Medicine
MEDICINE
10
100.1 Subinternship in Medicine
Instructors: Warren Hershman, M.D., M.P.H.
Contact: Britt Simonson
Location: Boston Medical Center
Telephone: 638-7230
Number of Students: 8
Period to be Offered: 4 week block
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 subintern will work as an advanced care provider under the direct supervision of the ward resident and assume increasing responsibility for the initial evaluation and integration of the total care of assigned patients. The student is expected to integrate 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.
The subintern will play a crucial role in patient care and must commit to working the complete four-week block. Late night call in the hospital should be expected.
Responsibilities include:
admitting patients to the team
following a core of patients (on average 3-6 patients)
taking “long call” approximately every 4th night
providing overnight cross-coverage for other houseofficers’ or students’ patients during “call” nights
providing patient care through the last Sunday of the rotation
100.11 Advanced Acting Internship in Medicine
Instructors: Warren Hershman, M.D., M.P.H.
Contact: Britt Simonson
Location: Boston Medical Center
Telephone: 638-7230
Number of Students: 4 (available to Boston University School of Medicine students only)
Period to be Offered: 4 week block, through Block 14
Description of Elective:
The Advanced Acting Internship (AAI) builds upon and is a more intensive version of the version of the traditional subinternship. Two AAI students are paired on a ward team that has one fewer intern than the traditional ward team, and together, are expected to fulfill the role of one intern. Advanced acting interns work under the direct supervision of the ward resident and assume care of assigned patients. The student is expected to integrate book 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.
The Advanced Acting Intern will play a crucial role in patient care and must commit to working the complete 4 week block. Late night call in the hospital should be expected.
By providing this in-depth experience, we believe that you will have a unique opportunity to develop the attributes of an increasingly independent clinician and better prepare yourself for your internship. Your work as an Advanced Acting Intern will be recognized in your course evaluation and letters of recommendation.
Because of space limitations, we cannot guarantee that everyone who is interested can be an AAI. Students will be selected by lottery weighted by your clinical performance during the third year.
Responsibilities include:
admitting patients to the team
following a core of patients (on average 4-10 patients)
taking “long call” approximately every 4th night
providing overnight cross-coverage for other houseofficers’ or students’ patients during “call” nights
providing patient care through the last Sunday of the rotation
100.33 Advanced Medicine Elective – Medical Care of the Surgical Patient
Instructors: Craig Noronha, M.D.
Contact Person: Sarah Brunt email: sarah.brunt@bmc.org
Location: Department of Medicine, Crosstown, 2nd Floor
Telephone: (617) 414-6910
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 expose himself/herself to 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 half day Internal Medicine Preoperative Assessment Clinics (IMPAC) where patients scheduled for elective surgery are assessed. The student will be expected to give one 30 minute case-based preclinic talk during their month on service. Students considering surgery, anesthesia, or internal medicine as career choices 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.
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 Advanced Medicine Elective-Medical Intensive Care Unit: Menino Pavilion
Instructor: Arthur C. Theodore, M.D., Christine Reardon, M.D., Pulmonary/Critical Care Medicine Faculty
Location: Boston Medical Center, Menino Pavilion
Telephone: 617-638-4860 (Kathyann Adamson-R3)
Number of Students: Two (fourth year BU medical students only)
Period to be offered: One Month
Description of Elective:
The Advanced Medicine elective in the Medical Intensive Care Unit at the Menino Pavilion 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 unit has a particular emphasis on respiratory failure and ventilator management. Patients are cared for by two teams, each consisting of 2 residents, 2 interns and a pulmonary/critical care attending; a pulmonary/critical care fellow is also dedicated to the unit. Students are expected to participate on daily radiology 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. There is no night call and/or weekend coverage.
Restrictions:
1) Completion of a sub-internship.
2) Reception of Honors grade in third year medicine clerkship or in the medicine sub-internship.
3) These requirements may be waived if the student is approved by the clerkship selection committee, chaired by Dr. Warren Hershman.
033.2 Geriatrics/Home Medical Care
Instructors:Lisa Norton, M.D., Serene Chao, M.D.,M.Sc., Dan Oates, M.D., M.Sc. and Matthew Russell, M.D., M.Sc.
Location: Robinson 2700 – Boston Medical Center, Robinson Complex
Telephone: 638-6109
Course Director: Lisa Norton, M.D. lisa.norton@bmc.org
Course Administrator: Jill Whitney
www.bumc.bu.edu/geriatrics
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 house calls with a physician or nurse preceptor. There will also be home visits, which trainees will conduct independently (paired with one other student). Additional experiences may include going to community sites such as an adult day health center or nursing home. Students will attend lectures, prepare a written case study and participate in a Geriatrics OSCE (Objective Structured Clinical Exam). 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 including nurses, social workers, and community health care providers to develop care plans, and learn about home care and what is possible to provide medically for elderly patients living in the community.
Note: This is a required rotation at BUSM but may be taken as an elective by external students on a space available basis only.
420.3 Nutritional Support in Clinical Practice
Instructors: Caroline Apovian, M.D. and Peter Burke, M.D.
Location: Boston Medical Center – Harrison and East Newton Pavilions
Telephone: 638-8443 Contact: Myriam Castagne
Number of Students: Two
Period to be Offered: One month
Description of Elective:
This elective provides “hands on” exposure to the problems of malnutrition in the hospitalized patient in both medical and surgical wards. Instruction is by the Nutrition Support Team with time divided between both campuses at Boston Medical Center. Clinical responsibilities include completion of nutrition support consultations with full nutritional assessment and formulation of plan of nutritional intervention on all patients receiving parenteral nutrition, and many patients receiving enteral therapy. Metabolic and fluid management is closely monitored on daily rounds and adequacy of nutritional support documented. The Service follows approximately 10-12 patients daily. Advanced training in central venous access techniques is offered depending on patient need. It is the overall purpose of this elective to provide students planning careers in internal medicine or surgery with basic skills to recognize and treat all forms of malnutrition in adult hospitalized patients.
