinguish common, insignificant abnormalities from clinically important abnormalities.
  11. Provides documentation that is comprehensive and contains important information without unnecessary details or redundancies.
  12. Filter, synthesize, and prioritize information and recognize patterns, resulting in a concise, well organized, and accurate presentation.
  13. Adjust oral presentations for the receiver of information (e.g., faculty, patient/family, team members) and for the context of the presentation (e.g., emergent versus stable).
  14. Routinely identify the need to ask for help or seek new information in the context of the clinical setting, based on awareness of one's own knowledge gaps and patient needs.
  15. Provide key aspects of the ideal handover to the recipient, including verbalizing the patient's illness severity and/or providing action planning and/or contingency planning.
  16. Demonstrates awareness of known threats to handover communication (e.g., interruptions and distractions) by paying attention to the timing and location of the handover communication.
  17. Acts as an active and integrate member of the team who in most situations prioritizes team goals over one's own professional goals.
  18. Understands the roles of other team members, seek their counsel, actively listen to their recommendations, and incorporate them into practice.
  19. Interpret common test results to anticipate and respond to early clinical deterioration.
  20. Adhere to institutional procedures and protocols regarding escalation of patient care.
  21. Understand the importance of informed consent to rapport building and shared decision making.
  22. Demonstrate an understanding of the elements of informed consent generally (indications, contraindications, risks, benefits, alternatives) and the specifics of these elements for the procedures for which consent is being sought.
  23. Demonstrate patient-centered skills in performing procedures:
    • Avoid medical jargon such that patients are able to verbalize understanding of the procedure.
    • Participate in shared decision making with patients about procedures
    • Have confidence commensurate with level of knowledge and skill that puts patients at ease.
    • Simultaneously pay attention to both the procedure and the patient's emotional response.
  24. Identify real potential errors.
  25. Perform common safety behaviors (e.g., universal precautions, hand washing).
  26. Understand the importance of error prevention both to individual patients and to systems.