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Fourth Year

Advanced Clinical Clerkships and Electives

Sub-Internships

Students are required to do a sub-internship in Internal Medicine, Surgery or Pediatrics.  The goals of the sub-internship are to prepare students for intern year by increasing their experience in independently applying knowledge, clinical skills, and diagnostic and therapeutic decision-making skills.  They will take on increased responsibility in patient care, and will be the primary communicator with patients, families and other healthcare workers.  They will also engage in evidence-based medicine and improve skills for lifelong learning and self-reflection

Emergency Medicine

The required 4th year emergency medicine rotation will expose you to the evaluation and management of the undifferentiated patient presenting to the emergency department.  By its nature, patients presenting to the emergency department span the patient profile from pediatrics to geriatrics and include a wide variety of both serious and benign clinical conditions.  Throughout your emergency medicine clerkship, you will care for these patients under the direct supervision of emergency medicine faculty.  You will participate in the initial evaluation, diagnostic work up and management of emergency department cases. 

Radiology

During the 4-weel rotation, students will determine the role that the various imaging modalities and their specific examinations should play in patient care and apply it to imaging management of patients.  In support of this, they will utilize ACR appropriateness criteria in clinical practice; identify safety issues related to irradiation, MRI scanners and contrast materials; realize the importance of providing clinical history to optimize interpretation of the exam and synthesize appropriate clinical histories when ordering a radiology exam; analyze basic plain films; learn to recognize radiologic emergencies; develop appropriate imaging management skills, including cost effective imaging; and identify indications and contraindications to exams and exam risks.

Intensive Care Unit (ICU)

Students are required to do a 4-week ICU rotation in their 4th year.  This can be in any ICU, including medical, surgical, and pediatrics.  Students will experience caring for patients who are critically ill.  They will work on a multidisciplinary team, and learn about ventilation management, resuscitative management and treatment of unstable patients.  They will participate in family meetings, including conversations about prognosis and end of life care.

Electives (6 blocks)

Students must complete six 4-week elective blocks in their 4th year.  Students may choose any elective offered, including clinical and non-clinical experiences.  Electives give students the opportunity to learn more about the specific field, and in clinical rotations, to continue to participate in patient care and improve clinical skills.  Non-clinical experiences include a Research or an Academic Medicine block, and Advanced Anatomy. 

Scholarly Project

Students may elect to do a year-long scholarly project in their 4th year.  The project can be in clinical or basic science research, education, or school or community engagement.  They will have an advisor for the project and will complete a Poster Presentation at the end of the year.

Capstone Course

This is a 2 week course at the end of 4th year.  The course includes lectures, small group sessions and simulation experiences.  Students will come together as a class and review important knowledge and skills needed for internship.  They will reflect with classmates on the medical school experience and prepare for the transition to intern year.