Medicine

100.1 Subinternship in Medicine

Director: Joseph Rencic,  M.D.

Contact: Fatima Chowdhury       email: fatimajc@bu.edu

Location: Boston Medical Center

Telephone: (617) 358-3524

Number of Students: 5

Period to be 0ffered: Four weeks (Blocks 9-14 and 16-20)

Description of Elective:

The Subinternship in Medicine is designed to challenge and enhance the capacity of the student to work as an increasingly independent, highly competent and compassionate caregiver and contributing team member. To achieve this goal, the acting intern will work as an advanced care provider integrated into the Medicine ward team.  Under the direct supervision of the ward resident and teaching attending, students will assume increasing responsibility for the initial evaluation and management of assigned patients. The student is expected to combine medical knowledge with clinical and interpersonal skills in order to demonstrate independent thought and develop a plan of action. The student is expected to develop a balance between acting independently and acknowledging his/her limitations and seeking help as appropriate. Students on the integrated team will have the opportunity to interface with 3rd year students on their Medicine clerkship.  Clinical work will be supplemented by conferences offered by the Department of Medicine. The student will play a crucial role in patient care and must commit to working the complete four week block.

Responsibilities include:

  • Admitting patients to the team – you will likely start at one admission per day during several days of the week but should work toward admitting two patients regularly on long call days, and hopefully, three or more patients on one or more occasions.
  • Following a core of patients (on average 3-6 patients)
  • Providing patient care through the last Sunday of the rotation

 

100.11 Advanced Acting Internship in Medicine

Director: Joseph Rencic,  M.D.

Contact: Fatima Chowdhury    email: fatimajc@bu.edu

Location: Boston Medical Center

Telephone: (617) 358-3524

Number of Students: 6 (available to Boston University School of Medicine students only)

Period to be 0ffered: 4 week block (Blocks 9-12)

Description of Elective:

The Advanced Acting Internship (AAI) 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.  These students are on a non-traditional Medicine team. Three acting intern students are paired on a ward team under the supervision of a ward resident and teaching attending 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 appropriated. Clinical work will be supplemented by conferences offered by the Department of Medicine. As above, the Acting Intern will play a crucial role in patient care and must commit to working the complete 4-week block. Overnight call in the hospital should be expected, to develop the attributes of an increasingly independent clinician and prepare yourself for your internship.  Absences are not able to be accommodated on this rotation.  Students will be selected based on a lottery system; third year clinical performance may be factored into selection. The Acting Internship experience is only open to BUSM students.

Responsibilities include:

  • Admitting patients to the team
  • Following a core of patients (on average 4-10 patients)
  • Taking overnight shifts 3-4 nights over the 4-week block (Dates will be assigned)

 

100.33 Advanced Medicine Elective – Medical Care of the Surgical Patient

Instructor: Henry Trier, M.D.

Contact Person: Jerlene Matthias  email: Jerlene.Matthias@bmc.org

Location: Department of  General Internal Medicine, Crosstown, 801 Massachusetts Ave., 2nd Floor

Telephone: (617) 414-6927  Fax: (617) 414-4676

Number of Students: One

Period to be offered: One month, between June and May inclusive

Description of Elective:

The elective is designed to provide an opportunity for the student interested in a surgical or medical career to gain experience in the management of medical problems in the surgical patient. Students spend one month on the Medical Consult Service and work under the direct supervision of two senior medical residents and the medical attending. He/she will actively participate in completing inpatient consultations including generation of management plans, daily work rounds and twice a week didactic sessions. The student is expected to work Monday through Friday, 8 am to 6 pm. There is no overnight call. The student will also participate in two half-day sessions per week in the Pre-Procedure Clinic, located in Shapiro Lower Level, where patients scheduled for elective surgery are assessed by providers from both Surgery and Anesthesia departments.  Students considering surgery including orthopedics, anesthesia, or internal medicine careers have found this elective valuable.

The interactions of medical and surgical illness are complex and may complicate management in the perioperative period. Many questions commonly arise. What are the risks of surgery and general anesthesia in patients with a given set of medical illnesses? What are the predictors of these risks? Can they be reduced by preoperative measures? How should medical problems be managed before and after surgery? What complications might be expected? It is hoped at the conclusion of this elective, the student will have an appreciation of how medical problems in the perioperative period should be approached diagnostically and therapeutically.  The Medicine Consult service is also the primary care team for patients admitted to Boston Medical Center with acute hip fractures, as the patients have many medical comorbidities that make their preoperative and postoperative management challenging.

Students should contact the Medicine Consult service director, Dr. Henry Trier, via email (Henry.Trier@bmc.org) in the week prior to starting service for more information as well as link to educational supplemental materials.

A core syllabus of articles from the medical, surgical and obstetrical literature relevant to medical consultation is available and should be picked up from the coordinator one week prior to beginning the rotation.

 

101.1 Advanced Medicine Sub-Internship-Medical Intensive Care Unit

Instructors: Hector Marquez, M.D. and Christine Reardon, M.D., Pulmonary/Critical Care Medicine Faculty

Location: Boston Medical Center, Menino Pavilion

Contact: Kathyann Adamson  email: kathyw@bu.edu

Number of Students: Two (fourth year BU medical students only)

Period to be offered: One Month

Description of Elective:

The Advanced Medicine Sub-Internship in the Medical Intensive Care Unit (MICU) is designed to provide highly motivated students with an introduction to the diagnosis and management of critically ill patients with single and multi-system organ failure. The MICU is designed to provide state of the art care to seriously or critically ill patients in an environment that emphasizes learning, teaching and independence. Students are exposed to a large spectrum of clinical problems including, but not limited to, respiratory failure with or without mechanical ventilation, ARDS, shock, sepsis, gastrointestinal hemorrhage, diseases related to alcohol or drug excess, HIV-related conditions, pulmonary edema, pulmonary emboli, renal, hepatic or cardiac failure, DKA, fluid, electrolyte or thermic disturbances, CVA or complications of malignancies.

Care is provided in a team format which besides physicians, nurse practitioners and senior medical students, includes nurses, respiratory therapists, pharmacists, nutritionists, physical therapists and social workers. This multi-disciplinary approach provides excellent care to patients by capitalizing on the expertise of many services. Students are expected to participate on daily ventilator and work rounds, and to contribute to the management of patients by collecting and assimilating data for presentation to the attending, arranging consults and tests, and by placing orders and performing common procedures under direct supervision.

Patients are cared for by three teams.  Two teams (Red and Blue) consist of 2 PGY2 or PGY3 residents, 2 PGY1 residents, a pulmonary/critical care attending and a pulmonary/critical care fellow.  The third team (Green) consists of 2 PGY2 or PGY3 residents, 2 PGY1 residents, a nurse practitioner and pulmonary/critical care attending.  The PGY2 or PGY3 admits and performs the initial management on all patients in the MICU with the supervision of the MICU Attending/Fellow during the day or the Special Care Unit Night Coverage (SCUNC) at night.  Subsequent daily care is then assumed by a PGY1 resident, Nurse Practitioner or a Medical Student on a sub-internship rotation.

Students are assigned to the Red and Blue MICU teams preferentially but if necessary can be assigned to the Green Team.  Students are required to be present for 6 days of the week (weekdays and either Saturday or Sunday).  There is no night call.

Restrictions:

1) Reception of Honors grade in third year medicine clerkship or in the medicine sub-internship.

2) These requirements may be waived if the student is approved by the Clerkship Selection Committee,  chaired by Dr. Sonia Ananthakrishnan.

 

102.1 Ambulatory Medicine

Contact: Fatima Chowdhury     email: fatimajc@bu.edu

Location: Boston Medical Center, E122

Telephone: (617) 358-3524

Description of Elective:

Advanced Internal Medicine, Medicine II Block: All Students will complete a required four week Ambulatory Medicine rotation in the fourth year. For the 4 week ambulatory medicine rotation, students will be assigned to one of the following sites:  Jamaica Plain/West Roxbury VA, Bedford VA, Roger Williams Medical Center, Neighborhood Health Centers, Private Practices or BMC.  BUSM is exploring additional possible clinical venues for training in Ambulatory Internal Medicine and may add new venues in the coming year.

Course restricted to 4th year BUSM students only.

 

103.1    Internal Medicine Bootcamp Elective

Co-Directors: Joseph Rencic, M.D. and Ryan Chippendale M.D.

Contact: Fatima Chowdhury    email: fatimajc@bu.edu

Telephone: (617) 358-3524

Number of Students: 10 students

Length of Elective:  2 weeks

Period to be Offered:  offered last 2 weeks of Block 20

Grading:  Pass/Fail

Description of Elective:

This elective will prepare students who are planning to enter an Internal Medicine Residency.  It is designed to build specific skills and knowledge to facilitate the transition from medical student to intern.  Students will participate in small group activities and didactic learning.  These will take place in the Boston Medical Center Simulation Center (for procedural/simulation sessions) and the Boston University School of Medicine (for classroom learning sessions).  BUSM IV students will be oriented to the elective on the first day of the rotation during a formal orientation session with the course directors.

The sessions will include a mixture of case-based, small-group classroom learning, as well as hands-on simulation and procedural sessions led by content-expert faculty members and procedurists. There will be no direct patient contact.

By the end of the two week Internal Medicine Bootcamp students will be able to:

    1. Identify, evaluate, and manage acute medical situations including hypoxia, altered mental status, hypertensive emergency, shock, and chest pain as observed by faculty in simulated medical scenarios.
    2. Interpret common diagnostic tests, such as EKGs and chest X-rays, during simulated medical scenarios.
    3. Describe and demonstrate the steps for performing common medical procedures, including central line placement, intravenous line placement, and arterial puncture as observed by faculty in simulated procedures.
    4. Discuss how to effectively and respectfully communicate with patients from different cultural backgrounds about end of life issues, decision making capacity, and bad news during small group discussions.
    5. Demonstrate techniques to communicate effectively and respectfully with a medical team from different cultural backgrounds when presenting a new patient, responding to pages, calling consults, handing off or discharging patients as observed during small group discussions and during simulated pages.
    6. Discuss strategies to balance responsibilities and wellness as interns through effective learning, time management, and organization during small group discussions.

Internal Medicine Bootcamp Elective additional information

 

104.1 Addiction Medicine Elective

Elective Director: Zoe Weinstein, M.D., M.D., Assistant Professor of Medicine

Contact and Course Orientation: Linda Neville, Program Manager

Linda.Neville@bmc.org

Location:      801 Massachusetts Ave, 2nd floor, Boston, MA 02118

Telephone:  617-638-8344

Number of students: 1

Length of Elective: 4 weeks

Period to be offered:  All Blocks

Student will contact Dr. Weinstein prior to the first day of the elective to review schedule and arrange for a brief orientation and discussion about issues related to the care of patients with SUD.

If you must be absent email Linda Neville (Linda.Neville@bmc.org) as soon as possible. Students should be available by pager/email during working hours.

DESCRIPTION OF ELECTIVE:

The Addiction Medicine elective will take place at Boston Medical Center’s inpatient wards, as well as various community sites, including but not limited to: HCRC Methadone Clinic, FASTER-PATHS discharge clinic, and AHOPE Needle Exchange. This is an opportunity for a 4th year medical student to understand addiction as a chronic medical condition, and SUD as an important and prevalent public health issue. Students will engage in care of persons with SUD in a professional, health-oriented, responsible and proactive manner, in order to reduce substance-related harm, promote health and address co-existing medical problems. Students will interview and examine patients with attending physician supervision and be involved in the patients treatment planning. Students will also rotate through Hope House where they will be exposed to a community residential and outpatient treatment settings.

Students are expected to participate, Monday through Friday, at least 40 hours/week. Students will attend teaching conferences that are scheduled during the elective time. Students will receive timely, formative feedback from the attending preceptors including a mid-clerkship evaluation to assess their progress in developing the skills needed to treat patients with SUD.

 

Addiction Medicine Elective additional information

 

105.1 Palliative Care     (elective will not be offered for the 2021/2022 academic year)

Elective Director: TBD

Instructors:   Alexandra Dobie, LICSW, MSW,  Henri Lee, M.D., Sandhya Rao, M.D. and Jessica Knight, NP, NP

Location: Boston Medical Center, Palliative Medicine Unit, 801 Massachusetts Ave., 2nd Floor

Telephone: (617) 414-7591

Number of Students: TBD

Period to be offered:  Please contact Palliative Care Senior Administrative Coordinator, Amy L. Cann (amy.cann@bmc.org), regarding availability

DESCRIPTION OF ELECTIVE:

This elective is designed to give students with an interest in palliative care increased exposure to the role of the palliative care provider in the inpatient setting.  Students will participate as members of the palliative care team during which time they will staff palliative care consults, attend family meetings, and learn more about the role of the palliative care provider in the care of patients in the inpatient setting.

Students will also spend time involved in self-directed teaching sessions, using a curriculum developed by the National Cancer Institute.  Modules include topics such as how to perform a comprehensive palliative care assessment, cancer pain management, loss/grief/bereavement, survivorship, the last hours of living, communicating effectively, clarifying diagnosis and prognosis, negotiating goals of care, clinical trials, withdrawing nutrition/hydration, conflict resolution, advance care planning, physician-assisted suicide, cancer doctors and burnout.   Students will complete all modules by the conclusion of the two or four week elective.  Additionally students will be asked to conduct a literature search on topics relevant to palliative care and will be asked to present one topic weekly to the faculty.

 

106.1 Primary Care Clinic Acting Intern (PCCAI)

Director: Rodolfo Calderon-Villareal,  M.D.

Contact: Fatima Chowdhury       email: fatimajc@bu.edu

Location: Boston Medical Center

Telephone: (617) 358-3524

Number of Students: 1

Period to be 0ffered: Four weeks (Block 12)

Description of Elective:

This elective will be a centralized BMC primary care clinical experience, taking place at one of BMC’s primary care clinics (Shapiro Building or Crosstown Building) depending on the available preceptors.

There will be 4-6 half-days of primary care clinic and one full day of didactics every week. The half-days will be split evenly between the 2 attendings (2-3 half-days per attending), with a preference for an even distribution throughout the week but depending on attending schedules, may be concentrated on as few as 2 full days. The very low preceptor to student ratio promotes preceptors who are not only able to provide personalized feedback over time, but also can serve as potential authors to strong letters of recommendation. There is also 1 half-day reserved for administrative duties such as follow-up of results, calling back patients, and responding to Epic inbox messaging.

Students will interact with patients at an intern-level of responsibility and expectations. That means, among a number of things, pre-charting the day prior to the patient’s appointment, so as to focus the entirety of the clinic time to providing patient care rather than chart or medical resource review. It also involves students presenting their patients with their plan for initial work-up of the differential diagnoses, along with management plans for acute and chronic outpatient medical issues. This is done with adequate supervision–for example, students can give patients their initial impressions, then step out of the room, review the interview and plan with their preceptor, then return to fully present the plan, even if the preceptor is in the room as well).

Students must be strongly considering primary care as a career path. Part of the value of this elective is not only the acting intern level of responsibility, but also the incorporated mentoring towards a primary care career. One-on-one mentoring is provided with Primary Care Training Program Director at BMC, Dr. Catherine Rich, and recently graduated resident of the BMC Primary Care Track, Dr. Rodolfo Villarreal-Calderon.

Each preceptor will determine and form a “mini-panel” composed from the list of their own panel. This mini-panel will be patients who have been relatively lost to follow-up and would benefit from re-establishing contact with the medical system (namely, primary care). Disease states that would be especially conducive for this mini-panel would be diabetes and asthma, for how they lend themselves to a combination of adherence to guidelines, counseling, and medication titration.

By the end of the elective, students will have expanded the depth and breadth of their primary care knowledge. This will be achieved not only via direct patient clinical encounters, but also through their weekly presentations and PEAC modules. There will be no standardized assessment of that knowledge base (i.e., no tests) but the 2 preceptors will be able to monitor and trend students’ growth. Feedback sessions will be helpful in identifying deficiencies and establishing weekly goals. The enhanced responsibilities of students will also have promoted their practical primary care knowledge, a progression that can be tracked via feedback as well. Dr. Villarreal-Calderon will engage in weekly direct observation of the student in clinic in order to provide feedback on aspects of a clinical encounter such as agenda-setting, building rapport, teach-back method, and counseling.

 

033.2 Geriatrics/Home Medical Care

Instructors: Megan Young, 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: 638-6155

Course Director: Megan Young, M.D.

Course Administrator: Jessica Restrepo   email:  jrestrep@bu.edu

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.

 

440.1 Multidisciplinary Breast Cancer Care Elective

Multiple Departments

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

Coordinator: TBD

CONTACT AND COURSE ORIENTATION INFORMATION

Michael Cassidy, MD, FACS
Department of Surgery
Section of Surgical Oncology
820 Harrison Ave
FGH 5006
Boston, MA 02118

617-414-8090

michael.cassidy@bmc.org

Students will receive an orientation on the first day of the elective including clinical schedule and expectations.

NUMBER OF STUDENTS

One per block.

LENGTH OF ELECTIVE

4 weeks.

AVAILABLE BLOCKS / SEMESTERS

This elective is available all year.

 DESCRIPTION OF ELECTIVE

This elective is based at Boston Medical Center and the Boston University School of Medicine.  The student will participate in outpatient activities of the core faculty members including surgical oncology, medical oncology, and radiation oncology clinics.  Students will also participate in the operative management of breast cancer patients as assistants in the operating room.  Exposure to breast imaging technology and interpretation, breast cancer pathology interpretation, and genetics will be incorporated through sessions in those disciplines. In addition, select newly diagnosed patients will be identified at the beginning of the elective and the student will follow those patients to all consultations and treatments.  Students will be expected to participate in weekly multidisciplinary breast tumor board including preparing and presenting case presentations for discussion with direct faculty guidance.  Students will be exposed to early breast cancer, locoregionally advanced breast cancer, and metastatic breast cancer, gaining an appreciation for the full spectrum of presentation.  Integration of expertise from all disciplines will be emphasized.  Landmark clinical trials in breast cancer will be reviewed and discussed through a program of assigned reading and discussion with faculty.  This is primarily an outpatient elective with rare select inpatient activities.  The student will be expected to participate in clinical activities on all weekdays during the elective.  There will be no weekend responsibilities.