Medical Student Education

Fourth Year Electives

Anesthesiology

ANE2-3010/F ANESTHESIA CRITICAL CARE-JUNIOR INTERNSHIP (JI) - KNOX
Course Coordinator: Matthew Ison, MD
Contact Information: mison@utmck.edu
Location: University of Tennessee Medical Center
Maximum Class Size: 2 Students

The student will learn the evidence based approach to treatment and diagnosis of the critically ill patient; the pathophysiology of common intenstive care disease processes; and pharmacology pertinent to common critical illnesses. Student will learn the interpretation and utilization of common ICU lab and physiologic data. Students will follow up to 4 patients per day on service. As students demonstrate proficiency, they will gain more autonomy appropriate for level of training. Student is expected to attend weekly departmental conferences and ICU lectures. Informal teaching in the form of “chalk talks” and bedside teaching. Student will be on duty during weekdays from pre-rounding in the morning until night team handoff.

ANE2-4010/F CLINICAL ANESTHESIOLOGY - KNOX
Course Coordinator: Blake Moore, MD
Contact Information: bamoore@utmck.edu
Location: University of Tennessee Medical Center
Maximum Class Size: 3 Students

This elective provides an opportunity to experience the many facets of the practice of anesthesiology while emphasizing the role of the anesthesiologist as a perioperative physician. The main focus of the rotation is centered on supervised practical experience in the administration of intravenous, inhaled and regional anesthesia. Exposure to the anesthesiologist's role in critical care medicine, acute and chronic pain management, obstetrical anesthesia and pre-operative evaluation is also provided. During the rotation, medical students will have multiple opportunities to improve clinical skills in airway management, central venous and arterial cannulation.

Emergency Medicine

EME2-4030/F EMERGENCY MEDICINE - KNOX
Course Coordinator: Dr. Leo Lamsen
Location: University of Tennessee Medical Center (Knoxville)
Maximum Class Size: 2 Students

Students participating in this elective will become acquainted with the diverse medical, surgical, and pediatric cases routinely treated in a busy Emergency Department. This Level I Adult and Pediatric Trauma Center treats approximately 70,000 patients per year and serves as the EMS and air-ambulance control for the area. Students will be encouraged to be involved in the care of acutely ill patients. This rotation allows the student the opportunity for a variety of different procedures. Students will be supervised at all times by an attending staff physician with an excellent opportunity for learning as they participate in patient care. All cases will be reviewed with faculty prior to treatment and final disposition.

Family Medicine

FME2-3010/F JI ANY - FAMILY PRACTICE PRECEPTORSHIP - KNOX
Course Coordinator: William S. Dabbs, MD
Location: University of Tennessee Medical Center (Knoxville)
Maximum Class Size: 2 Students

This clinical rotation is for M4 students who have completed at least 6 of their 7 core clinical clerkships. The student will function as a junior intern with increased autonomy in patient care. This rotation will expose students to the full spectrum of Family Medicine in this department. The course is a combination of inpatient and outpatient Family Medicine. In our outpatient office, students provide patient care for a patient population that is diverse and challenging in their health care needs under the direct supervision of family medicine residents and faculty. Students are also integrated into the UFP Inpatient Team, admitting and managing University of Tennessee Medical Center inpatients for our cohort of affiliated community providers. Rotation sites in the local or adjacent rural area with a board certified Family Physician in our area may be considered for approval. The student’s clinical interests can be integrated into the curriculum of their Junior Internship and should be requested up to 30 days prior to starting the rotation. Junior Internships provide an intensive experience in patient care and an opportunity to demonstrate competency in the clinical skills, knowledge, and attitudes expected for graduation. In keeping with the focus on direct patient care, objectives and assessment are structured around the 13 Entrustable Professional Activities developed by AAMC. Additionally, students are expected to incorporate professionalism and an attitude of life-long learning into their clinical responsibilities.

FME2-4150/F  PRIMARY CARE SPORTS MEDICINE ELECTIVE
Course Coordinator: Rebecca Kendra Kemmet, MD
Location: University of Tennessee Medical Center (Knoxville)
Maximum Class Size: 1 Student

The student will learn the basic principles of sports medicine, which will increase the  understanding of diagnosis, management and treatment of patients with musculoskeletal injuries. The student will outline steps for diagnosis and management of injury, interpret diagnostic testing (ultrasound, xray, MRI, CT, etc.) , treatment approach including intervention strategies (injections, taping, splinting, casting), and outline strategies for rehabilitation and return to play for injured athlete. This elective includes weekly didactics/radiology rounds, and noon conferences. This is an outpatient rotation. No scheduled call but student is expected to attend all sports medicine related activities, which may occur during normal weekday but most likely weekends and evenings.  

Internal Medicine

BIO 45010/F MEDICAL GENETICS - KNOX
Course Coordinators: Dr. Ilse Anderson
Location: University of Tennessee Medical Center (Knoxville)
Session Length 2 and 4 weeks
Prior Approval Required
Maximum Class Size: 1 Student - (Course is not offered in Blocks 3, 7 and 8)

This is a face-to-face clinical rotation. The student should function with increased autonomy in patient care and must demonstrate competency in several of the Entrustable Professional Activities required for graduation. This elective course combines clinical experience in the evaluation of genetic disorders with basic understanding of medical genetics. The clinical experience involves assisting in obtaining family pedigree, physical examinations of patients, investigative tests, differential diagnosis and genetic counseling.

MED 45900 - VISITING STUDENT ELECTIVE IN MEDICINE - KNOX (Visiting Elective Only)
Course Coordinator: Dr. Janet L. Purkey
Location: University of Tennessee Medical Center (Knoxville)
Session Length: 4 weeks
VSAS Prior Approval Required
Maximum Class Size: 1 Student

This elective is for visiting fourth year medical students only. UTHSC students are not permitted to enroll. (For UTHSC students, see JI in Medicine MED-40101. This is a face-to-face clinical rotation. Due to variations in visiting students’ experiences, the student will initially work under an intern with resident and attending supervision. As the student shows aptitude and ability to function at an advanced level, he/she will be moved to direct supervision by the resident, completing the rotation as a junior intern. As an acting intern, the student will be working directly with a senior resident and attending faculty. They will be responsible for direct patient care including admitting patients, writing daily notes and orders, diagnosing and managing patients on a general medicine service. The student will attend daily work rounds and teaching rounds. Emphasis is placed on improving diagnostic and therapeutic planning and management skills. Patient care activities are paramount, and students are expected to be an integral member
This clinical elective in internal medicine affords the visiting medical student opportunity to develop advanced skills in comprehensive patient evaluation and management under daily supervision of medical faculty through the care of patients admitted to the house-staff service at UT Medical Center.

MED 40123 - JI CRITICAL CARE INTERNAL MEDICINE - KNOX
Course Coordinator: Dr. Tina Dudney
Location: University of Tennessee Medical Center (Knoxville)
Session Length: 4 weeks
Maximum Class Size: 2 Students

This is a face-to-face clinical rotation receiving 6 credit hours. The student will function as a junior intern with increased autonomy in patient care and must demonstrate competency in all of the Entrustable Professional Activities required for graduation. The objective of this course is to learn about pathophysiology, the appropriate diagnostic process, and the best management techniques for common medical problems and acute medical emergencies in the Critical Care Internal Medicine setting. Our goals include learning the technical and interpretative skills of common procedures performed in a Medical ICU (ventilator management, arterial lines, etc.) The student will be expected to be the primary care provider for one or two critically ill patients under the supervision of an upper-level medicine resident and critical care attending. The student will perform the admission history and physical examination and write the admission orders (under the supervision of the upper-level resident). In addition, the student will present the patient on rounds in a problem and organ-oriented fashion. Daily orders will be written by the student on management rounds with the critical care attending. The student will also write problem-orientated daily notes and will be responsible for seeing that therapeutic plans are carried out.

MED 45004 - CARDIOLOGY - KNOX
Course Coordinators: Dr. Stuart Bresee
Location: University of Tennessee Medical Center (Knoxville)
Session: 2 and 4 weeks
Maximum Class Size: 2 Students

This is a face-to-face clinical rotation receiving 3 or 6 credit hours. The student should function with increased autonomy in patient care and must demonstrate competency in several of the Entrustable Professional Activities required for graduation. This is a clinical elective offering the student an intensive experience in clinical cardiology under select preceptor cardiologists for a four-week period of time. During that time, the student will evaluate and follow a number of cardiology patients, participate in their care, and accompany them to the cardiovascular laboratory and cardiac surgery as indicated. Students will attend cardiology conferences, twice-weekly teaching rounds, weekly EKG teaching sessions and review a prepared sampling of the literature. Other literature reviews will be suggested as clinical material warrants.

MED 45026 CLINICAL GASTROENTEROLOGY - KNOX
Course Coordinator: Dr. Thomas Young
Location: University of Tennessee Medical Center (Knoxville)
Session: 2 and 4 weeks
Prior Approval Required
Maximum Class Size: 2 Students

This is a face-to-face clinical rotation receiving 3 or 6 credit hours. The student should function with increased autonomy in patient care and must demonstrate competency in several of the Entrustable Professional Activities required for graduation. This elective is designed to acquaint the student with the clinical approach to the patient presenting with a GI illness including a pertinent history and physical, intelligent selection of laboratory, x-ray, and endoscopic studies to the ultimate culmination of diagnosis. Clinical management of the patient and therapy will be emphasized.

MED 45032 - HEMATOLOGY - CLINICAL AND RESEARCH - KNOX
Course Coordinator: Dr. Wahid T. Hanna
Location: University of Tennessee Medical Center (Knoxville) -
Maximum Class Size: 1 Student
Prior Approval Required
Session: 2 and 4 weeks

This is a face-to-face clinical rotation receiving 3 or 6 credit hours. The student should function with increased autonomy in patient care and must demonstrate competency in several of the Entrustable Professional Activities required for graduation. This elective introduces the student to disease of the hematopoietic system/Oncology, their diagnosis and management by combining clinical experience and introduction to relevant research in hematology oncology. Students will spend part of their time on the clinical service and part in the laboratory.

MED 45042 - INFECTIOUS DISEASES CLINICAL BLOCK - KNOX
Course Coordinator: Dr. Mahmoud Shorman
Location: University of Tennessee Medical Center
Session: 2 and 4 weeks
Maximum Class Size: 1 Student

This is a face-to-face clinical rotation receiving 3 or 6 credit hours. The student should function with increased autonomy in patient care and must demonstrate competency in several of the Entrustable Professional Activities required for graduations. This elective will be to teach the student how to be and effective consultant and assist the student in improving his/her knowledge of infectious diseases. Upgrade the student’s knowledge regarding the use of antimicrobial agents and improve the student’s understanding of the diagnosis and management of commonly encountered infectious diseases with attention to the use of the history and readily available laboratory tests. The student will be responsible for >5 new patient workups per week. Attending rounds will be held at least 5 days per week. At attending rounds the student will present his/her new patients to the attending physician. At the time of presentation, the students should also have formulated an assessment and plan. The student will see new patients, make daily rounds on his/her own patients and be present at attending. Faculty and residents will review patient assessments and plans of therapy. Each student is given reading materials.

MED 45062 - CLINICAL PULMONARY DISEASE - KNOX
Course Coordinator: Dr. Tina Dudney
Location: University of Tennessee Medical Center (Knoxville)
Session 2 and 4 weeks
Maximum Class Size: 2 Students

This is a face-to-face clinical rotation receiving 3 or 6 credit hours. The student should function with increased autonomy in patient care and must demonstrate competency in several of the Entrustable Professional Activities required for graduation. The student will have the opportunity to evaluate, follow, and participate in the management of patients in the office and when admitted to the University of Tennessee Medical Center by the faculty of the University Pulmonary and Critical Care Physicians. In addition to improving clinical skills in history taking and physical examination, the student will have an intensive experience in the application and interpretation of blood gases, pulmonary function testing, radiologic study, and other diagnostic modalities in medical chest diseases. Lectures on Pulmonology topics will be available. Opportunities for exposure in subspecialty clinics (Cystic Fibrosis, Pulmonary Hypertension, Interstitial Lung Disease, Interventional Pulmonary and Chest Cancer Clinic).

MED 45072 - CLINICAL RHEUMATOLOGY - KNOX
Course Coordinator: Dr. Jeffry Bieber
Location: University of Tennessee Medical Center (Knoxville)
Session: 2 and 4 weeks
Maximum Class Size: 2 Students

This is a face-to-face clinical rotation receiving 3 or 6 credit hours. The student should function with increased autonomy in patient care and must demonstrate competency in several of the Entrustable Professional Activities required for graduation.  The purpose of this elective is to develop an approach to the assessment and management of articular diseases such as osteoarthritis or rheumatoid arthritis and of systemic rheumatic disease such as systemic lupus erythematosus. This includes an understanding of and proficiency in the musculoskeletal exam.
The format of this rotation is that of a clinical preceptorship. Students will have the opportunity to evaluate, present, discuss, document and participate in the management of private patients in the office setting and hospital consults. In these activities students work one on one with experienced faculty.

OBG2-4022/F FEMALE PELVIC MEDICINE AND RECONSTRUCTIVE SURGERY-KNOX
Course Coordinator: Dr. Michael Polin
Location: University of Tennessee Medical Center (Knoxville)
Maximum Size: 1 Student

The purpose of this elective is to allow the student to learn the principles of female pelvic floor disorders. Students will obtain a pertinent history and perform a focused physical exam using the Pelvic Organ Prolaps Quantification (POP-Q) system to identify and characterize specific pelvic support defects. Student will be able to interpret results of diagnostic tests to characterize pelvic floor disorders; develop diagnostic strategies and appropriate treatment approach. Student will scrub for operative cases and be expected to round on inpatients throughout their post-op course. Inpatient and outpatient setting. Student is expected to attend weekly conferences/rounds. Typical patient load per week is 10-14 inpatients. No call responsibilities or weekend duties on this elective.

Oral and Maxillofacial Surgery

Pathology

Radiology

Surgery

This clerkship will allow students to learn the diagnosis, evaluation, and medical management as well as surgical and endovascular treatment options for patients suffering from peripheral vascular diseases. They will develop the familiarity with the noninvasive vascular laboratory and participate in all aspects of patient care for patients on the vascular service assigned. Students will participate in both open surgical and endovascular treatment of patients on the vascular service. Under supervision of the attending surgeon and surgical resident, the student will also be involved in writing notes and orders, performing history and physical, instituting care, making diagnosis, evaluating problems, plan therapy and seeing consultations. There will be one formal vascular conference per week in addition to the conferences regularly held in the Department of Surgery.

Clinical performance at the level of a PGY1 and responses to Socratic questioning form the basis for evaluation.   All six core competencies are assessed through daily and call interactions with the faculty.

The objectives of this senior clerkship are for the student to learn how to evaluate and treat the acutely  injured patient.   Each student will manage patients during resuscitation and evaluation phase.   They follow patients and coordinate care through initial treatment to their rehabilitation from acute injury.   The students will be expected to assume primary control of a limited number of patients and will be responsible for working with their resident and faculty advisors to come up with appropriate treatment and plans.   Students are also expected to see these patients during outpatient visits in the Trauma Clinic.   Students must attend all conferences regularly held in the Division of Trauma/Department of Surgery and actively participate in discussion and lectures.   Students are expected to take night call, but may set their own schedules for this. 

The student will learn how to manage the critically ill and injured surgical patient (both pre and post-operatively). In addition, they will learn how to use invasive hemodynamic monitoring and manage other support systems, such as ventilators, while dealing with multisystem failure and interacting with families of critically ill patients. The students will be expected to assume primary control of 1 or 2 critically ill patients during their shifts. They will perform admission history and physicals, write daily notes and orders, interact with the primary service and consulting services to help make diagnoses, evaluate problems and plan therapy. They will also see that the therapeutic plan is carried out. All of this will be done under the direction of residents who are assigned to the Critical Care Service, the Critical Care Fellow, and the attending physicians of both the Critical Care Service and the primary service. Students will be closely supervised by residents who are assigned to the Critical Care Service 24 hours a day, as well as the Critical Care Fellow and Faculty who are available 24 hours a day. They will also be supervised by the residents and faculty of the patient's primary service. Rounds with the attendings and residents are conducted at least twice daily. Critical Care Conferences to discuss management of critical care problems are conducted 2-3 times per week. In addition, there are daily Critical Care Service rounds, as well as the other conferences of the Department of Surgery, which include grand rounds, M & M conference, and x-ray conferences.

Broad exposure to the diagnosis, evaluation, and multimodal treatment approach to a variety of cancers Intensive exposure to both the outpatient and inpatient management of patients with malignant disease. Outpatient: responsible for performing history and physical examinations on patients with newly diagnosed malignancies; analyzing treatment options for both new and returning patients. Inpatient: daily rounds under the supervision of the resident and attending staff, write progress notes, and assist in surgical procedures. Attend the weekly conferences of the Department of Surgery, and participate in the weekly Multidisciplinary Tumor and Breast Disease Diagnosis and Management Conferences. Weekly didactic session with a faculty proctor to guide the student's literature review of a particular topic in surgical oncology. Students' presentation of the review topic to the members of the surgical oncology division. One or two days may be spent with a faculty proctor in Radiation Therapy or Medical Oncology to allow the student an opportunity to understand more fully the concept of multidisciplinary cancer care from each disciplines perspective. Objectives of Clerkship: Improved understanding of cancer biology, surgical treatment approaches to both primary and recurrent cancer. Improved understanding of the integration of other treatment modalities in the overall management of malignant diseases.

The students will learn the fundamentals of Advanced Surgical Technologies, optics, energy sources and staplers. The students will learn the basics of Laparoscopic physiology and anatomy. They will gain exposure to Laparoscopic simulator and dry lab skills experience. The students will see 3 to 10 patients per week. The students will work with residents and faculty to care for patients. They will make daily rounds, attend operative cases and evaluate patients in the clinic for pre- and post-operative care. Students are expected to work as an integral surgical team member during the rotation. Students will receive a high level of supervision from residents, faculty on the wards, in the OR, and in the clinic. Students will have a weekly lecture given by the participating (4 total lectures) faculty. Subjects will focus on advanced laparoscopic techniques, anatomy and physiology. This rotation/elective is a "patient care" elective. Additionally students will be given access Laparoscopic Laboratory facilities and will be provided with faculty teaching to learn basic Laparoscopic operative skills. Call will not be required for participation in this rotation.

Students who complete this rotation have expanded their knowledge of the musculoskeletal system and the central and peripheral nervous systems. Students will develop a beginning level of competence in management of patients with disability through exposure to an academic rehabilitation practice. This will include rehabilitative history, examination, and exposure to rehabilitation in several settings. Students will develop skills in management of complex wounds. The students will have some responsibility for about 4-6 patients per week. By the latter part of the rotation, students will examine patients, take a rehabilitative history, and work with the attending physiatrist to develop a rehabilitative plan. They will be able to follow their patients through therapy in the inpatient setting. Students will monitor their patients and directly report to the attending physician. Students will work closely with the attending faculty. The settings are University Hospital for Consultations, the outpatient UT Wound Center, an acute Inpatient Rehabilitation Center, and a Skilled Nursing Facility with a Rehabilitation unit. The attending physiatrist is a member of the Surgery department and attends Surgery Grand Rounds on Thursdays. The students will not be on call during this rotation. Students will have weekends free to study and enjoy the Knoxville area. Interested students are asked to contact Dr. Hecht at least a week in advance by text or call to 865-209-6089 to make arrangements regarding where to meet and what to read.

The student will serve under the preceptorship of the faculty at The University of Tennessee Medical Center and will become familiar with cranial and spinal trauma, tumors, congenital malformations, vascular disease, and benign spinal disease. The student will scrub and assist the staff with operative procedures, participate in peri-operative care,  and will become familiar with neuroanatomical basis of diagnosis and treatment.

Serving the tenure on orthopedics, the student will attend several weekly orthopedic conferences of varying types as well as attend the general orthopedics and fracture clinics.. Rotation in the office of an attending staff with participation in patient care will be required during the clerkship. The student will be given the opportunity to develop diagnostic skills and participate in active treatment of patients, including case application, manipulation of simple fractures, attending surgery and helping with post-op cases.

The students will become familiar with the care and management of kidney transplant recipient, living kidney donors and patients with end stage renal disease in need of dialysis access.  The students will have responsibility for 3 to 6 patients per week.  The students will be expected to function as a junior intern in care and management of transplant patients to facilitate flow of patients in the hospital and clinic as well as participate in surgical procedures at a level commiserate with skill and experience.  The students will receive direct supervision by attending surgeon and PGY2 resident.  The student will attend selection committee to discuss donor and recipient candidates, morbidity and mortality conference, general surgery grand rounds, and optional participation in GI tumor service.  For non-patient care the typical procedure and activities the students will perform will be kidney transplant and vascular access.  No in-house, overnight call.  One weekend day rounds every other week.

The Plastic Surgery Elective rotation is open to any 4th year student who is interested in pursuing a career in this specialty, or who would like to polish their surgical skills in preparation for a residency in another area. The student will be exposed to a wide variety of problems including facial trauma, head and neck reconstruction, breast surgery of all types, extremity trauma and body contouring procedures. We expect the student to function at a high level, and perform the duties of a 1st year resident. There will be close and intense supervision, and the student will work with our entire full-time faculty. This will be an energetic, stimulating, fun and educational surgical experience.

The student will be an integral part of the Pediatric Surgical Team and will learn to evaluate and manage pre- and post-operative pediatric surgical patients including neonates and multisystem trauma victims, and will assist in their operative care. Related opportunities to learn the essentials of pediatric enteral and parenteral nutritional support, invasive and non-invasive monitoring procedures and techniques, respiratory support techniques, and a variety of pediatric vascular access procedures will be available. The student will learn to refine communication skills in dealing with patients' families and the children themselves. Students will be on call every fourth night. Patients will be assigned to the student and he/she will be responsible for daily assessment, progress notes, and execution of the therapeutic plan. Direct supervision will be provided by the Pediatric Surgery Resident and Faculty, each of who is accessible 24 hours a day. Rounds with residents or faculty will be held at least twice daily, and informal conferences will be held at least twice a week. One such conference during the rotation will be the responsibility of each student, where a researched, bibliographed and outlined presentation on a topic of his/her choice will be presented to the other members of the service.

The student will act as an Intern on this service and be exposed to all aspects of a University based Urology Service. The student will be responsible with one house staff member for approximately 25-30 patients and will assist in surgery. The student should obtain good 'hands on' diagnostic urological skills and be given duties commensurate with demonstrated ability, knowledge and skills. The student will attend Surgery Grand Rounds, and the weekly M & M and Cancer Meeting Conferences. In addition, the student will participate in the monthly GU Radiology Conference. The student will attend weekly departmental conferences.