Fourth Year Course Bulletin

Academic Year 2013 -2014July 1, 2013 – May 2, 2014

Released March, 2013

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Summary of TCMC 4th Year Curriculum:Rotation Weeks

Medicine Subinternship 4

Other Subinternship 4

Acute Care – Emergency Medicine 2

Acute Care –Critical Care 2

Interprofessional Selective (IPE) 2

Senior Seminar 1

Electives (20 weeks) 20

Core Weeks 2

Total Weeks 37

Students must complete 37 weeks of study within the 44 weeks allocated for the year.Students are required to complete:

MD 900: Medicine Subinternship A second Subinternship of their choice (including an additional

4 weeks of MD 900) One Subinternship must be done in the TCMC system 2 weeks of Emergency Medicine – this requirement can be filled

by MD 911, MD 913, or MD 919 2 weeks of Adult Critical Care Medicine – this requirement can

be filled by MD 912, MD 913, or MD 903. MD 915: Interprofessional Selective MD 999: Senior Seminar, one week, on-line course.

Students are required to complete 20 weeks of electives: 12 of 20 elective weeks must be patient care focused 8 weeks may be in non-patient care electives (but students may

choose patient care focused electives) Up to 16 weeks may be done outside of TCMC system 8 weeks must be completed in a resident-team setting No more than 2 electives can be completed in the same elective

Students are required to participate in all activities during two core weeks: There are two options for the fall core week (students

participate in one or the other) The spring core week contains Match Day.

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Required Clerkships for the Fourth Year:

MD 900: Medicine Subinternship (4 weeks) Because of the primarily ambulatory nature of the third year LIC, all students are required a four-week, inpatient Internal Medicine Subinternship. At the completion of the Medicine Subinternship students will demonstrate proficiency in the following core competencies required for the care of the acutely ill adult patient:

1. Communication skills – students will demonstrate knowledge of local, national, and ethical guidelines pertaining to patient physician communication. Students will demonstrate the ability to communicate with patients and their family members. Students will also demonstrate the ability to effectively communicate verbally and in writing with members of the health care team. We will assess these skills by direct observation of the student by faculty preceptors, residents, and other members of the healthcare team as reported on a standard evaluation form, formative mini-CEXs, and in activities during the 4th year core weeks.

2. Coordination of care -- students will demonstrate the ability to contact all members of the healthcare team and safely transfer care to other members of that team. Students will demonstrate the ability to utilize and interact with consultants of multiple disciplines and effectively cooperate with non-physician members of the health-care team. Students will communicate with outpatient providers and community resources to facilitate a smooth transition of a patient’s care between both the inpatient and outpatient settings. Students will demonstrate an understanding of their patient’s plan of care both verbally and in writing. We will assess these skills by direct observation of the student by faculty preceptors, residents, and other members of the healthcare team as reported on a standard evaluation form.

3. Information management – students will demonstrate the ability to access and report relevant clinical data on their patients. Students will demonstrate the ability to prioritize tasks, document in a clear and coherent manner, and utilize both paper and electronic resources to assist in patient care. We will assess these skills by direct observation of the student by faculty preceptors, residents, and other members of the healthcare team as reported on a standard evaluation form and during weekly student chief rounds.

4. Procedures – students will demonstrate the ability to explain the risks and benefits of common bedside procedures to patients and their family members. Students will demonstrate the ability to perform venipuncture, arterial blood gas sampling, nasogastric tube insertion, and urethral catheter insertion. Students will demonstrate familiarity

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with central venous catheter insertion and lumbar puncture. We will assess these skills by direct observation of the student by faculty preceptors, residents, and other members of the healthcare team as reported on a standard evaluation form as well as in planned simulation sessions during the 4th year core weeks.

5. Professionalism – students will demonstrate the attitudes and behaviors of health care professionals at all times, but especially in interactions with patients, family members, fellow students, and all members of the health care team. We will assess these skills by direct observation of the student by faculty preceptors, residents, and other members of the healthcare team as reported on a standard evaluation form as well as in activities during the 4th year core weeks.

Requirements of the Medicine Subinternship:

1. Students will work on an inpatient medicine service for 4 weeks.2. Students’ usual work hours will be from 7AM to 6PM (weekdays).3. Students will take “call” which will require students to assist the

primary healthcare team with admissions and other responsibilities until 11 PM on average every 4th evening. Students will not take overnight call in the hospital (in keeping with ACGME requirements).

4. Students will have primary responsibility for 3-4 patients at one time.5. Students will participate in all required student educational activities

for the medicine subinternship including an academic presentation as determined by the medicine faculty.

Other Subinternships (4 weeks)

All other subinternships will require demonstrated proficiency in the five core competencies outlined above. All other subinternships will share the five requirements outlined above as well. Due to the differences in disciplines, other subinternships may have a different focus than the medicine subinternship and may require demonstration of additional proficiencies. Students may take a second subinternship as outlined below or students may take a second subinternship in Medicine, MD 900, if desired.

MD 901: Pediatrics SubinternshipThis subinternship focuses on the care of children on the pediatrics inpatient hospital service, the well-baby nursery, and in the delivery suite.

MD 902: Family Medicine SubinternshipThis subinternship focuses on the care of children and adults on the family medicine inpatient hospital service.

MD 903: Medical/Surgical Intensive Care Subinternship (may fulfill the requirement for MD 912: Acute Care – Critical Care)An extramural subinternship, this subinternship focuses on the care of critically ill adults in the intensive care unit.

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MD 904: Neonatal Intensive Care SubinternshipThis subinternship focuses on the care of critically ill neonates in the intensive care unit.

MD 905: Surgery SubinternshipThis subinternship focuses on the preoperative, intraoperative, and postoperative care of adult surgical patients.

MD 906: Obstetrics SubinternshipThis subinternship focuses on the care of mother and baby during the prepartum, intrapartum, and postpartum care of women.

MD907: Gynecology SubinternshipThis subinternship focuses on the preoperative, intraoperative, and postoperative care of women on the gynecologic surgery service.

MD 908: Psychiatry SubinternshipThis subinternship will involve both the inpatient and outpatient care of patients on the psychiatry service. “call” will involve evaluation of patients on the inpatient psychiatric services, crisis centers, and emergency departments. This subinternship can be adult, adolescent, or child focused or some combination of these patient populations.

MD 909: Rural Family Medicine SubinternshipThe subinternship in rural family medicine will be a combination of inpatient and outpatient settings. Call may not be the same as for the other subinternships. It is expected that students will work closely with an individual preceptor in his/her practice setting.

Other Required Clerkships

MD 911: Acute Care—Emergency Medicine (2 weeks)A required two-week rotation in emergency medicine in which students will routinely spend four, 12-hour shifts per week.

MD 912: Acute Care – Critical Care (2 weeks)A required two-week rotation in an adult intensive care setting – students will spend time in an assigned ICU. Critical care nurses will work with core faculty with input from the multiple disciplines that work in this setting (respiratory therapists, etc). Students will interact with physicians of all specialties and will follow 2 patients at a time. Students will spend 2 evenings/week until 11PM in the ICU.

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MD 913: Acute Care – Emergency and Critical Care Medicine (4 weeks) (fulfills the requirements for MD 911: Acute Care – Emergency Medicine and MD 912: Acute Care – Critical Care) This is a rotation that fills the acute care medicine requirement in one four-week block that combines the care of patients in the emergency department and intensive care unit. Students are encouraged to follow patients from admission in the emergency department to transfer into the intensive care unit. This rotation stresses the continuity of care through these two settings. This rotation is offered by Wayne Memorial Hospital and Pocono Medical Center in the Northern region.

Interprofessional (IPE) Selective (2weeks)

All students are required to complete a 2-week selective in a highly functioning team. This clerkship requirement addresses the need for physicians in-training to understand the roles of all members of the health-care team and to function well within these teams. The IPE selective requirement can be fulfilled through this IPE selective course (MD 915) or on a very rare occasion at another site with preauthorization by one of the course directors(a request in writing must be received a minimum of 30 days prior to beginning clerkship). This IPE selective can occur in a number of different settings allowing students to foster individual interest so that they can continue to develop the attitudes and skills necessary to practice medicine in a team setting.

Other Required Activities

MD 999: Senior Seminar (1 week)

A required one week seminar that examines the issues of quality improvement and patient safety, biomedical ethics, health policy and economics, medical informatics, cultural competency and health literacy, evidence based medicine, and professional development as medical students transition to their roles as residents. This course is a self directed study of a collection of articles and videos within the constraints of one calendar week during the M4 year.

Core Weeks (2 weeks)

A required two weeks devoted to both formative and summative evaluation of students with activities and simulations. These weeks will also address student concerns and the transition to residency.

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Elective Clerkships for the Fourth Year as of March, 2013:

Family Medicine Electives – Family Medicine Education Director: Mario Cornacchione, DO

MD 974 Palliative Medicine (2 or 4 weeks)The Palliative Medicine Elective is a 2 or 4 week inpatient, outpatient, and long-term care facility experience. Students will follow patients and perform consultations with an interprofessional team under the direction of an assigned preceptor. Students will work closely with palliative medicine nursing and are required at least one patient home visit. Students will participate in interdisciplinary conferences. Students may spend extended evening time with the team in keeping with ACGME requirements.

MD 975 Geriatric Medicine (2 or 4 weeks- depending on Regional Campus)The Geriatric Medicine Elective is a 2 or 4-week primarily outpatient experience. Students will follow patients in the outpatient setting, the hospital, rehabilitation medicine, the skilled-nursing facility, the nursing home, and in assisted living under the direction of an assigned preceptor. Students will work closely with all members of the health-care team in an interprofessional setting. Students will participate in multi-disciplinary conferences. Students may spend extended evening time with the team in keeping with ACGME requirements.

MD 976 Clinical Epidemiology (2 weeks)The Clinical Epidemiology Elective is a 2-week, non-clinical experience. Students will participate in classroom and small group activities. Students will prepare a presentation at the end of the elective and will share this with other participants.

MD 977 Family Medicine Elective (2 or 4 weeks)

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The Family Medicine Elective is either a 2 or 4 week STUDENT DESIGNED experience that allows the student to work within another area of interest within or outside of the TCMC system. Requirements may be modified, but will generally follow the same guidelines established for the 4-week rotations in a given specialty. All electives must be approved by the Family Medicine Education Director.

Medicine Electives – Medicine Education Director: Margrit Shoemaker, MD

MD 919 Emergency Medicine (4 weeks) (fulfills the requirements for MD 911: Acute Care – Emergency Medicine, but NOT MD 912: Acute Care – Critical Care)The Emergency Medicine Elective is a 4-week experience. Students will routinely work 4 to 5 12-hour shifts per week with at least 2 days completely free of clinical responsibilities per week. Students will participate in the care and management of patients who present to the emergency department. Work hours will not exceed 80-hour per week as per ACGME requirements.

MD 920 Allergy & Clinical Immunology (2 or 4 weeks - depending on Regional Campus)The Allergy and Clinical Immunology Elective is either a 2 or 4-week inpatient and outpatient experience. Students will primarily follow ambulatory patients, but will also perform inpatient consultation under the direction of an assigned preceptor. Students will participate in the diagnosis and medical management of patients with atopic conditions and may spend extended evening time in the ambulatory or inpatient setting in keeping with ACGME requirements.

MD 921 Cardiology (2 or 4 weeks- depending on Regional Campus)The Cardiology Elective is a 2 or 4-week inpatient and outpatient experience. Students will follow ambulatory patients and perform inpatient consultation under the direction of an assigned preceptor. Students will participate in the diagnosis and medical management of patients with cardiac disease. The focus will be on both the non-interventional service, but may include time with the interventional service. Students may spend extended evening time in the ambulatory or inpatient setting in keeping with ACGME requirements.

MD 922 Dermatology (2 or 4 weeks- depending on Regional Campus) The Dermatology Elective is either a 2 or 4-week inpatient and outpatient experience. Students will follow ambulatory patients and perform inpatient consultation under the direction of an assigned preceptor. Students will participate in the diagnosis and management of patients with skin conditions

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and may spend extended evening time in the ambulatory or inpatient setting in keeping with ACGME requirements.

MD 923 Endocrinology (2 or 4 weeks – depending on Regional Campus)The Endocrinology Elective is a 2 or 4-week inpatient and outpatient experience. Students will follow ambulatory patients and perform inpatient consultation under the direction of an assigned preceptor. Students will participate in the diagnosis and medical management of patients with Diabetes Mellitus and other endocrinopathies and may spend extended evening time in the ambulatory or inpatient setting in keeping with ACGME requirements.

MD 924 Gastroenterology (2 or 4 weeks- depending on Regional Campus)The Gastroenterology Elective is a 2 or 4-week inpatient and outpatient experience. Students will follow ambulatory patients and perform inpatient consultation under the direction of an assigned preceptor. Students will participate in the diagnosis and medical management of patients with gastrointestinal

conditions and may spend extended evening time in the ambulatory or inpatient setting in keeping with ACGME requirements.

MD 925 Infectious Disease (2 or 4 weeks – depending on Regional Campus)The Infectious Disease Elective is a 2 or 4-week inpatient and outpatient experience. Students will follow ambulatory patients and perform inpatient consultation under the direction of an assigned preceptor. Students will participate in the diagnosis and medical management of patients with acute and chronic infections and may spend extended evening time in the ambulatory or inpatient setting in keeping with ACGME requirements.

MD 926 Nephrology (2 or 4 weeks- depending on Regional Campus)The Nephrology Elective is a 2 or 4-week inpatient and outpatient experience. Students will follow ambulatory patients and perform inpatient consultation with an interprofessional team under the direction of an assigned preceptor. Students will interact with multiple disciplines involved in the care of patients with kidney disease and may spend extended evening time with the team in keeping with ACGME requirements.

MD 928 Rheumatology (2 or 4 weeks)The Rheumatology Elective is a 2 or 4-week inpatient and outpatient experience. Students will follow ambulatory patients and perform inpatient consultation under the direction of an assigned preceptor. Students will participate in the diagnosis and medical management of patients with bone and joint disease as well as connective tissue disorders and may spend extended evening time in the ambulatory or inpatient setting in keeping with ACGME requirements.

MD 929 Hematology/Medical Oncology ( 2 or 4 weeks- depending on Regional Campus)

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The Hematology/Medical Oncology Elective is a 2 or 4-week inpatient and outpatient experience. Students will follow ambulatory patients and perform inpatient consultation with an interprofessional team under the direction of an assigned preceptor. Students will interact with multiple disciplines involved in the care of patients with malignant disease. Students will present a case at Tumor Board and may spend extended evening time with the team in keeping with ACGME requirements.

MD 930 Neurology (2 or 4 weeks- depending on Regional Campus)The Neurology Elective is a 2 or 4-week inpatient and outpatient experience. Students will follow ambulatory patients and perform inpatient consultation with an interprofessional team under the direction of an assigned preceptor. Students will gain exposure to EEGs and the interpretation of neuro-imaging. Students may spend extended evening time with the team in keeping with ACGME requirements.

MD 931 Pathology (2 or 4 weeks- depending on Regional Campus)The Pathology Elective is either a 2 or 4 week experience without direct patient care. Students will participate in specimen processing, autopsy (if available), and morphologic and molecular diagnostics.

Students will participate in clinicopathologic conferences. Students participating in the 4 week elective will spend time in the hospital clinical laboratory. Students may spend extended evening time in the hospital in keeping with ACGME requirements.

MD 932 Radiology (2 or 4 weeks- depending on Regional Campus)The Radiology Elective is either a 2 or 4 week experience without direct patient care in diagnostic radiology. Students will participate in the acquisition of imaging studies and their interpretation. Students will work with radiologists, nurses, and radiology technicians in an interprofessional setting. Students may spend extended evening time with the team in keeping with ACGME requirements.

MD 933 Interventional Radiology (2 weeks)The Interventional Radiology Elective is a 2 week experience. 4 weeks of MD 932 is a prerequisite for this clerkship. Students will perform pre-procedure evaluation of patients and participate in diagnostic and therapeutic procedures under the direction of an assigned preceptor. Students may spend extended evening time in the hospital in keeping with ACGME requirements.

MD 934 Radiation Oncology (2 or 4 weeks- depending on Regional Campus) The Radiation Oncology Elective is either a 2 or 4 week inpatient and outpatient experience. Students will follow ambulatory patients and perform inpatient consultation with an interprofessional team under the direction of an assigned preceptor. Students will interact with multiple disciplines involved in the care of patients with malignant disease. Students will present a case at Tumor Board and may spend extended evening time with the team in keeping with ACGME requirements.

MD 935 Ambulatory Outpatient Internal Medicine (4 weeks)A 4-week extramural ambulatory internal medicine elective during which students will evaluate and follow patients under the direction of an assigned preceptor in a general medical office.

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MD 936 Medicine Elective (2 or 4 weeks)The Medicine elective is either a 2 or 4 week STUDENT DESIGNED experience that allows the student to work within another area of interest within or outside of the TCMC system. Requirements may be modified, but will generally follow the same guidelines established for the 4-week rotations in a given specialty. All electives must be approved by the Medicine Education Director.

MD 964 Sports Medicine, Non- Surgical (2 weeks) The Sports Medicine, Non-Surgical elective is a 2 week experience requiring the approval of the Medicine Education Director. Students will gain an understanding of how to correctly perform a pre-participation exam, the common overuses of musculoskeletal injuries, cardiac issues and screening in athletes, head injuries and concussions, as well as the use of herbal and prohibited substances. Students may spend extended evening time in the ambulatory or inpatient setting in keeping with ACGME requirements.

MD 973 Physical Medicine and Rehabilitation (2 or 4 weeks- depending on Regional Campus) The Physical Medicine and Rehabilitation elective is a 2 or 4 week experience in both the acute care hospital and the rehabilitation hospital. Students will follow patients and perform consultations with an interprofessional team under the direction of an assigned preceptor. Students will participate in multi-disciplinary conferences. Students may spend extended evening time in the hospital in keeping with ACGME requirements.

Obstetrics and Gynecology Electives -- OB/GYN Education Director: Brian Wilcox, MD, PhD

MD 979 Obstetrics and Gynecology Selective ( 2 or 4 week – depending on Regional Campus)

The OB/GYN Selective is either a 2 or 4 week STUDENT DESIGNED experience that allows the student to work within another area of interest within or outside of the TCMC system. Requirements may be modified, but will generally follow the same guidelines established for the 4-week rotations in a given specialty. All selectives must be approved by the OB/GYN Education Director.

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Pediatrics Electives – Pediatric Education Director: Thomas Martin, MD

MD 940 Pediatric Cardiology (4 weeks)The Pediatric Cardiology Elective is a 4-week inpatient and outpatient experience. Students will follow ambulatory patients and perform inpatient consultation under the direction of an assigned preceptor. Students will interpret ECGs and echocardiograms. Significant travel is required for this elective. Students will spend extended evening time in the hospital or in the ambulatory setting in keeping with ACGME requirements.

MD 941 Pediatric Dermatology (4 weeks)A 4-week extramural pediatrics elective requiring the approval of the Pediatrics Education Director.

MD 942 Adult and Pediatric Gastroenterology ( 2 or 4 weeks) The Adult and Pediatric Gastroenterology Elective is a 2 or 4-week inpatient and outpatient experience. Students will follow ambulatory patients and perform inpatient consultation under the direction of an assigned preceptor. Students will observe and interpret gastrointestinal studies. Students may spend extended evening time in the hospital in keeping with ACGME requirements.

MD 943 Pediatric Endocrinology (4 weeks)A 4-week extramural pediatrics elective requiring the approval of the Pediatrics Education Director.

MD 944 Pediatric Infectious Disease (4 weeks)A 4-week extramural pediatrics elective requiring the approval of the Pediatrics Education Director.

MD 945 Pediatric Nephrology (4 weeks)

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A 4-week extramural pediatrics elective requiring the approval of the Pediatrics Education Director.

MD 946 Pediatric Gastroenterology (4 weeks)A 4-week extramural pediatrics elective requiring the approval of the Pediatrics Education Director.

MD 947 Pediatric Neurology (4 weeks)A 4-week extramural pediatrics elective requiring the approval of the Pediatrics Education Director.

MD 948 Adolescent Medicine (4 weeks)A 4-week extramural pediatrics elective requiring the approval of the Pediatrics Education Director.

MD 949 Ambulatory Pediatrics (4 weeks)A 4-week extramural pediatrics elective requiring the approval of the Pediatrics Education Director.

MD 950 Pediatrics Elective (2 or 4 weeks)The Pediatrics elective is either a 2 or 4 week STUDENT DESIGNED experience that allows the student to work within another area of interest within or outside of the TCMC system. Requirements may be modified, but will generally follow the same guidelines established for the 4-week rotations in a given specialty. All electives must be approved by the Pediatrics Education Director.

MD 954 Adult and Pediatric Neurology (4 weeks)The Adult and Pediatric Neurology Elective is a 4-week inpatient, outpatient, and long-term care facility experience. Students will follow patients in all of these settings and will perform inpatient consultation under the direction of an assigned preceptor. Students will interpret EEG and neuro-imaging studies. Students may spend extended evening time in the hospital in keeping with ACGME requirements.

MD 953 Adult and Pediatric Allergy and Immunology (4 weeks)The Adult and Pediatric Allergy and Immunology Elective is a 4-week inpatient, but primarily outpatient experience. Students will follow patients in the ambulatory setting and will perform inpatient consultation under the direction of an assigned preceptor. Students will interpret RAST testing, skin testing, pulmonary function testing, and participate in desensitization. Students may spend extended evening time in the hospital in keeping with ACGME requirements.

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Psychiatry Elective – Psychiatry Education Director: A.C. Patel, MD

MD 955 Psychiatry Elective (2 or 4 week – depending on Regional Campus)The Psychiatry elective is either a 2 or 4 week STUDENT DESIGNED experience that allows the student to work within another area of interest within or outside of the TCMC system. Requirements may be modified, but will generally follow the same guidelines established for the 4-week rotations in a given specialty. All electives must be approved by the Psychiatry Education Director.

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Surgery Electives – Surgery Education Director: Mark Frattali, MD MD 960 Urology (4 weeks)The Urology elective is a 4-week inpatient and outpatient experience. Students will follow patients and participate in the preoperative, intraoperative, and postoperative care of patients on the service under the direction of an assigned preceptor. Students will present at Urology case conference and will spend extended evening time in the hospital in keeping with ACGME requirements.

MD 961 Otorhinolaryngology (2 or 4 weeks – depending on Regional Campus)The Otorinholaryngology elective is a 2 or 4-week inpatient and outpatient experience. Students will follow patients and participate in the preoperative, intraoperative and postoperative care of patients on the service under the direction of an assigned preceptor. Students will conduct inpatient consultations under the direction of the preceptor. Students will present at Head and Neck Tumor conference and/or Tumor Board and will spend extended evening time in the hospital in keeping with ACGME requirements.

MD 962 Anesthesiology (2 or 4 weeks- depending on Regional Campus)The Anesthesiology Elective is a 2 or 4-week inpatient experience. Students will follow patients through the preoperative evaluation, the perioperative period, and the post-anesthesia care unit (PACU) under the direction of an assigned preceptor. This is a more intensive experience than offered in the 3 rd year. During this elective the student will develop more skill in the management of the surgical patient and performing procedures including airway and vascular access. Students will spend extended evening time in the hospital in keeping with ACGME requirements.

MD 963 Orthopedic Surgery (4 weeks)The Orthopedic Surgery Elective is a 4-week inpatient and outpatient experience. Students will follow patients and participate in the surgical and ambulatory care of the patient with an orthopedic condition. Students will participate in sports medicine and will present during the departmental rounds and will spend extended evening time in the hospital in keeping with ACGME requirements.

MD 964 Ophthalmology (2 or 4 weeks)The Ophthalmology Elective is a 2 or 4-week inpatient and outpatient experience. Students will follow patients and gain exposure to the medical and surgical treatment of ocular pathology under the direction of an assigned preceptor. Students will prepare a presentation for the department.

MD 965 Sports Medicine (4 weeks)A 4-week extramural surgery elective requiring the approval of the Surgery Education Director

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MD 966 Plastic Surgery (2 or 4 weeks – depending on Regional Campus)The Plastic Surgery Elective is a 2 or 4-week inpatient and outpatient experience. Students will follow patients and participate in the preoperative, intraoperative, and postoperative care of patients on the service under the direction of an assigned preceptor. Students will gain exposure to patients requiring elective cosmetic procedures as well as complex reconstructive procedures. Students will prepare a presentation for the department and will spend extended evening time in the hospital in keeping with ACGME requirements.

MD 967 Colorectal Surgery (4 weeks)The Colorectal Surgery Elective is a 4-week inpatient and outpatient experience. Students will follow patients and participate in the preoperative, intraoperative, and postoperative care of patients on the service under the direction of an assigned preceptor. Students will see patients in the ambulatory setting, perform outpatient and inpatient consultations, and participate in procedures under supervision. Students will present at Surgical case conference and will spend extended evening time in the hospital in keeping with ACGME requirements.

MD 968 Vascular Surgery (4 weeks) The Vascular Surgery Elective is a 4-week inpatient and outpatient experience. Students will follow patients and participate in the preoperative, intraoperative, and postoperative care of patients on the service under the direction of an assigned preceptor. Students will gain familiarity with the diagnosis and surgical treatment of vascular disease. Students will present at Surgical case conference and will spend extended evening time in the hospital in keeping with ACGME requirements.

MD 969 Breast Surgery (2 weeks)The Breast Surgery Elective is a 2 week inpatient and outpatient experience. Students will work with a preceptor whose practice specializes in the diagnosis and surgical treatment of breast disease. Students will participate in hospital rounds, perform consultations and procedures, and will present at breast cancer conference under the direction of an assigned preceptor. Students will prepare a presentation at Surgical conference and will spend extended evening time in the hospital in keeping with ACGME requirements.

MD 970 Cardiothoracic Surgery (4 weeks)The Cardiothoracic Surgery Elective is an intensive 4-week primarily inpatient experience. Students will follow patients and participate in the preoperative, intraoperative, and postoperative care of patients on the service with an interprofessional team under the direction of an assigned preceptor. Students will be a member of the team performing daily rounds, hospital conferences, and attending daily conferences. Students will prepare a presentation for the team and will spend extended evening time in the hospital in keeping with ACGME requirements.

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MD 971 Surgery Elective (2 or 4 weeks)The Surgery elective is either a 2 or 4 week STUDENT DESIGNED experience that allows the student to either combine the surgical electives (MD 960-970) or work within another area of interest (such as transplant or trauma surgery for example) within or outside of the TCMC system. Requirements may be modified, but will generally follow the same guidelines established for the 4-week rotations in a given specialty. All electives must be approved by the Surgery Education Director.

MD 972 Neurosurgery (4 weeks)An extramural elective in neurosurgery is a 4 week inpatient and outpatient experience . Students will follow patients and participate in the preoperative, intraoperative, and postoperative care of patients on the service under the direction of an assigned preceptor. Students will see patients in the ambulatory setting, perform outpatient and inpatient consultations, and participate in procedures under supervision. Students will present at Surgical case conference and will spend extended evening time in the hospital in keeping with ACGME requirements.

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Basic Science Electives – Chair of Basic Science: Maureen McLeod, PhD

MD 980 Advanced Anatomy (4)The Advanced Anatomy Elective is a 4-week experience in the general anatomy lab with a member of the clinical and basic science faculty. It is primarily designed for students entering surgical specialties; this elective will allow students an opportunity to perform advanced gross anatomy dissection.

MD 981 Basic Science Research (2 or 4 weeks)A 2 or 4 week STUDENT DESIGNED experience in basic science research with a research mentor. The Basic Science Research Elective must be approved by the Chair of Basic Science.

MD 982 Readings in Basic Science (2 or 4 weeks)A 2 or 4 week experience with lectures and/or in depth reading in a STUDENT SELECTED field with a mentor. Students are required to write a paper (hopefully for submission for publication) at the end of the elective. The Readings in Basic Science Elective must be approved by the Chair of Basic Science.

MD 983 Clinical Pharmacology (2 or 4 weeks)A 2 or 4 week experience in pharmacology with an emphasis on mechanisms of drug action and how this relates to clinical practice.

MD 985 Basic Science Elective (2 or 4 weeks)A 2 or 4 week STUDENT DESIGNED experience under a faculty tutor. The Basic Science Selective must be approved by the Chair of Basic Science.

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Clinical Sciences Electives – Chair of Clinical Science: Valerie Weber, MD

MD 914 Teaching Elective (4 weeks) The purpose of this elective is to have future physicians explore medical education at The Commonwealth Medical College. This elective gives 4th year medical students the opportunity to participate in teaching activities within the MD and MBS educational programs. Each elective will be custom designed to meet the interests of the student enrolled and will involve one or more faculty mentors from the TCMC MD and/or MBS curricula.

MD 991 Research in Clinical Sciences (2 or 4 weeks)A two or four week STUDENT DESIGNED experience in clinical research with a research mentor. The Clinical Research Elective must be approved by the Chair of Clinical Sciences.

MD 992 Medical Humanities (2 or 4 weeks)The Medical Humanities Elective is a 2 or 4 -week, non-clinical experience. The experience may vary depending on the number of students enrolled in the block. Minimally students will conduct readings within the medical arts and discuss these with student colleagues and the clerkship director. In seat or phone conference meetings are coordinated within the block based upon the number of students enrolled. Students will write one paper per week of the elective. All two week electives must be taken consecutively. All four week electives must have the first two weeks as a consecutive experience with the remaining two weeks flexible within the student schedule based upon the approval of the clerkship director.

MD 993 Medical Ethics (2 weeks)The Medical Ethics Elective is a 2-week, non-clinical experience. Students will participate in classroom and small group activities. Students will prepare a presentation at the end of the elective and will share this with other participants.

MD 994 Readings in the Clinical Sciences (2 or 4 weeks)A two or four week experience with lectures and/or in depth reading in a STUDENT SELECTED field with a mentor. Students are required to write a paper (hopefully for submission for publication) at the end of the elective. The Readings in the Clinical Sciences Elective must be approved by the Chair of Clinical Sciences.

MD 995 Clinical Sciences Selective (2 or 4 weeks- depending on Regional Campus)A two or four week STUDENT DESIGNED clinical, research, or reading tutorial experience under a faculty tutor. The Clinical Sciences Selective must be approved by the Chair of Clinical Sciences.

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Family, Community, and Rural Health Electives – Chair of FCRH: Janet Townsend, MD

MD 996 Community Research (2 or 4 weeks)A two or four week STUDENT DESIGNED experience in community research with a research mentor. The Community Research Elective must be approved by the Chair of Family, Community, and Rural Health.

MD 997 Readings in Family, Community, and Rural Health (2 or 4 weeks)A two or four week experience with lectures and/or in depth reading in a STUDENT SELECTED field with a mentor. Students are required to write a paper (hopefully for submission for publication) at the end of the elective. The Readings in Family, Community, and Rural Health Elective must be approved by the Chair of Family, Community, and Rural Health.

MD 998 Family, Community, and Rural Health Selective (2 or 4 weeks)A two or four week STUDENT DESIGNED clinical, research, or reading tutorial experience under a faculty tutor. The Family, Community, and Rural Health Selective must be approved by the Chair of Family, Community, and Rural Health.

Approved by the Year 3/4 Subcommittee of the CAC: March 4, 2013Bulletin distributed to the Class of 2014: March 2013

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Academic Calendar, 4 th year, 2013-2014

Important Note regarding USMLE Step 2 Examinations! USMLE Step 2 CK and Step 2 CS must be taken by all M4 students by December 31, 2013. We strongly encourage all students to register for and take these examinations by October 31, 2013.

BLOCK 1 7/1/13 to 7/26/13

BLOCK 2 7/29/13 to 8/23/13

BLOCK 3 8/25/13 to 9/20/13 CORE WEEK 1 - 9/16/13- 9/20/13*

BLOCK 4 9/23/13 to 10/18/13 CORE WEEK 2 – 10/14/13- 10/18/13*

BLOCK 5 10/21/13 to 11/15/13

BLOCK 6 11/18/13 to 12/13/13

BLOCK 7 12/16/13 to 1/10/14

BLOCK 8 1/13/14 to 2/7/14

BLOCK 9 2/10/14 to 3/7/14

BLOCK 10 3/10/14 to 4/4/14 CORE WEEK 3 – 3/17/14-3/21/14

BLOCK 11 4/7/14 to 5/2/14

GRADUATION FOR CLASS OF 2014 5/10/14

ALL TCMC clinical clerkships follow this block schedule and so clinical clerkships may be taken for the first two weeks of the block or the second two weeks of the block for two week clerkships. Four week clerkships may only be taken according to this block schedule.

Students taking clerkships at other institutions will find 1-2 week openings in their schedules because of the difference in the timing of clerkships between outside institutions and TCMC. Students are encouraged to fill these spaces with student designed clinical electives (MD 936, MD 950, MD 955, MD 971, MD 977, or MD 979) or Electives from the Department of Basic Science, the Department of Clinical Science, or the Department of Family, Community, and Rural Health.

Use the following worksheet to draft possible schedules for the 4th year.

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