Surgery

Boston University Medical Center
Fourth-Year Elective Rotations in Surgery

Directors for BU Surgical Electives: Joanne Favuzza, D.O., Assistant Professor of Surgery

Coordinator for BU Surgical Electives: Lana Ketlere-Student Coordinator, Office of Surgical Education, Room C515, 617 638-8442

The electives listed below are administered through the Office of Surgical Education.  These are all four-week rotations.  Availability can be checked with Ms. Ketlere by telephoning her at 617-638-8442 or emailing, lana.ketlere@bmc.org

Learning Objectives for the Fourth-Year General Surgery Rotations:

At the end of this rotation the student will be able to:

1) Participate fully in the activities of the surgical team, including rounds, conferences, clinics, and operating room;

2) Take individual responsibility for patient care with appropriate supervision, including initial patient assessment, daily care, participation in surgery, and accurate notes;

3) Assist residents with their night time call responsibilities, including consults and ward care;

4)  Communicate patient information to the surgical team in an accurate and organized way at rounds and conferences;

5) Research patient issues and provide education to the surgical team, especially the third year students;

6) Demonstrate a professional appearance and courteous behavior in the workplace.

Grading Criteria for the Fourth-Year Rotations:

Students will be graded by the surgical faculty at their site with input from chief residents. Evaluation will emphasize the student’s ability to assume responsibility as a member of the surgical team, as demonstrated by reliable participation, punctuality, and willingness to help when needed.

All fourth year students doing sub-internships will be expected to take call with the residents. Sub-interns will take at least three nights of overnight in-house call during the rotation. Students will have the day off after overnight call.  Taking overnight call will be optional for fourth-year students on electives that are not sub-internships.

Students will be assessed on knowledge base and improvement of knowledge.  All fourth year students will be expected to provide weekly five-minute teaching sessions to the surgical team on topics of interest.

Students will be graded on their ability to document a thorough history and physical, write accurate progress notes, and present patient information in a succinct and organized way.  Organizational skill and attention to detail will be emphasized.

Sub-internships in General Surgery Course Description:

The Department of Surgery offers fourth year students four-week sub-internships at our major teaching hospitals. The student will be assigned patients to admit and follow during their hospital course. The student will work with the resident and attending staff in managing the patient’s surgical problems in the operating room, on the inpatient wards and in the ambulatory setting. Attendance at morning and afternoon rounds, morbidity and mortality conferences, and other teaching conferences is required in the rotation, as well as taking call with residents. Instruction will focus on pathophysiology of surgical disease, pre- and post-operative care, indication for surgical intervention, and procedural skills. This elective is especially suitable for any student wishing more intensive training in surgery than is possible during the required third year clerkship.

Sub-internship Sites and Services:

Boston Medical Center – Menino Pavilion

Sub I – Vascular Surgery   (400.1a)
Instructors: Elizabeth King, M.D. and Staff
Number of Students: One
Period to be offered: One Month

Sub I – Surgical Oncology (400.1b)
Instructors: Teviah Sachs, M.D. and Staff
Number of Students: One
Period to be offered: One Month

Sub I – Acute Care and Trauma Surgery (400.3)
Instructor: Kathryn Twomey, M.D.
Number of Students: Two
Period to be offered: One Month

Sub I – Surgical Intensive Care Unit (403.1)
Instructors: Aaron Richman, M.D.
Number of Students: Four
Period to be offered: One Month

Sub I – Minimally Invasive Surgery (404.2)
Instructor: Donald Hess, M.D.
Number of Students: One
Period to be offered: One Month

Sub I – Colon and Rectal Surgery (404.3)
Instructor: Olga Beresneva, M.D.
Number of Students: One
Period to be offered: One Month

Sub I – Cardiac Surgery (405.2)
Instructor: Alex Karavas, M.D.
Number of Students: One
Period to be offered: One Month

Sub I – Thoracic Surgery (410.2)
Instructors: Kei Suzuki, M.D. and Virginia Litle, M.D.
Number of Students: One
Period to be offered: One Month

Sub I – Plastic & Reconstructive Surgery (465.2)
Instructors: Daniel Roh, M.D.
Number of Students: Two
Period to be offered: One Month

 

400.1a Sub I – Vascular Surgery

Instructor:  Elizabeth G. King, M.D.

Faculty: Alik Farber, M.D.; Jeffrey Siracuse, M.D.; Jeffrey Kalish, M.D.

Contact: Lana Ketlere     email: lana.ketlere@bmc.org

Telephone: 617- 638-8442

Number of Students: One

Period to be offered: One month

Description of Elective:

The Vascular Surgery elective at Boston Medical Center provides 4th year medical students with an immersive experience in vascular surgery, offering a comprehensive view of the diagnosis, management and treatment of vascular diseases. Students will work closely with the vascular surgery team, participating in the care of patients across a variety of clinical settings, including the operating room, interventional radiology suite, inpatient wards and outpatient clinic.

Learning objectives:

Develop proficiency in obtaining detailed vascular histories and performing focused physical exams

Gain hands-on experience with vascular diagnostic tools, including vascular ultrasound and non-invasive vascular laboratory tests (ankle-brachial index, arterial duplex, venous reflux studies)

Enhance clinical reasoning and decision making skills in managing commonly encountered vascular conditions, such as peripheral artery disease, dialysis access creation and maintenance, carotid artery disease, aortic aneurysms, venous disease and vascular trauma

 

400.1b – Surgical Oncology

Course description pending

 

 400.3 Sub I – Acute Care and Trauma Surgery

Instructor:  Kathryn Twomey, M.D.

Faculty: Peter Burke, M.D. FACS; Tracey Dechert, M.D. FACS; Aaron Richman, M.D.; Sabrina Sanchez M.D. MPH FACS; Robert Schulze M.D. MBA FACS FCCM

Contact: Lana Ketlere     email: lana.ketlere@bmc.org

Telephone: 617- 638-8442

Number of Students: Two

Period to be offered: One month

Description of Elective:

The Trauma and Acute Care surgery elective at Boston Medical Center is clinical program with a strong focus on management of acute general surgical disease and the multimodal and multidisciplinary management of traumatic injury. The elective is four weeks in duration and is designed to develop the complex peri-, intra-, and post- operative decision making and basic open and laparoscopic surgical skills of the medical student.  The goals of the elective include:

  • Provide exceptional care for surgical patients
  • Develop pre-operative, intra-operative, and post-operative management strategies in acute general surgical and traumatic surgical maladies
  • Develop an understanding of co-morbid medical conditions that can influence surgical decision making.

Once assigned students will be notified via email with instructions for reporting and service specific assignments and duties.

Note: This elective satisfies the sub-internship requirement

 

403.1 Sub I – Surgical Intensive Care Unit

Instructors: Aaron Richman, M.D.

Location:Boston Menino Pavilion

Telephone: 638-8442  Contact: Lana Ketlere   email: lana.ketlere@bmc.org

Number of Students: Four

Period to be Offered: One Month

Description of Elective:

Fourth year medical students are eligible to participate in the Surgical Intensive Care Unit elective at Boston Medical Center. This can be a one or two month elective which will be spent at the Menino Pavilion surgical intensive care unit. Students will be active members of the team and will participate in daily rounds and will be responsible for presenting in detail, all patients whom they have called on previously. He/she will defend the therapy initiated and propose a comprehensive treatment plan. Additionally, the student will participate in all procedures performed in the surgical intensive care unit. The Section on Critical Care offers daily teaching rounds as well as didactic lectures. It is hoped at the conclusion of this elective the student will have an appreciation of the problems and care of the critically ill patient.

Note: This elective satisfies the sub-internship requirement

 

404.2  Sub I – Minimally Invasive Surgery

Instructor:  Donald Hess, M.D., FACS

Faculty: Brian Carmine, M.D. , Cullen Carter, M.D. and Luise Pernar, M.D.

Contact: Lana Ketlere  email: lana.ketlere@bmc.org

Telephone: 617 638-8442

Number of Students: One

Period to be Offered: One Month

Description of Elective:

The minimally invasive surgery elective at Boston University Medical Center is a combined clinical and research program with a strong focus in laparoscopic bariatric surgery and additional experience in laparoscopic foregut, endoscopic and robotic surgery.  The elective is four weeks in duration and is designed to develop the surgical, educational and research skills of the medical student.  The goals of the elective include:

  • Provide exceptional care for surgical patients
  • Learn pre-operative and post-operative management of bariatric surgery
  • Obtain introductory training in minimally invasive surgery with special focus in bariatric surgery

Students should report on the first day of the rotation to morning rounds at 6:00 a.m., Menino 4W

Note: This elective satisfies the sub-internship requirement

 

404.3  Sub I – Colon and Rectal Surgery

 Course Director – Dr. Olga Beresneva

 Course Instructors:

  • Jason Hall, MD
    • Pager: 2373
  • Joanne Favuzza, DO
    • Pager: 3880
  • Olga Beresneva, MD
    • Pager: 8139

Administrative Contacts

  • Coordinator: The student administrative contact for this rotation will be Lana Ketlere in the Department of General Surgery at BU/BMC (lana.ketlere@bmc.org).

NUMBER OF STUDENTS

1 student per block

LENGTH OF SUB-I

4 weeks

AVAILABLE BLOCK

Block 9-20

Description of Sub-internship

The Fourth Year Sub-internship is a 4 week course in Colon and Rectal Surgery designed to immerse the 4th year student in all aspects of Colon and Rectal Surgery at Boston Medical Center. This rotation will provide students with the basic components of colon and rectal disorders and surgeries and the care of patients with these disorders. The student will be an integral part of the surgical team in the inpatient unit, the operating room, and the surgical clinic.

The acquisition of knowledge and skills in the care of the colorectal patient will be conducted in the following setting and activities.

  • Colon and Rectal surgery clinic – Shapiro 6th floor
    1. evaluation of new and established patients
    2. follow-up of medically and surgically treated patients
    3. assist in basic endoscopy including anoscopy and proctoscopy
    4. assist in office procedures such as drainage of abscesses, excision of thrombosed external hemorrhoids and tags, rubber band ligation
    5. assist in wound care
    6. assist in ostomy care
    • Emergency department – as above
    • Surgical inpatient service – comprehensive perioperative management

    The 4th year student will be an integral part of the surgery team on the inpatient units, outpatient clinic, and in the operating room during the 4-week sub-internship. The student will function as acting interns responsible for the evaluation and continued management of their own patients, under the direct supervision of the attending physicians, residents and physician assistants. Specifically, the student will take on the management of at least three new patients each week, and will assume primary responsibility for the care of these patients, with appropriate supervision. In addition, the student will be expected to do the following: perform initial history and physicals, write orders, assist in coordinating care, assist with or perform supervised procedures as applicable and appropriate for the sub-intern, present cases, use evidence-based medicine principles to help guide patient care, participate in teaching sessions, and take at least 2 weekend calls during the 4 week rotation alongside residents and attending physicians. With supervision, the student will also perform or assist procedures as appropriate to educational level and patient safety including venipuncture, IV line placement, arterial blood gas, foley catheter placement, nasogastric tube insertion, preparing and draping for surgery, assisting with surgery, and closure of surgical wounds.  All Sub-I activities will be performed under appropriate supervision which can include attendings, residents, APP’s or other qualified individuals on the Service.

    Note: This elective satisfies the sub-internship requirement

     

    405.2  Sub I – Cardiac Surgery

    Instructor: Alex Karavas, M.D.

    Location: Boston Menino Pavilion

    Telephone: 618-638-8442  Contact: Lana Ketlere   email: lana.ketlere@bmc.org

    Number of Students: One

    Period to be Offered: One Month

    Description of Elective:

    The rotation takes place at Boston Medical Center. Student will be part of the cardiac surgery team and expected to be involved in the day-to-day clinical care. Student will be working directly with the cardiac surgeons and physician assistants with goal to gain gradual comfort and supervised independency with basic surgical skills and management of cardiac surgery in the preoperative and postoperative setting as well as in the clinic.

     

    Note: This elective satisfies the sub-internship requirement

     

    Other Fourth Year Elective Rotations in Surgery

    403.2   Surgery Internship Prep Course

    Course  Director: Alik Farber, M.D.

    Period Offered:   Block 19

    Administrative Contact:

    Lana Ketlere   email: lana.ketlere@bmc.org

    Telephone:  617-638-8442

    Description of Elective:

    In this elective, 4th year medical students are given the opportunity to delve deeper into the surgical management of patients.  This rotation is for individuals who are going into general surgery or a surgical subspecialty, and is designed to prepare them for their internship.

    This rotation will expose students to crucial concrete knowledge and technical skills important for a surgical internship as well as for a surgical career. It includes focused didactic lectures, hands-on skills laboratory, a mock pager experience, and focused rotations; these activities are all designed to augment a student’s exposure to real-life scenarios one would expect in a surgical internship and beyond.

    Grading:

    Students will be graded based on the following:

    1. Final examination based on lecture materials (60% of grade)
    2. Practical skills set examination (20% of grade)
    3. Evaluation of mock page experience (20% of grade)

    Grading will be: Pass/Fail.  A passing grade will be a minimum 50% overall score using the elements listed above.

     

    404.1 Surgery Subspecialty

    Contact: Lana Ketlere   email: lana.ketlere@bmc.org

    Description of Elective:

    The Surgical Subspecialty clerkship is a four-week rotation that consists of two two-week sessions in two different surgical specialties.  Students will provide their preferences for specialties to the Surgical Education coordinator, and will be assigned to two specialties based on availability.  The different surgical sessions and individual learning objectives are described below.

    Cardiac Surgery (BMC)

    Neurosurgery (BMC)

    Ophthalmology (BMC)

    Orthopedics (BMC)

    Otolaryngology (BMC)

    Plastic Surgery (BMC)

    Thoracic Surgery (BMC)

    Urology (BMC)

    GRADING CRITERIA

    Each student will receive an evaluation from each of the subspecialty sessions.  The scores in each field of the evaluation will be averaged to create a final score, from which the grade will be determined.

    Students in all sessions will be graded on their participation, willingness to take responsibility as a member of the surgical team, and professional appearance and manner.

    Additional grading criteria for many of the sessions are included in the complete course description.

    Course restricted to 4th year CAMED students only.

     

    410.2 Sub I – Thoracic Surgery

    Instructors:  Kei Suzuki, M.D. and Virginia Litle, M.D.

    Location: Boston Medical Center

    Contact: Lana Ketlere    email: lana.ketlere@bmc.org

    Number of Students: One

    Period to be Offered: One month (2020/2021-Block 9, 10 and 11)

    Description of Elective:

    The thoracic surgery service sees a high volume of patients with chest disease, and performs a broad range of procedures related to the thoracic cavity including, but not limited to thoracotomy, thoracoscopy, bronchoscopy, mediastinoscopy, pulmonary wedge resection, lobectomy, pneumonectomy, endoscopy, esophageal stenting, esophageal myotomy, esophagectomy, hiatal hernia repair, antireflux surgery, etc.  The service cares for a number of postoperative patients, and frequently consults on patients with complex needs on other services.  Due to the nature of thoracic disease, patients can be quite ill during the perioperative and postoperative period.

    The sub-intern student will be an integral part of the thoracic surgery team in the operating room, inpatient unit, and outpatient clinic at Boston Medical Center during this 4-week sub-internship experience.  Students will be responsible for evaluation and management of their own patients under the direct supervision of attending surgeons and residents, and will care for at least three new patients per week, performing histories and physicals, coordinating care, etc.  They will perform procedures as appropriate, including venipuncture, IV placement, arterial blood gas, foley catheter placement, nasogastric tube insertion, bronchoscopy, thoracostomy, and closure of surgical wounds, all under appropriate supervision.  The sub-intern will also take call with the surgical team on a regular schedule.

    As Boston University is a teaching program, students will also have the opportunity to enhance their teaching skills by assisting in the education of clerkship students in the operating room as well as the inpatient and outpatient settings.

    The goals for the rotation include:

    ·         Assist in the care for acute and chronic disease seen in these surgical patients, as evaluated and managed by the service

    ·         Learn pre-operative and post-operative management of patients undergoing thoracic procedures

    ·         Obtain introductory training in thoracic surgery procedures such as bronchoscopy, endoscopy, thoracentesis, chest tube placement/management/removal, etc

    ·         Function as a sub-intern with responsibilities commensurate with this educational requirement:

    o    Function as acting interns responsible for the evaluation and continued management of their own patients, under the direct supervision of the attending physicians and residents.

    o    Care for at least three new patients per week, and possibly more depending on the opportunities for patient care.

    o    As part of patient care you will be expected to do the following: perform initial history and physicals, write orders, assist in coordinating care, assist with or perform supervised procedures as applicable and appropriate for the sub-intern, present cases, use evidence-based medicine principles to help guide patient care, participate in teaching sessions, and take call alongside residents and attending physicians.

    Students should report to morning rounds at the thoracic surgery workroom on Menino 3rd floor IMCU (near patient bed 30)

     

    430.3 Pediatric Surgery

    Instructor: Christopher Muratore, M.D., M.S.

    Additional preceptors (Starting March 2019): Konstantinos Papadakis, M.D. and Samuel Rice-Townsend, M.D.

    Location 1: Pediatric Surgery, Dowling 2 South (Boston Medical Center)

    Contact: Lana Ketlere, C-515       Telephone: 617 638-8442

    Location 2: General Surgery, Fegan 3 (Boston Children’s Hospital, 300 Longwood Avenue)

    Contact: Andrea Rudolph, Fegan 3      Telephone: 617 335-7557

    Number of Students: One

    Period to be Offered: One month

    Description of Elective:

    This elective on the Pediatric Surgical Service will provide a broad experience in the evaluation and operative management of a wide range of surgical disorders of infants and children (abdominal, thoracic, genital, transplant, trauma, endocrine). It is geared toward those with an interest in surgery, pediatrics, or both.

    The student’s time is split between the BMC and BCH campuses.  This will allow the student to see two different practice settings at two different institutions.  The BMC experience is heavily weighted towards a busy outpatient elective surgery experience, including pediatric urology, with some inpatient emergency surgery of common pediatric surgical conditions such as appendicitis, pyloric stenosis, incarcerated hernias, and intussusception. Elective operative cases are held at BMC on Mondays and Pediatric General Surgery Clinic is held at BMC on Tuesdays.

    Wednesdays through Fridays are then spent at Children’s in the ORs, clinics, and rounding on the floors.  During the clinics, children who are seen for surgical conditions are discussed and scheduled for surgery; follow-up is provided for those who have recently undergone surgery.

    At Children’s, the medical student will be part of a large team, including interns, residents, fellows, nurse practitioners and faculty, that provides general and specialized surgical services to infants, children, and adolescents presenting with a wide range of congenital and acquired conditions.

    The students’ activities include patient evaluation, assisting in the operating room, and participating in teaching conferences and rounds. An extensive number of conferences are held per week including grand rounds, morbidity and mortality, vascular anomalies, fetal surgery, oncology, clinical teaching rounds and several didactic lectures. Students will be exposed to and may participate in multidisciplinary patient care programs of the Department of Surgery which include: trauma, surgical critical care including extracorporeal membrane oxygenation, vascular malformations, solid organ transplantation, fetal surgery and minimally invasive surgery.

    The medical student will receive teaching and supervision on the wards, in the operating room and in the pediatric emergency room. The student will assist in the operating room depending on his/her technical skills, and may be permitted to first assist or perform minor procedures with the attending.

    During your rotation, the fellows may assign you a case to present at Professor Rounds with Dr. Robert Shamberger, Chief of Surgery and Dr. Craig Lillehei. The purpose of this is for you to practice presenting an “unknown” to an audience while leading them through an initial presentation, differential diagnosis, lab tests, etc.

    Wednesday through Friday, students are encouraged to join morning sign out and rounds with the team. Morning Sign Out with the entire team starts early at 5:45am and is led by the Pediatric Surgery Chief Fellow, and all senior residents, nurse practitioners, and the Surgeon of the Week (attending SOW) are in attendance. These are fast-moving work rounds where large volumes of data are discussed. Students are encouraged but not required to attend these portions of morning rounds.

    Students SHOULD plan to attend SOW floor rounds on Wednesdays, Thursdays and Fridays. They should arrive at 7:30am on 10E and introduce themselves to the SOW and the nurse practitioners, who will then walk around to see all inpatient surgical patients and consults; students who are following patients may present during SOW rounds; daily patient census and OR schedules are available prior to these rounds.

    Students are also encouraged to attend Surgical Grand Rounds and Resident Lecture in addition to Professor Rounds and the Medical Student Lecture. All of these are held on Wednesdays at Children’s making Wednesdays primarily a non-clinical teaching day. Students may be able to attend clinic at Children’s but should anticipate most of their clinic days being held at BMC and spending the majority of their time at Children’s in the ORs and on the floors.

     

    440.1 Multidisciplinary Breast Cancer Care Elective

    Multiple Departments

    Rotation Director(s): Michael Cassidy, MD and Naomi Ko, MD

    Coordinator: Lana Ketlere  email: lana.ketlere@bmc.org

    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

    michael.cassidy@bmc.org

    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.

     

     

    465.2 Sub I – Plastic & Reconstructive Surgery

    Instructor: Daniel Roh, M.D.

    Location: Boston Medical Center,  Menino Pavilion

    Contact: Lana Ketlere    email: lana.ketlere@bmc.org

    Number of Students: Two

    Period to be Offered: One month

    Description of Elective:

    The elective in Plastic and Reconstructive Surgery will consist of a two week period with exposure to general plastic surgery with an emphasis on the aesthetic aspects of the field. This will provide the student with a broad basis in the area of elective plastic surgery.

    All arrangements for electives must be made through the Medical Student Coordinator at Boston Medical Center.

     

    510.2 Neurosurgery

    Instructors: James Holsapple, M.D., Justin Massengale, M.D., Emanuela Binello, M.D., Ph.D., Justin Moore, M.D., Ph.D.

    Location: Boston Medical Center

    Contact: Lana Ketlere        email: lana.ketlere@bmc.org

    Number of Students: Two

    Period to be Offered: One month

    Description of Elective:

    Fourth year students electing Neurosurgery will have an opportunity to make daily ward rounds with an attending neurosurgeon, perform clinical examinations, discuss differential diagnosis and diagnostic procedures. Under direct supervision, the student may participate in patient management and follow up. The student will also have the opportunity to review and learn about the interpretation of different diagnostic tests, such as angiograms, CT and MRI of the central nervous system. The student will be able to attend and participate in weekly neurosurgical teaching conferences. Ongoing research projects within the department are available to stimulate the student’s academic interest. In the operating room, the student will be instructed about the duties of a surgical assistant and will be exposed to the surgical anatomy of the brain and spine. The student will also be encouraged to evaluate the patients post-operatively, especially in the setting of the intensive care unit.

     

    Surgical Specialties: Anesthesiology

    505.2 Anesthesiology

    Instructor: Alexis Ramirez, M.D.

    Location: Boston Medical Center, Powerplant Building, 750 Albany St. Floor 2R

    Telephone:  (617) 638-6981

    Rotation Coordinator: Natalia Ibañez email: Natalia.Ibanez@bmc.org

    Number of Students: Four BU 4th year medical students

    Period to be Offered: 2 weeks and 4 weeks (2 week rotations will only be offered during the first 2 weeks of every month block)

    Description of Elective:

    The Anesthesiology four week elective rotation is an opportunity for CAMED 4th year medical students to become well versed in the principles and concepts of the practice of anesthesiology, and to identify the multiple roles the anesthesiologist plays both in and outside of the operative room.

    Learning will primarily occur in the Boston Medical Center operating rooms, where medical students will be paired with residents and attending faculty. The experience will involve the perioperative evaluation and care of the surgical patient. Students will participate in the management of patients undergoing general surgery, head and neck surgery, neurosurgery, thoracic and cardiac surgery, obstetrics and gynecology procedures, orthopedic surgery, pediatric surgery, urologic procedures and vascular surgery. Additional educational sites include the pain clinic, off site imaging locations (CT/MRI), labor and delivery and the gynecology procedure unit.

    On their first day students will receive an orientation from the rotation director. During the elective, medical students will attend a series of lectures and case conferences. These will serve to enhance their knowledge, skills and understanding of the field. Students will also attend Departmental Grand Rounds, held most Fridays.

    Logistics:

    1- Students will receive a packet of information via e-mail prior to the start of the rotation.
    2- Students must report to the Anesthesiology Office at 6:30 AM on the first day (or when otherwise specified) for orientation. (Location: Powerplant Building, 750 Albany St., Floor 2R)
    3- Students are expected to be present for all departmental academic activities.
    4- There are no call responsibilities for this rotation.

    For further details, please refer to the welcome packet.

    Absences: All scheduled absences need prior approval from the rotation director Alexis Ramirez, M.D. As per CAMED policy, 4th years may have no more than 2 absences during a 2 week elective or 4 absences during a 4 week elective. Students are required to attend orientation on the first day of the rotation.

     

    508.2 Anesthesiology Multimedia Elective   (non-clinical elective)

    Instructor:  

    Telephone:  (617) 638-6229

    Location: 750 Albany St. Floor 2R

    Rotation Coordinator: Natalia Ibañez email: Natalia.Ibanez@bmc.org

    Number of Students: Two BU 4th year medical students per four week block

    Period to be Offered: 4 weeks

    Description of Elective:

     

    The Department of Anesthesiology manages a multimedia laboratory in which students become familiar with computer-assisted instruction, digital media applications for educational purposes, and image and video editing.  The materials produced in collaboration with the students may lead to presentations at national meetings and publication in peer-reviewed journals and textbooks. The Anesthesiology four week scholarly elective rotation is an opportunity for CAMED 4th year medical students to be introduced to script development, storyboard building, instructional design, digital photography and video, and computer applications used for the creation of digital media for medical education.

    A 4-week elective allows students to become familiar with filming procedures, collecting digital assets, and designing computer-based educational projects.  The students will learn digital photography and video editing using industry standard software such as Photoshop, Premiere, and Illustrator.  The student will meet with the technical advisor 4 weeks in advance prior to the start of the elective for one hour at which time they will agree to a plan of operations and a learning timeline to be followed during the elective.  The plan of operations includes an agreed upon number of work hours per week to satisfy the CAMED minimum of 40 hours per week, a description of the specific activities to be performed by the student, and the required deliverables of the rotation.  Finally, in this preparatory meeting, they will also agree on completing all operational project pre-requirements to fulfill prior to the elective’s start date.

    The multimedia elective will take place in the Department of Anesthesiology Media Laboratory.

    During the first few days of the rotation, the student will be trained on the specific photographic and video equipment (including cameras, computers, and software) by the technical advisor or by a senior member of the laboratory.  During the elective, the student will meet with the technical advisor daily to review the project progress.  Furthermore, a mid-clerkship review by the technical advisor will be performed, which will be submitted to the course director.  This review will be documented, with any points for improvement relayed, and will include a statement on whether or not the student is at the expected timeline for the project.  If the student is not meeting the expected timeline, then the reviewer will provide a plan (which may be as short as a statement or longer depending on the needs) on how to get the student back on the timeline if possible.  If getting back on track with the project is not possible, then an alternate plan need to be defined where the student can meet project objectives and hourly requirements to receive credit for the rotation.  The rotation will be graded according to an Honors, Pass, Fail scale depending on the performance and accomplishments of the student.

    Students must report to the Anesthesiology Office (second floor Power Plant) at 6:50 AM to Neil Ray (617 638-6229) on the first day of the rotation for further instructions.

     

     

    Surgical Specialties: Ophthalmology

    514.2 Ophthalmology (Clinical/Surgical Elective)

    Instructors: Tomas Andersen, M.D. and faculty, fellows and residents of the CAMED Department of Ophthalmology

    Contact: Valerie Worrell-617 638-4552

    Location: Boston Medical Center YACC Eye Clinic

    Number of Students: Maximum of 4 students at BMC (including students assigned to Ophthalmology as part of the Surgery Clerkship)

    Period to be Offered: Four weeks (graded)

    Eligibility:  CAMED IV students applying to an ophthalmology residency will be given priority during Blocks 9 -11.

    Outside fourth year allopathic medical students whose schools do not offer an ophthalmology elective may apply for Blocks 10-20.  Students enrolled in a GHLO (Global Health Learning Opportunities) participating international medical school may apply for blocks 14-20.   All other outside students may apply for Blocks 11-20.

    Priority will be given to CAMED students and outside students may not be accepted until all CAMED students have been accommodated.

    Description of Elective:

    Students will work with residents and faculty at BMC. Activities will involve examining patients in the outpatient clinic and the in-patient consultation service. A clinic work sheet will be used to guide the student in the development of examination skills and to ensure that the student participates with faculty, fellows and residents in a discussion of selected ophthalmic topics.  Students will spend time on subspecialty services such as triage, consults, neuro-ophthalmology, retina, glaucoma, pediatric ophthalmology, cornea, and oculoplastics. Students will also have the opportunity to attend ophthalmic procedures in the office and surgical procedures in the operating room.

    Students will be required to prepare a short (10 minute) slide presentation on a case encountered during their rotation, including a discussion of the differential diagnosis and main clinical teaching points.

    At the end of the elective the student should:
    (1) Be acquainted with basic anatomy and physiology of the eye
    (2) Be able to take a basic history for eye-related chief complaints
    (3) Perform a basic ocular examination
    (4) Diagnose independently and begin emergency treatment for urgent conditions
    (5) Recognize the need for urgent referral
    (6) Diagnose and articulate the initial treatment of ocular conditions
    (7) Diagnose and recognize the need for routine referrals

    Methods: Clinical sessions, lectures, case conferences, assigned text book, Powerpoint case presentation

    Evaluation for CAMED students:

    4 week rotation: Honors / High Pass / Pass / Fail /Incomplete

     

    Surgical Specialties: Orthopedic and Fracture Surgery

    551.3  Sub I – Orthopaedic Surgery

    Rotation Director: Xinning (Tiger) Li, M.D., FAOA, FAAOS   email: xinning.li@bmc.org

    CONTACT AND COURSE ORIENTATION INFORMATION

    Lynnette St. Louis | Residency & Fellowship Program Coordinator

    Department of Orthopaedic Surgery

    Boston Medical Center

    850 Harrison Ave. | Dowling 2 North | Boston, MA  02118

    617-638-8934  (phone) | 617-414-4003 (fax)

    lynnette.st.louis@bmc.org

     Number of Students: 5 per block

    Period to be Offered: 4 weeks  ( Blocks 9-20)

     Description of Elective:

    The Orthopaedic Sub-I will take place at the Boston Medical Center at both the inpatient and outpatient setting that comprises of six total subspecialties:

    • Orthopaedic Trauma – Fracture Care
    • Hand and Elbow Surgery
    • Spine
    • Sports Medicine and Shoulder Surgery
    • Foot and Ankle
    • Arthroplasty (Hip and Knee)

    The Sub-I will have the option to choose which subspecialty will fit their clinical interest and career goals.  Please go to https://www.bumc.bu.edu/orthopaedics/ to read about the description of each specific subspecialty.  The Sub-I on the Orthopaedic service will be responsible for the following:

    1. Assist in the care for patients in the emergency room, clinics and operating room whom have orthopedic injuries.
    2. Learn the preoperative and postoperative management of patients undergoing orthopedic procedures.
    3. Learn how to evaluate patients in the clinic setting including taking pertinent orthopaedic history and performing an appropriate physical examination.
    4. Obtain introductory training in orthopedic procedures such as casting, splinting, joint aspirations, wound closure, wound management, management of wound vacs, management of external fixation devices, principles of surgical stabilization of fractures and basics in arthroplasty and spine fixation.
    5. Function as a Acting-Intern with responsibilities commensurate with this educational requirement:
      1. Function as acting intern responsible for the evaluation and continued management of patients under supervision of residents and attendings.
      2. As part of the care team, will perform initial H&Ps, assist in coordinating care, assist with or perform supervised procedures appropriate for the sub-intern, present cases, use evidence-based medicine principles to help guide patient care, etc.
      3. All Sub-I will be required to present a 12 min talk on the 3rd weds of the month during grand rounds on a case or topic of interest. 3 mins for questions at the end.
      4. It is expected that the Sub-I will prepare for every single OR case by obtaining the patient history, indications for surgery, anatomy, surgical approach, steps to the procedure, and read two pertinent articles related to each case.
      5. It is expected that the Sub-I will read daily, on the consults seen in the ED, patients seen in clinic the OR cases.

    Sub-I will meet with their respective supervisor and the senior resident on service for the subspecialty at the beginning, 2weeks, and at the end of the month for formal feedback

     

    Surgical Specialties: Otolaryngology

    560.1 Sub I – Otolaryngology–Head and Neck Surgery

    Instructors: Jessica Levi, M.D. and Gregory Grillone, M.D., Chairman

    Location: Boston Medical Center

    Contact: Janine Lipsky

    Telephone: 617 638-7066

    Number of Students: Four

    Period to be Offered: One month

    Description of Elective:

    This elective provides an intense learning experience for students interested in a career in Otolaryngology – Head and Neck Surgery, and for others with specific interest in head and neck cancer, facial plastic and reconstructive surgery, allergy involving the nose and sinuses, and the auditory system. Students observe and work with faculty and residents in the Department of Otolaryngology – Head and Neck Surgery at the Boston Medical Center. Approximately half of the time is devoted to learning how to evaluate and treat ambulatory outpatients with otolaryngologic disorders. The other half of the time is spent observing and assisting in the operating room and evaluating hospitalized patients. Students are expected to attend weekly teaching conferences including Friday morning case conference, Pathology conference, Radiology conference, Audiology conference, Tumor Board conference, and structured Wednesday afternoon didactic lectures.

    Student Responsibilities – Fourth year medical students are required to do the following:

    1.  Be present and on time for clinics, rounds, surgeries, conferences
    2.  Acquire specified knowledge and skills (as delineated in “Otolaryngology Student Knowledge/ Skills  Checklist”)
    3.  Assist residents in providing patient care
    4.  Prepare and present an eight minute Powerpoint presentation on a chosen topic.

    Participation, Expectations of Performance, and Grading
    The Department of Otolaryngology uses elements adapted from the ACGME Residency Review Committee Guidelines for General Competencies in Medical Education as a basis for student evaluations. Because the clinical rotation can be considered an opportunity to begin learning skills that a medical school graduate will be expected to acquire, we shall judge student performance in the categories of the six ACGME1 competencies listed below:

    1. Patient care that is compassionate, appropriate, and effective for the treatment of health   programs and the promotion of health
    2. Medical Knowledge about established and evolving biomedical, clinical, and cognate sciences, as well as the application of this knowledge to patient care
    3. Practice-based learning and improvement that involves the investigation and evaluation of care for their patients, the appraisal and assimilation of scientific evidence, and improvements in patient care
    4. Interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and other health professionals;
    5. Professionalism, as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to patients of diverse backgrounds;
    6. Systems-based practice, as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care.

    Requests to drop this elective must be submitted via the electronic add/drop system to Janine Lipsky, Education Program Coordinator at least 30 days prior to the start of the elective. Students who wish to drop the elective less than 30 days prior to the start must request special permission from Jessica Levi, M.D.   All requests must be in writing.

     

    560.2  Advanced Otolaryngology

    Course Directors: Jessica Levi, M.D. and Gregory Grillone, M.D. (Chair)

    Contact and Course Orientation Information: Janine Lipsky, MPH (Education Coordinator);

    email: Janine.Lipsky@bmc.org

    Telephone: 617-638-7066

    Number of Students: 4

    Period to be Offered: 4 weeks (Blocks 9-20)

    Prerequisite: Students must successfully complete the Otolaryngology-Head and Neck Surgery Sub-I prior to taking this elective.

    DESCRIPTION OF ELECTIVE

    The student will be an integral part of the Otolaryngology-Head and Neck Surgery team in the ambulatory outpatient clinic, with hospitalized patients, and in the operating room.  The student is expected to function as a sub-intern while on rotation with the Department of Otolaryngology-Head and Neck Surgery at Boston Medical Center.  The experience should focus on 2-3 subspecialties, of the student’s choice, within Otolaryngology and is customizable with the assistance of the Clerkship Coordinator.

    The Otolaryngology – Head and Neck Surgery service provides broad opportunities to explore key services for patient care that are seen in this specialty.  This includes all subspecialties of the field such as head and neck surgery and oncology, otology, neurotology, skull base surgery, pediatrics, plastic and reconstructive surgery, laryngology/swallowing disorders, thyroid and parathyroid surgery, allergy, and rhinology.

    Each sub-intern is expected to create their own learning objectives, relative to Otolaryngology-Head and Neck Surgery.  As each objective is obtained the sub-intern is expected to review the objective, and what was learned, with an attending or senior level resident.  At the end of the rotation the objectives will be reviewed for completeness by the Clerkship Director and/or Clerkship Coordinator.  The rotation will conclude with the submission of a case report, written by the sub-intern, to the Clerkship Director.  The case report is to be an in depth study of one aspect within Otolaryngology while critically examining, appraising and assimilating published literature.  This will be written according to all standards of scientific writing.
    The student is expected to function as a sub-intern with responsibilities commensurate with this educational requirement:

    • As part of patient care you will be expected to do the following: perform initial history and physicals, write orders, assist in coordinating care, assist with or perform supervised procedures as applicable and appropriate for the sub-intern, present cases, use evidence-based medicine principles to help guide patient care, and participate in teaching sessions.
    • Students will see patients in clinic where there will be a mix of observation as well as direct patient care. They will function as acting interns responsible for the evaluation and management of patients seen, under the direct supervision of attending physicians. There, students may also interact with APPs, residents, other students, or Audiologists and Speech Language Pathologists.
    • Students will be present on rounds with the residents (the beginning and end of the day).
    • Students will be asked to assist in coordinating care for the inpatients.
    • Students will see consults with a resident or APP where they will be exposed to acute and chronically ill patients
    • Students are expected to be involved in surgeries as well.
    • Students are expected to attend educational conferences (see curriculum).

     

    560.11 Research Elective in Otolaryngology-Head and Neck Surgery  (non-clinical elective)

    Supervisor: Jessica Levi, M.D.

    Location: Boston Medical Center

    Contact: Janine Lipsky

    Telephone: 617 638-7066

    Period to be offered: One Month

    Description of Elective:

    This elective is designed for students willing to take the initiative and devote time to planning, investigating, and implementing an independent study that will culminate in preparation of a manuscript for publication in a peer reviewed medical journal. The student is required to meet with Dr. Levi two months prior to beginning the elective to review potential projects and arrange a mentor. Although most projects should be designed for completion within the four week elective, students may need to devote additional time to complete the independent study project after conclusion of the one month elective rotation. Students who have taken this elective have had high success at having completed projects presented at a national Otolaryngology meeting and subsequently published.

     

     

    Surgical Specialties: Urology

    570.1 Urology

    Instructor: Mark Katz, M.D.

    Location: Boston Medical Center, Shapiro 3B

    Telephone: 638-8451 Contact: Karen Clements

    Number of Students: Three

    Period to be Offered: One month

    Description of Elective:

    Full-time clerkship of one month’s duration offered by the Urology Department for two students during each month. Students will be assigned to Boston Medical Center. Students will participate in all aspects of general urology, functioning as integral members with the urology resident staff. They will be assigned to perform primary urologic consultations on patients from other services; in addition they will participate in the evaluation and management of urology service patients. Students will have the opportunity to prepare for the operating room and participate/observe surgical cases.  Students of exceptional excellence may be assigned to striker positions during their elective. They will become proficient in the evaluation of a variety of urologic problems, including urologic neoplasms, neurogenic bladder, reconstructive urologic surgery, urinary calculus disease, obstructive uropathy and sexual and transgender medicine.  Students will be direct participants in all department conferences and will be expected to contribute to the didactic teaching program of the department.

     

    571.2 Clinical Elective in Sexual Medicine

    Instructor: Ricardo Munarriz, M.D.

    Location: Center for Sexual Medicine,Shapiro Building-725 Albany St., Suite 3B

    Contact: Karen Clements   617 638-8451

    Number of Students Per Block: One (Fourth Year Medical Students)

    Period to be offered: One Month

    Description of Elective:

    Students will learn about the specialty of Sexual Medicine and what makes Sexual Medicine unique in regard to patient care. Sexual Medicine is the medical discipline that embraces the study, diagnosis and treatment of sexual health concerns of men and women. It is based on knowledge primarily from the areas of endocrinology, gynecology, neurology psychology and urology, but incorporates other disciplines as well.

    The elective is primarily an outpatient experience. Students choosing this elective will observe patients being evaluated and treated and potentially participate in ongoing clinical research at the Center for Sexual Medicine. Students will have the opportunity to observe patient examinations and patient surgeries, and accompany physicians on rounds. They will learn how to 1) generate a sexual health history, 2) perform an appropriate physical exam, 3) make an assessment and 4) develop a plan of therapy. They will be invited to attend ongoing educational programs including but not limited to rounds and sexual medicine information sessions for the general public.

    The student must demonstrate that he or she is not embarrassed discussing sexual health issues, is comfortable using the vocabulary of the genital anatomy, and is not judgmental about the sexual practices of others.

    This elective is offered only to students attending Boston University Chobanian & Avedisian School of Medicine or medical schools with established exchange programs with Boston University.