Description: This four-week outpatient clerkship will provide an immersive outpatient family medicine experience, with emphasis on evaluation and development of Entrustable Professional Activities (EPAs) 1-12 for Residency. Please see the table below for a list of the EPAs and how they will each be addressed. In addition, students will complete written assignments to demonstrate their competence in evidence based medicine, and a case based family and community evaluation. Clinical Experiences Students will be assigned to Cambridge Health Alliance affiliated community family medicine practices. All of the teaching practices will provide full spectrum outpatient family medicine patient care, including patients of all ages and all genders, with the exception that all practices may not provide prenatal care. The range of clinical problems is expected to include: ● routine health maintenance for adults and children ● management of chronic and recurrent medical and psychiatric problems ( for example diabetes, COPD, thyroid disorders, sports injuries, GERD, Inflammatory bowel disease, depression, ADHD) ● routine women's health (for example pap smears, menstrual concerns, menopause management) ● reproductive health (sexually transmitted infections, contraception, pre-conception counseling, erectile dysfunction), ● evaluation of the acute undifferentiated complaint (for instance abdominal pain, cough, fever). ● Procedural visits (IUD placement, colposcopy, skin biopsy, cryotherapy and more) There will be a maximum of one student per preceptor in a given month. ● Students will independently evaluate patients who present for acute visits, health maintenance visits, hospital follow up, and follow up of chronic conditions. Students will be assigned patients at the beginning of each care session, 1-2 per hour, with the following expectations: Review the chart prior to seeing the patient for recent issues, health-care maintenance needs, and problems in need of follow-up. ● Obtain history and perform physical exam ● Develop and prioritize a differential diagnosis and problem list for each patient ● Provide written and oral presentations of each patient ● By the end of this rotation, students will place orders for appropriate treatment and evaluative testing (to be reviewed by the preceptor) , discuss assessment and treatment plans with the patient, deliver patient education and practice shared decision-making models (with the guidance of the preceptor). ● Interpret all testing results both during and after the visit, and communicate with patients about these results. Patients will be seen initially by students alone; once the student has completed an oral presentation including assessment, workup, and treatment plans, the preceptor will see the patient and confirm the findings. Students may also follow prenatal patients, and participate in outpatient procedures such as IUD placements and skin procedures including pre-procedure counseling and informed consent. Students will participate in care team meetings and coordinate their patient care activities with other members of the team including nurses, medical assistants, social workers, nutritionists and clinical pharmacists, depending on the team structure at their site. EPAS 1-6 will be demonstrated repeatedly in the context of patient care in the office, in which students will see patients independently, perform the H&P needed for each patient, present each patient to the attending including a differential diagnosis, assessment, and workup/treatment plan, and document the encounter in the medical record including order entry. Preceptors will see each patient and confirm findings as needed once the student work has been completed (documentation may be completed after the patient has left the visit). (1) Gather a history and perform a physical exam (2) Prioritize a differential diagnosis following a clinical encounter (3) Recommend and interpret common diagnostic and screening tests (4) Enter and discuss orders and prescriptions (5) Document an encounter in the medical record (6) Provide an oral presentation of a clinical encounter (7) Form clinical questions and retrieve evidence to advance patient care Will be demonstrated both by identifying and incorporating evidence-based recommendations for workup and treatment into the plan for patients at the time of care, and by completion of a once-weekly information mastery assignment (see attached). (8) Give or receive a patient handover to transition care responsibly For patients transferred to the emergency or inpatient setting during the course of the rotation, students will contact the receiving team and provide clinical information (with supervision) (9) Collaborate as a member of an interprofessional team Students will work with all members of the office team, including nurses, medical assistants, behavioral health specialists, nutritionists, and others based on the needs of the specific patients seen during the rotation (10) Recognize a patient requiring urgent/emergent care and initiate evaluation and management Students are expected to identify patients who require transfer to the emergency or inpatient setting or who require urgent/emergent testing or intervention (would include conditions such as respiratory distress, suspected thromboembolic events, anaphylaxis), alert the preceptor, and with preceptor supervision initiate treatment (nebulizers, oxygen, etc) and initiate/assist with transfer. (11) Obtain informed consent for tests and/or procedures Students will obtain informed consent (with supervision) for routine office procedures, including but not limited to skin biopsies, colposcopy, IUD insertions. (12) Perform the general procedures of a physician Students will participate in the procedures listed above as a first assistant, and will have the option to become proficient in phlebotomy. (13) Identify system failures and contribute to a culture of safety and improvement Written Assignments In addition to daily patient write-ups and follow up of lab and consultant reports, students will have written assignments which strive to develop students’ understanding of essential longitudinal concepts in family medicine. Descriptions are provided below. ● Assignment 1 - Each week students will submit a one page Evidence Based Medicine assignment, in which the student will document the results of an evidence based medicine search on a clinical question encountered during an office visit. These assignments should be discussed with the clinical team and then submitted to the course director ● Assignment 2 - Students will complete a community study based on a complex patient from the practice, following the instructions outlined in the course description.

Description: This four-week sub-internship level outpatient course will provide an immersive outpatient family medicine experience, with emphasis on evaluation and development of Entrustable Professional Activities for Residency, numbers 1-7 and 9. Students will be placed in community practices, and will independently evaluate patients who present for acute visits, health maintenance visits, hospital follow up, and follow up of chronic conditions. In addition to obtaining history and performing physical exam, students will develop and prioritize a differential diagnosis for each patient, provide written and oral presentations of each patient, place orders for appropriate treatment and evaluative testing (to be reviewed by the preceptor) and, with the guidance of their preceptor, discuss assessment and treatment plans with the patient, deliver patient education and practice shared decision-making models. Students will be expected to interpret all testing results, and after discussion with preceptor communicate the results to their patients. Students may also follow prenatal patients, and participate in outpatient procedures such as IUD placements and skin procedures including pre-procedure counseling and informed consent. Students will participate in care team meetings and coordinate their patient care activities with other members of the team. Students will also participate in 3 day-long group learning sessions, where a combination of lecture, small group and hands on learning will be used to review a selection of high-yield primary care topics including pain management, point-of-care Evidence Based Medicine, substance abuse treatment, primary care and mental health, care of the geriatric patient with a focus on polypharmacy, end of life discussions, and immigrant health. Each week students will submit a brief Evidence Based Medicine assignment, and there will be a final project - a community study based on a complex patient from the practice.

Description: Students in this one month elective will learn a team-based care approach to the diagnosis and management of a variety of acute and chronic diseases in adult and pediatric patients in a primary care community health center. A focus of this elective will be how the patient care team identifies and addresses social determinants of health (SDOH) with their patients. Students will spend time interacting with various members of the patient care team – learning about each person’s role on the team. They will be paired with a clinical pharmacist and/or pharmacy resident/student in the collaborative care of a patient(s) with a chronic disease whom they will follow together over the course of the elective. During the elective students will be asked to explore how factors such as economics, housing, education, food insecurity, employment, and transportation impact the health of their patients and how the members of the patient’s care team each play their role in screening for, addressing, and managing these issues. Students will also spend some time in the community itself – with immersion experiences such as visiting a food pantry/mobile market, patient home visit(s), school health center, senior center, housing, etc. Students will further explore SDOH through literature, narrative reflection, case presentation/discussion, and be asked to construct a time line of a patient’s life in collaboration with their pharmacy partner to see how a patient’s life path leads to their present situation. Students will observe and participate in our panel management - observing how we act as a team to manage patients with certain health conditions/risks and in the management of our more complex patients. Weekly interprofessional educational conferences will provide an opportunity to further discuss and process these experiences and further cement learning.

Description: This elective is an ambulatory rotation designed to introduce medical students to the field of medical/primary care sports medicine. The student will work with sports medicine physicians who also have primary training in internal medicine, pediatrics, emergency medicine, family medicine or physiatry in outpatient clinics and at mass participation and team-based sporting events. Students will see pediatric and adult patients with sports- and exercise-related musculoskeletal and medical complaints in the clinic setting. Though we will emphasize proficiency with the full sports medicine history and focused musculoskeletal exam, students will also gain familiarity with interpretation of radiological studies and will learn to develop a basic management plan. Students will participate in departmental educational conferences. Opportunities for exposure to sideline/medical tent sporting event coverage, ultrasound examinations, and surgical procedures are also available based on student interest. The rotation is designed for those interested in sports medicine, primary care medicine and non-surgical specialties. This is an ambulatory care rotation with no overnight call. Event coverage may be scheduled in the evenings or on weekends.

Description: Students may add themselves to the waiting list for this course during add/drop periods but not during lottery periods. Prior approval required, please email Dr. Katherine Miller: kmiller@challiance.org, forward approval to registrar@hms.harvard.edu. This 4 week clinical elective will take place in rural Family Medicine practices in Western Massachusetts and Northern Maine. Participants will need access to a car to reach sites. Housing is frequently available at each site for no or low cost. Students will participate in outpatient clinic visits, and may also be included in inpatient rounding, community outreach events, and clinical team meetings. The rotation will not include overnight call, though weekend clinic, rounding and other activities may be included. Students will be expected to work 40 hours of work per week, which may include home visits, inpatient rounding, group visits and in office visits. Community outreach, clinical and community planning meetings and care team meetings may also be included. Students will be expected to independently evaluate patients and create treatment plans to present to their attending clinician. The course will include required written reflections and a final paper.

Description: During the Anesthesia elective, students will work closely with faculty preceptors and residents in the pre-operative, intra-operative and post-operative management of patients. Students will spend the first week with a faculty mentor in their clinical area of expertise. During the remaining weeks, students are proactively assigned to anesthesiology subspecialties according to their personal interests. These sub-specialties include cardiac, thoracic, vascular, orthopedic, plastic, neurosurgical and obstetrical anesthesiology, as well as the acute and chronic pain management services. In addition to weekly Problem Based Learning Discussions, students will also participate in our departmental conferences. While students will have the opportunity to participate in hands on learning, the goal of this clerkship is to provide a more in depth exposure to the diverse field of anesthesiology and further develop their critical thinking and decision making skills. Rather than focus on technical skills, we strive to help students understand important clinical concepts applicable no matter what specialty they choose. Real time applied physiology and pharmacology will be emphasized. As the month progresses and in accordance with level of enthusiasm and ability, students can expect to be given limited responsibility in caring for patients. If students are interested in exploring anesthesiology as a career, we will provide them with mentorship and career exploration opportunities.

Description: During the Anesthesia elective, students will work closely with faculty preceptors and residents in the pre-operative, intra-operative and post-operative management of patients. Students will spend the first week with a faculty mentor in their clinical area of expertise. During the remaining weeks, students are proactively assigned to anesthesiology subspecialties according to their personal interests. These sub-specialties include cardiac, thoracic, vascular, orthopedic, plastic, neurosurgical and obstetrical anesthesiology, as well as the acute and chronic pain management services. In addition to weekly Problem Based Learning Discussions, students will also participate in our departmental conferences. While students will have the opportunity to participate in hands on learning, the goal of this clerkship is to provide a more in depth exposure to the diverse field of anesthesiology and further develop their critical thinking and decision making skills. Rather than focus on technical skills, we strive to help students understand important clinical concepts applicable no matter what specialty they choose. Real time applied physiology and pharmacology will be emphasized. As the month progresses and in accordance with level of enthusiasm and ability, students can expect to be given limited responsibility in caring for patients. If students are interested in exploring anesthesiology as a career, we will provide them with mentorship and career exploration opportunities.

Description: This course offers an opportunity to learn about the practice of anesthesiology and its role in the peri-operative care of the surgical patient. In addition, the student will begin to learn how to effectively manage critically ill patients. Teaching is based on hands-on experience in the operating room where the student will have progressive participation and responsibility for the administration of anesthesia care to patients. The first 1-2 weeks of the rotation is spent providing anesthesia for general surgical, day care and gynecological operations where the skills of pre-operative evaluation, choosing an anesthetic plan and the basics of airway management will be taught. Subsequently, students will participate in the anesthetic management of patients undergoing thoracic, neurosurgical, vascular, orthopedic and cardiac procedures where advanced pharmacologic/physiologic principles and monitoring techniques are reviewed in the context of caring for these complex patients. Lastly, the student with spend one day in the Harvard Anesthesia Simulator and when the course is scheduled, the student will participate one day in the Advanced Trauma Life Support Lab. The student is expected to attend our; weekly Departmental Grand Rounds and Case Conference, weekly resident education lecture, bi-weekly medical student lecture / literature / case review conference.

Description: The course is designed to give the senior medical student a broad experience in clinical anesthesiology and acute pain management that is consistent with his/her career goals and motivation for taking the course. The student is assigned to clinical learning activities primarily in the operating rooms at BIDMC. Each day the student is assigned to an anesthesia faculty member (and usually an anesthesia resident or fellow), who will instruct and supervise the student during their learning experience. The student initially will be assigned to operating rooms where non-complex, predominantly ambulatory procedures are being performed, so that the basics of simple anesthetics and airway management can be mastered. As the month progresses the student will be assigned to progressively more complex surgical procedures in more medically complicated patients, so that the student can gain an understanding of advanced anesthetic techniques and the perioperative medical management of patients with multisystem disease. In addition to these clinical assignments, the student will attend department conferences and lectures. By the end of the month the student is expected to complete and present a detailed case writeup in which the anesthetic management of a complicated case will be discussed. Although there is no required night call, the student is free to remain after hours and on weekends with the night call team if they so desire.

Description: The course is designed to give the senior medical student a broad experience in clinical anesthesiology and acute pain management that is consistent with his/her career goals and motivation for taking the course. The student is assigned to clinical learning activities primarily in the operating rooms at BIDMC. Each day the student is assigned to an anesthesia faculty member (and usually an anesthesia resident or fellow), who will instruct and supervise the student during their learning experience. The student initially will be assigned to operating rooms where non-complex, predominantly ambulatory procedures are being performed, so that the basics of simple anesthetics and airway management can be mastered. As the month progresses the student will be assigned to progressively more complex surgical procedures in more medically complicated patients, so that the student can gain an understanding of advanced anesthetic techniques and the perioperative medical management of patients with multisystem disease. In addition to these clinical assignments, the student will attend department conferences and lectures. By the end of the month the student is expected to complete and present a detailed case writeup in which the anesthetic management of a complicated case will be discussed. Although there is no required night call, the student is free to remain after hours and on weekends with the night call team if they so desire.

Description: This course covers the theory and practice of pain relief during childbirth and the medical management of high risk obstetrical patients. Special attention will be focused on the interaction between obstetric anesthetic techniques and maternal/fetal physiology. The student will work closely with the obstetric anesthesia team (residents, fellow, and attendings) in the daily activities including providing analgesia for labor and anesthesia for cesarean delivery. Students will be expected to perform medical assessments, play an active role in the anesthetic care, and round on their patients the following day. In addition, the students will be assigned to follow particular high risk patients and will be expected to research and discuss the anesthetic implications of their diseases. Schedule will be M-F 7am to 5pm. Students will attend all afternoon and morning lectures. Overnight and weekend call is optional at the discretion of the student.

Description: Since pain is a prevalent feature in treating all patients, this rotation is intended to offer training for students interested in any clinical specialty. Students will be directly involved with the practice of contemporary multidisciplinary Pain Medicine including acute, chronic and cancer pain. Students will work with attending staff from disciplines of anesthesiology, palliative care, psychiatry, neurology, and physical medicine and rehabilitation. They will follow staff, fellows and residents on daily rounds on the inpatient and service as well as in the outpatient clinic. Students will be part of the team that provides medical management of chronic and cancer pain in both the outpatient continuity care setting and the inpatient consultation setting. Students will also be exposed to interventional procedures, such as nerve block techniques like epidural steroid injections, sympathetic nervous system blocks (stellate ganglion blockade, lumbar sympathetic blockade, intravenous phentolamine), facet joint blockade, as well as bier blocks and intravenous lidocaine infusions. The program offers a daily mix of formal and informal educational experiences. Students are exposed to contemporary thinking in pain treatment from multiple disciplines. Our core faculty collectively has formal training in Pain Medicine as well as Anesthesiology, Neurology, Internal Medicine, Pediatrics,Psychiatry, basic science research and clinical trials. Collaborations with almost every other service at MGH offer our students an extremely diverse experience. From the experience on this rotation, students will be expected to have gained the following skills: 1) understand basic concepts of the physiology of pain; 2) understand and be able to perform a pain oriented evaluation and physical examination; 3) understand the known diagnostic classifications of pain and their treatments; 4) understand the complex interplay of medical, psychological and social issues with pain; and 5) understand the basic indications for and practice of analgesic therapy.

Description: Students will gain exposure to the daily management of critically ill patients in a surgical critical care setting in a Level 1 Trauma Center. Through active participation in daily teaching rounds as well as with hands-on experience and lectures, students will be expected to learn basic management principles in hemodynamic and neurological monitoring and manipulation, respiratory failure and mechanical ventilation, renal and endocrine pathophysiology as well as with broader topics including ethics and end-of-life care.

Description: The student will be introduced to and participate in all aspects of the management of critically ill post-operative and major trauma patients. A unified physiologic approach to patient management will be emphasized. During the rotation, the student will learn the assessment of respiratory and hemodynamic function at the bedside, the physiologic principles of mechanical ventilation, and the evaluation and treatment of hemodynamic and metabolic disorders. The student will become familiar with the assessment needs for the critically ill patient, selecting appropriate diagnostic tests, use and interpretation of invasive and non-invasive physiologic monitoring, identifying and responding to acute changes in the unstable patient, and recognizing and initiating management of life-threatening conditions. Students will be assigned to a SICU team consisting of a critical care attending, fellow, and 3-4 anesthesia residents. Lectures are provided daily by the attendings and fellows and further teaching occurs during rounds as well as during close supervision in the care of critically ill patients.

Description: Intraoperating & Postoperative Management of the Cardiac Surgical Patient provides an opportunity for an advanced medical student to gain further insight into the pre-operative, interoperative, and post-operative management of patients presenting for cardiac surgery including coronary artery bypass grafting, valve replacement, aortic procedures, and transplantation. The medical student will be exposed to preoperative evaluation, central and arterial line placement, intubation, hemodynamic monitoring, resuscitation, echocardiography, the principles of cardiac surgery, and patient transport. The student will be exposed to cardiac anatomy, pharmacology, and physiology. The student will be expected to attend the established resident and fellow lecture series, Morbidity and Mortality Conferences, department wide Thursday morning conference, and multiple issue discussions. The resident is invited to attend the Advanced Trauma Operative Management Course when offered and any other conferences in which our trainees participate. Call is optional allowing the student to choose to remain with a case if interested. The student is free of duties if involved with a case late into the evening.

Description: This course provides students with an introduction to the anesthesia care of children. The student will participate in departmental conferences and the pre-, intra-, and post-operative evaluation and management of patients undergoing anesthesia and surgery.

Description: The Advanced Clinical Anatomy elective offers an in-depth study and review of human anatomy and its applications to clinical practice in all disciplines. Clearly, all physicians regardless of specialty access their anatomical knowledge daily when caring for patients at the bedside. This advanced course provides an opportunity for students to review this material through the eyes of a clinician such as a surgeon, obstetrician/gynecologist, interventional radiologist and primary care provider. A relevant daily bibliography is available for review regarding each procedure. The sessions are “case-based” around a particular procedure and begin with a brief presentation by a visiting surgeon with particular expertise in the procedure. A brief discussion of the pathophysiology, diagnosis, radiographic imaging, relevant anatomy and treatment alternatives is provided. After a brief break, students then proceed to the laboratory where they perform actual operative procedures with surgical instruments on donor cadavers under the supervision of practicing surgeons from across the Harvard system. You will learn valuable techniques and management strategies while reviewing the anatomic relationships critical to the safe performance of the procedure. Examples include the following: Whipple procedure (pancreaticoduodenectomy for pancreatic cancer), hysterectomy with salpingo-oophorectomy (for endometrial carcinoma), inguinal and femoral hernia repairs, correction of congenital malrotation, bladder cystectomy for diffuse transitional cell carcinoma, carotid endarterectomy, anterior and posterior exposure for hip replacement, arthroscopic knee exploration for torn cruciate ligament, arthroscopic exploration of the shoulder for rotator cuff injuries and many others. Laboratory teaching will be provided by the core faculty alongside specialist surgeons who perform these procedures routinely in their practice. Throughout the course students develop clinical skills in a safe and structured environment preparing them for clinical performance in their future “audition” rotations, sub-internships and future postgraduate training. When this course was last offered in the spring of 2020, all students rated it as excellent and multiple students described it as the “best course they had taken at HMS”! Many also noted the close interactions and support provided by the senior faculty and their commitment to teaching throughout the course. Some typical comments from students on the evaluations included, “This course is an unparalleled opportunity to explore the human body in a way that is tactile and 3-dimensional now that many of us have more experience and focused questions than in first-year anatomy.” Another student noted, “Phenomenal faculty- are by far the most dedicated and enthusiastic I’ve had the privilege of working with at HMS. They organized an incredible course, brought in great guest lecturers, and were present for every dissection. They were the perfect balance of helpful without doing the procedures for us. They also went above and beyond to make sure we had adequate prep materials and that our outside materials lined up well with their goals.” A third student said, “This was an exceptional course. The three core instructors were fantastic and the care and dedication they put into this course was evident. I am applying into a non-surgical specialty and this was without a doubt one of the best courses I have taken in my time at HMS. They created a warm and inviting atmosphere that was perfectly suited to learning. . . . This class gave me an opportunity to synthesize all of the anatomy that I have learned in medical school, while learning so much more and providing great clinical context to the anatomic relationships.” Finally, a student wrote, “The teaching was incredible. The course directors put together an amazing course and recruited some of the most talented surgeons and experts in their fields to come lecture. The faculty and guest lecturers gave us useful literature to read, tied the cases to general medical principles, and shared their passion for their fields. This experience is unmatched in all of my other experiences at HMS.” Course Manager: Tim Gailius

Description: The combined dermatology elective offered across the Harvard affiliated hospitals (BCH, BIDMC, BWH, and MGH) provides a concentrated experience in: 1) the diagnosis and treatment of diseases that primarily affect the skin; 2) the recognition of skin changes that reflect multisystem disease; 3) exposure to the role of dematologic surgery in the management of skin conditions; and 4) appreciation of the diversity of skin and its medical conditions across varied ethnic populations. The Departments of Dermatology have ambulatory and inpatient facilities in the BCH, BIDMC, BWH, and MGH. Each student may opt to spend the entire elective at the site of their choice or may elect to spend 3 weeks at one site and one week at another site. Students will be given the opportunity to request the site(s) of their preference; however, final assignments will be based on availability. Site assignments will be determined prior to the first day of the rotation. The students will do their clinics and consultations at the assigned sites and will participate in joint teaching activities at BCH, BIDMC, BWH, and MGH. Under the supervision of faculty members of the Department of Dermatology, students will actively participate as clinical clerks in the diagnosis and therapy of patients with dermatologic problems at one or more of the hospitals listed above; the majority of patients will be ambulatory. Competency in performing several of the diagnostic and therapeutic procedures will be attained by the students. Students will also participate in clinical-pathological conferences, consultation and departmental rounds, and weekly diagnostic conferences. Student-specific teaching activities include a weekly didactic lecture and a seminar with the teach resident for which each student presents a talk.

Description: The goal of this course is to teach students how to evaluate and manage patients with complex medical dermatologic illness. The course is designed to build on foundations of dermatology as learned in the introductory dermatology DE501M.J course or an equivalent course at another institution. Students will choose to rotate among ambulatory dermatology subspecialty clinics at Brigham and Women's Hospital and the Dana Farber Cancer Institute. Available clinics focus on skin and related musculocutaneous disorders, bullous disease, angiogenesis and wound healing, graft versus host disease, cutaneous oncology (including melanoma and merkel cell carcinoma), infectious disease, and cutaneous T-cell lymphoma. In addition, students will round on a daily basis with the inpatient dermatology consultation service at BWH. Under the supervision of faculty members of the Department of Dermatology, students will actively participate as clinical clerks in the diagnosis and therapy of patients with dermatologic problems at the clinics listed above. Competency in performing several of the diagnostic and therapeutic procedures will be attained by the students. Attending physicians will provide ongoing daily feedback about the student's performance. Students will also participate in clinical-pathological conferences, consultation and departmental rounds, and weekly diagnostic conferences. Student-specific teaching activities include a weekly didactic lecture and a seminar with a senior resident for which each student presents a talk.

Description: This course is designed for students who are interested in learning the necessary tools for the comprehensive evaluation and management of our oncodermatology patients. The course will build on the foundations acquired through the introductory dermatology course (DE501M.J) or an equivalent course at a different institution. Approximately half of the student's time will be spent in clinics at Massachusetts General Hospital and the MGH Cancer Center. The other half will be spent as independent study in support of a scholarly project. Students will rotate in clinics caring for patients with cutaneous lymphoma, melanoma, graft-versus-host disease, and high-risk skin cancer as a result of prior transplantation. Many clinic experiences will be in multi-disciplinary format, so as to show the intricate multi-pronged approach to the management of these patients. Under the supervision of faculty members from the Departments of Dermatology and Medical Oncology, students will be expected to function as clinical clerks in the work up and management of these complex patients. This includes the mastery of common procedures and tests used in diagnosis and management. Separate time will also be spent to review pathology specimens from the types of malignancies and diseases they are seeing, so as to provide clinicopathological correlation. Students will also participate in clinico-pathological conference and tumor board, as well as department conferences. Comprehensive and daily feedback will be given to the student by attending physicians. The scholarly project will be mentored by a faculty member of the student's choosing. Ideally, students will identify a topic to study related to oncodermatology, however, students can also spend this time working on existing projects already started prior to the rotation. During the rotation, the student will be expected to complete a proposal to summarize progress and plans for completion for their scholarly project.

Description: Emergency Medicine Boot Camp is an interactive, high-yield advanced skills course designed to optimize the effectiveness of graduating HMS students to manage medical/surgical emergencies as incoming interns. The course will include: simulation skills lab course and didactic lessons designed to provide rising interns with a review of critical diagnoses, procedural skills and teamwork strategies essential to working in an Emergency Department (ED) or while on call. Lectures will be structured around emergent clinical presentations and management. In addition, inter-disciplinary lectures with Medicine, OB/GYN and Surgery will be held several times a week to allow for a greater focus on the patient as a whole. This will provide insight into the potential difficulties of resident life and overall functions and expectations of an intern. Simulation sessions will focus on critical EM presentations allowing students exposure to effectively manage critically ill patients in a safe environment. Procedural skills workshops will provide hands-on experience of suturing, central venous access, lumbar puncture, intubation, thoracostomy, procedural ultrasound and splinting. Upon completion of this course, students will be prepared for the clinical and social expectations of incoming practioners.

Description: According to the Center for Medicare Services, one in five Medicare patients discharged from the hospital approximately 2.6 million seniors is readmitted within 30 days, at a cost of over $26 billion every year. Transitions in care are a high risk time for patients and navigating these successfully is critical to providing optimal patient care. This elective offers the student a diverse, broad-based experience in the practice of geriatric medicine and understanding successful care transitions. Students will have the opportunity to rotate through a variety of clinical experiences including acute inpatient geriatrics, geriatrics inpatient consultations, acute and subacute rehabilitation, geriatric psychiatry, geriatric primary care/consultative clinics, home visits, and geriatric specialty clinics (i.e. memory clinic). During these experiences, students follow a patient from the inpatient to post-acute care setting to increase their understanding of the complexities of care transitions. Students interact closely with residents, geriatric medicine fellows, and attending physicians. In addition, students will also have the unique opportunity to work within interdisciplinary teams including nurse practitioners, RNs, social workers, and physical/occupational therapists, to further understand systems aspects of geriatric medicine. As a relatively new but rapidly growing field, geriatric medicine is a frontier of novel models of care. Students attend an ECHO-AGE telecomputing clinic where experts at BIDMC, including geriatricians, a neurologist, a geriatrics psychiatrist, and a social worker, provide consultation to long-term care facilities in Massachusetts and Maine regarding management of dementia and delirium. Students also participate in ECHO-CT telecomputing clinics where experts at BIDMC interact with post-acute care facilities to optimize the care of patients recently discharged from the hospital. The clinical experiences are supported by a formal educational curriculum including participation in geriatrics fellow conferences, geriatric medicine grand rounds, didactics that explore the costs of geriatrics care and regularly scheduled research and teaching conferences. There is no weekend or call requirement.

Description: Students may add themselves to the waiting list for this course during add/drop periods but not during lottery periods. Please contact Dr. Alex Keuroghlian, akeuroghlian@partners.org, for approval to enroll. This elective is a four-week multidisciplinary clinical-and-scholarly experience that trains students to provide high-quality, culturally responsive care for patients with diverse sexual orientations, gender identities, and sex development. Many of these patients identify as lesbian, gay, bisexual, transgender, queer, intersex or asexual (LGBTQIA+). Clinical exposure and education will focus on serving gender and sexual minority people across the lifespan, from infants to older adults. The elective includes partnerships and clinical experiences at Harvard Medical School hospitals and within community settings, including clinical experiences at Boston Children’s Hospital, Massachusetts General Hospital, Cambridge Health Alliance, Fenway Health Center, Boston Health Care for the Homeless, and other health care organizations in the Great Boston Area that serve LGBTQIA+ communities. Students will work with multidisciplinary teams in a variety of clinical settings and specialties, including but not limited to Adolescent Medicine, Endocrinology, Family Practice, Infectious Disease, OBGYN, Pediatrics, Psychiatry, Psychology, Primary Medical Care, and Plastic Surgery. They will be immersed in clinical practices committed to promoting health and resiliency for gender and sexual minority communities. The combination of clinical experiences will be tailored based on students’ interests. This rotation will emphasize both mentored and self-directed learning, with core educational material developed by faculty at Harvard Medical School and its affiliates, The Fenway Institute, and other national experts. Based on individual interests, students will have the opportunity to engage in a mentored scholarly endeavor related to gender and sexual minority health. This project may consist of an advocacy, quality improvement, medical education, original research, or public health project. A scholarly product is required at the end of the rotation and could be in the form of a poster, case report, literature review, viewpoint or perspective piece, original research report, oral presentation, or contribution to the course curriculum. Many students have successfully published their mentored scholarly project from the elective as a peer-reviewed article or parlayed this work into their Scholars in Medicine project. There is no call expectation during this elective.

Description: Students may add themselves to the waiting list for this course during add/drop periods but not during lottery periods. Please contact Dr. Rick Mitchell, rmitchell@rics.bwh.harvard.edu, for approval to enroll. One Health is the concept that human health, animal health, and ecosystem health are interconnected and interdependent on each other. It is a framework that fosters multidisciplinary approaches to complex health problems. Students accompany veterinarians in their daily clinical practice based at the Franklin Park Zoo in Dorchester, MA, and are actively engaged in all aspects of case management, diagnostic work-up, and treatment of zoological species. This foundation of comparative medicine provides the basis for broader discussions on One Health, while a syllabus that includes weekly reading assignments and review of current literature introduces concepts such as the protective role of biodiversity for human health, and how ecosystem disturbances and climate change can influence emerging infectious disease threats. A novel research proposal that incorporates the tenets of One Health is to be prepared, with an informal presentation to be given during the final week. Daily activities will generally involve 4-6 hours of clinical experience (dependent on active case load) with 2 -4 hours of independent research of learning issues, presentation preparation, etc. Learning issues will be identified with each case, which the student is expected to spend independent time researching daily, being prepared to discuss the material with attendings the following day. The Department of Animal Health for Zoo New England is staffed by three full time veterinarians, board certified by the American College of Zoological Medicine, and four veterinary nurses.

Description: The course will familiarize students with healthcare and preventive measures specific to the women's health specialty - treating those patients who are female bodied and identify as women and/or gender nonconforming - and the care of women throughout their adult lives. Students will learn about how sex and gender inform medicine with primary care physicians, obstetricians/gynecologists, and specialists in an outpatient setting. They will have the opportunity to work with physicians focusing on women’s health across these interdisciplinary fields. The course will include a focus on the role of social determinants of health, including violence and trauma. Students will be taught principles and techniques of trauma-informed care for all patients. Emphasis will be placed on critical analysis of medical literature and current practices for topics specific to women’s health, and students will learn a sex- and gender-informed perspective on the presentation, treatment, and outcomes of disease in women. Primarily the clinic experiences will focus on cis women, with special attention to the diversity among patients who seek out women's health specialists. This course will utilize a flipped classroom model. Students will be provided a formal core curriculum in evidence-based women’s health to read and/or view prior to each clinic session. They will be exposed to evidence-based medicine in practice through observing and participating in clinical encounters. Additionally, they will have dedicated time to discuss these curricular materials with their preceptors. Students will produce a capstone project on a topic of their choice and will present their work during the final week of the course; outstanding projects will have the opportunity to be incorporated into the course curriculum for future students.

Description: The goal of this Community Engagement Clerkship is to transform the student’s understanding of the social determinants of health from theory into practice. This is a 4-week elective with two closely coordinated elements: 1) A full 4 week immersive, experiential component with the student embedded within a community organization; 2) A faculty-mentored didactic component of 5-10 additional hours of reading, discussion and analysis, under the direction of the Faculty Mentor. This clerkship is designed to be an immersive educational experience for students interested in learning more about the principles and practice of community engagement and community health. IMMERSION COMPONENT: Students will be assigned to ONE of 4 community-based organizations: Health Care for the Homeless, The Family Van, Health Care Without Walls or Southcentral Foundation in Anchorage Alaska. The student will be integrated into the work of the assigned organization. The immersion activities will generally include: direct interaction with patients (25%); mentoring by the organization leadership(25%); structured interactions with program stakeholders (25%); and introduction to the organization CQI, outcomes assessment and research (25%). MENTORED ONLINE CURRICULUM COMPONENT: Students will be assigned a Faculty Mentor who will serve as a guide to the online curriculum and for the student to debrief and reflect on their experience with the community organization. The online curriculum has 12 themed modules which reflect the theory and practice of community engagement. These modules include readings and other multimedia materials. The first week is required reading to prepare the student for the immersive work in the community organization, the second week is a selection of seminal papers on community-engaged healthcare, and in weeks three and four the student choses one paper a night from the themed modules. Each week the student will write a reflection paper on their immersive experience and readings. The student will have a weekly debriefing meeting with their Faculty Mentor to discuss their reflection paper and experience within the community organization. Students should contact Marcie Naumowicz (marcie_naumowicz@hms.harvard.edu) for information and site availability.

Description: The course will give students a well-rounded exposure to clinical cardiology as it is practiced in a community hospital. Students will participate in the evaluation of cardiac catheterization patients; see and present cardiology consultations; make daily rounds in the coronary care unit with the Unit Attending Physician; and assist in exercise testing and echocardiography. In addition, students may sit in with the daily EKG reader. Opportunities may also be available for experience in evaluation of cardiac patients in the outpatient setting, and for observation of cardiac surgery.

Description: This course will enable students to acquire the fundamentals of clinical cardiology. Students will be assigned to the clinical consultation service. Students will evaluate patients in whom cardiac consultation is required including patients with arrhythmias, coronary artery disease, heart failure and valvular disease. Along with the Senior Cardiology attending and fellows,the student will formulate a diagnostic and therapeutic plan. There will be the opportunity to learn the fundamentals of cardiac physical diagnosis, electrocardiography, echocardiography, exercise testing, cardiac catheterization and angiography, and nuclear cardiology. The student will participate in daily ECG reading sessions and is also welcome to attend at the various clinical and teaching conferences that occur during the week. If the student wishes, they can spend some time acquiring a more in-depth knowledge of the elements of cardiac care, which could include time spent in the cardiac catheterization, echocardiography, electrophysiology labs or in the out-patient department.

Description: This course will enable students to acquire the fundamentals of clinical cardiology. Students will be assigned to the clinical consultation service. Students will evaluate patients in whom cardiac consultation is required including patients with arrhythmias, coronary artery disease, heart failure and valvular disease. Along with the Senior Cardiology attending and fellows,the student will formulate a diagnostic and therapeutic plan. There will be the opportunity to learn the fundamentals of cardiac physical diagnosis, electrocardiography, echocardiography, exercise testing, cardiac catheterization and angiography, and nuclear cardiology. The student will participate in daily ECG reading sessions and is also welcome to attend at the various clinical and teaching conferences that occur during the week. If the student wishes, they can spend some time acquiring a more in-depth knowledge of the elements of cardiac care, which could include time spent in the cardiac catheterization, echocardiography, electrophysiology labs or in the out-patient department.

Description: The course will provide opportunities in clinical history-taking and physical examination of the cardiac patient in order to give students a broad clinical exposure to cardiology and particularly to sharpen the basic skills necessary in all aspects of clinical medicine. The resulting information will be correlated with electrocardiographic, echocardiographic, radiologic, catheterization and angiographic data. Students will function as an integral part of the clinical team and work up patients, formulate diagnostic and management plans, and participate in patient care under the direction of the attending staff, cardiology fellows, and house staff. Electrocardiography will be taught by participation in reading sessions. Daily rounds and teaching conferences will provide both didactic and informal learning experiences.

Description: The course will provide opportunities in clinical history-taking and physical examination of the cardiac patient in order to give students a broad clinical exposure to cardiology and particularly to sharpen the basic skills necessary in all aspects of clinical medicine. The resulting information will be correlated with electrocardiographic, echocardiographic, radiologic, catheterization and angiographic data. Students will function as an integral part of the clinical team and work up patients, formulate diagnostic and management plans, and participate in patient care under the direction of the attending staff, cardiology fellows, and house staff. Electrocardiography will be taught by participation in reading sessions. Daily rounds and teaching conferences will provide both didactic and informal learning experiences.

Description: This course is a one-month exposure to outpatient, office-based cardiology at the Lown Cardiovacular Center. The subject matter will include the office-based diagnosis and management of chest pain, palpitations, shortness of breath, near syncope and syncope, with emphasis on the managment of coronary artery disease, congestive heart failure, hypercholesterolemia, hypertension, and cardiac arrhythmia. The students will have ample exposure to office-based diagnostic testing including exercise tolerance testing, stress echocardiography, echocardiography, ambulatory monitoring, event recording, and pacemaker surveillance. The course will focus on the critical link between office and hospital-based cardiology with exposure to the decision-making process leading to hospitalization and the care of the recently discharged cardiac patient. Instruction in the interpretation of electrocardiograms and arrhythmia analysis will be provided.

Description: This rotation provides an overview of consultative cardiology in an inpatient setting, with an ancillary focus on the invasive and non-invasive modalities most used by cardiologists in their daily practice. Students will be responsible for performing consults on patients throughout the hospital under the supervision of a cardiology fellow. Students will have the option to spent time rotating through different laboratories, such as those for echocardiography, cardiac catheterization, and nuclear stress testing. One of the strengths of training at Massachusetts General Hospital is the remarkable variety and complexity of patients seen during this rotation. Senior staff supervise through daily rounds, but the student and fellow are the main provider and decision makers for patient care.

Description: Students may add themselves to the waiting list for this course during add/drop periods but not during lottery periods. Please contact Dr. Carolina Abuelo, CABUELO@mgh.harvard.edu, for approval to enroll. The student who must be planning career in primary care will work at MGH-Charlestown Health Care Center with a team of physicians, nurse practitioners, and social service personnel that provide direct primary adult health care. This is a clinical elective and students will be focused on developing clinical skills. The team orientation is towards early intervention, prevention and health maintenance. As many patients face the challenge of living in poverty, the focus will be on how to best deliver care in that setting. The student will have numerous opportunities to see patients at home, as walk-ins and at appointments. Opportunities are open for involvement with pediatrics, mental health, ob-gyn, physical therapy, and other services at the health center, and for involvement with community groups and agencies.

Description: Students may add themselves to the waiting list for this course during add/drop periods but not during lottery periods. Students will be involved in the development or implementation of a project involving the application of computers to patient care in one of the following areas: Web-based Knowledge Access; Computer-Based Medical Record System for Inpatient and Outpatient Practice; Application of Computers to Clinical Education; Web-based Computer-Based Physician Consultation and Guidance Systems, Information Technology for Clinical Research, Large Scale Clinical Data Repositories, Clinical Bioinformatics. The student will usually work closely with one or more of the Physician Fellows at the Laboratory who are part of the NLM sponsored Medical Informatics Training Program. The course will make students aware of the potentials and problems of computer applications and familiarize them with the literature and other activities of the laboratory in their area of interest. Students will have a brief but intensive exposure to a particular computer application in medicine and the opportunity to develop and implement a particular project of mutual interest. Prior approval from course director is required, please email to Dr.Chueh hcchueh@partners.org

Description: This training provides an intensive exposure to clinical endocrinology and metabolism, including diabetes, hypertension, neuroendocrine and thyroid diseases; as well as other disorders such as, calcium and bone metabolism, thyroid and adrenal glands, pituitary dysfunction, hypertensive disorders, and other disorders of fuel homeostasis. Residents and students will perform endocrine consultations and participate in the diagnostic and therapeutic management of a broad variety of patients with these disorders, including work-up, background reading and presentation/discussion of cases at rounds. Teaching rounds will be held four to five times weekly and will focus on new and follow-up consultations. Students will also attend clinics in one or more of these same areas on a weekly basis. Interhospital Endocrine Grand Rounds and clinical/teaching conferences will be held weekly, in conjunction with the Children's Hospital. Evidence-based medicine is the expected standard for the student's learning related to the cases evaluated and discussed in teaching rounds and clinics. Students are expected to perform literature searches to identify original articles, review articles and meta-analyses related to their case load, read relevant sections of endocrinology textbooks and utilize electronic resources, such as Up-to-Date, as appropriate. Basic science, as it is relevant to the team's consultations and to clinic patients, is an integral component of the student's reading, principally in textbooks, and is also presented as part of teaching rounds and/or in clinics by attendings and fellows.

Description: Students will be active in all functions of the integrated endocrine program of the medical service, attending clinics and conferences, and evaluating new consultations under the supervision of clinical fellows and staff members. Students will take a comprehensive history, perform a physicial examination and review all laboratory tests. They will learn key history and physical examination features important in the diagnosis of endocrine disorders. They will learn how to order appropriate endocrine tests and learn how in interpret these tests in the context of diagnostic and therapeutic paradigms. In-patient consultation rounds will be held four mornings per week, and patients will be seen in the out-patient setting in clinics devoted to general endocrinology as well as in the areas of thyroid, diabetes and metabolism, neuroendocrinology, reproductive endocrinology, and mineral ion/bone disorders. Calcium Rounds, Thyroid/Neuroendocrine/Diabetes conference, Endocrine Grand Rounds, and Reproductive Endocrine Conference are held weekly.

Description: The purpose of this elective is to teach medical students a multidisciplinary approach to the diagnosis and management of pituitary disorders. Additional goals of the course are: to expose students to a broad range of clinical subspecialties involved in the care of patients with pituitary disorders, including neuroendocrine, neurosurgery, radiation oncology, neuro-oncology and neuro-ophthalmology; to offer observation of experienced faculty in neuroendocrine consultation in the outpatient clinic and in the hospital;and to provide an opportunity to follow a patient through process of transsphpenoidal surgery including preoperative evaluation,surgery and postoperative care. Curriculum: Students will be provided with the Clinical Neuroendocrine Syllabus including individual clinical reviews on hypopituitarism, Cushing's, hyperprolactinemia and non functioning tumors, as well as on surgical and radiation therapy of pituitary tumors. Suggested references will be encouraged based on student's individual interests. This material will be re-enforced by case base learning in the clinic and hospital and through a variety of neuroendocrine lectures. Students will be expected to attend 2 weekly conferences including: 1)Weekly Neuroendocrine Clinical Case Conference, which is is one hour in length and is attended by neuroendocrine faculty and fellows, radiation, oncology, neuro-oncology and neurosurgery and includes in depth multi-disciplinary discussion of complex and challenging neuroendocrine disorders and 2) Neuroendocrine Journal Club which is 1 hour conference focusing on recent neuroendocrine literature which typically includes analysis of recent basic and clinical neuroendocrine published literature. Students will be encouraged to observe a transsphenoidal surgery, neuroendocrine consultation in and outpatient, neuroendocrine dynamic testing and stereotactic radio surgery and will be offered corresponding educational material and the opportunity to interact with faculty in discussion of cases. This course is recommended for medical students with interest in endocrinology, neuroendocrinology, neurosurgery, neurology, neuro-oncology or neuro-ophthalmology.

Description: This course is designed to provide broad exposure to clinical endocrinology, metabolism and diabetes. Half of the month (a two week block of time) will be devoted to training in endocrinology and metabolism at BIDMC, while the other half of the month will be devoted to training in diabetes at the Joslin clinic. Endocrinology and metabolism: Students will see consults and participate in the diagnostic and therapeutic management of patients with a wide range of endocrine and metabolic disorders at both the inpatient and outpatient setting. Diabetes: The first week will be devoted to the "Do It" program, following a specific diabetic patient as he/she goes through the different medical and laboratory evaluations as well as teaching sessions of the program. During the second week of this block, students will be active on the consult service and will work up cases for presentation at consult rounds.

Description: The course will provide students with a deep understanding of the pathophysiology and clinical aspects of gastroenterology. There will be an emphasis on diagnosis and therapeutics, including exposure to gastrointestinal procedures and management of hospitalized and ambulatory patients. Students will participate as part of the inpatient consultation team and work with the faculty and GI fellows in the ambulatory setting. Students will be expected to be a integral memeber of the gastroenterology team. They will perform a comprehensive history and physical exam, generate a differential diagnosis, and make diagnostic and therapeutic recommendations. In addition to active participation in rounds, the students will be expected to attend and contribute to multi-disciplinary conferences, journal clubs and research seminars. In addition, a unique learning opportunity will be available in the form of a computer-based case simulation, the Virtual Patient. This will be available in the Center for Clinical Education along with other teaching programs at BIDMC-East.

Description: The course will provide the student with a well-rounded exposure to clinical gastroenterology in a community teaching hospital. The student will perform consultations on hospitalized patients with a wide variety of gastrointestinal problems. These patients will be discussed in detail with a senior staff gastroenterologist who will also personally evaluate the patient. The student will participate in private office visits as well as rounds, conferences and Journal Club. Relevant imaging studies and pathology specimens will be reviewed. The student will also observe a variety of diagnostic/therapeutic procedures including endoscopy, colonoscopy and ERCP and will learn their usefulness, limitations and appropriate role in clinical problem solving. Emphasis will be placed on the relationship between understanding of pathophysiologic mechanisms of disease and the evaluation and management of patients with gastrointestinal disorders.

Description: Students will become familiar with the pathophysiology, diagnosis, application of endoscopic procedures (diagnostic and interventional) and treatment of diseases of the gastrointestinal tract, hepatobiliary system, and pancreas. As an integral member of the patient care team, students will evaluate patients with a wide range of disorders on the hospital-based consult service and in ambulatory clinic, and will be exposed to a wide range of endoscopic procedures. The consult service is comprised of 3 fellows each month and an attending who rotates each week. Students will be encouraged to consider the pathophysiology, basic/clinical research, and evidence-based guidelines informing the care of GI and hepatology patients. In addition to patient care, students will attend and participate in multiple conferences with GI fellows and faculty, including teaching on core topics (didactic and case-based), research seminars, journal club, and multidisciplinary subspecialty conferences (in hepatology, IBD, motility, pancreas, etc.) with radiology and pathology review.

Description: Students will become familiar with the pathophysiology, diagnosis, application of endoscopic procedures (diagnostic and interventional) and treatment of diseases of the gastrointestinal tract, hepatobiliary system, and pancreas. As an integral member of the patient care team, students will evaluate patients with a wide range of disorders on the hospital-based consult service and in ambulatory clinic, and will be exposed to a wide range of endoscopic procedures. The consult service is comprised of 3 fellows each month and an attending who rotates each week. Students will be encouraged to consider the pathophysiology, basic/clinical research, and evidence-based guidelines informing the care of GI and hepatology patients. In addition to patient care, students will attend and participate in multiple conferences with GI fellows and faculty, including teaching on core topics (didactic and case-based), research seminars, journal club, and multidisciplinary subspecialty conferences (in hepatology, IBD, motility, pancreas, etc.) with radiology and pathology review.

Description: The course will acquaint students with the major problems in gastrointestinal and liver disease and familiarize them with approaches and techniques involved in treatment. The students will spend two weeks with three fellows and an attending physician on the inpatient general gastroenterology service, and two weeks with one fellow and an attending physician on the inpatient hepatology service. The students can expect to see 1-2 new consults each day with oversight and teaching by a clinical fellow and the GI attending physician. The students will be involved in all aspects of assessment and treatment for their patients, including observation of any endoscopic procedures performed on their patients. In order to gain maximum exposure to all facets of gastrointestinal disease, students will participate in all clinical and education activities available to the GI fellows, including patient rounds, consultations, GI Grand Rounds, research and clinical seminars, didactic and case-based teaching conferences, and Clinical Journal Club. During the course of the rotation, students will be asked to present a brief talk on a GI topic of his/her choosing. There is no call.

Description: The course will acquaint students with the major problems in gastrointestinal and liver disease and familiarize them with approaches and techniques involved in treatment. The students will spend two weeks with three fellows and an attending physician on the inpatient general gastroenterology service, and two weeks with one fellow and an attending physician on the inpatient hepatology service. The students can expect to see 1-2 new consults each day with oversight and teaching by a clinical fellow and the GI attending physician. The students will be involved in all aspects of assessment and treatment for their patients, including observation of any endoscopic procedures performed on their patients. In order to gain maximum exposure to all facets of gastrointestinal disease, students will participate in all clinical and education activities available to the GI fellows, including patient rounds, consultations, GI Grand Rounds, research and clinical seminars, didactic and case-based teaching conferences, and Clinical Journal Club. During the course of the rotation, students will be asked to present a brief talk on a GI topic of his/her choosing. There is no call.

Description: The Hematology-Oncology Elective at BIDMC accepts up to 2 students who play an active role on the Hematology-Oncology Consult service. Students work closely with a 2nd-year Hematology-Oncology Fellow, 1 or 2 Attending Physicians and often an internal medicine resident, seeing inpatients in consultation for a variety of hematologic and oncologic concerns that arise on medicine, surgery, obstetrics-gynecology, and intensive care services. Students are expected to present their patients histories, physical examinations, and laboratory findings with preliminary assessment and plans for discussion at daily rounds, where basic science and pathophysiologic concepts are integrated into clinical teaching. Additionally, students attend weekly teaching conferences, where cases are discussed in depth for didactic purposes, again stressing basic science and pathophysiologic concepts that inform evidence-based and insight-based care of patients. Many of the hematology-oncology conferences at BIDMC are multidisciplinary, including the participation of surgeons, radiation oncologists, pathologists, radiologists, transfusion medicine specialists, and laboratory personnel. Multidisciplinary case discussions enrich in-depth understanding of complex aspects of patient care, occasionally resulting in altered patient management plans and highlighting important aspects of systems-based practice and practice-based quality improvement. At one of the weekly Hematology Conferences, students will have an opportunity to give a PowerPoint presentation based on one of their cases from the Consult Service, with a discussion of basic science, pathophysiology, differential diagnoses, and diagnostic and therapeutic considerations relevant to the case chosen for presentation. In addition to serving as an integral member of the consult service, students will also have an opportunity to see patients with attending physicians in outpatient clinics in the BIDMC Shapiro Clinical Center Hematology-Oncology Ambulatory Unit. Outpatient clinics span a variety of subspecialty interests, including benign and malignant hematologic disorders, disorders of hemostasis and thrombosis, breast cancer, gastrointestinal and hepatobiliary malignancies, thoracic oncology, cutaneous oncology, genitourinary oncology, and biological and experimental therapeutics.

Description: The Hematology-Oncology Elective at BIDMC accepts up to 2 students who play an active role on the Hematology-Oncology Consult service. Students work closely with a 2nd-year Hematology-Oncology Fellow, 1 or 2 Attending Physicians and often an internal medicine resident, seeing inpatients in consultation for a variety of hematologic and oncologic concerns that arise on medicine, surgery, obstetrics-gynecology, and intensive care services. Students are expected to present their patients histories, physical examinations, and laboratory findings with preliminary assessment and plans for discussion at daily rounds, where basic science and pathophysiologic concepts are integrated into clinical teaching. Additionally, students attend weekly teaching conferences, where cases are discussed in depth for didactic purposes, again stressing basic science and pathophysiologic concepts that inform evidence-based and insight-based care of patients. Many of the hematology-oncology conferences at BIDMC are multidisciplinary, including the participation of surgeons, radiation oncologists, pathologists, radiologists, transfusion medicine specialists, and laboratory personnel. Multidisciplinary case discussions enrich in-depth understanding of complex aspects of patient care, occasionally resulting in altered patient management plans and highlighting important aspects of systems-based practice and practice-based quality improvement. At one of the weekly Hematology Conferences, students will have an opportunity to give a PowerPoint presentation based on one of their cases from the Consult Service, with a discussion of basic science, pathophysiology, differential diagnoses, and diagnostic and therapeutic considerations relevant to the case chosen for presentation. In addition to serving as an integral member of the consult service, students will also have an opportunity to see patients with attending physicians in outpatient clinics in the BIDMC Shapiro Clinical Center Hematology-Oncology Ambulatory Unit. Outpatient clinics span a variety of subspecialty interests, including benign and malignant hematologic disorders, disorders of hemostasis and thrombosis, breast cancer, gastrointestinal and hepatobiliary malignancies, thoracic oncology, cutaneous oncology, genitourinary oncology, and biological and experimental therapeutics.

Description: The consult service of the Massachusetts General Hospital is responsible for the evaluation and treatment recommendations for a variety of hematologic and oncologic questions in the medical and surgical services, both benign and malignant. It consists of a fellow, an attending and rotating students and residents from Harvard Medical School or outside institutions. Students are assigned cases to review and present to the team, typically one consult per day. Radiology and pertinent pathology is frequently reviewed in the appropriate departments (and students are encouraged to review them prior to case presentations). Moreover, there are scheduled rounds for review of peripheral blood smears. The division offers a series of lectures on a weekly basis, both on general topics, such as the new patient conference, as well as on specialized topics covered in the conferences of the individual disease centers (such as bone marrow transplantation, lymphoma/leukemia, lung cancer, breast cancer, colorectal cancer etc.)

Description: This course will provide students with experience in clinical infectious diseases in an academic community hospital setting. Students will gain experience in the evaluation of patients presenting with a wide range of infectious issues, including community-acquired and nosocomial infections, travel-related infections and infections associated with immunosuppressed patients. This course will place emphasis on the approach to a patient presenting with an infectious issue, incorporating the associated epidemiology and host susceptibility in order to generate a differential diagnosis and treatment plan. Students will gain an understanding of the principles of antimicrobial therapy through patient based learning. Students will also have the opportunity to evaluate patients in the outpatient setting, including outpatient infectious diseases consultations as well as experience in the Travel Medicine Clinic. Students will carry out inpatient consultations under the direct supervision of attending infectious diseases physicians. Students will participate and be expected to give one presentation at the bi-weekly Infectious Diseases conference. Students will also meet at least weekly with the course director to review pertinent issues in clinical infectious diseases.

Description: The course will provide students with experience in clinical Infectious Diseases. Students will evaluate patients with infectious diseases each day and discuss diagnosis and management with the attending physician and fellow on rounds. They will attend three weekly scheduled clinical conferences and a weekly teaching session in the microbiology laboratory. The course will emphasize the pathophysiology of infectious disease, differential diagnosis and principles of antimicrobial therapy. There will be an opportunity to see a broad spectrum of clinical problems including common community-acquired infections, AIDS, nosocomial infections and infections related to immunosuppression, surgery and pregnancy. Students with a special interest in infections of immunosuppressed patients with malignancies or receiving organ transplants may elect to spend the time with the infectious disease team responsible for these patients. Students will meet at least weekly with the course director to review the basics of antimicrobial therapy in both the inpatient and outpatient settings.

Description: The course will provide students with experience in clinical Infectious Diseases. Students will evaluate patients with infectious diseases each day and discuss diagnosis and management with the attending physician and fellow on rounds. They will attend three weekly scheduled clinical conferences and a weekly teaching session in the microbiology laboratory. The course will emphasize the pathophysiology of infectious disease, differential diagnosis and principles of antimicrobial therapy. There will be an opportunity to see a broad spectrum of clinical problems including common community-acquired infections, AIDS, nosocomial infections and infections related to immunosuppression, surgery and pregnancy. Students with a special interest in infections of immunosuppressed patients with malignancies or receiving organ transplants may elect to spend the time with the infectious disease team responsible for these patients. Students will meet at least weekly with the course director to review the basics of antimicrobial therapy in both the inpatient and outpatient settings.

Description: Students will learn to evaluate patients presenting with a wide range of infectious problems. Students will be assigned to one of three inpatient consultation teams. Each team will consist of an attending and a fellow, and may also have a medical resident. Students will perform one consult each day in coordination with the fellow. They will take a comprehensive history with emphasis on clinical presentation, epidemiologic risk factors for infections, and predisposing medical conditions. They will perform and observe physical examinations with particular attention pain to common physical findings associated with important infectious problems. They will generate a differential diagnosis with particular attention pain to the most probable and the most serious causes of a patient�s complaint. Students will present their findings, both written and oral, to the attending each day for review and feedback. Students will round on each of their consults daily until discharge or signoff and write progress notes in the medical record. The attending physician will supervise each student�s work on a daily basis and will provide ongoing daily feedback about the student�s performance. Students will attend weekly lectures and conferences (radiology, pathology, clinical management). Students are expected to give at least one comprehensive talk during the course of the month about a patient or a problem that they encountered, with particular emphasis on practicing evidence-based medicine and in understanding basic science and physiology as it a applies to a clinical problem.

Description: Students will learn to evaluate patients presenting with a wide range of infectious problems. Students will be assigned to one of three inpatient consultation teams. Each team will consist of an attending and a fellow, and may also have a medical resident. Students will perform one consult each day in coordination with the fellow. They will take a comprehensive history with emphasis on clinical presentation, epidemiologic risk factors for infections, and predisposing medical conditions. They will perform and observe physical examinations with particular attention pain to common physical findings associated with important infectious problems. They will generate a differential diagnosis with particular attention pain to the most probable and the most serious causes of a patient�s complaint. Students will present their findings, both written and oral, to the attending each day for review and feedback. Students will round on each of their consults daily until discharge or signoff and write progress notes in the medical record. The attending physician will supervise each student�s work on a daily basis and will provide ongoing daily feedback about the student�s performance. Students will attend weekly lectures and conferences (radiology, pathology, clinical management). Students are expected to give at least one comprehensive talk during the course of the month about a patient or a problem that they encountered, with particular emphasis on practicing evidence-based medicine and in understanding basic science and physiology as it a applies to a clinical problem.

Description: The student will be an integral part of the consultation team of the Infectious Disease Unit at Beth Israel Deaconess Medical Center and will be assigned to either the East or West Campus. The service sees a wide range of Infectious Disease cases throughout the medical, surgical and obstetrical services at the hospital. The student will act as primary consultant for their patients, will be responsible for the initial evaluation and daily follow-up and will join the team for afternoon rounds, where the focus will be the practical evaluation and management of Infectious Disease problems. They will also attend weekly microbiology rounds, journal club, case management conference and the Inter-City Infectious Disease Grand Rounds. A weekly session for the students will provide further didactic teaching. A core syllabus will be provided.

Description: This course will provide students an opportunity to explore in depth the work-up and management of infections in immunocompromised hosts. Specifically, patients seen on this rotation will be primarily oncology patients and patients having undergone bone marrow or solid organ (heart, lung or kidney) transplantation. On a daily basis, students will be asked to evaluate new patients in consultation as well as follow-up on previously seen patients. The differential diagnosis and management will be discussed with the attending physician and a fellow on rounds. Students will also have the opportunity to participate in outpatient infectious disease consultations. In addition, students will be expected to attend weekly conferences and microbiology laboratory teaching sessions. This course will emphasize the differential diagnosis and principles of antimicrobial therapy specific to this patient-population. Students will be asked to make a formal presentation showing in depth understanding of a topic of interest to them within the field.

Description: This elective focuses on the multidisciplinary approach to the evaluation and treatment of patients with gastrointestinal malignancies. With a focus on disease sites, medical students will work with surgical oncologists, medical oncologists, and radiation oncologists as part of clinical multidisciplinary team. Students will attend and participate in multidisciplinary clinics where all providers are present including rectal cancer clinic, pancreatic cancer clinic, and hepatobiliary cancer clinic. Furthermore, students will interact with other members of the team including radiologists, pathologists, gastroenterologists, geneticists, nutritionists, and residents/fellows in their respective disciplines. Students will gain an understanding of the intricacies involved in multidisciplinary management of complex GI cancer patients, and how each team member contributes. Students will attain working knowledge of the synergistic and/or complementary effects of chemotherapy, radiation, and surgery. They will appreciate novel treatment modalities including laparoscopic and/or robotic surgeries, transplant surgery, complex pancreatic surgery with vascular reconstruction, targeted therapy and/or immunotherapy, and advanced radiation treatment modalities. The curriculum includes longitudinal exposures to patients with various malignancies; intra-operative exposure to open and minimally invasive surgery, correlating radiology and pathology findings, and understanding multidisciplinary team decision making. Involvement in ongoing clinical and laboratory research projects is encouraged but no required. No night or weekend responsibilities.

Description: Students may add themselves to the waiting list for this course during add/drop periods but not during lottery periods. This course acquaints students with medical care in rural and peri-urban areas of Latin America. First hand experience in primary health care delivery facilitates the understanding of how health care and access to health care are influenced by political, economic, cultural and agricultural factors. Students will become familiar with Latin American culture and will have an opportunity to refine their clinical interviewing skills in the Spanish language thus preparing them to care for Latinos in the United States. Students participate in two-month clerkships in Bolivia, Colombia, Chile, Costa Rica, Guatemala or Paraguay. In Bolivia, Costa Rica, Paraguay and Chile, students will be assigned to district hospitals or health centers where they participate full time in outpatient and inpatient care. In Guatemala, students are assigned to a maternal and child health care center and to rural health posts operated by the Francisco Marroquin Medical School. In all settings, students work as members of a health team, in most cases together with local senior medical students, under the supervision of medical officers of the host institutions. Students work full time at their assigned field sites. Spanish is used in all communications with patients, colleagues and preceptors. Evaluation: P/F performance and written report. Prerequisites: ME518M.41a and/or permission of Course Director. Ability to take a medical history in Spanish is required. Students may apply to SMO for a stipend to cover air fare.

Description: This course represents an introduction to medical oncology and clinical hematology with an emphasis on the broad areas of diagnosis and treatment of neoplastic disease. The four week block is divided into two sections; a two week experience as part of the inpatient hematology consultation team at the Brigham and Women's Hospital with each team consisting of an Attending Physician, one or two fellows, and an occasional medical resident; and a two week experience in ambulatory oncology with each student assigned to a first year medical oncology fellow whom he/she accompanies through the outpatient disease centers at the Dana-Farber Cancer Institute (e.g. Breast Oncology Center, Hematologic Malignancies, etc.), assessing patients in all of these centers along with an Attending Physician. Students are exposed to the multidisciplinary approach to the management of patients with neoplastic disease. Students attend such weekly conferences as Fellows Report, Hematology/Oncology Grand Rounds, a fellow-oriented research conference, pathology conference, and New Patient Conference. Additionally, students are encouraged to attend weekly patient-oriented conferences held by the benign hematology, breast oncology, gastrointestinal oncology, hematologic malignancy, and thoracic oncology groups. Additional lectures and conferences in basic, health services, clinical, and bioethical areas are open to student participation.

Description: The course is designed to give students a well-rounded exposure to the evaluation and management of patients with pulmonary disease. Particular emphasis is placed on differential diagnosis of various clinical and radiologic problems in pulmonary disease. The use and interpretation of pulmonary function tests as well as the role of bronchoscopic and other diagnostic procedures will be covered. Students will be actively involved in both inpatient and outpatient consultations under the direct supervision of the pulmonary fellow and attending physician. There will be several weekly conferences as well as didactic sessions to broaden the student's exposure to pulmonary diseases and pathophysiology.

Description: The student will become familiar with the evaluation and management of patients with acute and chronic respiratory diseases and will actively participate in clinical consultations. In addition, frequent informal lectures will acquaint him/her with modalities of respiratory therapy and pulmonary function testing. See also ME520M.J.

Description: During this clerkship, the medical student will be exposed to several aspects of consultative pulmonary medicine including both inpatient and outpatient experiences. Central to the rotation, the student will be an active member of the inpatient consult team composed of a PCCM attending and fellow as well as occasional Internal Medicine residents. This team is responsible for providing diagnostic and therapeutic recommendations for patients with a variety of respiratory issues as well as assisting in ventilator management of patients in non-medical intensive care units. The medical student will evaluate patients alone and then with the team, allowing for instruction on history taking and physical diagnosis. Subsequently, the student will be involved in formulating a series of recommendations for the consulting team. Through this experience, the student will be exposed to a wide variety of inpatient respiratory issues and become familiar with the role of the consultant. The daily experience includes morning rounds including didactic teaching from both the attending and fellow, regularly scheduled bronchoscopies, and consultation on new patients. Afternoons afford time for the student to participate in pulmonary clinic with particular emphasis on urgent outpatient consultation. In addition to these experiences, the student will gain great familiarity with the interpretation of chest radiographs, chest CT scans and pulmonary function tests. Students will have the opportunity to attend a variety of conferences through the PCCM division at Brigham and Women's Hospital. These include weekly Pulmonary Grand Rounds and Radiology/Pathology Case Conferences. In addition, there are many research as well as sub-specialty conferences (e.g. lung transplant rounds) which the student may attend if interested. There is no call on this rotation.

Description: To appreciate the application of physiologic principles to specific lung disorders and develop a better feeling for the magnitude of lung diseases and their management, students are given the opportunity to see patients with a wide variety of pulmonary disorders. They will take part in the management of these patients with the staff of the Pulmonary Unit. A special preceptor is assigned to each student. During the course students will become familiar with basic concepts in pulmonary physiology and medicine and the application of these to the diagnosis and treatment of acute and chronic lung disease. Students work up at least one new patient daily from all patients that are referred to the Unit. Students participate in the administration and interpretation of tests of lung function and attend the clinical rounds, conferences and seminars of the Pulmonary Unit.

Description: The course is designed to give students a well-rounded exposure to the principles and practices of nephrology, with major emphasis on renal physiology, patho-physiology, hypertension, immunology,ICU nephrology transplantation and dialysis. Students will participate in rounds, conferences, clinical sessions and didactic exercises. Students will work with renal fellows, medical residents and staff attendings. Particular emphasis will be given to problem-solving of disorders of fluid and electrolyte, as well as acid-base, metabolism. Joint sessions will be conducted in renal pathology and radiology. There is no night or weekend schedule.

Description: The course will enable students to gain skills and confidence in the management of patients with renal diseases and electrolyte disorders. In particular, an opportunity is provided to apply principles of pathophysiology to patient care. Students participate actively in all clinical activities of the Renal Unit, including daily rounds on service and private patients and consultations throughout the hospital. Regular conferences include: Renal Grand Rounds, Fellows' Seminar, Journal Club, Renal Pathology Conference. Students may participate in conferences and activities of the Dialysis and Transplantation Units. Student run seminars are also held. Students will be assigned to the inpatient consult service as their primary designation. The consult service includes the supervising Attending Physician, Ward Consult Renal Fellow, ICU Consult Renal Fellow, and on some months Medical Residents on elective rotation. Students will perform consultations based on availablity but usually at least one a day. Consults will will be performed in coordination with the Renal Fellow and the student will present his or her findings, both written and oral, to the attending each day for review and feedback. The attending physician will supervise each students work on a daily basis and will provide ongoing feedback about the students performance. Students will participate in daily conferences designed to improve clinical decision making. Students will attend weekly rounds and conferences designed to enhance their knowledge in the principles of Clincal Nephrology. Students will be expected to give at least one comprehensive talk during the month about a patient focused problem with particular emphasis on the practice of evidence based medicine and understanding basic science and physiology as it applies to a clinical problem.

Description: The course will provide the student an immersion into the specialty of nephrology by hands-on care of inpatients with kidney disease, kidney and pancreas transplants, and electrolyte and acid-base disorders referred for consultation and management. In addition, the student will attend a half-day each week of general nephrology or transplant clinic to gain exposure to ambulatory patients with kidney disease, electrolyte disorders and urinalysis abnormalities. The student will evaluate such inpatients and outpatients, participate, together with a renal fellow, in their diagnosis and management, and present their patients on daily attending rounds and at clinical conferences. In addition to a weekly formal clinical conference, the student will attend a weekly journal club/research conference, a literature based seminar with Dr. Bud Rose, core curriculum conferences emphasizing renal pathology, radiology, dialysis and transplantation, and monthly special conferences which include a Dartmouth Teleconference, GU/Nephrology conference, and internationally known invited lecturers at Renal Grand Rounds. There is no night or weekend call on this elective.

Description: The course is designed to give medical students a comprehensive exposure in clinical rheumatology. This four week elective provides the student with t he opportunity to see patients with complex rheumatologic illness such as rheumatoid arthritis, vasculitis, SLE among others. Students will see patients in the rheumatology clinic a minimum of two mornings and three afternoons per week. One afternoon (Thursday) will be with Dr. Fitzgerald. The days they are in the clinic in the morning, they would have the option of seeing inpatient rheumatology consultations. The students will work under the direct supervision of an attending rheumatologist. There will also be opportunities to discuss musculoskeletal imaging with radiology and histology with pathology at Mount Auburn Hospital. Students will attend rheumatology morning report and rheumatology noon conference which are held on Wednesdays. Students will also attend Rheumatology Grand Rounds at BIDMC with Dr. Fitzgerald on Friday mornings. Students will also learn basics of MSK-USG while working with Dr. Sehra

Description: The goal for this elective is to expose students to a wide array of allergic and immunologic diseases. Students will be meaningful and fully integrated members of the Brigham and Women’s Hospital (BWH) Allergy and Immunology inpatient consult service, the outpatient clinical service, and the rapid drug desensitization service. Working alongside the Attendings and Fellows, they will learn to gather a relevant history, perform a focused physical exam, and interpret clinical and laboratory findings of patients being evaluated for known or suspected allergic diseases and adult immunodeficiencies. Students will attend the BWH Rheumatology, Immunology, and Allergy (RIA) weekly allergy and clinical immunology conference Interested students may elect to write an in-depth paper on a topic of interest. With sufficient effort and interest, these papers can be submitted for publication as review articles. There is no requirement for students to take call.

Description: The MGH Rheumatology clerkship focuses on exposing students to a broad range of rheumatologic diseases, including inflammatory arthritis, connective tissue diseases and vasculitis. A major focus of the course is clinical reasoning, especially in the presence of diagnostic uncertainty. The rotation is composed of three half day outpatient clinics and participation on the inpatient rheumatology consult service. Additional specialized outpatient clinics, such as musculoskeletal ultrasound, are also available. Students typically evaluate new patients in both the inpatient and outpatient settings and are given primary responsibility for patient evaluation, note writing and communicating with medical teams. Students meet for one on one teaching with the clerkship director as well as attend Rheumatology Unit conferences including Rheumatology Grand Rounds, Medical Grand Rounds, Radiology Rounds, Case Conferences, Journal Clubs and Pathology conference.

Description: The goal for this elective is to expose students to a wide array of rheumatic and autoimmune diseases. Students will serve as an integral part of the Consult Service @ BWH. Working alongside the Fellows, they will learn the musculoskeletal exam and acquire the skills to interpret clinical and laboratory findings in this unique cohort of patients. Students will also have the opportunity to see patients in the Clinic setting, including General Rheumatology Clinics as well as sub-speciality clinics such as RA, SLE, Young Adult. On a weekly basis, the Divisions hosts 5- 7 hours of clinical teaching lectures and conferences. Interested students may elect to write an in-depth paper on a topic of interest. With sufficient effort and interest, these papers can be submitted for publication as review articles. There is no requirement for students to take call.

Description: Students may add themselves to the waiting list for this course during add/drop periods but not during lottery periods. This clinical elective is designed to acquaint students with rural primary care delivery through the Indian Health Services at the Northern Navajo Medical Center in Shiprock, New Mexico. Students can apply for the four week elective in Internal Medicine, Pediatrics or Family Medicine. The majority of the rotation will be in the outpatient setting, with opportunities for some inpatient and emergency care experience. Students will also be invited to participate in community outreach activities. Students will gain an understanding of how the role of a primary care provider differs in a rural environment as well as the unique cultural, social, economic and political factors that shape health care needs and delivery on the Navajo Nation. Space is awarded on first-come basis by the on-site coordinators, please contact the course director for more information: Dr. Miller; kmiller@challiance.org.

Description: Students may add themselves to the waiting list for this course during add/drop periods but not during lottery periods. This elective will provided students with a broad overview of the newly recognized field of clinical informatics. The American Board of Medical Specialties has recognized "Clinical Informatics" as a medical sub-specialty and physicians in all 24 subspecialties are now eligible to become Board Certified in Clinical Informatics. Clinical Informatics is the application of information and communication technology to deliver healthcare services. Students with have the opportunity to interact with both local and national leaders as we explore the opportunities and barriers at the intersection of medical education and health information technology. Students will explore how can Electronic Health records be leveraged in clinical settings to improve patient engagement, optimize disease management, and implement prevention initiatives? Students will have the opportunity to work with faculty mentors and physician leaders at the Office of the National Coordinator for health Information Technology (ONC) in the US Department of Health and Human Services to explore these questions, design "lean" experiments, and collaborate with both government and educational leaders to better understand and define policy or process interventions. The Division of Clinical Informatics is a research division of the Department of Medicine at the Beth Israel Deaconess Medical Center and has been at the forefront of computers in healthcare for 40 years. This elective is designed to give students hands-on experience with the design, implementation, governance, and evolution of electronic health records and other real-world clinical computing systems. Enrollment is subject to the pre-approval of the course director, Dr. Yuri Quintana, yquintan@bidmc.harvard.edu.

Description: This elective will introduce students to the field of clinical informatics, a field which has recently been recognized as a medical subspecialty by the American Board of Preventive Medicine. Students will learn about the core content of clinical informatics, current challenges, and opportunities for future work through a combination of practicum, seminars and didactic sessions, independent reading, presentations, and written assignments. Partners HealthCare is a recognized leader in the field of clinical informatics and an early adopter of health IT solutions, with several labs and divisions devoted to clinical informatics and health IT work distributed among various affiliated institutions, including Brigham and Women's Hospital and Massachusetts General Hospital. Partners is currently in the process of a multi-disciplinary, organization-wide electronic healthcare system implementation, which will touch many aspects of clinical and non-clinical workflow and process re-design. Students will be matched with one or more of our over 50 informatics faculty members based on personal areas of interests, and will have the opportunity to participate in informatics operational initiatives and/or research projects during the course of the elective.

Description: Systemic lupus is an ideal disease process to afford medical students the opportunities to gain an appreciation for systemic disease and to learn within a multidisciplinary healthcare team. In this one-month course, medical students will engage in a wide breadth of activities, including five half-days of ambulatory patient care per week in rheumatology, dermatology, and multidisciplinary clinics, predominantly at Brigham and Women's Hospital with some additional time at Children's Hospital. Three half-days per week will be available to learn about lupus in the inpatient setting. Finally, two half-days per week will be reserved for scholarly pursuits. This dedicated time to scholarly activity is flexible in that it can be devoted to learning from a certain faculty member, acquiring additional clinical experiences in a related field, learning how clinical trials are conducted in the healthcare setting, working on a short-term clinical or translational research project or case write-up, or initiating work on a longer-term scholarly project with the assistance of faculty mentors. In this way, students' experiences in this course should reflect their own unique and individual interests. To allow students to gain an appreciation for how systemic disease affects an individual patient, rotators will have the opportunity to develop a unique connection with one patient with systemic lupus. The medical student will be included in this patient's visits with multiple specialists, including visits with rheumatology, dermatology, nephrology, and neurology, amongst others, gaining an unparalleled perspective on their many disease manifestations. Medical students will have the opportunity to attend weekly Rheumatology Grand Rounds, Clinic Consult Rounds, Rheumatology Journal Club, Lupus Case Conferences, and a Joint BWH-DFCI-JDC Immunology Seminar. There will be no call taken by the medical student, and their schedule will be arranged on a Monday through Friday basis.

Description: Students may add themselves to the waiting list for this course during add/drop periods but not during lottery periods. Prior approval required, please email Dr. Huang; ckhuang@partners.org, forward approval to registrar@hms.harvard.edu. Emergency Ultrasound is increasingly becoming an indispensable clinical tool to every emergency medicine physician. The Emergency Ultrasound elective is a four week advanced elective that introduces students to the basics of emergency ultrasound. Students will be learn the essentials of emergency ultrasound, including types of studies performed, indications and limitations of these studies, the evidence behind clinician-performed ultrasonography, minimal criteria of imaging, and incorporation of emergency ultrasound into clinical practice, and spend a significant amount of time practicing and perfecting their ultrasound scanning abilities. Learning modalities include narrated didactic lectures, scan review, independent reading, computer-based didactic modules, hands-on scanning of emergency patients, scanning in the simulation lab, an independent project, and reading of selected literature. Location: This elective represents a collaborative effort amongst all of the Harvard-affiliated hospitals, including Massachusetts General Hospital, Brigham and Women's Hospital, Beth Israel Deaconess, Mount Auburn Hospital, and Children's Hospital. Residents will rotate at different sites throughout the rotation for expanded exposure to different patients and faculty. Exact schedules will vary from rotation to rotation and will be dependent on sites abilities to accommodate rotators. Student preferences will be considered but cannot be guaranteed.

Description: Students may add themselves to the waiting list for this course during add/drop periods but not during lottery periods. Prior approval required, please email Dr. Huang; ckhuang@partners.org, forward approval to registrar@hms.harvard.edu. Point-of Care Ultrasound (POCUS) is an indispensable clinical tool to every Emergency Medicine physician. The Emergency Ultrasound elective is a four-week advanced elective that introduces students to the basics of POCUS. Students will learn the essentials of POCUS including types of studies performed, indications and limitations of these studies, the evidence behind clinician-performed ultrasonography, minimal criteria of imaging, and incorporation of POCUS into clinical practice. Students will spend a significant amount of time at the bedside practicing and perfecting their ultrasound scanning abilities. Ultrasound guided procedures will be taught however this elective is primarily diagnostic not procedural. Learning modalities include narrated didactic lectures, scan/image review, independent reading, computer-based didactic modules, hands-on scanning of emergency patients, scanning in the simulation lab, and a scholarly presentation. Exposure to ongoing Emergency Ultrasound fellowship research projects is offered to students however this is not a requirement of the elective. This advanced elective mirrors the MGB Harvard Affiliated Emergency Medicine Residency PGY-1 required ultrasound rotation.

Description: This course is designed to give students a comprehensive experience in Emergency Medicine. The student will evaluate and manage patients that present to the ER under the supervision of the attending physician. They will be responsible for taking histories, performing physical examinations, ordering laboratory and radiology studies, and implementing treatment plans as guided by the attending physician. Students will have the opportunity to evaluate a wide variety of patients from lower acuity patients, complicated medical and surgical patients, to experience treating more critically ill patients. The students will also be able to observe and perform simple procedures such as laceration repairs and incision and drainage of abscesses as well as more advanced procedures such as arterial blood gas, lumbar puncture and central line insertion. The majority of teaching will be bedside teaching by the attending physician.

Description: This course is designed to provide exposure to Emergency Medicine under the supervision of full-time faculty. Emphasis will be placed on the use of an Emergency Medicine approach to patient care, with attention directed towards the recognition and management of life-threatening problems. Students will function as Emergency Medicine subinterns and will be expected to develop the ability to identify acutely ill patients and respond quickly and appropriately to their needs. Development of technical and procedural skills will be encouraged, including airway management, wound care, suturing, lumbar puncture, fracture and dislocation care, abscess incision and drainage, nasogastric intubation, arthrocentesis, slit lamp exam, femoral venipuncture, and arterial puncture. This course will also include lectures from the BIDMC Harvard Affiliated Emergency Medicine Residency, divisional lectures, medic rounds, weekly presentations, simulation sessions and case conferences. Prehospital care experience will be provided through local ambulance services. The option to work with nurses to learn such skills as I.V. placement, catheter placement, patient triage (and others) will also be offered. During the baseball season, students may participate in providing medical control and first aid at Fenway Park. Students will also learn about the use of ultrasound in the emergency department.

Description:

Description: The Mass General Brigham Emergency Medicine clerkship exposes students to the fundamentals of emergency care, emphasizing the opportunity to perform initial assessments and develop diagnostic and therapeutic plans for patients with undifferentiated disease. Students will work clinically in both the Massachusetts General Hospital and Brigham and Women’s Hospital emergency departments, managing the full spectrum of disease acuity from minor illnesses to major trauma. Students are encouraged to embrace the opportunity for autonomy in patient care and will be supervised by senior residents and attending emergency physicians. The clinical experience will be complemented by a longitudinal series of workshops and simulation training throughout the clerkship, including airway management and point-of-care ultrasound. Students interested in more details regarding the course may contact the clerkship directors directly.

Description: This course is designed for the student eager to improve one’s clinical skill and knowledge while working as a key team member in advanced primary care practices, one at the MGH and the other at an affiliated community health center. A secondary objective is development of advocacy skills for primary care reform. Three full days per week are devoted to clinical work in the evaluation and management of adults in the patient-centered medical home practices of two principal course faculty. One-on-one precepting is provided to enable personalized in-depth learning and mentoring. Two days per week are reserved for directed reading, patient follow-up, and researching and writing an op-ed (for possible submission) focusing on reform of primary care. Evaluation is based on growth in clinical knowledge, judgment, and skill and emerging advocacy competencies. Students interested in honing their clinical skills while beginning to participate in health system reform are encouraged to take this elective.

Description: Students may add themselves to the waiting list for this course during add/drop periods but not during lottery periods. For approval, contact Linda Fowler at (617) 665-1801. The Primary Care Elective ME536M.6 is a 4 week rotation of Primary Care Internal Medicine. The student spends time in 1-2 clinics affiliated with Cambridge Health Alliance working with 1-3 faculty members, based on student interest and faculty availability. Each morning begins with the internal medicine resident ambulatory case conference at Cambridge Hospital, and Thursday mornings are dedicated to ambulatory didactics. The course objective is for the student to gain competence in diagnosis and management of common problems seen in Primary Care Internal Medicine, including screening and prevention.

Description: The student will serve as a sub-intern in the Medical Intensive Care Unit at BIDMC, functioning as an integral part of the intensive care team with direct responsibility for patient care. The student will be involved in the primary evaluation and management of patients, and will be under the direct supervision of the medical resident, the critical care fellow, and the attending physician (one of the full-time staff physicians of the Pulmonary and Critical Care Division). The student, as the primary physician, will admit up to one patient every other day, and will be expected to be on call in the unit every fourth night. The student will be responsible for the initial work-up and the management of the patient, including performing bedside procedure, and will manage the patient for the duration of the patient's ICU care. All patients will also be evaluated by the medical resident, and will be presented by the student to the attending physician. The student will participate in daily work rounds and attending rounds in the intensive care unit.

Description: The student will function as an integral member of the ICU team in a busy 20-bed mixed medical, surgical, and cardiac ICU where at least half the patients are on the medical service. The student's primary role will be caring for medical ICU patients under the supervision of the medical resident and the Pulmonary and Critical Care attending. There is also opportunity to participate in the care of critically ill patients on the surgical and cardiothoracic surgical services. The unique setting of Mount Auburn Hospital allows for the diagnosis and management of common and uncommon life-threatening illness presenting from the community. Management of respiratory failure, sepsis, shock, cardiac injury and stroke will be emphasized. The student will stay for a longer call, and admit one patient every third day with an intern and resident team. The student will have one day off per week. In addition to participating in patient care, the student will attend a regular ICU didactic lecture series and medical grand rounds, and will also present a short talk at the end of the rotation.

Description: The student will serve as a sub-intern in the Medical Intensive Care Unit at BIDMC, functioning as an integral part of the intensive care team with direct responsibility for patient care. The student will be involved in the primary evaluation and management of patients, and will be under the direct supervision of the medical resident, the critical care fellow, and the attending physician (one of the full-time staff physicians of the Pulmonary and Critical Care Division). The student, as the primary physician, will admit up to one patient every other day, and will be expected to be on call in the unit every fourth night. The student will be responsible for the initial work-up and the management of the patient, including performing bedside procedure, and will manage the patient for the duration of the patient's ICU care. All patients will also be evaluated by the medical resident, and will be presented by the student to the attending physician. The student will participate in daily work rounds and attending rounds in the intensive care unit.

Description: In this clerkship students will be introduced to the evaluation and management of patients in a tertiary care center Medical Intensive Care Unit. The student will be part of a team comprised of 3 interns, 3 residents, a critical care fellow and an attending Pulmonary and Critical Care physician. Students will be responsible for evaluation of patients on admission and follow these critically ill patients throughout their ICU stay. With assistance from the intern and resident, the student will formulate and present a daily plan of care. The student will take call every fourth night with an intern and resident. During the rotation, the student will gain an understanding of the pathophysiology and management of patients with a variety of critical illneses including respiratory failure, hypotension, sepsis, gastrointestinal bleeding and renal failure. As an integral member of the team, the student will also interact with varied consultative services and participate in regular family meetings. The student will gain exposure to a variety of procedures performed in the intensive care unit including placement of central venous access, arterial access, thoracentesis, paracentesis and bronchoscopy. Activities will also include participation in daily morning didactic teaching session as well as regularly scheduled MICU conferences (Ethics Rounds, Journal Club, Morbidity and Mortality Conference and a shared MICU/SICU conference). During the last week of the rotation, the student will be expected to lead a teaching session on a critical care topic of their choice.

Description: The rotation takes place in a very busy 18 bed intensive care unit in a tertiary care hospital. The student will be exposed to critically ill patients with a broad range of medical illnesses including sepsis, respiratory failure, and heart failure. In addition there is some exposure to critically ill surgical trauma, and neurology patients. The student will be a working member of the intensive care unit. He/she will be teamed up with a second year resident, and take call with the resident every fourth night. The student will admit 1 patient each call night, participate in all procedures where appropriate, and present their patients on daily rounds (7 days a week, 3 hrs a day). The student will be expected to attend the morning critical care lecture series, which covers important aspects of critical care medicine and evidence-based best practice. This series is updated and repeated monthly. The student is also expected to engage in tutorial work and literature reviews with the residents, fellows and attending intensivists.

Description: This course is intended to provide advanced medical students with an exposure to the care of patients with Down syndrome across the age spectrum. People with Down syndrome typically have a number of health needs that arise from their chromosomal condition, which alters the screening tests and milestones that must be considered in the course of a regular clinic visit. They can also present with an array of developmental and pathological issues that require special attention. A global and holistic approach to their care demands that the health practitioner involve family members, school and/or work peers, social networks, expert medical consultants, and allied health professionals in the shared goal of supporting them to achieve their full potential and enjoy the best quality of life. The student will attend clinic sessions for newborns/toddlers, children, and adolescents at Boston Children's Hospital ; infants, children, young adults, and adults at the Massachusetts General Hospital Down Syndrome Program; older adults at the Beth Israel Deaconess Medical Center and the Mclean Hospital, Aging and Developmental Disabilities Clinic In addition, observerships will be secured at specialty clinics that address medical issues more common in Down syndrome (e.g., obstructive sleep apnea, celiac disease, Alzheimer's disease, cardiology), and home visits will be scheduled with participating host families. The student will be provided with a Reader that includes best practices in the care of people with Down syndrome and will attend regularly scheduled conferences at the various clinical sites where the rotation will be held. The rotation is entirely outpatient-based, although the student will be welcome in attending an occasional inpatient consultation were it to arise during the course of the rotation. There is no overnight or weekend call. Participation in ongoing clinical research activities is available but not required. Evaluation will be based on clinical performance (70%) and a final project (30%).

Description: Students may add themselves to the waiting list for this course during add/drop periods but not during lottery periods. Prior approval required, please email Dr. Spitzer; spitzer.thomas@mgh.harvard.edu , forward approval to registrar@hms.harvard.edu.The student will see patients with hematologic malignancies who are undergoing active treatment including but not limited to bone marrow transplantation in both the inpatient and outpatient settings. They will see and examine the patients, then discuss their impression and proposed plan of management with a supervising attending physician from the BMT/Leukemia Unit. The student will write histories and physical exams for new patients and progress notes for other patients, which will be reviewed by the attending physician. The student will also attend 2 multi-disciplinary team meetings per week at which time their patients will be discussed, and other lectures related to BMT and hematologic malignancies. The principles of chemotherapy for leukemia and related hematologic malignancies and the central immunologic principles of bone marrow transplantation will be discussed with the student, and written materials regarding these topics will be provided to the student. Formal feedback will be provided to the student at the end of the rotation.

Description: The course will cover common primary care problems in women, including contraception, office gynecology, endocrine disorders, eating disorders, issues around menopause, breast cancer screening, medical problems in pregnancy, and common dermatoses seen in women. Students will see patients under the close supervision of the preceptor in our offices at Women's Health Associates. They also have an opportunity to rotate through the breast clinic, colposcopy clinic, and other specialties of their particular interest. The student will also learn how to incorporate the history and physical examination into a concise and comprehensive note that reflects the visit. Please contact Dr. Elizabeth Roth for approval to enroll, eroth@mgh.harvard.edu.

Description: Physical Medicine and Rehabilitation (PM&R) physicians provide care for people with a range of conditions associated with disability. This four-week introductory clerkship provides exposure to the breadth of PM&R, highlighting PM&R's patient-centered approach, focus on optimizing function and quality of life, and interprofessional collaborative practice. The first two weeks are spent on an inpatient rehabilitation service (typically spinal cord injury/disease, brain injury, stroke, amputation, or burn). The following two weeks are spent in outpatient clinics (typically spine care, musculoskeletal medicine, or sports medicine). On the inpatient service, students carry 3-4 patients, whom they accompany through all aspects of rehabilitation, including medical evaluation and management, physical, occupational, speech, and recreational therapies, evaluation/fitting for adaptive equipment, and planning for life following discharge from the rehabilitation setting. In outpatient clinics, students participate in guided patient evaluations and office-based neuromusculoskeletal procedures. Students participate in interactive didactics provided by residents and attendings throughout the clerkship. Students learn rehabilitation-focused history-taking, neuromusculoskeletal physical examination skills, condition-specific management, diagnosis and management of secondary complications of immobility, and provision of high quality care for patients with disabilities and their families. Students are expected to attend all resident and medical student didactic sessions and assigned clinical experiences. Students are also expected to be respectful of all patients and staff and to be committed to learning about disability and its implications. There is one required 15-minute oral case presentation based on a patient closely followed during the inpatient experience, and one required reflection on interprofessional rehabilitation care. There are no weekend responsibilities and there is no call.

Description: The sleep medicine elective is a flexibly structured experience that takes into account the background training of the student and their individual goals. The structure has an inner core, an outer core, and opportunities for electives. The inner core is the adult and pediatric sleep medicine clinics at the Beth Israel Deaconess Medical Center in Boston (primarily), supplemented by the Brigham and Women's hospital-affiliated Sleep health Centers sleep clinic (Brighton) and the Children's Hospital (Boston). The outer core consists of an exposure to sleep laboratory technology at the American Academy of Sleep Medicine accredited clinical sleep laboratories affiliated with the Beth Israel Deaconess Medical Center. This includes direct teaching by the course director during physician-attended laboratory nights that also form part of the curriculum for the ACGME-accredited sleep medicine fellowship. The student will be exposed to standard and innovative approaches to recording physiological data and management of sleep-breathing disorders. Electives (one or two half days a week) are structured based on the interest of the candidate - dental sleep medicine, maxillofacial surgery, circadian lab, basic sleep research, functional brain imaging, advanced non-linear signal analysis, upper airway pathophysiology, hemodynamic approaches to sleep research, and the business aspects of sleep medicine. At least one full day is dedicated reading time (no clinical activities). There are two 2-hour lectures per week that are student-specific. Learning activities thus span across attending sleep clinic, sleep laboratory, conferences (2/week), and targeted reading. Students interact closely with faculty and Fellows in the training program, and may if they choose shadow a Fellow of Faculty to appreciate "a day in the life of".

Description: Obesity is a chronic multifactorial disease expected to affect 50% US adults by 2030, disproportionately affecting low-income and minority populations. It is associated with high morbidity and mortality with annual cost of $210 billion in the US. Yet obesity has not been addressed adequately. For example, only2% of eligible patients receive medical treatment for obesity compared to 86%for diabetes. With the increasing burden of obesity, it is imperative that medical students have adequate knowledge and clinical experience in evidence-based obesity prevention and management approaches. This is a one-month immersive clinical clerkship within primary care to improve students’ knowledge and competencies of lifestyle assessment and counseling for the prevention and management of obesity. The course is designed to be a highly engaging and multidisciplinary active learning experience for students. The clerkship will include collaborative team-based approaches involving experienced physician, physical therapist, nutritionist and behavioral therapist along with regular interactive didactics, journal clubs, and case-based learning. Students will have the opportunity to participate in a Bariatric surgery clinic as well as work with social workers and a local foodbank to address related social determinants of health, such as food insecurity. The elective will utilize innovative pedagogical techniques to equip students with hands-on experiences and skills to apply evidence-based tools, such as motivational interviewing, stages of change model, mindfulness and 5 As approaches. Students will have unique opportunities to facilitate and lead weight management group sessions, in addition to individual and telehealth visits. Students will gain practical skills to provide culturally sensitive patient-centered approaches that would empower and support patient self-efficacy. Students will also learn in-depth about medical and surgical management options of obesity as well as weight bias and stigma issues. Students will have the option to get involved in obesity-related mentored research or quality improvement projects.

Description: Students may add themselves to the waiting list for this course during add/drop periods but not during lottery periods. Prior approval required, please email Dr. Matthew Tobey, matthew.tobey@mgh.harvard.edu, forward approval to registrar@hms.harvard.edu. Rural American Indian and Alaska Native (AI/AN) communities face substantial health challenges. In South Dakota, Lakota tribes have built remarkable communities with growing, energetic efforts to renew traditional values in a modern context. Nevertheless, four such counties experience the lowest life expectancy at birth in the United States, with high mortality rates across major causes. This 4-week rotation offers clinical and community-based experiences for medical students who seek to learn from and with members of the Rosebud Sioux Tribe in Rosebud, South Dakota. Clinical experiences are based at the Indian Health Service (IHS) facility. Students are expected to display a high degree of professionalism, integrity and cultural humility throughout the experience. Clinical opportunities include (at least 4 half-days per week): -Primarily: outpatient and inpatient care at the IHS facility in Rosebud, SD, supervised by MGH primary care faculty -Community-based clinical care including home visits, health outreach activities, and care at the tribal jail -Depending on interest, supplemental clinical experiences in women's health, pediatrics, and emergency medicine Community-based opportunities, each subject to availability: -Health education with 1) individuals incarcerated at the tribal jail, 2) residents at the methamphetamine treatment program, and 3) the Rosebud community health worker team -Meetings or collaboration with tribal health programs and non-profit organizations operating in Rosebud -Miscellaneous community outreach, e.g. educating high school students about health careers -In discussion with the elective director, students may pursue community-based activities matching career interest All students are encouraged to participate in the full 4-week elective. Alternate visit plans may be possible in discussion with the elective director, but will not count toward completion of this elective.

Description: Students participating in this one-month opportunity will perform a “deep-dive” scientific investigation of a complex case that falls outside traditional clinical areas. Activities include interview of the patient and their family/contacts, discussion with the clinical teams, and reviews of the case with experts in several fields. Students will demonstrate the ability to independently review and critically assess relevant literature; develop innovative approaches to address the clinical and basic science questions posed by the case; generate hypotheses; prepare and execute a clear case presentation; and develop an experimental plan with the goal of gaining mechanistic insights into the underlying disease process. Opportunities for scholarly output stemming from the rotation including case write-ups and abstracts as well as follow up scientific experiments are strongly encouraged. Students will be evaluated on their final presentation as well as their engagement with the MGH Pathways patients, expert faculty involved in the case, and the clinical team. This is an in-person rotation.

Description: Humans and other animals share vulnerability to many of the same pathologies but historically, physicians-in-training have had minimal exposure to the field of veterinary medicine. The zoonotic origin of COVID-19 has intensified calls for greater communication between veterinary and human medicine and for strengthened physician knowledge of animal health. This one-month rotation offers in-depth exposure to clinical, scientific, ethical and other challenges in veterinary medicine. It presents medical students with a framework for understanding how connections between human, animal and environmental health can be integrated into human medical practice, investigation and education. COURSE COMPONENTS Clinical Activities and Symposia A. CLINICAL ACTIVITIES In primary care and specialty human and veterinary clinical settings (cardiovascular medicine, oncology, endocrinology, behavioral medicine, ophthalmology, orthopedic and sports medicine and primary care) students will be exposed to Clinical pathology (somatic and behavioral); Clinical assessment, diagnosis, treatment planning, follow-up and prevention in clinical care; A range of clinical procedures (diagnostic and therapeutic); Clinical dilemmas and problem solving in human and veterinary medicine. B. SYMPOSIA In lectures and discussions students will gain a greater an understanding of: Comparative genomics at the interface of human and veterinary medicine; Natural animal models; The evolutionary basis for shared disease vulnerability; Ethical and moral challenges in veterinary medicine; Emerging legal issues at the intersection of human and animal health

Description: This eight week course is designed to help students refresh clinical skills after a hiatus. This course is mandatory for returning MD-PhD students and may also be useful for MD students who are beginning their transition back to full-time clinical clerkships following a protracted period of non-clinical pursuits. This course is not intended for students who have taken off for a year or less. There are three aspects to this course: 1. Didactic and discussion seminars, with each day 8am-5pm EST: Module 1: Jan. 11 & 12 A re-introduction to core clinical topics and tools in medicine. Module 2: Mar. 1 & 2 Case-based approaches to common clinical problems. 2. Rounding with a Medical Service Team at BWH or MGH: Students will participate in Attending Rounds with a specific Medical Service Team at BWH or MGH three times during the course. This experience will expose the student to inpatient clinical management. 3. Presenting a patient to a preceptor: Seven times during the course, students will be assigned a patient from that service to "work-up.” Each student will then meet with his/her clinical preceptor to present and discuss the patient they have evaluated.

Description: This Advanced Neurology clerkship offers the opportunity to learn clinical Neurology beyond the basic, elementary level. Students work with more highly experienced neurologists on the consultation and ward services at BIDMC and may serve in a subinternship-type role, if desired and chosen. The student evaluates patients on those services, with supervision by Neurology residents and attending physicians. There is also the opportunity to see patients in the many busy General Neurology and subspecialty clinics. Students attend many clinical conferences and lectures, and there are teaching sessions solely for students. Beyond the General Neurology ward service, there are specialty units covering Epilepsy, Stroke, and an Intensive Care Unit. Students may modify the clerkship to suit individual interests within Neurology by electing to work in such areas as the Emergency room, several subspecialty Neurology clinics, and in the Behavioral Neurology unit. Call is every 4th night (with some flexibility).

Description: This Advanced Neurology clerkship offers the opportunity to learn clinical Neurology beyond the basic, elementary level. Students work with more highly experienced neurologists on the consultation and ward services at BIDMC and may serve in a subinternship-type role, if desired and chosen. The student evaluates patients on those services, with supervision by Neurology residents and attending physicians. There is also the opportunity to see patients in the many busy General Neurology and subspecialty clinics. Students attend many clinical conferences and lectures, and there are teaching sessions solely for students. Beyond the General Neurology ward service, there are specialty units covering Epilepsy, Stroke, and an Intensive Care Unit. Students may modify the clerkship to suit individual interests within Neurology by electing to work in such areas as the Emergency room, several subspecialty Neurology clinics, and in the Behavioral Neurology unit. Call is every 4th night (with some flexibility).

Description: This course offers an exposure, under the direct supervision of instructors, to a wide variety of neurologic problems. There is ample opportunity for practice in history-taking and neurological examination. The goal of the course is for students to gain increased confidence in neurologic examination and in understanding of the neurologic patient. Opportunity can be provided, at the student's request, for extended exposure to a particular area or for participation in a research project. The student will be involved in lectures, clinics, and conferences as well. The call schedule is every forth night.

Description: This course offers an exposure, under the direct supervision of instructors, to a wide variety of neurologic problems. There is ample opportunity for practice in history-taking and neurological examination. The goal of the course is for students to gain increased confidence in neurologic examination and in understanding of the neurologic patient. Opportunity can be provided, at the student's request, for extended exposure to a particular area or for participation in a research project. The student will be involved in lectures, clinics, and conferences as well. The call schedule is every forth night.

Description: The Neurology Consultation Rotation at the Massachusetts General Hospital is available to students with prior exposure to Internal Medicine and Neurology. The students spend two weeks each on the general consult service and the stroke/intensive care unit consult service. The student works closely with a senior resident and an attending physician in the evaluation and management of patients with neurologic complications of systemic illness, and those with cerbrovascular disease. The student consults on new patients on the medical services, discusses them with the consultation team, and follows the clinical course. In addition, advanced clerkship students contribute to discussion in brain cutting conferences, and attend the clerkship director's weekly tutorial. Students are also assigned to a weekly outpatient clinic session with general or subspecialty attendings, and these clinics can be tailored to the student's particular interest. As their schedule permits, advanced neurology students attend tutorials by our residents and fellows on a variety of neuroimaging and clinical topics in neurology. A clinical examination is offered in mid-rotation which provides direct one-on-one clinical teaching for the student, and an opportunity for the student to assess his or her own performance. The advanced student also takes the shelf exam on the final Friday of the rotation. This rotation is particularly well suited to students who wish to explore the discipline of neurology and clinical neuroscience in greater depth.

Description: The course consists of participation in ongoing examinations of surgical and autopsy neuropathology specimens, attendance at teaching conferences and case discussions and individual study of the pathologic-anatomical aspects of diseases of the human nervous system, from current cases and rich historical archives. The diagnostic neuropathology service of MGH includes a large volume of neoplasms (mostly primary brain tumors), nerve and muscle diseases, neurologic diseases and neurodegenerative disorders. Students are active participants in all aspects of the clinical service. Particular exposure to molecular neurooncology or neurodegenerative diseases may be arranged. Please contact Dr. Matthew Frosch, MFROSCH@mgh.harvard.edu, for approval to enroll and opportunity to shape the experience to align with your interests.

Description: This clerkship is designed to give students an in-depth experience in child neurology. During the 4 week block, the clerk will primarily work directly with the pediatric neurology inpatient consult service. This team typically consists of one pediatric neurology resident, one adult neurology resident and the neurology attending on service. The consult team sees patients in the pediatric wards, neonatal intensive care unit, newborn nursery, pediatric intensive care unit and emergency department, affording the clerk exposure to a variety of levels of acuity and the breadth of disease in child neurology. Scheduled educational activities include the Monday morning outpatient conference, Tuesday morning neuroradiology rounds, Tuesday afternoon case conference, Thursday morning Neurology Grand Rounds, Thursday afternoon chief rounds and Friday core neurology noon conference. Other elective educational opportunities include Neurology noon conferences (daily), pediatric and adult epilepsy surgery conferences, and Friday morning neuropathology conference. A weekly schedule of events and topics is updated by the pediatric neurology chief residents. Clerks will spend time in the general neurology resident clinic weekly. Based on the student�s interest, there are opportunities to attend clinic in several subspecialties, including pediatric multiple sclerosis, epilepsy, leukodystrophies, neuromuscular disorders, tuberous sclerosis, neurogenetics, Angelman syndrome, mitochondrial disorders, learning disorders and neurofibromatosis. The clerk will meet once weekly with the course director to review his or her experience on the rotation and provide feedback. These meetings are not structured and can be used to review a case, the pediatric neurological exam, discuss a written history and physical examination or for any other purpose desired by the rotating clerk.

Description: This clerkship is designed to give students an in-depth experience in child neurology. During the 4 week block, the clerk will primarily work directly with the pediatric neurology inpatient consult service. This team typically c

Description: This advanced clerkship is structured to expose the clerk to a wide variety of experiences in child neurology, and can be tailored to meet interests or needs of individual clerks. Clerks will spend week-long rotations on four of the following: inpatient neurology service with step-up unit, ward and emergency department consult service, critical care neurology service (covering 5 intensive care units in Longwood Medical area), epilepsy inpatient service, and outpatient clinics. There are daily seminars/lectures/formal teaching rounds which the clerk is expected to attend; these include a core curriculum in child neurology, a multicultural ethics curriculum, a neurophysiology curriculum, and a neuropharmacology curriculum. Chief of service rounds, a more academic teaching conference, is held weekly, as are neuroradiology rounds, neuropathology rounds, Longwood Area Neurology Grand Rounds, and senior resident rounds. The clerk is not required to take night call, but may elect to do so by arrangement with the senior resident to broaden their experience of the field. A case presentation or talk on a particular topic of interest is expected during the clerkship.

Description: This advanced clerkship is structured to expose the clerk to a wide variety of experiences in child neurology, and can be tailored to meet interests or needs of individual clerks. Clerks will spend week-long rotations on four of the following: inpatient neurology service with step-up unit, ward and emergency department consult service, critical care neurology service (covering 5 intensive care units in Longwood Medical area), epilepsy inpatient service, and outpatient clinics. There are daily seminars/lectures/formal teaching rounds which the clerk is expected to attend; these include a core curriculum in child neurology, a multicultural ethics curriculum, a neurophysiology curriculum, and a neuropharmacology curriculum. Chief of service rounds, a more academic teaching conference, is held weekly, as are neuroradiology rounds, neuropathology rounds, Longwood Area Neurology Grand Rounds, and senior resident rounds. The clerk is not required to take night call, but may elect to do so by arrangement with the senior resident to broaden their experience of the field. A case presentation or talk on a particular topic of interest is expected during the clerkship.

Description: The student will participate as an acting intern on the night team of the Obstetrical Service. They will admit patients on Labor and Delivery, assess labor, assess maternal and fetal status, perform pelvic examinations, perform initial screening ultrasound examinations, fully participate and perform deliveries of uncomplicated patients under supervision, and participate in all rounds and conferences of the service. Selected interesting high risk patients may be followed as well. The sub-intern will also participate actively in any surgical procedures on his/her patients. Sub-interns will care for patients from all admitting physicians (faculty group, resident clinic, Harvard Vanguard, and private practice). The sub-intern will be on night shift Monday - Thursday. The student will also have the opportunity to complete a quality improvement or medical education project during the course and will have Friday - Sunday to work on it. The sub-intern will report directly to the chief resident on Labor and Delivery and ultimately to the attending physician for each patient treated. Students may attend MFM or ultrasound ambulatory sessions by arrangement. The student will have the opportunity to present their project at Perinatal conference, morning report, or other venue if desired.

Description: This course is offered to provide students greater exposure to the health issues of underserved urban women and their care at community health centers. BIDMC is affiliated with several of Boston�s community health centers: South Cove Community Health Center in Chinatown and North Quincy, Dimock Health Center in Roxbury, Bowdoin Street Health Center in Dorchester, Fenway Health Center, and BIDMC Chelsea. Students may rotate through several or all sites. Students will evaluate patients in the outpatient clinical setting and will be supervised primarily by attending faculty. While most of the rotation will be in the health centers, students also will longitudinally follow several patients into the hospital setting. Night call is optional. Student evaluation will be based on clinical performance, completion of a community health center project, as well as a final paper/oral presentation on a topic of interest. Spanish or Chinese language skills are a plus.

Description: This course is structured to provide students with adequate clinical exposure to the evaluation and management of women with disorders of the pelvic floor. Students will work directly with a Urogynecologist in both inpatient/outpatient settings at BIDMC. They will learn focused history-taking skills, thorough pelvic examination and participate in all diagnostic testing and procedures performed in the office. Daily teaching will occur during clinic sessions and cover relevant topics such as: pelvic anatomy, pelvic organ prolapse, urinary & fecal incontinence, urinary tract infections, female sexual health and others. Students will also assist in all surgical cases where the above concepts will be reinforced. They will learn about postoperative management and assessment of potential surgical complications during daily rounds in the hospital with the gynecology team. The division of Urogynecology at BIDMC encourages but does not require students to participate in ongoing research projects.

Description: This course is primarily a clinical experience, focused on providing the student with a fund of knowledge in the diagnosis, natural history, and management of gynecologic tumors. The multidisciplinary approach to cancer management will be emphasized. Students will attend weekly colposcopy clinics. Students will also see patients with attendings during outpatient sessions. Each student will be assigned several patients to follow in the hospital. The student will perform the preoperative evaluation, attend surgery, and follow the patient postoperatively. Management will be discussed with the faculty at daily beside teaching rounds. The students will present their patients at a weekly multidisciplinary gynecologic tumor conference and be expected to provide a discussion of management options. During the four weeks, the student will be expected to prepare a literature review relevant to a case on the service. The topic will be selected together with the course director and will emphasize the multimodality approach to cancer management. The student will prepare a oral report of his/her literature review.

Description: The course is designed to provide a sound background, relevant to neoplastic disease in general, in the early detection, diagnosis and management of gynecologic cancer. Weekly clinics will be devoted to early detection of cervical neoplasia and the correlation of clinical cytologic and histologic findings. Students will have an opportunity to actively participate in surgical, radiotherapeutic and chemotherapeutic management of individual patients. Investigative aspects of anti-cancer pharmacology and immunology will be considered.

Description: -The student will function as a sub intern on the gyn oncology service at MGH during the 4 week block. This involves the following: --Rounding with the house staff and following individually assigned patients --Scrubbing in surgical cases every day --Spending one session per week in the outpatient gyn oncology practice --Spending two sessions with the gyn pathologist in intensive pathology review -The student will attend all the weekly gyn oncology conferences which are: --Monday - Surgical Teaching conference 7 am,; --Monday - Gynecologic Oncology Didactic Lecture 5:30pm --Tuesday - Combined Gyn Benign Gyn Oncology Case review --Wednesday 7 am Gyn Oncology Tumor Board --Thursday OB GYN didactics 7:30-8:30 am --Thursday OB GYN Grand Rounds 8:30 am --Friday Gyn Oncology Chemotherapy Meeting

Description: The course is designed to acquaint students with current concepts of infertility and management of interrelated reproductive endocrine problems and to familiarize them with laboratory techniques used in evaluating patients with such problems. Students will observe the workup and care of fertility and endocrinology patients as well as patients with recurrent miscarriage. There is extensive exposure to surgical management of such patients, including mininmally invasive surgery and robotic cases. They will attend conferences and seminars related to these subjects. Students will also have exposure to laboratory techniques used in the work up and treatment of such patients. Exposure to assisted reproductive technologies in clinics and laboratories, and pediatric gynecology and endocrinology is also available and encouraged.

Description: The student will be assigned primarily to two attending physicians at Boston IVF Centers around Boston (transportation necessary, public transportation is not sufficient). The student will see 1-2 new patients each day in coordination with the attending, present findings in oral and written form to that attending and develop an evaluation plan to be discussed with the attending. The student will be expected to perform the physical exam on this patient under the supervision of the attending. Additional clinical experience will include time in the IVF OR suite observing IVF procedures and the IVF laboratory, observation in the andrology laboratory to learn the basics of performing a semen analysis and sperm preparation for intrauterine insemination, instruction in the technique of hysterosalpingograms and sonohysteorgrams and observation of follicular, prenatal and gynecologic ultrasounds. The student will spend time in an out patient surgicenter observing reproductive surgery, will be expected to attend all departmental and divisional conferences and will be expected to prepare a brief presentation for weekly discussion with the attending to whom he/she is assigned based on a patient seen in the office.

Description: Students may add themselves to the waiting list for this course during add/drop periods but not during lottery periods. Please contact Dr. Deborah Bartz, dbartz@partners.org, for approval to enroll. This course will expose the student to the range of clinical experiences and issues related to family planning, in order to provide a comprehensive knowledge base, an opportunity for skill development, and a context for clarification of values related to family planning. Seventy percent (7-half day sessions) of the student's time will be spent in family planning and gynecology clinics where she will gain exposure to abortion and contraceptive care. This clinical training will include exposure to abortion in a hospital setting and with community-based abortion providers, as well as time spent in outpatient gyn services within a community health center (CHC). By observing the full spectrum of family planning care delivery sites from the integrated approach to primary prevention within the CHC medical home model to the tertiary care afforded to more complex cases in the hospital the student will gain appreciation of the role of family planning in the full spectrum of women's health. Across these settings, advanced instruction will be provided in patient counseling and health promotion related to reproductive decision-making. Thirty percent of the student's time (3 half day sessions) will be dedicated to didactics and research, including the 4 hours of regularly scheduled didactic time dedicated to the BWH-MGH combined ob/gyn residency and including the 2 hours of weekly seminar provided at BWH Family Planning Center. Didactic sessions will supplement the knowledge base built in prior core clerkships, covering issues rarely addressed elsewhere in the curriculum, including abortion, reproductive health policy, and domestic and global family planning concerns. Seminars will provide an opportunity for discussion and values clarification regarding family planning care provision. Students will be required to generate a substantive scholarly product on a topic of chosen interest and to prepare a presentation of this work to the family planning faculty and staff.

Description: During their rotation as subinterns on the MFM inpatient service, students actively admit and follow patients, participating in their procedures and deliveries. The students are expected to be the physicians for their panel of patients under the supervision of the MFM fellows, a third year obstetrics resident and the attending perinatologist. Formal structured teaching occurs during Wednesday didactic sessions, after morning rounds and during weekly perinatal conferences. Students are expected to take night call, but the schedule is flexible. Grading is based on evaluations from resident staff, fellows and divisional faculty.

Description: During their rotation as subinterns on the MFM inpatient service, students actively admit and follow patients, participating in their procedures and deliveries. The students are expected to be the physicians for their panel of patients under the supervision of the MFM fellows, a third year obstetrics resident and the attending perinatologist. Formal structured teaching occurs during Wednesday didactic sessions, after morning rounds and during weekly perinatal conferences. Students are expected to take night call, but the schedule is flexible. Grading is based on evaluations from resident staff, fellows and divisional faculty.

Description: The student will function as a sub intern on the maternal-fetal medicine service at MGH as part of a three person team which includes the maternal fetal medicine(MFM) specialist, the MFM fellow and the sub intern. The activities will include: Participating in daily sign out rounds of laboring and complicated postpartum patients Rounding daily on the antepartum service Labor and delivery night call 1x per week to allow participation in deliveries Scrubbing on select MFM surgical cases Spending 4 outpatient sessions doing MFM consultation with MFM attendings and seeing patients in the MFM practice Spending 2-3 outpatient sessions doing genetics, obstetric ultrasound and general obstetrics The student will also attend all weekly MFM conferences including: Perinatal Morbidity/Mortality conference, Ob/Gyn resident didactics, Ob/Gyn Grand Rounds, Ob Case Reviews, Perinatal Conference, MFM fellow didactics, Perinatal NICU rounds

Description: The student will work directly with Maternal-Fetal Medicine faculty and fellows, as well as OB-GYN residents rotating on their high-risk rotation. Students will be caring for high-risk pregnant patients, in both ambulatory and in-patient settings. The student will function as a sub-intern on the antepartum service and expected to be fully cognizant and involved in all aspects of patient care. Students will attend a daily high-risk signout where they will be presenting patients to the team, as well as attend at least two formal lectures each week. Students will spend at least one half day per week on the labor floor. Students will rotate in high-risk pregnancy clinics, participating in the care of women with various medical and surgical conditions. Students will be expected to present at a weekly perinatal conference during the last week of their rotation.

Description: The student will work directly with Maternal-Fetal Medicine faculty and fellows, as well as OB-GYN residents rotating on their high-risk rotation. Students will be caring for high-risk pregnant patients, in both ambulatory and in-patient settings. The student will function as a sub-intern on the antepartum service and expected to be fully cognizant and involved in all aspects of patient care. Students will attend a daily high-risk signout where they will be presenting patients to the team, as well as attend at least two formal lectures each week. Students will spend at least one half day per week on the labor floor. Students will rotate in high-risk pregnancy clinics, participating in the care of women with various medical and surgical conditions. Students will be expected to present at a weekly perinatal conference during the last week of their rotation.

Description: This course will expose you to all facets of Urogynecology/pelvic floor disorders focusing on outpatient evaluation and surgical and non-surgical treatment of urinary incontinence, pelvic organ prolapse, and defecatory dysfunction. Current clinical and basic science will be introduced where applicable. You will have the opportunity to participate with the Urogynecology faculty in clinic and in the operating room at BWH, Newton-Wellesley Hospital (NWH), and Faulkner Hospital (FH). There will be opportunities to observe urodynamic testing, cystoscopy, pessary care, bladder instillations, posterior tibial nerve stimulation (PTNS), and potentially pelvic floor physical therapy. Furthermore, you will have the opportunity to scrub and assist in the operating room both at BWH and FH with 2 different Urogynecologists.

Description: OBGYN Boot Camp is an interactive, practically based curriculum designed to prepare fourth year medical students for internship in Obstetrics and Gynecology by helping students develop clinical skills in a safe, structured setting. Over a four week period, students will engage with OBGYN residents, attendings, nurse practitioners, and ancillary staff in a dedicated learning environment. The curriculum will provide students with skills needed to perform common obstetric and gynecologic procedures, make sound decisions regarding peri-operative management, perform vaginal delivery, manage shoulder dystocia, manage postpartum complications, and understand surgical anatomy. Additionally, a concentration on effective communication is provided so students can easily transition to and excel in their first year of residency. Students will be expected to attend department-sponsored Journal Club, Grand Rounds, Surgery Committee, and M&M conferences.Time for independent study is also provided. Special emphasis will be given to practice-based learning, with hands-on sessions including suture and knot-tying drills, surgical and obstetric scenarios, and laparoscopy skills. Students will be expected to participate in simulation sessions in which emergency scenarios commonly encountered while on-call will be presented to the students, allowing students to practice critical thinking skills, as well as independent and team-based evaluation and management of patients. Upon completion of this course, students will have reviewed, significantly extended, and refined their knowledge of gynecologic and obstetric procedures and common clinical scenarios. Participants will gain hands-on experience with common challenges faced by OBGYN residents and will improve confidence and clinical performance in preparation for internship.

Description: This elective is a modified apprenticeship designed to introduce the student to the specialty of Ophthalmology. The goals are to expand the student's knowledge of eye diseases, refine his/her eye examination skills, and to become familiar with the activities of an ophthalmic clinician working in a busy clinical environment. Since all potential mentors inevitably have conflicts that would sometimes prevent them from being with the student, each student will be assigned to two or occasionally three mentors who, when possible, work in reasonable proximity but preferably not in the same sub-specialty of Ophthalmology. The elective student will accompany the mentors and attend the mentors clinical sessions, surgical operations, and conferences, and will be supervised primarily by the faculty members and not by trainees. Four excellent texts are loaned to each student at the beginning of the elective, and students are also directed to several outstanding web resources. Students are also issued a basic set of two hand lenses to use as their skills develop. Students attend an orientation and basic skills session on the first day of the course, and also have at least one weekly session in the Emergency Department of the Massachusetts Eye and Ear Infirmary where they are assisted in learning to use the various types of equipment used in eye examinations, including the slit-lamp biomicroscope, the applanation tonometer, and the ophthalmoscope. The student will also have the opportunity to evaluate emergency patients under close supervision. Students are required to attend the weekly Grand Rounds from 8-9AM and the Friday morning 7-9AM Resident lectures at Massachusetts Eye and Ear, as well as a weekly medical student case discussion series led by a faculty member. Other conferences (Retina Conference, Neuro-Ophthalmology Conference, Cornea Slit Lamp Conference) may be required or recommended depending on the student's mentors. When appropriate, students are invited to attend Chief Resident Rounds from 8-9AM Monday through Wednesday. Students are ordinarily expected to make a brief oral presentation to their mentors or their mentor's conference(s) at the conclusion of the elective.

Description: This elective is a modified apprenticeship designed to introduce the student to the specialty of Ophthalmology. The goals are to expand the student's knowledge of eye diseases, refine his/her eye examination skills, and to become familiar with the activities of an ophthalmic clinician working in a busy clinical environment. Since all potential mentors inevitably have conflicts that would sometimes prevent them from being with the student, each student will be assigned to two or occasionally three mentors who, when possible, work in reasonable proximity but preferably not in the same sub-specialty of Ophthalmology. The elective student will accompany the mentors and attend the mentors clinical sessions, surgical operations, and conferences, and will be supervised primarily by the faculty members and not by trainees. Four excellent texts are loaned to each student at the beginning of the elective, and students are also directed to several outstanding web resources. Students are also issued a basic set of two hand lenses to use as their skills develop. Students attend an orientation and basic skills session on the first day of the course, and also have at least one weekly session in the Emergency Department of the Massachusetts Eye and Ear Infirmary where they are assisted in learning to use the various types of equipment used in eye examinations, including the slit-lamp biomicroscope, the applanation tonometer, and the ophthalmoscope. The student will also have the opportunity to evaluate emergency patients under close supervision. Students are required to attend the weekly Grand Rounds from 8-9AM and the Friday morning 7-9AM Resident lectures at Massachusetts Eye and Ear, as well as a weekly medical student case discussion series led by a faculty member. Other conferences (Retina Conference, Neuro-Ophthalmology Conference, Cornea Slit Lamp Conference) may be required or recommended depending on the student's mentors. When appropriate, students are invited to attend Chief Resident Rounds from 8-9AM Monday through Wednesday. Students are ordinarily expected to make a brief oral presentation to their mentors or their mentor's conference(s) at the conclusion of the elective.

Description: Students may add themselves to the waiting list for this course during add/drop periods but not during lottery periods. OP 502M.8 is an advanced elective. Basic Ophthalmology (OP 501) is a prerequisite for OP502M.8 or a similar course taken at another institution approved by Harvard Medical School. The Advanced Ophthalmology Elective represents an opportunity for a student to participate with a member of the Harvard Medical School Ophthalmology faculty in clinical or laboratory research. It is meant to be joint scholarly experience not primarily involving direct patient care. each preceptor develops a research project for the medical student to pursue or the student may develop a specific research interest that is approved by the Preceptor. The minimum period of and advanced elective is four weeks and that the duration must be in blocks of four weeks. Their are 23 Preceptors with varying research projects who mentor the course. The student is given the list of mentors and descriptions of the research that they are involved with. It is the students responsibility to contact the mentor and set up a schedule.

Description: Course OP503.M.7. Introduction to Pediatric Ophthalmology. This is an introductory course, requiring no prior experience in ophthalmology. The student, supervised by David G. Hunter, MD, PhD (Ophthalmologist in Chief at Children�s Hospital Boston), will observe the clinical and surgical practice of Dr. Hunter and most of the attending pediatric ophthalmologists, pediatric optometrists, and orthoptists in the department. How is it possible to determine how well a baby can see, or whether a young child needs glasses or surgery? What do you do if a toddler refuses to participate in an eye exam? How do you evaluate a child who might be blind, and at the same time provide support for the concerned parent? How do you surgically align an eye or take a cataract out of a baby�s eye? The student will observe how experienced pediatric ophthalmologists deal with these concerns and solve these problems. Our department conducts over 20,000 patient visits every year, and the diversity of pathology presenting each year is unmatched anywhere in the world. We offer a weekly conference that includes critical reviews of manuscripts, a biweekly patient conference attended by the actual patients, the opportunity to attend Grand Rounds at the Mass Eye and Ear Infirmary, and a pediatric ocular pathology conference. There are occasional special lectures and journal clubs throughout the year. During the rotation the student will identify a case of interest and present that case during departmental rounds. By the end of the rotation, the student should have a solid understanding of basic conditions affecting the eyes of children, of the ocular consequences of systemic diseases, and of how a general practitioner can suspect and detect when these conditions are present.

Description: The Harvard Combined Orthopaedic Clerkship is a collaboration among Massachusetts General Hospital, Beth Israel Deaconess Hospital, and Brigham and Women's Hospital. The clerkship is designed to parallel our combined residency program, in which our trainees work in each of these institutions throughout their training. Students will be randomly assigned to the month long rotation at one of the hospitals. While each of the training sites offers a distinct experience, they are equivalent and they are all equally a part of the combined residency.

Description: The Harvard Combined Orthopaedic Clerkship is a collaboration among Massachusetts General Hospital, Beth Israel Deaconess Hospital, and Brigham and Women's Hospital. The clerkship is designed to parallel our combined residency program, in which our trainees work in each of these institutions throughout their training. Students will be randomly assigned to the month long rotation at one of the hospitals. While each of the training sites offers a distinct experience, they are equivalent and they are all equally a part of the combined residency.

Description: This course involves interactions with the pediatric orthopaedic service at Children's Hospital. The department includes divisions of sports medicine, hand surgery, spine surgery, and neuromuscular programs. The curriculum can be altered to the needs of the advanced student with exposure to out patient clinical care, in patient care, surgical procedures, and attendance at core curriculum lectures. The student will integrate into the department service with contact with attendings, residents and fellows. On call will be one night per week.

Description: Students may add themselves to the waiting list for this course during add/drop periods but not during lottery periods. Prior approval required, please email Megan Eichhorn, meichhorn@carlosotisclinic.org, forward approval to registrar@hms.harvard.edu. This course takes place at The Carlos Otis Stratton Mountain Clinic, Stratton Mountain, VT. The clinic is staffed by two volunteer physicians, an orthopaedic surgeon and an internist or family practitioner each week from late November through mid-April. There is a clinic secretary and a staff of experienced nurses, as well as EMTs from the Ski Patrol. Two students are accepted per month) and are expected to be integral members of the staff, helping to assess and treat patients as well as lending a hand with clinic operations. On a busy weekend we may see 40+ patients in a day with trauma, plus medical emergencies such as cardiac arrests etc. We are fully able to care for cardiac patients and all medical staff and RNs have taken ACLS. Drugs, IVs, airway support, and defibrillators are available. On the orthopaedic side, the student will become skilled with the history, physical exam and X-ray assessment of a wide variety of musculoskeletal injuries. Many of the fractures and dislocations are definitively treated and immobilized. Serious injuries requiring hospital care or evaluation (CT MRI) are sent by ambulance to Bennington, Rutland, or Hanover. Life-threatening injuries are sent by helicopter to Hanover. On busy days 3 or 4 ambulance runs are the norm. The students and physicians carry radios so that they may ski, but be available when needed in the clinic. There is no call schedule per se, students are expected to be available daily from 8:30 to 5 or so. Most "graduates" from this clerkship have found it to be a busy and stimulating time while being also able to enjoy the facilities at one of New Englands premier winter sports resorts.

Description: This course is designed to provide the student an in-depth exposure to the field of Otolaryngology/Head and Neck Surgery and its principal subspecialty areas including otology, neuro-otology, head and neck surgical oncology. A combination of clinical opportunities in inpatient and ambulatory ORL-HNS subspecialties and related fields (i.e. radiology, radiation medicine, medical oncology, audiology, voice and swallowing)will be tailored to the career objectives of the student. The student will be an active participant on the inpatient service making rounds and providing care under the supervision of the attending physician and chief resident. Students will participate in the operating room and follow those patients post-operatively. Students will perform consultations in the outpatient clinic setting of attending physicians who will provide ongoing feedback about the students performance. Emphasis will be on increasing familiarity with clinical problems through direct patient contact and relevant background reading and through the acquisition of improved practical skills including performing the physical examination of the head and neck and operating room technique. Attendance at daily rounds, conferences, clinics and selected operations is expected. A half-hour presentation on a topic prepared from intensive reading is required. This course is strongly recommended for those considering a career in Otolaryngology.

Description: This one-month elective will offer students a comprehensive clinical experience in Otolaryngology-Head and Neck Surgery. It will include experience in managing pediatric and adult populations. The rotation is available to all interested students, and will be particularly useful for students interested in pursuing a career in Otolaryngology-Head and Neck Surgery. The rotation will consist of a combination of operative, inpatient, and outpatient experiences. Students will spend time with each of the various subspecialty services (H&N oncology, Otology, Laryngology, pediatric otolaryngology and rhinology) during this rotation, and will be expected to be active participants within each service. Students will be expected to take call one night during the week and one weekend during the rotation. The students will assist residents and faculty in evaluating outpatients and taking care of inpatients and in the operating room. Learning activities will include weekly didactics, multi-disciplinary conferences, and outpatient specialty clinics. The course director will orient the students on the first day of the elective, and have a mid-rotation meeting to discuss progress and experience of the rotation. It is expected that the student will prepare for each aspect of the experience through active reading and inquisition. At the end of the rotation, it is expected that the student present on a topic of their choosing during to the department.

Description: This one month elective will provide interested and motivated students with a comprehensive and advanced clinical experience in the specialty of Otolaryngology-Head and Neck Surgery. Although highly suggested for students pursuing a career in Otolaryngology-Head and Neck Surgery, the elective is designed to be a positive educational experience for all interested students, regardless of eventual career choice. Students will serve as integral members of the inpatient service. They will have both a clinical and operative experience which can be customized to the students' specific interests and career goals. Students will be oriented to the elective by the clerkship director on the first morning of the rotation. The clerkship director will have a feedback session with each student at the two week mark and again at the end of the elective. Students will be expected to do thorough backgruond reading relevant to the clinical care of their assigned patients. They will give a brief (10 minute) presentation on the topic of their choice at the end of the rotation.

Description: This one-month elective will offer students a comprehensive clinical experience in Otolaryngology-Head and Neck Surgery. It will include experience in managing pediatric and adult populations. The rotation is available to all interested students, and will be particularly useful for students interested in pursuing a career in Otolaryngology-Head and Neck Surgery. The rotation will consist of a combination of operative, inpatient, and outpatient experiences. Students will spend time with each of the various subspecialty services (H&N oncology, Otology, Laryngology, pediatric otolaryngology and rhinology) during this rotation, and will be expected to be active participants within each service. Students will be expected to take call one night during the week and one weekend during the rotation. The students will assist residents and faculty in evaluating outpatients and taking care of inpatients and in the operating room. Learning activities will include weekly didactics, multi-disciplinary conferences, and outpatient specialty clinics. The course director will orient the students on the first day of the elective, and have a mid-rotation meeting to discuss progress and experience of the rotation. It is expected that the student will prepare for each aspect of the experience through active reading and inquisition. At the end of the rotation, it is expected that the student present on a topic of their choosing during to the department.

Description: The course is designed for third and fourth year medical students interested in the field of Otolaryngology. Students will be exposed to outpatient clinics, inpatient care, and the operating room. He/she will be expected to attend 2-4 teaching/lecture sessions per week. All facets of pediatric otolaryngology (airway - head & neck - otology - rhinology) will be introduced. There is no in-house call required.

Description: The month-long elective at Brigham and Women’s Hospital is designed to give senior medical students an educational experience in anatomic pathology. Students spend one week in general surgical pathology, following specimens as they are processed for frozen section consultation, gross pathology and histopathology. The remaining time is spent on pathology subspecialty services. The schedule is individualized to fit the student’s areas of interest, and opportunities are available in a wide array of diagnostic subspecialties, including but not limited to dermatopathology, gynecologic pathology and molecular diagnostics. Participation in autopsies is available for interested students. Interactive and individualized microscopic teaching sessions are provided, and students may join in daily educational didactic conferences in the department. Students will have daily interactions with pathology residents, staff and faculty. Students have an option to prepare a presentation or short article on a pathology topic of their choice at the end of the rotation.

Description: This course is designed for the student who is seeking an introduction to both the practice and the academic aspects of pathology and laboratory medicine, and is directed toward understanding pathophysiology and molecular pathology. The clerkship involves a coordinated combination of short rotations, to provide exposure to several subspecialty areas within the pathology department. The cumulative effect will be a representative introduction to elements of surgical pathology, molecular pathology, cytopathology, informatics, laboratory medicine (including transfusion medicine, microbiology, hematology, immunology, and/or clinical chemistry) and translational research. Cross-cutting case histories are used each week to illustrate and integrate the diverse roles of the different disciplines within pathology. Students will work closely with faculty and trainees, and will participate in tutorial sessions in their areas of rotation as well as attending department-wide academic conferences. All students will have the opportunity to focus on a specific topic of pathophysiological and molecular pathological interest, and to present an aspect of this topic at the close of their clerkship. Consideration of career options in academic pathology is integral to the clerkship. While the course is primarily organized to provide preparation for a potential career in pathology, students interested in other areas of medicine will be able to gain insights into disease processes and the role of pathologists in medical and surgical diagnosis and management.

Description: This course is designed for the student who is seeking an introduction to both the practice and the academic aspects of pathology and laboratory medicine, and is directed toward understanding pathophysiology and molecular pathology. The clerkship involves a coordinated combination of short rotations, to provide exposure to several subspecialty areas within the pathology department. The cumulative effect will be a representative introduction to elements of surgical pathology, molecular pathology, cytopathology, informatics, laboratory medicine (including transfusion medicine, microbiology, hematology, immunology, and/or clinical chemistry) and translational research. Cross-cutting case histories are used each week to illustrate and integrate the diverse roles of the different disciplines within pathology. Students will work closely with faculty and trainees, and will participate in tutorial sessions in their areas of rotation as well as attending department-wide academic conferences. All students will have the opportunity to focus on a specific topic of pathophysiological and molecular pathological interest, and to present an aspect of this topic at the close of their clerkship. Consideration of career options in academic pathology is integral to the clerkship. While the course is primarily organized to provide preparation for a potential career in pathology, students interested in other areas of medicine will be able to gain insights into disease processes and the role of pathologists in medical and surgical diagnosis and management.

Description: Medical students will have the opportunity to participate in both anatomic and clinical pathology. Students will be scheduled to work with residents, fellows and attending physicians in the various fields of surgical pathology, clinical pathology and autopsy. They will attend intraoperative consultations, follow surgical cases from gross evaluation to microscopic sign-out, participate in autopsies, be involved with the clinical laboratories (chemistry, microbiology, hematology) and attend blood transfusion medicine rounds. As an elective rotation, if a student has a particular interest in one field of pathology, the schedule can be tailored to allow adequate exposure if advance notice is given to the Course Director. At the end of the rotation, the medical student will give a presentation on a case or relevant topic of his or her choice. There is a maximum of two students per rotation.

Description: Prior approval required, please email Dr. Klepeis; vklepeis@mgh.harvard.edu. Pathology Informatics uses data management, imaging and information theory to facilitate the diagnostic, research, and patient care missions of Pathology. This course will introduce students to the challenges and accomplishments in Pathology Informatics, while simultaneously providing integrated exposure to several subspecialty areas within the pathology department (i.e. surgical pathology, molecular pathology, cytopathology, laboratory medicine, etc.). Didactic sessions and hands-on laboratory experience from the core of the rotation. The student will also have the opportunity to work closely with faculty, fellows, and residents on a project of mutual interest. At the end of the clerkship, the student will present to the department on a topic of his or her choice. While the course is primarily organized to provide preparation for a potential career in Pathology, students interested in other areas of medicine will be able to gain insights into the role of pathologists and laboratory information systems in medical and surgical diagnosis and management. Previous computer experience is not required, but may be helpful. Enrollment is subject to the pre-approval of the course director, Dr. John Gilbertson.

Description: Students are integrated into the daily activities of the Women's and Perinatal Pathology Division, which encompass tissue gynecologic oncology, placental and perinatal pathology and biopsy services. They are supervised by the staff and fellows and provided a seat with a microscope. They are expected to participate in the following activities: 1) Attendance at the daily diagnostic case sign-out sessions. 2) Weekly conference attendance incuding tumor conference, problem case review conference, Pap smear biopsy correlation conference, and weekly Women's and Perinatal Conference. 3) Shadowing fellows and residents in gross room activities, frozen section consultations and fetal and perinatal autopsies. 4) Involvement in short research projects, time and interest permitting. 5) Review of the interesting case files to broaden their scope of difficult pathologic diagnoses, time and interest permitting. 6) An optional presentation to the Pathology Department at the end of their month on the service. 7) A mandatory short oral exam at the end of the course will determine the degree of information retention.

Description: Students may add themselves to the waiting list for this course during add/drop periods but not during lottery periods. Please contact Dr. Keith Ligon, keith_ligon@dfci.harvard.edu, for approval to enroll. This course is aimed at introducing students to Neuropathology in a hospital setting. The emphasis will be to correlate neuropathological findings from autopsy and surgical material with clinical and neuroradiological data. The student will be expected to participate in all of the activities of the Divisions of Neuropathology at the Children's Hospital and Brigham and Women's Hospital, including Autopsy and Surgical Neuropathology, and give an oral presentation on a topic of current interest in Neuropathology.

Description: Students may add themselves to the waiting list for this course during add/drop periods but not during lottery periods. Please contact Dr. Lisa Teot, lisa.teot@childrens.harvard.edu, for approval to enroll. The course is designed to teach the principles and techniques of pathology, with particular emphasis on diseases of childhood. Gross and microscopic studies emphasize clinico-pathologic correlations and the impact of development upon disease. The course includes didactic instruction; formal supervised study; and interpretation of gross and microscopic features of diseases particular to children, the special biology of childhood tumors, embryologic and anatomic concepts of congential heart disease and pediatric neuropathology.

Description: This course is designed to fully integrate the principles of pathology, embryology, and medical genetics as they relate to human maldevelopment and unexpected pregnancy loss through first-hand study of case material, assigned reading, and individual tutorial instruction. Thus, the course provides a focus on an area often overlooked in more general courses in pathology or genetics. Topics include detailed study of the biology, embryology, pathology, and genetics of maldevelopment and spontaneous abortion in the human embryo, fetus, stillborn, and deceased newborn. Material will be presented via didactic tutorial instruction based on assigned readings from assembled syllabus, participation in autopsy, examination of microscopic material, attendance at departmental and interdisciplinary weekly conferences in pathology, cytogenetics and perinatal medicine, library research, and oral presentation of cases. Patient contact is provided in genetic counseling sessions in the Center for Women and Newborns. When appropriate, visits to see infants in the nursery will be arranged.

Description: This clerkship is a month long elective designed to expose medical students to the discipline of laboratory medicine. Regardless of intended specialty, a deeper understanding of laboratory testing will provide a very useful foundation for future patient care. Medical students will spend time in each of the four major clinical laboratories (blood bank, microbiology, chemistry, and hematology). Through discussion with the course directors prior to the start of the rotation, a schedule will be tailored to the medical student�s interests and aspirations. Students, along with technologists, residents, fellows and attendings, will become part of clinical pathology team in each laboratory. They will spend time at the bench observing and/or performing testing (e.g., bacterial culture, antibody identification in the blood bank) and participate in daily laboratory rounds where clinical, methodology, management, and quality assurance issues are discussed. They will also participate in the laboratory specific didactic/tutorial sessions and be given directed readings to help build an adequate knowledge base. In addition, students will attend laboratory specific interdisciplinary conferences where they may present select material (e.g., microbiology plate rounds to the infectious disease fellows and attendings). Students will be expected to give at least one presentation at our weekly laboratory medicine case conference during the third or fourth week of their rotation. The presentation will be approximately 15 minutes in length and focus on a case that occurred during the rotation with a discussion on management and pertinent laboratory medicine issues. The relevant attending will advise the student on choice of topic and presentation. Note: Drs. Richard L. Haspel and James Kirby are co-directors for the course.

Description: This elective provides an experience in Clinical Laboratory Medicine and is designed to teach medical students how the vast array of clinical assays is used in the diagnosis and treatment of disease. Students will rotate through laboratories in Clinical Chemistry, Clinical Immunology, Clinical Microbiology, Hematology, Coagulation, Endocrinology, Molecular Diagnostics and Transfusion Medicine at the Brigham and Women's Hospital, and will have the opportunity to learn how to select the appropriate laboratory tests and interpret the results. Additionally, they will participate in regularly scheduled didactic sessions and work closely with senior staff and residents. Upon completion of this elective, students will acquire practical skills such as, diagnostic molecular biology, flow cytometry, interpretation of cardiac markers & serum protein electrophoresis/immunofixation patterns, analysis of blood smears & bone marrow aspirates, and effective use of blood component therapy. All activities will be under faculty supervision.

Description: This is an advanced pediatric clerkship designed for students who have completed their Core Clerkship in Pediatrics and who desire a more intensive experience with increased responsibility in the management of pediatric patients. The student will function as a sub-intern, admitting and managing a mix of general and subspecialty patients as part of an inpatient ward team under the supervision of senior residents and attending physicians. At night, the student will share responsibility with their ward team for admissions and coverage. The student will attend daily teaching conferences and radiology rounds. By request, additional experiences can be arranged in general pediatric and subspecialty outpatient settings. The goal of this clerkship is to provide an opportunity to strengthen skills in the evaluation and management of pediatric patients.

Description: This is an advanced pediatric clerkship designed for students who have completed their Core Clerkship in Pediatrics and who desire a more intensive experience with increased responsibility in the management of pediatric patients. The student will function as a sub-intern, admitting and managing a mix of general and subspecialty patients as part of an inpatient ward team under the supervision of senior residents and attending physicians. At night, the student will share responsibility with their ward team for admissions and coverage. The student will attend daily teaching conferences and radiology rounds. By request, additional experiences can be arranged in general pediatric and subspecialty outpatient settings. The goal of this clerkship is to provide an opportunity to strengthen skills in the evaluation and management of pediatric patients.

Description: This is an advanced pediatric clerkship designed for students who have completed their Core Clerkship in Pediatrics and who desire a more intensive experience with increased responsibility in the management of pediatric patients. The student will function as a subintern and admit and manage patients as a part of an inpatient team under the supervision of senior residents and/or attending physicians. At night, the student will share responsibility with the team for providing coverage for all of the patients. The student will attend daily teaching conferences and radiology rounds with their team. The goal of this clerkship is to provide an opportunity to strengthen skills in the evaluation and management of pediatric patients.

Description: This is an advanced pediatric clerkship designed for students who have completed their Core Clerkship in Pediatrics and who desire a more intensive experience with increased responsibility in the management of pediatric patients. The student will function as a subintern and admit and manage patients as a part of an inpatient team under the supervision of senior residents and/or attending physicians. At night, the student will share responsibility with the team for providing coverage for all of the patients. The student will attend daily teaching conferences and radiology rounds with their team. The goal of this clerkship is to provide an opportunity to strengthen skills in the evaluation and management of pediatric patients.

Description: This course provides experience for the medical student in a busy outpatient adolescent medicine practice. The rotation will prepare students for patient care in the outpatient setting that they may experience during residency and beyond. Students are scheduled to see their own teen patients with a variety of complaints from reproductive health issues to urgent care to primary care. All clinical care is supervised by attending and fellow perceptors. A weekly conference series on various adolescent health issues augments learning. Students help assemble information for our young men's health website. Students are required to give a short presentation at the end of the rotation. There is no on call.

Description: This is a course for fourth year students who have completed their core pediatrics rotation and are interested in further outpatient pediatrics training. Students will spend several sessions a week in Children's Hospital Primary Care Center and/or a community health center, delivering primary care. The other sessions will be in pediatric subspecialty programs, possibly including rheumatology, dermatology, gastroenterology, cardiology, endocrinology, orthopedic surgery, and developmental pediatrics. Students residing locally are welcome to contact the course director in advance to tailor the experience to their interests (when possible).

Description: The Pediatric Cardiolovascular Disease clerkship at Boston Children's Hospital is an advanced, sub-internship level clerkship designed to give students a flavor of the depth and breadth of diseases encountered in pediatric cardiology, an opportunity to participate in patient management, and exposure to the various subspecialties within cardiology. Students spend dedicated time on the Inpatient Cardiology service as well as the Cardiology Consult service, and are given the opportunity to observe rounds in the Cardiac Intensive Care Unit, select outpatient clinics, cases in the catheterization and electrophysiology laboratories, and in the cardiac operating theater. In addition, they are encouraged to attend a range of lectures and conferences available through the Departments of Medicine and of Cardiology, including a month-long series of daily lecture on a broad range of topics in congenital heart disease, many of which include the application of current research and state-of-the-art science as it guides current clinical management. Prior to their arrival, students are expected to have a basic understanding of pediatrics and experience in patient/parent interviews, physical examination, generation of differential diagnoses, and oral presentation and documentation of patient histories and progress notes. Evaluations at the rotation end will be commensurate with clinical performance and the successful student will function at the level of an intern, taking ownership of their patients, demonstrating the desire and ability to supplement clinical experience with self-directed learning throughout the month, and integrating well with all members of the care team. As this is an advanced level rotation, fluency in English is an absolute must and prior experience in US-type medical systems encouraged.

Description: This elective provides inpatient and outpatient experiences in caring for children with developmental disabilities and special health care needs. The student will participate in interdisciplinary developmental assessment teams for children with a variety of developmental disorders, including developmental delays, mental retardations, autism, cerebral palsy, myelodysplasia, attention deficit hyperactivity disorder, and other conditions. There is opportunity to learn the basics of interdisciplinary developmental assessment, with progressively increasing opportunity to participate as a team member. These clinics may be comprised of attending physicians, developmental-behavioral pediatric fellows and/or neurodevelopmental disabilities residents, as well as pediatric interns. Some of the teams also have psychologists, educators, social workers, physical and occupational therapists, and other disciplines. He/she will also spend time on our inpatient Complex Care Service (CCS) that cares for children with a variety of developmental and genetic disorders and complex medical problems. The student will function as part of the team that is made up of attending physicians, pediatric residents, and a neurodevelopmental disabilities resident. The resident is expected to attend didactic sessions and conferences that are provided on a regular basis during the inpatient and outpatient experiences. Readings will be recommended and resources will be provided.

Description: The course offers a clinical overview, using the clerkship technique, of problems of somatic growth, development, chronic illness, and endocrine/metabolic dysfunction. This course will enable the student to recognize causes of disturbances in growth and development, design and carry out critical diagnostic evaluations, provide rational therapy, evaluate effectiveness, and communicate relevant information to the child, parents, and referring physician. Emphasis will be on utilizing evidence-based medical knowledge, tempered by a humanistic approach to patient care. Management of children with diabetes mellitus will provide an opportunity to master multidisciplinary management of chronic illness in childhood. The student will work with 5 attending faculty, fellows, and ancillary personnel. Patient care will be largely in an ambulatory setting and the student will work in a preceptored relationship with various attendings. Inpatient rounds and some inpatient consultations will be conducted in a similar manner. Formal didactic experiences include regularly scheduled conferences (7:45-8:45 AM) on Tuesdays and Thursdays encompassing clinical care and didactic discussions. A review of pediatric endocrine disorders (Tuesdays 9 AM- 10AM) is additionally available. The student will also be expected to attend Endocrine Grand Rounds (Tuesday 12 noon), and Endocrine Rounds offered in some of the internal medicine services can enrich the didactic experience. The student will be expected to review a subject of interest and present a conference on this subject toward the end of the clerkship. There is no assigned night or weekend call, but the student may be available for particularly interesting or critical patient care during these times.

Description: This is a one month clinical clerkship in pediatric endocrinology and metabolism through adolescence. The student will beomce an integral member of a team of pediatric residents, Endocrine fellows and an attending responsiblt for inpatients, including an active consultations service including 3 NICU's. The student will see outpatients under attending supervision in the endocrine/diabetes program three afternoons per week. Each session is followed by a post-clinic conference. He/she may present patients at conferences of the Endocrine Division or the Dept. of Medicine. Attendance is expected at three to four weekly conferences either within the Division of Endocrinology or shared with other Endocrine programs in the Longwood area: Beth Israel Deaconess, Brigham and Women's and Joslin Diabetes Center. This is a call free rotation.

Description: This course introduces students to the principles of human genetics and teratology and how these principles relate to patient care. The teaching focuses on consultations with children and adults evaluated in the daily Genetics Clinic, the Prenatal Diagnosis Center and in-patient consultations. Students learn how to carry out diagnostic evaluations and to provide counseling for all types of genetic disorders. They will participate in the management of inborn errors of metabolism, mitochondrial conditions, disorders in adults and human teratogens. Students observe in Specialty Clinics for neurofibromatosis, Huntington Disease, Williams Syndrome, Von Hippel-Lindau Disease and other genetic disorders.

Description: This course will introduce students to the application of basic genetic principles to clinical genetics problems. Students will attend Genetic Rounds and clinics and participate, under supervision, in the consultation/management of families with genetic problems. Students will attend outpatient clinics, under the direct supervision of the genetics fellows (either first or second year fellow) and attendings according to a set schedule. They also will participate in in-patient consultations, also under the direct supervision of the 1st year genetics fellow and attending. Students will also be exposed to various cytogenetic, biochemical and molecular diagnostic methodologies, including those employed in prenatal diagnosis. They will deal with disorders such as inborn errors of metabolism, congenital malformations, chromosomal abnormalities and other genetic diseases. They will also attend lectures and seminars of the genetics group and general hospital rounds. They will also be expected to give a brief presentation about one of the cases they have seen with a discussion of the disorder. There is no night call.

Description: The course will develop awareness and experience of non-malignant clinical hematology of infants, children and adolescents. The format is a clinical consult service. Students with closely with the hematology fellow and attending in the inpatient setting, and they see ambulatory patients with hematology attendings. He/She will observe the full range of clinical pediatric hematology and meet daily with the senior hematologist in charge. Each student will deliver a series of brief reports during the weekly hematology rounds relating either to patients seen during the week, or to advances in the current literature.

Description: The student will join the fellow-resident-attending team in caring for all consultations in difficult infectious disease problems at the CH, the student taking responsibility for his/her share of this busy service. The schedule includes daily rounds, conferences (some of them joint with the BIH, BWH and DFCI), reading in pediatric infectious disease problems, and one-on-one teaching sessions with the attending.

Description: The course will introduce students to the physiologic and biochemical adaptations involved in the transition from fetus to newborn. Students will understand, recognize, and manage the disease states that result from prematurity, asphyxia, infection, congenital anomalies, and abnormal perinatal conditions. Students will attend high risk deliveries, participate in antepartum consultations, and care for infants and their families in the forty-five bed intensive and intermediate care neonatal unit under the direction of the attending neonatologist. As a member of a multi-disciplinary care team, the student will participate in daily rounds and several neonatal, perinatal, and pediatric conferences. Students will also gain experience in high risk newborn transport and in an outpatient infant follow-up clinic for NICU graduates.

Description: This is an elective experience for students with clinical experience in Pediatrics that extends knowledge in Newborn and Perinatal Medicine. The student will join a team of physicians and participate in the care of patients in the Newborn Intensive Care Unit. Students are expected to function in the role of sub-intern under the supervision of Residents, Fellow, and Neonatologist, presenting and discussing patients on rounds, establishing care plans, and meeting with families. Daily teaching conferences are held with a syllabus is provided. Experience in high risk deliveries and antenatal consultation is also provided

Description: This course will introduce students to the normal physiological and biochemical adaptations involved in the transition from fetus to newborn and acquaint the student with the recognition and treatment of major disease states that result from prematurity, congenital anomalies, infection, asphyxia, and other abnormal perinatal conditions. Particular focus will be paid to integrating underlying basic science principles to the pathobiology of these disease processes. Students will work closely with the medical team including Neonatal Nurse Practitioners and Fellows with daily supervision and feedback by an Attending Neonatologist. They will follow 1-3 patients per day. During daily work rounds, the student will present pertinent overnight events, physical exam findings, interpret lab data and formulate a plan of management with guidance from the medical team. They will write daily progress notes in the medical record, including admission and discharge notes, and participate in critical care procedures and family education. The student will attend Neonatology conferences including daily Intern Core Lectures in Newborn Medicine, and weekly Neonatology Grand Rounds, Advanced Fetal Care Conference, Newborn Epidemiology and Clinical Research Seminar Series, Newborn Medicine Research Seminar Series, and monthly Morbidity and Mortality meetings. There will be opportunities to attend deliveries, surgeries, the Infant Healthy Lung Development Clinic, Infant Follow-up Clinic, as well as take overnight call. In addition, students will have the opportunity to participate in a unique multidisciplinary crisis simulation training program, mock codes and be certified for NRP. These conferences and clinical sessions are designed to enhance clinical decision making and extend and fortify the student's knowledge of perinatal and neonatal disease processes. Students are expected to give a formal case conference about a patient or problem that they encountered with particular emphasis placed on practicing evidence-based medicine and in understanding basic science and physiology as it applies to the clinical problem.

Description: Students each function as a member of the oncology consult team at Children's Hospital Boston and the Dana Farber Cancer Institute. The team consists of an attending physician, a fellow, and a nurse practitioner. The team consults on patients with new or suspected malignancy on the inpatient medical and surgical services as well as on patients referred to the outpatient clinic at DFCI for evaluation of new or suspected cancer. In addition, the team follows previously diagnosed pediatric cancer patients admitted to the surgical services or in the intensive care units at CHB. Students are assigned patients and follow them with the team. They also present a short didactic session at the end of the month on a topic of their choice to the team.

Description: This course is designed to introduce the student to the wide range of gastrointestinal and hepatic diseases encountered in infants, children, and adolescents. The student will have the opportunity to participate in the management of inpatients at MassGeneral Hospital for Children, as well as to evaluate patients on an ambulatory basis in a variety of settings. The exact schedule will be tailored to the specific interests of the student. Students will also observe endoscopic and manometric procedures. An extensive conference schedule will familiarize student with the pathophysiology, clinical presentation, and management of gastrointestinal diseases and provide examples of relevant clinical research. Over the course of the elective the student will work closely with several attending physicians and fellows in the division.

Description: This course is designed to provide the student in-depth exposure to the wide range of gastrointestinal and hepatic disease encountered in infants, children, and adolescents. The student will rotate on the inpatient gastroenterology service for two weeks and be responsible for admitting and managing children with gastrointestinal problems, under the guidance of a team of two junior residents, a fellow, and an attending physician. The student will present each of his or her patients on rounds and write daily progress notes. For the second two weeks, the student will join the gastroenterology consult team of two fellows and an attending, and learn to perform consultations. The student will perform one consult each day and present his or her findings, both written and oral, to the attending each day for review and feedback. Students will round on each of their consults daily until discharge or signoff, and write a note documenting the visit. Students will also have an opportunity to observe and participate in outpatient visits and endoscopic procedures. In addition to bedside teaching and teaching on rounds, the student will participate in a morning didactic series, and weekly case-based clinical, pathology, and inter-hospital gastroenterology conferences. These conferences all stress the relationship between basic science disciplines and clinical care. The attending will supervise each student�s work on a daily basis and will provide ongoing feedback. In addition, the student will meet with the course director three times over the course of the month to monitor the student�s progress and provide feedback about the rotation. The student will prepare one in-depth talk on a gastrointestinal topic of their choice and receive feedback from the attending, on both content and delivery. This course is open to students enrolled at US medical schools only.

Description: The course offers firsthand experience with pediatric lung disease. Students will participate in the diagnostic evaluation and therapeutic decision-making for hospitalized and ambulatory patients with support and instruction from the staff of the Pulmonary Division. During the course, students will rotate on the inpatient pulmonary service, the pulmonary consult service and the outpatient clinic. Students will be exposed to a variety of diseases and conditions including pneumonia, cystic fibrosis, bronchsopulonary dysplasia, immunological deficiences, asthma, restrictive lung disease, and congenital malformations among others. In addition, the student will have exposure fo bronchoscocpy procedures. Emphasis will be placed on both the correlation of clincal and radiologic findings with pathophysiology. Formal didactic exercises will consisst of daily walking rounds, multiple conferences. There is no night call associated with this rotation.

Description: Students will rotate as team members in the Pediatric Intensive Care Unit at Massachusetts General Hospital. The Team consists of an attending, a fellow, and 3-4 residents in pediatrics and emergency medicine. Students will admit patients into the pediatric intensive care unit with the help of a resident or fellow. Students will round on their patients daily, participate in their daily care, including arranging consults, studies and procedures, and expect to present them in morning rounds. A full admission note as well as daily progress notes for the medical record is expected for each patient followed by the student. The attending physician will supervise the student�s work on a daily basis and provide ongoing feedback on the student�s performance. Students will participate in daily lectures on pediatric intensive care topics as well as mock codes to expand the students� knowledge base of critical illness. The opportunity to attend daily pediatric conferences and weekly Grand Rounds presentations is also available.

Description: The pediatric critical-care rotation in the Medical/Surgical Intensive Care Unit (MSICU) at Children's Hospital Boston is designed to teach students to recognize, prevent and/or treat critical illness in children. Staff, at all levels, emphasize a systematic approach to multiorgan failure assessment and support, while simultaneously addressing the family needs at the time of crisis. Students will be integrated into the care team as part of a 29-bed multidisciplinary pediatric intensive care unit. Opportunities as the principle provider with supervision from critical care staff, fellows and residents will include care of the child with cardiorespiratory failure, neurologic insults, metabolic derangements, surgical emergencies, and other unique physiologic crises. Student will also participate in the critical-care simulator suite located in the MSICU. Here the students will gain hands on skills in airway management, the fibrillation, chest tube placement, and EKG with interpretation emphasizing the pediatric advance life support guidelines. In addition, students will participate in conferences as well as other patient related activities throughout the unit.

Description: Student will participate in clinical activities, including clinics and in-patient consultations. The student will spend two weeks each in outpatient and in-patient setting with no night or weekend calls. The pediatric nephrology team consists of an attending, and may have a medical resident. Student will perform one consult each day and present his or her findings,both written and oral to the attending each day for review and feedback. When on an in-patient rotation students will round on each of their consults daily and write progress notes until discharge or sign off. The student may carry maximum three patients at a given time. Students will be required to do core reading and optional reading depending on the diagnosis they come in contact with. The didactic teaching will involve core teaching and weekly patient management conferences designed to improve clinical decision-making. Students are expected to give at least one comprehensive talk during the course of one month about a patient or a problem that they encountered with particular emphasis placed on practicing evidence-based medicine and understanding basic science and physiology as it applies to a clinical problem. At the end of the rotation, the student should be able to know when to refer a patient to a pediatric nephrologist. Further, student will gain core knowledge of renal physiology, interpretation of relevant tests and management of common renal/urological disorders in various settings.

Description: The course will provide a working knowledge of clinical nephrology, including principles to integrate natural history, immunopathology and methods of patient evaluation ( renal biopsy, special studies, response to therapy and follow-up) in diagnosis and management. The Nephrology Program at CHB is divided into 2 Services (1) General Consult Renal and (2)Dialysis and Transplantation. The Renal Clinics offer extensive exposure to a wide variety of congenital and acquired renal problems and fluid and electrolyte abnormalities. The Student will see patients and participate in patient care under the supervision of the Attending Physician on the General Consult Service. The Student will see patients awaiting renal transplant and in transplant follow-up. He/she will be expected to attend Grand Rounds and 2 Clinical nephrology conferences per week at in the Division. Attendance is expected at the 2 practical working seminars for fellows in training each week The Student will prepare and present clinical findings from both their outpatient and inpatients for discussion and planning during working ward rounds. These presentations are used as basis for ongoing formative direction and evaluation. One formal case based presentation during the elective month will be expected - this case will demonstrate both underlying basic science and evidence based decisions in a patient managed.

Description: The Developmental Medicine Center provides evaluation and follow-up for children with developmental and behavioral concerns. It serves as both a fellow and residency training program and serves a wide variety of patient needs. This course will enable students to become familiar with the diagnosis and treatment of various developmental and behavioral disorders in children. They will learn about normal and abnormal development. They will be exposed to various clinical services that evaluate learning and behavioral issues in children, and will become familiar with diagnosis and treatment of specific disorders such as autism, ADHD, and learning disabilities, and become more familiar with general behavioral principals and specific developmental and behavioral issues including feeding, sleep and toileting. They will learn about developmental screening tools and their importance in the primary care setting. They will be introduced to specific developmental assessment techniques and to the relevant literature and research in the area child development. Students will participate in specialty clinics (i.e. ADHD, toilet school), multidisciplinary clinics (along with team conferences), general Developmental and Behavioral follow-up clinics as well as attend didactic sessions. Level of student involvement is dependent on the motivation of the student. There is no call requirement.

Description: This course will provide the student with an intensive approach to nutritional problems in the hospitalized patient and to general topics in pediatric nutrition. Activities will include: didactic and clinical experience in pediatric nutrition, patient contact, bedside teaching, rounds and conferences, and independent study in nutrition. The student will take histories, assess nutritional status and develop a plan for the patient's management. A senior member of the faculty will serve as a tutor.

Description: Students may add themselves to the waiting list for this course during add/drop periods but not during lottery periods. Written permission must be obtained from the Course Director 4 months prior to registering for this clerkship. Spanish proficiency is preferred. Please contact Dr. Wanda Gonzalez, wigonzalez@partners.org, for approval to enroll. The course offers students the opportunity to explore community medicine at MGH Chelsea Healthcare Center. Chelsea is an small city with a high percentage of immigrants and low income households. Approximately half their time will be spent directly seeing patients in an outpatient setting under the supervision of the pediatric providers at the Health Center. They will learn how to evaluate and treat children in an outpatient setting. Students may attend pertinent conferences at the Health Center or at MGH. The rest of their time will be spent working with the various community programs and services at the health center, including, but not limited to Speech and Language, Nutrition, Refugee Program, the Student Health Center at the local high school and programs aimed at curbing the impact of Domestic Violence on our patients. Although no call is required, students may be scheduled for evening clinics. Completion of a community health project is a requirement of the course. The ultimate goal is to provide students with an understanding of a community pediatrician's role in coordinating care, including any special medical, education and social services as needed.

Description: The elective provides an opportunity for you to directly participate in the clinical care of acutely ill and injured patients ages 0-19 years in the Pediatric Emergency Department at Massachusetts General Hospital. It is open to all senior students who would like gain additional clinical exposure to acute evaluation and management in an emergency setting, and recommended for students who are considering a career in pediatrics or emergency medicine. There are usually 4-5 eight hour clinical shifts for each week of the elective, in addition to training sessions on bedside ultrasound, airway management, and suturing.

Description: The student will learn to care for children with a wide variety of illnesses and injuries and will gain an appreciation of aspects of pediatric practice unique to the emergency setting including triage, tailored assessments, and caring for high acuity. Students, under the direct supervision of pediatric emergency medicine attendings, will assume primary responsibility for emergency department patients with medical, surgical, and trauma related conditions. The student will be responsible for the initial assessment, generating differential diagnoses, and proposing and executing treatment and follow-up plans. The student may have opportunities to perform supervised procedures including incision and drainage, lumbar puncture, procedural sedation, splinting, and suturing. Students will attend weekly didactic and simulation sessions given by the Division of Pediatric Emergency Medicine at Boston Children’s Hospital.

Description: The rotation in Pediatric Physical Medicine and Rehabilitation will offer the student experience in working with children who have special needs. The primary objectives will include working with families, understanding the pathophysiology of a variety of disabling conditions, and evaluating options for treatment within a family centered care model. The student will see patients on the inpatient unit, in outpatient clinics, and also participate in procedures in the operating room. Experience in the outpatient clinic will include evaluating children with cerebral palsy, myelodysplasia, neuromuscular conditions, chronic pain, and traumatic brain injury. At the end of the course, the students will be asked to give a presentation on a topic of his or her choice related to children with disabilities. There will also be a mid-term exam presentation. The final history and physical exam presentation will also require a treatment plan.

Description: Introduction to Pediatric Critical Care is a course offered to 4th year and qualified 3rd year medical students interested in the evaluation, stabilization, and management of critically ill children. The course encompasses 4 weeks, during which time the student rotates through both units of the Medicine Critical Care Program. During their time in rotation, the student should maintain a case load of 1-2 patients. The medical student participant will round with the Unit team and present their primary patient. It is expected that he/she is the primary provider and advocate for his/her patient(s), and will be involved with all subspecialty services, allied professionals, and family discussions. He/she shall be an integral part of management, and should develop strong working relationships with both the staff and patient families. The medical student shall be assigned to a Primary Resident who can co-sign orders and supervise clinical decision-making, with final supervision by the unit attending. Additionally, the student will be assigned to one co-director of the course who will provide individual support, feedback, and mentoring. The goal of the rotation is to provide opportunities for the student clerk to integrate and apply knowledge of basic sciences, pathophysiology, physical exam skills, and assessment/management of critically ill children, from the onset of acute illness to recovery. The student should not only gain understanding of their patients� disease processes, but additionally, criteria for the patient being defined as critically ill. Teaching will be given through a mix of didactic lectures and demonstrations (such as use of airway cart/mannequins), bedside instruction, and journal review. Schedule: � 4 weeks � 1st two weeks in Intermediate Care Program, 2nd two weeks in MICU � Exception to this structure will be made when the student is following a patient who transfers between units � Typical day: 7:30am � 5pm, no required call

Description: This course will offer exposure to and education about the field of Child Abuse Pediatrics, a recently designated board certified subspecialty. Students will assist with consultation on inpatient and outpatient cases where there is a concern about child maltreatment. They will also attend multidisciplinary meetings within Boston Children's Hospital designed to help providers manage cases of child abuse and neglect. Given the legal nature of child protection work, students will not be asked to evaluate patients independently or to document in the medical record. There is no overnight call, although students may wish to come to the hospital for weekend consults should the child abuse pediatrician be called to see a patient. Students will also attend teaching sessions provided by our BCH child protection staff. Additionally, the student will have substantial time dedicated to independent study and one-on-one didactic teaching, as well as ample exposure to other subspecialists who often assist in the diagnosis of child abuse. Students will learn about the role of other agencies (e.g. child protective services, law enforcement) involved in the management of child maltreatment. When possible, students will attend community meetings and observe criminal trials when the child abuse pediatrician testifies in court proceedings.

Description: This course is an advanced surgical elective focused on the surgical management of pediatric and adult congenital heart disease. The experience will involve all phases of the care of these patients, including pre-operative evaluation and surgical planning/decision-making, intra-operative management, and post-operative care in the intensive care and post ICU care units at Children's Hospital. The student is expected to be directly involved in all phases of care. The student will be expected to focus on 1-2 patients each week (out of 20-25 patients undergoing surgery each week), and make case presentations to one or both course directors on the preoperative condition, choice of operative approach, and post-operative management. The student will be expected to undertake a review of a specific topic in congenital heart disease and to make a presentation to the course co-directors and to the surgical trainees during the final week of the course. The course also includes student participation in all clinical, research, and dedicated educational conferences and a series of educational sessions tailored specifically for the student selecting this elective.

Description: Making A Human Connection: Establishing Trust with Children is a four week advanced course for students who have completed the Core Clerkship in Pediatrics and want to strengthen their bedside interpersonal skills and their ability to effectively communicate and establish trust with children. The course meets three days per week and is built around more than 20 hours of clinical interactions with children. This clinical experience is supplemented by weekly seminars, readings (in child development, nonverbal communication, and behavioral psychology), and case-based collaborative learning sessions. One day per week will consist of didactic seminars; one day interacting with patients in one-on-one student-faculty tutorial sessions with Dr. Krauss in the Boston Children’s Hospital emergency department; and one self-designated day each week of practice-based learning sessions where students see patients in the BCH ED independently. Students will gain a framework, detailed methodology, and set of practical skills for establishing trust with children and their families. Field trips to pre-school and kindergarten classes provide an opportunity for students to observe children at play and to recognize features of their behavior and developmental stages. Students will be required to keep a journal of all activities, and will be evaluated based on the scope and content of their journals, and an objective structured clinical examination.

Description: The advanced clerkship at McLean is designed for students who have completed the Core Clerkship in Psychiatry. It provides an opportunity for intense clinical experience and in-depth exploration of a particular area of interest. Any of the numerous services afforded by the hospital may be elected as the area of concentration. These include: Clinical Evaluation Center, substance abuse unit, behavioral neurology service, partial hospitalization program, Short Term Unit, and geriatric psychiatry service. Individual supervision is provided for all clinical assignments. Advanced seminars on psychopathology and pychopharmacology will be offered to students. Interviewing techniques are emphasized if requested. Biomedical aspects of psychotic disorders may be elected as an area of concentration. The geriatric psychiatry elective will include inpatient, outpatient and long term care consulting opportunities.

Description: The advanced clerkship at McLean is designed for students who have completed the Core Clerkship in Psychiatry. It provides an opportunity for intense clinical experience and in-depth exploration of a particular area of interest. Any of the numerous services afforded by the hospital may be elected as the area of concentration. These include: Clinical Evaluation Center, substance abuse unit, behavioral neurology service, partial hospitalization program, and geriatric psychiatry service. Individual supervision is provided for all clinical assignments. Advanced seminars on psychopathology and pychopharmacology will be offered to students. Interviewing techniques are emphasized if requested. Biomedical aspects of psychotic disorders may be elected as an area of concentration. The geriatric psychiatry elective will include inpatient, outpatient and long term care consulting opportunities.

Description: Advanced Psychiatry Clerks spend one month on an inpatient component of the Schizophrenia & Bipolar Disorder Program directed by Dost Ongur, M.D., Ph.D. Advanced clerks work closely as a member of a psychiatric team, participate in daily rounds, meet regularly with the Psychiatrist-in-Charge of the inpatient team and discuss cases with other psychiatrists and residents in a variety of settings including seminars, and case conferences. Advanced Clerks work closely with professional colleagues in psychology, social work, and psychiatric nursing to learn their approaches to the assessment and treatment of severely mentally ill patients. Advanced Clerks are exposed to the rich environment of the facilities at McLean Hospital, including elective participation in a weekly Research Seminar, Academic Grand Rounds, and a conference on psychiatric interviewing. The clerk is expected to prepare a detailed written summary of one of their clinical cases to be handed in to their attending psychiatrist. In addition, the clerk will give a brief oral academic presentation on a topic relevant to the clinical work of the program at the end of the rotation.

Description: Advanced Psychiatry Clerks spend one month on an inpatient component of the Schizophrenia & Bipolar Disorder Program directed by Dost Ongur, M.D., Ph.D. Advanced clerks work closely as a member of a psychiatric team, participate in daily rounds, meet regularly with the Psychiatrist-in-Charge of the inpatient team and discuss cases with other psychiatrists and residents in a variety of settings including seminars, and case conferences. Advanced Clerks work closely with professional colleagues in psychology, social work, and psychiatric nursing to learn their approaches to the assessment and treatment of severely mentally ill patients. Advanced Clerks are exposed to the rich environment of the facilities at McLean Hospital, including elective participation in a weekly Research Seminar, Academic Grand Rounds, and a conference on psychiatric interviewing. The clerk is expected to prepare a detailed written summary of one of their clinical cases to be handed in to their attending psychiatrist. In addition, the clerk will give a brief oral academic presentation on a topic relevant to the clinical work of the program at the end of the rotation.

Description: Students may add themselves to the waiting list for this course during add/drop periods but not during lottery periods. Please contact Dr. Fremonta Meyer, flmeyer@partners.org, for approval to enroll. This is a one-month-long course offered to fourth-year medical students who have completed the core clerkship in psychiatry. Under close supervision, students in this elective course will participate as integral members of the working clinical team in the Division of Medical Psychiatry in evaluation and treatment of patients with psychiatric, substance abuse, and behavioral problems on the wards of a general hospital. The team includes attending staff members, psychosomatic medicine fellows, and a chief resident and third-year psychiatric residents from the Harvard Longwood Psychiatry Residency Training Program. The students take part in daily teaching rounds, weekly teaching case conferences, and formal didactics with emphasis on understanding the nature of psychological reactions associated with illness and hospitalization. Students receive individual supervision both at the bedside and in formal sessions. The students are expected to follow up to three patients at any given time and actively participate in daily patient care. There are no call requirements in this course. The students take part in daily teaching rounds, weekly teaching case conferences, and formal didactics with emphasis on understanding the nature of psychological reactions associated with illness and hospitalization. Students receive individual supervision both at the bedside and in formal sessions. The students are expected to follow up to three patients at any given time and actively participate in daily patient care. There are no call requirements in this course.

Description: Students may add themselves to the waiting list for this course during add/drop periods but not during lottery periods. Please contact Dr. Suzanne Bird, sabird@partners.org, for approval to enroll. This course is based at the Acute Psychiatry Service (APS) at the MGH, one of the largest and most active psychiatry emergency services in Massachusetts. The APS allows for the ongoing study of a broad spectrum of psychiatric patients, many of whom are in acute crisis. Under close supervision by senior staff and residents, students learn techniques of crisis intervention, how to make a rapid assessment of the major psychiatric disorders, as well as the major therapeutic approaches used in an acute ambulatory setting. Students also learn to conceptualize illnesses in terms of biological, psychological, and sociocultural factors that determine normal and abnormal behavior. In addition, students participate in regular teaching conferences, daily rounds and department grand rounds. Students will also give a brief presentation on a clinical topic of their interest during the final week of the rotation. Students participating in this course should have completed one introductory psychiatry rotation.

Description: Students may add themselves to the waiting list for this course during add/drop periods but not during lottery periods. Please contact Dr. Marta Herschkopf, mherschk@bidmc.harvard.edu, for approval to enroll. This course offers the student an opportunity to supplement the Core Clerkship in Psychiatry by extended exposure to either the inpatient psychiatric unit at BIDMC (Deaconess 4) or the consultation-liaison service (with potential for a focus on emergency room psychiatry). In addition to patient care responsibilities, students have the option to participate in Harvard-BIDMC Psychiatry PGY-II residency didactics. Clinical instruction will be from attendings and chief residents in the Harvard Longwood Psychiatry Residency Training Program, and the student may be paired as well with PGY-I and -II residents. Night call is optional but may include emergency room shifts from 6-10pm Monday-Thursday.

Description: This is a four week advanced elective in addiction psychiatry. During the first week of the rotation, students will spend mornings as observer participants in the group-based treatment of the McLean Belmont Ambulatory Treatment Program Partial Hospital, with afternoons spent both in didactic sessions led by psychiatry residents, addiction psychiatry fellows and / or addiction psychiatry faculty, and in meetings with senior addiction psychiatry faculty based at sites throughout McLean Hospital�s Alcohol and Drug Abuse Treatment Program. During this week, students will observe the intake and psychiatric management process for patients in this level of care. During the second week of the rotation, students will spend mornings observing at an acute residential treatment, McLean Fernside (in Princeton, MA), and afternoons at McLean Naukeag (in Ashburnham, MA). During the third and fourth weeks of the rotation, students will spend mornings at the adult detoxification unit on the McLean Hospital campus in Belmont, MA. During the afternoons of these final two weeks, students will rotate through the men�s residential treatment unit for uniformed services (LEADER = Law enforcement, Active Duty military, and Emergency Responders), Adolescent residential treatment program for patients with addiction and co-occurring psychiatric disorders (in the McLean Hospital Division of Child and Adolescent services), interspersed with ongoing didactic training and senior faculty meetings. During the rotation, students will observe the psychiatric care offered to patients with substance use disorders and other psychiatric disorders, participate through their observed interviewing of patients, and be asked to formulate a mental status exam and initial diagnostic impressions based upon their interviews. There is no overnight call or weekend requirements during the rotation.

Description: Students may add themselves to the waiting list for this course during add/drop periods but not during lottery periods. Please contact Dr. Hathaway, dbhathaway@bwh.harvard.edu and Dr. Vercollone, lvercollone@bwh.harvard.edu, for approval to enroll. The elective in addiction medicine/psychiatry is designed to provide students with an opportunity to gain knowledge and experience in the assessment and management of substance use disorders with a focus on medical settings. Students will have the opportunity to gain proficiency in a range of addiction treatment that may include the following: � Addiction consultation-liaison (BWH): As part of the medical-psychiatry consultation service, students will evaluate patients in the inpatient medical and surgical floors, emergency room, and intensive care units. Students will gain experience in a variety of clinical issues such as managing intoxications, overdoses and withdrawals, buprenorphine/methadone dosing, pain management in addicted patients, and managing pregnant patients. Students will also have the opportunity to experience outpatient addiction consultation-liaison practice in primary care, OB, and HIV clinics. � Inpatient detoxification (BWFH): Under supervision of the Addiction Recovery Team, students will follow patients on hospital-based level 4 inpatient detoxification unit. � Dual diagnosis intensive outpatient program (BWFH): Students will work closely with the Addiction Recovery Program staff in treating dually diagnosed patients participating in an intensive outpatient program. Opportunities to co-facilitate group therapy are available. � Buprenorphine maintenance treatment (BWH and BWFH): Students will gain experience in buprenorphine treatment, including induction and stabilization. Students can participate in innovative models of care: collaborative care management at a primary care clinic, or a shared visit model at an outpatient addiction clinic. Students will have the opportunity to co-facilitate groups. � Motivational Interviewing (BWH and BWFH): Students interested in gaining proficiency in motivational interviewing (MI) will learn the basics and will be given ample opportunity to practice this skill under supervision from trainers who are members of the Motivational Interviewing Network of Trainers (MINT). � Students are expected to complete a scholarly project in collaboration with the course director.

Description: Students may add themselves to the waiting list for this course during add/drop periods but not during lottery periods. Prior approval required, please email Dr. Herschkopf; mherschk@bidmc.harvard.edu, forward approval to registrar@hms.harvard.edu. In this fast-paced elective, students will see inpatients on medical floors who have substance use disorders and co-occurring medical conditions. Students will also observe outpatient addiction psychiatry visits. An emphasis will be placed on learning appropriate pharmacotherapies and behavioral interventions for substance use disorders. Interested students may also participate in ongoing clinical research within the Division of Addiction Psychiatry. Students may take non-overnight call if desired and can also arrange to see new psychiatric evaluations in the Emergency department. The Addiction Psychiatry team consists of one MD, 2 NPs and 2 social workers. Lots of inpatient consults and considerable number of outpatient visits as well. Medical student would shadow MD which includes inpatient consults daily, 2 outpatient clinics/week and various rounds. Medical student would also work with resident from the psych C/L team who are assigned to see patients with MD. Potential to take call in ED.

Description: Students may add themselves to the waiting list for this course during add/drop periods but not during lottery periods. Advanced Child Psychiatry Clerks spend one month on the McLean 2E Adolescent Residential Treatment (ART) Program, under the supervision of McLean Child and Adolescent Psychiatrists and the clinical teams in the programs. Advanced clerks participate actively as a member of our clinical team, participating in rounds, groups, seminars, conferences, team meetings and family meetings. Advanced Clerks work closely with other psychiatrists and child psychiatry fellows as well as professional colleagues in psychology, social work, and psychiatric nursing to learn their approaches to the assessment and treatment of adolescents with a wide range of mental illnesses and substance use disorders. Students observe and participate in patient interviews and learn about specific treatment modalities, including individual, family, group, and milieu therapies; as well as psychodynamic, cognitive behavioral, dialectical behavioral and psychopharmacological approaches to adolescents. Selective readings in the current and classical literature are offered. Please note that this is an advanced clerkship. Qualified applicants would include medical students who have already completed a core rotation in psychiatry and are able to complete thorough mental status examinations and document them appropriately. Interest in residency training in psychiatry is strongly preferred. Advanced clerks should be prepared to carry 2-3 adolescent patients with an attending psychiatrist, meaning that they would essentially be performing in the role of an acting intern. Interested applicants should plan on submitting a clinical resume and a confidential writing sample of a past psychiatric clinical encounter. Interested applicants should submit a clinical resume and confidential writing sample of a past psychiatric clinical encounter via email to Bryan Pridgen,M.D. at bpridgen@partners.org for prior approval.

Description: The Child and Adolescent Psychiatry elective is a four week clinical experience on the Inpatient Psychiatry Service, the Pediatric Psychiatry Consultation Service and in the Outpatient Psychiatry Clinic. There is direct supervision of clinical work by faculty attendings and senior house staff. Elective students attend classes in the core Child & Adolescent Psychiatry seminar series of the Child & Adolescent Psychiatry Residency Training Program. Performance evaluation includes direct observation of patient care, participation in seminars, review of documentation, critique of a clinical case report, the preparation and presentation of a literature review on a selected topic and the demonstration of learing and clinical skills acquisition over the course of the elective.

Description: Students may add themselves to the waiting list for this course during add/drop periods but not during lottery periods. Please contact Dr. Fremonta Meyer, flmeyer@partners.org, for approval to enroll. This elective is designed to increase students� knowledge of the influence of sex, gender and reproductive cycle events on psychopathology and psychiatric care, and to augment their skills in assessing and treating psychiatric disorders related to gender and reproduction. It includes concentrated clinical experience with patients with premenstrual, perinatal and perimenopausal psychiatric disorders, as well as patients with infertility, pregnancy loss, and breast and gynecologic cancers. Students also learn how to do preconception planning with patients at risk for perinatal psychiatric problems, and about trauma-informed care for women who have experienced sexual trauma. Students see patients within Women�s Mental Health clinical services at Brigham and Women�s Hospital (BWH) and the Fish Center for Women�s Health. Students are supervised by faculty within the BWH Women�s Mental Health Division. Students work closely with senior residents and a women�s mental health fellow, and attend biweekly multidisciplinary rounds with attendings, residents and a women�s mental health fellow. Students also do a scholarly project, consisting of either a written case report, a written literature review, or a presentation to the Women�s Mental Health Division. Students participant in relevant lectures, symposia and Grand Rounds. There is no call.

Description: This advanced course will teach students how to work with patients who have psychiatric symptoms in medical settings. Through exposure to a wide range of neuropsychiatric presentations in medical and surgical patients, students will learn how to perform a psychiatric interview, to develop a rapid differential diagnosis,and to create a treatment plan relevant to the medically ill patients. The rotation will guide students in the use of multiple treatment modalities (including brief psychotherapies, pharmacotherapy, electroconvulsive therapy, and behavioral techniques). Students will learn about the impact of illness, of hospitalization, and of medical treatment on the function of patients and will help students to appreciate the role of psychiatric factors in the presentation and course of medical illness. The rotation will provide daily bedside teaching and didactics.

Description: This course is offered to students who would like to develop clinical experience on one or more of the psychiatric programs available at Cambridge Health Alliance. Possibilities include inpatient services, outpatient department, child inpatient and outpatient services, consultation to medical/surgical wards, addictions services, psychiatric emergency service, couples and family therapy, Victims of Violence program, geriatric services, and a program in cross-cultural psychiatry (including Haitian, Latino, Asian, and Portuguese clinics). With the course director, each student will tailor a program fitted to his/her particular interests. In addition to the clinical work, reading tutorials and individual preceptorships are available. Students should contact the course director prior to the start of the rotation to confirm the availability of specific clinical services.

Description: In the setting of MGH's locked 24-bed general hospital psychiatric unit, students care for patients, age 18 to geriatric, with acute psychiatric presentations often in the context of previous mental illness or comorbid medical illness. The student joins an attending-resident team, rounds each morning, and participates in the evaluation of new patients and closely follows team patients. Patients have a range of diagnoses seen in the general hospital: major depressive disorder, first-episode psychoses, complex medical and psychiatric-illness interactions, treatment-resistant psychiatric illness. With supervision from attending and resident, they help to manage the diagnostic evaluation and formulation of treatment plans that include somatic treatments and psychotherapies. They participate with residents and other medical students in conferences and lectures.

Description: Students may add themselves to the waiting list for this course during add/drop periods but not during lottery periods. Please contact Dr. Gaston Baslet, gbaslet@partners.org, for approval to enroll. This elective is designed to increase students� knowledge and recognition of brain-behavior relationships in a clinical setting, and to increase their skills in assessing and treating behavioral and cognitive presentations due to neurological illness. It includes concentrated clinical experience with patients with behavioral and cognitive complaints in the context of neurodegenerative illnesses, epilepsy, multiple sclerosis, cerebrovascular disease, developmental disabilities, traumatic brain injury, conversion disorder and other brain disorders. Students will also learn how to communicate with patients and their families about a neurobehavioral diagnosis and to discuss therapeutic and management options. Students see patients within the Neuropsychiatry and Behavioral Neurology services at Brigham and Women�s Hospital (BWH) and are supervised by faculty within the BWH Neuropsychiatry group and Behavioral Neurology group. Students work closely with senior residents and Behavioral Neurology/ Neuropsychiatry fellows, and attend multiple weekly multidisciplinary rounds with attendings, residents and fellows within different subspecialty clinics and weekly journal club and relevant didactic activities. Students are also required to present a scholarly project at the end of their rotation, consisting of a written case report or a written literature review. There is no call responsibility.

Description: This course provides opportunities to develop knowledge and skills in the comprehensive care of patients and their families with serious illness at any stage of their disease, including the end of life and those with cancer and non-cancer diagnoses. Management of symptoms such as pain and nausea, anxiety and depression, psychosocial and spiritual support of patients and families, decision making, communication, coordination of care and bereavement care will be emphasized. Students will participate actively with residents, fellows, and members of the interdisciplinary team (nurses, SW, chaplain, pharmacy) on the psychosocial oncology and palliative care teams providing these patients with expert interdisciplinary care. Shared activities include collaborative interviews with faculty members; assessment, management recommendations for, and follow-up of patients; teaching rounds; and a range of conferences examining the clinical, ethical and research aspects of comprehensive palliative and end of life care. Senior palliative medicine and psychiatric staff supervise clinical work, acquisition of a knowledge base, and preparation of a brief presentation on a topic of the student's interest. Student interested in pediatric palliative care may choose to shadow the Boston Children's Hospital/DFCI pediatric palliative care team for one day of the rotation. Course Directors - John Peteet, MD and Kristen Schaefer, MD. Clinical sites: BWH, DFCI.

Description: Students may add themselves to the waiting list for this course during add/drop periods but not during lottery periods. Please contact Dr. Marisol Segundo (marisol.segundo@mass.gov), for approval to enroll. This elective is offered for students who have had a core psychiatry clerkship and who have a significant interest in community psychiatry, primary care, public health, or socio-economic issues in health care delivery. Students electing this course will have a wide range of experiences at the Massachusetts Mental Health Center (MMHC). These will include: placement at MMHC RAFT (Rapid Access to Flexible Treatment), an outpatient program for patients with severe and persistent mental illness; outpatient team meetings; supervised patient evaluations in the MMHC Intake and Evaluation Service. Individual supervision will be supplemented by conferences and directed reading. There is no night call.

Description: The Lurie Center is a multidisciplinary clinic that provides initial diagnosis and ongoing care for children, adolescents and adults with autism spectrum and other neurodevelopmental disorders. The Center includes child and adult neurologists and psychiatrists, developmental and gastrointestinal pediatricians, an adult internist, neuropsychologists, and speech, occupational and physical therapists. Students spend one week with neurologists, psychiatrists, pediatricians and among the remaining disciplines, respectively. They will become familiar with the presentation, diagnosis and treatment of autism and related disorders. Students will be provided with a reading list of seminal papers in autism that will be discussed with faculty over the course of the rotation. Students will attend weekly clinical case conferences and weekly presentations by various providers within and outside of the Lurie Center. Students will spend one day each week off-site observing and learning from our primary research collaborating sites, including the Martinos Center for Biomedical Imaging (J Hooker PhD et al), the Center for Human Genetic Research (J Gusella PhD et al) and the Behavioral Genetics Laboratory at McLean Hospital (W Carlezon PhD et al). Residents/fellows rotate through the Center on a limited basis. There are no "on-call" responsibilities. Mentorship for writing/publishing a case report pertaining to a patient seen during the month is available. This elective takes place at the Lurie Center for Autism located in Lexington, MA. Students are responsible for their own transportation to and from the Lexington, MA location.

Description: This elective is meant to introduce clinical radiation oncology to medical students. This rotation is ideal for both students interesed in pursing a career in this field and for those simply interested in learning about radiation oncology. The majority of students' time is spent in out-patient clinics with opportunities to be involved in in-patient consults, radiation planning, and radiation treatments. Students are encourage to become engaged with clinical activities and will work closely with faculty, residents, and fellows. There will be a half day session of radiation biology didactics, touring departmental lab space in Charlestown, and discussion with a staff radiation biologist. The course structure is assigned clinic or didactic time for the month. There are mandatory educational lectures each morning. One half hour presentation is expected of each student at the end of their rotation. Topics are chosen by student interest. No weekends or calls.

Description: This elective is meant to introduce clinical radiation oncology to medical students. This rotation is ideal for both students interesed in pursing a career in this field and for those simply interested in learning about radiation oncology. The majority of students' time is spent in out-patient clinics with opportunities to be involved in in-patient consults, radiation planning, and radiation treatments. Students are encourage to become engaged with clinical activities and will work closely with faculty, residents, and fellows. There will be a half day session of radiation biology didactics, touring departmental lab space in Charlestown, and discussion with a staff radiation biologist. The course structure is assigned clinic or didactic time for the month. There are mandatory educational lectures each morning. One half hour presentation is expected of each student at the end of their rotation. Topics are chosen by student interest. No weekends or calls.

Description: The course in radiation oncology is designed to provide students with a broad exposure to the field. Students attend daily morning conferences with the residents and attending faculty. Students are paired one-on-one with an attending daily in order to observe and evaluate patients presenting to the outpatient clinic and occasionally see consults on the inpatient ward. In order to appreciate the fundamental evidence-based management necessary in the field, students will prepare a case conference to be presented at the end of the month discussing a patient and relevant literature supporting the use of radiation in the patient's care. All students will be expected to prepare for patient visits in advance, to interact with the health care team and patients directly, and to present the case conference as part of their learning experience. Students will gain an appreciation for the multi-disciplinairy aspects of oncology care, and also appreciate the scientific aspects of radiation biology and physics.

Description: The course in radiation oncology is designed to provide students with a broad exposure to the field. Students attend daily morning conferences with the residents and attending faculty. Students are paired one-on-one with an attending daily in order to observe and evaluate patients presenting to the outpatient clinic and occasionally see consults on the inpatient ward. In order to appreciate the fundamental evidence-based management necessary in the field, students will prepare a case conference to be presented at the end of the month discussing a patient and relevant literature supporting the use of radiation in the patient's care. All students will be expected to prepare for patient visits in advance, to interact with the health care team and patients directly, and to present the case conference as part of their learning experience. Students will gain an appreciation for the multi-disciplinairy aspects of oncology care, and also appreciate the scientific aspects of radiation biology and physics.

Description: This course is offered to students who complete the Radiology Core Clerkship and want a more thorough understanding of the Radiologic subspecialties. The standard course would include a week each of CT scanning, ultrasound, MRI and angiography. The student will be part of the workteam with radiology residents and fellows under constant supervision by a staff person. They will be involved in various procedures e.g. amniocentesis, abscess drainages. Daily film reading sessions and daily department conference provide classroom teaching but the course is the clinical hands on opportunity to practice radiology. A planning conference with Dr. Lieberman (754-2597) is required upon acceptance to the course as content can be tailored for individual student requirements e.g. Neuroradiology, Nuclear Medicine or Mammography may be preferred. Clinical and laboratory research opportunities also exist.

Description: The course provides an opportunity for students who, having completed the core clerkship, wish further instruction in specific radiological subspecialty areas. Programs will be individually tailored to students' interests. The student should email to discuss their areas of interest with either Dr. Karimova or Dr. Perlmutter-Goldenson at least two weeks before the clerkship so that arrangements can be made in advance. Sites of interest will be distributed on a first-come, first-served basis. Students have the opportunity to observe the practice of radiology in action. Students may choose one or two specific subspecialty areas of academic interest including: abdominal, cardiac, thoracic, interventional, musculoskeletal, neuroradiology, nuclear medicine, breast imaging or emergency radiology. Under the supervision of Chief of that section along with section faculty, fellows, and residents the student will participate in daily clinical activities of radiology with an emphasis on image interpretation, observing procedures, attending clinical conferences, and viewing teaching files.

Description: The advanced radiology clerkship is designed to build upon the fundamentals of radiological interpretation presented during the core radiology clerkship. Students will expand their knowledge of the clinical indications for imaging examinations and interventional radiological procedures. The clerkship allows students to rotate through various subspecialty divisions of radiology at MGH. The schedule will be tailored to the student�s interests and clinical needs. The student will work as a member of the radiology team observing interpretations, helping with image retrieval, and researching interesting cases.

Description: Students will be assigned to each one of the organ based divisions in the department such as abdominal, musculoskeletal, thoracic, oncology, vascular, fetal,interventional and neuroradiology imaging. Each of these divisons consist of attendings, fellows and residents. Students will participate in the daily clinical practice in the radiology department by observing the performance, evaluation and interpretation of the radiologic studies. Students will attend the departmental lectures and conferences, and will have one-hour lectures geared to their level at which an overview of pediatric imaging will be presented over the four-week rotation. Students will each present an interesting case to the Radiology Department. There will be an oral examination at the end of the four-week period. Night call: Once a week until 10:00pm.

Description: Students may add themselves to the waiting list for this course during add/drop periods but not during lottery periods. Please contact Dr. Perlmutter, rperlmutter@bwh.harvard.edu, for approval to enroll. This course provides an opportunity for students who, having completed the core clerkship in radiology, wish further advanced instruction in ultrasound. Students will spend four weeks in the Ultrasound Division of the Department of Radiology at Brigham and Women's Hospital. During these four weeks, the students will be supervised by Brigham and Women's Hospital attending radiology ultrasound specialists, including Dr. Sara Durfee, Dr. Carol Benson, and Dr. Mary Frates. The student will also be paired with an experienced ultrasound technologist or a senior radiology resident or fellow and will be given hands-on instruction as to how to perform basic ultrasound examinations, including abdominal, renal, thyroid and scrotal studies, with a heavy emphasis on gynecologic and obstetric ultrasound exams. Students will learn the essentials of diagnostic ultrasound in a busy academic practice, including indications and limitations of these studies, practical tips for performing the studies, interpretation of the exam, and generation of a radiology report. Each day the student will be scanning approximately 12 patients, for a total of approximately 240 patients by the end of the rotation. Depending on availability, separate short observation periods (1-2 days) may be scheduled in the following departments: high risk obstetrics cross sectional interventional radiology (ultrasound guided biopsies and drainages) and angiography (ultrasound guided central line placement). Students will also participate in a daily morning thirty minute ultrasound conference and will attend resident conferences during the lunch hour. By the end of the clerkship, the student will be comfortable with basic scanning techniques and will be able identify common abnormalities on ultrasound. Weekly reading assignments will be given. The student will be assessed with a final examination at the end of the clerkship. This course would be particularly suited to a student interested in diagnostic radiology, obstetrics/gynecology, emergency medicine, medicine or surgery.

Description: Students will learn how radiology is practiced in an academically oriented busy community hospital, Mount Auburn in Cambridge. The day starts at 7:30 a.m. with 'positives conference'. Current interesting cases are presented in this 30 minute interactive conference attended by students, residents and faculty. This is followed by a 1 hour didactic session led by expert faculty. Students will then participate in a daily resident led educational curriculum dedicated to providing them with a strong foundation in medical imaging. Students will spend the rest of the day integrated into the clinical experience as an active member of our team and will work along side radiology residents and staff where they gain experience in a modality based environment caring for a high volume of patients with a broad spectrum of disease. The rotation schedule can be tailored to the student's interests and can include experience in vascular and interventional radiology, CT, MRI, nuclear medicine, fluoroscopy, women's imaging, ultrasound, and emergency radiology. In addition, students will attend various multidisciplinary conferences with the residents. Students are expected to present a radiology topic of their choice to the department at the end of the month.

Description: This course provides an opportunity for students who, having completed the core clerkship in radiology, wish further advanced instruction in Interventional Radiology. Students will spend four weeks in the Interventional Radiology Division at Brigham and Women’s Hospital. During these four weeks, the students will be supervised by Brigham and Women’s Hospital attending Interventional Radiology physicians. Students will also be paired with an experienced Interventional radiology senior radiology resident or fellow. The students will be able to observe and participate in vascular procedures (including chemo- and radio-embolization, TIPS and BRTO) and non-vascular interventional procedures (such vertebral augmentation, hepatobiliary and urinary interventions). Students will learn the essentials of interventional radiology in a busy academic practice, including clinical evaluation and preparation for the interventional procedures, performing the actual procedures and post-procedural management. The students will have an opportunity to participate in evaluation of the patients in the Interventional Radiology Outpatient Clinic. The students will also be able to elect to visit Interventional Radiology Vein Centers and participate in endovascular management of patients with varicose veins. The students will also have an opportunity to practice performing variety of interventional radiologic procedures on an endovascular simulator. Each day the students will be able to observe about 20 different interventional procedures and actively participate in 4-5 interventional procedures of their choice. Students will also participate in a daily morning rounds. By the end of the clerkship, the students will be familiar with clinical aspects of managing patients before, during and after interventional radiologic procedures, and with technical aspects of basic and more advanced radiologic interventions. Suggested weekly reading assignments will be given. Students will be assessed with a final evaluation at the end of the clerkship. This course would be particularly suited to a student interested in interventional radiology, diagnostic radiology, emergency medicine, or surgery.

Description: Advanced Clinical Elective (Sub-Internship) in Interventional Radiology (IR) Massachusetts General Hospital. Students will have direct patient responsibilities. The student will participate in the work-up of patients who are scheduled to undergo interventional procedures by reviewing the indications for the procedure, the pre-procedural imaging and laboratory parameters, and will present these data during the daily divisional working rounds. Similar to a junior resident, the students will then have the opportunity to participate in these scheduled procedures as a supervised assistant operator, gaining experience in developing clinical and technical skills. The student will be expected to outline the patient’s experience during interventional procedures including pre-procedural preparation, procedural sedation, procedural outcomes and post procedural care and follow up management. Additionally, the student will “round” on inpatients with all members of the team including physicians, nurses, and physician assistants. The students will have the opportunity to participate in the longitudinal care of patients and developing a better understanding of the Interventional Radiologist’s role in the care of complex patients. Students will have the opportunity to attend and participate in multi-disciplinary conferences and clinics to observe the IR team devise appropriate management strategies and therapies while gaining insight into the value of interventional radiology in patient centered care. At the conclusion of the elective the student will be expected to give a short presentation detailing a clinical case/procedure in which he or she was involved, with accompanying medical justification/literature support.

Description: Interventional radiology (IR) is at the forefront in the development of minimally invasive therapies used to treat patients with a wide variety of ailments. From patients who require venous access to patients who require emergent embolization or shunt placement for bleeding, interventional radiology is at the core of many tertiary care medical centers. Students who rotate through BIDMC IR operate as active members of the clinical service, including morning rounds, daily case review, scrubbing in as first assistant on procedures, and inpatient consultations. Students will work closely with the fellows and staff throughout their rotation. Students will be exposed to the full range of diagnostic and interventional procedures including arteriography/venography, angioplasty, stents, thrombolysis, interventional oncology, TIPS, biliary drainage, venous and enteral access, varicose vein therapy, uterine fibroid embolization, and caval filters. Opportunities to participate in ongoing research activities are available for interested students. There are daily informal teaching sessions given by the faculty that highlight every aspect of IR. Multiple weekly formal teaching sessions and didactics are a component of the IR elective as well. The clerkship directors are highly vested in every medical student to ensure that they are getting the most out of the rotation regardless of whether their intended future career is in IR. Students will walk away from this elective with new insight and appreciation into this exciting and highly competitive field that most students are not exposed to during their medical education. Any student thinking about a career in a surgical field who wants to practice the most advanced technology in medicine should consider IR.

Description: Students will learn how radiology is practiced in an academically oriented busy community hospital, Mount Auburn in Cambridge. The day starts at 7:30 a.m. with 'positives conference' conducted on Zoom. Current interesting cases are presented in this 30-minute interactive conference attended by students, residents and faculty. This is followed by a 1-hour didactic session led by expert faculty over zoon. Students will then participate in a daily resident led educational curriculum dedicated to providing them with a strong foundation in medical imaging. Students will spend the rest of the day integrated into the clinical experience as an active member of our team and will virtually work alongside radiology residents and staff where they gain experience in a modality-based environment caring for a high volume of patients with a broad spectrum of disease. They will have VPN access to review cases on PACs concurrently with the residents and be present during readout over Zoom. The rotation schedule can be tailored to the student's interests and can include experience in CT, MRI, nuclear medicine, women's imaging, ultrasound, and emergency radiology. In addition, students will attend various multidisciplinary conferences with the residents over zoom. Students are expected to present a radiology topic of their choice to the department at the end of the month.

Description: This course is about musculoskeletal disorders- trauma (acute, occupational and recreational) arthritis, infection, tumors, metabolic disorders (including osteoporosis) and congenital conditions as revealed by imaging studies including x-ray, CT, MRI, ultrasound and PET. These conditions, although usually less dramatic than cardiac or neurological disease, are extremely common. Almost all patients who live a full life span will experience one or more of them. Most physicians should be prepared to diagnose and treat the common ailments. The course is intended for any students who expect to encounter such patients-including primary care doctors, emergency physicians orthopedists, PM&R doctors , as well as potential radiologists. This first two weeks of the course are organized by body part, for example, shoulder, elbow wrist etc. This is done to allow a gradual introduction to the anatomical details needed to interpret each examination, A variety of imaging modalities will be considered for each region included x-ray, MRI, CT and PET. The second two weeks is organized around pathological conditions. The student will read didactic material, review imaging studies and actually create reports under the close supervision of the practicing Radiologists. It is very unusual for Radiology course to include this feature, but we think it helps to clarify what the student has learned. In addition to this �hands-on� experience will be a series of more formal instructional sessions. The student will also attend all musculoskeletal interdisciplinary conferences, and the midday teaching conferences of the Radiology residents. A limited amount of time can be made available to observe other operations of the Radiology department depending upon student objectives.

Description: This elective provides a 4-week opportunity for medical students (with/without core clerkship in radiology completion) for hands-on experience in Nuclear Medicine and Molecular Imaging. Students’ home institution is BWH, but like residents who train in the Joint Program in Nuclear Medicine (JPNM), an ACGME-approved training program, they will spend time at Dana-Farber Cancer Institute and Boston Children’s Hospital based on interest and availability. At each institution, the student will also be paired with an experienced senior diagnostic radiology resident, fellow or JPNM resident; the overall supervision of the student will be by an attending physician. The student will be paired with an experienced nuclear medicine technologist at least once at each site so that he/she can observe the entire process of obtaining nuclear medicine and molecular imaging studies from the technologists’ and patients’ perspectives. After an initial day of observation, the student will play an integral role in the care of patients who present for imaging or therapy to the Nuclear Medicine and Molecular Imaging Division. The student will have access to electronic patient records as well as digital image systems. The student will participate in determining patient history and clinical indications for requested imaging studies. He or she will observe and then participate in decision-making process regarding performance of requested studies and their interpretation. The student will be expected to look at one to two cases per day on his or her own and to incorporate what he or she learns by observation into active practice, becoming familiar with the appropriate use of physiologic imaging in the context of anatomic imaging such as CTs.

Description: Brigham and Women’s Hospital offers a four-week course for students who have completed a core clerkship or equivalent in radiology and would like further exposure to neuroradiology. The schedule will be customized to the student’s interests and goals. The student will observe and participate in interpretation of brain, spine, and head and neck imaging while paired with a resident or fellow with overall supervision by neuroradiology faculty. The student will have opportunity to independently review cases prior to discussion with a resident or fellow and then faculty member. In addition to traditional reading room consultations at Brigham and Women’s Hospital, the student may also observe consultations in the Neuroradiology Virtual Reading Room or within oncology clinic at the Dana Farber Cancer Institute. Basic procedural exposure will include fluoroscopically guided lumbar punctures and myelograms. Required educational conferences include daily radiology didactic and case conferences. A variety of multidisciplinary meetings are also available for attendance, including brain tumor board, head and neck conference, neurology conference, neurosurgery conference, and spine conference. Optional activities include but are not exclusive to the following: - Exposure to functional MRI, including the pre-imaging patient interview and training, test administration, and final study interpretation - Time on the neurointerventional radiology and/or cross-sectional interventional neuroradiology services - Observation in the Advanced Multimodality Image Guided Operating (AMIGO) suite The student will select a case to present to the course director at the end of the rotation, and appropriate cases can be considered to submit for publication, if desired. Opportunities for assisting in research projects may be accommodated.

Description: Annie Brewster, MD '99 and Jonathan Adler, PhD will co-teach this elective, which will offer students a solid foundation in the social science research on the health benefits of narrative through readings and didactic sessions, as well as experience working directly with patients and their loved ones, under supervision, to apply this knowledge. It is relevant for students pursuing any specialty. The didactic component of the elective includes assigned readings drawn from the interdisciplinary literature on narrative and health, with an emphasis on the empirical social science literature, writing exercises, and a once-weekly two-hour seminar. The applied work will occur in collaboration with Health Story Collaborative (HSC), a nonprofit organization founded by Dr. Brewster with the goal of using storytelling for therapeutic purposes. Elective participants will work within two of HSC's existing programs: The Healing Story Sessions program and the SharingClinic program. Healing Story Sessions (HSS) are live storytelling events. Elective participants will spend time preparing for and ultimately participating in a Patient-Provider Story Session (there is also a Patient-Patient version). Dr. Brewster and Dr. Adler will oversee this process, from story writing to story sharing. On a designated evening, patient-provider pairs will come together to share their stories in front of invited guests, including other medical students, facilitated by Dr. Brewster and Dr. Adler. SharingClinic is an evolving collaboration between HSC and MGH which involves hospital-based listening kiosks where patients, their loved ones, health care providers can access pre-recorded audio stories focused on the emotional experience of facing health challenges. Students will work for two hours each week at MGH in designated clinics and inpatient units to collect audio stories for SharingClinic. Dr. Brewster will supervise this process. This will provide students with valuable direct experience with patient narrative and an opportunity to contribute to an on-going project.

Description: This course will give students an in-depth experience in clinical management of patients with surgical problems. It will provide students an opportunity to evaluate patients, decide on a diagnostic and management strategy and provide care under housestaff and faculty supervision. Students will serve as clerks on a busy general surgical service. Students will be responsible for patient management with housestaff and under the guidance of the chief resident and attending surgeon. The course will offer an opportunity for students to gain experience in preoperative, intraoperative and postoperative patient management. There will be ample opportunity to attend and participate in conferences.

Description: This course will give students an in-depth experience in clinical management of patients with surgical problems, on one of the six General Surgery services at Brigham and Women’s Hospital: Surgical Oncology/Breast (Moore), Surgical Oncology/Endocrine (Chiefs), Colorectal (Zinner), GI/Minimally Invasive (Cutler), Vascular (Mannick), or Emergency General Surgery/Trauma (Cushing). Students will be contacted by the clerkship coordinator (Charity Stafford) as soon as they are confirmed for the rotation, and asked to rank the services of their choice. Students will serve as clerks on a busy general surgical service, and are expected to perform close to the level of an intern. The course will provide students the opportunity to gain experience in preoperative, intraoperative and postoperative patient management, including evaluating patients, deciding on a diagnostic and management strategy, and providing care under housestaff and faculty supervision. There will be ample opportunity to attend and participate in didactic conferences. The student will do up to 4 overnight/weekend shifts during the rotation, after discussion with the preceptor. This course assumes experience in the Core Surgery sequence at HMS or its equivalent. The elective student functions under the supervision of senior and junior residents, assisting in management of patients in clinic and on the floor, and participating actively in procedures in the operating room. Evaluation of performance and progress is based on evaluation by staff and residents. Areas of evaluation will include: organization and reporting of clinical data for patients assigned to the student, ability to interpret information to develop differential diagnoses and plans of management, professionalism in carrying out assigned tasks and interacting with the team and other care providers, efforts to contribute to the environment of learning by presentations to the team, and progress in technical areas. Feedback will be provided to students by their assigned preceptor in the middle and end of the rotation, in addition to a final debriefing session with Dr. Fairweather.

Description: This course will give students an in-depth experience in clinical management of patients with surgical problems, on one of the six General Surgery services at Brigham and Women’s Hospital: Surgical Oncology/Breast (Moore), Surgical Oncology/Endocrine (Chiefs), Colorectal (Zinner), GI/Minimally Invasive (Cutler), Vascular (Mannick), or Emergency General Surgery/Trauma (Cushing). Students will be contacted by the clerkship coordinator (Charity Stafford) as soon as they are confirmed for the rotation, and asked to rank the services of their choice. Students will serve as clerks on a busy general surgical service, and are expected to perform close to the level of an intern. The course will provide students the opportunity to gain experience in preoperative, intraoperative and postoperative patient management, including evaluating patients, deciding on a diagnostic and management strategy, and providing care under housestaff and faculty supervision. There will be ample opportunity to attend and participate in didactic conferences. The student will do up to 4 overnight/weekend shifts during the rotation, after discussion with the preceptor. This course assumes experience in the Core Surgery sequence at HMS or its equivalent. The elective student functions under the supervision of senior and junior residents, assisting in management of patients in clinic and on the floor, and participating actively in procedures in the operating room. Evaluation of performance and progress is based on evaluation by staff and residents. Areas of evaluation will include: organization and reporting of clinical data for patients assigned to the student, ability to interpret information to develop differential diagnoses and plans of management, professionalism in carrying out assigned tasks and interacting with the team and other care providers, efforts to contribute to the environment of learning by presentations to the team, and progress in technical areas. Feedback will be provided to students by their assigned preceptor in the middle and end of the rotation, in addition to a final debriefing session with Dr. Fairweather.

Description: This course allows students to join a Surgical Oncology, Hepatobiliary/Pancreas, Colorectal, Gen/GI, Endocrine, Minimally Invasive, or Trauma/Emergency Surgical Service. The student is expected to function closer to the level of an intern. Each team is composed of 1-5 attendings, 1 Senior, and 1 junior resident/intern and a variable number of nurse practitioners. The student is expected to take responsibility for the patients on his/her team. This is meant to prepare the student for a future in surgical training program. Learning occurs in the operating room, rounds, and specialty conferences. There are no overnight calls on these services except the trauma/emergency surgical service. Students are asked to rank the services of their choice and send to the clerkship director as soon as they are confirmed for the rotation.

Description: This course is a preceptorship under the direct supervision of a cardiac surgeon. It will provide exposure to the diagnosis and pre- and post-operative care of the cardiac surgical patient, with patient care. The student will attend Cardiac Surgical Rounds and catheterization conferences. He/she will take an active part in the operating room and the Surgical Intensive Care Unit, and will follow selected cardiac surgical patients from admission to discharge. The student will be expected to take night call one night per week, one of which will be under the direct supervision of the CT resident. The pedagogical emphasis in this course will be on the integration of the student within the cardiac surgical team, but under the preceptorship of a single cardiac surgeon.

Description: The course is designed to acquaint students with concepts, philosophy and techniques of clinical cardiac surgery. There will be opportunities to participate in pre- and postoperative care of cardiac surgical patients and assist at cardiac operations at the BWH. Weekly lectures in clinical cardiology, conferences on preoperative evaluation of cardiac surgical patients and rounds in the intensive care units and general wards will be conducted. The course will give students sufficient experience in an academic atmosphere to judge the depth of their own interest in cardiac surgery.

Description: This course will provide exposure to the diagnosis and pre- and post-operative care of the cardiac surgical patient, with direct involvement in patient care. The student will attend weekly Cardiac Didactics and teaching conferences. He/she will take an active part in the operating room and the Surgical Intensive Care Unit, and will follow selected cardiac surgical patients from admission to discharge. The main emphasis in this course will be on the integration of the student within the cardiac surgical team to effectively learn the anatomy and pathophysiology of cardiac surgical disease and