Medicine
100.1 Sub I – Medicine
Director: Joseph Rencic, M.D.
Location: Boston Medical Center
Telephone: (617) 358-3524
Number of Students: 5
Period to be 0ffered: Four weeks (Blocks 9-14 and 16-20)
Description of Elective:
The Subinternship in Medicine is designed to challenge and enhance the capacity of the student to work as an increasingly independent, highly competent, and compassionate caregiver and contributing team member. To achieve this goal, the acting intern will work as an advanced care provider under the direct supervision of a medicine ward resident and teaching attending, Students will assume increasing responsibility for the initial evaluation and management of assigned patients. The student is expected to combine medical knowledge with clinical and interpersonal skills in order to demonstrate independent thought and develop a plan of action. The student is expected to develop a balance between acting independently and acknowledging his/her limitations and seeking help as appropriate. Clinical work will be supplemented by conferences offered by the Department of Medicine.
There are 2 pathways of experience in the Acting Internship.
Pathway A (Integrated Acting Internship): Running throughout the year, the Pathway A experience provides a ward experience with 5 students per block. In this experience, students are integrated onto a typical ward team consisting of a resident and 2 interns. Students on the integrated team will have the opportunity to interface with 3rd year students on their Medicine clerkship.
Responsibilities of the Pathway A Integrated Acting Internship include:
- Admitting patients to the team – you will likely start at one admission per day during several days of the week but should work toward admitting two patients regularly on long call days, and hopefully, three or more patients on one or more occasions.
- Following a core of patients (on average 3-6 patients)
- Providing patient care through the last Sunday of the rotation
Pathway B (Acting Internship): Only occurs from June to September. We have the capacity for 6 students to participate in this experience per block. You will be part of a team with a resident and two other acting interns and no interns.
Responsibilities of the Pathway B Acting Internship include:
- Admitting patients to the team
- Following a core of patients (team of 3 students covers on average 4-10 patients)
- Taking overnight shifts 3-4 nights over the 4-week block (# of nights to be determined)
- Providing patient care through the last Sunday of the rotation
After selecting a block for your Acting Internship in Medicine, you will be assigned to either Pathway A or Pathway B and be notified within ~4 weeks of the start of your block.
100.33 Advanced Medicine: Medical Care of the Surgical Patient
Instructor: Henry Trier, M.D.
Contact Person: Alexis Parry email: Alexis.Parry@bmc.org
Location: Department of General Internal Medicine, Crosstown, 801 Massachusetts Ave., 2nd Floor
Telephone: (617) 414-6927 Fax: (617) 414-4676
Number of Students: One
Period to be offered: One month, between June and May inclusive
Description of Elective:
The elective is designed to provide an opportunity for the student interested in a surgical or medical career to gain experience in the management of medical problems in the surgical patient. Students spend one month on the Medical Consult Service and work under the direct supervision of two senior medical residents and the medical attending. He/she will actively participate in completing inpatient consultations including generation of management plans, daily work rounds and twice a week didactic sessions. The student is expected to work Monday through Friday, 8 am to 6 pm. There is no overnight call. The student will also participate in two half-day sessions per week in the Pre-Procedure Clinic, located in Shapiro Lower Level, where patients scheduled for elective surgery are assessed by providers from both Surgery and Anesthesia departments. Students considering surgery including orthopedics, anesthesia, or internal medicine careers have found this elective valuable.
The interactions of medical and surgical illness are complex and may complicate management in the perioperative period. Many questions commonly arise. What are the risks of surgery and general anesthesia in patients with a given set of medical illnesses? What are the predictors of these risks? Can they be reduced by preoperative measures? How should medical problems be managed before and after surgery? What complications might be expected? It is hoped at the conclusion of this elective, the student will have an appreciation of how medical problems in the perioperative period should be approached diagnostically and therapeutically. The Medicine Consult service is also the primary care team for patients admitted to Boston Medical Center with acute hip fractures, as the patients have many medical comorbidities that make their preoperative and postoperative management challenging.
Students should contact the Medicine Consult service director, Dr. Henry Trier, via email (Henry.Trier@bmc.org) in the week prior to starting service for more information as well as link to educational supplemental materials.
A core syllabus of articles from the medical, surgical and obstetrical literature relevant to medical consultation is available and should be picked up from the coordinator one week prior to beginning the rotation.
101.1 Sub I – Advanced Medicine: Medical Intensive Care Unit
Instructors: Hector Marquez, M.D. and Christine Reardon, M.D., Pulmonary/Critical Care Medicine Faculty
Location: Boston Medical Center, Menino Pavilion
Contact: Kathyann Adamson email: kathyw@bu.edu
Number of Students: Two (fourth year BU medical students only)
Period to be offered: One Month
Description of Elective:
The Advanced Medicine Sub-Internship in the Medical Intensive Care Unit (MICU) is designed to provide highly motivated students with an introduction to the diagnosis and management of critically ill patients with single and multi-system organ failure. The MICU is designed to provide state of the art care to seriously or critically ill patients in an environment that emphasizes learning, teaching and independence. Students are exposed to a large spectrum of clinical problems including, but not limited to, respiratory failure with or without mechanical ventilation, ARDS, shock, sepsis, gastrointestinal hemorrhage, diseases related to alcohol or drug excess, HIV-related conditions, pulmonary edema, pulmonary emboli, renal, hepatic or cardiac failure, DKA, fluid, electrolyte or thermic disturbances, CVA or complications of malignancies.
Care is provided in a team format which besides physicians, nurse practitioners and senior medical students, includes nurses, respiratory therapists, pharmacists, nutritionists, physical therapists and social workers. This multi-disciplinary approach provides excellent care to patients by capitalizing on the expertise of many services. Students are expected to participate on daily ventilator and work rounds, and to contribute to the management of patients by collecting and assimilating data for presentation to the attending, arranging consults and tests, and by placing orders and performing common procedures under direct supervision.
Patients are cared for by three teams. Two teams (Red and Blue) consist of 2 PGY2 or PGY3 residents, 2 PGY1 residents, a pulmonary/critical care attending and a pulmonary/critical care fellow. The third team (Green) consists of 2 PGY2 or PGY3 residents, 2 PGY1 residents, a nurse practitioner and pulmonary/critical care attending. The PGY2 or PGY3 admits and performs the initial management on all patients in the MICU with the supervision of the MICU Attending/Fellow during the day or the Special Care Unit Night Coverage (SCUNC) at night. Subsequent daily care is then assumed by a PGY1 resident, Nurse Practitioner or a Medical Student on a sub-internship rotation.
Students are assigned to the Red and Blue MICU teams preferentially but if necessary can be assigned to the Green Team. Students are required to be present for 6 days of the week (weekdays and either Saturday or Sunday). There is no night call.
Restrictions:
1) Reception of Honors grade in third year medicine clerkship or in the medicine sub-internship.
2) These requirements may be waived if the student is approved by the Clerkship Selection Committee, chaired by Dr. Sonia Ananthakrishnan.
102.1 Ambulatory Medicine
Director: TBD
Contact: Alyssa Pace email: apace@bu.edu
Telephone: (617) 358-3524
Period to be offered: 4 weeks
Description of Elective:
Advanced Internal Medicine, Medicine II Block: All Students will complete a required four week Ambulatory Medicine rotation in the fourth year. For the 4 week ambulatory medicine rotation, students will be assigned to one of the following sites: Jamaica Plain/West Roxbury VA, Bedford VA, Roger Williams Medical Center, Neighborhood Health Centers, Private Practices or BMC. CAMED is exploring additional possible clinical venues for training in Ambulatory Internal Medicine and may add new venues in the coming year.
103.1 Internal Medicine Internship Prep Course
Co-Directors: Joseph Rencic, M.D. and Ryan Chippendale M.D.
Telephone: (617) 358-3524
Number of Students: 10 students
Length of Elective: 2 weeks
Period to be Offered: offered last 2 weeks of Block 20 (academic year 2022-2023); last 2 weeks of Block 19 (academic year 2023-2024)
Grading: Pass/Fail
Description of Elective:
This elective will prepare students who are planning to enter an Internal Medicine Residency. It is designed to build specific skills and knowledge to facilitate the transition from medical student to intern. Students will participate in small group activities and didactic learning. These will take place in the Boston Medical Center Simulation Center (for procedural/simulation sessions) and the Boston University Chobanian & Avedisian School of Medicine (for classroom learning sessions). CAMED IV students will be oriented to the elective on the first day of the rotation during a formal orientation session with the course directors.
The sessions will include a mixture of case-based, small-group classroom learning, as well as hands-on simulation and procedural sessions led by content-expert faculty members and procedurists. There will be no direct patient contact.
By the end of the two week Internal Medicine Internship Prep Course students will be able to:
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- Identify, evaluate, and manage acute medical situations including hypoxia, altered mental status, hypertensive emergency, shock, and chest pain as observed by faculty in simulated medical scenarios.
- Interpret common diagnostic tests, such as EKGs and chest X-rays, during simulated medical scenarios.
- Describe and demonstrate the steps for performing common medical procedures, including central line placement, intravenous line placement, and arterial puncture as observed by faculty in simulated procedures.
- Discuss how to effectively and respectfully communicate with patients from different cultural backgrounds about end of life issues, decision making capacity, and bad news during small group discussions.
- Demonstrate techniques to communicate effectively and respectfully with a medical team from different cultural backgrounds when presenting a new patient, responding to pages, calling consults, handing off or discharging patients as observed during small group discussions and during simulated pages.
- Discuss strategies to balance responsibilities and wellness as interns through effective learning, time management, and organization during small group discussions.
Internal Medicine Bootcamp Elective additional information
104.1 Addiction Medicine Elective
Elective Director: Zoe Weinstein, M.D., M.D., Assistant Professor of Medicine
Contact and Course Orientation: Linda Neville, Program Manager
Location: 801 Massachusetts Ave, 2nd floor, Boston, MA 02118
Telephone: 617-638-8344
Number of students: 1
Length of Elective: 4 weeks
Period to be offered: All Blocks
Student will contact Dr. Weinstein prior to the first day of the elective to review schedule and arrange for a brief orientation and discussion about issues related to the care of patients with SUD.
If you must be absent email Linda Neville (Linda.Neville@bmc.org) as soon as possible. Students should be available by pager/email during working hours.
DESCRIPTION OF ELECTIVE:
The Addiction Medicine elective will take place at Boston Medical Center’s inpatient wards, as well as various community sites, including but not limited to: HCRC Methadone Clinic, FASTER-PATHS discharge clinic, and AHOPE Needle Exchange. This is an opportunity for a 4th year medical student to understand addiction as a chronic medical condition, and SUD as an important and prevalent public health issue. Students will engage in care of persons with SUD in a professional, health-oriented, responsible and proactive manner, in order to reduce substance-related harm, promote health and address co-existing medical problems. Students will interview and examine patients with attending physician supervision and be involved in the patients treatment planning. Students will also rotate through Hope House where they will be exposed to a community residential and outpatient treatment settings.
Students are expected to participate, Monday through Friday, at least 40 hours/week. Students will attend teaching conferences that are scheduled during the elective time. Students will receive timely, formative feedback from the attending preceptors including a mid-clerkship evaluation to assess their progress in developing the skills needed to treat patients with SUD.
Addiction Medicine Elective additional information
105.1 Palliative Care
Elective Director: Rachel Rome, M.D.
Instructors: Alexandra Dobie, LICSW, MSW, Henri Lee, M.D., and Jessica Knight, NP, NP
Contact: Amy L. Cann (amy.cann@bmc.org)
Location: Boston Medical Center, Palliative Medicine Unit, 801 Massachusetts Ave., 2nd Floor
Telephone: (617) 414-7591
Number of Students: 1 per block
Period to be offered: Blocks 13-20
Length of Elective: Four weeks (contact Amy Cann amy.cann@bmc.org regarding arranging 2 week elective)
DESCRIPTION OF ELECTIVE:
This elective is designed to give students with an interest in palliative care increased exposure to the role of the palliative care provider in the inpatient setting. Students will participate as members of the palliative care team during which time they will staff palliative care consults, attend family meetings, and learn more about the role of the palliative care provider in the care of patients in the inpatient setting.
Students will also spend time involved in self-directed teaching sessions, using a curriculum developed by the National Cancer Institute. Modules include topics such as how to perform a comprehensive palliative care assessment, cancer pain management, loss/grief/bereavement, survivorship, the last hours of living, communicating effectively, clarifying diagnosis and prognosis, negotiating goals of care, clinical trials, withdrawing nutrition/hydration, conflict resolution, advance care planning, physician-assisted suicide, cancer doctors and burnout. Students will complete all modules by the conclusion of the two or four week elective. Additionally students will be asked to conduct a literature search on topics relevant to palliative care and will be asked to present one topic weekly to the faculty.
033.2 Geriatrics Clerkship
Instructors: Megan Young, M.D.
Location: Robinson 2700 – Boston Medical Center, Robinson Complex
Telephone: 638-6155
Course Director: Megan Young, M.D.
Course Administrator: Megan Rose email: megrose@bu.edu
Number of Students: Varies (see note below)
Period to be offered: One month
Description of Elective:
During this rotation, students will have the unique opportunity (few medical schools offer this experience) to go out regularly on home visits with a physician or nurse preceptor. Additional experiences may include going to community sites such as an adult day health center or nursing home. Students will participate in case-based lectures, write an evidence-based discussion of a patient management problem, engage in computer-based case discussions, interview a patient or family member for The My Life My Story Project, present an end-of-life project and learn about social determinants of health.
Both physician and nurse preceptors will evaluate students’ performance in the rotation. Course objectives include: students will learn about common geriatric syndromes, understand and use functional assessment in the evaluation of older adults, work with an interdisciplinary team to develop complex care plans. Students will and learn about home care and what is possible to provide medically for elderly patients living in the community. Additionally students will be able to Define and explain the philosophy and role of palliative care, and differentiate hospice from palliative care, participate in discussions about what matters most to an older adult, and work with the patient and team to honor these priorities. Furthermore students will formally identify how structural and social determinants of health impact health outcomes and healthcare access for older adults and those who care for them.
Note: This is a required rotation at CAMED but may be taken as an elective by external students on a space available basis only.
440.1 Multidisciplinary Breast Cancer Care Elective
Multiple Departments
Rotation Director(s): Michael Cassidy, MD and Naomi Ko, MD
Coordinator: TBD
CONTACT AND COURSE ORIENTATION INFORMATION
Michael Cassidy, MD, FACS
Department of Surgery
Section of Surgical Oncology
820 Harrison Ave
FGH 5006
Boston, MA 02118
617-414-8090
Students will receive an orientation on the first day of the elective including clinical schedule and expectations.
NUMBER OF STUDENTS
One per block.
LENGTH OF ELECTIVE
4 weeks.
AVAILABLE BLOCKS / SEMESTERS
This elective is available all year.
DESCRIPTION OF ELECTIVE
This elective is based at Boston Medical Center and the Boston University Chobanian & Avedisian School of Medicine. The student will participate in outpatient activities of the core faculty members including surgical oncology, medical oncology, and radiation oncology clinics. Students will also participate in the operative management of breast cancer patients as assistants in the operating room. Exposure to breast imaging technology and interpretation, breast cancer pathology interpretation, and genetics will be incorporated through sessions in those disciplines. In addition, select newly diagnosed patients will be identified at the beginning of the elective and the student will follow those patients to all consultations and treatments. Students will be expected to participate in weekly multidisciplinary breast tumor board including preparing and presenting case presentations for discussion with direct faculty guidance. Students will be exposed to early breast cancer, locoregionally advanced breast cancer, and metastatic breast cancer, gaining an appreciation for the full spectrum of presentation. Integration of expertise from all disciplines will be emphasized. Landmark clinical trials in breast cancer will be reviewed and discussed through a program of assigned reading and discussion with faculty. This is primarily an outpatient elective with rare select inpatient activities. The student will be expected to participate in clinical activities on all weekdays during the elective. There will be no weekend responsibilities.