Surgery

Surgery

Boston University Medical Center
Fourth-Year Elective Rotations in Surgery

Director for BU Surgical Electives: Luise Pernar, MD

Coordinator for BU Surgical Electives: Lana Ketlere-Student Coordinator,

Office of Surgical Education, 617 638-8442

The electives listed below are administered through the Office of Surgical Education.  These are all four-week rotations.  Availability can be checked  using add/drop system or emailing, lana.ketlere@bmc.org

Learning Objectives for the Fourth-Year General Surgery Rotations:

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

  • Participate fully in the activities of the surgical team, including rounds, conferences, clinics, and operating room;
  • Take individual responsibility for patient care with appropriate supervision, including initial patient assessment, daily care, participation in surgery, and accurate notes;
  • Assist residents with their night time call responsibilities, including consults and ward care;
  • Communicate patient information to the surgical team in an accurate and organized way at rounds and conferences;
  • Research patient issues and provide education to the surgical team, especially the third year students;
  • Demonstrate a professional appearance and courteous behavior in the workplace.

Grading Criteria for the Fourth-Year Rotations:

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

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

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

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

Sub-internships in General Surgery Course Description:

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

Sub-internship Sites and Services: Boston Medical Center – Menino Pavilion

 

Sub I – Vascular Surgery   (400.1a/MEDMD558)
Course Director: Elizabeth King, M.D.
Number of Students: One
Period to be offered: One Month

Sub I – Surgical Oncology (400.1b/MEDMD557)
Course Director: Joseph Tobias, M.D.
Number of Students: One
Period to be offered: One Month

Sub I – Acute Care and Trauma Surgery (400.3/MEDMD555)
Instructor: Kathryn Twomey, M.D., FACS
Number of Students: Two
Period to be offered: One Month

Advanced Acute Care and Trauma Surgery (656/MEDMD650)
Course Director: Kathryn Twomey, M.D., FACS
Number of Students: Two
Period to be offered: One Month

Surgery Internship Prep Course (403.2/MEDMD547)
Course Director: Kathryn Twomey, M.D., FACS
Period Offered: Please inquire with course director

Sub I – Surgical Intensive Care Unit (403.1/MEDMD546)
Course Director: Aaron Richman, M.D.
Number of Students: Two
Period to be offered: One Month

Sub I – Minimally Invasive Surgery (404.2/MEDMD550)
Course Director: Donald Hess, M.D., FACS
Number of Students: One
Period to be offered: One Month

Sub I – Colon and Rectal Surgery (404.3/MEDMD549)
Course Director: Olga Beresneva, M.D.
Number of Students: One
Period to be offered: One Month

Sub I – Cardiac Surgery (405.2/MEDMD552)
Course Director: Alex Karavas, M.D.
Number of Students: One
Period to be offered: One Month

Sub I – Thoracic Surgery (410.2/MEDMD554)
Course Director: Christopher Digesu, M.D.
Number of Students: One
Period to be offered: One Month

Pediatric Surgery (430.3/MEDMD513)
Course Director: Christopher Muratore, M.D., M.S.
Number of Students: One
Period to be offered: One Month

440.1/MEDMD480 Multidisciplinary Breast Cancer Care Elective
Course Director: Claire Miller, M.D.
Number of Students: One
Period to be offered: One Month

Sub I – Plastic & Reconstructive Surgery (465.2/MEDMD548)
Course Director: Jorge Lujan, M.D.
Number of Students: Two
Period to be offered: One Month

 

Sub I – Vascular Surgery (400.1a/MEDMD558)
Instructor: Elizabeth King, M.D.

Faculty: Alik Farber, M.D.; Jeffrey Siracuse, M.D.; Jeffrey Kalish, M.D. and Stephanie Talutis, M.D.
Contact: Lana Ketlere     email: lana.ketlere@bmc.org
Telephone: 617- 638-8442
Number of Students: One
Period to be offered: One Month

Description of Elective:

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

Learning objectives:

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

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

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

 

Sub I – Surgical Oncology (400.1b/MEDMD557)
Instructors: Joseph Tobias, M.D.

Faculty: Teviah Sachs, M.D., Thurston Drake, M.D., Claire Miller, M.D., David McAneny, M.D.
Contact: Lana Ketlere     email: lana.ketlere@bmc.org
Telephone: 617- 638-8442
Number of Students: One
Period to be offered: One Month

General Objectives & Expectations:

The Mozden Surgical Service sub-internship offers senior medical students interested in pursuing a career in surgery a four-week structured experience in surgical oncology. The sub-internship focuses on the surgical management of benign and malignant tumors of the breast, thyroid, parathyroid, adrenal glands, pancreas, liver, biliary tree and skin/soft tissues. The aim of the sub-internship is for students to work as integral members of the surgical team with primary responsibility for patient care. Students are therefore responsible for the evaluation and management of their own patients under the supervision of attending surgeons and residents. Sub-interns perform histories and physicals, write orders, coordinate care, assist in the operating room, present cases, participate in teaching sessions and take call.  The sub-intern should also work toward developing a deeper understanding of the natural history and long-term management of surgical oncologic disease, informed by contemporary evidence.

Endocrine:

  • Anatomy of the thyroid, parathyroid and adrenal glands
  • Work-up of (1) a thyroid nodule, (2) hyperparathyroidism and (3) an adrenal adenoma
  • Basic interpretation of neck ultrasonography, FNA biopsy cytology and molecular testing
  • Histologies of thyroid cancer and their natural histories
  • Treatment options for Graves disease/hyperthyroidism
  • Complications of thyroid surgery

Breast

  • Anatomy of the breast
  • Work-up of a breast mass
  • Basic interpretation of mammography, including the BIRADS system, pathology and oncotype
  • Histologies of breast cancer and their natural histories
  • Extent of surgery (lumpectomy versus mastectomy), including sentinel lymph node biopsy
  • Neoadjuvant and adjuvant therapies, including radiation, hormone therapy and chemotherapy
  • Breast cancer genetics and prevention

Skin and Soft Tissue

  • Work-up of a pigmented skin lesion
  • Staging of melanoma
  • Extent of surgery, including sentinel lymph node biopsy
  • Site of distant metastasis/recurrence and systemic therapies
  • Skin cancer prevention

Pancreas, Liver and Biliary Tree

  • Anatomy of the liver, biliary tree and pancreas
  • Work-up of a hepatobiliary or pancreatic mass
  • Basic interpretation of CT and MRI, including tumor resectability and staging
  • Histologies of pancreatic cancers (adenocarcinoma versus neuroendocrine) and their natural histories
  • Describe components of a Whipple procedure
  • Complications of pancreatic and liver surgery
  • Neoadjuvant and adjuvant therapies
  • Causes of and treatments for hepatocellular cancer

     

    Sub I – Acute Care and Trauma Surgery (400.3/MEDMD555)

    Instructor:  Kathryn Twomey, M.D., FACS

    Faculty:  Tracey Dechert M.D. FACS; Sabrina Sanchez M.D. MPH FACS; Noelle Saillant M.D. FACS; Aaron Richman, M.D. FACS; Abraham Jaffe, M.D.; Dane Scantling D.O. FACS; Sheina Theodore M.D. FACS; Crisanto Torres, M.D. FACS; Megan Janeway M.D.; Danby Kang M.D.; Edward Michael Dussom, M.D.

    Contact:     Lana Ketlere    email: lana.ketlere@bmc.org
    Number of Students: Two
    Period to be offered: One month

    Description of Elective:

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

    Provide exceptional care for surgical patients

    Develop the skillset required to be a successful surgical intern (i.e., floor management including patient presentation on rounds, carrying pager and answering basic pages, entering basic orders, writing floor notes, etc.)

    Develop pre-operative, intra-operative, and post-operative management strategies in acute general surgical and traumatic surgical maladies

    Develop an understanding of co-morbid medical conditions that can influence surgical decision making

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

    Note: This elective satisfies the sub-internship requirement

     

    Advanced Acute Care and Trauma Surgery (656/MEDMD650) 

    Course Director: Kathryn Twomey, M.D., FACS

    Faculty: Tracey Dechert M.D. FACS; Sabrina Sanchez M.D. MPH FACS; Noelle Saillant M.D. FACS; Aaron Richman, M.D. FACS; Abraham Jaffe, M.D.; Dane Scantling D.O. FACS; Sheina Theodore M.D. FACS; Crisanto Torres, M.D. FACS; Megan Janeway M.D.; Danby Kang M.D.; Edward Michael Dussom, M.D. 

    Location: Boston Medical Center
    Contact: Lana Ketlere        email: lana.ketlere@bmc.org
    Number of Students: Two
    Period to be Offered: One month

    Description of Elective:

    The Advanced Acute Care and Trauma Surgery elective at Boston Medical Center is a clinical program with a strong focus on management of acute general surgical disease and the multimodal and multidisciplinary management of traumatic injury. The elective is four weeks in duration and is designed to further develop the complex peri-, intra-, and post- operative decision making and basic open and laparoscopic surgical skills of the medical student who might be interested in a future career in trauma surgery. This is an Advanced Course that can only be taken following completion of the Acute Care and Trauma Surgery Sub-internship.  The BU medical student will be able to expand their responsibilities under direct supervision and develop their own learning objectives to focus their interests throughout the rotation.

     

    Surgery Internship Prep Course (403.2/MEDMD547)

    Course Director: Kathryn Twomey, M.D., FACS
    Period Offered: Please inquire with course director
    Contact: Lana Ketlere     email: lana.ketlere@bmc.org
    Telephone: 617- 638-8442

    Description of Elective:

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

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

    Grading:

    Students will be graded based on the following:

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

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

     

    Sub I – Surgical Intensive Care Unit (403.1/MEDMD546)
    Instructors: Aaron Richman, M.D.
    Contact: Lana Ketlere     email: lana.ketlere@bmc.org
    Telephone: 617- 638-8442
    Number of Students: two
    Period to be offered: Four weeks

    Description of Elective:

    Fourth year medical students are eligible to participate in the Surgical Intensive Care Unit elective at Boston Medical Center. All four weeks of the elective rotation are spent in the BMC-Main Surgical Intensive Care Unit. Students become active members of the team and participate in daily rounds. On rounds, students are responsible for presenting their patients in detail. Students 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. At the conclusion of this elective the student will have an appreciation of the pathophysiology of the Surgical ICU patient and understanding of the principles of care of the critically ill patient

     

    Sub I – Minimally Invasive Surgery (404.2/MEDMD550)
    Course Director: Donald Hess, M.D., FACS
    Faculty: Brian Carmine, M.D., Luise Pernar, M.D., Joshua Davies, M.D. and Jacob Nudel, M.D.
    Contact: Lana Ketlere     email: lana.ketlere@bmc.org
    Telephone: 617- 638-8442
    Number of Students: One
    Period to be offered: One Month

    Description of Elective:

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

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

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

     

    Sub I – Colon and Rectal Surgery (404.3/MEDMD549)
    Course Director: Olga Beresneva, M.D.
    Faculty;  Jennifer Davids, M.D. and Samantha Rivard, M.D.
    Contact: Lana Ketlere     email: lana.ketlere@bmc.org
    Telephone: 617- 638-8442
    Number of Students: One
    Period to be offered: One Month

    Description of Sub-internship

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

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

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

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

     

    Sub I – Cardiac Surgery (405.2/MEDMD552)
    Course Director: Alex Karavas, M.D.
    Faculty: : Morgan Harloff, M.D.
    Contact: Lana Ketlere     email: lana.ketlere@bmc.org
    Telephone: 617- 638-8442
    Number of Students: One
    Period to be offered: One Month

    Description of Elective:

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

     

    Sub I – Thoracic Surgery (410.2/MEDMD554)
    Course Director: Christopher Digesu, M.D.
    Contact: Lana Ketlere     email: lana.ketlere@bmc.org
    Telephone: 617- 638-8442
    Number of Students: One
    Period to be offered: One Month

    Description of Elective:

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

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

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

    The goals for the rotation include:

    • Assist in the care for acute and chronic disease seen in these surgical patients, as evaluated and managed by the service
    • Learn pre-operative and post-operative management of patients undergoing thoracic procedures
    • Obtain introductory training in thoracic surgery procedures such as bronchoscopy, endoscopy, thoracentesis, chest tube placement/management/removal, etc
    • Function as a sub-intern with responsibilities commensurate with this educational requirement:
    • Function as acting interns responsible for the evaluation and continued management of their own patients, under the direct supervision of the attending physicians and residents.
    • Care for at least three new patients per week, and possibly more depending on the opportunities for patient care.
    • As part of patient care you will be expected to do the following: perform initial history and physicals, write orders, assist in coordinating care, assist with or perform supervised procedures as applicable and appropriate for the sub-intern, present cases, use evidence-based medicine principles to help guide patient care, participate in teaching sessions, and take call alongside residents and attending physicians.

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

     

    Pediatric Surgery (430.3/MEDMD513)

    Course Director: Christopher Muratore, M.D.
    Faculty : Christophe Muratore (BMC), Catherine Chen (BCH), Konstantinos Papadakis (BCH)

    Location 1: Pediatric Surgery, 85 E Concord St (Boston Medical Center)
    Contact: Lana Ketlere, C-515       Telephone: 617 638-8442

    Location 2: General Surgery, Fegan 3 (Boston Children’s Hospital, 300 Longwood Avenue)
    Contact: Andrea Rudolph, Fegan 3      Telephone: 617 335-7557

    Number of Students: One

    Period to be Offered: One month

    Pediatric Surgical Elective:

    Course Description

    This elective offers a comprehensive experience in the evaluation and operative management of surgical disorders in infants, children, and adolescents. Covering abdominal, thoracic, general, endocrine, trauma, and transplant surgery, this rotation is designed for students interested in surgery, pediatrics, or the intersection of both fields.

    Students split their time between Boston Medical Center (BMC) and Boston Children’s Hospital (BCH), providing exposure to two distinct institutional practice settings:

    BMC Experience: Focused on a high-volume outpatient elective surgery service covering the full breadth of general pediatric surgery and inpatient emergency surgery for common conditions such as appendicitis, pyloric stenosis, and intussusception. Students join a team comprising a senior resident, intern, PA and faculty to manage consults, trauma, NICU, clinics, and the OR.

    BCH Experience: Students join a large team of fellows, residents, NPs, and faculty providing specialized care for complex congenital and acquired conditions. This setting emphasizes tertiary care, including ECMO, solid organ transplantation, and fetal surgery.

    Clinical Responsibilities, Schedule & Teaching

    At both locations students engage in patient evaluations, OR assistance, and multidisciplinary rounds.

    At BMC, elective operative cases are held on Mondays, Fridays, and frequently on Thursdays. Pediatric General Surgery Clinic is held at BMC on Tuesdays and Wednesdays.

    Typically, the students will spend Wednesdays through Fridays at BCH to participate in Academic Day, ORs, clinics, and rounding on the floors.

    Morning Sign-Out (BCH): Starts at 5:45 AM. Led by the Chief Fellow and Surgeon of the Week (SOW). While these fast-paced rounds are optional for students, they offer excellent insight into high-volume data management.

    SOW Floor Rounds (BCH): Mandatory attendance at 7:30 AM (10E) on Wed/Thu/Fri. Students following specific patients are encouraged to present during these rounds.

    Day Location Primary Activities
    Mon/Tue BMC OR Cases (Mon), Pediatric General Surgery Clinic (Tue)
    Wed BCH Academic Day: Grand Rounds, Resident Lectures, Professor Rounds
    Thu/Fri BCH SOW Floor Rounds, OR Cases, Specialized Clinics

    Expectations:

    Attendance is encouraged at didactic events including Professor Rounds where students may be assigned a case to present, Grand Rounds, Morbidity and Mortality (M&M) conferences, and specialized multidisciplinary programs (e.g., vascular anomalies, oncology).

    Weekly schedules at both BMC and BCH are busy but allow flexibility for the student to maximize exposure to cases or areas of curiosity. Communicating interests with faculty at both locations is encouraged.

     

    440.1/MEDMD480 Multidisciplinary Breast Cancer Care Elective

    Multiple Departments

    Rotation Director(s): Claire Miller, M.D.
    Contact: Lana Ketlere     email: lana.ketlere@bmc.org
    Telephone: 617- 638-8442
    Number of Students: One
    Period to be Offered: One month

    DESCRIPTION OF ELECTIVE

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

     

    Sub I – Plastic & Reconstructive Surgery (465.2/MEDMD548)
    Course Director: Jorge Lujan, M.D.

    Faculty: Jaromir Slama, M.D, Daniel Roh, M.D.
    Contact: Lana Ketlere     email: lana.ketlere@bmc.org
    Telephone: 617- 638-8442
    Number of Students: Two
    Period to be offered: One Month

    Description of Elective:

    This fourth-year clinical rotation in Plastic and Reconstructive Surgery offers medical students a broad exposure to the full scope of the specialty, encompassing both reconstructive and aesthetic surgery across diverse patient populations. Students will participate in the evaluation, surgical planning, and management of patients with congenital, traumatic, oncologic, and acquired conditions.

    Clinical experiences include exposure to reconstructive and cosmetic surgery of the face, breast and body, lower extremity reconstruction, craniofacial surgery, pediatric plastic surgery, post-bariatric body contouring, oncologic reconstruction and gender-affirming surgery of the face and body. Students will gain familiarity with the principles of soft tissue reconstruction, wound healing, microsurgery, and aesthetic judgment, as well as the functional and psychosocial aspects of surgical care.

    The rotation emphasizes the management of traumatic injuries, post-oncologic defects, congenital anomalies, and acquired deformities, providing insight into multidisciplinary care and longitudinal patient outcomes. Students will participate in outpatient clinics, operating room cases, inpatient rounds, and interdisciplinary conferences, with graduated responsibility appropriate to their level of training.

    By the end of the rotation, students will develop a foundational understanding of plastic and reconstructive surgery, enhanced surgical anatomy knowledge, and an appreciation for the specialty’s role in restoring form, function, and quality of life.



    Neurosurgery

     

    657/MEDMD467 Sub I – Neurosurgery

    Instructors:  Pratik Rohatgi, M.D. and Matt Ordon, M.D.

    Location: Boston Medical Center

    Contact: Kelley Stewart    email: Kelley.Stewart@bmc.org

    Number of Students: Two

    Period to be Offered: One month (blocks TBD)

    Description of Elective:

    The neurosurgery sub-internship is designed to immerse the student in neurological surgery, a specialty focused on the identification and treatment of neurological disorders managed surgically. The student will be an integral part of the neurosurgery team at Boston Medical Center (BMC) working in the operating room, inpatient unit, surgical ICU, emergency department and outpatient clinics during this 4-week sub-internship experience under the direct supervision and mentorship of neurosurgery faculty, residents, NPPs and fellows.  All students are welcome to take this course and those who plan to apply for Neurosurgery residency should prioritize this course over other Neurosurgery electives.

     

    510.2/MEDMD461 Neurosurgery

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

    Location: Boston Medical Center

    Contact: Kelley Stewart    email: Kelley.Stewart@bmc.org

    Number of Students: Two

    Period to be Offered: One month

    Description of Elective:

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

     

    Surgical Specialties: Anesthesiology

    505.2/MEDMD405 Anesthesiology

    Instructor: Alexis Ramirez, M.D.

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

    Telephone:  (617) 638-6981

    Rotation Coordinator: Hanzhang Zhao email: hanzhang.zhao@bmc.org

    Number of Students: Four BU 4th year medical students

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

    Description of Elective:

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

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

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

    Logistics:

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

    For further details, please refer to the welcome packet.

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

     

    508.2/MEDMD406 Anesthesiology Multimedia Elective   (non-clinical elective)

    Instructor:  

    Telephone:  (617) 638-6229

    Location: 750 Albany St. Floor 2R

    Rotation Coordinator: Hanzhang Zhao email: hanzhang.zhao@bmc.org

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

    Period to be Offered: 4 weeks

    Description of Elective:

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

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

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

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

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

     

    Surgical Specialties: Ophthalmology

    514.2/MEDMD573 Ophthalmology (Clinical/Surgical Elective)

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

    Contact: Valerie Worrell-617 638-4552

    Location: Boston Medical Center YACC Eye Clinic

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

    Period to be Offered: Four weeks (graded)

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

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

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

    Description of Elective:

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

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

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

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

    Evaluation for CAMED students:

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

     

    Surgical Specialties: Orthopedic and Fracture Surgery

    551.3/MEDMD551  Sub I – Orthopaedic Surgery

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

    CONTACT AND COURSE ORIENTATION INFORMATION

    Lynnette St. Louis | Residency & Fellowship Program Coordinator

    Department of Orthopaedic Surgery

    Boston Medical Center

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

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

    lynnette.st.louis@bmc.org

     Number of Students: 5 per block

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

     Description of Elective:

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

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

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

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

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

     

    Surgical Specialties: Otolaryngology

    560.1/MEDMD485 Sub I – Otolaryngology–Head and Neck Surgery

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

    Location: Boston Medical Center

    Contact: TBD – contact Jessica.Levi@bmc.org in interim

    Telephone: 617 638-7066

    Number of Students: Four

    Period to be Offered: One month

    Description of Elective:

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

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

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

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

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

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

     

    560.2/MEDMD487  Advanced Otolaryngology

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

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

    email: TBD – contact Jessica.Levi@bmc.org in interim

    Telephone: 617-638-7066

    Number of Students: 4

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

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

    DESCRIPTION OF ELECTIVE

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

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

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

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

     

    560.11/MEDMD486 Research Elective in Otolaryngology-Head and Neck Surgery  (non-clinical elective)

    Supervisor: Jessica Levi, M.D.

    Location: Boston Medical Center

    Contact: TBD – contact Jessica.Levi@bmc.org in interim

    Telephone: 617 638-7066

    Period to be offered: One Month

    Description of Elective:

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

     

    560.3/MEDMD488 Otolaryngology Multi-Site Elective

    Supervisor: Jessica Levi, M.D.

    Location: Boston Medical Center

    Contact: TBD – contact Jessica.Levi@bmc.org in interim

    Telephone: 617 638-7066

    Period to be offered: One Month

    Description of Elective:

    This Otolaryngology-Head and Neck Surgery elective is designed to immerse Boston University Chobanian & Avedisian School of Medicine students in Otolaryngology, which includes head and neck cancer, facial plastic and reconstructive surgery, allergy involving the nose and sinuses, and the auditory system, as well as introduce them to two of our resident rotation sites.  The student will be an integral part of the Otolaryngology-Head and Neck Surgery team in the ambulatory outpatient clinic, with hospitalized patients, and in the operating room at Boston Medical Center, Lahey Hospital and Medical Center, and the Veterans Affair Boston Health Care System (VA Boston) during this 4-week elective.

     

    Surgical Specialties: Urology

    570.1/MEDMD580 Urology

    Instructor: Mark Katz, M.D.

    Location: Boston Medical Center, Shapiro 3B

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

    Telephone: 617-638-8451

    Number of Students: Three

    Period to be Offered: One month

    Description of Elective:

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