Elective Rotations

During the final year, students have the opportunity to choose from a wide selection of elective rotations at various disciplines and sub-specialties. The clinical sites for these electives are more expansive geographically and programmatically than the Core Clerkship sites. These are most often provided in clinical settings although students may participate in a limited amount of electives in non clinical research settings. A brief description of some of the more popular clinical electives is listed below; however, there are many other areas of clinical electives available.

Anesthesiology 
The management of patients rendered unconscious or insensitive to pain and stress during surgical, obstetric and other medical procedures. The pre-operative evaluation and treatment of patients in specialized care and pain management, cardio-pulmonary resuscitation, respiratory care problems, and management of critically ill patients in special care units.

Immunology
The study of allergic, autoimmune and other immunological disorders such as asthma, rheumatic diseases, immune deficiencies and related disorders. The application of immunologic theoretical principles and techniques in the evaluation and diagnosis of a broad spectrum of human maladies. Discussion of newer issues in human transplant technologies will be addressed when practical.

Cardiology
This sub-specialty of internal medicine provides an educational experience in the evaluation and management of a wide variety of patients with acute and chronic cardiovascular conditions. These disorders include coronary artery disease, congestive heart failure, arrhythmias, acute myocardial infarction, acute ischemic syndromes, lipid disorders, hypertension, cardiomyopathy, vascular heart disease, pulmonary heart diseases, peripheral vascular disease, infectious and inflammatory heart disease and adult congenital heart disease. The new technologies in minimally invasive approaches to cardiac disease will be observed during these rotations.

Critical Care
Critical care is a multi-disciplinary field and also a sub-specialty of internal medicine. Students are exposed to the training of managing critically ill patients and supervising critical-care units. Students follow patients throughout the patient’s stay in critical-care units and monitor the subsequent course of patients throughout the remainder of their hospitalization. Students may obtain clinical experience with critically ill patients including surgical patients, shock trauma patients, neurological, neurosurgical patients (stroke and spinal injury), pediatrics, intensive care patients, burn-unit patients, dialysis-unit, anesthesia service, cardiac catheterization, and motor vehicle injury intensive care patients, as well as transplant patients. Exposure to facilities that are accredited disaster management trauma units may be part of the students experience.

Dermatology
Students are introduced to patients with diseases of the skin, hair, and mucous membranes, as well as the continuum of procedures in allergy and immunology, cryosurgery, dermatologic surgery, dermopathology, clinical pathology, photobiology, topical and systemic pharmacotherapy, and microbiology, including sexually transmitted diseases. Some centers will provide students with an in-depth look at the newer technologies in laser care and restorative skin treatment.

Emergency Medicine
Students are provided with various experiences in the emergent care and urgent care of medical and surgical patients to include gastrointestinal, cardiovascular, dermatological, endocrine, hematologic, infectious, musculoskeletal, neurological, gynecological, psychiatric and traumatic disorders. The patient exposure will be in adult and pediatric emergency facilities.

Endocrinology, Diabetes and Metabolism
This is a sub-specialty of internal medicine. The students will receive a range of clinical experiences that may include the opportunity to diagnose and manage inpatient, outpatient, adolescent and adult patients of both sexes, representing variable acuity and with a wide variety of endocrine and metabolic diseases. The ideal opportunites will expose the student to diseases such as diabetes, metabolic syndrome, obesity, precocious puberty and lipid abnormalities.

Gastroenterology
This type of clinical training provides a variety of experiences in the fields of herpatology, clinical nutrition, eating disorders and gastrointestinal oncology. Students will learn to diagnose and treat the following disorders: diseases of the esophagus, acid peptic disorders, motor disorders of the gastrointestinal tract, irritable bowel syndrome, disorders of nutrient assimilation, inflammatory bowel disease, gastrointestinal infections, gallstones, alcohol-liver diseases, drug-induced hepatic injury, chronic liver disease, gastrointestinal manifestation of HIV infections, gastrointestinal neoplastic disease and hepatitis, both acute and chronic.

Geriatric Medicine
This is a sub-specialty of internal medicine providing clinical experience in managing elderly patients with a wide variety of medical problems in both an inpatient and outpatient settings. Students receive clinical experience caring for patients in acute, ambulatory, community, and long-term care settings in order to understand the interaction of natural aging and disease, as well as the techniques of assessment, therapy and disease management. Students receive training in the physiology of aging, youth preservation and the pathophysiology that commonly occurs in the older person.

Infectious Diseases
Students observe and manage adults with a wide variety of infectious disease in both inpatient and ambulatory settings including observing the course of illness and the effects of therapy. Therapeutic modalities, including management of antibiotics in hospital, office, and other ambulatory care settings, as well as the experience with pediatric infectious diseases is included. A critical area for these rotations addresses the current health crisis with HIV, Hep-C, SARS, MRSA and other communicable disease outbreaks.

Nephrology 
Students gain experience in the clinical setting of acute and chronic hemodialysis, continuous renal replacement therapy, acute and chronic peritoneal dialysis, post-renal transplant management and renal biopsy evaluations. Students are exposed to the management and evaluation of complex patients with advancing end-stage renal disease as well as patients with chronic urinary infections.

Neurology
Students receive exposure to the diagnosis and treatment of all categories of disease involving the central, peripheral, autonomic nervous system, including those covering, blood vessels, and all effector tissues, such as muscle. Particular emphasis will be on the prevention, evaluation and management of stroke, brain tumors, traumatic brain injury and dementia with experience in inpatient and outpatient clinical settings.

Oncology 
Students will have the opportunity to become involved in treatment of both acutely and chronically ill patients to include the natural history of cancer and the effectiveness of various therapeutic programs. Ethical and end-of-life hospice care will be a major component of students' education during these electives.

Ophthalmology
Students will encounter the care and treatment of a broad range of eye diseases. The focus is to introduce students to the major technical and patient care responsibilities in ophthalmic care, preservation of sight, diabetic retinal management, glaucoma care and eye surgery.

Orthopedic Surgery
Students study the prevention of musculoskeletal diseases, disorders and injuries and their treatment. Clinical experience includes preoperative evaluation and post operative followup. Students will also evaluate the treatment of patients not requiring surgery and alternatives to surgery as a modality of treatment for those patients. Some electives will focus primarily on sports injuries and chronic gait disorders.

Preventative Medicine
Students will gain knowledge of the disease processes as they occur in communities and defined population groups. Advancing health by promoting healthy environments and behavior in the home, the workplace and the community is stressed. The course will include the prevention of diseases, injuries, toxic exposure as well as early diagnosis of impending disease. Encouraging habilitation and rehabilitation of persons with disabilities are also addressed. A knowledge of the important aspect of health advocacy is important during these rotations.

Pulmonary 
They will be instructed in the differential diagnosis, evaluation and treatment of pulmonary diseases including shortness of breath asthma, chronic obstructive pulmonary disorders, pulmonary fibrosis, pleural effusion, pulmonary emboli and sleep apnea.

Radiology
Students gain knowledge and experience in diagnostic radiology and image-guided therapeutic techniques. This includes nuclear radiology, diagnostic ultrasound, magnetic resonance, computer axial tomography (CAT), interventional procedures, and the use of other forms of radiant energy. A thorough knowledge of techniques used in cancer care will be addressed in the clerkship.

Rheumatology
This sub-specialty of internal medicine provides students the opportunity to participate in management of inpatients and outpatients with a wide variety of rheumatic and musculoskeletal diseases. Other illnesses with rheumatologic musculoskeletal manifestations are examined. Students acquire an understanding of anatomic and clinical pathology, including techniques and methods of treatment.