Area Health Education Consortium (AHEC) Electives

These electives are offered at Anderson Area Medical Center, Carolina Family Care in Denmark, Greenville Hospital System, Carolinas Hospital System and McLeod Regional Medical Center in Florence, Self Memorial Hospital in Greenwood, Spartanburg Regional Healthcare System, and Palmetto Women's Healthcare with offices in Manning and in Sumter.

Housing is offered at no charge to the student at each of these locations.  Meals or a stipend are provided by the hospital for most rotations and students are paid mileage for one round trip from Charleston to the rotation site.

These electives can be requested any time throughout the senior year, however the appropriate paperwork MUST be completed before the elective begins.

Registration for these courses must be completed and approved through the AHEC office.

Course Description

The course is an introduction to general anesthetic management and encompasses the anesthetic subspecialties of pediatric, neurosurgical, cardiothoracic, obstetrical anesthesia and pain management. The student will acquire a working knowledge of commonly used anesthetic agents, techniques and airway management.

Course Objectives

• Anesthetic drug management
• Management of general, regional and monitored anesthesia techniques
• Post-op pain managment (acute and chronic)
• Airway management
• Intravenous access
• Fluid and electrolyte management

• Rounds/Discussions - 10
• Patient Contact - 40
• Lab - none
• Patient Load - none
• Call - every 4th night

Description

The course will provide an interactive, yet academic introduction to Emergency Medicine. The emphasis will be to develop the student's ability to rapidly create appropriate differential diagnoses based on historical and physical exmaination findings.  These findings will elicit further diagnostic and treatment decision-making, in addition to numerous procedures. All patient-student interactions will be performed under the close supervision of the Attending Emergency Physician. The student will also learn about the management of emergency conditions from the patient's and medical staff member's standpoint. In addition to the mastery of basic sciences and development of a strong clinical acumen, the student will realize that compassion and communication are crucial physician and mid-level provider attributes. Throughout the rotation, the student will work with emergency medicine Residency trained and board certified Emergency Physicians.

Course Objectives

• Be acquainted with the efficient and compassionate care necessary for patients in the Emergency Department (ED).
• Perform specific skills and procedures necessary for patient care in the ED.
• Recognize and treat common emergencies (trauma, burns, drug O.D., shock, coma, head injury, psychiatric emergency, orthopaedic injuries, fracture, medical emergency, acute abdominal pain)
• Interpret laboratory results and radiograph findings.

Instructional Methodology

Patient contact in the ED is in 12-hour shifts under the supervision of Emergency Physicians.  Independent and regluar reading of Rosen's Emergency Medicine Concepts and Clinical Practice and Tintinalli's Emergency Medicine Comprehensive Study Guide.  Independent viewing of films.

Students Report to:  Please call Dr. Andre Creese, (843) 777-5440, or Ms. Kristen Palles, (843) 777-5345, two weeks before the rotation begins.

Description

This course is designed to present to the student the basic principles and techniques necessary to evaluate and manage the complete gamut of acutely ill or injured patients who present to a busy Emergency Department. This initial care of the patient is not to be viewed as an isolated treatment measure, but as the first step in the patient's comprehensive medical care. Complaints of patients seen in this setting range from such problems as drug overdose, cardiac arrest, major trauma and acute psychosis to minor lacerations, vaginal bleeding and sore throat. Each Thursday at 7:45 am there is a combined Internal Medicine/Emergency Medicine conference in the 5th floor classroom at Greenville Memorial. Each student is encouraged to attend, but is not required to present a case. Optimal time may be spent by the student riding in an Emergency Medical Service Ambulance.

Course Objectives

Upon completion of this course, the student will be able to obtain and record an accurate history relating to the patient's presenting complaint, perform an appropriate physician examination and determine a logical treatment plan. He will be able to perform such procedures as wound closure of simple lacerations, nasal packing, removal of foreign bodies, intravenous infusions, lumbar punctures, and cardiopulmonary resuscitation. The student will gain an overview of Emergency Medical services and the management of a large general hospital Emergency Department.

Instructional Methodology

Students work varied shifts in the Intermediate Care area alongside an emergency physician. The major emergency facility for the Greenville Hospital system is located at Greenville Memorial Hospital and handles over 65,000 visits per year, serving as the major trauma center for the region. Those students demonstrating a high degree of talent and aptitude can expect to perform additional procedures. The student will also be asked to participate in the instruction of Emergency Medical Technicians and Paramedics.

Description

The student will work under the direction of the family medicine faculty and senior family medicine residents in the Family Medicine Center at Spartanburg Regional Medical Center. The student will have the opportunity of actively participating in ambulatory care of family medicine patients and discussion of patients hospitalized on the family medicine service. Special emphasis will be made to familiarize the student with the opportunities available to a family physician, the continuity of care, and awareness of the total life situation of the patient. The student will have the opportunity of working with the family physician, various consultants in the specialized areas of medicine and behavioral science faculty. The role of the family physician as coordinator of health care will be demonstrated.

Course objectives

Upon completion of this course, the student will have had brief exposure to the Family Medicine Residency Training Program available in a large community (Consortium) hospital. The "team management" of the patient, family, and the illness will be demonstrated and emphasized under the direction and supervision of a family physician.

Instructional methodology

The student will be working in the Family Medicine Center, the Emergency Department, Outpatient Department, and with in-patients of the Spartanburg Regional Medical Center. The student will also make daily (Monday through Friday) Rounds with the family medicine teaching staff on all Family Medicine Center in-patients. In addition, the student is expected to attend regularly scheduled and special visiting professors' conferences. In addition to the time spent on rounds and in conferences, each student will be given a minimum of 1-2 hours per week with a faculty member during which any specific problems he may have encountered with his patients or families may be discussed.

Description

This exlective is structed to provide the student an inpatient experience consistent with the practice of community family medicine physicians.  Based on the common discharge diagnoese of the approximately 2,000 admissions for fiscal year 2002, the Inpatient Service is able to provide a comprehensive education experience for a fourth year student.

Course objectives

• Learn basic components for inpatient medicine
• Become familiar with the problems sen in the hospitalized patient
• Be exposed and learn the emergent problems commonly seen in the hospitalized patient
• Be exposed to and learn many of the procedures commonly performed by a family physician in a community hospital

• Lectures - 7
• Rounds/discussions -10
• Patient contact - 25
• Lab - none
• Patient load - 4
• Call - every 4th to 6th night

Description

The student will work with the faculty members as well as the family medicine residents. Assessment utilizing the problem -oriented approach will be made at all levels of care including acute care, chronic care, and preventive care. The student will be exposed to patient care in both the Family Medicine Center and the McLeod Regional Medical Center. Emphasis will be placed on history taking, physical assessment, laboratory data interpretation, and differential diagnosis. The student will be exposed to office management and record organization as well as a team approach utilizing various health care professionals. Appropriate methods of referral to community resources and consultants will be stressed. Inclusion of inpatient care is an option. Evidence-based medicine, pharmacology and patient education receive special attention.

Course objectives

The student will demonstrate their effectiveness in taking a quick and pertinent history including appropriate physical, emotional, social, and family data, performing thorough examinations, and interpreting laboratory data. The student will formulate appropriate care plans and will describe the environment in which  the disease arose as a way of discovering an etiology.

Instructional methodology

The major portion of this elective will be spent discussing patient encounters, hospital rounds, house calls, and time at community resource centers. Daily topic conferences will be presented in the Family Medicine Center at noon. Selected literature articles will be chosen for review. (The core family medicine textbook will be: Family Medicine. Robert Taylor, M.D., Editor, 2nd Edition).

Description

This course is designed to give the student first-hand exposure to and practical experience with private patients in a working family practice setting. Instruction will include emphasis on comprehensive, continuing care, office management and introduction to industrial medicine, professional relations and family practice in a community hospital. The student will be expected to actively participate in all phases of the course.

Course objectives

Upon completion of this course, the student will have had a beneficial exposure to a private group of family practitioners in a private office. The management of the family practitioner's private patient seen in the office, as well as those in the community hospital under the direction and supervision of a family physician.

Instructional methodology

The student will be working in an office setting. Rounds will be made in two of the hospitals in the Spartanburg community. The student will be expected to accompany the preceptor on house calls, emergency room visits, and nursing home visits.

• List the diagnostic criteria for common tropical diseases
• Outline a treatment plan for common tropical diseases
• Better understand a different culture
• Function as a valuable member in a multi-discipline medical team

• Lectures = none
• Rounds/Discussions = none
• Patient Contact = none
• Lab = none
• Patient Load = varies
• Call = None

Course #: 6-FAMMD-842

Title:  Religion and Medicine

 Instructor: H.E. Woodall, M.D., Stuart Sprague, Ph.D.

Robert M. Todd, M.D.

 Location: Anderson Family Practice Residency Program

Anderson, SC

Number of students: 2

 Duration: 4 weeks

 Credithours: 5

 Course offered: Fall, Spring

Description

Many physicians struggle to find the most appropriate ways to address questions of relating religious faith and practice to their clinical practice. This one-month elective uses directed readings, clinical preceptorships, and opportunities for individual study to explore the application of religion to clinical medicine. Students of all religions are welcome. In South Carolina the vast majority of patients are nominally Christian, so even physicians of other faiths can benefit from this elective. Students are required to complete a journal on assigned readings, and are evaluated by their clinical preceptors, and may choose to complete other independent studies. Clinical preceptors are family physicians with unique training or experience in applying faith to practice. Time is spent in a 32 bed hospice in-patient facility. Study materials explore the spiritual aspects of medical illness and emphasize a holistic, non-judgmental, respectful approach to patients. Evaluations are based on effort, punctuality and the quality of completed assignments.

Course objectives

• The student will increase understanding of the spiritual aspects of illness and disease.
• The student will increase understanding of the application of faith in clinical practice.
• The student will explore areas of personal interest in religion and medicine, medical ethics, the doctor- patient relationship and other related studies.

  Instructional methodology

• The student will complete the assigned readings and write a journal of reactions to the readings.
• The student will spend two weeks with the preceptors in their clinical practices.
• The student will complete a project selected and approved at the beginning of the rotation. Options for the project may include a short paper on a topic in religion and medicine, a research project, or one proposed by the student based on interest and/or previous experience.

• Develop an understanding of family medicine and its role in the community
• Review common problems in family medicine
• Prepare to transition to residency responsibilities
• Expand knowledge base in ambulatory areas of interest to students

• Lectures - 7-9
• Rounds/Discussions - 5-10
• Patient contact - 30
• Call - optional

• Provide for patients in an outpatient setting in preventive medicine.
• Follow patients in an inpatient setting.
• Assist in office procedures such as lesion removal, suturing, I and D of abcesses.
• An overall view of the rural doctor/patient relationship.

• Lectures - 4-5
• Rounds/Discussions - 10
• Patient contact - 35
• Patient Load - 3-5
• Call (How many nights/week): - 1-2

Description

The Greenville Hospital System Family Medicine Residency Training Program (FMRTP) offers the opportunity for the student to become involved directly in patient care and management in a clinical setting and to become familiar with the philosophy of family medicine and its holistic approach to patients. There is a full schedule of conferences and rounds each morning. Much emphasis will be placed on utilizing the SOAP method of charting. Also, history-taking and physical exam performance will be stressed.

Course objectives

Upon completion the student should have acquired the basic diagnostic skills necessary to do histories and physicals on children and adult patients in order to implement meaningful patient treatment and management. Also, the student will be able to order appropriate ancillary studies needed in obtaining an accurate diagnosis and to utilize properly, consultants in all medical specialties. The student should also have sufficient exposure to hypertension, diabetes, otitis and gout (either by direct patient contact or in didactic sessions) to initiate proper treatment and management.

Instructional methodology

The student will participate in morning teaching rounds, all noon conferences, didactic lectures, weekly behavioral science sessions, and direct patient contact. The student will be assigned patients and will be supervised by a third-year resident. A faculty member will always be available. An assigned faculty member will conduct a daily review of patients seen by the student. The student will be given as much responsibility in direct patient care as their medical and clinical acumen allows. The student will have the option to spend time on call in the hospital. The student will then be under the direct supervision of a resident and the faculty as routinely done will review admissions. A medical library with audio-visual and self-instruction equipment is available for the student throughout the day. The student will be encouraged to utilize these teaching aids.

Description

This elective is structured to provide the student an outpatient and inpatient experience with the practice of community family medicine.  The student will see ambulatory patients in the Anderson Family Practice Residency Program alongside family practice residents and faculty members.  The student will follow family practice hospital patients.  This elective will provide a comprehensive educational opportunity for a fourth year medical student interested in primary care.

Course Objectives

• Exposure to and learning of procedures commonly performed by family physicians in office and community hospital settings.
• Active hands-on learning about basic components of community family medicine in the outpatient and inpatient setting.
• Exposure to and learning about emergent problems commonly seen in community hospitalized patients.

Instructional methodology (approximate # of hours per week)

• Call: every 4th night with assigned resident
• Patient Load: OFFICE-3-4 office patients per half day at Family Practice Center.  Patient care time also will be scheduled at our Women’s Health Clinic, Child Health Clinic and/or Anderson Free Clinic.  HOSPITAL-maximum of 4 patients at any given time
• Lectures: one teaching conference per day (approximately one hour each)

Description

This student elective, located in a satellite office of the Anderson Family Practice Residency Program, offers unique educational opportunities for medical students interested in rural family medicine. The student will become acquainted with the health care needs of patients in a community-oriented primary care model practice. The student will be involved in community health assessment, patient care, counseling, chemical dependency, and occupational medicine. Supervision will be provided by faculty of the residency program.

Course objectives

Medical students will have the opportunity to gain first-hand experience in health care on a level not seen in a tertiary care setting. They will become acquainted with the unique health needs of a rural population and develop skills to address competently these needs by use of a community-oriented primary care model. Through this process, students will develop a commitment to rural health care.

Instructional methodology

Students will make hospital rounds with the family medicine resident before arriving at the satellite for office hours Mornings will be spent predominantly on the curricular elements of occupational medicine, chemical dependent family therapy and community-oriented primary care. Afternoons will be spent seeing patients with one-on-one precepting by family physician faculty. Housing is available.

Course description

Student will work with the Medical Director (Dr. Hunter F. Woodall, Clinical Professor of Family Medicine) at Hospice of the Upstate, a 32-bed Inpatient Hospice unit in Anderson, South Carolina.

Course objectives

• Manage pain syndromes at the end-of-life
• Manage common non-pain symptoms at the end-of-life
• Discuss goals of care with terminal patients and their families
• Discuss the advantages and disadvantages of palliative care versus curative care

• Lectures - none
• Rounds/discussions - 8
• Patient contact - 20
• Lab/X-ray - none
• Readings - 8
• Patient load - 3-4
• Call - none

Course #:  5-FAMMD-870

Course description

Student will work on the Family Medicine Teaching Service; 371 bed acute care regional hospital with a team consisting of an attending, senior resident and 2 interns.  Student will have exposure to all critical care units.

Course objectives

• Admission H&P on each assigned patient
• Discharge summary
• Present patients at morning report
• Attend procedures on assigned patients
• Discuss consultants role in management

• Lectures - 5
• Rounds/discussions - 4
• Patient contact - 30
• Lab/X-ray - 2
• Patient load - 2
• Call - every 4th night

Description

In this course, the student gains a better understanding of the appropriate use of the laboratory and how it is integrated into total patient care. The student learns the procedures involved from the time a laboratory test is requested until the results are transmitted to the attending physician. The student performs some of the less complicated laboratory procedures using such equipment as the Coulter Counter. In addition, they perform and interpret bone marrow studies and evaluates peripheral blood smears.

Description

Students and residents will experience the delivery of health care in a developing multidisciplinary primary care model practice. They will be involved in the decision making process. The physician and other health care personnel will interact with social services agencies, home health agencies, the patient, the family and other community resources in making decisions to improve health care for the individual patient and the community.

Course objectives

To introduce students/residents to integrated rural health care delivery system. The students and residents will be a part of the rural health care delivery team, and witness the uniqueness of rural health care.

Instructional methodology

Early mornings will be spent in the hospital seeing hospitalized patients. Mornings and afternoons will be spent in the outpatient office setting. Cost containment and clinical judgment will be emphasized.

Description

This rotation is an inpatient general internal medicine experience.  The student will take call with a a family practice resident evaluating patients admitted to the Internal Medicine teaching service of the Anderson Family Practice residency program.

Course objectives

• Evaluation of internal medicine patients
• Learn how to write admission orders
• Learn how to present patients on rounds in a succinct manner
• Refine history and physical skills
• Develop treatment plans for inpatients

• Lectures - 5
• Rounds/Discussions - 8 - 10
• Patient contact - 15-20
• Lab - None
• Patient load - 4-6
• Call - every 4th or 5th day

Description

Infectious Diseases

Course objectives

• Understand rational for antimicrobial selection
• Become familiar with evaluating and treating HIV infection
• See a variety of nusocomial infections and their impact
• Interface within the microbiology lab and pathology

Instructional methodology

• Lectures - 1
• Rounds/Discussions - 12
• Patient Contact - 12
• Lab - 2
• Patient Load - ~5
• Call - 2 weekends per rotation

Description

This rotation develops a basic understanding of the pathophysiology and treatment of endocrine disorders, as well as improving medical history and physical examination skills. The student will be responsible for, and participate in, the medical evaluation, work-up, data interpretation, diagnostic formulation, and management of patients with endocrine disorders under the supervision of faculty attendings. Spectrum of problems encountered will include, but is not limited to, thyroid and parathyroid disease, diabetes mellitus, osteoporosis and other metabolic bone diseases, hypertension, galactorrhea, amenorrhea, pituitary gland dysfunction, adrenal gland dysfunction, and ovarian and testicular dysfunction. The student will be involved with both inpatient and outpatient care, although much of the rotation is office based. The inpatient experience will largely be concerned with consultations provided to other services.

Course objectives

Our aim is to impart sound, basic information on which the student will be able to build as they mature in their medical career.

Instructional methodology

Students will be required to interview and examine patients and then present their findings to attendings. Much of the teaching on this rotation will be one-on-one. There will also be sessions of didactic instruction covering topics in general endocrinology. Ample time will be provided for reading. Textbooks recommended for this course include general medicine texts such as Cecil's and Harrison's textbooks, and the Williams Endocrinology textbook. The endocrine sections in the general medicine texts mentioned represent the expected minimum of material to be read. Additional reading materials include "core" set of articles concerning various endocrine topics, recent editions of The Endocrine Society postgraduate course syllabus, and other articles pertinent to patients seen in day-to-day care. The materials will be provided by the attendings.

 Description

 Through didactic and clinical office, clinic and hospital experiences the student will be introduced to the interpretation of electrocardiograms, echocardiograms, and other graphic studies including stress testing; the role of consultant in the evaluation and management of selected cardiac patients presenting acute or chronic cardiovascular disorders. In addition, the student will elicit and conduct detailed histories and physical examinations and subsequent presentation of findings, the cardiopulmonary resuscitation technique including situations and the participation in cardiology conferences.

 Course objectives

• Identify, on a normal cardiac x-ray series (four views), the location of the heart, the bronchi, the esophagus, the diaphragms and the sternum with 80% accuracy in two minutes
• Examine the following areas in such a way as to obtain reliable information regarding the normality or abnormality of the peripheral arterial pulses and carotid pulse: the jugular venous pulse; the liver and hepatic pulsation; the extremities; the lungs; the heart, rhythm, size, pulsations, thrill sounds, murmurs, friction rubs; ophthalmoscopic examination
• Differentiate innocent versus pathologic murmurs; comprehend and apply clinical therapeutics as related to: the in-hospital and long-term management of patients with myocardial infarction; the treatment of acute pulmonary edema; the treatment of rhythm disturbances; the fundamentals of cardiopulmonary resuscitation
• Identify on photomicrographs of ventricular and atrial wall, the endocardium, the myocardial fibers and their nuclei and the epicardium with 80% accuracy in four minutes

Description

The student will round daily with the attending physician; all aspects of nephrology and hypertension will be discussed. Acid base electrolytes and water metabolism and other subjects of interest will be discussed by the attending. Students will be at the office where, under supervision, they will be able to examine urinary sediments. There is a bimonthly outpatient nephrology clinic at which sessions on an average of six patients are seen. Reprints on the topics discussed will be distributed; adequate time will be provided the student to prepare the topic they are to present the following day.

Course objectives

Our aim is to impart sound, basic information on which the student will be able to build as they mature in their medical career.

Instructional methodology

The student will have first contact with the patient and make their initial assessment and physical examination prior to discussing the case with the nephrologist. Attendance at daily 12:30 p.m. Internal Medicine Conferences is expected. Reading: General Medicine text; Nephrology texts, and articles as needed.

Description

A preceptorial orientation is utilized with a busy consultative hematology practice dealing with diagnosis and treatment in-hospital and in the office. Patients with hematological neoplasm, immunohematological problems; including blood banking problems, clotting difficulties, various cytoses and cytopenias, and patients undergoing plasmapheresis for a variety of disorders are evaluated and discussed.

Course objectives

At the conclusion of the rotation, the student should be able to reasonably approach a patient with various cytopenias, clotting disorders and hematological neoplasm.

Instructional methodology

 Attendance at daily 12:30 p.m. Internal Medicine conferences and one on one patient oriented instructions. Didactic patient oriented teaching will be given daily. No nights but frequent late evenings.

Description

ID Consultation practice with 1/12 day ambulatory HIV and approximtaely 2 new consults per day.  About 2 half says will be spent in ID administration such as infection control and P&T.

Course objectives

• Concepts of antibiotic use
• HIV care by a generalist
• Art of consultation
• How to use a micro lab
• Inpatient ID consults

• Lectures - 5
• Rounds/Discussions - 25
• Patient contact - 20
• Lab - 5
• Patient load - 2 new consults per day on average
• Call - none

Description

The student will perform and record history and physical findings and formulate a plan of management, including appropriate diagnostic and therapeutic measures, on each patient assigned to them for care. The student is directly responsible to the resident in charge of each team, caring for an average of 4 to 6 patients at a time, and must have all orders countersigned by a member of the team. The student will participate in special procedures required in the care of patients assigned e.g., sigmoidoscopy, thoracentesis, paracentesis, bone marrow biopsy, lumbar puncture, stress testing. The student shall make observations on blood smears, urine sediments, and gram stains as needed in the care of their patients. The student shall present cases to the attending on teaching rounds or at conferences. The student is expected to take an active role in the management of the patient and ideally will come to function as the patient's primary doctor.

Course objectives

Gain knowledge in the care of general internal medicine with an emphasis on primary patient care.

Instructional methodology

The student will participate in daily teaching conferences by presenting cases or a short discussion of a problem presented by one of their patients and will be called upon to interpret X-rays and EKGs. Night call is every fourth night, corresponding to the team schedule (one weekend day off per week). Where appropriate, the student will see patients in the ER and participate in decisions regarding admission to the hospital. Attendance at daily 12:30p.m. Internal Medicine Conferences is expected. Reading: General medicine text and articles as needed.

Description

Students are assigned to work with a specific group of cardiologists with duties very similar to that of the first year internal medicine resident and family practice resident assigned to the group. The student will be assigned specific patients to examine and follow throughout the patient's hospital course. It shall be the student's responsibility to record a history and physicals and present to the attendings on rounds. Students will write orders, but these must be countersigned by a resident or attending. Students will participate in rounds each day. There is an opportunity to observe and perform procedures done on patients that includes: pacemaker insertion, cardioversion, hemodynamic monitoring, coronary angiography and stress testing. Considerable emphasis is placed on instruction and interpretation of electrograms. The student is responsible to interpret an average of 10 records a day.

Course objectives

The student will gain knowledge in the diagnosis and management of patients with acute problems admitted to the Coronary Care Unit.

Instructional methodology

 Daily rounds with cardiologists. Daily electrocardiogram teaching sessions. No nights, but frequently in hospital until 10:00 p.m. Attendance at daily 12:30 p.m. Medicine conference is expected. Read cardiology section in general medicine text as well as articles and specialty texts as needed.

Description

This course is designed to give the student experience in pulmonary medicine and respiratory critical care. They will be assigned patients who have either been admitted by or on whom a consultation is requested from the Pulmonary Critical Care Service. The student will complete a history and physical examination on their patients and report their findings to the attending physician. They will be responsible for writing orders (countersigned by a resident) and managing the patient. The student will be seeing patients admitted to pulmonary floor service and ICU of the Greenville Memorial Medical Center, a 628-bed acute care facility. The student will also participate in the Pulmonary Outpatient Diagnostic clinic.

Course objectives

The student should understand basic pathophysiology of various pulmonary diseases. They will learn to interpret tests of pulmonary physiologic function including the usual tests of ventilation and gas exchange and will be able to assist in cardiopulmonary exercise testing procedures in the pulmonary laboratory. The student will learn emergency management of acute and chronic respiratory diseases. In the critical care units, the techniques of ventilation management and respiratory care will be taught. An understanding of hemodynamic monitoring and management and nutritional support including hyperalimentation in the critically ill patient should be mastered. Diagnostic procedures including examination and interpretation of stained sputum, thoracentesis with pleural biopsy, placement of arterial lines, placement of central venous catheters including Swan-Ganz catheters and tracheal intubation will be taught.

Instructional Methodology

Daily teaching rounds will be performed beginning at 8:30 each morning. Daily attendance at the 12:30 p.m.

Department of Internal Medicine conferences, Wednesday morning 7:30 Pulmonary/Thoracic Surgical X-ray

Conference and Friday morning Grand Rounds is mandatory. The student will be on call every fourth night including weekends.

Description

Active participation in all aspects of care of patients as specified by attendings. The student will be responsible for the initial evaluation of selected patients referred to the infectious disease consult service. These patients will then be presented to the resident and the faculty. The student will be responsible for recording the history, physical and orders with countersignatures by the resident and faculty. The average number of consults seen is one and one-half per day. Rounds will also be made, on a daily Monday-Friday basis, on patients being followed by this service. There is a biweekly Infectious Disease clinic which the student will also be expected to attend. Outpatients in the offices of Drs. Potts and Weems are also available for teaching depending upon the consultation workload. Opportunities also exist to spend time in the county STD Clinic and in the hospital microbiology laboratory.

Course objectives

At the end of this rotation the student should be able to discuss and understand the appropriate use of antibiotic therapy. They should be able to understand and become familiar with common entities in Infectious Disease such as FUO, hepatitis, STD, septicemia, osteomyelitis, endocarditis, AIDS, postoperative wound infections, etc.

Instructional methodology

Attendance at daily 12:30 p.m. Internal Medicine conferences, daily patient-oriented didactic discussions with the attending. No nights. Frequent late evenings. Reading: ID chapters in General Medicine text as well as selected journal articles and specialty texts as needed.

Description

Students see patients in the Internal Medicine Clinic during morning hours and in subspecialty clinics in the afternoon periods. Attending physicians in general medicine and subspecialty clinics provides full time supervision. Participation in daily conferences is required.

Course objectives

The student should be able to obtain and present a precise organized case summary including appropriate history, physical findings, accessory clinical data and formulate an appropriate treatment plan. An appreciation for health maintenance should also be obtained.

Instructional methodology

Daily 12:30 p.m. Internal Medicine conferences; daily ambulatory care conferences; case discussion with an attending about each patient seen. No nights or weekends. Reading: General Medicine text, ambulatory medicine text and articles as needed.

Description

This clerkship will allow the student to recognize clinical problems in allergy-immunology, to gather the important historical details, to perform the proper examinations including ENT examinations, and to perform and analyze the allergy work-up. Students will work in the clinic and manage the work-up of three to four new patients each week. Four hours of patient care will be the minimum for each day. The student will also participate in the emergency treatment and any hospital consultations. The student will learn the rudiments of allergy skin testing and pulmonary function testing. Each patient contact will be thoroughly reviewed by the instructor and a complete write-up of each new patient work-up will be graded.

Course objectives

• Learn to perform an allergy history and physical
• Learn to recognize and treat allergy syndromes
• Learn special procedures and treatment plans

• Lectures - none
• Rounds/Discussions - 4
• Patient contact - 30
• Lab - none
• Patient load - 2-3 per day
• Call - none

Description

Acting internship for inpatient internal medicine.

Course objectives

• Evaluation
• Differential diagnosis
• Management and follow-up of moderately to severely ill internal medicine patients

• Lectures - 2
• Rounds/Discussions - 10
• Patient contact - 20
• Lab -none
• Patient Load - 15 - 20
• Call - as desired, however, at least one night per week

Description

This course is designed to present to the student the essential aspects of prenatal obstetrical care and routine office gynecological care. In addition, they should become familiar with the conduct of both normal and abnormal labor and delivery. The student will be assigned patients in each of these areas and will participate in their management and assist with their deliveries in the case of laboring patients. The student will personally conduct normal deliveries with supervision, and will follow these patients through their postpartum care as well. The student will make rounds with the residents assigned to the service, as well as with the course instructors. The student will attend all regularly scheduled prenatal and gynecological clinics, as well as all regularly scheduled obstetrical and gynecological conferences and rounds. The student will be instructed in the immediate neonatal care of the newborn.

Course objectives

Upon completion of this course, it is expected that the student will be able to examine and evaluate routine gynecological patients presenting for office consultation. The student should be able to take a complete history and perform an adequate pelvic examination with cancer screening smears. Additionally, the student should be thoroughly familiar with the prenatal management of normal obstetrical patients. The student will have conducted the delivery of several normal patients with supervision and should be able to manage the postpartum care of normal obstetrical cases.

Instructional methodology

The student will be working on the obstetrical and gynecological services and in the Labor and Delivery Room area of Spartanburg Regional Medical Center. In addition to observing this active service, the student will have more than adequate clinical material with which they can develop their own expertise. There will be direct contact with the teaching faculty on a formal and informal basis. There is a wealth of audiovisual teaching material to which the student will have access during this period.

Description

The student shall participate in an integral part of the obstetric rotation of the residency program. Emphasis shall be placed upon the evaluation of the prenatal patient, management of routine vaginal delivery and postpartum care. Evaluation shall be by the faculty of the residency program.

Course objectives

• Increase familiarity with management of labor
• Develop colposcopy skills
• Expose student to office gynecology in the primary care setting
• Enhance knowledge of basic OB and GYN patient problems

Description

The course is designed to acquaint the student with the management of both normal and high-risk pregnancies and to become acquainted with gynecologic management and surgical procedures. The student will be assigned to appropriate clinics where evaluations and treatment of new and return-visit patients with supervision of the faculty and chief residents. The student will be instructed in the use of a fetal monitor and the principles of ultrasound as they relate to the discipline. The student will make daily rounds with the faculty and residents, and will take labor and delivery call every third or fourth night. In addition, they will attend all regularly scheduled conferences.

Course objectives

• Perform normal delivery
• Learn episiotomy repair
• Participate in major GYN surgery
• Participate in OB/GYN outpatient care

• Lectures - 4
• Rounds/discussions - 5
• Patient contact - 20
• Lab - 0
• Patient Load - 4
• Call - 1-2 nights/week

Description

This elective is offered to students having satisfactorily completed their third year of clinical rotations. Students will work closely with perinatologists in the care of high-risk obstetrical patients. Integration of obstetrics with genetics and neonatal medicine will be emphasized. Obstetrical ultrasound and antenatal diagnosis modalities of amniocentesis and chorionic villus sampling will be utilized for evaluation of high-risk mothers and fetuses.

Course objectives

• Gain experience with ultrasound diagnosis
• Learn genetic counseling for common disorders
• Learn management of high risk pregnancies
• Learn to perform/assist with complicated deliveries

• Lectures - 4
• Rounds/discussions - 5
• Patient contact - 30
• Lab - none
• Patient load - 4
• Call - 1-2 nights perweek

Description

This elective is offered to students having satisfactorily completed their third year clinical rotations. The course is an acting internship in which the student will participate with an attending in ward rounds, clinics and operating room in the management of patients with gynecologic malignancies. Patients undergoing radical surgery, radiation, chemotherapy was well as diagnostic procedures will be followed and the student will take call on a regular basis for those patients on the service. The student will be asked to present one or more in-depth reviews during the rotation. Specific reading assignments will be required during the rotation.

Course objectives

• Familiarize with gynecologic oncology practice
• Develop surgical skills
• Managing post-operative patients
• Review of gynecologic pathology

• Lectures - none
• Rounds/discussions - 5
• Pateint contact - varies
• Lab - none
• Patient load - none
• Call - none

Description

This elective is offered to students who have satisfactorily completed their third year clinical rotations. Experience will be offered in both infertility and in endocrine abnormalities, especially those related to the reproductive tract. The student will see patients with an attending physician, will participate in surgical procedures characteristic of reproductive endocrinology, learn about assisted reproductive technologies and attend didactic teaching sessions. The student will be required to make at least one presentation on a topic of interest during the four weeks.

Course Objectives

• To understand abnormalities of sex steroids leading to hirsuitism and ovulatory dysfunction