phase iii clerkship catalog 2009-2010

PHASE III

CLERKSHIP CATALOG 2009-2010

Fourth Year Catalog of Learning Opportunities

Clerkship Descriptions

Credit Policies and Procedures Preceptorship Rotations

PHASE III

CLERKSHIP CATALOG

2010-2011

Fourth Year Catalog of Learning Opportunities Clerkship Descriptions

Credit Policies and Procedures Preceptorship Rotations

The University of New Mexico School of Medicine

Phase III Clerkship Catalog :: 2010-2011

The University of New Mexico School of Medicine reserves the right to make changes to any of the policies, procedures, codes,

standards, requirements, or services included in this handbook as it deems necessary, with the changes applicable to all students in attendance at the School of Medicine.

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TABLE OF CONTENTS POLICIES ON PHASE III CLERKSHIPS ................................................................... 5 COMPENSATION .................................................................................................... 6 AWARDING OF THE MD DEGREE ............................................................................ 6 PHASE III REQUIREMENTS ................................................................................... 6 ICU AND SUB-INTERNSHIP CREDITS .................................................................... 6 SUB-INTERNSHIP AND INTENSIVE CARE UNIT COURSES...................................... 7 NEW MEXICO PRECEPTORSHIP CREDIT ................................................................ 8 ELECTIVE CREDIT ................................................................................................. 8 ELECTIVE CREDIT FOR REQUIRED RESEARCH ....................................................... 9 PHASE III NON-CATALOG EDUCATIONAL EXPERIENCES ..................................... 10 ELECTIVE CREDIT FOR SUB-INTERNSHIPS AND ICUs ......................................... 11 REQUESTING SUB-I or ICU CREDIT FROM CSPE .................................................. 11 INTERNATIONAL CLERKSHIPS ............................................................................ 12 PROMOTION TO PHASE III.................................................................................. 14 2010-2011 PHASE III CLERKSHIP SCHEDULE ..................................................... 15 2010-2011 PHASE II ROTATION DATES .............................................................. 15 DEPARTMENT OF ANESTHESIOLOGY ................................................................... 17

Anesthesiology and Critical Care Medicine ..................................................... 17 Clinical Dermatology at UNMH and VAMC ....................................................... 18 Dermatology Research at UNMH and VAMC .................................................... 19

DEPARTMENT OF EMERGENCY MEDICINE ............................................................ 20 Pediatric Emergency Medicine ........................................................................ 20 Emergency Medicine at VAMC......................................................................... 21 Emergency Medicine at UNMH ........................................................................ 22 First Track ...................................................................................................... 23 Emergency Medical Services .......................................................................... 24 Toxicology ...................................................................................................... 25 Wilderness Medicine ...................................................................................... 26 Advanced EMS and Disaster Medicine and Medical Care Under the Austere

Conditions ...................................................................................................... 27 Travel and Emergency Medicine ..................................................................... 29 Leadership in Wilderness Medicine ................................................................ 31 Advanced Emergency Medicine/Critical Care ................................................. 33 International Emergency Medicine - Nepal ..................................................... 35 Evolutionary Medicine .................................................................................... 37 Emergency Ultrasound Elective at UNMH ....................................................... 39

DEPARTMENT OF FAMILY & COMMUNITY MEDICINE ........................................... 40 Public Health Epidemiology in Santa Fe, NM ................................................... 40 Family Practice at UNMH Sub-Internship ....................................................... 41 Health for the Public ...................................................................................... 42 Rural Primary Care in Cuba, New Mexico ........................................................ 43 Health Care for the Homeless ......................................................................... 44 Family Medicine Maternal Child Health ........................................................... 45 Writing and Healing ....................................................................................... 47

INTERDEPARTMENTAL OFFERING ....................................................................... 48 Comprehensive Ambulatory Care ................................................................... 48

DEPARTMENT OF INTERNAL MEDICINE ............................................................... 49 Hematology Oncology Clinic ........................................................................... 49 Infectious Disease at Inpatient ...................................................................... 50 Internal Medicine at UNMH Sub-Internship .................................................... 51 Geriatric Medicine .......................................................................................... 52 Occupational and Environmental Health Course ............................................. 53 Gastroenterology ........................................................................................... 55 Nephrology .................................................................................................... 56





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Pulmonary Medicine ....................................................................................... 57 Cardiovascular Elective at UNMH .................................................................... 58 Arthritis and the Rheumatic Diseases ............................................................ 59 Adult Endocrinology and Metabolism ............................................................. 60 Sleep Disorders Center ................................................................................... 61 Internal Medicine at VAMC Sub-Internship .................................................... 62 Medicine Intensive Care at UNMH .................................................................. 63 Infectious Disease Outpatient ........................................................................ 64 Alternative and Complementary Medicine ...................................................... 65

DEPARTMENT OF INTERNAL MEDICINE ............................................................... 66 Radiation Oncology ........................................................................................ 66

DEPARTMENT OF NEUROLOGY ............................................................................ 67 Neurology at UNMH Sub-Internship ............................................................... 67 Spinal Cord Injury [SCI] at VAMC .................................................................. 68 Neurology at VAMC Sub-Internship ................................................................ 69 Child Neurology at UNMH Sub-Internship ...................................................... 70 Neurology Research ....................................................................................... 72

DEPARTMENT OF NEUROSCIENCES ..................................................................... 73 Neuroscience Teaching .................................................................................. 73

DEPARTMENT OF NEUROSURGERY ...................................................................... 74 Neurosurgery at UNMH Sub-Internship .......................................................... 74

DEPARTMENT OF OBSTETRICS & GYNECOLOGY .................................................. 75 Ambulatory Gynecology ................................................................................. 75 Gynecologic Oncology Sub-Internship ............................................................ 76 Maternal Fetal Medicine at UNMH ................................................................... 78 Maternal and Child Health in Guatemala ........................................................ 79 Maternal Fetal Medicine in Sierra Leone ......................................................... 80 Benign Gynecology at UNMH Sub-Internship ................................................. 81

DEPARTMENT OF ORTHOPAEDICS ....................................................................... 82 General Orthopaedic Surgery Sub-Internship ................................................ 82 Pediatric Orthopaedics at Carrie Tingley Hospital .......................................... 83 Orthopaedic Trauma Sub-Internship .............................................................. 85 Hand Surgery ................................................................................................. 87 Orthopaedic Spine Clinical Experience ........................................................... 88 Sports Medicine .............................................................................................. 89

DEPARTMENT OF PATHOLOGY ............................................................................. 90 Anatomic Pathology at UNMH ......................................................................... 90 Anatomic Pathology at VAMC ......................................................................... 91 Clinical Pathology ........................................................................................... 92 Clerkship in Forensic Pathology ..................................................................... 94

DEPARTMENT OF PEDIATRICS ............................................................................ 96 Ambulatory Pediatrics at Young Children’s Health Center .............................. 96 Pediatrics at UNMH Sub-Internship ................................................................ 98 Pediatric Cardiology ....................................................................................... 99 Pediatric Rehabilitation/Pediatric Chronic Disease ...................................... 101 Pediatric Genetics and Dysmorphology ........................................................ 102 Pediatric Hematology / Oncology ................................................................. 103 Adolescent Medicine ..................................................................................... 104 Pediatric Intensive Care ............................................................................... 105 Pediatric Infectious Disease ......................................................................... 107 Newborn Intensive Care Unit ....................................................................... 108 Pediatric Outpatient Department ................................................................. 109 Westside Family Health Outpatient Clinic ..................................................... 110

DEPARTMENT OF PSYCHIATRY .......................................................................... 112 Advanced Clinical Psychiatry [Inpatient] ..................................................... 112 Sub-Internship ............................................................................................. 112





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Advanced Clinical Emergency Psychiatry [Ambulatory] ............................... 113 Neuropsychology ......................................................................................... 114 Alcohol and Substance Abuse Program ........................................................ 115 Consultation and Liaison Psychiatry ............................................................. 116 Advanced Clinical Psychiatry [Ambulatory] .................................................. 117 Psychiatric Care of Developmental Disabilities ............................................. 118

DEPARTMENT OF RADIOLOGY ........................................................................... 119 Neuroradiology ............................................................................................ 119 Diagnostic Radiology .................................................................................... 120

DEPARTMENT OF SURGERY ............................................................................... 121 Burns and Trauma Sub-Internship ............................................................... 121 Thoracic Surgery at UNMH ........................................................................... 122 Ophthalmology ............................................................................................. 123 Otolaryngology Sub-Internship .................................................................... 124 General Surgery at VAMC Sub-Internship..................................................... 125 Pediatric Surgery at UNMH Sub-Internship .................................................. 126 Urology Sub-Internship ................................................................................ 127 Surgery at UNMH Sub-Internship ................................................................. 128 Surgical Critical Care ICU ............................................................................. 129 Plastic Surgery ............................................................................................. 130 Introduction to Transplantation ................................................................... 131 Vascular Surgery Sub-Internship ................................................................. 132 Pediatric Urology.......................................................................................... 133 Adult Cardiothoracic Surgery at UNMH ......................................................... 134 General Surgery Teaching Elective ............................................................... 135 Pediatric Ophthalmology .............................................................................. 136 Adult Cardiothoracic Surgery at VAMC ......................................................... 137 Clinical Applications of Anatomy .................................................................. 138 Surgical Specialties Elective ......................................................................... 139

DEPARTMENT OF UNDERGRADUATE MEDICAL EDUCATION ............................... 142 Medical Education Scholarship in Assessment or Curriculum Development .. 142

OFFICE OF GLOBAL HEALTH .............................................................................. 144 International Electives – Clinical .................................................................. 144 International Electives – Non-Clinical .......................................................... 147

PRECEPTORSHIP OFFICE ................................................................................... 149 New Mexico Preceptorship ........................................................................... 149





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INTRODUCTION The purpose of the Phase III medical curriculum at the University of New Mexico School of Medicine is to:

Provide opportunities for students to further develop their skills and knowledge of patient care

Provide opportunities for students to broaden their understanding of medicine and its specialties

Provide opportunities for students to explore fields in which they may wish to pursue careers

Provide opportunities for students to remediate deficiencies in medically relevant skills, knowledge and behaviors

This catalog contains descriptive information about courses, clerkships and preceptorship opportunities available to Phase III students. The variety of learning experiences includes hospital, clinic, community and laboratory environments. The information has been condensed in this listing. Further information may be obtained by contacting the faculty evaluator. All departments and individuals offering Phase III courses have been queried regarding prerequisites, which are stated with each description in this catalog. Students are not restricted to the courses contained in this catalog and are encouraged to initiate educational experiences here or at other institutions. For information about requesting Phase III credit for rotations not listed in this catalog, please refer to the Non-Catalog Education Experiences section.

POLICIES ON PHASE III CLERKSHIPS The Committee on Student Promotions and Evaluation (CSPE) may

require students to take and pass specifically designated Phase III Clerkships to remediate deficiencies in knowledge, skills or behavior important to the practice of medicine.

Study away from The University of New Mexico School of Medicine is considered a privilege and may be denied by CSPE, if the committee deems such activities are not in the best interest of the student’s education.

To receive credit for a Phase III educational experience at another medical facility, a Phase III Credit request must be submitted for consideration by CSPE at least 45 days prior to the commencement of the rotation. Failure to do so will result in no credit for the rotation.

No credit will be given for a non-catalog experience which commences prior to CSPE having the opportunity to consider the Phase III Credit Request.

A student who has had academic difficultly may be prohibited from taking Phase III clerkships away from the UNM SOM campus.

Approval from CSPE is required for a student to take any Phase III clerkship prior to promotion to Phase III. Students may not receive more than eight weeks of Phase III credit prior to promotion to

Phase III.





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COMPENSATION Students are usually not permitted to receive monetary compensation for courses taken to meet graduation requirements. Special circumstances permit exceptions for clerkships taken outside the Albuquerque area. In some cases, research electives or other rotations may be approved by CSPE for credit as well as monetary compensation. Any exception must be approved by the Office of Undergraduate Medical Education and CSPE prior to taking the course.

AWARDING OF THE MD DEGREE To be eligible for consideration by the faculty for award of the MD degree, a student must fulfill all of the following requirements:

Achieve a grade of Satisfactory or above in all Phase III rotations Successfully complete the research requirement Take the final Clinical Skills Performance Exam Record a passing Score for USMLE Step 1, Step 2 CK and Step 2 CS Adhere to ethical and professional standards of behavior

Any first attempt “Fail” grade in a Phase III Clerkship must be successfully remediated prior to initiating another Phase III clerkship. For more information, please see the entire “Policy on Student Promotion and Awarding the MD Degree” in the UNM SOM Student Handbook.

PHASE III REQUIREMENTS

Intensive Care Unit 4 weeks

Sub-Internship 4 weeks

Comprehensive Ambulatory Care 4 weeks

New Mexico Preceptorship 4 weeks

Electives 16 weeks

Total required 32 weeks

ICU AND SUB-INTERNSHIP CREDITS Phase III Students are required to complete a four week ICU and a four week of Sub-Internship. Prerequisites for these courses include completion of all Phase II clerkships.





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SUB-INTERNSHIP AND INTENSIVE CARE UNIT COURSES

Name of Rotation Course

Number Sub-I

Intensive

Care

Anesthesiology and Critical Care Sub-Internship 801 X

Family Medicine Maternal Child Health Sub-Internship 781 X

Family Practice at UNMH Sub-Internship 777 X

Medicine Intensive Care at UNMH 622 X

Internal Medicine at UNMH Sub-Internship 606 X

Internal Medicine at VAMC Sub-Internship 620 X

Neurology at UNMH Sub-Internship 701 X

Neurology at VAMC Sub-Internship 703 X

Spinal Cord Injury at VAMC Sub-Internship 702 X

Child Neurology at UNMH Sub-Internship 704 X

Neurosurgery at UNMH Sub-Internship 753 X

Gynecologic Oncology Sub-Internship 653 X

Maternal Fetal Medicine at UNMH Sub-Internship 654 X

Benign Gynecology at UNMH Sub-Internship 656 X

General Orthopaedic Surgery Sub-Internship 850 X

Orthopaedic Trauma Sub-Internship 852 X

Pediatric Intensive Care 684 X

Newborn Intensive Care Unit 687 X

Pediatrics at UNMH Sub-Internship 677 X

Advanced Clinical Psychiatry [Inpatient] Sub-Internship 726 X

Burns and Trauma Sub-Internship 751 X

Surgical Critical Care ICU 760 X

General Surgery at VAMC Sub-Internship 756 X

Surgery at UNMH Sub-Internship 759 X

Pediatric Surgery at UNMH Sub-Internship 757 X

Vascular Surgery Sub-Internship 763 X

Urology Sub-Internship 758 X

Otolaryngology Sub-Internship 755 X





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NEW MEXICO PRECEPTORSHIP CREDIT

OBJECTIVES OF THE PRECEPTORSHIP PROGRAM The preceptorship is intended to supplement traditional intramural medical education with a view of medicine as it is practiced outside the metropolitan medical center. The preceptorship is designed to provide medical students with opportunities for significant clinical service to patients, enabling student to obtain a foundation of practical experience in a community setting. The preceptorship provides the opportunity to experience the role and life of a practicing physician as a member of a family and of the community. Students are also provided the opportunity to learn about the organization and economics of health care in a variety of settings such as: community clinics, solo or group private practice or HMO.

The student is required to dedicate one half day of this rotation to a community project. The community medicine project should be developed out of patient problems, basic science issues or student’s exploration of what it is like to become a member of a community as a medical provider. Students will receive more information before departure to the preceptorship site. PRECEPTORSHIP SCHEDULING Preceptorships are available in all types of practice settings, from solo to group practices, from community clinics to private multi-specialty practices. The minimum duration of the Phase III preceptorship is four weeks. If a student requests a second month, the student may receive elective credit. No student may arrange a rotation without contacting the Preceptorship Office. It is mandatory that preceptorships be scheduled through the Preceptorship Office. Once a student is scheduled for a specific rotation, that schedule is binding to the same extent as other clinical rotations. Preceptorships will only be rescheduled with extenuating circumstances. Changes must be requested within 45 days of the beginning of the rotation. Also required is an orientation interview prior to starting the preceptorship and an exit interview (within two weeks) at the end of the preceptorship. Preceptorship course numbers are as follows: Required Preceptorship: #910 Elective Preceptorship: #911 To schedule a preceptorship, contact the Preceptorship Office located in the Family Practice Building, 272-8399. Course information for the Preceptorship is at the end of this catalog.

ELECTIVE CREDIT

A minimum of 16 weeks in Phase III must be scheduled for elective credit. All courses listed in the catalog are approved for elective credit, including the preceptorships. Non-Catalog courses and courses at other institutions must be

approved in advance by CSPE for elective credit.





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An elective is defined by the CSPE as an educational activity related to medical science. To receive elective credit, the experience must meet the following criteria:

It must be approved in advance by the appropriate UNM department chair/director, the Office of Medical Student Affairs, the Office of Undergraduate Medical Education and CSPE

It must be a medically relevant educational experience rather than a job, and the student must have adequate background so that the experience is of educational value

The performance of the student in the experience must be evaluated and reported to the Office of Medical Student Affairs at UNM SOM

All of the above criteria must be met before consideration will be given to awarding elective credit for study at other institutions. Any request must be accompanied by a course description (often a description may be found in an institution’s catalog or website).

ELECTIVE CREDIT FOR REQUIRED RESEARCH Students may receive elective credit in Phase III for required research according to the following criteria. Students who wish to receive Phase III elective credit for required research must register as they would for other rotations. Required research rotations are graded on a credit/no credit basis. The course number for required research elective is CLNS 900.





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PHASE III NON-CATALOG EDUCATIONAL EXPERIENCES Students are not restricted to the courses listed in this catalog and are encouraged to initiate educational experiences here or at other institutions. VSAS AWAY ROTATIONS The Visiting Student Application System (VSAS) is used by LCME schools to receive, review, approve and schedule away rotations. Medical Student Affairs will issue all eligible students authorizations to access this system. If a student accepts a rotation in VSAS, they must still complete an Add/Drop slip in OSS to have it added to their schedule. This process is not automatic and an away rotation approved in VSAS will NOT appear

on your schedule until this task is completed. Where the Add/Drop slip or Online Workflow requests a Department Signature, the student should write “Approved in VSAS” and OSS will confirm. Students must add a VSAS Away rotation to their schedule 30 days prior to the start date. OSS will consider a rotation accepted in VSAS “pre-approved” for credit if it meets the follow criteria:

It is at an LCME School (currently VSAS is only available for LCME accredited schools)

It is 4 weeks in length The student is using it only for “Elective” credit (Not Sub-I or ICU) It is NOT an international rotation

If the rotation does not meet that criteria, or you wish to use the away rotation to satisfy a Sub-Internship or ICU requirement, “pre-approval” does not apply and the student must follow the directions listed under Non-VSAS Away rotations in order to receive credit. NON-VSAS AWAY ROTATIONS All non-catalog experiences that are not applied for and approved through VSAS must have the prior approval of CSPE. Requests must be submitted 45 days in advance of the start of the rotation. To request approval of a non-catalog experience, the student must

Complete the Phase III Credit Request form available on the OSS website.

Provide a written description of the course, either from a course catalog or affiliated website.

Present the Credit Request and Sub-I/ICU credit request (if applicable) and course description to the appropriate UNM SOM department chair/director for review and signature approval.

Submit the request with the department chair’s signature and all other documents to the Office of Medical Student Affairs at least 45 days prior to the beginning date of the requested course. The request is reviewed by that office, UME, and is then forwarded to CSPE for final consideration.





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Any student who takes a non-catalog course without the required prior approval of CSPE will not receive credit for the course, regardless of the grade given by the course instructor. Keep in mind, there is no guarantee of malpractice insurance coverage if a course has not been pre-approved by CSPE. Following CSPE’s review, the student is notified by email of CSPE’s decision regarding the request. The student is also responsible for providing the faculty evaluator with the appropriate evaluation form to receive a grade or credit. Credit for a course will not be given until a completed UNM SOM evaluation form with a passing grade is received in the Office of Medical Student Affairs. In the event of a cancelled rotation, students are responsible for meeting any policies set forth by the intended institution, including but not limited to: cancellation deadlines, fees, notifications, etc. Students must also ensure that the course is removed from their UNM SOM schedule.

ELECTIVE CREDIT FOR SUB-INTERNSHIPS AND ICUs A student may use a course at another institution to meet the SUB-I or ICU credit requirement. This is rare and students are encouraged to complete a Sub-I and ICU at UNM. In order to receive Sub-I or ICU credit, programs must fulfill the following requirements:

The student must act as a sub-intern, assuming primary responsibility for overall care in an inpatient setting

Full-time physician supervision must be provided on site or by telephone

The experience must include initial or early patient contact, history and physical examination, formulation of problem list, diagnostic plan, therapeutic plan, writing orders, patient follow up, progress notes and discharge notes

In clerkships requiring on call activity the student’s activity must be in rotation with intern schedules (including night and weekend call)

No rotation may be less than four weeks. Travel or absence for pursuit of residency positions is not allowed during these clerkships, except with written permission of the service

REQUESTING SUB-I or ICU CREDIT FROM CSPE

Students wishing to receive Sub-I or ICU credit for an away rotation must follow the same steps as requesting Phase III credit from CSPE. In addition:

Students must complete the Sub-I/ICU Credit Request Form available on the OSS website.

Students must have the faculty evaluator from the intended institution sign the Sub-I/ICU credit form prior to submitting it to CSPE.

Retroactive requests for credit will not be considered by CSPE.





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INTERNATIONAL CLERKSHIPS During Phase III, students may choose to participate in an international clerkship which must meet the following criteria to be approved by CSPE for academic credit:

Level of participation in the elective must be active and meaningful o Experiences that are predominantly observational or passive

may not be approved o Clinical care includes direct participation in care giving and

decision making. o Participation in a research project involves a meaningful role.

Supervision with regard to educational goals and responsibilities must be active to ensure the quality of the experience, critical assessment

and feedback on strengths and weaknesses of the student. An individual at the clerkship site must be responsible for monitoring

the student’s learning objectives, ensuring the quality of the experience and providing a written evaluation of the student’s performance. Evaluation must address the required levels of participation of the student’s clinical experience or project, gathering of information, critical management of information and setting of priorities, intervention or implementation and the ability to evaluate outcomes.

A student seeking approval of CSPE to participate in an international clerkship must follow the same procedures for requesting Phase III Credit from CSPE and meet the following requirements:

Student must be in good academic standing Student must submit a written report describing the experience to

CSPE Student must have appropriate language skills Proposed educational activities must not violate applicable laws or

regulations Student is responsible for financing

The University of New Mexico places the highest priority on protecting students’ health and safety when traveling outside the US as part of University programs. Therefore, students planning to travel outside the country must work with the Office of International Programs, 2111 Mesa Vista Hall, 277-4032 to:

Complete and submit the conditions of travel form Purchase the following insurance policies as applicable

o TRAVMED o Health Insurance which includes medical evacuation and

repatriation of remains Submit a travel itinerary and emergency contact form Obtain health and safety information for travelers from the US State

Department Submit a copy of your passport





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PHASE III SCHEDULING PHASE II FLOAT RESCHEDULING Most Phase III clerkships have prerequisites stating that all or specific Phase II clerkships must be completed. Students who were approved to float one or more clerkships during Phase II will be required to schedule those Phase II courses prior to Phase III clerkships unless approved by CSPE. Students will be scheduled on a space available basis after the incoming Phase II students have been scheduled and in consultation with clerkship directors and CSPE. The Office of Medical Student Affairs will notify students of Phase II assignments. PHASE III SCHEDULING Students state preferences for their Phase III schedule using the Phase III schedule worksheet. Upon consultation and approval of their Match Advisor the worksheet is then submitted to the OSS. Students request all courses except the Preceptorship rotation and any rotations requiring approval from CSPE. Students register for their preceptorship requirement through the Preceptorship Office and list it in the appropriate block on the scheduling worksheet. Students should keep the following in mind when requesting courses through:

• Phase II prerequisites stated in the Clerkship Catalog must be met. • Students granted departmental approval for a course must provide the

appropriate documentation to the Office of Medical Student Affairs prior to listing the course on the scheduling worksheet.

• Early and Regular Match Interviewing Schedules • Ambulatory Care is only offered during certain blocks.

While every effort is made to accommodate students’ stated preferences, departmental needs and limitation take precedence. In developing schedules, the Office of Medical Student Affairs takes these priorities into account. By necessity, elective courses must be planned around required clerkships. Each department establishes the maximum number of students accepted for each rotation, and UNM students are given priority over students from other schools during the initial Phase III scheduling period. The Office of Medical Student Affairs maintains the official schedule of clinical clerkships for all Phase III students. Changes to that schedule may be made only with the approval of the department in which a course is offered. Courses appearing on the approved schedule are the only ones that may be used by the faculty in determining completion of degree requirements. For more information on how to change your schedule, students may contact the SOM Registrar.





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PROMOTION TO PHASE III To be eligible for consideration for promotion to Phase III, a student must fulfill all of the following promotion requirements:

Achieve a grade of Satisfactory of above in all seven Phase II clerkships.

The scholarly research proposal must be approved by the Medical Student Research Committee, or the required research project completed.

Achieve a grade of Credit for PIM, Continuity Clinical and Performance Assessments (Formerly OSCEs).

Adhere to ethical and professional standards of behavior.

Please see entire policy on student promotion and awarding the MD degree in the UNM SOM Student Handbook. Except in very unusual circumstances, all required Phase II clerkships must be taken within the UNM SOM departments. Phase I and Phase II students who wish to take any Phase III clerkship must have prior approval from CSPE. Students may only receive 8 weeks of Phase III credit prior to promotion to Phase III. This generally works out to 2 courses. This rule applies to students who have delayed sitting for board exams. Students must have completed all course prerequisites established by departments or individuals offering Phase III electives. Prerequisites are stated in each course description in the catalog. Prerequisites for Sub-I, ICU and Preceptorship courses include completion of all Phase II clerkships. Exceptions to these guidelines are rarely approved.





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2010-2011 PHASE III CLERKSHIP SCHEDULE

4/26/10-5/23/10 5/24/10-6/20/10 VACATION

6/21/10-6/27/10

6/28/10-7/25/10

7/26/10-8/22/10 8/23/10-9/19/10 9/20/10-10/17/10 10/18/10-11/14/10

11/15/10-12/12/10 12/13/10-1/9/11 1/10/11-2/6/11 2/7/11-3/6/11

3/7/11-4/3/11 4/4/11-5/1/11 5/2/11-5/29/11

2010-2011 PHASE II ROTATION DATES

4/26/10-6/18/10 6/21/10-8/13/10 8/30/10-10/22/10

10/25/10-12/17/10 1/3/11-2/25/11 2/28/11-4/22/11

Phase II Vacation: 8/14/10-8/29/10 12/18/10-1/2/11





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VISITING MEDICAL STUDENTS The University of New Mexico School of Medicine welcomes visiting medical students to participate in senior year elective clerkships. Clerkships for visiting students are coordinated by the Office of Medical Student Affairs. UNM SOM participates in the Visiting Student Application System (VSAS). All applications from students attending LCME accredited schools must be submitted using VSAS. Osteopathic Students and International Students will continue to use a paper application. For current application processes please visit our website at http://hsc.unm.edu/som/oss/Visiting_Students.shtml

CONTACT INFORMATION

The information in this handbook is subject to change at any time. For the most up to date information, or if you have questions regarding any policy or requirement listed in this handbook, please contact the Office of Medical Student Affairs. Physical Location:

Basic Medical Sciences Building Room #107 Phone: 505-272-3414 Fax: 505-272-8239

Faculty and Staff:

Eve Espey, MD, MPH, Associate Dean of Students [email protected]

Sheila Hickey, MD, Assistant Dean of Students, Chair of CSPE [email protected]

Todd Hynson, Registrar-Student Enrollment Director [email protected]

Cristina Beraun, Operations Specialist [email protected]

Sarah Abrahamson, Senior Student Enrollment Officer [email protected]

Anastasia Andersen, Administrative Coordinator [email protected]

Elizabeth Lopez, Senior Student Records Clerk [email protected]

Janell Valdez, Financial Aid Manager [email protected]

Karen Sampson, Financial Aid Officer

[email protected]

http://hsc.unm.edu/som/oss/Visiting_Students.shtml

mailto:[email protected]












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DEPARTMENT OF ANESTHESIOLOGY

Anesthesiology and Critical Care Medicine Sub-Internship

Course #: CLNS 801

Credit: Sub-Internship

Duration: 4 Weeks

Students per Rotation: 2

Faculty Evaluator(s): Saul Wiesel, MD

Sally Fortner, MD

Prerequisites:

Accepting Visiting Students: Yes

Contact: Charlotte Jaramillo

Goals and Unique Aspects:

The rotation seeks to achieve goals set by the student, in particular, the student gains

an understanding of the bodily response to invasive perioperative medicine.

Objectives:

Student gains understanding of the affect of physiology, pathology and pharmacology on

the care of a patient under anesthesia; and gains proficiency in essential anesthesia manual skills such as airway management and vessel cannulation. Student increases

independence of thought in patient management and acquires insight into management

of an operating room and lifestyle of an anesthesiologist.

Responsibilities:

Student observes and participates in all aspects of patient care, pre-operative to post

operative. Student is assigned patients daily and participates in night call once a week.

Student also participates weekly in the Bat Cave anesthesia simulation. Research

projects are available in clinical, pharmacological, and education fields. However,

participation in not required.

Supervision and Teaching:

Student has daily direct teaching by attending physicians and residents in the OR and

attends weekly seminars with Dr. Sanders. Twelve reading assignments are made from

textbooks provided by the department and material is reviewed regularly. Student is

expected to attend three meetings and lectures per week and to participate in the

monthly Journal Club.

Evaluation: 25% - Written examination and seminar participation. 25% - Bat Cave simulator. 50% -

Clinical observations. Criteria for outstanding grade: Determined by evaluation of the

students assessed overall performance by supervising physicians, and based on an

“Outstanding” in clinical observations and “Outstanding” in either the Bat Cave or the

written exam, and at least a “Good” in the third category.





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DEPARTMENT OF DERMATOLOGY

Clinical Dermatology at UNMH and VAMC

Course #: CLNS 810

Credit: Elective: Clinical

Duration: 4 Weeks


Faculty Evaluator(s): R. Steven Padilla, MD Prerequisites: Completion of all Phase II Clerkships


Contact: Michele Barth


Opportunity to work in dermatology clinics at UNMH, VAMC, and UNM Student Health

Center, and participate in didactic sessions with faculty and residents.

Objectives:

Emphasis placed on the diagnosis and treatment of the most common skin diseases and

on cutaneous manifestations of systemic diseases.

Responsibilities:

Clinical: Most days are spent in clinics. Student must attend all clinics and conferences

as directed by chief resident. No night or weekend responsibilities.

Supervision and Teaching: Amount and type: Full time and volunteer faculty members supervise all teaching clinics.

Didactic content: Formal instruction three times a week in the form of small

conferences. Student participates in other conferences as directed by chief resident.

Evaluation:

All residents and faculty evaluate the student and Dr. Padilla summarizes the

evaluations. Evaluation based on attendance (25%), participation (25%), and brief

examination (50%). The examination, consisting of 10 Kodachrome slides and 60

additional questions, should not be difficult if all clinics have been attended and all assignments completed. Must attend all clinics and conferences as directed by chief

resident. One unexcused or two excused absences results in lowering the final grade by

one level (i.e. “good” to “satisfactory”). Absences may be made up by completing

requirements for “outstanding” grade described below. Criteria for outstanding grade:

Given only to those individuals who are outstanding in all categories and who complete

one of the following on the dermatologic disease category of his/her choice, due at the

completion of the rotation. Paper: eight pages in length (excluding references). OR

Presentation: 15 minutes duration on a disease entity, including an in-depth historical

review on morphology, histopathology and therapy.





19

DEPARTMENT OF DERMATOLOGY

Dermatology Research at UNMH and VAMC

Course #: CLNS 811

Credit: Elective: Non-Clinical

Duration: 4 Weeks


Faculty Evaluator(s): R. Steven Padilla, MD Prerequisites: Completion of all Phase II Clerkships


Contact: Michele Barth


Opportunity to work in a clinical or laboratory setting with one of the dermatology

faculty or residents. Strongly recommended for a student interested in a career in dermatology.

Objectives:

Participate in clinical or laboratory research projects related to the skin and its diseases

under supervision of faculty of Department of Dermatology at UNMSOM

Responsibilities:

Research: Participation in a prearranged research project. Student is encouraged to

attend dermatology teaching conferences and clinics, as time permits, but performance

of research activities takes priority.


Amount and type: All teaching is conducted in a laboratory or clinical setting. The

responsible faculty is the supervisor for the student.

Evaluation:

Criteria for outstanding grade: The faculty member responsible for the student’s elective

is solely responsible for grading, which is entirely subjective based upon performance

during the elective.





20

DEPARTMENT OF EMERGENCY MEDICINE

Pediatric Emergency Medicine

Course #: CLNS 689


Duration: 4 Weeks


Faculty Evaluator(s): Robert Sapien, MD Prerequisites: Completion of all Phase II Clerkships


Contact: Annette Creasman


To become more comfortable with the general care of the acutely ill or injured child.

Objectives:

Familiarize the student with general suturing and splinting procedures, and the approach

to the child in the acutely ill or injured phase.

Responsibilities:

Research: Many on-going clinical studies in Peds ER. Required: Shift work. Ambulance

ride a longs (8hrs) and Poison Center (8hrs).


Amount and type: Faculty always on site. Presentations (patient) to faculty or senior house officer with faculty direct supervision of house officer.

Evaluation:

Clinical observation. Criteria for outstanding grade: Any supervising faculty can

nominate the student for Outstanding. In general, the student must be hardworking,

enthusiastic, a team worker, and provide his/her patients with outstanding and

comprehensive care.

Additional Information: This rotation adheres to a strict add/drop policy. No changes are allowed less than 14

days prior to the rotation start date. This includes requesting to drop the rotation.





21


Emergency Medicine at VAMC

Course #: CLNS 820


Duration: 4 Weeks


Faculty Evaluator(s): Jot Khalsa, MD Prerequisites: Completion of all Phase II Clerkships


Contact: Vicky Rechkemmer

505-265-1711 x2621

Goals and Unique Aspects: This clerkship is designed to be useful in addition to a core EM rotation for students

interested in pursuing EM as a career. Students destined fro non-EM specialties are also

encouraged to sign up and can have the rotation tailored to their specific clinical

interests. Gain experience and knowledge of emergency medicine in a busy full-service

emergency department. Patients with cardiac and pulmonary disease are well

represented in the New Mexico VA patient population, as are patients with multiple

coexisting disease processes. The complicated VA patients provide challenges to the

student practitioner. The VA also cares for Active Duty military patients and their

families, affording opportunities to care for women and children.

Objectives:

To learn to diagnose emergency conditions, to appropriately use laboratory and

diagnostic studies, to make admission and initial treatment decisions. Emphasis is placed

on development of a broad differential diagnosis and the process needed to arrive at an

appropriate disposition and plan.

Responsibilities:

Clinical: Fifteen eight hour shifts as a sub-intern in the Emergency Department working

with ED attendings. Teaching: Four hours of student conference are required, and five hours of Emergency Medicine Resident conference are optional. Students work through

three teaching cases per week in addition to required readings. Required: Wound care

and suturing, splinting, and ultrasound skills labs.


Amount and type: Direct, by senior faculty. Didactic Content: Four hours of student

conference per week.

Evaluation:

Daily evaluations for ED shifts and weekly evaluations of student rounds. Criteria for outstanding grade: Outstanding students will show near-intern level ability to synthesize

clinical information, devise a treatment plan, and communicate effectively with patients,

consultants and staff.

Additional Information:

This rotation adheres to a strict add/drop policy. No changes are allowed less than 14






22


Emergency Medicine at UNMH

Course #: CLNS 821


Duration: 4 Weeks


Faculty Evaluator(s): Diane Rimple, MD Prerequisites: Completion of all Phase II Clerkships




To learn about the specialty of emergency medicine and gain proficiency at the

evaluation and treatment of common emergency conditions. Emergency medicine deals with patients and diseases of varying severity in an outpatient setting with rapid

problems analysis, treatment and disposition based on limited data.

Objectives:

Create a complete differential diagnosis and plan of management for common and life-

threatening chief complaints. Learn effective multi-tasking of patients. Develop

proficiency in basic procedures such as wound care, splinting, lumbar puncture,

venipuncture and beside ultrasound. Continued exposure to a variety of normal and

abnormal physical exam findings. Develop the thought process necessary to identify

patients with occult diseases that are potentially catastrophic. Understand the role of the Emergency Physician in the delivery of health care, and the role of the Emergency

Department in overall hospital functioning. Recognize your own limitations and the need

for consultation.

Responsibilities:

Didactic: Four hours per week of dedicated student conference time, and the opportunity

to attend an additional five hours per week of resident conference, if the student

chooses. Three cases and assigned readings from “Emergency Medicine: A

Comprehensive Study Guide” by Tintinalli, which is available for loan during the rotation. Skills: Ultrasound, EKGs, wound care and suturing, splinting, and patient simulation.

Additional procedures are learned and performed in the ED. Clinical: Function as a sub-

intern under the direct supervision of the ED attendings and teaching residents. Shift

load is about 15-16 eight hour shifts per rotation plus four hours of conference per

week.

Evaluation:

Student is provided feedback and evaluated at the end of each shift by the faculty and

residents. These evaluations are summarized at the end of the rotation and are the bulk

of the grade. Additional data from performance and participation in the student conferences is considered, including quizzes. Criteria for outstanding grade: An O is

given about 10-15% of students and recognizes superior performance in all areas of the

rotation. Areas of evaluation include: Interpersonal skills, data collection, data synthesis

and procedural skills.








23


First Track

Course #: CLNS 822


Duration: 4 Weeks


Faculty Evaluator(s): Don Lemke, MD Prerequisites: Completion of all Phase II Clerkships




To enhance knowledge of the basic principles of out-patient medicine. Requires a rapid

assessment of the patient’s chief complaint with subsequent treatment and disposition.

Objectives:

Manage common urgent care center patient complaints, perform basic laboratory

procedures, splinting techniques and minor surgical procedures, focused history and

physicals.

Responsibilities:

Reading: Will be recommended by the attendings. Observational: Observe the care of a

wide variety of illnesses involving all specialties of medicine. Clinical: large amount of

patient contact (approximately 20 patients per day). Student sees patients independently and reviews with attending. Hours: 9am-6pm, Monday –Friday plus one

Saturday per month. Perform all tests necessary to evaluate the patient. Teaching:

Informal presentation of patient’s history and physical to attendings; one presentation

on a literature review.


Direct supervision by attending physician. Required attendance at the Emergency

Medicine case conferences or student conferences on Tuesday mornings. Informal case

discussions with attendings.

Evaluation:

Criteria for outstanding grade: Accomplish goals and objectives by seeing, evaluating,

problem-solving and presenting patient care problems at a level of achievement well

above that expected of the usual student.


Busy clinic with a lot of clinical contact. A practical rotation regardless of future specialty

plans. This rotation adheres to a strict add/drop policy. No changes are allowed less than

14 days prior to the rotation start date. This includes requesting to drop the rotation.





24


Emergency Medical Services

Course #: CLNS 823


Duration: 4 Weeks


Faculty Evaluator(s): Marc-David Munk, MD Prerequisites:




Enhance appreciation for the clinical care provided by EMS, including the limitations and

challenges of the prehospital and interhospital environments. Understand the education and training of EMTs and paramedics. Understand the scope of the work of the EMS

Medical Director.

Objectives:

1. Clinical patient care in the prehospital setting. 2. Educational experience in the

classroom and laboratory settings. 3. Interaction with EMS Medical Directors.

Responsibilities:

Observational: Basic and advanced life support procedures during actual emergencies in

the community setting; patient care transfers with clinical care provided en route; Educational classes and research meetings. Clinical: Airway management with basic

adjuncts, 12-lead ECG & Analysis, BGL, placing intravenous lines and PPV. Research:

Potential involvement in ongoing research projects. Teaching: Presentation of at least

one paramedic course lecture; participation in skills workshops; presentation of clinical

care summaries to the Medical Director or designee; Trauma Life Support and PALS

courses may be offered on a case-by-case basis. Required: No night call. No subintern

requirements. Minimum of 60 direct contact hours, including 32 hours of EMS shifts with

area service providers. Optional: Attendance at statewide EMS meetings, departmental

meetings, and other educational opportunities.


Amount and type: Steve Weiss, MD, Laura Banks, DMV: Faculty evaluation and direction

provided in weekly meetings. Bill Raynovich: Daily coordination and contact. Didactic

content: Assigned topical readings and texts.

Evaluation:

Based on review of experience journal and clinical reports, self-assessment and direct

observation of performance with feedback. Written examinations: clinical and

administrative (e.g. ACLS, Practice Protocols, Medical Director Guidelines and Responsibilities), focused topic paper. Criteria for outstanding grade: Meet minimum

objectives with outstanding preparation and presentation of teaching cases, participation

in EMS activities and thorough assessment and review of EMS clinical cases and care.








25


Toxicology

Course #: CLNS 824


Duration: 4 Weeks


Faculty Evaluator(s): Steven Seifert, MD Prerequisites: Completion of all Phase II Clerkships


Contact: Steven Seifert, MD


Meet minimum objectives with outstanding preparation and presentation of teaching

cases, participation in EMS activities, and thorough assessment and review of EMS clinical cases and care.

Objectives:

Enable the student to integrate basic pharmacology with clinical care of overdoes

patient. Enable the student to manage the emergency care of the overdose patient.

Responsibilities:

Observational: Inpatient clinical rounds. Clinical: Toxicology inpatient consults,

Emergency Department consults. Research: Poison Center and quality assurance and

education projects, 30-minutes lecture on toxicology topic, opportunity to publish case reports, and Journal Club. Required: Pre-rounding.


Amount and type: Daily teaching rounds by Drs. Seifert, Rogers and Benson and Poison

Center pharmacists. Didactic content: A notebook and directed readings in toxicology

are provided. Completion of toxicology goals and objectives.

Evaluation:

Based on clinical observation. Criteria for outstanding grade: Participate in patient care opportunities, interact in teaching sessions, demonstrate good grasp of toxicology

fundamentals in directed readings, complete short project evaluating selected questions

in toxicology.


Prior approval is required. This rotation adheres to a strict add/drop policy. No changes

are allowed less than 14 days prior to the rotation start date. This includes requesting to

drop the rotation.





26


Wilderness Medicine

Course #: CLNS 825


Duration: 4 Weeks


Faculty Evaluator(s): Darryl Macias, MD Prerequisites: Phase II Clerkships: Medicine and Surgery;

and either Pediatrics, OBGYN, or Family

Practice.



Goals and Unique Aspects: Learn Wilderness preparedness, emergency procedures and treatment, and strengthen

leadership, teamwork and communication skills.

Objectives:

Learn the wilderness medicine core curriculum as developed by the Wilderness Medical

Society. Core curriculum includes, but is not limited to: high altitude illness,

environmental emergencies (heat, cold), medical kit development, orthopaedic injury

management in the field, wound care, plant toxicology, bites and stings, travel medicine

(infectious disease), search and rescue, patient assessment and field management.

Responsibilities:

Observational: all skills are observational and hands on. Clinical: Students work through

scenarios of wilderness emergency medicine in outdoor setting. Teaching: Wilderness

medicine topics are presented in a tutorial setting using cases as the starting point:

Didactic and hands on teaching. Required: Eight hours a week in outdoor field work: skill

stations, practical scenarios. Sixteen hours a week in group sessions: four hours didactic

lectures, eight hours tutorial working through relevant cases, four hours skills.

Supervision and Teaching: Amount and type: Direct supervision by faculty facilitators and ED attendings.

Emergency Medicine residents and community experts may present some didactic

sessions. Didactic content: Auerbach Wilderness and Environmental Medicine text, cases

and lectures.

Evaluation:

Based on clinical observations, tutorial and scenario/skills assessment. Criteria for

outstanding grade: Outstanding performance (top 10%)

Additional Information: This rotation is only offered once per year, generally in March. Several field trips

throughout New Mexico. This rotation adheres to a strict add/drop policy. No changes

are allowed less than 14 days prior to the rotation start date. This includes requesting to

drop the rotation.





27


Advanced EMS and Disaster Medicine and Medical Care Under the Austere Conditions

Course #: CLNS 827


Duration: 4 Weeks

Students per Rotation: 8 maximum

Faculty Evaluator(s): Diane Rimple, MD

Prerequisites: Prior completion of General Emergency

Medicine or Pediatrics Emergency Medicine or

basic EMS clerkship. Must be Phase III

student in good standing.




1. Develop basic skills in providing patient care under austere conditions with special

emphasis on disaster medicine. 2. Develop an understanding of Disaster Medicine infrastructures nationally and locally. 3. Develop an understanding of available

International Medicine resources and organizations. 4. Appreciate the differences in

providing care under wilderness, international and disaster conditions.

Objectives:

At the end of the rotation the student should be able to: Describe a system for mass

casualty triage. Decontaminate potentially exposed patients. Describe the principles of the Incident Command System. Provide advanced life saving care to adults and children.

Demonstrate their ability to improvise in order to initiate a wilderness or confined space

rescue as a team. Demonstrate proficiency in extremity immobilization and intubation

under austere and difficult conditions. Perform basic rope management including setting

anchors, belaying, z pulleys and appropriate knots. Organize their own wilderness

medical kit. Responsibilities

Responsibilities:

Observational: The student will act primarily as an observer during “ride along” activities

with Albuquerque Fire Department paramedics. They will fly along with the paramedics

and flight nurses with Life Guard fixed wing crews. Clinical: Students will be acting at a

Sub-Intern level during 3 shifts in the UNM ED. The will assume primary responsibility

for data gathering and interpretation of data. With faculty supervision, they will develop

and implement a plan for diagnosis and treatment. Required: Attendance and

participation in each of the didactic sessions. Completion of ADLS and ACLS. Satisfactory

performance during 3 clinical shifts in the UNM Emergency Department. Participation in core educational experiences including: Confined space rescue, Eco Resus Challenge,

Decontamination Exercise, Lifeguard Air Medical Transport flights, AFD ride alongs.


Faculty members of the Department of Emergency Medicine will: Directly supervise

students during all clinical activities; Provide all of the core didactic content; Provide the

ACLS and ADLS courses; Supervision during ride along activities will be provided by licensed EMT-Ps or Flight Nurses. Didactic content: ACLS and NDLS course didactics,

Orientation to UNM ED and elective requirements, Building Blocks of Disaster Medicine,





28


Advanced EMS and Disaster Medicine and Medical Care Under the Austere Conditions

(continued)

Course #: CLNS 827


Duration: 4 Weeks


Faculty Evaluator(s): Diane Rimple, MD Prerequisites: Prior completion of General Emergency

Medicine or Pediatrics Emergency Medicine or

basic EMS clerkship. Must be Phase III

student in good standing.



Disaster Medicine Assistance Teams, Mass triage, Medical treatment of blast injuries, Medical treatment of crush injuries, FEMA Incident Command System 100, 200, 700,

800 courses, Research in Disaster Medicine, Myths in Disaster Medicine, Tactical

Emergency Medicine: Urban Search and Rescue, International Medicine Table Top

Exercise, Pandemic Influenza Table Top Exercise, International Medicine Opportunities:

Opportunities and Hurdles, MSF in Darfur , UNM Emergency Residents’ Weekly

Conference (5 hours standard resident curriculum), UNM Emergency Resident Journal

Club. Readings will be provided for each lecture and students will be loaned a textbook

for background reading. A comprehensive orientation manual will also be provided.

Evaluation:

All students will be evaluated based on: Successful completion of ACLS and NDLS

courses, Clinical performance in the ED, Participation in core activities. This is a P/F

course


This is an advanced, career track rotation that builds on the knowledge and skills

obtained in the basic rotations in emergency medicine. IT is primarily intended for

students interested in pursuing a career in acute care medicine, EMS, public health,

disaster medicine or international medicine.

This course is only available once per year, during the 9/20/10 block.







29


Travel and Emergency Medicine

Course #: CLNS 828


Duration: 4 Weeks


Faculty Evaluator(s): Jim Fleming, MD Prerequisites: Completion of all Phase II Clerkships



505-265-1711 x2621


Travel Medicine is a rapidly developing area of knowledge with applications to a variety of medical specialties. In this elective, students will learn to conduct a pre-travel workup

and patient counseling in the travel medicine clinic at UNM. Students will also learn

emergency medicine as it relates to travel and expedition medicine through tutorials and

shifts at the VA emergency department. Students will also learn how travel medicine

concepts apply to emergency practice as disaster medicine. The elective will show how

travel medicine information can benefit some emergency medicine patients, specifically

military personnel, disaster victims, immigrants, and homeless travelers.

Objectives:

Through lectures, case discussions, scenarios, readings and clinical experiences with travel patients, students should be able to: Understand tropical paristology

pharmacology, prevention and treatment; discuss public health issues relating to third

world disease & foreign aid priorities; understand the key components of a travel

medicine history and exam; recognized clinical presentation of malaria, dengue fever,

hemorrhagic fevers; describe malaria prophylaxis and travel vaccinations for travelers to

Africa, Asia, South America; broaden understanding of the differential diagnosis for

traveler’s diarrhea; recognize manifestations of tropical arthropod-borne disease in

military personnel; appreciate how emerging infectious diseases, such as SARS and

avian influenza, impact the emergency department.

Responsibilities:

Observational: There will be an opportunity to see travel medicine cases first hand in the

Travel medicine clinic at UNM. Travel medicine faculty will provide up to date travel

vaccination and chemoprophylaxis information. Students will also do shifts at the VA

emergency department where many patients have had direct experience with tropical

diseases. Malaria and leishmaniasis are only two examples of diseases faced by new

veterans. Clinical: Students will have direct patient care opportunities in the emergency

department and travel medicine clinic. Teaching: Students will have opportunities to

pursue in depth study of selected travel medicine topics and present these to the faculty, staff and students in the travel clinic and ED. Required: 5 travel clinic days/ED

shifts per week, including 2 weekend ED shifts during the rotation. Weekly tutorials and

readings in travel medicine. No overnight call.

Supervision and Teaching: Amount and type: Direct supervision by UNM travel medicine clinic faculty and

emergency department faculty. Didactic content: Student will be assigned readings and





30


Travel and Emergency Medicine (continued)

Course #: CLNS 828


Duration: 4 Weeks


Faculty Evaluator(s): Jim Fleming, MD Prerequisites: Completion of all Phase II Clerkships



505-265-1711 x2621

will be expected to participate in tutorials and lectures. Partial reading list: Desowitz, Robert S. The Malaria Capers: More Tales of Parasites and People, Research and Reality.

Desowitz’s cogent discussion of a variety of tropical diseases and the politics of

combating them.

Evaluation:

The RIME (Reporter, Interpreter, Manager and Educator; Pangaro, et al.) model will

guide feedback to students. Individual faculty (ED and travel clinic) evaluations will

make up 80% of the grade. Participation in didactic sessions, tutorials, and reading

discussions will make up 20%. Criteria for outstanding grade: Outstanding students will

show proficiency in integrating ravel and emergency medicine concepts in the clinic and ED. The grade of “outstanding” will be awarded to students with exceptional or near

exceptional performance in the following categories: professionalism, history and exam

and presentation skills, ability to manage clinical problems and convey information

effectively to patients and providers.


Availability of this course TBD. Contact Emergency Medicine Department for more

information.







31


Leadership in Wilderness Medicine

Course #: CLNS 829


Duration: 4 Weeks


Faculty Evaluator(s): Jot Khalsa, MD Prerequisites: Experience with wilderness medicine or

international medicine or expedition

medicine. Wilderness first responder,

National Outdoor Leadership School or EMS

experience also acceptable.



505-265-1711 x2621


Student will join faculty of Wilderness, International and Improvisational Medicine

(WIIM) clerkship in planning educational modules and skills labs. Student will participate

in lectures, course organization, and development of outdoor laboratory sessions and

patient scenarios. Student will develop teaching skills, organizational abilities, and interpersonal skills needed to carry out a logistically complex clerkship.

Objectives:

By the end of this elective, the student will be expected to: learn how to develop

education labs in wilderness medicine; gain experience in leading a tutorial on a

wilderness medicine topic; develop and participate in patient scenarios in wilderness

medicine; learn wilderness ALS and BLS skills while teaching them to other participants; gain teaching experience while leading small group sessions during a backcountry

wilderness excursion; learn how to lead participants through physically difficult skills

stations during the final exam for the Wilderness Medicine Clerkship.

Responsibilities:

Observational: Student will observe and help teach patient scenarios in the wilderness

BLS/ALS module, BATCAVE, backcountry excursion, and Eco-Resus challenge, among others. Contact WIIM faculty for additional details. Clinical: No direct patient care.

Research: A variety of Wilderness Medicine research opportunities are available.

Teaching: Student is expected to lead a tutorial for participants in the WIIM clerkship

and lecture opportunities will be available. Leadership roles in multiple education

laboratories will be encouraged. Required: Some overnight activities and a multi-day

excursion are required.


Amount and type: Director and Co-Director of WIIM clerkship will provide supervision.

Didactic content: Student will be assigned readings from Wilderness Medicine, text by

Paul Aurbach.

Evaluation:

Student will work closely with faculty during the 4 week clerkship. Evaluation will be based on performance during several modules during the course. Evaluations by main

faculty of Wilderness medicine clerkship will provide 80% of the grade. 20% of the





32


Leadership in Wilderness Medicine (continued)

Course #: CLNS 829


Duration: 4 Weeks


Faculty Evaluator(s): Jot Khalsa, MD Prerequisites: Experience with wilderness medicine or

international medicine or expedition

medicine. Wilderness first responder,

National Outdoor Leadership School or EMS

experience also acceptable.



505-265-1711 x2621

student’s grade will be derived from evaluations from participants (students, residents)

in WIIM clerkship. Criteria for outstanding grade: The preceptorship requires a different

skill set from most Phase III rotations. Successful students will demonstrate leadership

and teaching ability, skill in managing students in demanding outdoor labs, and

contribute to the effectiveness of the WIIM clerkship. The grade of outstanding will be

awarded to students receiving commendable evaluations from WIIM participants and

who perform at exceptional or near exceptional on visual analog scale for the following: professional and interpersonal skills, organizational ability, contribution to skills labs,

tutorials, BLS/ALS modules, small group teaching and final exam.


This course is only available once per year, generally in March.







33


Advanced Emergency Medicine/Critical Care

Course #: CLNS 832


Duration: 4 Weeks


Faculty Evaluator(s): Isaac Tawil, MD Prerequisites: Prior completion of general Emergency

Medicine clerkship


Contact: Isaac Tawil, MD; [email protected]


1. To develop a comfort level tending to the critically ill medical and surgical patients in the Emergency Department. 2. To learn the basics of resuscitation of the various shock

states. 3. To gain an appreciation for the crossover between Emergency Medicine and

Critical Care Medicine. 4. To learn the fundamentals of ICU care for a wide variety of

pathologies, including traumatic illness, neurosurgical emergencies and critical medical

conditions.

Objectives:

At the end of the clerkship the student should be able to: Differentiate the various shock

states and a comprehensive approach to their treatment; Organize treatment priorities

during resuscitations both in the emergency department and the ICU; Discuss the fundamentals of critical care including ventilator management, hemodynamic

monitoring, nosocomial infections, metabolic disturbances, and managing multi-system

issues.

Responsibilities:

Clinical: The student will function as a subintern under the direction of ED/ICU

attendings and senior residents while in the respective departments. There will be a

particular focus on care of the acute trauma or medical resuscitative cases. Didactic:

There will be 2 weekly lunch time Trauma/Critical care lectures. There will also be another weekly EM/CCM didactic session led by EM.CCM physicians. Each student will be

expected to present a lecture on a EM/CCM topic to a resident level audience. If

available during the months of rotation, the student will be able to attend our ATLS

course and the FCCS (Fundamentals of Critical Care Support) course. Skills: Vascular

access, ultrasound, EKG interpretation and others. Simulation: Resuscitation skills are

honed during simulations using our state of the art “Simulation Lab”. The students will

have several didactic sessions practicing resuscitation scenarios on the patient simulator.

Evaluation:

Student feedback will be provided and evaluated by faculty and residents at the end of each ED shift or ICU week. Overall, the student will be graded using the following

paradigm: 60% based on clinical performance, 30% based on performance during

didactic sessions, 10% based on the presented lecture. An outstanding grade will be

given to students who achieve greater than 85%.





34


Advanced Emergency Medicine/Critical Care (continued)

Course #: CLNS 832


Duration: 4 Weeks


Faculty Evaluator(s): Isaac Tawil, MD

Prerequisites: Prior completion of general Emergency

Medicine clerkship


Contact: Isaac Tawil, MD; [email protected]


This course is offered during during certain blocks only, please contact the department

for dates. This is an advanced career track rotation that builds on the basic knowledge

and skills obtained during the basic rotations in Emergency Medicine and critical care. It

is primarily intended for students interested in pursuing a career in emergency medicine

and critical care. As the subspecialty of critical care medicine is becoming a more

popular career path for emergency physicians, this rotation is intended to propagate that interest and highlight the crossover between the two disciplines.

Selection Criteria:

As this unique rotation promises to be a sought after clinical experience, the following

are required prior to approval: a completed CV and a letter of interest explaining why

you would like to participate in this rotation should be sent to Dr Tawil.








35


International Emergency Medicine - Nepal

Course #: CLNS 833


Duration: 4-5 Weeks


Faculty Evaluator(s): David Wachter, MD Prerequisites:


Contact: David Wachter, MD


See objectives.

Objectives:

To examine the major barriers to health and provision of medical care in Nepal which are

common to other Developing Countries using selected readings, on-site study and

discussions; To explore approaches to overcoming those barriers through site visits and

discussions; To learn to diagnose and treat problems commonly encountered in

Travel/Tropical medicine and Altitude/Mountaineering Medicine through readings,

discussions and first hand experience in the mountains; To learn to use ultrasound for

emergency medical diagnosis and as an adjunct to treatment in a resource limited

setting.

Responsibilities:

We will visit teaching hospitals in Kathmandu and Dharan, in which we will co-host

courses in emergency ultrasound and important aspects of trauma care with our Nepali

colleagues. We will also teach ultrasound in smaller hospitals and clinics in rural settings.

Students will initially attend conferences as trainees, and will help with presentations

and hands-on labs as the month progresses. Bedside rounds in emergency departments

and clinics, discussing cases with local health care providers and introducing them to the

use of diagnostic bedside ultrasound. We will visit traditional medical clinics where we

will be given lectures on Ayurvedic medicine, Tibetan medicine and Chinese medicine/Acupuncture by experts in those fields. The group will travel to the jungle

preserve of Chitwan national park where lectures will be given on Malaria, Kala Azar,

and other tropical diseases, as well as other common local emergency medical problems

such as cobra and krait envenomations and organohosphate poisoning.


Lectures and practical training sessions will be directly taught by faculty, including

emergency Physicians from the US and Nepal, as well as practitioners of traditional

medicine. Due to the brief exposure to the local medical system and culture, students

will not perform independent clinical work, but will gain clinical experience through group rounds led by faculty from Nepal and the US. Discussionson reading material and

site visits will be led by course faculty.





36


International Emergency Medicine – Nepal (continued)

Course #: CLNS 833


Duration: 4-5 Weeks


Faculty Evaluator(s): David Wachter, MD

Prerequisites:



Evaluation:

Students will be assessed by faculty coordinator based on observation of participation in

discussions and performance in hands-on training (ultrasound and trauma labs). They

will also be given a final examination covering key concepts. “Outstanding” grade will be

given to those who show exceptional initiative and superior understanding of core

subject matter, participate effectively in conferences and trainings, and perform in the

top quartile on the final exam (must meet all of above criteria).


This course is only available in the late fall/winter. Please contact the department for

exact dates. Please see

http://web.mac.com/drwachter/iWeb/Nepal%20Page/Itinerary%20Fall%202009%20(te

ntative).html for more information.



http://web.mac.com/drwachter/iWeb/Nepal%20Page/Itinerary%20Fall%202009%20(tentative).html






37


Evolutionary Medicine

Course #: CLNS 835


Duration: 4 Weeks


Faculty Evaluator(s): Joe Alcock, MD Prerequisites: Phase II Clerkships

Accepting Visiting Students:


505-265-1711 x2621


Evolutionary biology has important implications for the medical concepts of health, "normal" physiology and illness. The last 15 years have seen increased exchange of

information between the two fields of study. For instance, medicine has embraced

evolutionary concepts that relate to pathogen resistance to antibiotics. We will explore

how natural selection influences pathogen-host interactions, human genetics,

immunology, development, cancer, and diseases of senescence.

Objectives:

Understand basic concepts of evolutionary biology as they relate to disease and health;

Discuss natural selection, antibiotic resistance and emerging diseases and implications

for public health; Understand how gene-environment mismatch contributes to diseases of western civilization; Recognize how some disease symptoms represent host defenses

and others are pathogen virulence factors; Describe how common genetic

polymorphisms such as sickle cell trait and Factor V Leiden can result from natural

Selection; Understand how viruses can cause cancer and how selective processes

contribute to carcinogenesis; Learn how genetic conflicts contribute to reproductive

diseases. Gain insight into evolutionary hypotheses of human menopause and morning

sickness; Recognize the link between diet, obesity, diabetes, and evolution

This is a lecture, tutorial, and discussion based course. Students are expected to attend daily lectures, interactive casebased discussions, and presentations given by guest

lecturers and other students. Student will have opportunities to pursue in-depth study of

evolutionary medicine topics and present these to the faculty and students.

Evaluation:

Direct teaching by clerkship faculty and guest lecturers. Students will be expected to

attend all lectures. Students should complete assigned readings prior to that day's

lecture and contribute to discussions. Each week, following lectures and discussions,

students will be asked to complete a written summary of that week's topic. As a one-

time assignment, students will be asked to evaluate the strengths and weaknesses of journal articles in evolutionary medicine. For this "Journal Club", each student will be

assigned a journal article to present to the group and provide commentary. Finally, each

student will make a presentation during the last week of the course. Students should

choose an area that interests them and produce a brief talk (powerpoint or equivalent)

to present to the group. Participation (35%), Journal Club (10%), Weekly Writing Project

(20%), Final Presentation (35%)





38


Evolutionary Medicine (continued)

Course #: CLNS 835


Duration: 4 Weeks


Faculty Evaluator(s): Joe Alcock, MD Prerequisites: Phase II Clerkships

Accepting Visiting Students:


505-265-1711 x2621


This rotation is offered all year. Certain months will feature guest speakers and additional educational opportunities. Please email Dr. Alcock for more details.

Partial Reading List

1. Introduction and Overview of Evolutionary Medicine. Chapter 1 in: Evolutionary

Medicine and Health. 2008. Trevathan WR, Smith EO, McKenna JJ. Page 1-54.

2. The Great Opportunity: Evolutionary applications to medicine and public health.

Nesse, RM and Steams SC. Evolutionary Applications 1 (2008) 28-48.

3. The adaptive value of fever. Kluger, MJ. et al. Infectious Disease Clinics North

America. 1996.

4. Carriership of Factor V Leiden and Evolutionary Selection Advantage. Lindqvist PG, Dahlback B. Cur Med Chern 2008. 15: 1541-1544.

5. Crossing the Line: Selection and Evolution of Virulence Traits. Brown NF et al.

2006. PLoS Pathogens. 2(5) e42. Pages 0346-0353

6. Cancer as a microevolutionary process. Komarova NL and Wodarz D. Chapter 22

in: Evolution in Health and Disease. Second edition. Eds. Steams SC and Koella

JC. 2008. pages 289-299.

7. Emergence of new infectious diseases. Woolhouse M and Antia R. Chapter 16 in:

Evolution in Health and Disease. Second edition. Eds. Steams SC and Koella JC.

2008. pages 215-252. 8. Haig D. Genetic Conflicts in Pregnancy. Quarterly Review of biology. Volume

68(4). Dec 1993, 495-532.

9. The Developmental Origins of Adult Health. Kuzawa C. Chapter 18 in

Evolutionary Medicine and Health. 2008. Trevathan WR, Smith EO, McKenna JJ.

pages 325-349.

10. Still Pondering an Age-Old Question. Flatt T and Promislow EL. 2007. Science

(318) 1255-1256.


This rotation adheres to a strict add/drop policy. No changes are allowed less than 14 days prior to the rotation start date. This includes requesting to drop the rotation.





39


Emergency Ultrasound Elective at UNMH

Course #: CLNS TBA


Duration: 4 Weeks

Students per Rotation: 1-2

Faculty Evaluator(s): Gillian Baty, MD Prerequisites: All Phase II Clerkships and at least one EM

clerkship.




Emergency Ultrasound is a clinical elective that integrates emergency medicine knowledge with technical bedside ultrasound skills. Didactics are in a small-group

format, with PowerPoint lectures, discussion and demonstration. Hands-on scanning will

be with rotation preceptor, EM residents and EM faculty in the emergency department.

Students will have plenty of opportunity for primary hands-on scanning, as well as small

group scanning participation.

Objectives:

Describe the basics of ultrasound physics, ultrasound equipment and image/control

modification to maximize image quality. Describe the utilization and application of

clinician-performed limited bedside ultrasound and its differences from comprehensive ultrasound studies. List the indications, scanning protocols, and limited emergency

diagnostic possibilities for the common EUS applications. Integrate existing clinical

knowledge into use of bedside ultrasound. Recognize normal and abnormal sonographic

anatomy.

Responsibilities:

Students are expected to do outside reading and study, to document scans they

perform, to attend all weekly small-group lectures and clip review sessions (5

hours/week), come to scheduled shifts with the rotation preceptor which may be weekday, weekend, day, eve or night shifts (4 hours / week), and additional hands-on

scanning (11 hours/week). There are no specific research activities. There are also

occasional EM Conference lectures or small-group sessions offered for EM residents that

students are welcome and encouraged to attend and participate in.

Evaluation:

Pre-rotation exam. Student evaluation of EUS Elective and faculty. Faculty and resident

evaluation of student. All evaluations submitted by faculty they have worked with and

rotating residents, scores will be averaged. A score of 4.0 and above (out of 5.0) is

needed for an outstanding in the clinical area. Post-rotation exam: score of 70% or better needed to pass. Final grade: 70% from clinical evaluations, 30% from

participation in didactic sessions (an evaluation by didactic faculty, currently Dr. Baty)








40

DEPARTMENT OF FAMILY & COMMUNITY MEDICINE

Public Health Epidemiology in Santa Fe, NM

Course #: CLNS 776


Duration: 4 Weeks


Faculty Evaluator(s): C. Mack Sewell, PhD Prerequisites: Phase II Clerkships: Internal Medicine and

Pediatrics


Contact: New Mexico Health Department

Epidemiology Branch

505-827-0006


To develop practical knowledge of epidemiology as a tool to promote health and prevent

disease at the population level. Practicum-type rotation. Student actively involved in

investigations of disease occurrence and prevention.

Objectives:

To identify and apply resources to detect, investigate and prevent acute outbreaks of

disease. To outline steps to analyze the impact of disease on population. To use Epi lnfo

or other epidemiological software to collect and analyze health data. To understand basic

principles of public health surveillance, descriptive epidemiology, analytic epidemiology

and applied public health practices. To learn to critically read medical literature

describing epidemiologic studies and clinical trials.

Responsibilities:

Practicum: Student participates in ongoing disease control activities. Academic: Student

attends and engages in didactic sessions with preceptor and others; reads assigned

chapters and journal articles and analyzes them critically. Research: Student develops

and completes a short research project in an area of mutual interest.


Student works closely with Epidemiology staff. A primary preceptor, for both daily

activities and the research project, is assigned. Rounds held daily to discuss events and

current investigations.

Evaluation:

Student evaluated on thorough completion of daily investigations and quality of the

research project. Criteria for Outstanding Grade: Thorough investigation and response to

assigned problems, and completion and presentation of research project to meet the

criteria for presentation set by an Epidemic Intelligence Service Fellow.


Office of Epidemiology with a staff of 45+, including 12 doctoral level and 11 masters or

nursing level epidemiologists, computer support personnel, and others, is involved with

acute infectious /environ-mental disease outbreaks; analyses of infectious and

noninfectious conditions affecting public health, including HIV/AIDS, injury

epidemiology, cancer epidemiology, diabetes surveillance, substance abuse epidemiology, lead toxicity prevention, investigation and risk assessment of

environmental contamination; and other issues. The rotation is a unique opportunity to

become familiar with medicine at the population level and to learn useful approaches to

disease prevention and public health.





41


Family Practice at UNMH Sub-Internship

Course #: CLNS 777


Duration: 4 Weeks


Faculty Evaluator(s): Attendings and Chief Residents Prerequisites: Completion of all Phase II Clerkships


Contact: Ann Thibodeaux


In depth experience caring for individuals and families in a hospital setting; biological

and psychosocial aspects of illness.

Objectives:

Increase skill level in caring for hospitalized patients through increased responsibility

(supervised) for patients. Provide the opportunity to take increasing responsibility for

the care of patients in the inpatient setting. Work in a team of residents, consultants,

attendings, social workers, discharge planners, etc. Gain experience working with

consultants and primary health care providers while patients are hospitalized. Become

familiar with and use the principles of Evidence Based Medicine in their study, using EMB

literature searches and critically evaluating the literature.

Responsibilities:

Observational: Grand rounds Wednesdays, 12:30pm-3:00pm. Clinical: Morning and

afternoon rounds, responsible for 1-3 patients. Night Call: Every fourth night. Average

day: 7:00am-5:30pm. Students participate in discharge planning and ethics

consultations, accompany patients to surgery and diagnostic procedures, and may make

home visits to discharged patients. Teaching: Teaching patients self-care, compliance

with prescribed regimens, prevention of deleterious habits. Responsible for teaching the

health care team on inpatients rounds, using the principles of EBM.


Amount and type: Close supervision and teaching by attending faculty and chief

resident. Didactic content: Grand Rounds, inpatient rounds and morning report.

Evaluation:

Criteria for outstanding grade: Quality of care provided and degree of responsibility

shown for patients. Degree to which student researches learning issues and teaches

others on health care team. Participation in discharge planning, ethics consultations,

teaching rounds.


45 day add/drop policy strictly enforced.





42


Health for the Public

Course #: CLNS 778


Duration: 4 Weeks


Faculty Evaluator(s): Veronica Plaza, MD, MPH Prerequisites: Completion of all Phase II Clerkships


Contact: Veronica Plaza, MD, MPH


To provide a population level understanding of the health problems in New Mexico with

an emphasis on the integration of public health and medicine.

Objectives:

Understand health problems in New Mexico and how the public health system addressed

those problems, the basic tools of public health, especially epidemiology, and the role

medical professionals can play in fostering the health of communities.

Responsibilities:

Observational: Observe particular aspects of the public health system in New Mexico

including, but not limited to, outbreak investigation epidemiology, vaccination programs,

maternal-child programs, chronic disease epidemiology, and health policy advocacy. Clinical: May have the opportunity to work in public health clinics such as the STD clinic.

Teaching: Assignment of an educational role defined by SOM’s Population Health Task

Force. Required: Complete web-based epidemiology modules and complete required

readings. Submit evaluation form prior to the completion of the rotation. Optional: May

observe health policy issues at the state legislature.


Direct supervision by supervising faculty, as well as professionals from the New Mexico

Department of Health. Reading assignments and weekly tutorials with student and supervising faculty are held.

Evaluation:

Predicated upon attendance and performance in tutorials. Web-based epidemiology

modules include an evaluation component. Grading system is Credit/No Credit.


Prior approval is required.





43


Rural Primary Care in Cuba, New Mexico

Course #: CLNS 779


Duration: 4 Weeks


Faculty Evaluator(s): Tim Garcia, MD Prerequisites: Phase II Clerkships: Family Practice, Internal

Medicine and Pediatrics


Contact: Teresa Woodfill

575-289-3291

Goals and Unique Aspects: Develop clinical and research skills integral to rural family practice in a multicultural

setting. Learn the complexities, personal and institutional challenges, and special needs

of primary care development in a multicultural, rural setting.

Objectives:

Participate in full spectrum of clinical team activities at Cuba Health Center and Outpost

Clinics of Checkerboard Area Health System. Participate in community health projects,

community outreach and patient education activities. Participate in rural primary health

care development efforts.

Responsibilities:

Observational: Full spectrum family practice in a multicultural, rural setting. Clinical: Full

spectrum family practice in Cuba Health Center or in Checkerboard Area Health System

Outpost Clinics on Navajo Reservation. Research: May join ongoing community projects,

public health research; may initiate own projects/research with faculty and resident

support. Required: Full participation in clinic team activities; direct patient care,

community and public health projects, patient education. No night call; weekdays only.

Optional: Can carpool with faculty/residents.


Amount and type: Drs. Tim Garcia, and Chacon of Family and Community Medicine

(faculty and Family Practice residents on rotation in Cuba). Didactic content: Patient

care and community research guided reading. No formal lectures of seminars planned.

Evaluation:

Based on clinical observation, participation in clinical and possible research activities.

Criteria for outstanding grade: Truly outstanding (“exceptional” “above average”)

performance in rotation activities.


Must have prior departmental and preceptor approval.





44


Health Care for the Homeless

Course #: CLNS 780


Duration: 4 Weeks


Faculty Evaluator(s): Winona Stoltzfus, MD Matias Vega, MD

Prerequisites: Phase II Clerkships: Family Practice, Internal

Medicine and Pediatrics


Contact: Winona Stoltzfus, MD

Matias Vega, MD

505-767-1118


To provide health care for Albuquerque’s homeless population in a multidisciplinary

setting. Many unusual and advanced presentations of disease, often complicated by

problems of poverty, isolation, addictions and mental illness.

Objectives:

1. Assess and treat the usual illnesses seen in the clinic. 2. Consult with a variety of

specialists. 3. Participate as a team member. 4. Learn drug, alcohol, mental health and

other social services and resources. 5. Appreciate barriers to resources. 6. Participate in community outreach teams, AIDS prevention, needle exchange, domestic violence,

teen shelters, etc.

Responsibilities:

Clinical: 1. Assess and treat the usual illnesses seen in the clinic. 2. Consult with a

variety of specialists. 3. Participate as a team member. 4. Learn drug, alcohol, mental

health and other social services and resources. 5. Appreciate barriers to resources. 6.

Participate in community outreach teams, AIDS prevention, needle exchange, domestic

violence, teen shelters, etc. Research: Few ongoing research projects; could possibly be involved in research. Teaching: Practitioners continually discuss patients with each

other, providing both teaching and learning opportunities.


Amount and Type: Team of Family Practice physicians, specialty physicians, and nurse

practitioners always available. Didactic Content: Informal patient-related discussions,

reading and semi-monthly in-services.

Evaluation:

Criteria for Outstanding Grade: Based on evaluator’s assessment and nurse practitioners’ input. Student must work at intern level while in clinic.


Prior approval is required. This course is only offered during certain blocks. Please

contact for more information.





45


Family Medicine Maternal Child Health Sub-Internship

Course #: CLNS 781


Duration: 4 Weeks


Faculty Evaluator(s): Lawrence Leeman, MD

Sarah Gopman, MD

Jennifer Phillips, MD

Prerequisites: Phase II Clerkships: Family Practice, OB/GYN

and Pediatrics

Accepting Visiting Students: No



To understand and participate in the care of women and children in the contest of Family

Medicine.

Objectives: The student will: participate in the care of pregnant women, infants and children in the

Model of Family Centered Maternity Care; Participate in the range of reproductive

services provided by family physicians including contraceptive counseling, emergency

contraception, IUD insertion and removal, vasectomy, first trimester dating ultrasounds,

options counseling and medical and surgical abortion services; Participate in the range of

pregnancy care including preconception counseling, prenatal care, first trimester dating

ultrasound, labor and delivery, cesarean sections, postnatal care in the setting of the

family unit. The care of the mother and baby are performed together. Participate in the

care of the newborn infant and children with family physicians, who care for pregnant

women in prenatal care, the labor and delivery, as well as the care of the newborn infants, and children as they grow and develop. Participate in the care of children in the

setting of the family, including normal growth and development, adjustment in the

family of the arrival of new children. Participate in the care of at-risk pregnant mothers,

newborns and children in a multidisciplinary and comprehensive setting, designed to

proved comprehensive care to the mothers and their infants (The Focus Clinic and the

Family Practice Center). Participate in the gynecological care of women provided by

family physicians, including colposcopy, LEEP, endometrial biopsy, IUD insertion and

removal, contraception counseling and emergency contraception. Be able to compare

and contrast Family Centered maternity Care, with that of the care of the mother by one set of providers and the infants and children by a different set of providers.

Responsibilities:

Clinical: Full participation in deliveries, pelvic exam. Research: Possible participation in

project. Required: Student will have call every 4-6 day (overnight). Student will function

as a subintern. Direct care including H&P, procedure, patient education and follow-up of

patient.


Amount and type: Direct supervision by senior faculty. Didactic content: Participate in Tuesday AM Maternal Child Health Seminars, participate in Wednesday AM Repro

education sessions.





46


Family Medicine Maternal Child Health Sub-Internship (continued)

Course #: CLNS 781


Duration: 4 Weeks


Faculty Evaluator(s): Lawrence Leeman, MD

Sarah Gopman, MD

Jennifer Phillips, MD

Prerequisites: Phase II Clerkships: Family Practice, OB/GYN

and Pediatrics



Evaluation:

Clinical performance and procedural skills. Criteria for outstanding grade: Participation,

demonstrate proficiency with history and physicals, differential procedural skills.

Additional Information: Only accepting current UNM Students. Settings: Family Practice Center: Focus Clinic for

at risk mother and infants. Options counseling and medical option clinic. UNM Family

Health at 1209, First Choice South Valley, First Choice in Los Lunas, UNM Hospital, Cuba

PMS Clinic.





47


Writing and Healing

Course #: CLNS 787


Duration: 4 Weeks


Faculty Evaluator(s): Julie Reichert, PhD Prerequisites:


Contact: Julie Reichert, PhD

[email protected]


To enhance “reflectiveness” as a means to better understand self and patients’ experiences. To engage key issues in medicine through the writings of others. To

enhance written communication skills.

Objectives:

Write regularly each week. Complete a piece of writing (narrative, poetry, fiction). Read

and discuss assigned books and articles.

Responsibilities:

Observational: Yourself and your patients.


Two-hour class meetings twice weekly with writer/medical educator Julie Reichert, PhD.,

and a minimum of two individual conferences with her.

Evaluation:

On the basis of oral discussion of the readings, and on completion of writing

assignments. Criteria for Outstanding Grade: Thoughtful response, daily engagement

with the writing process, completion of assigned exercises, a completed piece of writing

(memoir, story, poems, essay, short play or screenplay) to be publicly presented and/or submitted for publication.


Prior approval is required. Writing is a means for expression and communication, a tool

for learning and discovery, and a way to meaningfully engage. Readings and structured

writing exercises introduce the student to basic writing techniques and literary forms

(personal narratives, poetry, fiction, essays). Readings and writing exercises help

develop a greater awareness of self and patients by expanding the ability to articulate

experiences and ideas. Enhanced self-knowledge, in turn, sharpens the capacity of

empathic knowledge and care of patients. The course is an opportunity to address the “art of medicine” through directed work on the craft of writing (getting started,

exploration of genres, language use, development of voice, revision strategies), and

through a literary examination of the writer/physician as a reflective practitioner. The

student is expected to use the clerkship to delve deeply into the writing process by

making a daily commitment to writing and reading.





48

INTERDEPARTMENTAL OFFERING

Comprehensive Ambulatory Care

Course #: CLNS 605

Credit: Ambulatory Care

Duration: 4 Weeks

Students per Rotation: Minimum 10, Maximum 14

Faculty Evaluator(s): Cynthia Arndell, MD Prerequisites: Completion of all Phase II Clerkships


Contact: Elizabeth Sanchez - UME


Provide Phase III students with: advanced clinical ambulatory rotation focused on

medical knowledge, patient care, communication skills, ethics and professionalism, practice-based learning and improvement, and systems-based care; advanced learning

opportunities in public health through seminars, problem sets and projects, and public

health clinical sites; advanced learning opportunities in ethics and professionalism

through seminars and problem sets; linkage of public health and ethics and

professionalism curricula to the clinical portion of rotation; reflective exercises as a

learning method based on clinical situation

Objectives:

Clinical: Each clinical site has general and specific objectives based on ACGME

competencies. Ethics: Read and discuss advanced ethics topics, and write on ethics

topics related to patients seen at clinical sites. Public Health: Read and discuss advanced

public health topics, and reflect and write on public health topics related to patients seen

at clinical sites. Spend time in a public health setting.

Responsibilities:

Students provide direct care for ambulatory care patients, including history and physical

exam, lab/tests, management plan, writing an appropriate note, presenting to the

attending physician preceptor. Students may participate in outpatient procedures at the

preceptor’s discretion. Clinical: See each site description for clinical description.

Required: Attend all clinical and seminar sessions. Complete required reading,

reflections, projects, write-ups.


Attending faculty supervise residents on rotation. Public health and ethics and

professionalism faculty supervise those components of the rotation.

Evaluation:

PRIME (Professionalism, Reporter, Interpreter, Manager and Educator, Pangaro, et. al.) model used for feedback. Rotation components are weighted in the final grade as

follows: Clinical = 40%, Ambulatory Seminars = 40%, Oral Presentation = 10%, Written

Presentation = 10%.


This required rotation is offered six times during Phase III. Block dates are as follows:

8/23/10-9/19/10, 9/20/10-10/17/10, 10/18/10-11/14/10, 1/10/11-2/6/11, 2/7/11-3/6/11, 4/4/11-5/1/11. The Ambulatory Care Rotation is a “NO TIME OFF ROTATION.”

The seminars in Public Health and Ethics & Professionalism require 100% participation.





49

DEPARTMENT OF INTERNAL MEDICINE

Hematology Oncology Clinic

Course #: CLNS 603


Duration: 4 Weeks


Faculty Evaluator(s): Ian Rabinowitz, MD Prerequisites: Phase II Clerkship: Medicine


Contact: Internal Medicine Office of Education


An opportunity to deal with complex diseases and issues in an outpatient and inpatient

setting. Allows in-depth study of clinical and laboratory aspects of hematology and oncology.

Objectives:

Plan the work-up and management of patients with abnormal blood counts or those with

established diseases of the hematopoietic system. Also, the student should be able to

discuss and recommend treatment options for patients with different types of cancer.

Understand the role of experimental protocols in the clinical research programs in

oncology. The student should feel comfortable dealing with patients and families in the

setting of catastrophic illness.

Responsibilities:

Observational: Procedures (bone marrow biopsy and aspirate, intrathecal chemotherapy,

intravenous chemotherapy); interaction with patients, especially those involving

discussion of life and death issues. Clinical: Work-up of patients in clinic and for hospital

consultations. Each work-up is discussed with the attending. Follow up of patients in the

hospital and clinic on a regular basis. In the hospital, the role is that of a consultant

working with the primary care-giving team. No weekend call, but weekend rounds as

needed. Research: No laboratory research. Many patients are on clinical research

protocols and the student is involved in discussion of the protocol studies. Teaching: The student is not expected to take any teaching responsibilities.


Amount and Type: Direct contact with attending and fellow. Teaching of clinical nature is

usually “one-on-one.” Didactic Content: Weekly conferences within the division, tumor

boards, hematopathology conference and protocol meetings. Daily rounds with

attending.

Evaluation:

Criteria for Outstanding Grade: On the basis of interest and ability to understand the general concepts and principle of managing patients with hematology oncology

problems.


Not available 1/5-2/1. 45 day add/drop strictly enforced.





50


Infectious Disease at Inpatient

Course #: CLNS 604


Duration: 4 Weeks


Faculty Evaluator(s): Corey Tancik, MD Prerequisites: Completion of all Phase II Clerkships




To understand the range of problems in infectious disease.

Objectives:

To develop an approach to the patient with infection and to the field of infectious

disease.

Responsibilities:

Observational: Evaluate patient (under supervision of faculty), make rounds, attend

conferences. Clinical: See no fewer than four - five patients per week, 8:00 am - 5:00

pm, Monday - Friday. Research: Clinical studies underway. Teaching: Patient work-ups

to be presented to attending faculty.


Amount and Type: Faculty and fellow on infectious disease supervise the students.

Didactic Content: Lectures, seminars, rounds and structured reading.

Evaluation:

Observation of students by faculty through daily contact to review the effort, knowledge

base, clinical skills in problem identification, and analysis of infectious diseases. Criteria

for Outstanding Grade: Demonstrate consistently above average effort, talent in

problem analysis and superior improvement in knowledge and skills.


45 day add/drop policy strictly enforced.





51


Internal Medicine at UNMH Sub-Internship

Course #: CLNS 606


Duration: 4 Weeks


Faculty Evaluator(s): Deepti Rao, MD Prerequisites: Completion of all Phase II Clerkships

Accepting Visiting Students: Yes (no international students)



Provide the student with a “hands-on” experience in inpatient internal medicine, with

assumption of an increasing degree of authority and responsibility for patient care under close supervision of the ward resident and attending, to simulate the challenges of

internship.

Objectives:

Assess and develop knowledge, skills and professional characteristics in internal

medicine, including the ability to function as an “intern.”

Responsibilities:

Observational: Attendance/participation in a variety of rounds, conferences, etc. Clinical:

Student averages 5-7 admissions per week. Average stay: 4 days at UNMH. On call every 4 days. Off day about once per week. Teaching: Responsible for helping to teach

Phase II students assigned to the service.


Amount and Type: Student “lives” with the ward residents and interns during this

rotation. Attending physicians round with the team at least once per day. Currently,

subinterns do not stay overnight . Didactic Content: Medical Grand Rounds weekly, noon

conference daily, morning report, multiple unscheduled consultations, conferences, etc.

Evaluation:

Criteria for Outstanding Grade: Evaluations are based entirely on direct observations by

faculty of the student’s role in care of his/her patients. An “Outstanding” requires

performance at the level of an intern in caring for patients and in team participation.


Flinders Students accepted. 45 day add/drop policy strictly enforced. Student must give

at least 45 days notice prior to dropping the rotation. Student may be transferred to

SUBI at UH, or SUBI at VA, or SUBI in Cardiology at VA as needed by the teams and per

the discretion of the chief residents. Student must not have a floated Phase II clerkship scheduled directly after the SUBI due to potential overlap on call days.





52


Geriatric Medicine

Course #: CLNS 608


Duration: 4 Weeks


Faculty Evaluator(s): Suzanne Pinon, MD Prerequisites: Completion of all Phase II Clerkships




For students interested in primary care this is an excellent opportunity to learn about

caring for our rapidly expanding population of elderly patients. Students learn to evaluate and manage multiple complex medical, functional and psychosocial problems

faced by our elderly. Students also learn how to work with multidisciplinary team

members such as physicians, nurses, social workers and pharmacists.

Objectives:

Students attend hospital rounds, geriatrics clinics, home, hospice, and nursing home

visits as well as geriatric subspecialty clinics. Students participate in various

interdisciplinary conferences where patients are presented and discussed in detail.

Students also attend the weekly Geriatric Interest Rounds where General Geriatric topics

are presented by fellows, attendings and outside experts. Lastly, students receive a series of six core geriatric lectures and are introduced to a General Geriatric as well as a

Hospice and Palliative Medicine core curriculum.

Responsibilities:

Observational: Observe multidisciplinary team approach to care of frail, elderly patient in

hospital setting, outpatient clinic, nursing home, and home care settings. Clinical: Learn

to perform complete history and physical exam on elderly patients with multiple medical

problems. Assessment screening tools include mini-mental status exam and geriatric

depression scale. Learn to determine patient’s ability to perform Activities of Daily Living (ADL’s) and Instrumental Activities of Daily Living (IADL’s). Research: Introduction to

current research endeavors in Department of Geriatrics. Teaching: Present one topic at

Geriatric Interest rounds. Considerable opportunity for interaction with health care

professionals from other disciplines.


Amount and Type: Direct supervision by faculty members in all Interdepartmental

Geriatric Medicine Program clinical activities. In addition, the department provides

several computer-based teaching programs. Didactic Content: Post clinic case

management, nursing home, and geriatric conferences, journal club, and other didactic sessions as arranged.

Evaluation:

Dr. Suzanne Pinon coordinates evaluations by obtaining feedback from each faculty

member having contact with the student. Evaluation based on Student Handbook

definition.





53


Occupational and Environmental Health Course

Course #: CLNS 609


Duration: 2-4 Weeks


Faculty Evaluator(s): Denece Kesler, MD, MPH Prerequisites:




Learn to incorporate occupational medicine diagnosis and interventions into medical

practice including workplace exposure evaluations, diagnosis and treatment of occupational injury and illness, and workers’ compensation, legal, policy and ethical

issues. Based in patient care at various occupational medicine clinics A project is

required (research or patient education development for the four week elective or a

presentation for the two week elective).

Objectives:

Obtain and interpret occupational and environmental patient histories. Conduct

toxicological research on occupational exposures. Become familiar with work site

assessments, role of industrial hygienists and other occupational safety specialists, and

the workers’ compensation system. Identify components of occupational medicine service, medical surveillance and disability assessment. Understand public health

aspects of occupational and environmental health, prevention and policy.

Responsibilities:

Observational: Observe/practice occupational medical services at various clinics, visit

work sites to view industrial hygiene and safety roles, participate in teaching or other

prevention interventions. Discuss career options in occupational/environmental

preventive medicine and toxicology. Occupational medicine clinics:

Dr. Akhshay Sood in the pulmonary clinic, which is held in the sleep study center in Medical Arts; Dr. Denece Kesler, UH Occupational Health Services, 272-2517; ACC5,

UNM Employee Occupational Health Services, 272-8043, FPC2; Dr. Pope Moseley,

Occupational Pulmonary Disease & Toxicology Clinic, 272-3850, 5 ACC Clinic C. Clinical:

Patient responsibilities up to three days a week in clinics such as acute injury care,

disability assessment, and medical surveillance. Participate in worksite health and safety

evaluations such as ergonomic evaluations, indoor air quality, and chemical exposures.

Discuss and present case studies which apply occupational and environmental health

and toxicological principles. Research: Conduct toxicology research for patients, or

choose one industry or set of exposures to research (for a two week rotation the

research requirement is reduced). Teaching: Opportunities to educate workers, off-campus or in UNM departments, in chemical hazard identification, “Right to Know” or

specific areas of interest, e.g., noise, back protection, etc.


Amount and Type: Weekly meetings. Didactic Content: Core readings and case study

material.





54


Occupational and Environmental Health Course (continued)

Course #: CLNS 609


Duration: 2-4 Weeks


Faculty Evaluator(s): Denece Kesler, MD, MPH

Prerequisites:



Evaluation:

Criteria for Outstanding Grade: Participate in activities that demonstrate breadth of

field: patient care and teaching or research project choosing. Complete a mini-report

that documents teaching or research.


Worksite visits are in a variety of locations on and off campus.





55


Gastroenterology

Course #: CLNS 610


Duration: 4 Weeks


Faculty Evaluator(s): Thomas Ma, MD Prerequisites: Completion of all Phase II Clerkships




To expose the student to clinical consultative gastroenterology.

Objectives:

Take a competent history and physical exam for patients with chief complaints of a GI

nature. Gain a detailed knowledge of GI anatomy, physiology, and pathophysiology.

Develop clinical skills, including first-hand observation of GI procedures, and

participation in the process of taking diagnostic and therapeutic decisions critical to good

patient care.

Responsibilities:

Observational: Student may elect to observe some GI diagnostic and therapeutic

procedures. Clinical: Student becomes a member of the GI consult team. He/she sees patient consultations, as well as sees patients in two or three clinics per week. Research:

Interested students are encouraged to use this time to identify research interests.

Teaching: Student may be asked to present and discuss a case at the weekly clinical GI

rounds, but only in exceptional circumstances when the student has played a major role

in handling the problem (no student is forced to do this). The student does, however,

present and discuss cases daily, during routine ward rounds at both UNMH and VAMC.


Amount and Type: The attending makes rounds several times a week. The student presents cases, formulate diagnosis and plan management under attending supervision.

Didactic Content: The student is expected to attend all conferences, a list of which can

be obtained from the contact person at UNMH.

Evaluation:

Criteria for Outstanding Grade: The student is evaluated subjectively by the supervising

attending according to the evaluation used by the UNM-SOM. “Outstanding” is awarded

to students in the top 5% of those participating in this elective.

Additional Information: The student is assigned to UNMH or the VAMC as needed by the teams.





56


Nephrology

Course #: CLNS 611


Duration: 4 Weeks


Faculty Evaluator(s): Mark Rohrscheib, MD Prerequisites:




Provide students with experience in outpatient nephrology including hypertension, acid-

base, electrolyte disorders. Also gain experience in managing end stage renal disease maintained on dialysis and renal transplantation.

Objectives:

Learn ethical, economic and social aspects of end stage renal disease. Learn quality

assurance and management in end stage renal disease. Learn acid-base, hypertension,

fluid-electrolyte. Learn the process of chronic kidney disease and appropriate

interventions.

Responsibilities:

Observational: Hemo or peritoneal dialysis, kidney transplantation. Clinical: Chronic kidney disease clinic. Diabetic nephropathy, cyclosporin nephrotoxity, regulation of

endothetin and aldose reductase gene expression. Research: Outcomes research in end

stage renal disease. Numerous research opportunities within the division.


Amount and Type: Daily rounds with Nephrology faculty and fellows. Didactic Content:

Formal curriculum lectures, case discussions, research conferences, journal club.

Evaluation: Criteria for Outstanding Grade: Excellence in performance, active participation in

didactic sessions.


Not available 12/8-1/4. 45 day add/drop policy strictly enforced. Weekly rounds on

dialysis patients occur at DCI Albuquerque (Indian School and University) with fellow on

UNM service.





57


Pulmonary Medicine

Course #: CLNS 612


Duration: 4 Weeks


Faculty Evaluator(s): Helen Busby, MD Prerequisites: Completion of all Phase II Clerkships




Introduces the student to inpatient and outpatient pulmonary medicine; experiences are

offered in a variety of settings including wards and outpatient clinics for chest diseases, sleep disorders, lung cancer and allergic diseases. Opportunity also to participate in

clinics held throughout the state for miners. A concentrated experience with adults with

pulmonary disorders can be achieved.

Objectives:

Evaluate and manage patients with the most prevalent respiratory disorders.

Appropriately utilize pulmonary diagnostic procedures. Interpret routine pulmonary

function tests. Gain experience in evaluating chest X-rays and CT scans.

Responsibilities: Observational: Opportunity to observe procedures including bronchoscopy, thoracentesis

and pleural biopsy. Clinical: Extensive patient contact. The student may attend four

outpatient clinics weekly. Evaluate inpatient consultations. Participation in daily rounds

in the MICU is optional. Approximately six hours per day is spent in direct patient-

related activities. The student shares weekend call with the resident or fellow, two

weekends per rotation. Research: Diverse opportunities for research available in ongoing

programs in epidemiology, immunology, and sleep disorders.

Supervision and Teaching: Amount and Type: The supervision is direct and intense. The fellow reviews all work-ups

and all cases are presented to the attending in both inpatient and outpatient settings.

Didactic Content: A syllabus is given to each student and additional materials relevant to

specific cases are supplied. A weekly case conference covers unusual and informative

patients and additional weekly seminar addresses particular subjects in depth.

Evaluation:

Criteria for Outstanding Grade: Awarded largely on the basis of assessment by the

attending. The quality of the clinical performance receives the predominant weighting,

but conference participation is also considered.


Contact the IM Dept for information on dates of availability. 45 day add/drop policy

strictly enforced.





58


Cardiovascular Elective at UNMH

Course #: CLNS 614

Credit: Consult Service

Duration: 4 Weeks


Faculty Evaluator(s): Veena Raizada, MD Prerequisites: Completion of all Phase II Clerkships

Accepting Visiting Students: Please Contact for more information



Enhance skills in the evaluation and management of common cardiovascular disorders in

the in and out patient settings. Enhance knowledge of pathophysiology and management of common cardiovascular disorders.

Objectives:

1. Accurately diagnose heart disease through history and physical exam. 2. Be able to

read routine EKGs. 3. Know basic principles of diagnosis or arrhythmias, CHF, chest pain

syndromes. 4. Understand normal CV physiology and how pathophysiologic states result

in heart disease.

Responsibilities:

Observational: Participate in all CV conferences. Clinical: Rounds 1-2 times daily, including one weekend as a rule. See patients in consultation and follow patients on

General Medicine, Surgery, and Family Medicine services, under supervision of a faculty,

fellow or house staff.


Amount and type: Daily, direct contact with faculty and fellow. Didactic content: Weekly

conferences, “chalk talks” with fellows, residents and faculty.

Evaluation: Criteria for outstanding grade: Exceptional performance and knowledge.


The rotation provides a valuable opportunity to serve as a consultant (rather than

primary physician) for those services requesting help with the diagnosis and

management of cardiovascular conditions. This rotation is not available 12/1-12/28. The

45 day add/drop policy is strictly enforced.





59


Arthritis and the Rheumatic Diseases

Course #: CLNS 615


Duration: 4 Weeks


Faculty Evaluator(s): Arthur Bankhurst, MD Prerequisites: Completion of all Phase II Clerkships




The diagnosis and treatment of the rheumatic diseases primarily in an outpatient setting

to which medical students usually do not have exposure.

Objectives:

Diagnoses rheumatic disease, interpret tests unique to rheumatic diseases, and treat

rheumatic diseases.

Responsibilities:

Observational: Observe the varied manifestation of the rheumatic diseases. Clinical:

Approximately 20 hours of outpatient clinics, 5 hours of inpatient (consultation) contact.

No night or weekend call. Research: Optional.


Amount and type: Constant supervision in inpatient and outpatient settings. Didactic

content: A complete review of the Primer of Rheumatic Diseases, a complete

examination of the arthritis slide collection and weekly x-ray clinical records.

Evaluation:

Criteria for outstanding grade: Assessment by observation.

Additional Information: Visiting students require prior approval by Division Chief. Contact IM Dept for

information on dates of availability. 45 add/drop policy strictly enforced.





60


Adult Endocrinology and Metabolism

Course #: CLNS 616


Duration: 4 Weeks


Faculty Evaluator(s): Patricia Kapsner, MD Prerequisites: Completion of all Phase II Clerkships




To introduce the student to endocrinology.

Objectives:

Think critically about patient problems. Handle 90% of endocrine problems. Interpret

laboratory tests.

Responsibilities:

Observational: Perform endocrine oriented history and physical examination. Work with

the endocrine fellow or resident on the Endocrine Service. Discuss all cases at endocrine

rounds. Clinical: Make therapeutic decisions, attend all endocrine clinics at UNMH and

VAMC, see all endocrine consults in the hospital, will be called only for interesting

patients (no weekend call). Research: None required, but students are encouraged to participate, if desired.


Amount and Type: Daily rounds with supervisor, weekly rounds with entire endocrine

staff. Didactic Content: No formal lectures. Weekly seminars, daily rounds, suggested

reading for all patients as well as the Endocrine Textbook. Program is generally

structured to students’ needs.

Evaluation: Criteria for Outstanding Grade: Depends on participation at clinics, amount of reading

done, quality of case presentation at endocrine rounds, quality of consult notes.


Contact the IM Dept for information on dates of availability. 45 day add/drop policy is

strictly enforced.





61


Sleep Disorders Center

Course #: CLNS 619


Duration: 4 Weeks


Faculty Evaluator(s): Amanda Beck, MD Prerequisites: Completion of all Phase II Clerkships




To give the student a thorough introduction to sleep medicine so that he/she recognizes

the multi-disciplinary nature of this new field of patient care and evaluate for career planning.

Objectives:

Learn to evaluate the major sleep complaints. Learn to use diagnostic technology. Relate

basic science of sleep to clinical disorders.

Responsibilities:

Observational: Sleep disorder patients. Clinical: Evaluate new and follow-up patients.

Interpret sleep studies. Research: Several projects related to insomnia, sleep apnea,

and restless leg syndrome. Teaching: One conference to local sleep specialists. Required: None, however, it is recommended that the student spend one or two “partial

nights” in the sleep lab (8:00pm to 2:00am) to observe how polysomnograms are

performed.


Amount and type: Direct faculty and fellow contact in five half day clinics per week.

Learning to read polysomnographic records of sleep disorders twice per week. Didactic

content: Assorted readings from texts, case conference, journal club.

Evaluation:

Clinical observations. Criteria fro outstanding grade: Prepare and conduct a one-half

hour conference on a sleep disorder topic. Demonstrate ability to evaluate and treat

patients with sleep apnea and patients with insomnia. Read and discuss with faculty the

pertinent literature of sleep medicine.


This rotation is not available during the second week of June or over the Winter Holidays

(12/23-1/2)





62


Internal Medicine at VAMC Sub-Internship

Course #: CLNS 620


Duration: 4 Weeks

Students per Rotation: 4 Faculty Evaluator(s): Ed Fancovic, MD

Yvonne Dalton-Etheridge. MD

Prerequisites: Completion of all Phase II Clerkships

Accepting Visiting Students: Yes (no international students)


Goals and Unique Aspects: Provide the student with a “hands-on” experience in inpatient internal medicine, with

assumption of an increasing degree of authority and responsibility for patient care under

close supervision of the ward resident and attending, to simulate the challenges of

internship.

Objectives:

Assess and develop knowledge, skills and professional characteristics in internal medicine, including the ability to function as an “intern.”

Responsibilities:

Observational: Attendance/participation in a variety of rounds, conferences, etc. Clinical:

Student averages 5-7 admissions per week. Average stay: 4 days at VAMC. On call

every 4 days. Off day about once per week. Teaching: Responsible for helping to teach

Phase II students assigned to the service.


Amount and Type: Student “lives” with the ward residents and interns during this

rotation. Attending physicians round with the team at least once per day. Currently,

subinterns stay overnight . Didactic Content: Medical Grand Rounds weekly, noon

conference daily, morning report, multiple unscheduled consultations, conferences, etc.

The Sub-I IM curriculum guide can be found on the IM website.

Evaluation:

Criteria for Outstanding Grade: Evaluations are based entirely on direct observations by

faculty of the student’s role in care of his/her patients. An “Outstanding” requires

performance at the level of an intern in caring for patients and in team participation.

Competency based criteria for evaluation will be given to student.


Flinders Students accepted. 45 day add/drop policy strictly enforced. Student must give

at least 45 days notice prior to dropping the rotation. Student may be transferred to

SUBI at UH, or SUBI at VA, or SUBI in Cardiology at VA as needed by the teams and per

the discretion of the chief residents. Student must not have a floated Phase II clerkship

scheduled directly after the SUBI due to potential overlap on call days.





63


Medicine Intensive Care at UNMH

Course #: CLNS 622

Credit: Intensive Care Unit

Duration: 4 Weeks


Faculty Evaluator(s): MICU Team Harkins, MD Prerequisites: Completion of all Phase II Clerkships

Accepting Visiting Students: Yes, if fewer than 2 UNM Students scheduled



Introduction to intensive care medicine; experiences offered in pulmonary, cardiology,

gastrointestinal, infectious disease and multiple organ dysfunction. A concentrated experience and acquisition of invasive skills achieved under close supervision.

Objectives:

Evaluate patients with the most prevalent life threatening organ dysfunction. Manage

routine ventilator care, perform most procedures of venous and arterial access, intubate

patients, obtain and interpret hemodynamic data.

Responsibilities:

Observational: Observe and participate in procedures including intubation, arterial and

pulmonary artery catheterization and central catheter placement. Clinical: Extensive patient contact. Daily rounds in MICU. Approximately 8 hrs per day spent in direct

patient related activity. Night and weekend call shared with residents. Research:

Opportunities available in ongoing MICU patient care or research protocols and quality

assurance programs. Teaching: Morning MICU rounds are primarily educational. Daily

teaching on intensive care core curriculum topics is provided.


Amount and Type: Fellow or R2/R3 together with attending MD. Constant supervision

provided for all procedures and decisions on these critically ill patients. Didactic Content: Daily teaching rounds and discussion of core curriculum. Weekly departmental seminars.

Combined critical care curriculum weekly.

Evaluation:

Criteria for Outstanding Grade: Ability to distill clinical and laboratory data, generate a

list of possible diagnoses and institute appropriate management. Performance must be

equal to first-year house officer.


45 day add/drop policy is strictly enforced. Once a commitment has been made, you must give at least 45 days notice to drop the rotation. Floated Phase II clerkship must

not be scheduled after this rotation due to potential overlap of call days.





64


Infectious Disease Outpatient

Course #: CLNS 623


Duration: 4 Weeks


Faculty Evaluator(s): Elaine Thomas, MD Prerequisites: Completion of all Phase II Clerkships




To study infectious diseases in outpatient settings.

Objectives:

Understand basic pathophysiology, natural history and management of HIV. Assess risks

for HIV transmission and counsel patients on risk reduction. Understand ethical, social,

psychological, legal aspects of HIV and importance of ancillary services in managing HIV

(model for management of serious chronic illness). Understand safe, effective outpatient

use of parenteral antibiotics. Recognize epidemiology and clinical presentation of STD

and how they are controlled in collaboration with public health. Observe outpatient

management of tuberculosis and cystic fibrosis. Integrate knowledge of pathophysiology,

clinical presentation, management, and social aspects of these diseases.

Responsibilities:

Observational: Participate in clinical care of outpatients in various settings. Clinical:

Interview, examine, and assess clinic patients and discus with attending faculty.

Required: Attend clinics in HIV, STD, Tuberculosis, Outpatient Parenteral Antibiotic

Therapy, Cystic Fibrosis, and other clinical experiences, plus infectious disease

conferences, plus outside reading, Schedule is planned by student and faculty

coordinator. No night or weekend call.

Supervision and Teaching: Amount and type: Direct by faculty physicians in clinics. Some teaching by ancillary

staff. Didactic content: Packet of readings and resources provided. The student is

expected to do further reading and discuss with faculty.

Evaluation:

Faculty observation of student’s clinical skills, self-education, synthesis of reading and

clinical experience, and progress towards goals identified with faculty coordinator.


Some clinics are off-campus (within 2 miles of UNMH). The Office of Education must check with faculty coordinator to be sure slot is available. Trainee must work with faculty

coordinator to arrange schedule in advance. Students may not add the course less than

4 weeks before rotation. Course is not available during the block nearest the winter

holidays.





65


Alternative and Complementary Medicine

Course #: CLNS 685


Duration: 4 Weeks


Faculty Evaluator(s): Arti Prasad, MD Prerequisites: Completion of all Phase II Clerkships




An experimental approach to integrative medicine, tailored to individual student needs

to introduce healing techniques complementary to allopathic medicine. It is an opportunity to explore all four aspects of human health: physical, mental, spiritual and

social.

Objectives:

Students can gain an understanding of the range of healing options available to patients

i.e. homeopathy, herbal medicine, acupuncture, massage, etc. Students can also attain

a sense of the historical development of these fields in relation to allopathic medicine. In

addition, students, may explore the barriers to attaining care in these systems. Student

may also focus their experience in one area, e.g. phytotherapy or pain management.

Responsibilities:

It is very important to contact Dr. Prasad before registering for this elective. Contact the

Clerkship Coordinator to arrange to do so. Students are responsible for establishing

personal goals for the rotation and arranging schedules with practitioners from an

established list available from the faculty evaluator. The faculty evaluator and the

student agree on the format of the rotation, and the method of recording and reporting

the results of the rotation.

Supervision and Teaching: Individual meetings with the faculty advisor on a weekly basis will help provide direction

and support.

Evaluation:

Evaluation is individually tailored based on agreement between the faculty advisor and

the student. The student is expected to provide a written analysis and summary of their

experience during the elective.


Available to externs. Rotation offered off-site, therefore, personal transportation is a must.





66


Radiation Oncology

Course #: CLNS 881


Duration: 4 Weeks


Faculty Evaluator(s): Thomas Schroeder, MD Prerequisites: Completion of Phase II Clerkships


Contact: Laura Jaramillo


Introduction to radiation oncology and cancer patient care.

Objectives:

Basic introduction to radiation oncology, physics and biology and involvement in patient

care.

Responsibilities:

Observational: Teletherapy, brachytherapy, consultations, daily management of

radiation patients. Clinical: Involved in consultations, and presents to attending.

Involved in patient education on radiation therapy and side effects.

Supervision and Teaching: Amount and type: One-on-one teaching by clinical associate professor with direct

feedback. Didactic Content: Some readings required. No didactic lectures.

Evaluation:

Evaluation is based on clinical performance, patient care, and attitude toward the

specialty and the staff. Criteria for outstanding grade: Must demonstrate great

enthusiasm and work beyond the expected level.

Additional Information: Students may go to other cancer centers for observation of special procedures within

Albuquerque.





67

DEPARTMENT OF NEUROLOGY

Neurology at UNMH Sub-Internship

Course #: CLNS 701


Duration: 4 Weeks


Faculty Evaluator(s): Gary Rosenberg, MD Prerequisites: Completion of all Phase II Clerkships


Contact: Barbara Jackson


To learn the diagnosis, pathophysiology, and management of common neurologic

disease through caring for inpatients and outpatients and being an integral part of the neurology team. To learn the physiologic basis for common neurologic diagnostic tests

such as lumbar puncture, CT, MRI, EEG and EMG.

Responsibilities:

As part of the Neurology team, the student will work with senior neurology residents and

attending faculty neurologists in the work up and management of inpatients and

outpatients. Students will be responsible for managing (under the supervision of the

senior resident and attending) up to five inpatients with neurologic diseases and

attending one teaching neurology outpatient clinic per week. Students will be expected

to attend all regularly scheduled neurology conferences.


Students will be taught and supervised by the senior ward neurology resident, the

inpatient neurology attending and the clinic teaching attending neurologist. Teaching

conferences occur daily and vary. At daily attending rounds, the student will present

his/her patients to the staff neurologist and discuss the diagnosis, work up and

management. Formal teaching conferences will include Grand Rounds, Neuroradiology

Conferences, Neuropathology Conferences, Pediatric Neurology Conferences and Basic

Neuroscience Conferences. Students will be expected to read about common neurologic diseases and the diseases of their patients. Training and supervision in performance of a

lumbar puncture will be done with the neurology senior resident.

Evaluation:

Grading will be based on: 1. quality of patient care. 2. knowledge of patients’ diseases

and common neurologic diseases. 3. participation in teaching conferences.





68


Spinal Cord Injury [SCI] at VAMC Sub-Internship

Course #: CLNS 702


Duration: 4 Weeks


Faculty Evaluator(s): Kurt J. Fiedler, MD





To enable student to participate in multi-disciplinary general and rehabilitative inpatient

care for a population defined by the biographical accident of having a spinal cord injury

or disease, such as multiple sclerosis. This includes acute rehabilitation following the

injury, as well as preventive out-patient care, “sustaining care” (care of subsequent

illnesses including those not directly related to SCI but requiring hospitalization), and

planning and maintenance of community integration.

Objectives:

The student will provide care ranging from the specialized requirements of patients

affected by the pathophysiology of SCI, to the general primary care of their ongoing

medical needs, understand the short and long-term direct effects of paralysis and

deafferentation, and the indications for associated medical and psychosocial treatments,

appreciate the effects of SCI on unrelated common medical illnesses, learn the scope of

physical, occupational, and communicative therapies, and participates in multi-

disciplinary planning and treatment.

Responsibilities: Observational: Follow own patients to communication, physical and occupational

therapies. Observe specialized clinics: GU/urodynamics, wheel-chair/eating clinic, driver

training, pool therapy, etc. Clinical: Extensive patient contact on twenty bed unit. Initial

patient assessment (history, physical, order-writing) and continued care of patients with

acute illnesses and those admitted electively for comprehensive annual evaluations.

Ongoing involvement in multi-disciplinary assessment and planning meetings.

Participation in general SCI out-patient clinic. Rotate evening and weekend call (beeper)

with direct supervision by attending physicians. Research: Student may become involved

in ongoing bench and clinical research. Recent projects include nosocomial transmission of MRSA, thermoregulation after SCI, and outcomes of periodic evaluation.


Focused student teaching and direct supervision is provided daily by the attending

physicians: Dr. M. Puerzer and Dr. B. Porter, both boarded in Internal medicine and

Infectious Diseases, and Dr. Friedler, boarded in Neurology and Family Medicine.

Students work with physician assistants and gain insight into the supervisory role, and,

in turn, are educated by the expertise.

Evaluation: Evaluation is based on achievement of the individual goals established jointly by the

student and attending at the start of the rotation.





69


Neurology at VAMC Sub-Internship

Course #: CLNS 703


Duration: 4 Weeks


Faculty Evaluator(s): Molly King, MD Prerequisites:




To learn the diagnosis, pathophysiology, and management of common neurologic

disease through caring for inpatients and outpatients and being an integral part of the neurology team. To learn the physiologic basis for common neurologic diagnostic tests

such as lumbar puncture, CT, MRI, EEG and EMG.

Responsibilities:

As part of the Neurology team, the student will work with senior neurology residents and

attending faculty neurologists in the work up and management of inpatients and

outpatients. Students will be responsible for managing (under the supervision of the

senior resident and attending) up to five inpatients with neurologic diseases and

attending one teaching neurology outpatient clinic per week. Students will be expected

to attend all regularly scheduled neurology conferences.


Students will be taught and supervised by the senior ward neurology resident, the

inpatient neurology attending and the clinic teaching attending neurologist. Teaching

conferences occur daily and vary. At daily attending rounds, the student will present

his/her patients to the staff neurologist and discuss the diagnosis, work up and

management. Formal teaching conferences will include Grand Rounds, Neuroradiology

Conferences, Neuropathology Conferences, Pediatric Neurology Conferences and Basic

Neuroscience Conferences. Students will be expected to read about common neurologic diseases and the diseases of their patients. Training and supervision in performance of a

lumbar puncture will be done with the neurology senior resident.

Evaluation:

Grading will be based on: 1. quality of patient care. 2. knowledge of patients’ diseases

and common neurologic diseases. 3. participation in teaching conferences.





70


Child Neurology at UNMH Sub-Internship

Course #: CLNS 704


Duration: 4 Weeks


Faculty Evaluator(s): Mary Johnson, MD Prerequisites: Phase II Clerkship: Neurology




At the end of this rotation, the student should be able to: Orally present their patients’

history and physical completely and concisely; Accurately localize and discuss the localization of their patients’ neurological problems; Formulate reasonable differential

diagnoses; Generate management plans; Demonstrate consistent longitudinal daily care

of their patient, including anticipatory preparation for discharge; Read peer reviewed

journals relating to the diagnosis and/or treatment of their patients; List the typical

presenting symptoms and history, neurological findings, management

approach/treatment, and prognosis for the following conditions: Epilepsy of childhood

including neonatal seizures, infantile spasm, febrile convulsions, childhood absence,

benign Rolandic epilepsy, juvenile myoclonic epilepsy, Childhood migraine, Guillain Barre

Syndrome, Transverse myelitis, Neurological complications of fetal alcohol exposure,

Common genetic disorders and their neurological complications, Tourette’s Syndrom, Hydrocephalus, Chiari malformation; Gain familiarity with CT and MRI imaging changes

associated with the above neurological conditions.

Responsibilities:

As part of the neurology team, the student will work with senior neurology residents and

attending faculty child neurologists in the work up and management of inpatients (UNM

Children’s Hospital) and outpatients (Clinical Neuroscience Center). Students will be

responsible for managing (under the supervision of the senior resident and attending) up

to four inpatients with neurologic diseases, and attending two to three child neurology outpatient clinics per week. Students will be expected to attend all regularly scheduled

neurology conferences. Formal Teaching conferences include weekly grand rounds,

Neuroradiology/neuropathology conference, Child Neurology Conference and professor

rounds. Students will be expected to read about common neurologic diseases and the

disorders of their patients. Along with the child neurology team (residents and

attendings) the student will be involved in the teaching of the Phase II clerkship

students on the service.


Students will be taught and supervised by the senior consult neurology residents, the inpatient child neurology attending and the clinic attending child neurologist. At daily

attending rounds, the student will present his/her patients to the attending child

neurologist and discuss the diagnosis, work up and management. Training and

supervision in performance of a lumbar puncture will be done by neurology residents.





71


Child Neurology at UNMH Sub-Internship (continued)

Course #: CLNS 704


Duration: 4 Weeks


Faculty Evaluator(s): Mary Johnson, MD

Prerequisites: Phase II Clerkship: Neurology



Evaluation:

The student will be evaluated using the PRIME format, including competence in

professionalism and as a reporter, interpreter, manager, and educator. The student who

demonstrates above that expected for a 4th year student in all areas will meet the

criteria for the grade “Outstanding”. This requires dependability in attendance for rounds

and conferences, well-taken and orally presented histories, the ability to obtain and

present the examination (general and neurological) in all age groups of children and the

demonstration of logical thinking beginning with localization through the most likely diagnosis, and best management approaches all of which are dependent on an above

expected base knowledge. Simply put, an outstanding would require a student

demonstrate a first year resident level performance.





72


Neurology Research

Course #: CLNS 705


Duration: 4-12 Weeks


Faculty Evaluator(s): Gary Rosenberg, MD Prerequisites: Molecular biology or small animal physiology




This is an in depth exposure to research on neurological diseases. Molecular mechanisms

of brain injury are studied in animal models of stroke and trauma. The student will learn concepts in mechanism of brain injury that will be useful for a career in the

neurosciences.

Objectives:

The objectives are determined between the student and the mentor. These could range

from an extensive research report based on review of the current literature to a small

focused research project.

Responsibilities:

Observational: Observe laboratory methods in neurobiology. Clinical: Analysis of proteolytic enzymes in CSF. Research: Projects on proteolytic enzymes in brain injury.

Optional: Experience in biochemical or physiological studies.


Amount and type: laboratory personnel and Dr. Rosenberg. Didactic content:

Neuroscience seminars, neurology conferences, laboratory meetings.

Evaluation:

Based on work in the laboratory and report. Criteria for outstanding grade: Quality of research paper.





73

DEPARTMENT OF NEUROSCIENCES

Neuroscience Teaching

Course #: CLNS 707


Duration: 4 or 8 Weeks


Faculty Evaluator(s): Linda C. Saland, PhD Prerequisites: Phase II Clerkships: Neurology or Psychiatry


Contact: Linda C. Saland, PhD


To become proficient as a Phase I facilitator in neuroscience. To enhance knowledge

base in basic neurobiology related to medicine.

Objectives:

To participate in Phase I neuroscience tutorials as a co-tutor with faculty tutors.

Alternatives: To participate in laboratory teaching of neuroanatomy/neurophysiology to

first year medical students.

Responsibilities:

Teaching: Students observe Phase I tutorials. They are required to co-tutor.

Neuroanatomy/neurophysiology labs: students work together with faculty teaching the

labs to assist medical students.


Amount and type: Students are supervised directly by faculty in tutorials for first year

medical students. Didactic content: Students are assigned in-depth reading and review

of neuroscience basic biology. For neuroanatomy/neurophysiology labs: students are

directly supervised by faculty.

Evaluation:

Students are assessed by faculty tutors. They are also responsible to self-assess in all areas. Criteria for outstanding grade: Attend assigned Phase I tutorials and demonstrate

ability to facilitate and interact in a constructive, mature fashion, at the level of a

graduate assistant. Students in lab teaching will be assessed by faculty in those teaching

labs.


Time required per week is six hours, Mondays 9am-12pm, and 12pm-1pm for case

review, and Wednesdays 10am-12pm. This rotation is only available during the Phase I

Neuroscience Block. For neuroanatomy and/or neurophysiology labs: Time required: 2

hours X 2 sessions per lab for 4 or 5 labs (neuroanatomy), 2 hours X 2 sessions per lab for 1 or 2 labs (neurophysiology).





74

DEPARTMENT OF NEUROSURGERY

Neurosurgery at UNMH Sub-Internship

Course #: CLNS 753


Duration: 4 Weeks


Faculty Evaluator(s): Howard Yonas, MD Prerequisites: Completion of all Phase II Clerkships


Contact: Pat Cleve


To learn the neurological exam, management of head and spinal cord in juries,

management of low back pain, and interpretation of neuro-imaging studies.

Objectives:

To perform a detailed neurological exam tailored to the patient’s symptoms and be able

to formulate a working diagnosis and treatment plan.

Responsibilities:

Observational: Work-up admissions, present cases on rounds, select one topic for review

and presentation. Clinical: Admit one to two patients per day, participate in night call

once every three days, be an integral part of the care team. Research: Students may

elect to become involved in neurosurgical research which includes biomechanics of spinal instrumentation and magnetic source imaging. Teaching: Examination of inpatients

presented to chief resident and outpatients presented to attending. Required: Mandatory

weekday attendance on surgery and in clinics, Journal Club and Friday conferences.


Amount and type: Direct supervision by attendings and residents. Didactic content:

Daily rounds; conferences twice per week.

Evaluation: Evaluation by Howard Yonas, MD. Criteria for outstanding grade: Based on performance

and review of a topic. Quality of work-ups, ability to sustain work level, performance in

operating room and oral presentation.


Student obtains a great deal of practical exposure, assisting on complex cases, suturing

and other procedures appropriate to interests and capabilities.





75

DEPARTMENT OF OBSTETRICS & GYNECOLOGY

Ambulatory Gynecology

Course #: CLNS 652


Duration: 4 Weeks


Faculty Evaluator(s): Kathleen Kennedy, MD Prerequisites: Completion of all Phase II Clerkships


Contact: Shawne Riley


Increase knowledge of ambulatory gynecology.

Objectives:

Increase depth of knowledge of ambulatory gynecology and procedures; continue to

develop skills in diagnosis and management.

Responsibilities:

Observational: Problems and procedures in ambulatory gynecology. Clinical: patient

evaluation and examination; perform pregnancy tests, wet smears, cultures, Pap tests

under supervision. Perform procedures under supervision. Research: May participate in

ongoing department research. Teaching: By faculty and residents. Conferences:

Colposcopy – Tuesday and Wednesday AM; Grand Rounds – Friday AM; M&M – Friday PM. Required: Monday-Friday clinic and conferences; attend assigned gynecology clinics

and subspecialty clinics (colposcopy, urogynecology). No overnight call.


Amount and type: Supervised by faculty and residents.

Evaluation:

Clinical observations of knowledge and improvement of skills. Criteria for outstanding

grade: Outstanding clinical evaluations and a brief oral presentation.


Priority for scheduling the Benign Gyn and Ambulatory Gyn rotations will be given to

those requesting Benign Gyn Sub-I from July-January. Prior authorization is required. An

add/drop slip must be completed to add this course to your schedule.





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Gynecologic Oncology Sub-Internship

Course #: CLNS 653


Duration: 4 Weeks


Faculty Evaluator(s): Carolyn Muller, MD Prerequisites: Completion of all Phase II Clerkships




This rotation will provide its student the unique opportunity of comprehensive care for

the Gynecologic Cancer patient. This student will actively participate in techniques of diagnosis and cancer treatment, including surgical management, radiation therapy,

chemo therapy and palliative care. In addition, the student will learn techniques in

delivering bad news and end of life transitioning. Also, risk assessment and cancer

prevention strategies will be taught.

Objectives:

The primary objective is to learn globally about the field of Gyn Oncology and the

common sense approach to caring for women with gynecologic malignancies. At the end

of the rotation, the student should be able to understand the primary principles of

cancer care, goals of therapy, and quality of life issues related to therapy and compassionate care to the dying patient. Students should also understand the general

facts about the main gynecologic malignancies including ovarian, cervical and

endometrial cancer and understand risk factors, screening modalities, prevention

modalities, diagnostic workup and general basics for treating these malignancies.

Responsibilities:

This is a vigorous but rewarding clinical rotation. The student will act at the sub-intern

level under the direct supervision of senior residents and the faculty. The student is

expected to participate as a full member of the Gyn Oncology team and will have increasing technical experiences as the rotation and individual competency progresses.

The student will be assigned inpatients and will be expected to make daily rounds,

collect data and interpret and formulate treatment plans. In addition, students will

experience outpatient services and will be taught techniques such as diagnostic

colposcopy tumor biopsies and proper preoperative workup of the patient with an

anticipated gynecologic malignancy. Students will also be taught dictation skills for both

inpatient and outpatient services. Call: Once weekly (Thursday or Friday). Some

weekend rounding experience is strongly suggested.

Supervision and Teaching: Amount and type: The student will be supervised at all times by either a resident and/or

faculty Gyn Oncologist. All invasive procedures including pelvic exams, biopsies or any

technical procedures will be directly supervised by senior resident or faculty physicians.

All treatment plans will be discussed with the team orders and notes will be written by

the student and co-signed by the resident and/or faculty. Didactic Content: Most of the

didactics occur during the day-to-day operation of the service. These will include daily

ward rounds, clinic sessions, weekly tumor board conferences, Friday morning grand





77


Gynecologic Oncology Sub-Internship [continued]

Course #: CLNS 653


Duration: 4 Weeks


Faculty Evaluator(s): Carolyn Muller, MD




rounds and monthly M & M conferences. Students may be asked to present a topic for

review and would discuss the aspects for a surgical case either prior to or while in the

operating room. This strongly suggests the pelvic anatomy be reviewed prior to this

course. We anticipate the learning curve to rise exponentially

Evaluation:

Student will be evaluated by residents and faculty. Similarly to the criteria of resident

evaluation this is based on observational assessment. The student should strive to excel on all aspects including knowledge based technical skills, data recovery and analysis,

teamwork, communication skills, understanding of anatomy and general principles of

oncology.


If any student wishes for additional information, do not hesitate to contact Dr. Muller at

272-0185 or via email at [email protected].





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Maternal Fetal Medicine at UNMH Sub-Internship

Course #: CLNS 654


Duration: 4 Weeks


Faculty Evaluator(s): William Rayburn, MD





Acquaint the student with diagnostic and therapeutic modalities and decision strategies

in the management of complicated pregnancies.

Objectives:

Achieve a substantial level of competence in identifying and managing high risk

pregnancies.

Responsibilities:

Clinical: Function as sub-intern for Perinatal High Risk Service. Responsible for high-risk

obstetrics patients both in-house and in the clinic during the day. Expect to see a variety

of low and high risk patients. Attending rounds are at 7:30 AM. On average, the student

performs at least three work-ups of inpatients per week. Student takes one call per

week during the rotation on Thursday or Friday. Research: For students with special

interests, the opportunity to participate in ongoing clinical research of the Maternal Fetal

Medicine Division can be made available. Call: Once weekly (Thursday or Friday).

Supervision and Teaching: Amount and Type: All pelvic exams are supervised, all fetal tracings reviewed, and all

management plans reviewed and evaluated. Didactic Content: MFM rounds daily.

Diabetic conference every Tuesday and high risk clinic conference every Thursday.

Ultrasound conference every Monday. Perinatal conference every Thursday. Friday

morning Grand Rounds and M & M Conferences. Required reading includes parts of

Williams Obstetrics and articles appropriate to patients on the service. Students present

topics and make patient presentations during daily rounds.

Evaluation: Grading is based upon clinical performance.


The UNM High Risk Obstetrics Services see a tremendous variety of obstetric

complications, ranging from preterm labor and ruptured membranes, to serious, life

threatening maternal and fetal complications, including severe fetal anomalies, maternal

health problems from heart disease to leukemia to myasthenia gravis, and a substantial

volume of Class C through R diabetics and complex, severe pre-eclampsia. This referral

service treats a substantial proportion of all of the high risk pregnancies in the state of

New Mexico.





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Maternal and Child Health in Guatemala

Course #: CLNS 655


Duration: 4 Weeks


Faculty Evaluator(s): Lawrence Leeman, MD Eve Espey, MD

Prerequisites: See Additional Information




To experience the realities of delivering maternal/child/women’s health in a developing country.

Objectives:

To enhance clinical skills in OB/GYN, improve Spanish language skills, and participate in

a population based project related to maternal/child health.

Responsibilities:

Observational: OB/GYN-Neonatal Care in a developing nation setting. Clinical:

Enhancement of clinical/physical diagnosis skills in a setting with minimal technologic

back-up services. Research: Effect of traditional birth attendant training on maternal/neonatal mortality. Barriers to access of care in rural Guatemala. Teaching:

Interact/teach/role model with 5th and 6th year Guatemalan medical students.

Required: Rounds, conferences, at least one 24 hour call at least once per week.

Optional: Explore Guatemala!


Amount and Type: By Guatemalan faculty/residents in OB/GYN. Sergio Flores, MD, is the

preceptor in Guatemala. Didactic Content: Daily morning conferences. If Spanish

language improvement is needed, attend one of 39 Spanish language schools in Quetzaltenango.

Evaluation:

Based on evaluation by faculty and written report/project after return. Criteria for

outstanding grade: Quality of project/report and evaluation of faculty.


Preferably have completed all of Phase II, but will consider if Phase II Ob/Gyn, Medicine,

and Pediatrics are complete. Fluency in basic Spanish is required. Student must cover all

travel and living expenses. Need to consult UNM travel medicine clinic for required vaccinations. Must contact UNM Office of International Programs and Studies (main

campus) for foreign travel insurance and safety issues discussion. U.S. passport required

(tourist visa obtained at airport). See department for suggested reading list.





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Maternal Fetal Medicine in Sierra Leone

Course #: CLNS 659


Duration: 4 Weeks


Faculty Evaluator(s): TBD Prerequisites: Completion of all Phase II Clerkships


Contact: OBGYN


To experience and understand the difference in the provision of medical care in an

underdeveloped country and its impact on maternal and fetal health.

Objectives:

To participate in a project related to maternal-fetal health. To become familiar with

models of health care delivery different from the United States model.

Responsibilities:

Observational: Obstetric/Gynecologic care in a developing country. Required Research:

Student project. Teaching: The first week of the course will consist of sessions with the

preceptor to design a student project.


Supervision by the course director and nursing staff on the outreach team.

Evaluation:

Criteria for outstanding grade: For an outstanding grade the student must demonstrate

the ability to work with the outreach team, but also be able to coordinate and manage a

student project.

Additional Information: Please contact the OBGYN Dept for specific dates. Student must cover all travel and

living expenses. Need to consult UNM travel clinic for required vaccinations. Must contact

UNM Office of Itnernational Programs and Students for foreign travel, insurance and

saftey information. United States Passport is requried.

This course will only be offerend in 2011.





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Benign Gynecology at UNMH Sub-Internship

Course #: CLNS 656


Duration: 4 Weeks


Faculty Evaluator(s): Kathleen Kennedy, MD Prerequisites: Completion of all Phase II Clerkships




Increase knowledge of benign gynecology.

Objectives:

Increase depth of knowledge of benign gynecology, procedures and surgeries; continue

to develop skills in diagnosis and management.

Responsibilities: The student will act at the sub-intern level under direct supervision of senior residents

and faculty. The student is expected to participate as a full member of the benign

gynecology team. Responsibilities include: being assigned inpatients, making daily

rounds and presentations, formulating treatment plans, writing orders (with co-

signature), and managing and coordinating all aspects of the patient’s care during the

hospitalization with assistance from residents and faculty. The student will see patients

in the outpatient clinic two full days a week and will be taught dictation skills.

Additionally, the student will participate in benign gynecology operations and procedures

two full days a week. Observational: Problems and procedures in ambulatory gynecology, gynecologic surgery. Clinical: Inpatient and outpatient evaluation and

examinations; perform pelvic exams, wet preps, cultures, Pap tests, and gynecology

procedures under supervision. Research: May participate in ongoing department

research. Teaching: By faculty and residents. Conferences: Colposcopy – Tuesday and

Wednesday; Grand Rounds – Friday AM; M&M/Residents’ School – Friday PM. Required:

Tuesday and Wednesday gynecology clinics and conferences; Monday and Thursday OR.

Inpatient rounds daily with some weekend rounding Saturday and Sunday. Call: Once

weekly (Thursday or Friday).


Amount and Type: Supervised by faculty and residents. Didactic Content: Tuesday and

Wednesday colposcopy conferences, Friday PM didactic sessions.

Evaluation: Clinical Observations of knowledge and improvement of skills. Criteria for outstanding

grade: Outstanding clinical evaluations and a brief oral presentation.


Recommended for students seriously considering OB/GYN residency. Priority for

scheduling the Benign Gyn and Ambulatory Gyn rotations will be given to those

requesting Benign Gyn Sub-I from July-January.





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DEPARTMENT OF ORTHOPAEDICS

General Orthopaedic Surgery Sub-Internship

Course #: CLNS 850


Duration: 4 Weeks


Faculty Evaluator(s): Robert Quinn, MD Prerequisites: Phase II Clerkship: Surgery


Contact: Joni Roberts


To participate as an active member of the surgical team, delivering care to patients with

musculoskeletal problems, especially trauma.

Objectives:

Learn to dramatically influence outcome of patients with musculoskeletal disease states

by direct operative and non-operative intervention. Perform procedures, with

appropriate supervision, which help patients improve their health.

Responsibilities:

Observational: While contributing at a student level, observe higher levels of care giving

(residents, attendings) in clinic, wards, and operating room. Required: Night call,

conference attendance, rounds, clinic and operating room assistance. Optional: Clinical research (case report of interesting case).


Amount and Type: Instruction directly by role model; principal role on ward. Didactic

Content: Attend all department conferences.

Evaluation:

Consensus subjective conclusion of team attendings and residents. Written exam

possible. Criteria for Outstanding Grade: Demonstrate knowledge of anatomy and clinical skills; demonstrate excellent acquisition of basic orthopaedic musculoskeletal

diagnostic and therapeutic knowledge. Actively and effectively participate in surgical

team (rounds, wards clinics, operating room). Excellence in conference participation, to

include presentation of cases of patients with musculoskeletal pathology, which

demonstrate extensive knowledge of the condition and treatment alternatives.





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Pediatric Orthopaedics at Carrie Tingley Hospital

Course #: CLNS 851


Duration: 4 Weeks


Faculty Evaluator(s): Elizabeth A. Szalay, MD Prerequisites: Completion of all Phase II Clerkships


Contact: Jude McMullan

Goals and Unique Aspects: Introduction to various aspects and principles of the musculoskeletal system in the

growing child with emphasis on modeling professional and ethical approach to pediatric

patient and family.

Objectives:

1. Learn the principles of normal development. 2. Understand common congenital,

developmental, neuromuscular and trauma conditions. 3. Properly obtain a relevant history. 4. Perform a musculoskeletal physical examination. 5. Discuss a simple and

specific differential diagnosis. 6. Demonstrate proficiency in simple orthopaedic

techniques, including: suturing, splinting, assisting in the operating room, and reading

radiographs and imaging studies. 7. Understand the basic ethical principles of informed

patient consent.

Responsibilities: Observational: Pediatric orthopaedics in clinic, inpatient and operating room

environments. Clinical: Assist in clinic and on wards in routine care of patients. Assist in

operating room and emergency department. Research: Ongoing optional clinical and

basic science research projects available. Teaching: Patient teaching in clinic at your

level of experience. One didactic presentation, and case presentations during Monday

morning pre-operative conference are required. Required: One weekday night call per

week and one weekend call (total of six calls during the one month rotation). Work

directly with, and under the supervision of the orthopaedic resident while on call. Call is

not busy and can be taken from home.


Amount and Type: Learning objectives discussed at beginning of rotation. Direct

supervision. Clinical cases presented to orthopaedic residents and attendings. Hands on

treatment with supervision. Didactic Content: 1. Rotation specific reading list and

learning objectives. 2. Readings on performing a history and physical examination. 3.

Audio visual CD and Power-point presentations available. 4. Literature search and relevant article readings (3) before any surgical case. 5. Assigned literature searches for

unusual clinic cases. 6. Attend all pediatric orthopaedic conferences. Present at the

Monday morning preoperative conference. 7. Present one Friday morning case to the

Orthopaedic Department. 8. Present one didactic conference during the rotation. A

historical talk is recommended.

Evaluation: Evaluation is based on integrity, punctuality, and achievement of the rotation goals and

learning objectives. Student is observed and questioned about required reading. A

written or oral examination is given at the end of the rotation. CTH Medical Director,

Chief of Pediatric Orthopaedics, attending staff and orthopaedic residents all have input





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Pediatric Orthopaedics at Carrie Tingley Hospital (continued)

Course #: CLNS 851


Duration: 4 Weeks


Faculty Evaluator(s): Elizabeth A Szalay, MD



Contact: Jude McMullan

to the final grade. Criteria for Outstanding Grade: Consistent performance of items

noted above. Successful participation in, and completion of a research project is helpful,

but not necessary for achieving an outstanding grade.


Research projects are available, and require a firm commitment by the student and

supervision and mentoring by one of the pediatric orthopaedic attending staff members.

Outreach clinics throughout New Mexico, cast room and brace shop are various aspects of this elective.





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Orthopaedic Trauma Sub-Internship

Course #: CLNS 852


Duration: 4 Weeks


Faculty Evaluator(s): Thomas DeCoster, MD Prerequisites: Phase II Clerkship: Surgery



Goals and Unique Aspects: Learn the appropriate anatomy, physiology, and exam skills needed to participate in the

care of orthopaedic trauma patients, including multiple trauma and isolated fractures.

Objectives:

Learn initial management of patients with acute traumatic injury including history,

physicals, resuscitation and treatment of open and closed fractures, soft tissue injury,

casting techniques, and introductory reduction techniques.

Responsibilities: Observational: Observe and participate in all aspects patient care including emergency

room and trauma call, inpatient and postoperative care, out-patient clinics and surgical

interventions. Clinical: Participate in inpatient daily rounds; assist with and observe

surgery two days per week. Various orthopaedic subspecialty clinics three days per

week. Research: May participate in ongoing research projects. Teaching: Present cases

at formal orthopaedic department conferences. Case presentation to the attending

physician in clinic, and interoperative teaching are provided. Required: Act as subintern,

assuming primary responsibility for patients, both inpatient and ambulatory set-tings,

include early patient contact, history and physical examinations, problem lists and

diagnostic/therapeutic plans. Participate in perioperative and postoperative management of patients, including following patient to operating room, evaluating patients and

writing notes on rounds twice a day, and following patient progress during follow-up

visits. Overnight call required every third night. Under supervision of an attending

physician and/or resident at all times. Optional: Opportunity to see patients in all

orthopaedic subspecialties at UNMH, Carrie Tingley Hospital and VAMC.

Evaluation:

Multifactoral by attending physicians and chief residents. Areas evaluated are knowledge

of musculoskeletal anatomy; ability to obtain focused history and physical exam; complete medical documentation and interpretation of radiographs and other tests;

ability to give accurate; concise, presentations to senior level residents and attendings

and participate as member of surgical team on rounds, wards, clinics, and operating

room. All criteria evaluated equally; primary emphasis placed on physical examination of

the musculoskeletal system. Criteria for Outstanding Grade: Consistently prepared for

surgical cases with excellent knowledge of relevant surgical anatomy, indications and

contraindications for surgery and rational for surgical interventions; regularly provide

evidence of ability to integrate information from resident conferences, selected readings

and current literature, clinical patient encounters and surgical cases; demonstrate

evidence based, logical treatment based on texts and current literature; demonstrate comprehension of both natural disease course and methods of treatment of common





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Orthopaedic Trauma Sub-Internship (continued)

Course #: CLNS 852


Duration: 4 Weeks


Faculty Evaluator(s): Thomas DeCoster, MD

Prerequisites: Phase II Clerkship: Surgery



Evaluation (continued):

clinical conditions; make effective and complete clinical case presentations at the

preoperative or resident conference; demonstrate superior skills in physical examination

of the musculoskeletal system including special tests related to patients encountered on

the service.





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Hand Surgery

Course #: CLNS 853


Duration: 4 Weeks


Faculty Evaluator(s): Moheb Moneim, MD Prerequisites: Phase II Clerkship: Surgery




To participate as an active member of the hand surgical team, delivering care to patients

with hand surgery problems including trauma, arthritis and other reconstructive problems.

Objectives:

To learn to examine a hand and be exposed to common disorders of the hand in a clinic

setting, in the operating room and follow-up in the office.

Responsibilities:

Observational: In clinic setting, operating room and inpatient setting. Required:

Attendance in clinics, operating room and at conferences. Optional: Night call and

research.


Amount and Type: Senior faculty and hand fellows 75%, residents 25%. Didactic

Content: Text available in the library and attendance at all hand surgery conferences.

Evaluation:

At the end of the rotation, evaluation will be according to knowledge base and

participation in various patient care activities.





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Orthopaedic Spine Clinical Experience

Course #: CLNS 854


Duration: 4 Weeks


Faculty Evaluator(s): Robert Quinn, MD Andrew Paterson, MD





To instruct medical students, particularly those interested in family practice, in evaluation, diagnosis and care of spine injured patients.

Objectives:

To teach interested students to approach a “spine” patient.

Responsibilities:

Observational: Learn to do “low back” history and physical. Learn to evaluate X-rays, CT

and MRI scans. Research: Optional. Teaching: Present an informal talk on an assigned

spine topic appropriate for his/her level. Required: Basic knowledge of anatomy and

neurophysiology. Optional: Assist in surgery of spine pathology on Tuesdays and Wednesdays.


Amount and Type: Tuesday: observe spine surgery; Wednesday a.m.: surgery,

orthopaedics teaching classes; Wednesday pm: spine surgery; Thursday: clinic all day;

Friday: clinic in a.m. Didactic Content: Teaching in peripatetic fashion.

Evaluation:

Criteria for Outstanding Grade: Demonstrate a grasp of evaluating a low back patient for pathology.





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Sports Medicine

Course #: CLNS 855


Duration: 4 Weeks


Faculty Evaluator(s): Chris McGrew, MD Prerequisites:


Contact: Nancy Jones

Goals and Unique Aspects: Student is introduced to the primary care sports medicine system through broad based

exposure to a variety of sports medicine settings at the University of New Mexico and in

the Albuquerque community. Goals include understanding the multifaceted make-up of a

complete sports medicine system, obtaining skills and understanding concerning the

care of the competitive and recreational athlete, both in organized and individual

settings, and understanding the role of exercise in the promotion of health and the

treatment of disease. This is NOT a surgical rotation.

Objectives: Objectives include defining a community sports system, proficiency in examination of

the shoulder, knee and ankle along with the ability to give a limited diagnosis, explain

principles of rehabilitation in the injured athlete, understanding the concept of

prevention of sports injuries and understanding the principles of exercise evaluation and

exercise prescription in the “well adult.”

Responsibilities:

Scholarly/Creative Work: Research and write a 3-5 page review of an area of interest in

sports medicine utilizing at least five resources, or develop a patient education handout.

Observational: Outpatient Sports Medicine Clinic, physical therapy, high school training room, UNM Human Performance Lab, and attend appropriate, indicated surgeries and

athletic events. Clinical: Examine patients in outpatient clinics. Present case to

attending. Assist with and complete medical record. Assist in exercise evaluation of well

adults in Human Performance Lab. Assist in initial evaluation of injured athlete in high

school training room.


Amount and type: Supervision by faculty al all levels of patient contact, including hands-

on training and direct observation. Didactic Content: Video tapes of selected joint exams and sports medicine topics. Recommended textbook lists with selected readings.

Recommended articles.

Evaluation:

Criteria for outstanding grade: Attendance at clinical and other sites of teaching on a

regular and timely basis. Appropriate progression of knowledge and hands-on ability and

skills with patients. Evaluation of research paper.


Student is expected to develop a personal exercise program during this rotation. This rotation is generally NOT available over the winter holidays and mid-May through Mid

August.





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DEPARTMENT OF PATHOLOGY

Anatomic Pathology at UNMH

Course #: CLNS 872


Duration: 2-4 Weeks


Faculty Evaluator(s): Nancy Joste, MD Prerequisites:


Contact: Jeanne Lay


Gain familiarity with diagnostic evaluation of tissue specimens, and the overall

organization of an anatomic pathology service. The student may rotate through two different sections of the pathology laboratory in blocks of 1-2 weeks or remain on

surgical pathology the entire month, depending on the needs of the division.

Objectives:

Interpret most tissues specimens grossly and microscopically in light of clinical history.

Perform frozen sections. Formulate a meaningful, communicative written report

interpreting tissue findings with clinical relevance.

Responsibilities:

Observational: Exposure to the diagnostic cytopathology service is optional. Dissect surgical tissue specimens. Sample and examine tissues histologically. Formulate surgical

pathology reports. Clinical: No direct patient contact required. 8-5 weekdays. No

night/weekend call. Research: Optional.


Amount and type: Abundant, direct supervision. Didactic content: Daily morning

conferences – both didactic and case conferences.

Evaluation: Criteria for outstanding grade: Progress in evaluation of specimens, understanding of

clinical-pathological correlations and formulation of reports.





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Anatomic Pathology at VAMC

Course #: CLNS 870


Duration: 4 Weeks


Faculty Evaluator(s): Larry Mossie, MD Prerequisites:


Contact: Jeanne Lay


Gain familiarity with diagnostic evaluation of tissue specimens, and the overall

organization of an anatomic pathology service. The student may rotate through two different sections of the pathology laboratory in blocks of 2 weeks or remain on

anatomic pathology the entire month.

Objectives:

Interpret most tissue specimens grossly and microscopically in light of clinical history.

Perform frozen sections. Formulate a meaningful, communicative written report

interpreting tissue findings with clinical relevance.

Responsibilities:

Observational: Exposure to the diagnostic cytopathology service is optional. Dissect surgical tissue specimens. Sample and examine tissues histologically. Formulate surgical

pathology reports. Clinical: No direct patient contact required. 8-5 weekdays. No

night/weekend call. Research: Optional.


Amount and type: Abundant, direct supervision. Didactic content: Daily morning

conferences – both didactic and case conferences.

Evaluation: Criteria for outstanding grade: Progress in evaluation of specimens, understanding of

clinical-pathological correlations and formulation of reports.


Veterans’ Administration Medical Center is located at 1501 San Pedro SE. Report to

Department of Pathology Services. 256-1711 ext. 2355





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Clinical Pathology

Course #: CLNS 871


Duration: 4 Weeks


Faculty Evaluator(s): See Additional Information Prerequisites: NO registration without prior consent of

clerkship director(s). We are not able to

accommodate students during the months of

June and July.


Contact: Miquella Herrera


To expose the student to laboratory diagnosis of disease on an intense level. The

student may rotate through different sections of the pathology laboratory in blocks

specifically tailored to individual career goals.

Objectives: Use the clinical laboratory more effectively in the diagnosis and management of disease.

Responsibilities:

Observational: In consultation with departmental faculty, the student tailors a rotation

through one or more areas of the laboratory most pertinent to the student’s career

goals. In this area (or areas), the student actively participates in the responsibilities of

the clinical pathologist or laboratory scientist determining appropriateness of laboratory tests for clinical services; reviewing the meaning of laboratory abnormalities for

laboratory uses; working up anomalous laboratory test values; presenting conference

cases; learning laboratory techniques, and participating in case sign out among others.

The student attends the daily pathology teaching conferences and may collaborate with

pathology faculty on research projects or laboratory test development. When rotating in

transfusion medicine, the student is involved in evaluating transfusion needs of patients,

diagnosis of bleeding and clotting disorders; and seeing patients receiving therapeutic

apheresis and stem cell collection.


Amount and type: Daily. Didactic content: UNMH, Monday AM Clinical pathology didactic

conference and Clinical Pathology call conferences. Other conferences may be assigned

as designated by laboratory section director.

Evaluation:

Defined in student handbook.


NO registration without prior consent of clerkship director(s). An add/drop slip must be

signed to add this course to your schedule. We are not able to accommodate students

during the months of June and July.





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Clinical Pathology [continued]

Course #: CLNS 871


Duration: 4 Weeks


Faculty Evaluator(s): See Additional Information Prerequisites:


Contact: Miquella Herrera

Additional Information [continued]:

Include section when registering:

Section: Area Faculty:

A. Transfusion Medicine/Coagulations/ Dr. Kendall Crookston (UNMH)

Therapeutic Apheresis

B. Hematology Dr. Qian-Yun Zhang

C. Medical Computing Dr. Matt Luke (UNMH)

D. Molecular Diagnostics, Cytogenetics Dr. Barbara Masten (BMSB 307)

Molecular Oncology and

Histocompatibility.

Note: Hematology available only one week out of each four week session.





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Clerkship in Forensic Pathology

Course #: CLNS 874


Duration: 4 Weeks


Faculty Evaluator(s): Ross E. Zumwalt, MD Prerequisites: Completion of all Phase II Clerkships


Contact: Connie Jefferson

505-272-0710


Autopsy means “I See.” Student views hospital autopsies in the classic tradition, the final medical procedure. The goal is for the student to understand that many roles of

forensic and autopsy pathology in the hospital and community. The course also affords

the opportunity to review normal anatomy and learn how different organ systems are

affected by common disease processes. This is potentially of value to students

considering pursuing one of the surgical specialties.

Objectives:

Expected learning issues include: Which cases fall under the jurisdiction of the Medical

Investigator; Which cases require a medicolegal autopsy; Correct completion of death

certificates; Basic performance of an autopsy including dissection techniques, and report preparation; Basic patterns of injury in violent death; Differential diagnosis of sudden,

unexpected, natural death; Significance of manners of death; Principles of identification

of bodies.

Responsibilities:

Observational: Student attends and participates in daily morning report and observes

autopsies subsequently performed. When appropriate, the student may visit scenes of

death or accompany faculty to courtroom proceedings. Research: Student selects a

discrete topic in forensic or autopsy pathology under supervision of the director of the rotation and, through targeted reading or review of cases on file at OMI, informally

presents his/her findings to staff. Teaching: Student has no formal teaching duties. On

occasion, she/he may assist with demonstrations for non-physician trainees or

conferences for medical personnel. Required: Student is present daily from 8:00am-

5:00pm in the Office of the Medical Investigator, unless specifically excused by the

supervising pathologist. Student has the opportunity for increasing participation and,

depending on the availability of appropriate cases and individual progress, may, with

guidance, perform an uncomplicated postmortem examination by the end of the

elective.


Amount and type: Close one-on-one supervision and instruction by the faculty, fellows in

forensic pathology and residents in anatomic pathology. Direct supervision is relatively

constant in autopsy suite, where the student spends approximately half the time. The

other half is devoted to directed reading (primarily in forensic pathology) and other

activities. Didactic Content: Required to attend morning report, weekly forensic

pathology journal club, weekly toxicology/pending case conference and weekly neuropathology conferences. Staff review microscopic slides of selected cases with the

student.





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Clerkship in Forensic Pathology [continued]

Course #: CLNS 874


Duration: 4 Weeks


Faculty Evaluator(s): Ross E. Zumwalt, MD Prerequisites: Completion of all Phase II Clerkships


Contact: Connie Jefferson

Evaluation:

Based on performance in the autopsy room during morning report and participation in

postmortem examinations, quality of verbal and written reports and application of new knowledge from readings and experience at the OMI. The student is also graded on

his/her presentation at the end of the rotation. To receive and “outstanding” grade, the

student must be evaluated as superior by faculty. In the last week of the rotation, the

student will give a 15 minute presentation on a topic of their choice, based upon an

autopsy that was observed/performed during the rotation. The presentation should be

reviewed beforehand with the attending in charge of the particular autopsy case. An

informal pre and post-test will be given at the beginning and end of the rotation,

respectively, as a guide to learning progress during the course.

Suggested Reading: DiMaio and DiMaio Forensic Pathology; CRC Press

Dolinak, Matshes and Lew Forensic Pathology, Principles and Practice; Elsevier





96

DEPARTMENT OF PEDIATRICS

Ambulatory Pediatrics at Young Children’s Health Center

Course #: CLNS 676


Duration: 4 Weeks


Faculty Evaluator(s): Javier Aceves, MD

Elizabeth Henderson, MD Gillian Harris, MD

Joseph Aguirre, MD

Lance Chilton, MD

Alex Stelzner, MD

Prerequisites: Phase II Clerkships: Pediatrics

Spanish Speaking


Contact: Pediatrics Clerkship Coordinator

Julia Martin


Clinical experience in a community based pediatric setting. Exposure to family-centered

services in low income community of southeast Albuquerque. There is a large immigrant

population. Exposure to multicultural aspects in medical care. Integration of primary

care and behavioral health in a pediatric setting , especially for children and youth with

special health care needs.

Objectives:

Learners will Be able to state advantages of an integrated clinical medicine – behavioral

health approach in pediatrics; Be able to discuss economic and social problems

associated with poverty and immigrant status; Be able to deal with common pediatric

outpatient problems, such as upper and lower respiratory tract infections, urinary tract

infections, diarrheal illness, etc.; Be able to handle common chronic pediatric conditions,

such as asthma, attention deficit disorder, seizure disorder, etc., specifying diagnostic

and treatment plans for each condition and means of supporting other family members

as well as the affected member; Be acquainted with community efforts to improve the

health and well-being of children and families in the Southeast Heights and be able to state how these might be generalized to other populations.

Responsibilities:

Observational: Observe multi-agency medical and family services. Clinical: Interview

and evaluate/assess health related problems of six to ten patients per day under direct

supervision of faculty. No night call. Research: Small scale clinical or community project

strongly encouraged. Teaching: May participate in educational activities provided by

faculty in neighborhood schools.


Amount and type: Supervised by pediatric faculty. Didactic content: Reading materials,

with reserve materials available on line through HSLIC.





97


Ambulatory Pediatrics at Young Children’s Health Center (continued)

Course #: CLNS 676


Duration: 4 Weeks


Faculty Evaluator(s): Javier Aceves, MD

Elizabeth Henderson, MD Gillian Harris, MD

Joseph Aguirre, MD

Lance Chilton, MD

Alex Stelzner, MD

Prerequisites: Phase II Clerkships: Pediatrics

Spanish Speaking



Julia Martin

Evaluation:

Based on direct observation, presentations, and clinical performance. Criteria for

outstanding grade: Consistently perform at an outstanding level in all areas, using

PRIME. Enthusiasm, ability to relate with patients and their families and with staff, and

participation in clinic and/or community projects are important factors.

Additional Information: Prior approval is required. Student can arrange schedule as desired since office hours

are 8am-7 pm Mon-Tue-Wed-Thurs. Friday hours are from 8am-5pm, and Saturday

hours are 9 am to 2 pm.





98


Pediatrics at UNMH Sub-Internship

Course #: CLNS 677


Duration: 4 Weeks


Faculty Evaluator(s): Teresa Vigil, MD Sara Bluefeather, MD


including an inpatient general pediatrics

component or comparable program in a

US/Canadian medical school.



Julia Martin


Direct responsibility for diagnosis and treatment of hospitalized pediatric patients (under

supervision of residents and faculty attending physicians).

Objectives:

To assess the nature and severity of illness in a child through history, physical

examination and laboratory examinations and to plan for and carry out that patient’s

care.

Responsibilities:

Observational: During rounds and teaching conferences the student observes the

approach of others to diagnose and manage patients for whom the student is not

directly responsible. Clinical: patient contact is extensive. Students are expected to take

ownership of 2-5 patients. Q 4 overnight call. Teaching: The student is responsible for

one small group teaching session related to his/her patients. Student is also responsible

for educating patients/parents.


Amount and type: Supervision by upper level resident (PL II, III) and faculty attending.

Upper level resident closely supervises student, reviews and countersigns all orders

written by the student. Faculty reviews history, physical and progress notes and will

directly observe patient presentations. Didactic content: Departmental conferences;

morning report Wednesday and Friday; Thursday Grand Rounds; Daily Social Service

rounds; daily x-ray rounds; Morbidity & Mortality conference monthly, daily noon

conference.

Evaluation: Criteria for outstanding grade: Outstanding grade results from PRIME: 1. patient care

excellence. 2. enthusiastic, motivated attitude. 3. overall knowledge. 4. commitment

to and demonstrated self learning. 5. managing patients in a logical manner

incorporating scientific evidence with individual patient needs.


International medical students will be accepted on a case-by-case basis.





99


Pediatric Cardiology

Course #: CLNS 678


Duration: 4 Weeks


Faculty Evaluator(s): Beth Goens, MD Prerequisites: Phase II Clerkship: Pediatrics



Julia Martin


To provide a well-rounded introductory experience to the field of pediatric cardiology.

Objectives:

Acquire basic knowledge of congenital and acquired heart disease in infants, children

and adolescents, and the pathophysiology associated with these problems. Learn to

evaluate cardiovascular system by history and physical examination, to distinguish

innocent from pathologic heart murmurs. Learn to interpret pediatric electrocardiograms

and chest X-rays. Be introduced to advanced cardiovascular diagnostic modalities

(echocardiography, exercise stress testing, and diagnostic and therapeutic cardiac

catheterization).

Responsibilities:

Observational: Observe evaluation, diagnosis and management of infants, children and

adolescents with suspected heart disease; uses and limitations of advanced

cardiovascular diagnostic modalities. Clinical: Evaluate all pediatric cardiology inpatients

and outpatients, write progress notes, consult, and interpret ECG. Observe

echocardiograms, exercise stress test, tilt table test and cardiac catheterizations.

Research: None. Teaching: Phase II students accompany us to clinic and you may have

the opportunity to teach them. Required: Read complete Pediatric Cardiology

syllabus/view DVD format. Attend Wednesday morning cardiosurgical care conference and Cardiology Clinical Conference on Tuesday afternoon. Give 30-minute talk on

pediatric cardiology topic. Night/weekend call not required.


Amount and Type: Direct supervision by attending cardiologist. Didactic Content:

Cardiology slide collection, review heart specimen, multimedia tools including Listen to

the Heart (CD-ROMS on heart sounds and murmurs), numerous sites on World Wide

Web, faculty PowerPoint presentations on the Children’s Hospital Heart Center website

and on New Innovations.

Evaluation:

Criteria for Outstanding Grade: High level pediatric cardiology knowledge at end of

rotation, determined subjectively by the attending cardiologists. High motivation and

initiative. Excellence in patient care, evidence of good clinical judgment, professional and

courteous interaction with faculty, staff, patients and families. Pre/post tests given as

study guide





100


Pediatric Cardiology (continued)

Course #: CLNS 678


Duration: 4 Weeks


Faculty Evaluator(s): Beth Goens, MD Prerequisites: Phase II Clerkship: Pediatrics



Julia Martin

Additional Information: Prior approval is required. The student has the opportunity to see many patients with

both pathologic and innocent heart murmurs. The student is able to study congenital

heart disease by direct inspection of congenital heart specimens. The student receives a

full syllabus covering all major topics in pediatric cardiology including: review of

embryology and physiology; congestive heart failure; congenital heart disease; acquired

heart disease in children; syndromes; pulmonary artery hypertension; drugs; operations

for congenital heart disease. 45 day add/drop policy will be strictly enforced.

This course will accept visiting students and scheduling can be flexible.





101


Pediatric Rehabilitation/Pediatric Chronic Disease

Course #: CLNS 679


Duration: 4 Weeks


Faculty Evaluator(s): Denise Taylor, MD M. Armstrong, MD




Julia Martin

Goals and Unique Aspects: Provides a comprehensive experience caring for special needs children and children and

adolescents recovering from traumatic brain injury and other disabling conditions,

integrating the medical and psychosocial aspects of their care. Understand the

neurologic basis of rehabilitation. Interact with multidisciplinary teams, the educational

system and community resources.

Objectives:

Recognize and contract the developmentally delayed child/infant to known normal

growth and development markers. Perform complete histories and physicals on special

needs children (inpatient and outpatient), and formulate treatment/rehabilitative plans. Recognize the impact of a chronic handicapping condition on child, family and

community.

Responsibilities:

Observational: Perform histories and physicals in clinics (Peds, rehab, multidisciplinary);

participate in team rehab conference; inpatient treatment sessions in PT, OT SLP,

recreation, special education, family conferences. Clinical: At least one new CP, pediatric

or rehabilitation evaluation, complete history and physical with formulation of treatment

plan. Research: Individually determined. Required: Attend multidisciplinary clinics and at least one rehab conference; visit at least one community program; follow two or more

rehab inpatients(s) through therapies. Participate in outpatient clinics. Optional:

Pediatric Orthopaedic Clinics, Resident Teaching Conferences, IRA, Pediatric Neurology

Clinics, observe PT, OT, SLP, O&P. Participate in neurobehavioral clinic.


Amount and type: Shared by pediatric physiatrist, and general pediatricians. Didactic

content: Reading lists provided, resident lectures, weekly rehabilitation lecture series.

Evaluation: Based on clinical observations by faculty. Criteria for outstanding grade: Meet goals and

objectives with enthusiasm and demonstrate excellence in skills and comprehension of

materials.


Prior approval is required.





102


Pediatric Genetics and Dysmorphology

Course #: CLNS 680


Duration: 4 Weeks


Faculty Evaluator(s): Richard Heidenreich, MD Prerequisites: Phase II Clerkship: Pediatrics



Julia Martin


Integrated experience in clinical dysmorphology and genetics with the application of DNA technology to clinical care. Gain experience in the use of clinical and laboratory tools in

the analysis of aberrant morphogenesis and genetic disorders. There is the opportunity

to attend an genetics outreach clinic by special arrangement.

Objectives:

Be able to take a detailed genetic history; perform a clinical examination for dysmorphic

features; develop a detailed understanding of genetic mechanisms; utilize computerized

genetic database resources.

Responsibilities: Observational: With the assistance of the genetics staff, learn how to conduct detailed

genetic examinations and history. Clinical: participate in weekly scheduled genetics clinic

and consultations (usually 3-5 per week). Research: Access web-based and other

resources for diagnosis and testing of genetic disorders in the patients. Teaching:

Educate patient and family as appropriate.


Amount and type: Shared by two clinical genetics faculty: Carol Clericuzio, MD; Tom

Cishing, MD; as well as by Joanne Milisa Drautz, MS, Genetic Counselor. Make daily rounds, participate in clinics and weekly clinical conference. Attend twice monthly

metabolic genetics clinics at Carrie Tingley Hospital. Didactic content: Designated

reading. Responsible for library searches as appropriate. Attend lectures and seminars

as appropriate.

Evaluation:

Criteria for outstanding grade: Assumes responsibility for follow up and counseling of all

patients he/she is involved with. Does independent reading, with evidence of effective

use of the literature for problem solving in clinical settings. Integrates basic biologic

mechanisms with clinical data. Is aware of all patients on the inpatient services who represent problems in morphogenesis and/or hereditary disorders.


Prior approval is required. Contact the Peds Dept for information on dates of availability.





103


Pediatric Hematology / Oncology

Course #: CLNS 681


Duration: 4 Weeks


Faculty Evaluator(s): James McKinnell, MD Prerequisites:



Julia Martin


Introduce the student to issues relating to clinical management in both the inpatient and outpatient settings of childhood cancers and hematologic disorders: diagnostic work up,

therapies, supportive care, emotional support, follow up of late effects and end of life

issues, as well as general hematology work ups and comprehensive hemophilia care.

Objectives:

Recognize common types of childhood cancers and hematologic disorders; develop some

expertise in taking focused histories and determining appropriate diagnostic work ups.

Become familiar with process of choosing and instituting therapy and special supportive

families/patients dealing with childhood cancer. See the importance of cooperative group

trials in clinical oncology.

Responsibilities:

Multidisciplinary team approach to management of childhood cancers and hematologic

disorders: medical, nursing, pharmacy, social work, and child life. Become familiar with

diagnostic and therapeutic procedures, central venous catheters and the administration

of chemotherapy. Clinical: Two weeks on the inpatient service and two weeks in the

outpatient clinic. While on inpatient service, round daily on patients with attending,

coordinate care plan and write daily progress notes on assigned patients. Also attend

any treatment or family conferences in the outpatient clinic setting, see patients presenting for follow up under the supervision of an attending, observe diagnostic and

therapeutic procedures. Will also review lab results, radiographic studies and peripheral

blood and bone marrow smears with attending faculty. Required attendance at monthly

pediatric tumor board. Research: Present seminar at the end of the course. Teaching:

Patient education and outcome evaluation.


Amount and type: Drs. Linda Butros, Jami Frost, Jeffrey Hanrahan, Richard Heideman,

Prasad Mathew, James McKinnel, and Stuart Winter are the responsible faculty. Close

supervision and teaching will also be given by the hematology/oncology nurses and social workers. Didactic content: Small didactic sessions conducted by the inpatient

attending at least once a week; clinic patient care discussions; ward rounds; selected

reading.

Evaluation:

Criteria for outstanding grade: Based on evaluation by oncology team: excellent fund of

knowledge consistently applied to patient care; mastery of pertinent data combined with

excellence in reporting; demonstration of independent thinking and initiative.





104


Adolescent Medicine

Course #: CLNS 683


Duration: 4 Weeks


Faculty Evaluator(s): Karen Campbell, MD Vic Strasburger, MD

Alberta Kong, MD

Prerequisites: Phase II Clerkship: Pediatrics



Julia Martin


Useful for anyone going into Primary Care or interested in adolescents. Exposure to

different groups of adolescents (clinic, schools, college), and to common adolescent

health problems, e.g. acne, mono, STD’s, contraception. Gain understanding of the basic

physiology and psychology of adolescence.

Objectives:

Perform a competent history and physical exam on a teenager. Interview a teenager and

his/her family. Prescribe contraceptives appropriately.

Responsibilities:

Observational: At locked treatment center for juvenile offenders (Sequoyah Adolescent

Treatment Center). Clinical: Opportunity to see and treat teenagers at a variety of

different clinical sites. Research: Readings in adolescent medicine (provided). Teaching:

Present an oral 15-20 minutes conference on any adolescent medicine topic at the end

of the rotation. Required: Attend one clinic per week at Pediatrics/Adolescent Medicine,

STD Clinic, School-based Clinic, and Sequoyah Adolescent Treatment Center. Optional:

Sports Medicine Clinic, Planned Parenthood, Job Corps.


Amount and type: Drs. Strasburger and Epstein supervise at Pediatrics/Adolescent

Medicine clinics and Dr. McGrath at the school-based clinic. Other supervision arranged,

depending on the student’s interests and choices. Didactic content: Readings provided.

Pediatric AM conferences, where appropriate. One or two adolescent medicine

conferences per week (informal).

Evaluation:

Criteria for outstanding grade: Clinical excellence, high degree of motivation and

interest, and excellent preparation of one talk on any adolescent medicine subject.


Prior approval is required. This is an informal exposure to the field of Adolescent

medicine which can be tailored to the needs of an individual student (e.g. more

gynecology, sports medicine, psychology, etc). Ample time for reading and reflection.

Travel to local clinics required.





105


Pediatric Intensive Care

Course #: CLNS 684


Duration: 4 Weeks


Faculty Evaluator(s): Dawn Joseph, MD Denise Coleman, MD

Mark Crowley, MD

Tito Monge, MD




Julia Martin


To learn the diagnosis and management of critically ill pediatric patients. The student

will learn the pathophysiology of the common pediatric diseases in the Pediatric

Intensive Care Unit including: 1. Recognition and stabilization of the critically ill patient.

2. Recognition and treatment of respiratory failure. 3. Recognition and treatment of

shock. 4. Treatment of status asthmaticus. 5. treatment of diabetic ketoacidosis. 6.

Recognition and treatment of increased intracranial pressure and coma. 7. management

of metabolic emergencies – problems with sodium, potassium, glucose, calcium. 8.

Recognition and management of hepatic failure. 9. Recognition and management of acute renal failure. 10. Participate in both procedural and ICU sedations.

Objectives:

Student will actively participate in the work up, presentation, and daily management of

critically ill pediatric patients in the PICU. Student will participate in procedures

(including airway management and vascular access), workups, present patients, write

notes.

Responsibilities: Clinical: Student will be responsible for working up, presenting, rounding on, and writing

notes on up to 3 patients at a time. Student will become familiar with mechanical

ventilation, blood gas interpretation, central venous catheter insertion, pharmacokinetics

and dynamics, organ failure, and TPN/enteral nutrition. Teaching: Work rounds and bed

side teaching daily. Attending lectures 2-3 times per week. Resident mini-lectures.

Students are also required to present a 15-20 minutes talk on an ICU topic of their

choice. Required: Q4 Night call; work up/follow up to three patients at a time. Attend

pediatric morning report on Wednesday and Friday and pediatric noon conferences.

Supervision and Teaching: Students will be directly supervised by PICU attendings and senior pediatric residents.

Amount and type: Student will be supervised by and have access to PICU attendings at

all times; also supervised by the senior resident. Didactic content: Textbooks available

in PICU. Student should review the Power Point presentations on www.picucourse.org as

well as have didactic lectures provided by the attendings on the core/common PICU

diseases.





106


Pediatric Intensive Care (continued)

Course #: CLNS 684


Duration: 4 Weeks


Faculty Evaluator(s): Dawn Joseph, MD Denise Coleman, MD

Mark Crowley, MD

Tito Monge, MD




Julia Martin

Evaluation:

Based on clinical knowledge, patient care, communication skills, topic presentation.

Based on clinical observations by faculty and senior resident. Criteria for outstanding

grade: Commitment to excellent patient care and enthusiasm for the role he/she plays

in the PICU team; demonstration of outside reading and self-motivated study. Accurate

data gathering and reporting and involvement in patient care. 45 day add/drop policy

will be strictly enforced.





107

DEPARTMENT OF PEDIATRICS Pediatric Infectious Disease

Course #: CLNS 686


Duration: 4 Weeks


Faculty Evaluator(s): Sheila Hickey, MD

Martha Miller, MD

Walter Dehority, MD

Prerequisites: Phase II Clerkship: Pediatrics



Julia Martin


Provide an approach to problem solving and management of pediatric infectious disease

and an overview of careers in pediatric infectious diseases.

Objectives:

Understand basic pediatric infectious disease processes, and immunization practice.

Learn to provide consultative pediatric care, organize and write a teaching review, and

choose the most appropriate antibiotic for empiric therapy of specific organ system

infections. Understand basic antimicrobial chemotherapy.

Responsibilities:

Observational: Observe/participate with faculty, residents, fellows in direct and

consultative care. Clinical: Ongoing projects require student participation to the same

extent house officers. Research: may participate in clinical or laboratory research,

written reviews, case reports. Teaching: Attend pediatrics and pediatric infectious

disease conference. May be asked to provide up to two oral and/or two written literature

searches. Required: Perform, write and present consults. Attend all pediatric weekly teaching conferences. Participate in problem based case analysis and in clinical

microbiology interactive teaching. Optional: No fixed call is required. Prepare an

oral/written case(s) review.


Amount and type: Supervised by faculty, occasional PL2/PL3 or adult ID fellow. Didactic content: Provided by Department of Pediatrics, ID Teaching Conferences (1 hour/week),

ID rounds (5 hours/week), additional didactic sessions.

Evaluation:

Based on clinical/written (e.g. consults) skills, verbal reports, attendance, completion of

reports and in-depth study. No examination. Criteria for outstanding grade: Commitment to excellent patient care and scholarly activity, quality self-direction and

independent study, excellent clinical skills. Performance at the level of consistent

reporter and interpreter, starting to manage.

Additional Information: Pediatric Infectious Disease has a highly variable patient load, which requires high

motivation and self-directed independent study skills. Contact the Peds Dept for

information on dates of availability. Prior approval is required. Not available to visiting

students.





108


Newborn Intensive Care Unit

Course #: CLNS 687


Duration: 4 Weeks


Faculty Evaluator(s): Renate Savich, MD Prerequisites: Phase II Clerkship: Pediatrics



Julia Martin


Attend all high risk deliveries. To learn intensive care management of neonates, fluids, nutrition, ventilator management, infectious diseases of the newborn, learn physiology

and embryology. Family centered approach to intensive care.

Objectives:

To provide excellent care for the sick newborn and understand pathophysiology of

newborns. Understand family dynamics during this time.

Responsibilities:

Observational: Rounds, procedures (involved in patient care as well as observation),

labor & delivery. Clinical: patient care and management. Perform procedures such as intubations, resuscitation, umbilical catheters. Research: Clinical studies as desired.

Teaching: Give one talk to group, participate in discussions on rounds. Required: No

night call, only daytime shifts (intern equivalent).


Amount and type: By senior faculty, fellows and resident. Didactic content: Read, attend

lectures.

Evaluation: Based on daily involvement with attendings, fellows, and resident. Criteria for

outstanding grade: Greatly increase fund of knowledge. Provide excellent care. Work

well with team.


The Phase III student in the NBICU functions as a subintern and has direct responsibility

for patient care and delivery room experience. Excellent rotation for those interested in

pediatrics, family practice, obstetrics or anesthesia. 45 day add/drop policy will be

strictly enforced.





109


Pediatric Outpatient Department

Course #: CLNS 688


Duration: 4 Weeks


Faculty Evaluator(s): Penny Brandt, MD Chandler Todd, MD




Julia Martin


Clinical experience in pediatrics in an ambulatory setting which includes patients of high

acuity as well as health care maintenance visits.

Objectives:

Diagnose and treat common pediatric problems. Evaluate and manage6-10 patients per

day. Appreciate the developmental milestones of childhood and adolescence and how

development impacts interactions.

Responsibilities: Observational: take responsibility, under supervision, of each patient assigned. Clinical:

6-10 patients per day (8 hours); full responsibility for each patient, call every 4th night,

including one Saturday and one Sunday. Research: Optional. Teaching: Patient

education, preparation and presentation of one informal brief morning report in clinic.


Amount and type: Every patient is presented and reviewed by clinic faculty at UNMH.

Didactic content: Attend 45-60 minute case management rounds every morning, give at

least one “report” to residents, faculty and staff; attend conferences as scheduled.

Evaluation:

Criteria for Outstanding grade: Fulfill expectations listed above in a consistently

“outstanding” manner – using the PRIME grading scale.





110


Westside Family Health Outpatient Clinic

Course: CLNS 690


Duration: 4 Weeks

Students per Rotation: 1 Faculty Evaluator(s): Sandra Whisler, MD

Michael Pleacher, MD


including an outpatient general pediatrics

component or comparable program in a

US/Canadian medical school.


Contact: Pediatrics Clerkship Coordinator Julia Martin


To know immunization schedules, to fell comfortable with well child checkups, to learn to

care for children with special health care needs in an outpatient setting. To learn how to

do a proper sports medicine physical exam, make an assessment of the problem, and

then formulate an appropriate treatment plan, To be exposed to patients from a variety

of social, economic, and ethnic backgrounds. To see many different payer systems and

learn to give quality medical care within these systems (third party payer and three Medicare Salud Programs)

Objectives:

To become competent in doing both acute and well child care in an outpatient office

setting. To become competent in doing sports medicine care in an outpatient office

setting. Students will be able to: Obtain and document an age appropriate pediatric

history; Obtain and document an age appropriate pediatric physical examination; Order

and interpret laboratory values, X-rays, and other examinations; Make an accurate

assessment of the problem/problems and formulate a differential diagnoses list; Develop and document a care plan; Implement and monitor through documentation the care

plan

Responsibilities:

Observational: Internal medicine and Pediatrics working together in an outpatient

setting. Clinical: Interpretation of lab results, participation in patient education, well

child checks, sick child visits, ages and stages questionnaire. X-rays, etc. Teaching:

Student receives several didactic sessions and learns patient education with materials

present in clinic. All patients are written up in the clinic log and presented to a faculty

member. Optional: Student may have opportunity to do suturing, wart removals, blood draws, PAPs, place splints, attend local high school athletic events, etc.


Amount and type: Supervision by Dr. Whisler and Dr Pleacher. Didactic content :Mini

lectures on a variety of topics. Student is expected to read about disease processes

seen in clinic. At the end of the 4 weeks students are expected to give a 30 minute

presentation on some aspect of ambulatory Pediatrics.





111


Westside Family Health Outpatient Clinic (continued)

Course: CLNS 690


Duration: 4 Weeks


Faculty Evaluator(s): Sandra Whisler, MD

Michael Pleacher, MD


including an outpatient general pediatrics

component or comparable program in a US/Canadian medical school.



Julia Martin

Evaluation:

Clinical observations and ability to do a complete history and physical exam, make an assessment, and formulate a plan as well as develop a differential diagnosis.

Criteria for outstanding grade: Fulfill expectations in an outstanding manner, using

PRIME. Give an outstanding 30 minute presentation at end of rotation.


Prior approval is required by Dr Whisler. This practice is truly a group practice with

approximately 50% insurance patients and 50% Salud/UNM Care patients. The practice

resembles private practice in many ways although Westside is under the umbrella of

UNM. This is an off-campus clerkship.





112

DEPARTMENT OF PSYCHIATRY

Advanced Clinical Psychiatry [Inpatient] Sub-Internship

Course #: CLNS 726


Duration: 4 Weeks


Faculty Evaluator(s): Deborah Dellmore, MD



Contact: Mary Haley


Direct responsibility for evaluation, diagnosis, treatment and discharge planning of

hospitalized psychiatric patients (under supervision of faculty attending psychiatrists and

house staff).

Objectives:

Evaluation (history, physical and mental status examinations, laboratory, psychological

testing), diagnosis and management of patients with severe psychiatric disorders.

Responsibilities:

Observational: Attendance/participation in reports, rounds and conferences; patient

interviews and procedures. Clinical: Extensive patient contact involving approximately

eight hours per day in direct patient related activity at the intern level of responsibility.

Students take two evening calls in the Psychiatric Emergency Service shared with a

resident. Research: Optional, depending upon program and ongoing research projects.

Teaching: Responsible for helping to teach Phase II students assigned to service.

Student is expected to select a relevant topic for research, and make an Evidence Based

Critical Appraisal prior to the end of the rotation.


The psychiatric attending faculty and house staff directly supervise the student.

Evaluative examinations, diagnostic treatment and management plans are thoroughly

reviewed, discussed and evaluated. The student is expected to attend morning reports,

meetings, weekly house staff seminars and departmental conferences.

Evaluation:

Student’s grade is determined by evaluation of performance in areas listed on student evaluation form. Criteria for outstanding grade: An “outstanding” grade is given for

performance demonstrating professionalism and patient rapport, an unusual depth of

knowledge, meticulous patient care and competent completion of charting in the

electronic medical record, and competence in formulation and presentation skills.


This rotation is able to accept visiting students. Scheduling can be flexible as long as

dates do not interfere with UNM students scheduled for the rotation. Rotation is offered

at MHC, VAMC and CPH.

This rotation is not offered in the month of December.





113


Advanced Clinical Emergency Psychiatry [Ambulatory]

Course #: CLNS 727


Duration: 4 Weeks


Faculty Evaluator(s): Deborah Dellmore, MD



Contact: Mary Haley


Direct responsibility for evaluation, diagnosis, planning and treatment of ambulatory

psychiatric patients (under supervision of faculty attending psychiatrists and house

staff).

Objectives:


testing), diagnosis and management of emergency ambulatory patients with acute and severe psychiatric symptoms.

Responsibilities:


interviews and procedures. Clinical: Extensive patient contact involving approximately

eight hours per day in direct patient related activity at the intern level of responsibility.

No evening or weekend call. Research: Student must find two patient problems to

research and present to attendings/residents/staff. Teaching: Responsible for helping to

teach and sign off to Phase II students assigned to service for evening call.



Evaluative examinations, diagnostic treatment and management plans are thoroughly

reviewed, discussed and evaluated. The student is expected to attend morning reports,

meetings, weekly house staff seminars and departmental conferences.

Evaluation:

Student’s grade is determined by evaluation of performance in areas listed on student

evaluation form. Criteria for outstanding grade: An “outstanding” grade is given for performance demonstrating professionalism and patient rapport, an unusual depth of

knowledge, meticulous patient care and competent completion of charting in the

electronic medical record and competence in formulation, presentation and risk

assessment skills.


This rotation is not able to accept visiting students. This rotation is not offered in the

month of December.





114


Neuropsychology

Course #: CLNS 729


Duration: 4 Weeks


Faculty Evaluator(s): Deborah Dellmore, MD Prerequisites: Completion of all Phase II Clerkships


Contact: Mary Haley


Develop experience and understanding of issues involved with evaluation of higher

cortical dysfunction.

Objectives:

Review mental status exams and develop expanded mental status exam. Assess ten

patients with mental status exam. Present mental status data formally on five patients.

Observe detailed neuropsychological evaluation of five patients. Observe videotapes on

at least five patients in video library.

Responsibilities:

Observational: Neuropsychological evaluations; therapeutic discussion of results with

patient. Clinical: Perform detailed mental status (cognitive) examination. Research: Optional involvement in research comparing utility of various approaches to cognitive

screening of older patients. Teaching: Present at least five patients to VA

neuropsychology clinical case conference. Required: Five patients (opportunity to work

with 10-20 patients), formal report on five. Optional: Readings in selected texts,

journals. View videotapes of well-defined patient presentations.


Amount and type: Approximately ten hours per week detailed supervision by faculty.

Didactic content: Relevant readings directed according to the patient population that is seen, and by student interest. Student should be available Thursdays from 10:00am

until 12:00pm in order to attend research seminar. This is an opportunity to hear

presentations on selected topics in neuropsychology.

Evaluation:

Evaluation is based on observation of student’s work with patients, the written report,

and presentations of patients in conference. Criteria for outstanding grade: Complete

required five patient examinations with reports and observe or participate in at least five

other exams. Show initiative in following up suggested readings. Demonstrate flexibility

in incorporating feedback and supervision into ongoing work with patients.


This rotation is not able to accept visiting students. Rotation is located off campus at

VAMC.

This rotation is not offered in the month of December.





115


Alcohol and Substance Abuse Program

Course #: CLNS 730


Duration: 4 Weeks




Contact: Mary Haley


Introduction to the areas of substance abuse, giving students an opportunity to work

with patients who have substance abuse problems in an outpatient detox and treatment program (ASAP) and in an outpatient dual diagnosis clinic at University Psychiatric

Center.

Objectives:

Take a thorough history, evaluating use and abuse of substances. Develop a working

knowledge of the detoxification process. Develop knowledge of physical symptoms of

substance abuse. Be able to identify patients with early problems related to substance

abuse and dependence.

Responsibilities: Observational: Observe patient evaluations at intake. Observe several clinical intakes

and interviews by experienced staff. Participate in treatment planning and triage

meetings. Participate in interviewing the family. Clinical: Assigned patients to follow for

detoxification or in the day program. Participate in the initial education of the patient.

Hours 8:00am-5:00pm, no night or weekend call. Prepare and deliver a lecture to day

program patients. Participate in AA/NA meetings. Research: May participate in ongoing

research. May initiate and complete small project with clinical staff’s supervision.

Teaching: Teach skill building in day program. Lecture to day program patients.


Amount and type: Meet weekly for at least one hour for supervision and more often as

necessary. Didactic content: Participate in Division’s in-service training. Attend

Psychiatry Grand Rounds. Must choose a topic for review in the substance abuse area,

and make a presentation to clinical supervisor. Attend treatment planning sessions.

Evaluation:

Criteria for outstanding grade: Ability to work with patients and staff. Ability to take a

competent substance abuse history and give competent presentations with plans.

Dependability and professionalism. Ability to maintain charts.



dates do not interfere with UNM students scheduled for the rotation. All students should

be advised this rotation is located off campus. Students will need to drive to another

location not located at the University. This rotation is not available during the month of

December.





116


Consultation and Liaison Psychiatry

Course #: CLNS 731


Duration: 4 Weeks




Contact: Mary Haley


Learn to perform comprehensive psychiatric evaluation (including mental status exam)

in a consultative setting. Opportunity to evaluate “biopsychosocial” issues in a hospital setting. Opportunity to learn to conduct family treatment, brief psychotherapy, and

make psychiatric treatment decisions.

Objectives:

Perform psychiatric consultation on a variety of medical, surgical, pediatric, and OB

patients.

Responsibilities:

Observational: Observe staff evaluate patients, formulate consultation, and

communicate with referring staff. Clinical: Act as “subintern” in doing consults and following patents in hospital or as outpatients while on rotation. 8:00am-5:00pm,

Monday through Friday, no night or weekend call. Research: If interested, student can

participate in ongoing studies and learn to use structured interviews or standardized

questionnaires. Teaching: May teach Phase II students on occasion.


Amount and type: Attends regular teaching rounds, conferences, seminars as well as

supervision for each case. Didactic content: Service rounds two/three times per week,

department rounds four times per month, individual supervision on each case.

Evaluation:

Criteria for outstanding grade: Clinical skills development, quality written and oral

presentation of consults. Ability to maintain electronic medical record.



dates do not interfere with UNM students scheduled for the rotation. This rotation is not

offered during the month of December.





117


Advanced Clinical Psychiatry [Ambulatory]

Course #: CLNS 732


Duration: 4 Weeks




Contact: Mary Haley


Direct responsibility for evaluation, diagnosis, planning and treatment of ambulatory

psychiatric patients (under supervision of faculty attending psychiatrists and house staff, especially chief resident).

Objectives:


testing), diagnosis and management of ambulatory patients with severe psychiatric

disorders and for consultation to primary care providers.

Responsibilities:


interviews and procedures. Clinical: Extensive patient contact involving approximately four to eight hours per day in direct patient related activity at the intern level of

responsibility. No Call. Research: Optional, depending upon program and ongoing

research projects. Teaching: Responsible for helping to teach Phase II students assigned

to service for afternoon. Students are expected to select a relevant topic and make an

Evidence Based Critical Appraisal presentation prior to the end of the rotation.



Evaluative examinations, diagnostic treatment and management plans are thoroughly reviewed, discussed and evaluated. The student is expected to attend meetings, weekly

house staff seminars and departmental conferences.

Evaluation:

Student’s grade is determined by evaluation of performance in areas listed on student

evaluation form. Criteria for outstanding grade: An “outstanding” grade is given for

performance demonstrating professionalism and patient rapport, an unusual depth of

knowledge, meticulous patient care and competent completion of electronic medical

record, and competence in formulation and presentation skills.


This rotation is not able to accept visiting students. This rotation is not offered during

the month of December.





118


Psychiatric Care of Developmental Disabilities

Course #: CLNS 733


Duration: 4 Weeks




Contact: Mary Haley


Increase knowledge about developmental disabilities. Increase accuracy diagnosing

psychiatric illness.

Objectives:

Competency in doing an interview with persons with developmental disabilities.

Demonstrate clear write-ups and comprehensive evaluation of psychiatric and medical

illness.

Responsibilities:

Observational: Attending psychiatrist performing exams. Clinical: Physical and mental

status clinical examinations as needed. Research: Movement d/o assessment, etiology of

MR (prevalence and incidence studies). Teaching: Case write-ups. Required: Attendance, seeing patients, doing clinical evaluation on at least two patients per clinic. Optional:

Attend related clinics and consultations.


Amount and type: Direct by faculty and residents. Didactic content: Readings.

Evaluation:

Clinical observation, and oral questions and answers. Criteria for outstanding grade:

Show initiative, research questions of interest with relevant literature search and review; Comprehensive diagnostic evaluation and formulation initiated and maintained by

student. Show/demonstrate cross-disciplinary interests for developmental

disabilities/follow-up.



dates do not interfere with UNM students scheduled for the rotation. This rotation is not

offered during the month of December.





119

DEPARTMENT OF RADIOLOGY

Neuroradiology

Course #: CLNS 882


Duration: 4 Weeks


Faculty Evaluator(s): Blaine L. Hart, MD Prerequisites:


Contact: Hollie Medina


In-depth exposure to neuroradiology, including clinical applications of brain and spine

adult imaging, pediatric neuroimaging, and head and neck (ENT and ophthalmologic) disorders. Also provides the opportunity to pursue investigation into specific topics,

either collaborative research with a faculty member in the Department of Radiology or

case report and literature review.

Objectives:

Exposure through current clinical material of all major areas of neuroradiology, as well

as introduction to associated procedures. Design and initiate research on a specific case

op topic, with a goal of publication in a peer-reviewed literature or department-

sponsored internet case presentations.


Amount and type: Daily supervision by Drs. Hart, Rupp, or Hayek. Didactic Content:

Daily neuroradiology film reading. Weekly neuroradiology conference. Monthly tumor

board.

Evaluation:

Criteria for outstanding grade: Active participation in breadth of neuroradiology clinical

work, and performance and review of research work and presentation.


This rotation is not available during UNM winter break.





120

DEPARTMENT OF RADIOLOGY

Diagnostic Radiology

Course #: CLNS 883


Duration: 4 Weeks

Students per Rotation: 6 maximum, 2 minimum

Faculty Evaluator(s): Gary Mlady, MD Prerequisites:


Contact: Hollie Medina


Acquaint student with multiple imaging modalities guided by subspecialized faculty.

Objectives:

Know proper sequencing of radiologic imaging modalities to achieve better patient care

while containing cost.

Responsibilities:

Observational: Observe performance of special, interventional, GI, and GU procedures.

Attend Clinical film reading sessions including Radiographs, MRI, CT, Ultrasound and

Nuclear Medicine students. Clinical: No night or weekend call. Optional: Opportunity to

dictate radiology studies and/or perform procedures under supervision of attending

radiologist.


Amount and type: Daily. Didactic Content: Lectures, seminars, observing procedures

and description by faculty, film reading, clinical sessions.

Evaluation:

Evaluation is based on the following criteria: written quiz, activity log, participation and

attendance.


Stress didactic orientation in academic setting covering all imaging modalities and

subspecialties.

This course is not available during UNM Winter Break.





121

DEPARTMENT OF SURGERY

Burns and Trauma Sub-Internship

Course #: CLNS 751


Duration: 4 Weeks


Faculty Evaluator(s): Thomas R. Howdieshell, MD Prerequisites: Completion of all Phase II Clerkships


Contact: Josh Vanlandingham


Students may go to other cancer centers for observation of special procedures within

Albuquerque.

Objectives:

Evaluate diagnostic and primary therapeutic modalities of care of acutely injured

patients. Emphasis on pre- and post-operative care. Some technical emphasis on basic

interventional procedures.

Responsibilities:

Clinical: On call every third night, function in capacity of subintern (no more than 80

hours per week).


Amount and type: Daily with rounds by attendings. All activities under supervision of

residents. Didactic Content: Morning rounds. Reading and background material provided.

Attend Thursday morning service conference and weekly teaching sessions. Student is

expected to make one didactic presentation of 15-20 minutes.

Evaluation:

Criteria for outstanding grade: By consensus of attendings and housestaff.





122


Thoracic Surgery at UNMH

Course #: CLNS 752


Duration: 4 Weeks


Faculty Evaluator(s): Jess Schwarz, MD Charles Dietl, MD





Exposure to thoracic surgical procedures. Cases involve benign and malignant diseases of the mediastinum, chest wall, lung, esophagus, and pleura. Students are exposed to

the pre-operative, intra-operative and post-operative care of thoracic patients.

Endoscopic and video procedures are also performed, clinic time is provided.

Objectives:

Participate in all operative procedures including bronchoscopy, esophagoscopy, video

thoracoscopy, mediastinoscopy and resections of lung, esophagus, chest wall, etc.

Present own patients on rounds. Attend conferences. Participate in selected case/topic

presentation.

Responsibilities:

Observational: As above, all aspects of patient care with general thoracic disease:

clinics, operating room, inpatients, intensive care unit, x-ray rounds. Clinical: As above,

student may perform consults, initial patients evaluations. Teaching: Student presents

patients on rounds, didactic conferences. Required: Brief paper on specific condition of

patients in the service and/or other relevant topics. Optional: Presentation to Thoracic

and Cardiovascular Surgery Education Conference on a topic of choice.

Supervision and Teaching: Amount and type: Daily contact with house staff, thoracic resident and attending.

Didactic Content: Conferences consist of weekly lectures and biweekly clinics. .

Evaluation:

Criteria for outstanding grade: Excellence in clinical performance, quality of required

papers and brief presentations to Education Conference. Demonstration of outstanding

fund of knowledge, interpersonal relationship and self-education.





123


Ophthalmology

Course #: CLNS 754


Duration: 4 Weeks


Faculty Evaluator(s): Mark Schluter, MD Prerequisites: Knowledge of head and neck anatomy,

neuroanatomy and basic scrub technique.




Direct hands-on patient exams (history, 8 point eye exam, technical steps) of ophthalmology patients using all the equipment.

Objectives:

For ophthalmology bound students, intense exposure to skills needed during first part of

their residency and thereafter.

Responsibilities:

Observational: All aspects of eye patient care: eye surgery, procedures, results,

complications. Research: Can be considered. Required: mastery of basic exam,

equipment, reading. Optional: Initial triage of emergency patients and consults.

Evaluation:

By chief resident and faculty.





124


Otolaryngology Sub-Internship

Course #: CLNS 755


Duration: 4 Weeks


Faculty Evaluator(s): Dan Morrison, MD Prerequisites: Completion of all Phase II Clerkships




To provide comprehensive exposure to clinical and surgical, general, pediatric, and

oncologic otolaryngology.

Objectives:

Perform a complete head and neck examination; recognize and diagnose common head

and neck problems such as dizziness, vertigo, headaches, sinus pathology, dysphasia,

etc; interpret an audiogram; understand appropriate referral criteria and database for all

head and neck diseases; demonstrate competence management of surgical ENT

patients.

Responsibilities:

Observational: Pediatric head and neck oncology, otology surgical cases, inpatient wards. Clinical: Patient care, consultations, surgery assistance, clinic participation with

faculty supervision. Research: Optional. Teaching: Required presentation at first surgical

conference; weekly presentations at Monday teaching conferences, and mentoring other

medical students. Required: Week on and weekend call, and direct patient care.

Optional: Rotation at VA.


Amount and type: Direct by senior faculty and residents. Didactic content: Monday

morning teaching conference.

Evaluation:

Assessment of clinical performance by residents and faculty, and performance on Friday

presentations. Criteria for outstanding grade: Based on overall quality of work,

presentation at surgical conference and consensus of faculty and residents.





125


General Surgery at VAMC Sub-Internship

Course #: CLNS 756


Duration: 4 Weeks


Faculty Evaluator(s): Darra Kingsley, MD Prerequisites: Completion of all Phase II Clerkships




The subinternship is designed for the student to serve at a more responsible level of

patient care management, performing history and physical exams, problem lists, ordering diagnostic tests, writing orders and all aspects of surgical care of selected

problems.

Objectives:

To enhance the student’s knowledge of the evaluation and management of more difficult

problems of a surgical patient. Recognize clinical problems in general surgery. Initial and

complete work-up of more difficult problems. Work independently in the surgical clinics.

Work as first assistant in the OR.

Responsibilities: Observational: Participate as a member of the surgical team. Become proficient in minor

surgery. Evaluate more difficult problems. Clinical: Daily assignment, alternate call with

an intern, work in hospital every third weekend. Research: Optional. Teaching: An

assignment of topic for third year instruction.


Amount and Type: All work is supervised. Daily ward rounds, review of cases two times

per week and approval of clinic work. Didactic Content: An assignment of topic.

Evaluation:

Criteria for Outstanding Grade: Quality of histories and physicals and problem list.

Quality of patient care. Responses to questions of patient care on ward rounds.

Knowledge in OR and clinics.





126


Pediatric Surgery at UNMH Sub-Internship

Course #: CLNS 757


Duration: 4 Weeks


Faculty Evaluator(s): David Lemon, MD Prerequisites: Completion of all Phase II Clerkships.




The student functions as a subintern on a service with two surgical residents. He/she,

under supervision, evaluates patients, writes orders and performs some diagnostic and therapeutic procedures. A wide range of pediatric surgical pathology is seen on this

service. Students develop clinical skills, making the transition between pure student and

practicing physician. Disciplines of basic sciences, especially embryology, are

coordinated with core information gained in Pediatrics and General Surgery.

Objectives:

To understand basic pediatric surgical principles in the areas of diagnosis, operative

treatment, anatomy, and physiology. Learn to work together as part of a surgical team

with a common effort and goal. Learn to appreciate the differences between adult and

pediatric surgical problems and their solutions. The student should acquire a knowledge of the work-up, pre and post-operative management and aspects of the operative

techniques involved in caring for patients that range in age from neonates to

adolescents with a wide variety of congenital and acquired disorders.

Responsibilities:

Observational: To be responsible for his/her share of work ups and day to day record

keeping.

Supervision and Teaching: Amount and type: Daily contact with faculty and senior resident during patient care

rounds and in the operating room. Close supervision by attendings and surgical

residents. Didactic content: The student is expected to attend most General Surgery and

Pediatric conferences. Additionally, attendance at a weekly pediatric seminar and

pediatric surgery pathology slide review with the Department of pathology is

encouraged. Text: Swenson Pediatric Surgery edited by Raffensperger.

Evaluation:

Criteria for outstanding grade: Based upon overall quality of work, enthusiasm,

comprehension of essential material, ability to accept responsibility and discharge it promptly and efficiently, and the ability to work as a team member.


Students who anticipate dealing with children in the future are strongly urged to

consider this rotation. This includes future pediatricians, surgeons and/or family

practitioners.





127


Urology Sub-Internship

Course #: CLNS 758


Duration: 4 Weeks


Faculty Evaluator(s): Anthony Smith, MD Prerequisites: Phase II Clerkship: Surgery



Goals and Unique Aspects: Student assumes level of responsibility commensurate with Phase III on wards and in

clinic for patient workup and management. Participates in the operating room at his/her

level of ability.

Objectives:

Enhance student’s knowledge of evaluation and management of challenging urologic

patients; recognize pertinent clinical problems in urology and develop appropriate treatment plans; develop a degree of competency that allows for independent initial

evaluation in the urology clinics; assist in operating room, and become more

comfortable with perioperative management of urologic patients.

Responsibilities:

Observational: Participate as an active urology team member, observe procedures and

surgeries, and become proficient in minor surgical procedures and in evaluation of more difficult problems. Clinical: Daily task include, but are not limited to, inpatient rounds,

evaluating and managing clinic patients, and familiarity with and ability to interpret all

tests and imaging modalities. Research: May participate in on-going research projects or

initiate a new one. Teaching: Responsible for teaching of junior medical students, and

presenting on selected topics to residents and faculty. Required: Function at, or near

intern level. Participate in inpatient care, clinics and OR. Take call as determined by

Chief Resident.


Amount and type: Faculty and residents closely supervise student’s work on wards, in

clinics, or in operating room. In addition to morning rounds teaching, the student

attends all urologic conferences and any other didactic teaching sessions. Attendance at

weekly grand rounds is required.

Evaluation:

Based on demonstrated knowledge on wards, in operating room and in clinic as relates

to quality of patient care, didactic materials comprehension and technical ability. Criteria

for outstanding grade: Demonstrate outstanding fund of knowledge in urological

diseases, technical ability and patient care. Base on faculty and resident consensus.

Additional Information: This is a unique opportunity to participate in New Mexico’s only comprehensive urologic

surgery program. Management of these patients provides invaluable knowledge

applicable to many other medicine disciplines.





128


Surgery at UNMH Sub-Internship

Course #: CLNS 759


Duration: 4 Weeks


Faculty Evaluator(s): Thomas R. Howdieshell, MD Prerequisites: Completion of all Phase II Clerkships.




Expose student to surgery in an applied, direct patient care setting at the responsibility

level of a surgery intern.

Objectives:

Evaluate and follow surgical patients in out-patient and hospital settings acting as a sub-

intern. Perform minor case under the supervision of an attending, depending on

technical ability. Experience the requirements of a surgery intern.

Responsibilities:

Observational: Observe ICU procedures, work closely with attending to evaluate and

treat patients, and observe consult resident’s work-up of more urgent cases. Clinical:

Minor procedures under direct attending supervision. Teaching: Assist with teaching Phase II students during clinic and attending rounds. Required: In-house call every

fourth to fifth night. No vacation allowed during the month. Time off given as with

surgery interns.


Amount and type: Direct supervision by residents and attending staff. Didactic content:

Self-study, attendance at resident conferences and education meetings. Curriculum

guided by resident schedule.

Evaluation:

Based on observations of attendings and residents. Criteria for outstanding grade:

Demonstrate clinical skills and patient care equal to or above that of surgical interns.


Student is personally responsibly, under the guidance of senior residents, for 5-7

patients on the hospital wards, and follows additional studies on the rest of the hospital

service. Average time in OR is 30%, in outpatient clinics 30%, and in hospital patient

care 40%.





129


Surgical Critical Care ICU

Course #: CLNS 760


Duration: 4 Weeks






Exposure to critically ill trauma and surgical patients.

Objectives:

At the end of the rotation, the student should be able to: 1. demonstrate an

understanding of the comprehensive approach to patients with multi-system critical

illness. 2. list the medication, complications and demonstrate the techniques in insertion

of arterial, ventral venous and pulmonary artery catheters. 3. present to peers the

complex problems of critically ill patients in a logical and comprehensive manner.

Responsibilities:

Clinical: Alternate every third night call, function in capacity of subintern (no more than

80 hours per week).


Amount and type: Daily with rounds by surgery or anesthesia attendings. All activities

under supervision of residents. Didactic content: Morning rounds, 2-3 weekly sessions

by resident, fellow, attendings, respiratory therapy, or pharmacy. Reading and

background material provided. Daily teaching sessions with staff. Student is expected to

make one didactic presentation of 15-20 minutes.

Evaluation: Criteria for outstanding grade: By consensus of attendings and house staff.





130


Plastic Surgery

Course #: CLNS 761


Duration: 4 Weeks


Faculty Evaluator(s): Bret Baack, MD Prerequisites: Completion of all Phase II Clerkships.




Gain an understanding of surgical specialty practice and learn about treatment

modalities in reconstructive and cosmetic plastic surgery.

Objectives:

Evaluate the physical and psychological condition of the patient presenting for plastic

surgery and participate in pre-, intra-, and postoperative care.

Responsibilities:

Observational: Student participates in clinic and operating room care.


Amount and type: Student is supervised by plastic surgeons.

Evaluation:

Criteria for outstanding grade: Superior effort on the part of the student to evaluate and

understand the patients’ problems and prepare for and participate in surgery.


Student travels to and from VA and Medical Arts.





131


Introduction to Transplantation

Course #: CLNS 762


Duration: 4 Weeks


Faculty Evaluator(s): Antonia Harford, MD Prerequisites: Completion of all Phase II Clerkships.


Contact: Antonia Harford, MD


Familiarize student with clinical concepts of transplantation immunology. Kidney

transplantation portal hypertension surgery and hepatobiliary diseases.

Objectives:

1. Care for kidney transplant recipients; 2. Operating room duties in transplant

procurements and hepatobiliary surgery; and 3. Clinical research in transplantation.

Responsibilities:

Observational: All procedures performed on transplant patients, i.e., renal biopsies,

transplants, procurements. Clinical: Follow all hepatobiliary consults. Research: Clinical

offered. Expected to start clinical project leading to abstract/publications. Teaching:

Direct new patients/consults to preceptor. Required: Night call for transplants and procurements.


Amount and Type: Direct by Dr. Antonia Harford. Didactic Content: Must attend all

education activities in Transplantation Division.

Evaluation:

Based on clinical observation, oral questions, demonstrated fund of knowledge and

written abstract. Criteria for Outstanding Grade: 1. participate in rounds, surgical procedures. 2. integrate him/herself into team. 3. write one abstract.





132


Vascular Surgery Sub-Internship

Course #: CLNS 763


Duration: 4 Weeks


Faculty Evaluator(s): Mark Langsfeld, MD John Marek, MD

Prerequisites: Completion of all Phase II Clerkships.




Exposure to patients with peripheral vascular disease.

Objectives:

1. Master the basic principles of the physical examination of the vascular system. 2. Be

able to recognize and diagnose patients with arterial and venous insufficiency. 3.

Become familiar with the non-invasive assessment of the arterial and venous

circulations. 4. Learn how to interpret an arteriogram. 5. Become familiar with medical

and surgical management of patients with diseases of the vascular system.

Responsibilities:

Clinical: Function in the capacity of a subintern. Optional: participate in ongoing clinical research projects and help prepare a paper or case report for presentation at

resident/student research forum.


Pre-op Didactic Content: Vascular Conference every Wednesday at 4:00pm. Vascular

Case Conference third Wednesday of the month. Weekly Morbidity and Mortality

Conference every Wednesday morning. Amount and type: Daily rounds with attending

staff and service. Participate in surgical procedures. Participate in vascular surgery

clinics.

Evaluation:

Evaluation to be determined by vascular house staff and service attending.





133


Pediatric Urology

Course #: CLNS 764


Duration: 4 Weeks


Faculty Evaluator(s): Anthony Smith, MD Prerequisites: Phase II Clerkship: Surgery




To assume more responsibility with regard to patient work-up and management on the

wards and in the clinic as compared to a Phase II student. To participate in the OR commensurate with his/her ability.

Objectives:

1. To enhance the student’s knowledge of the evaluation and management of pediatric

urology patients. 2. To recognize pertinent clinical problems and develop appropriate

treatment plans. 3. To develop a degree of competency that allows the student to do

independent initial evaluations in clinic. 4. To assist in the OR.

Responsibilities:

Observational: Clinics, OR, inpatient, x-rays, ICU’s. Clinical: Become familiar with all tests and x-rays ordered for pediatric urology patients, and be able to interpret them.

Research: Available, but not required.


Amount and type: Daily with faculty and residents. Didactic Content: Attend all

conferences, lectures and VP’s. Required readings.

Evaluation:

Based on fund of knowledge of urology, quality of patient care, technical ability, comprehension of didactic material and other usual criteria. Criteria for outstanding

grade: Demonstration of outstanding fund of knowledge of pediatric urological diseases,

technical ability and patient care.


This is a unique opportunity to participate in New Mexico’s only comprehensive pediatric

urology surgery program. Management of these patients provides invaluable knowledge,

which will be used in many other medicine disciplines.





134


Adult Cardiothoracic Surgery at UNMH

Course #: CLNS 765


Duration: 4 Weeks


Faculty Evaluator(s): Charles Dietl, MD Jorge A. Wernly, MD

Said Yassin, MD




Goals and Unique Aspects: To have an overall exposure to the field of cardiac and thoracic surgery with strong

emphasis on open-heart surgery.

Objectives:

Student should be able to describe the very basic principles of cardiopulmonary bypass

and its application to the management of cardiac surgical problems. He/she should be

able to identify the indication and the timing for the surgical intervention in the more

common cardiac surgical problems. Describe fundamentals of surgical treatment for

common conditions.

Responsibilities:

Observational: The student is responsible for the work-up of a few patients scheduled

for surgery, to observe their surgical procedures, and to observe and participate in their

postoperative care. Clinical: The student is expected to participate in daily rounds with

the house staff and participate under supervision in all patient management aspects.

Night call is not specifically scheduled, but the student should make him/herself

available to be called to participate in an occasional emergency surgical procedure. One

brief paper on a specific condition of patients in service or other relevant topics is

required. Optional: Presentation to Thoracic and Cardiovascular Surgery Education Conference on topic of choice.


Amount and type: Daily contact with house staff, thoracic resident and attending.

Didactic content: Attendance at the Thoracic Surgery Conference as well as the Adult

and Pediatric Cardiac Catheterization Conferences on a weekly basis. Suggested

readings will be offered.

Evaluation:

Criteria for outstanding grade: Excellence in clinical performance, quality of required papers and brief presentations to education conference. Demonstration of outstanding






135


General Surgery Teaching Elective

Course #: CLNS 766


Duration: 4 Weeks






Develop student’s teaching skills in general surgery as tutor, on wards, and in clinic.

Objectives:

Facilitate group discussions during tutorials; learn to provide useful feedback and write

useful narrative summaries; learn to prepare short lectures/presentations; learn to

recognize different styles of learning and teaching. Develop program for clinic teaching.

Responsibilities:

Observational: Students direct tutorials and word rounds. Students develop a program

for clinic teaching. Teaching: Direct tutorials for Phase II students, head teaching ward

rounds on Team A; give short lectures/presentations. Optional: Develop patient

education courses/materials in surgery clinic (i.e. breast cancer).


Amount and type: Direct by Dr. Howdieshell.

Evaluation:

Self-assessment, Phase II student evaluation, observation by attendings.


Students work at off-campus locations.





136


Pediatric Ophthalmology

Course #: CLNS 767


Duration: 2-4 Weeks


Faculty Evaluator(s): Mark Wood, MD Prerequisites: Completion of all Phase II Clerkships.




1. Learn basic exam techniques. 2. How to use instruments. 3. Understand ophthalmic

vocabulary.

Objectives:

Basic exam techniques with differential for anisocoria, nystagmus, strabismus, red eye,

amblyopia, and more.

Responsibilities:

Observational: All aspects of eye patient care: surgery, procedures, complications.

Clinical: Basic eye exams on clinical patients. Research: May be considered. Required:

Mastery of basic eye exam. Optional: Hands-on patient exams.


Amount and type: Direct, by senior faculty. Didactic Content: Handout with suggested

reading.

Evaluation:

Evaluation is based on clinical observations. Criteria for outstanding grade: mastery of

eye exam techniques.

Additional Information: A 4-week rotation can be scheduled with another specialty. Special arrangements to be

made with Dr. Wood for Pediatric Ophthalmology.





137


Adult Cardiothoracic Surgery at VAMC

Course #: CLNS 768


Duration: 4 Weeks


Faculty Evaluator(s): Stuart B. Pett, MD Prerequisites: Phase II Clerkship: Surgery




To have an overall exposure to the field of cardiac and thoracic surgery with strong

emphasis on open-heart surgery.

Objectives:

Student should be able to describe the very basic principles of cardiopulmonary bypass

and its application to the management of cardiac surgical problems. He/she should be

able to identify the indication and the timing for the surgical intervention in the more

common cardiac surgical problems. Describe fundamentals of surgical treatment for

common conditions.

Responsibilities:

Observational: The student is responsible for the work-up of a few patients scheduled for surgery, to observe their surgical procedures, and to observe and participate in their

postoperative care. Clinical: The student is expected to participate in daily rounds with

the house staff and participate under supervision in all patient management aspects.

Night call is not specifically scheduled, but the student should make him/herself

available to be called to participate in an occasional emergency surgical procedure. One

brief paper on a specific condition of patients in service or other relevant topics is

required. Optional: Presentation to Thoracic and Cardiovascular Surgery Education

Conference on topic of choice.


Amount and type: Daily contact with house staff, thoracic resident and attending.

Didactic content: Attendance at the Thoracic Surgery Conference as well as the Adult

and Pediatric Cardiac Catheterization Conferences on a weekly basis. Suggested

readings will be offered.

Evaluation:

Criteria for outstanding grade: Excellence in clinical performance, quality of required

papers and brief presentations to education conference. Demonstration of outstanding






138


Clinical Applications of Anatomy

Course #: CLNS 769


Duration: 4 Weeks

Students per Rotation: 24 Maximum

Faculty Evaluator(s): Tom Estenson, PhD Prerequisites: Completion of all Phase II Clerkships


Contact: Tom Estenson, PhD


To provide clinical correlation of anatomy through discussions of clinical problems, study

of relevant anatomy and thorough dissections.

Objectives:

Course is designed to improve the understanding of anatomy and its clinical relevance

for all students regardless of future specialty plans.

Responsibilities:

Observational: Procedures completed by surgical specialists. Teaching: Presentations to

faculty and students. Required: Class participation in discussions and presentations.

Students also do extensive dissections.


Amount and type: Surgical and basic science faculty. Didactic content: Anatomy texts,

surgical atlases and dissection guides.

Evaluation:

Attendance, performance in class, and presentations. Grading is Credit/No Credit


This course is generally offered during the month of March only.





139


Surgical Specialties Elective

Course #: Varies


Duration: 2 Weeks

Students per Rotation: Varies

Faculty Evaluator(s): Various Prerequisites: Completion of all Phase II Clerkships




These 2 week rotations allow 4th year students to sample surgical subspecialties in a

shorter time frame. These are clinical electives with hands-on patient care whose purpose is to introduce the knowledge and skills of the chosen surgical subspecialties

OPHTHALMOLOGY

Responsibilities: Observational: All aspects of eye patient care: eye surgery,

procedures, results, complications. Research: Can be considered. Required: mastery of

basic exam, equipment, reading. Optional: Initial triage of emergency patients and

consults. Evaluation: By chief resident and faculty.

VASCULAR SURGERY

Responsibilities: Clinical: Function in the capacity of a subintern. Optional: participate in ongoing clinical research projects and help prepare a paper or case report for

presentation at resident/student research forum. Supervision and Teaching: Pre-op

Didactic Content: Vascular Conference every Wednesday at 4:00pm. Vascular Case

Conference third Wednesday of the month. Weekly Morbidity and Mortality Conference

every Wednesday morning. Amount and type: Daily rounds with attending staff and

service. Participate in surgical procedures. Participate in vascular surgery clinics.

Evaluation: Evaluation to be determined by vascular house staff and service attending.

CARDIO-THORACIC SURGERY Responsibilities: Observational: The student is responsible for the work-up of a few

patients scheduled for surgery, to observe their surgical procedures, and to observe and

participate in their postoperative care. Clinical: The student is expected to participate in

daily rounds with the house staff and participate under supervision in all patient

management aspects. Night call is not specifically scheduled, but the student should

make him/herself available to be called to participate in an occasional emergency

surgical procedure. One brief paper on a specific condition of patients in service or other

relevant topics is required. Optional: Presentation to Thoracic and Cardiovascular

Surgery Education Conference on topic of choice. Supervision and Teaching: Amount

and type: Daily contact with house staff, thoracic resident and attending. Didactic content: Attendance at the Thoracic Surgery Conference as well as the Adult and

Pediatric Cardiac Catheterization Conferences on a weekly basis. Suggested readings will

be offered. Evaluation: Criteria for outstanding grade: Excellence in clinical

performance, quality of required papers and brief presentations to education conference.

Demonstration of outstanding fund of knowledge, interpersonal relationship and self-

education.





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Surgical Specialties Elective (continued)

Course #: Varies


Duration: 2 Weeks





GENERAL ORTHOPAEDIC SURGERY

Responsibilities: Observational: While contributing at a student level, observe higher

levels of care giving (residents, attendings) in clinic, wards, and operating room. Required: Night call, conference attendance, rounds, clinic and operating room

assistance. Optional: Clinical research (case report of interesting case). Supervision

and Teaching: Amount and Type: Instruction directly by role model; principal role on

ward. Didactic Content: Attend all department conferences. Evaluation: Consensus

subjective conclusion of team attendings and residents. Written exam possible. Criteria

for Outstanding Grade: Demonstrate knowledge of anatomy and clinical skills;

demonstrate excellent acquisition of basic orthopaedic musculoskeletal diagnostic and

therapeutic knowledge. Actively and effectively participate in surgical team (rounds,

wards clinics, operating room). Excellence in conference participation, to include

presentation of cases of patients with musculoskeletal pathology, which demonstrate extensive knowledge of the condition and treatment alternatives.

NEUROSURGERY

Responsibilities: Observational: Work-up admissions, present cases on rounds, select

one topic for review and presentation. Clinical: Admit one to two patients per day,

participate in night call once every three days, be an integral part of the care team.

Research: Students may elect to become involved in neurosurgical research which

includes biomechanics of spinal instrumentation and magnetic source imaging. Teaching:

Examination of inpatients presented to chief resident and outpatients presented to attending. Required: Mandatory weekday attendance on surgery and in clinics, Journal

Club and Friday conferences. Supervision and Teaching: Amount and type: Direct

supervision by attendings and residents. Didactic content: Daily rounds; conferences

twice per week. Evaluation: Evaluation by Howard Yonas, MD. Criteria for outstanding

grade: Based on performance and review of a topic. Quality of work-ups, ability to

sustain work level, performance in operating room and oral presentation. Additional

Information: Student obtains a great deal of practical exposure, assisting on complex

cases, suturing and other procedures appropriate to interests and capabilities.

UROLOGY Responsibilities: Observational: Participate as an active urology team member,

observe procedures and surgeries, and become proficient in minor surgical procedures

and in evaluation of more difficult problems. Clinical: Daily task include, but are not

limited to, inpatient rounds, evaluating and managing clinic patients, and familiarity with

and ability to interpret all tests and imaging modalities. Research: May participate in on-

going research projects or initiate a new one. Teaching: Responsible for teaching of

junior medical students, and presenting on selected topics to residents and faculty.

Required: Function at, or near intern level. Participate in inpatient care, clinics and OR.





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Surgical Specialties Elective (continued)

Course #: Varies


Duration: 2 Weeks





Take call as determined by Chief Resident. Supervision and Teaching: Amount and

type: Faculty and residents closely supervise student’s work on wards, in clinics, or in

operating room. In addition to morning rounds teaching, the student attends all urologic conferences and any other didactic teaching sessions. Attendance at weekly grand

rounds is required. Evaluation: Based on demonstrated knowledge on wards, in

operating room and in clinic as relates to quality of patient care, didactic materials

comprehension and technical ability. Criteria for outstanding grade: Demonstrate

outstanding fund of knowledge in urological diseases, technical ability and patient care.

Base on faculty and resident consensus. Additional Information: This is a unique

opportunity to participate in New Mexico’s only comprehensive urologic surgery

program. Management of these patients provides invaluable knowledge applicable to

many other medicine disciplines.

OTOLARYNGOLOGY

Responsibilities: Observational: Pediatric head and neck oncology, otology surgical

cases, inpatient wards. Clinical: Patient care, consultations, surgery assistance, clinic

participation with faculty supervision. Research: Optional. Teaching: Required

presentation at first surgical conference; weekly presentations at Monday teaching

conferences, and mentoring other medical students. Required: Week on and weekend

call, and direct patient care. Optional: Rotation at VA. Supervision and Teaching:

Amount and type: Direct by senior faculty and residents. Didactic content: Monday

morning teaching conference. Evaluation: Assessment of clinical performance by residents and faculty, and performance on Friday presentations. Criteria for outstanding

grade: Based on overall quality of work, presentation at surgical conference and

consensus of faculty and residents.





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DEPARTMENT OF UNDERGRADUATE MEDICAL EDUCATION

Medical Education Scholarship in Assessment or

Curriculum Development

Course #: CLNS 894


Duration: 4 Weeks


Faculty Evaluator(s): Teresita McCarty, MD

Prerequisites: For Assessment Emphasis: Completion of

Phase II, successful completion of all SOM assessments required up to the time of the

elective. For Curriculum Emphasis:

Successful completion of the pertinent

portions of the curriculum.


Contact: Teresita McCarty, MD


Students will work with Assessment & Learning or the BATCAVE programs to design,

carry out, and analyze a scholarly project that focuses on medical education or medical

education assessment. Students may create or design learning materials or assessment

items for use in clinical teaching or examinations (examples include creating tutorial

cases, simulation scenarios, lecture sequences, multiple choice questions, standardized

patient cases, authoring Calibrated Peer Review™ assignments, and designing a

practical skill station) and evaluate effectiveness.

Objectives:

In conjunction with faculty and staff the students will design, execute, and evaluate a

scholarly project that focuses on medical education. Students will: 1) develop their

personal learning objectives, 2) develop the objectives for the project, 3) review the

literature pertaining to scholarship in medical education or medical education

assessment, 4) implement the project, and 5) evaluate the outcome of the endeavor.

Responsibilities:

Observational: Students will observe, participate in and lead the processes involved in

preparing for a medical education activity or medical education assessment. Clinical:

Students will not have clinical duties during the four-week version of this rotation. No

call is required. Research: Students will be able to participate in various ongoing

scholarly research projects if consistent with the goals of their elective. Teaching: Curricular planning, lecturing, tutoring, writing cases (tutorial or assessment), and

assessing, are all possible activities depending on the particular project selected.

Additionally, students will present the results of their project to Assessment & Learning

or to appropriate faculty committees. Required: Students will be required to meet

regularly with the Director of Assessment and/or a designated curriculum leader and to

attend the curricular activities associated with the project. Optional: Students will be

afforded an opportunity to attend any Teacher and Educational Development or other

HSC workshops that are offered during the rotation.


Amount and Type: Direct supervision by Director of Assessment, Teresita McCarty, MD

or designated faculty educator. Didactic Content: Students will be expected to read the

current literature pertaining to their chosen scholarly project, and will be afforded the





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DEPARTMENT OF UNDERGRADUATE MEDICAL EDUCATION

Medical Education Scholarship in Assessment or

Curriculum Development (continued)

Course #: CLNS 894


Duration: 4 Weeks


Faculty Evaluator(s): Teresita McCarty, MD

Prerequisites: For Assessment Emphasis: Completion of

Phase II, successful completion of all SOM assessments required up to the time of the

elective. For Curriculum Emphasis:

Successful completion of the pertinent

portions of the curriculum.


Contact: Teresita McCarty, MD

Supervision and Teaching (continued): opportunity to attend any Teacher and Educational Development workshops offered

during the rotation. During this rotation, students are expected to attend various

curriculum and education scholarship committees such as Clinical Skills, Communication

Skills, and Cross-Cutting Issues committee meetings.

Evaluation:

Using scoring rubrics agreed upon by the student(s) assessment will be based on skill

and creativity in designing, carrying out, and analyzing a scholarly project; on

presentation of the project to a faculty committee, and on professionalism demonstrated during the rotation. Student(s) will also perform self-assessment and receive formative

feedback half-way through the rotation and summative feedback at the end of the

rotation. Criteria for Outstanding Grade: In order to receive an “Outstanding” grade,

students must develop or produce an innovative or excellent product that could add to

the scholarly literature, that adds to the educational resources of the learning

community and that others will continue to use and to build upon.





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OFFICE OF GLOBAL HEALTH

International Rotations

Course #: CLNS 897 and CLNS 896

Credit: Elective

Duration: Variable


Contact: Office of Medical Student Affairs

International Electives – Clinical

DEPARTMENT OF GLOBAL HEALTH IFMSA Elective

Course #: CLNS 897

Credit: Clinical

Duration: 4 Weeks


Faculty Evaluator(s): TBD

Prerequisites: Completion of All Phase II Clerkships, Phase III Student Standing


Contact: Office of Medical Student Affairs


Please contact the Office of Global Health via Medical Student Affairs for more

information.


Maternal and Child Health in Guatemala

Course #: CLNS 655 Credit: Clinical

Duration: 4 Weeks


Faculty Evaluator(s): Lawrence Leeman, MD, Eve Espey, MD

Prerequisites: See Additional Information



Goals and Unique Aspects: To experience the realities of delivering maternal/child/women’s health in a developing

country.

Objectives:

To enhance clinical skills in OB/GYN, improve Spanish language skills, and participate in

a population based project related to maternal/child health.

Responsibilities:

Observational: OB/GYN-Neonatal Care in a developing nation setting. Clinical:

Enhancement of clinical/physical diagnosis skills in a setting with minimal technologic back-up services. Research: Effect of traditional birth attendant training on

maternal/neonatal mortality. Barriers to access of care in rural Guatemala. Teaching:





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Interact/teach/role model with 5th and 6th year Guatemalan medical students.

Required: Rounds, conferences, at least one 24 hour call at least once per week.

Optional: Explore Guatemala!

Supervision and Teaching: Amount and Type: By Guatemalan faculty/residents in OB/GYN. Sergio Flores, MD, is the

preceptor in Guatemala. Didactic Content: Daily morning conferences. If Spanish

language improvement is needed, attend one of 39 Spanish language schools in

Quetzaltenango.

Evaluation:

Based on evaluation by faculty and written report/project after return. Criteria for

outstanding grade: Quality of project/report and evaluation of faculty.

Additional Information: Preferably have completed all of Phase II, but will consider if Phase II Ob/Gyn, Medicine,

and Pediatrics are complete. Fluency in basic Spanish is required. Student must cover all

travel and living expenses. Need to consult UNM travel medicine clinic for required

vaccinations. Must contact UNM Office of International Programs and Studies (main

campus) for foreign travel insurance and safety issues discussion. U.S. passport required

(tourist visa obtained at airport). See department for suggested reading list.


Maternal Fetal Medicine in Sierra Leone

Course #: CLNS 659


Duration: 4 Weeks


Faculty Evaluator(s): TBD


Accepting Visiting Students: No Contact: OBGYN


To experience and understand the difference in the provision of medical care in an

underdeveloped country and its impact on maternal and fetal health.

Objectives:

To participate in a project related to maternal-fetal health. To become familiar with

models of health care delivery different from the United States model.

Responsibilities:

Observational: Obstetric/Gynecologic care in a developing country. Required Research:

Student project. Teaching: The first week of the course will consist of sessions with the

preceptor to design a student project.


Supervision by the course director and nursing staff on the outreach team.

Evaluation: Criteria for outstanding grade: For an outstanding grade the student must demonstrate

the ability to work with the outreach team, but also be able to coordinate and manage a

student project.





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Please contact the OBGYN Dept for specific dates. Student must cover all travel and

living expenses. Need to consult UNM travel clinic for required vaccinations. Must contact

UNM Office of Itnernational Programs and Students for foreign travel, insurance and

saftey information. United States Passport is requried.


Senior Clerkship in Tropical Medicine and Emerging Diseases: Rajkot, India

Course #: CLNS 897

Credit: Clinical

Duration: 8 Weeks


Faculty Evaluator(s): Dr. Ravi Durvasula Prerequisites: Completion of Internal Medicine, Pediatrics, Surgery, and OBGYN. Sub-I in

Medicine preferred, but not required.


Contact: Dr. Ravi Durvasula


The Senior Clerkship in Tropical Medicine and Emerging Diseases aims to provide

structured education to senior medical students in relevant areas of global health. The

focus of the clerkship will be on major infectious disease syndromes of the tropics. However, additional focus on evolving trends in global health such as new epidemics in

chronic diseases will be provided. The setting for this clerkship is the vibrant city of

Rajkot, India. Rajkot is one of the fastest growing cities in the world with a current

population of 1.5 million people. Located in the state of Gujarat, Rajkot epitomizes the

emerging nature of India and provides an ideal backdrop for UNM trainees to witness

transformational forces in global health care. The Municipal Hospital where this clerkship

will take place is a very large public facility with over 800 teaching beds. Despite rapid

growth of modern private facilities in Rajkot, this hospital provides free care to

underserved sectors of the population and will allow UNM trainees the opportunity to participate in care for indigent populations with unique health care needs.

Objectives:

Structured clinical education for students in major infectious syndromes of developing

world. Familiarity with clinical presentation, diagnosis and treatment of tuberculosis,

malaria, dengue fever, infectious diarrheal syndromes, tropical dermatologic syndromes,

HIV in the tropics. Structured, curriculum-driven education in amnilatory and ward

settings at a major urban teaching hospital in India. Multi-disciplinary experience with

focus on Internal Medicine but options for clinical training in surgery, OBGYN, pediatrics,

dermatology, pathology, radiology. Exposure to "alternative" models of healthcare delivery in a cross-cultural setting with experience in therapeutic yoga, Ayurvedic

medicine and other holistic practices. Cultural enrichment of UNM students with

immersion experience in India with exposure to the peoples, language, religions and

cultural practices of Gujarat.

Responsibilities:

Senior medical students who are selected for this clerkship will participate in structured

rotations on the teaching services of Rajkot Medical College. Ward and clinic format at

the major teaching sites will approximate UNMH structure with academic attending physicians, senior and junior residents and medical students delivering care in a team

environment. Elective students will be expected to assess patients either in ward or

clinic settings and present findings to supervising residents and attending physicians.

The language of instruction is English and students will be expected to provide case





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reports and histories in English during teaching rounds. At certain times, house staff

from UNM Department of Medicine- residents and fellows- may be present during the

student rotation. Additionally, clinical faculty from the UNM Global Health Program may

be involved in components of student supervision. The majority of the education and

clinical supervision will be provided by faculty and house staff of Rajkot Medical College. Elective students are expected to conform to practices of the host institution and will be

encouraged to join their Indian counterparts in student activities.


Full-time faculty of Rajkot Medical College will provide supervision and training of UNM

medical students. Noindependent practice opportunities will be available and all clinical

care conducted by students will be in supervised settings. Faculty from Rajkot Medical

College will be adjunct members of UNM School of Medicine and will be familiar with the

training objectives of the UNM curriculum.

Evaluation:

This senior elective will be graded on a Credit/No Credit structure only. Satisfactory

participation in all training components in India will be required. Upon return to UNM,

students will be given a final exam. The exam will consist of multiple choice questions

designed to crystallize the 8 week experience and allow students to integrate their

didactic and clinical experiences. This exam will be graded as Pass/Fail only. Dr. Ravi

Durvasula, coordinator of this elective, will oversee the evaluation process by collecting

written evaluations from Rajkot Medical College faculty and reviewing student

performance on the final exam. Dr. Durvasula will submit final grades for the student.


Please contact the department for offering dates.

International Electives – Non-Clinical


International Emergency Medicine - Nepal

Course #: CLNS 833


Duration: 4-5 Weeks


Faculty Evaluator(s): David Wachter, MD

Prerequisites: Accepting Visiting Students: Yes



See objectives.

Objectives:

To examine the major barriers to health and provision of medical care in Nepal which are

common to other Developing Countries using selected readings, on-site study and discussions; To explore approaches to overcoming those barriers through site visits and

discussions; To learn to diagnose and treat problems commonly encountered in

Travel/Tropical medicine and Altitude/Mountaineering Medicine through readings,

discussions and first hand experience in the mountains; To learn to use ultrasound for

emergency medical diagnosis and as an adjunct to treatment in a resource limited

setting.





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Responsibilities:

We will visit teaching hospitals in Kathmandu and Dharan, in which we will co-host

courses in emergency ultrasound and important aspects of trauma care with our Nepali

colleagues. We will also teach ultrasound in smaller hospitals and clinics in rural settings. Students will initially attend conferences as trainees, and will help with presentations

and hands-on labs as the month progresses. Bedside rounds in emergency departments

and clinics, discussing cases with local health care providers and introducing them to the

use of diagnostic bedside ultrasound. We will visit traditional medical clinics where we

will be given lectures on Ayurvedic medicine, Tibetan medicine and Chinese

medicine/Acupuncture by experts in those fields. The group will travel to the jungle

preserve of Chitwan national park where lectures will be given on Malaria, Kala Azar,

and other tropical diseases, as well as other common local emergency medical problems

such as cobra and krait envenomations and organohosphate poisoning.


Lectures and practical training sessions will be directly taught by faculty, including

emergency Physicians from the US and Nepal, as well as practitioners of traditional

medicine. Due to the brief exposure to the local medical system and culture, students

will not perform independent clinical work, but will gain clinical experience through

group rounds led by faculty from Nepal and the US. Discussionson reading material and

site visits will be led by course faculty.

Evaluation: Students will be assessed by faculty coordinator based on observation of participation in

discussions and performance in hands-on training (ultrasound and trauma labs). They

will also be given a final examination covering key concepts. “Outstanding” grade will be

given to those who show exceptional initiative and superior understanding of core

subject matter, participate effectively in conferences and trainings, and perform in the

top quartile on the final exam (must meet all of above criteria).


This course is only available in the fall. Contact the department for specific dates. Please seehttp://web.mac.com/drwachter/iWeb/Nepal%20Page/Itinerary%20Fall%202009%20

(tentative).html for more information.







149

PRECEPTORSHIP OFFICE

New Mexico Preceptorship

Course #: CLNS 910

Credit: Preceptorship

Duration: 4 Weeks



Who:

All fourth year medical students are required to participate in the rural preceptorship

Why:

The purpose of the rural experience is to allow the student to experience medical care in

rural areas throughout New Mexico in private practice as well as community health clinics and Indian Hospitals and in all different subspecialties. The experience may assist the

student in making a decision about a career choice.

What/When/Where:

NM Preceptorship is a four-week rotation beginning the first block of the fourth year and

ending April before graduation. There is a minimum of 96 hours attendance requirement

during this rotation. A student may do an elective in addition to the required rotation if the

schedule permits. There are sites throughout the state.

There are required didactics and conferences that are being developed and will be implemented during 2010-2011 school year. These will be in Albuquerque and may impact

the day you start your clinical work. This is a pilot project and details were not available at

time of publication. Contact the Preceptorship Office for more information.

FREQUENTLY ASKED QUESTIONS

Do I have a choice of where I am placed?

Yes. You will have the same lottery number as in CC-III. This time around it will be

reversed. You will be given a catalog with the list of physicians, specialties/subspecialties

and practice descriptions. There are previous students' evaluations of the preceptors for your review to help you make a decision. You will submit requests and then advised of

your selection several weeks prior to Block I.

Where will I live?

You can stay with family or friends or you can find your own housing. You will pay rent

directly and submit a housing receipt which will be processed for reimbursement. A round

trip travel allowance will be given at the end of the rotation.

What are the requirements?

96 hours minimum attendance, a community service project (similar to PIE), a completed evaluation of the preceptor and the program, a completed evaluation from the preceptor

along with the signed certification, a one page form, "Expectations of Rural Preceptorship”,

weekly participation in Project Echo, patient encounters on STROLS,

Can I reschedule a rotation?

Rural rotations will only be rescheduled under extreme circumstances. We have made firm

commitments to preceptors and you are expected to honor your commitment. Once a

student is scheduled for a specific rotation, it is binding to the same extent as other clinical





150

rotations. If the date is to be changed, the request must be approved by the Office of

Medical Student Affairs and an add/drop slip must be submitted.

My father/mother/uncle/relative has suggested a doctor in my home town that

would like to be my preceptor. Can I do this? You are encouraged to choose the preceptors in the catalog, all approved volunteer faculty.

There are situations, however, when we will accommodate a preceptor who would like to

apply for the volunteer faculty position. There is paperwork that must be submitted with

approval at least six weeks prior to the beginning of the rotation.

My husband/wife/partner/child(ren)/pet wants to accompany me while I am out

of town. Is this OK?

Of course. This would be an agreement between you and the housing provider.

Important things to remember: Four to five weeks prior to the rotation, our office sends a reminder letter to your preceptor

along with a copy of the short biographical form you have provided and your photo. There

is a letter sent to the hospital(s) with a copy of your immunization record and your photo

to advise you will be making rounds with the preceptor. The week before your rotation

begins you will pick up a packet that has been prepared for you with copies of the letters

and all the requirements. The evaluation from your preceptor is sent to Medical Student

Affairs and a copy is kept in your file in this office.

NEW MEXICO PRECEPTORSHIP

The fourth year preceptorship is a RURAL ROTATION. Anyone requesting to stay in or near

Albuquerque will contact Brian Solan, MD directly. [email protected]

Lottery numbers will remain the same as CC-III but the order reversed.

Requirements for the Preceptorship

A completed community service project and project report entered into STROLS.

A completed evaluation of the preceptor and the program entered into STROLS. Patient encounters entered into STROLS.

Weekly participation in Project ECHO.

Completed one page form, “Expectations of NM Preceptorship”.

A completed evaluation from the preceptor.

A completed certification by the preceptor stating that the student has worked a minimum

of 96 hours during the four week period.

Student Folder:

The week prior to the beginning of each block, the student is requested to pick up a folder

that will include the requirement forms and a copy of the curriculum for Phase III. Included in the curriculum are details regarding the completion of all requirements.

Housing and Travel:

Housing expenses will be reimbursed up to various maximum amounts depending on the

area of NM.

Budgetary limits do not allow us to reimburse students for utilities and/or phone above and

beyond the rental agreement.

A round trip travel allowance will be given to the student at the end of the rotation.

Scheduling Information:

Please do not contact the preceptors listed in the catalog. There is a file cabinet in our






151

office with student evaluations of all preceptors and programs. You are welcome to check

these out any time you wish. Thank you in advance for your cooperation. You will be in

contact with your chosen preceptor prior to the beginning of the rotation.

Rotations will only be rescheduled under extreme circumstances. We have made firm commitments to preceptors and you are expected to honor your commitment to the

times/dates that you have chosen. Once a student is scheduled for a specific rotation, it is

binding to the same extent as other clinical rotations. Any cancellations must be requested

at least 45 days in advance of the start of the rotation.

Students are expected to turn in the site selection and biographical form by the deadline –

These forms will be sent electronically along with the site selection information in mid-

January and hard copies can will be available in the preceptorship office. Anyone not

meeting the deadline will lose the lottery number and subsequent placement will be done

after the entire class has been scheduled.

PRECEPTOR INFORMATION

The Preceptorship Office sends out a catalog of preceptors to all eligible students in

December. If you need updated or further information, please email Ms. Thibodeaux at

[email protected]


phase iii clerkship catalog 2009-2010

Health & Medicine