Surgery

Boston University Medical Center

Fourth-Year Elective Rotations in Surgery

Directors for BU Surgical Electives: Jane Mendez M.D., Associate Professor of Surgery; and Erica Brotschi M.D., Associate Professor of Surgery

Coordinator for BU Surgical Electives:
Grace Farnham-(Student Coordinator)
Office of Surgical Education Room C-515,   617-638-8443

The electives listed below are administered through the Office of Surgical Education.  These are all four-week rotations.  An application which is required for these electives can be obtained from Ms. Farnham by telephoning her at 617-638-8443 or visiting her office, C-515.

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 – Newton Pavilion
a. General Surgery (Vascular Service)(400.1a)
Instructor: Jeffrey Kalish, M.D. and Staff
Number of Students: One
Period to be offered: One Month

b. Mozden Service (Surgical Oncology, Endocrine Surgery and Colorectal Surgery)(400.1b)
Instructor: David McAneny, M.D. and Staff
Number of Students: One
Period to be offered: One Month

Boston Medical Center – Menino Pavilion

General and Trauma Surgery (400.3)

Instructor: Andrew Glantz, M.D.
Number of Students: One
Period to be offered: One Month

SICU Menino Pavilion (403.1)

Instructor: Robert Schulze, M.D, and Staff

Number of Students: Three

Period to be offered: One Month

VA Boston Healthcare System (West Roxbury VAMC)

General Surgery and SICU (400.2)

Instructor: Erica Brotschi, M.D. and staff
Number of Students: One
Period to be offered: One Month

Cape Cod Hospital

General Surgery (400.0)

Instructor: Stephen W. Brooks, M.D.
Number of Students: One
Period to be offered: One month

*The above electives satisfy the sub-internship requirement
Note: Elective 400.2 requires completion of an additional VA Healthcare System application and fingerprinting. Please obtain contact information from elective coordinator upon sign-up.

 


Other Fourth Year Elective Rotations in Surgery

402.3 GS-3 General Surgery

Instructor: Andrew Glantz, M.D.
Co-Instructors: General Surgery Staff

Location: Boston Medical Center – Menino Pavilion
Telephone: 638-8443 (contact Grace Farnham, C-515)

Number of Students: One
Period to be Offered: One month

Description of Elective:

Elective is a preceptorship type in which the student will be assigned to a group of staff surgeons whose interest span care of trauma patients, critically ill surgical patients. The student will work closely with the instructor in his activities at Boston Medical Center (primarily Menino Pavilion) in the evaluation, comprehensive physical examinations, treatment planning and operative care of all patients. The student will take calls with the instructor in the Emergency Room. Clinical rounds will be conducted daily.

In addition, the student will participate in the research activities of the department relating to trauma, critically ill surgical patients and burn patients.

Attendance at all regularly scheduled conferences conducted by the Division of Surgery, e.g., Academic Seminars, Surgical Grand Rounds, Mortality and Morbidity Conferences, Chief’s Conference, will be encouraged.

Note: This elective will not be offered academic year 2015-2016

 

403.1 Surgical Intensive Care Unit

Instructor: Robert Schulze, M.D. and Staff

Location:Boston Menino Pavilion
Telephone: 638-8443, Grace Farnham, C-515

Number of Students: 3
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

 

403.2   BMC Bootcamp: Getting Ready for Surgery Internship

Course  Director: Alik Farber, M.D.

Periods Offered:   Block 19: 3/9/15-4/12/15

Duration: 1 month

Administrative Contact:

Grace Farnham

Surgical Education Program Coordinator

Boston Medical Center

88 E. Newton Street, C515

Boston, MA 02118

Tel #    617-638-8443

Fax#    617-638-8841

Description:

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.

Purpose:

To prepare students entering surgical training for their intern role and responsibilities and to teach them basic skills essential to a surgical intern.

Course Objectives:

At the conclusion of the course a student earning at least a passing grade will, complying with the BU CARES principles, be able to;

  1. Discuss basic principles of surgical science as it relates to basic anatomy, wound healing, nutrition, and pharmacology (U).
  2. Associate physiological effects of surgical stress on the cardiovascular, digestive, endocrine, hematological, musculoskeletal, and neurological systems (U).
  3. Demonstrate knowledge of the diagnosis and work up of common post-surgical conditions and complications (U, R).
  4. Value the role of coding, risk management, ethics, work organization, and time management on the practice of surgery (E, S).
  5. Develop the motor skills critical to the surgical trainee including – but not limited to — learning how to tie knots, suturing, place chest tubes, and place central lines (E).
  6. Demonstrate proper judgment using the Mock page experience where the student will carry a pager and respond to mock pages by nurses regarding mock patient issues (A, B, C, E).

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: Honors/High Pass/Pass/Fail.  A passing grade will be a minimum 50% overall score using the elements listed above.  The grade will be supplemented by written evaluations completed by Dr. Olshaker, Dr.Ortega, and nurse evaluator (for the mock page experience).

 

404.1 Surgery Subspecialty

Contact: Grace Farnham

Location: Boston Medical Center, C-5
Telephone: 638-8443

Description:

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.

            Anesthesia (BMC or VA)

            Cardiac Surgery (VA)

            Neurosurgery (BMC)

            Ophthalmology (BMC or VA)

            Orthopedics (BMC or VA)

            Otolaryngology (BMC)

            Plastic Surgery (BMC)

            Urology (BMC or VA)

 

LEARNING OBJECTIVES FOR THE CLERKSHIP (ALL SESSIONS):

By the end of this clerkship, students will be able to:

1.  Interact with patients and surgical team members in a courteous and professional manner (B, C);

2.  Assess patients’ surgical risk for the types of procedures in the specialty (U, A);

3.  Interpret imaging and other diagnostic studies in the specialty and use them to suggest treatment for common diagnoses (U);

4.  Describe in general terms the technical approach to common procedures in the subspecialty (U, E);

5. Provide appropriate postoperative assessment, and plans for follow up after surgery (U, C, S).

 

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 BUSM students only.

 

 

404.2  Minimally Invasive Surgery

Dept. of Surgery-Boston University School of Medicine

Instructor: Donald Hess, M.D., FACS Faculty: Brian Carmine, M.D., Nicole Kissane, M.D.

Contact: Grace Farnham, C515   Telephone: 617 638-8443

Period to be Offered: Four Weeks

Goal and Summary:

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., on 8 west Floor of the East Newton Pavilion

 

410.2 Cardiothoracic Surgery

Instructors:, Harold Lazar, M.D., Benedict Daly, M.D., Oz Shapira, M.D., Hiran Fernando, M.D. and Virginia Litle., M.D.

Location: Boston Medical Center, Newton Pavilion, B-4
Number of Students: One
Period to be Offered: One month

Course Description:

Students participate in the clinical activities of the Cardiothoracic Surgery team. Students are instructed in the diagnosis and surgical treatment of cardiovascular, pulmonary, esophageal, mediastinal and chest wall diseases, thoracic trauma and endoscopic diagnostic procedures. About two-thirds of the clinical work of this service is comprised of cardiovascular disease and one-third, non-cardiac thoracic surgery. Students learn about surgical treatment of cardiovascular disease, and participate in care of a large group of seriously ill and intensively monitored patients. Students can learn about diagnosis and management of problems occurring in each of the organ systems after major surgery. Students will also become familiar with monitoring techniques to assess the post-operative hemodynamic state, and treatment interventions such as catecholamine drugs and the intra-aortic balloon.

Students may have the opportunity to observe technologically advanced surgical procedures in both cardiac and general thoracic surgery, using minimally invasive approaches and use of robotic assisted surgery.

 

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, Grace Farnham, C-515

Number of Students: One
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.

430.3 Pediatric Surgery

Instructor: Catherine Chen, M.D.

Location: Pediatric Surgery, Dowling 2 South
Telephone: 638-8443, Grace Farnham, C-515

Number of Students: One
Period to be Offered: One month

This elective on the Pediatric Surgical Service will provide a broad
experience in the evaluation and operative management of neonatal and childhood surgical problems. It is geared toward those with an interest in surgery, pediatrics, or both. Ward round with the attending are made daily. Elective operative cases are performed all day Monday, Wednesday and Friday. Clinics are held Tuesday and Thursday afternoons. 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. Every Thursday morning teaching rounds are held on a selected topic.

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.

Every Thursday teaching rounds are held with the attending and staff usually discussing one topic in depth. The medical student will also attend the numerous conferences available on the Pediatric and Pediatric Surgical Services.

434.2 Cardiovascular Research

Instructors: Oz Shapira, M.D., Harold Lazar, M.D., and Virginia Litle, M.D.

Location: Boston Medical Center, Newton Pavilion, B-4
Number of Students: Two

Course Description:

Current ongoing projects in the laboratory include reversal of reperfusion damage following cardioplegic arrest, evaluation and design of cardioplegic solutions, the use of lasers in coronary surgery, evaluation of arrest devices for the failing heart, prolonged storage of hearts for transplantation, and cryopreservation of tissue valves for transplantation and decreasing the inflammatory response of ischemia and cardiopulmonary bypass and their effect on endothelial function. All the laboratories are located on the medical school campus.

Our goal is to create an environment in the laboratory which will serve as a catalyst for learning and teaching. The student will work closely with the research fellow and technician, and will work both in large animal research projects, assisting in the open heart surgical procedures, and in an isolated heart laboratory where myocardial metabolism and endothelial function will be emphasized. Cardiopulmonary physiology will be stressed and the student will learn about designing and analyzing experimental data, and encouraged to create her/his own projects. There will be a two hour weekly research conference where data from the diverse research projects will be discussed. Students will be given background bibliographical information so that they are well versed in all ongoing areas of the research projects.

 

435.0 Private Community Vascular and General Surgery

Instructors: Ronald L. Nath, M.D. and Dennis Begos, M.D.

Contact: Susan Mansur

Location: Lawrence Memorial/Winchester Hospitals
Telephone: 781-279-1123

Number of Students: One

Period to be Offered: One month

Description of Elective:

This is a unique and outstanding opportunity for a student to experience the world of private practice surgery. The student will be given the opportunity to round on private patients in the community setting, work-up selected problems and be an integral part of the total post-operative care including ICU support. The student will be able to scrub on all cases, and in the majority of instances, become the first assistant. During this elective, students have usually scrubbed on 30 to 40 major vascular, general and advanced laparoscopic operations, and have played a major role in each case. This is a hands-on rotation. The student will also be able to assist on minor cases, participate in out-patient surgery and colonoscopy, and see private consultations.

After morning cases are complete, the student will be able to go to Commonwealth Surgical Associate’s private offices and see patients,  whether pre-op, post-op or nonoperative. This offers an unrivaled opportunity to follow patients from the office through the OR, and postoperatively. It is a one-on-one rotation with Commonwealth Surgical Physicians, allowing personal instruction and direct participation. Each student may choose to take as much responsibility for direct management of the patient as he/she desires, up to the level at which the rotation becomes similar to a subinternship. There is no requirement for night or weekend call, but availability for rounds and cases is encouraged. A strong emphasis is placed on surgical education, personally taught, with special units in anatomy, fluids and electrolytes, vascular diagnosis and treatment and intensive care.

This rotation is ideal for any student planning to become a surgeon or desiring a more personal insight into the field of community surgery. At the conclusion of this elective, the student will have had extensive hands-on operative experience, and an in-depth understanding of surgery and its practice in the community setting. Prerequisite: Completion of a clinical clerkship in Surgery.

Participation in this elective requires submission of the following materials to Dr. Nath’s office at Commonwealth Surgical Associates:

1. letter of good standing from the Office of the Registrar
2. copy of current immunization records
3. certificate of liability coverage

 

SURGERY: Special Clinical Areas and Research

465.2 Plastic & Reconstructive Surgery

Instructors: Nilton Medina, M.D.

Location: Boston Medical Center, Newton Pavilion and
Menino Pavilion
Telephone: 638-8443, Grace Farnham, C-515

Number of Students: Two
Period to be Offered: 1 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.

 

SURGICAL SPECIALTIES: Anesthesiology

505.2 Anesthesiology

Instructor: Joseph Louca, M.D.

Location: Boston Medical Center
Telephone: Newton Pavilion 2817A (617)638-6955

Rotation Coordinator: Ms. Susan Peterson- susan.peterson@bmc.org

Number of Students: Four BU 4th year medical students
Period to be Offered: 4 weeks

Summary of Elective:
The Anesthesiology four week elective rotation is an opportunity for BUSM 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 in areas other than the operating room.

Description of Elective:

Anesthesiology is the practice of perioperative medicine. Traditionally, anesthesiologists have been known primarily as physicians who administer anesthesia to alleviate pain and suppress consciousness of the patient undergoing surgery. They also provide medical care and consultations in many other settings and situations outside of the operating room. Anesthesiologists’ responsibilities include (1) preanesthetic evaluation, treatment and optimization for surgery, (2) intraoperative management from the medical and the anesthesia perspective, (3) postanesthetic evaluation and treatment, and (4) on-site medical direction of any non-physicians who assists in the technical aspects of anesthesia care. Today, many anesthesiologists have further specialized into providing critical care in the ICU setting and managing patients with chronic pain issues in pain clinics. Additionally, anesthesiologists work in labor and delivery suites for the provision of labor analgesia and anesthetic care for C-Sections and other procedures.
Students will be active members of the Department and will participate in all the academic activities, actively collaborate with tasks related to patient care in the perioperative area (at all three campuses; ENC, MP and Moakley), the pain clinic and the labor and delivery room. The student will spend two weeks in the operating room (ENC/MP), a week in the Moakley building (Ambulatory surgery/Pain Management) and a week in the labor and delivery room (MP). Opportunities to watch and perform procedures will be available. It is expected, at the conclusion of this elective that the student will have an appreciation of roles of the anesthesiologist in different areas of the institution and being able to summarize the fundamental principles of the specialty. This rotation will allow the student to gather the knowledge needed to assess and treat acute situations whereas anesthesiology is the career path the student desires.

Logistics:

1- Students will receive a packet of information via e-mail prior to the start of the rotation.
Anesthesiology 4-Week Elective – 4th Yr.
2- They must report to the Anesthesiology Office (second floor ENC) at 6:50 AM to Ms. Susan Peterson (extension 86955) on the first day of the rotation for further instructions.
3- Residents will receive a schedule for their rotation and will work with the anesthesiology team, which always includes and attending.
4- Students are expected to be present for all academic activities of the Department (see times below) and a release time of about 1600 should be expected (18:30 after lectures conclude).
5- There are no call responsibilities in this rotation.
6- Daily evaluations, case logs and a final quiz will all be part of the evaluation process.
7- Failure to obtain daily evaluations will preclude course directors the ability to evaluate the student.

For further details, please refer to the welcome packet.

GOAL
The purpose of the Anesthesia 4 week elective is for the BUSM student to gain exposure and experience in the perioperative management of patients presenting for surgery and anesthesia, the anesthetic management of the patient in labor and the management of chronic pain.
OBJECTIVES
The objectives have been divided in four groups: 1) The operating room anesthesia encompasses preoperative, intraoperative, and immediate postoperative periods (ENC and MP), 2) Labor and delivery room 3) Ambulatory anesthesia, and pain management (Moakley)

Operating room (2 weeks) A week at ENC a week at MP)

I.  Preanesthetic Evaluation:

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

1. Perform preanesthetic assessments, including (B, U, C, A):
a.Taking and recording a pertinent history
b. Performing an appropriate physical examination, including assessment of airway, cardiovascular system,       respiratory system, other systems as indicated
c. Reviewing pertinent laboratory data
d. Assigning appropriate ASA physical status
e. Develop a sound relationship with the patient

2. Discuss how the following factors may influence patient’s course during perioperative periods (B, U, C, A):
a. Age
b. Nature of the surgery, including minor versus major, peripheral versus central, and elective versus emergent
Anesthesiology 4-Week Elective – 4th Yr.
c.Cardiovascular disorders, including but not limited to coronary artery disease, hypertension, myocardial failure, dysrhythmias
d. Respiratory disorders: known or suspected difficult intubation, upper and/or lower respiratory infection, asthma, chronic obstructive pulmonary disease, lab work up (PFT, ABG)
e. Central nervous system disorders: increased ICP
f. Hematological disorders
g. Personal or family history of unusual response to anesthesia: malignant hyperthermia, abnormal response to succinylcholine
h. Life style factors: obesity, substance abuse (tobacco, alcohol, chemical)

3. Discuss medication history and the influence of chronic and current medications on the perioperative period including (B, U, and C):
a. Which drugs should be discontinued and why
b. The rebound pneumonia resulting from abrupt discontinuation of some classes of drugs, notably beta-blockers and clonidine.

4. Summarize the objectives and basic pharmacology and pharmacokinetics of preanesthesia medication by naming and discussing drugs used for: relief of anxiety, sedation, reducing gastric acidity and volume. (B, U, C)

II. Intraoperative care:

At the end of the rotation, the student should be able to:
1. Define the Standard ASA monitors and the reasons for their use. (U, R, E, S)

2. Identify several agents used on induction of general anesthesia and give their advantages and disadvantages: IV agents, inhalation agents, neuromuscular blocking agents (U, R, E)

3. Summarize an uncomplicated intravenous induction (U, C)

4. Perform basic airway management during several uncomplicated intravenous inductions (B, U, C, A)

5. Describe the indications, risks, and benefits of airway management by mask versus intubation versus LMA (U, R, E)

6. Identify basic equipment and techniques to aid proper mask ventilation: various masks, jaw thrust, nasopharyngeal and oropharyngeal airway (U, R, E)

7. Discuss results of ABG analysis in terms of oxyhemoglobin dissociation curve and acid-base status (U, C, E)

8. Propose appropriate intraoperative fluid and electrolyte therapy (U, C, R, E)
Anesthesiology 4-Week Elective – 4th Yr.

a. Discuss how the following preoperative conditions will alter requirements for perioperative maintenance therapy: NPO, bowel prep, NG suction, fever
b. Discuss intraoperative considerations, which alter maintenance fluid and electrolyte therapy, including blood loss, “third space” loss, and temperature
c. Interpret data from monitors of volume status such as physical examination of the patient, pulse and blood pressure, urine output, CVP, PAC, and SVV
d. Discuss indications, risks, and benefits of crystalloid, colloid, and blood product replacement therapies: regarding the functions of blood volume, oxygen carrying capacity, coagulation, regarding complications of each type of therapy

9. Identify the common sites for venous access and demonstrate skill at establishing venous access by: (B, C, A, R, E)
a.Using sterile technique and universal precautions
b.Successfully inserting several peripheral catheters of various calibers
c.Protecting venipuncture site and immobilizing the catheter

10. Identify position-related injuries that patients may sustain while unconscious and their potential causes (U, C, E)
a. Demonstrate knowledge of local anesthetic pharmacology appropriate to the practice of general medicine by (U,  R, E):
b. Classifying commonly used agents according to amide or ester linkage
c. Listing commonly used local anesthetics for: topical use, local infiltration, peripheral nerve blocks
d. Normal and toxic doses of lidocaine and bupivacaine
e. Describing signs of local anesthetic toxicity, and treatment of inadvertent local anesthetic toxicity
f. Describing allergic reactions to local anesthetics

III. Post Operative care

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

1. Discuss assessment and management of postoperative pain including (U, C, R, E):
a. Pain scales and visual analog scales
b. Define of different types of pain management including: PCA, epidural peripheral nerve blocks and pain management medication: administration route and dosing schedule (narcotics, acetaminophen with and without codeine, ketorolac, and other NSAID’s
c. How to convert patient from parenteral drugs to P.O. drugs

2. Summarize PONV prophylaxis and its treatment (U, C, R, E)

IV. Ambulatory Anesthesia (One week in combination with the pain clinic)

At the end of the rotation, the students will be able to:

1. Define of types of procedures and patients appropriate for ambulatory surgery (U, C, R, E, S)
2. Perform assessment and describe management of the ambulatory patient with respect to (B, U, C, A, R, E, S):
a. ASA classification
b. Appropriate lab work
c. Strategies to bypass phase one PACU and allow early discharge
d. Discharge criteria
e. Pain management

V. Chronic pain (One week in combination with Ambulatory experience)

At the end of the rotation, the students will be able to:

1.  Define most common causes of chronic pain syndromes. (U, C, R, E)
2.  Define the differences between acute and chronic pain. (U, C, R, E)
3. Discuss the pathophysiological changes that lead to chronic pain syndromes (U,C,R,E)
4. Discuss the interventional and non-interventional approaches to the management of chronic pain (U,C,R,E)
5. Discuss the impact of chronic pain in U.S workforce and healthcare (S)

VI. Labor and Delivery (A week at MP Labor and Delivery suites)

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

1. Define the physiological changes related to pregnancy an labor and the impact in the anesthesia management. (U)
2. Perform a complete anesthetic assessment of the pregnant woman. (B,U,C,A,R,E)
3. Discuss the indications and contraindications as well as risk and benefits of to neuroaxial techniques for labor analgesia. (U, R,E)
4. Discuss fetal monitoring. (U, R,E)
5. Identify indications for both elective and urgent cesarean section.(U, R,E)
6. Discuss anesthetic alternatives for cesarean section. (U, R,E)
7. Identify cause of third trimester maternal hemorrhage. (U, R,E)
8. Discos neonatal resuscitation (U, R,E)

Core Faculty
Keith P, Lewis, MD. Chair, Department of Anesthesiology, BUSM
Rafael Ortega, MD, Vice-Chair Academic Affairs Department of Anesthesiology, BUSM
Elena Brasoveanu, MD, Department of Anesthesiology, BUSM
Eddie Feliz, MD, Department of Anesthesiology, BUSM
Mauricio Gonzalez, MD, Department of Anesthesiology, BUSM
Oleg Gusakov, MD, Department of Anesthesiology, BUSM
Carlos Guzman, MD, Department of Anesthesiology, BUSM
Gerardo Rodriguez, MD, Department of Anesthesiology, BUSM

CURRICULUM

The curriculum includes:

-Daily participation in the operating room
-Monday Anesthesiology Department lectures (7:00-8:00 AM)
-Tuesday Anesthesiology Residents Didactic Series lecture (4:30- 6:30 PM)
-Tuesday Anesthesiology case discussions (C/D Room at 6:30 AM)
-Wednesday Oral Board Review (C/D Room at 6:30 AM)
-Thursday Board Rounds with Chair (ENC OR at 6:15 AM)
-Friday Written Board Review (C/D Room at 6:30 AM)

Suggested Reading Assignment

Students are encouraged to use the Clinical Anesthesiology, 4edition by G. Edward Morgan, Jr., Maged S. Mikhail, Michael J. Murray (eds) which is available on-line at the BMC web under the Tab Resources (Click on Harrison on-line, then click textbook tab and then link to book is found in next window). The suggested chapters are 1, 5 to 18, 43, 45, and 48
EVALUATION

The student will have a formal evaluation of their achievement regarding the above stated goals. The evaluation will entail direct daily observation and evaluation of performance in the perioperative area, an on-line quiz, and review of the case logs. At the end of the rotation, a member of the core faculty will meet with each student to discuss performance. Dr. Ruben J. Azocar will be responsible to submit the evaluations to the Medical School.

506.2  Anesthesiology Critical Care Elective for 4th year Boston University Medical Students

Department of Anesthesiology

Boston University School of Medicine

Course Directors: Gerardo Rodriguez, MD

Location: Boston Medical Center
Telephone: East Newton Pavilion 2817A  (617)638-6955

Rotation Coordinator: Ms. Susan Peterson-susan.peterson@bmc.org

Number of Students: Two BU 4th year medical students

Length of Rotation: 4 weeks (all blocks)

DESCRIPTION OF ELECTIVE:

The Anesthesiology Critical Care Medicine rotation is an opportunity for BUSM 4th year medical students to become familiar in the recognition and management of patients with the set of medical and surgical problems that require Critical Care (CC). The East Newton Pavilion (ENP) SICU patient population include many elderly patients with preexisting physiological derangements presenting for elective and emergency surgery. Major vascular, thoracic, neurosurgery, and general surgery patients comprise the majority of patients in the ENP SICU. Multisystem disease states (diabetes, cardiac, and peripheral vascular) are common in this ICU. Many patients require critical care before their surgical procedures.
Students will be active members of the team, will participate in daily rounds, present new consultations or admissions, actively collaborate with work related to the patients care and will be responsible for presenting in detail, all patients whom they have called on previously. The student will defend the therapy initiated and propose a comprehensive treatment plan. Opportunities to participate in procedures performed in the SICU will be available. The Critical Care Anesthesiology Faculty offers daily teaching rounds as well as daily didactic lectures. The students will participate in both the Monday morning conferences as well as the Tuesday afternoon resident didactic series provided by the Department of Anesthesiology. It is expected at the conclusion of this elective that the student will have an appreciation of the issues present and the management of the critically ill patient.
Logistics:
1-Students will receive a packet of information via e-mail prior to the start of the rotation.
2-They must report to the Anesthesiology Office (second floor ENC) at 06:50 AM to Ms. Susan Peterson (extension 86955) on the first day of the rotation for further instructions. Anesthesiology Critical Care – 4th Yr.
3-Students will receive patient assignments during this rotation and will work with the Anesthesiology ENC SICU team, which always includes an attending.
4-Students are expected to be present for all academic activities of the Department (see times below) with a release time of approximately 4:00 pm (or after the Tuesday 6:30 lecture concludes).
5-There are no call duties in this rotation, but if desired, student can assume call responsibilities.
6-Daily performance in rounds and the final presentation will be all part of the evaluation process.
7-Failure to obtain daily evaluations will preclude the course director’s ability to do student evaluations.
For further details, please refer to the welcome packet.
GOAL
The purpose of the Anesthesia Critical Care elective is for the BUSM student to gain exposure and experience in the evaluation and management of critically ill patients.
OBJECTIVES
By the end of the Anesthesia Critical Care elective, the BUSM student will be able to:
o Differentiate the normal physiology of the Cardiovascular, Pulmonary, Hematological, Neurological, Endocrine as well as Renal and Gastrointestinal systems from the changes noted in the critically ill patient. (U, R)

o Describe the pathophysiology of common disease processes that might lead to ICU admission and the effects on the Cardiovascular, Pulmonary, Hematological, Neurological, Endocrine as well as Renal and Gastrointestinal systems. (U, R)

o Present an organized approach to clinical problem solving including a differential diagnosis, well as systematic approach to the use of diagnostic testing and consultant activities. (U, R)

o Explain the goals of sedation and analgesia in the ICU. Discuss the various options available to facilitate sedation and analgesia, including sedation scales and various types of sedation medications. (U, R)

o Compare and contrast contemporary modes of ventilation and weaning strategies. (U, R)
Anesthesiology Critical Care – 4th Yr.

o  Explain the goal of basic nutrition support. Discuss the initial nutrition assessment of a CC patient. (U, R)

o  Discuss basic infection control goals and the techniques used to help in the prevention of ventilator-associated pneumonia (VAP), urinary tract infections (UTI), central venous line (CVL), and post- operative wound infections. (U, R)

o Compare and contrast the most commonly used antibiotics in the ICU. (U, R)

o Describe and display a systematic approach to the use of diagnostic testing and consultant activities in the ICU. (U, R, S)

o Discuss the indications for the use of invasive monitoring such as arterial lines, central venous lines, pulmonary artery catheters, and transesophageal echocardiography. (U, R)

o Describe the anatomy and technique for the placement of invasive monitoring. The student will have the opportunity to observe and assist in the placement of invasive monitors. (U, R)

o Review the anatomy and basic principles of airway management. The student will observe and assist in the procedures related to airway management. (U, R)

o Analyze the data from the invasive monitors and discuss appropriate interventions based on the data. (U, R)

o Participate in family meetings for critically ill patients and discuss issues such as delivery of bad news and end of life conversations. (B, U, A )

o Prepare and present a PowerPoint presentation of a critical care medicine case that they observed during the rotation (B, U, C,E )
Suggested Reading Assignment

1-The ICU Book by Paul Marino
2-Resident’s Guide to Learning in the Intensive Care Unit by the American Society of Critical Care Anesthesiologists (Download available at http://ascca.org/)
3-U Penn site: Critical Care tutorials http://ccmtutorials.com/
4-Society of Critical Care medicine Website www.sccm.org (guidelines and other information available there)

FACULTY

Jeanette Lee, MD, Department of Anesthesiology, BUSM
Cesar Castillo, MD, Department of Anesthesiology, BUSM
Bobby Chang, MD, Department of Anesthesiology, BUSM
Pavan Sekhar, Department of Anesthesiology, BUSM

 

CURRICULUM
The curriculum includes:
-Daily bedside rounds at the ENC SICU
-Participation in patient evaluations, write ups an patient presentations
-Daily lectures by CCM attending, fellows, residents, or medical students (under faculty supervision)
-Monday Anesthesiology Department lectures
-Tuesday Anesthesiology Residents Didactic Series lecture

EVALUATION

The student will have a formal evaluation of their achievement regarding the above stated goals. The evaluation will entail direct daily observation of performance in the SICU during and after, and a PowerPoint presentation based on a critical care medicine case they observed during the rotation. At the end of the rotation, the Anesthesiology CCM faculty will meet and discuss each student’s performance. Dr. Gerardo Rodriguez will be responsible for submitting the evaluation to the Medical School

 

507.2 Anesthesiology Research Elective

Course Director: Christopher Connor, M.D., Ph.D.

Rotation Coordinator: Ms. Susan Peterson- susan.peterson@bmc.org

Location: Boston Medical Center-Newton Pavilion 2817A
Telephone: (617)638-6955

Number of Students: Two BU 4th year medical students per four week block
Period to be Offered: 4 weeks

SHORT SUMMARY OF ELECTIVE

 

The Anesthesiology Research elective will allow medical students to pursue a research project in anesthesiology. The students will select a research project as defined by a scientist mentor who will serve as the project’s advisor. The research project will be sufficiently well defined and the required supporting infrastructure well developed so that the students will be able to start with data acquisition and/or data analysis on day one, and complete data analysis by the fourth week. This will require the medical students to identify the advisor, define an appropriate project to complete during this block, and have IRB or IUCAC approvals at least 8 weeks prior to the rotation. The students will write a report in the standard format of a scientific publication, including the Introduction, Materials and Methods, Results, and Discussion sections. The goals of this elective are to train medical students in anesthesia research and to give them the opportunity to publish in the scientific literature.

 

DESCRIPTION OF RESEARCH ELECTIVE

 

The students will meet with the faculty member who is overseeing the project, prior to the start of the elective to meet the above approval deadlines.  At that time they will agree to a plan of operations and a research timeline to be followed during the elective. This is a mandatory step in order to allow the students to participate in this rotation. The plan of operations includes a mutually agreed number of work hours per week to satisfy the BUSM minimum of 40 hours per week, a description of the specific research 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 be fulfilled prior to the elective’s start date, including any animal or human subjects training as well as IRB or IUCAC approvals.

 

To participate in a research study for which IRB approval has already been obtained, or for which IRB approval is not required, the student should make contact with the department no later than 3 months before the anticipated start date of the rotation so that necessary credentialing steps can be performed. If the student wishes to pursue an entirely novel project, it is essential to make contact with the department at the earliest possible time in order to determine the feasibility of the project and to arrange the necessary approvals.

 

The research elective will take place in the general facilities applicable and available to the overseeing faculty. During the elective, the students will meet with the faculty at least once a week to review research progress. Furthermore, a mid-clerkship review by the faculty 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 needs to 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, an alternate plan will be defined where the student can meet research project objectives and hourly requirements to receive credit for the rotation.

 

The rotation will be graded using an Honors, High Pass, Pass, Fail scale depending on the degree of success with the research project’s goal and course objectives. As part of determining the grade, an Honors grade requires submission of a first draft manuscript to the faculty and the course director. A Pass grade requires successful completion of data acquisition and analysis.

 

GOAL

 

 

The purpose of the research elective is for the BUSM students to develop scientific skills in anesthesiology research and implement them in the process of completing a defined research project.

 

OBJECTIVES

By the end of the research elective, the BUSM student will be able to:

 

  • Apply scientific methods for the study of problems in anesthesiology (U, R, E)
  • Analyze scientific data (U, R, E)
  • Synthesize new knowledge from experimental findings (U, A, R, E)
  • Construct a scientific paper (A, R, E)
  • Communicate scientific knowledge (A, R, E)

 

FACULTY REQUIREMENTS

 

 

The faculty for this elective must satisfy the following conditions to use this course to support a student research project:

1)     They must have constructed a research proposal with the student and submitted the appropriate approval form to the registrar 8 weeks prior to the start of the rotation

2)     Any IUCAC or IRB approvals must be in place at the time of submission of the research proposal to the registrar.

3)     The faculty must have a minimum of once-a-week meetings with the students

 

EVALUATION

The students will have a formal evaluation of their achievement of the above stated goals. The evaluation will entail direct daily observation and evaluation of performance and completion of the project. A mid-clerkship evaluation will be conducted by the overseeing faculty and submitted to Dr. Chris Connor. At the end of the rotation, the overseeing faculty will meet with each student to discuss performance.  Dr. Connor may also designate another core anesthesia research faculty member to review the project and performance and give further summative feedback.  Dr. Connor will be responsible to submit the evaluations to the Medical School.

 

Core Faculty

Keith P, Lewis, MD.  Chair, Department of Anesthesiology, BUSM

Rafael Ortega, MD, Vice-Chair Academic Affairs Department of Anesthesiology, BUSM

Christopher Connor, MD, Director of Research Department of Anesthesiology, BUSM

Ruben J. Azocar, MD, Department of Anesthesiology, BUSM

Gerardo Rodriguez, MD, Department of Anesthesiology, BUSM

 

508.2 Anesthesiology Multimedia Elective

Course Co-Directors: Rafael Ortega, M.D. and Ruben J. Azocar, M.D.

Rotation Coordinator: Ms. Susan Peterson-speterso@bu.edu

Location: Boston Medical Center-East Newton Pavilion 2817A
Telephone: (617)638-6955

Number of Students: Two BU 4th year medical students per four week block
Period to be Offered: 4 weeks

SUMMARY 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 BUSM 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.

 

DESCRIPTION OF ELECTIVE

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 BUSM 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 ENC) at 6:50 AM to Ms. Susan Peterson (extension 86955) on the first day of the rotation for further instructions.

Students are expected to be present for all academic activities of the Department and a release time of approximately 4:00 PM (on Tuesdays, release time is 6:30 PM after lecture concludes).

 

GOAL

The purpose of the Anesthesia 4 week elective is for the BUSM student to gain exposure and experience in the development of educational multimedia lessons and programs.

OBJECTIVES

By rotation end, students should be able to:

  1. Identify the requirements to develop a multimedia application using recorded sound, digital photography and video for medical education as it applies to anesthesiology  (R, E)
  2. Analyze the needs of the target audience and prepare project goals in order to design the correct type of anesthesia-related educational tool.  (R, E)
  3. Identify the relevant supporting literature and other multimedia resources in order to develop the multimedia project.  (R, E, S)
  4. Analyze and present data to produce the multimedia project.  (C, R, E, S)
  5. Discuss project with advisor and appropriate consultants including specialists in instructional media design.  (C, R, E, S)
  6. Prepare the project for presentation to the Core Faculty, with defined authorship for the final project.  (C, R, E, S)
  7. Learn methods for properly obtaining informed consent from patients to participate in obtaining video and still images used in educational projects.  (A)

 

Core Faculty

Keith P, Lewis, MD.  Chair, Department of Anesthesiology, BUSM

Rafael Ortega, MD, Vice-Chair Academic Affairs Department of Anesthesiology, BUSM

Christopher Connor, MD, Director of Research Department of Anesthesiology, BUSM

Ruben J. Azocar, MD, Department of Anesthesiology, BUSM

Gerardo Rodriguez, MD, Department of Anesthesiology, BUSM


CURRICULUM

The curriculum includes:

-          One-on-one faculty instructions to learn basic video editing with Adobe Premiere Pro, and basic image manipulation with Adobe Photoshop.

-          Participation in scheduled didactics to concurrently build the student’s fund of knowledge and relevant to project development:

  • Monthly Journal Club
  • Monday Anesthesiology Department lectures (7:00-8:00 AM)
  • Tuesday Anesthesiology Residents Didactic Series lecture (4:30- 6:30 PM)
  • Tuesday Anesthesiology case discussions (C/D Room at 6:30 AM)
  • Wednesday Oral Board Review (C/D Room at 0630)
  • Thursday Board Rounds with Chair (ENC OR at 6:15 AM)
  • Friday Written Board Review (C/D Room at 6:30 AM)

-          Review literature pertinent to the effectiveness of multimedia as a teaching tool, as arranged by the overseeing faculty and include (but not limited to) the following resources:

  • The use of multimedia to teach new cardiac anesthesia procedures.  Journal of Cardiothoracic and Vascular Anesthesia, Volume 12, Issue 6, Pages 695-700 (1998) Rafael A. Ortega, Harold Arkoff, Richard C. Havel
  • Using digital media to keep anesthesia history alive.  Journal of Anesthesia.  Volume 19, Number 4 (2005) Rafael A. Ortega and Sundara K. Rengasamy
  • Using a media center to facilitate team-based learning.

J Vis Commun Med. 2006 Jun; 29(2):61-5.

Ortega RA, Stanley G, Snavely A.

 

EVALUATION

The student will have a formal evaluation of their achievement of the above stated objectives and graded using an Honors/High Pass/Pass/Fail scale.  The evaluation will consist of direct daily observation, evaluation of performance, and completion of the project by the agreed timeline at the end of the rotation.  A mid-clerkship evaluation will be performed.  A member of the core faculty will meet with each student to discuss performance.  A review of the project will be a part of the final grade.  Dr. Ruben J. Azocar will be responsible to submit the evaluations to the Medical School.

 

 

SURGICAL SPECIALTIES: Neurosurgery

510.2 Neurosurgery

Instructors: James Holsapple, M.D., Anthony Jabre, M.D., F.A.C.S., James Reed, M.D., Jules Nazzaro, M.D., Shapur Ameri, M.D., Sin Choo, M.D., and Anand K. Devaiah, M.D.

Location: Boston Medical Center, Newton Pavilion and Menino Pavilion
Telephone: 638-8443, Grace Farnham, C-515

Number of Students: One
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, CAT scans and MRIs 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.

 

511.2 Clinical Management of the Neurosurgical Patient

Instructor: Anthony Jabre, M.D., F.A.C.S. (ajabre@bu.edu)

Location: Boston Medical Center, Newton Pavilion and Menino Pavilion
Telephone: 638-8443, Grace Farnham, C-515

Number of Students: One
Period to be Offered: One month

Description of Elective:

Fourth year students electing Neurosurgery may observe and participate in patient evaluation in the neurosurgery clinic. The student will be encouraged to continue to care for those patients, as they require hospital admission and elective surgery. The student will thus become familiar with the indication, risks and benefits of various neurosurgical operations. The student will participate in daily clinical rounds, and will have the opportunity to observe and assist in the operating room, in a wide variety of neurosurgical operations. The student will be taught basic interpretation skills of various radiographic tests, including angiograms, CAT scans, and MRIs. Through weekly teaching conferences, the student will be exposed to detailed review of current interesting or unusual cases, along with didactic lectures.

 

512.2 Transplant Surgery

Instructor: Matthew Nuhn, M.D. (matthew.nuhn@bmc.org or 617 638-8430)

Location: Boston Medical Center/Lahey Hospital and Clinic
Telephone: 638-8443, Grace Farnham, C-515

Number of Students: One
Period to be Offered: One month

Description of Elective:

Students will make daily rounds with the transplant team and attend all outpatient clinics at Boston Medical Center (BMC) and be expected to attend all meetings, including selection, clinical case conference, pathology conference and QAPI.  In addition the student will be able to attend selection meetings at Lahey Hospital and Clinic.  Students on the transplant service will be expected to scrub into all transplants and associated procedures, assuming these do not interfere with medical school hour requirements.  Kidney transplants take place on the East Newton Campus of BMC and liver transplants will take place at the Lahey Clinic (Burlington, MA).  During their rotation the student will also be asked to give a 15 minute powerpoint presentation on some transplant related topic.  The student will also have the opportunity to accompany the surgeon on any procurements that occur, assuming this is approved by the medical school.

 

SURGICAL SPECIALTIES: Ophthalmology

514.2 Ophthalmology – Four Week Clinical/Surgical Elective

Instructor: Nicole Siegel, M.D.

Contact: Valerie Worrell-617 638-4552

Instructor/s: Faculty and residents of the BUSM Department of Ophthalmology

Location: Boston Medical Center YACC Eye Clinic

Number of Students: Maximum of 4 students at BMC
Period to be Offered: Four weeks

Eligibility: BUSM III or BUSM IV; BUSM IV students applying to an ophthalmology residency will be given priority during Blocks 9 and 10.

Outside fourth year medical students whose schools do not  offer an ophthalmology elective may apply for Blocks 10-20 (7/2/12-4/15/13), all other outside students may apply for Blocks 13-20 (9/24/12-4/15/13).

Goal:
To allow students, regardless of ultimate career goals, the opportunity to gain exposure to the clinical practice of ophthalmology.
To allow students interested in pursuing a career in ophthalmology, the opportunity to explore the specialty in greater depth.

Course Description:
The four week elective is open to BUSM III and BUSM IV students. Students will work with residents and faculty at BMC. Activities will involve examining patients in the outpatient clinic and the in-patient consultation service. Many of the patients will have trauma related ocular injuries. 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 in a discussion of selected ophthalmic topics. Opportunities will be available, depending on student interest, to spend time on subspecialty services such as 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, such as cataract and glaucoma surgery, retinal detachment repair, and oculoplastic procedures.
Students will be asked to prepare a short (15 minute) Powerpoint presentation on a case relevant to his or her anticipated area of interest.

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 BUSM students: Honors / High Pass / Pass / Marginal Pass / Fail

 

516.1 Laboratory Investigation in Diseases of the Eye

Instructors: Dr. Thomas Freddo, Dr. Vickery Trinkaus Randall,
Dr. Haiyan Gong, Dr. Matthew Nugent, Dr. Nadir Rahimi and Dr. Sayon Roy

Location: BUMC L-9
Telephone: 638-4550

Number of Students: One per advisor
Period to be Offered: Rotation of 8 to 12 weeks minimum

Description of Elective:

This course will require a minimum of 2 months and will consist of full time basic research in one of the laboratories in the Ophthalmology Department. Areas of investigation include ocular ultrastructure and ophthalmic pathology, corneal wound healing and epithelial repair, diagnosis and treatment of corneal and uveal inflammatory disease, mechanisms underlying glaucoma and pathogenesis of eye-related macular degeneration and diabetic retinopathy. The course will be directed in a manner designed to acquaint the student with the research techniques of and their application to solving clinically related problems. Efforts will be made to design an individual research project for each student and the student will be required to present his/her results at the termination of the course. A project that is mutually satisfactory to both the student and the instructor must be designed before a student will be accepted for this course. Longer term projects are also available with previous discussion with faculty member.

 

SURGICAL SPECIALTIES: Orthopedic and Fracture Surgery

550.3 Trauma and Fracture(Shortell Service)

Supervisor: Paul Tornetta III, M.D.

Instructor: William R. Creevy, M.D. and Paul Tornetta III, M.D.

Location: Boston Medical Center
Telephone: 638-8934, Contact: Lynnette St. Louis

Number of Students: Three
Period to be Offered: One month

Description of Elective:

The elective will be shaped according to the individual student’s future objectives. In particular, there is access to pediatric and adult trauma as well as hand trauma and spine trauma. As an orthopaedic team member, the student will participate actively in the care of patients seen in the operating rooms, emergency rooms, clinics, and on the floors. Most of the time will be spent in the emergent care of patients, fracture reduction, application of casts and splints, and participating in the daily work effort.

Students are encouraged to go to the operating room to scrub on cases. The basic schedule begins with ward rounds, followed by a conference at 6:15 am in which the attending staff reviews all of the patients treated the previous day and their x-rays. There are teaching conferences on Monday, Wednesday, Thursday, Friday and some Tuesdays. These conferences include grand rounds, didactic lectures and a weekly case review of all operations performed during the week. Attending physicians run all conferences.
Guest lecturers are frequently present for grand rounds presentations.

This elective offers multiple opportunities in the clinical and academic environment from which the student can draw. The elective is a busy one but should be extremely educational. The opportunity to get involved in research also exists.

 

554.0 General Orthopaedic Surgery

Supervisor: Mark Lemos, M.D.

Location:Lahey Clinic, 41 Mall Road, Burlington, MA 01805
Telephone: 617-638-8934, Contact: Lynnette St. Louis

Number of Students: 2
Period to be offered: One Month

Description of Elective:

This elective is for fourth year medical students interested in pursuing a career in Orthopaedic Surgery. This elective can be focused on: adult reconstruction, hand surgery, sports medicine, foot and ankle surgery, spine surgery, or orthopaedic research. Students will participate in the care of patients treated in the outpatient clinics, emergency room, hospital, and operating room. Students will work as members of the orthopaedic resident team. In addition, medical students will participate in resident lectures and have the opportunity to do orthopaedic research.

 

554.1 Orthopedic Pediatric, Foot and Ankle and Hand Surgery (Cotton Service)

Supervisor: Andrew Stein, M.D.

Instructors: T. Desmond Brown, M.D. and Andrew Stein, M.D.

Location: Boston Medical Center
Telephone:(617) 638-8934,Contact: Lynnette St. Louis

Number of Students: Two
Period to be Offered: One month

Description of Elective:

Boston Medical Center has an active orthopaedic staff with the majority of operative procedures being reconstructive operations. The student will work with three orthopaedic surgeons specializing in foot and ankle, pediatric, and hand surgery. The student will act in the capacity of a junior resident with regular patient responsibilities, clinic and operating room duties. He/she will attend teaching conferences and rounds of the orthopaedic staff. It is not intended that the student act as an observer in this elective but as an integrated part of the patient care team.

Students are encouraged to go to the operating room to scrub on cases. The basic schedule begins with ward rounds, followed by a conference at 6:15 am in which the attending staff reviews all of the patients treated the previous day and their x-rays. There are teaching conferences on Monday, Wednesday, Thursday, Friday and some Tuesdays. These conferences include grand rounds, didactic lectures and a weekly case review of all operations performed during the week. Attending physicians run all conferences.
Guest lecturers are frequently present for grand rounds presentations.

 

554.2 Orthopaedic Sports Medicine, Adult Reconstruction and Spine(Leach Service)

Supervisor: Anthony A. Schepsis, M.D.

Instructors: Christopher Bono, M.D.,
Timothy Foster, M.D., Thomas Einhorn, M.D.,
G. Richard Paul, M.D.and Anthony Schepsis, M.D.

Location: Boston Medical Center
Telephone:(617)638-8934, Contact: Lynnette St. Louis

Number of Students: Three
Period to be Offered: One Month

Description of Elective:

This elective is for fourth year medical students interested in pursuing a career in orthopaedic surgery or a sports medicine related field. The student will be involved with inpatient/outpatient as well as on the field evaluation and treatment of athletic injuries. This includes sports medicine clinics at Boston Medical Center and Boston University. The student will also be involved closely with inpatient care of the orthopaedic service patients and with the surgical procedures performed by the preceptor. Furthermore, the student will be expected, at the appropriate time of year, to attend intercollegiate athletic events with the preceptor for on-the-field management and care of athletic injuries.

Students are encouraged to go to the operating room to scrub on cases. The basic schedule begins with ward rounds, followed by a conference at 6:15 am in which the attending staff reviews all of the patients treated the previous day and their x-rays. There are teaching conferences on Monday, Wednesday, Thursday, Friday and some Tuesdays. These conferences include grand rounds, didactic lectures and a weekly case review of all operations performed during the week. Attending physicians run all conferences.
Guest lecturers are frequently present for grand rounds presentations.

 

555.0 Pediatric Orthopedics

Supervisor: David M. Drvaric, M.D.

Location: Shriners Hospital for Children
516 Carew St.
Springfield, MA 01104-2396 (413) 787-2057
Telephone:(617)638-8934, Contact: Lynnette St. Louis

Number of Students: One
Period to be Offered: One month

Description of Elective:

The student will work at Shriners Hospital for Children in Springfield, Massachusetts. This institution has 400 inpatient beds, three operating rooms, extensive outpatient clinics, a Gait Analysis Laboratory, and a Department of Orthotics and Prosthetics. The student will participate in Outpatient and inpatient activities as well as daily teaching conferences. Time will be allowed for clinical research. The elective will be quite valuable for future orthopaedic surgeons, pediatricians, radiologists, and family practitioners.

 

SURGICAL SPECIALTIES: Otolaryngology

560.1 Otolaryngology – Head and Neck Surgery

Instructors: Kenneth Grundfast, M.D., Chairman; Gregory Grillone, M.D.,Vice-Chairman; Anand Devaiah, M.D., Director of Medical Student Education; Charles Vaughan, M.D., Clinical Associate Professor; and associates

Location: Boston Medical Center, Children’s Hospital Medical Center
Contact: Tabitha Fineberg

Telephone: 638-7066

Number of Students: Two
Period to be Offered: One month

Objective:

To expand knowledge of clinical and surgical aspects of otolaryngology-head and neck surgery; learn how to take history relevant to head and neck disorders, learn how to properly examine the head and neck.

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 or the Boston Children’s Hospital. Approximately half of the time is devoted to learning how to evaluate and treat ambulatory outpatients with otolaryngic disorders. The other half of the time is spent observing and assisting in the operating room and evaluating hospitalized patients. Students are encouraged to attend weekly teaching conferences including Monday 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 a ten-minute talk/seminar on a chosen topic and submit a two to three page summary of the talk with references

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 in writing to Ms. Tabitha Fineberg, 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 Anand Devaiah,M.D., Director of Medical Education. All requests must be in writing.

560.11 Research Elective in Otolaryngology-Head and Neck Surgery

Supervisor: Jeffrey H. Spiegel, M.D.
Location: Boston Medical Center, D608, 88 E. Newton St.

Contact: Tabitha Fineberg
Telephone: 638-7066

Number of Students: 2
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. Spiegel 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 three students during each month. Students will be assigned to one primary hospital (Boston Medical Center or Boston Veterans Administration Medical Center). Students will be able to participate in all departmental activities at both hospitals. 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 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, renal transplantation, reconstructive urologic surgery, urinary calculus disease and obstructive uropathy. 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

Instructors: 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
Period to be offered: All Blocks

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 School of Medicine or medical schools with established exchange programs with Boston University.

Sexual Medicine Elective for 4th Year Medical Students