Clerkships:
Anesthesiology
Duration: 4 weeks- 2 week rotation can be arranged on a case-by-case basis. Limited availability.
Student Level: MS4
The anesthesiology clinical rotation will provide the medical student with hands on experience at airway management including bag/mask ventilation, insertion of oral and nasal airways, laryngoscopy, and tracheal intubation. The student will learn the principles of anesthetic management and the indications for different general and regional techniques. S/he will be exposed to the anesthesiologist as a peri-operative physician. S/he will also experience a practical review of pharmacology and physiology in the clinical setting.
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Cardiothoracic Surgery
Duration: 4 weeks
Student Level: MS4
The Cardiothoracic Surgery Rotation will expose the student to all aspects of this specialty. It is designed for the fourth year medical student who has an interest in general thoracic or cardiac surgery. The student should have a desire to pursue a residency in cardiothoracic surgery, general surgery or have an interest in one of our medical counterparts (i.e. pulmonary medicine or cardiology).
The rotation will give the student experience in the pre- and post-operative care of the thoracic patient, and provide opportunities to participate in the surgical procedures. The student will be assigned to the surgical team covering cardiothoracic and vascular surgery. Additional time will be spent in both the cardiac catheterization laboratory and pulmonary suite to learn some of the basic principles of these studies. Didactic sessions in areas such as hemodynamics and lung cancer will supplement the clinical experience.
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Clinical Investigation Department
Duration: 4-8 weeks
Student level: MS1-4
Program Description
The Clinical Investigation Department (CID) at Naval Medical Center Portsmouth promotes and facilitates research activities throughout Navy Medicine East. From inception of an idea, through funding, execution, data analysis, and ultimately publication, CID educates and guides the researcher to achieve the best possible outcome of their research endeavor.
The clerkship program at CID involves an introduction to various components of research. While activities may vary, the clerk will be exposed to basic research practices and processes and have an opportunity to learn by working closely with research personnel at all levels. Ideally, the clerkship should be arranged well in advance so that the clerk can be added to an active protocol as an associate investigator (AI) and participate in the data collection and analysis. However, a large part of the work will involve one-on-one interactions with the CID clinical research support staff.
How It Works
There are two levels of clerkship:
Clerkship I - 4 weeks (160 hours):
The CID clerkship is designed to provide an overview of all aspects of research from study conception to dissemination of findings. However, as the entire research process takes longer than 4 weeks, the clerk will be assigned activities that involve various components of research associated with protocols in different departments. Activities may include, but are not limited to:
• NMCP Clerkship Orientation 3 hours
• Collaborative Institutional Training Initiative (CITI) 8 hours
• Research Integrity Training (RIT) 4 hours
• Institutional Review Board (IRB) meeting observation 4 hours
• Institutional Animal Care and Use (IACUC) meeting observation 2 hours
• Scientific Review Committee (SRC) meeting observation 1 hour
• Investigator Meeting participation 1 hour
• CID Department Meeting participation 2 hours
• CID Staff Orientation and Overview participation 4 hours
• Residency Program Academic Residency Days varies
• Departmental Journal Club participation varies
• Mock IRB Protocol Application Training 8 hours
• Literature Search Training 2 hours
• Emergency Resuscitative Training 6 hours
• Various research training applications varies
• Involvement as an associate investigator (AI), as appropriate varies
Clerkship II - 8 weeks (320 hours):
Following the completion of Clerkship I, an option of an additional 4 weeks, is available. During this time, the clerk will develop his or her own research protocol (IRB or IACUC). This should be submitted to their home institution IRB and the research will be conducted during the academic year.
For the accounting of time, the CID Director will provide the student with a calendar to track their activities. The student will enter activities and their completion throughout the clerkship. Clerks should submit their final calendar of completed tasks, meetings, and special events to the CID Director upon completion of the program. The last day will also include an exit interview with the director.
Eligibility Requirements
The research clerkship is open to individuals of all levels and backgrounds. Content can be tailored to the individual’s needs and interests. However, a genuine investment in learning about research will ensure a more successful experience.
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Dermatology
Duration: 4 weeks
Student level: MS4
The dermatology rotation will provide the medical student with exposure to a wide range of dermatology problems in a busy outpatient setting. He/she will be able to see and evaluate patients independently prior to presenting each case to a staff attending. The student will learn how to perform common office procedures to include: Tzanck smears, KOH preps, scabies preps, and liquid nitrogen therapy for benign skin lesions. Student will also have the opportunity to observe biopsy techniques, dermatologic surgery, Mohs, and laser presentation at the end of the rotation.
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Emergency Medicine
Duration: 4 weeks
Student Level: MS4
All core rotations must be finished first!
Rotating medical students may spend 4 weeks in our department, and function in a capacity similar to that of the typical sub-intern. Students evaluate patients autonomously and make presentations to emergency medicine attending staff and senior resident physicians. They participate in resuscitation on critically ill or injured patients, and perform necessary procedures when indicated. Didactically, the student participates in the weekly emergency medicine residency conferences, monthly intern lectures, and patient rounds. Additionally, students benefit from a specialized medical student curriculum, which covers key concepts in the field. They may also participate in the monthly journal club as well as other residency activities during their rotation. Students also benefit from their interaction with interns and residents of varied levels of training and specialty interests. Unique features of our rotation are the exposure to emergencies presenting primarily in the military setting, emergency physician use of the ultrasound, our observation unit, and our pediatric ED.
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ENT/Otorhinolaryngology
Duration: 4 weeks
Student Level: MS4
Prerequisite: Medicine & Surgery Clerkship
This elective offers a broad and flexible orientation suitable for medical students interested in surgery or the primary care specialties. The student will receive a wide exposure to medical and surgical aspects of diseases of the head and neck in adults and children. All students obtain experience with the diagnosis and initial treatment of head and neck problems commonly encountered by primary care providers. Because the ENT department serves a large and diversified patient population, there is also ample opportunity for more in-depth experience with the complete spectrum of head and neck disorders. The proportion of time each medical student spends in the clinic or operating room will be tailored to emphasize the student's interests.
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General Surgery
Duration: 4 weeks
Student Level: MS3 and MS4 active-duty students from the Uniformed Services University of Health Sciences, civilian MS3 students from Eastern Virginia Medical School, and DoD-affiliated MS3 and MS4 students from any accredited medical school.
Emphasis is placed on providing each student with comprehensive exposure to direct patient care in all settings, including outpatient clinics, inpatient wards, and operating room. Third year students will be assigned to one of three general surgery teams and will work closely with residents and staff to learn basic pre- and post-operative management of common general surgical disorders. Fourth year students will be similarly assigned and will function as sub-interns, applying skills and knowledge previously learned. All students will be assigned an individual faculty preceptor.
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Pediatric Surgery
Duration: 4 weeks
Student Level: MS4
This rotation provides an opportunity for medical students to gain exposure to a wide variety of pediatric surgical conditions. The 3rd year medical student may rotate for 2 weeks as part of their surgical subspecialty clerkship and will work closely with the residents and staff. The 4th year medical student may rotate for 4 weeks and may function as a sub-intern with increased responsibilities and expectations. The rotating medical student will gain experience providing medical care to pediatric patients in the outpatient clinic, operating room, inpatient ward, pediatric intensive care unit (PICU) and neonatal intensive care unit (NICU). The medical student will gain exposure to general abdominal, thoracic, genitourinary and oncologic procedures. They will also gain exposure to management of congenital lesions. Extensive clinic and operating room exposure is emphasized.
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Internal Medicine and Sub-specialties
Inpatient Environment- typically 4 week rotations
Inpatient Environment- typically 4 week rotations
Student Level: MS3 and MS4
INPATIENT GENERAL INTERNAL MEDICINE
The inpatient GIM team is designed to provide the opportunity for exposure to a variety of Internal Medicine patients and disease processes. Students are given the opportunity to admit patients, formulate treatment plans and follow patients throughout their admission to clearly appreciate the outcomes of their decisions. This rotation is available to two visiting MS-3 rotators and 1 MS-4 (elective or sub-I) each month. Rotators will incorporate onto a team of two PGY1s and one IM PGY2-3. Attending physicians are typically General Internists, but include Internal Medicine subspecialists. Patients are regularly admitted from the Emergency Medicine Department or are transferred from the Intensive Care Unit or outside facilities. Each team participates in a rolling admission cycle that is specifically structured to allow for team teaching time, and teams manage inpatient consults from other services throughout the week. All team members have an assigned day off each week Friday through Sunday. Opportunities are available to experience one week of night medicine, during which rotators work directly with junior and senior residents to triage and admit patients overnight and present them on attending rounds the following morning. All rotators are expected to attend the IM residency program’s regularly scheduled morning report and weekly academic activities.
All rotators are expected to attend the IM residency program’s regularly scheduled morning report and weekly academic activities.
Outpatient Environment
Elective opportunities for MS3s and MS4s exist in the following Internal Medicine subspecialty clinics. Each subspecialty elective rotation is generally limited to one student rotator each month. Rotators will see a mix of patients in both the outpatient clinic and inpatient consult settings, typically alongside an IM PGY1-3 trainee, and a subspecialty attending physician. All rotators are expected to attend the IM residency program’s regularly scheduled morning report and weekly academic activities.
ENDOCRINOLOGY
HEMATOLOGY/ONCOLOGY
INFECTIOUS DISEASE
NEPHROLOGY
NEUROLOGY
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Laboratory Medicine/Pathology
Duration: 4 weeks
Student Level: MS4
Laboratory Medicine is an exciting discipline that includes Anatomic Pathology (Surgical Pathology, Autopsy Pathology and Cytopathology), Clinical Pathology (Hematology, Chemistry, and Microbiology), Transfusion Medicine and Blood Banking. The goal of this rotation is to provide an opportunity to learn functional aspects of each of these areas and promote a better understanding of the laboratory services at NMCP. Aspects of the laboratory service include appropriateness of test ordering, test methodology, and limitations of testing commonly used in daily clinical practice.
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Obstetrics and Gynecology
Duration: 4 weeks
Student Level: MS4
Our department is based in a major military referral medical center allowing us to provide an abundant and vast array of obstetrical and gynecologic pathology to visiting students. We are dedicated to ensure that you will have a productive rotation. You will be exposed to the various aspects of OB/GYN and its sub-specialties in order to establish a fund of knowledge that will serve you well through your medical career. Training, during your clerkship, depends on the length of the clerkship and/or area(s) you choose for training. These objectives should be encompassed by formal and informal sessions as well as individual reading. The recommended textbook is "Obstetrics and Gynecology" 6th edition, by Beckmann and Ling, published by Williams & Watkins.
Third year medical students normally follow a pre-determined schedule including rotations in Gynecology and Obstetrics. Fourth year medical students, scheduled for an elective rotation, have a program tailored to their needs or interest in a specific specialty area.
Medical students are an integral component to any successful resident program and should be treated with respect. You are expected to work hard during the rotation and be dedicated to patient care. In turn, we are sure you will leave us with an understanding of the role of the OB/GYN in health management of women.
Listed below are the rotations that are available with a brief description:
Recommended textbooks are Blueprints for Obstetrics and Gynecology, and Obstetrics and Gynecology, Sixth Edition - Wolters Kluwer - Health, Lippincott, Williams & Watkins.
(1) Uro-Gynecology - This service has 2 ORs per week with clinical/procedure time. You will normally find a PGY4 and a PGY 2 on service.
(2) Gynecologic Oncology - This service has 1-2 ORs per week plus clinical time, including COLPO Clinics. You will normally find a PGY4 and a PGY 3 on service and occasionally a categorical intern.
(3) Complicated Obstetrics/Maternal Fetal Medicine - High risk OB service. Becoming part of this team, you can expect to have clinical (Complicated Obstetrical and Perinatal patients), ultrasonography, and Labor and Delivery experience. You will normally have a PGY 4 and PGY3 on service and occasionally R2s and Pediatric interns.
(4) Reproductive Endocrinology and Infertility - This service has approximately 1 OR per week and lots of clinical time. Please note that in vitro fertilizations are not performed at our facility; they are referred out. You will have a PGY3 and PGY2 on this service.
(5) Routine Obstetrics: Rounding with the Routine Obstetrical Team with cesarean Delivery\ and L&D experience.
(6) General Gynecology (Benign Service) - This service offers 1-3 ORs per week and clinical experience. This service carries the OB/GYN pager, responds to GYN problems or questions raised by other departments, and responds to Emergency Room consults and emergencies. You will normally have a PGY 4, PGY3 and PGY2 on service, and occasionally will have a PGY1 categorical intern.
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Ophthalmology
Duration: 4 weeks
Student Level: MS4
The student will work directly with a staff ophthalmologist, evaluating acute and chronic ocular complaints. The student will learn the 8-part eye exam and become facile in using the slit lamp. He/she will evaluate patients of all ages and be exposed to minor ocular procedures, as well as major cases. At the end of the rotation, he/she will be able to determine the gravity of certain ocular conditions and will be capable of primarily managing these cases in an isolated setting.
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Orthopaedics
Duration: 4 weeks
Student level: MS4
Texts to serve as basic reference while on rotation, (1) Essentials of Orthopaedic Surgery, by Sam Weisel, published by Saunders. Rotators will spend approximately 0645-0800 in conference, and 0800 to 1600 in clinical setting, which will primarily be the acute care clinic, but can be other services if desired and available (i.e., total joint, sports medicine, trauma, etc.) A comprehensive curriculum of lectures intended for non-orthopaedists will be given during the course of the month. (2) Physical Examination of the Spine and Extremities by Stanley Hoppenfeld (Appleton-Century-Crofts).
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Pediatrics
Duration: 4 weeks
Student Level: MS4
Acting Internship:
Student Level: 4th year
Prerequisite: 3rd year core pediatric clerkship
The student will be primarily responsible for the admission, evaluation, and management of pediatric inpatients on the inpatient ward, neonatal intensive care unit or pediatric intensive care unit. The student will be an integral part of the pediatric team, and will attend pediatric conferences and stand night and weekend watches.
Elective:
Student Level: MS4
Prerequisite: Pediatric Core Clerkship
The student will work with various general pediatricians and/or pediatric subspecialists to further enhance he/her knowledge and skills in pediatrics. Specific experiences will be tailored to the needs and interests of the student by the student coordinator. The rotation may involve attendance at a variety of outpatient clinics and/or inpatient responsibilities. The student may elect to concentrate on general pediatric or on one or more subspecialties. Students are required to attend all pediatric department conferences. Overnight call is not generally required, but may be arranged if the student desires. Availability of a specific specialty is subject to the availability of the appropriate attending specialist or general pediatric clinic availability.
The following is a list of pediatric rotations available for fourth year medical students:
INPATIENT
- General Pediatric Ward
- Nursery
- Neonatal ICU
- Pediatric ICU
OUTPATIENT
- General Pediatric Clinic
- Adolescent medicine
- Cardiology
- Developmental Pediatrics
- Endocrinology
- Gastroenterology
- Hematology/Oncology
- Neurology
- Pulmonology
- Infectious Disease
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Plastic Surgery
Duration: 4 weeks
Student Level: MS4
A clinical externship for students interested in exposure to all aspects of Plastic and Reconstructive Surgery. The goal of this rotation is to familiarize the student with the basic foundations of Plastic Surgery. Objectives are dependent upon the level of training of the student, but include principles of wound care, burn management, acquisition of wound closure techniques, basic aesthetic surgery principles, hand trauma evaluation and management. The clinical use of lasers in Plastic Surgery will be encountered. Exposure to microsurgical techniques will be encountered. Rotating students are required to prepare a PowerPoint presentation of a topic of interest and pertinence to Plastic and Reconstructive Surgery during their rotation. There will be weekend rounds on occasion but no mandatory weekend or night call.
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Psychiatry
Duration: 4 weeks (can be flexible on a case by case basis)
Student Level: MS3 or MS4
The rotation is focused on developing an understanding of the major mental illnesses from the biopsychosocial perspective and serving as an introduction to their treatment. The student will work directly with staff and residents to gain exposure to both inpatient and consult liaison psychiatry. The student will also be involved in the unique disposition planning of the military. Additional experiences in outpatient, child/adolescent psychiatry and substance use disorder treatment are available for half day and full day experiences during the rotation.
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Radiology
Duration: 4 weeks
Student Level: MS4
The department of Radiology offers an elective in general diagnostic radiology. This course involves all radiologic modalities. The student will gain experience in the imaging characteristics of a variety of disease processes. The elective rotation can vary in length; however, the course typically runs for four weeks. Shorter or longer time frames can be accommodated. For those persons interested in a career in radiology, it is recommended that the elective is taken in the late summer or early fall. Evaluation of the student is typically based on clinical observation; although a written test and unknown radiologic images are available. Additional electives in radiology, such as musculoskeletal, neuroradiology, and interventional radiology may be offered. Please contact the program coordinator for more information. Students who have already successfully completed the general elective at this facility may inquire about the electives that may be offered. Hours are generally 0800-1500 Monday through Friday and there is no overnight call.
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Urology
Duration: 4 weeks
Student Level: MS4
The Urology department offers an exciting elective in comprehensive Urologic care. This involves all aspects of urologic care from infants to elderly. The student will gain experience with inpatient and outpatient clinical urology under staff supervision. Attendance at weekly clinical conferences, bimonthly pathology conferences and journal club is required. Observation and participation in urologic procedures both in the clinic and main operating room is emphasized. With the combined residency program with EVMS, several days can be spent at Sentara Norfolk General Hospital for exposure to the urology residency program for students interested in a Urology residency.
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Vascular Surgery
Duration: 4 weeks
Student Level: MS4
The Vascular Surgery Rotation is designed for the fourth year medical student who has an interest in Vascular surgery. This student would ideally want to pursue a residency in general or vascular surgery, interventional radiology, or vascular medicine. The rotation will give the student exposure to the noninvasive vascular studies, arteriography, pre-and post-operative care of the vascular patient, and a chance to participate in the surgical procedures. The student will be assigned to the surgical team covering vascular surgery. Time will be spent in both the vascular laboratory and interventional radiography suite to learn some of the basic principles of these studies. Additional time will be spent in the vascular clinic evaluating patients. Attendance in the operating room is expected.
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