Doctor of Medicine Program

You are currently viewing the 2016–17 PLFSOM school catalog.

Curriculum

The M.D. degree will be awarded to students who satisfactorily complete all fourth year courses, clerkships, and graduation requirements including passing Steps 1 and 2 (both clinical knowledge and clinical skills components) of the USMLE examination. 

Institutional Learning Goals

The Curriculum and Educational Policy Committee has identified the following institutional learning goals that all students will achieve by the time they graduate:

Competency Domain:	Patient Care
Overall Goal:	“Provide patient centered care that is compassionate, appropriate and effective for the treatment of health problems and the promotion of health.”
1.1	Gather essential information about patients and their conditions through history taking, physical examination, and the use of laboratory data, imaging studies, and other tests.
1.2	Make informed decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment.
1.3	For a given clinical presentation, use data derived from the history, physical examination, imaging and/or laboratory investigation to categorize the disease process and generate and prioritize a focused list of diagnostic considerations.
1.4	Organize and prioritize responsibilities in order to provide care that is safe, efficient, and effective.
1.5	Recognize a patient requiring urgent or emergent care, and initiate evaluation and management.
1.6	Describe and propose treatments appropriate to the patient’s condition and preferences.
1.7	Accurately document history, physical examination, assessment, investigatory steps and treatment plans in the medical record.
1.8	Counsel and educate patients and their families to empower them to participate in their care and enable shared decision-making.
1.9	Provide preventative health care services and promote health in patients, families and communities.
Competency Domain:	Knowledge for Practice
Overall Goal:	“Demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences, as well as the application of this knowledge to patient care.”
2.1	Compare and contrast normal variation and pathological states in the structure and function of the human body across the life span.
2.2	Apply established and emerging foundational/basic science principles to health care.
2.3	Apply evidenced based principles of clinical sciences to diagnostic and therapeutic decision making and clinical problem solving.
2.4	Apply principles of epidemiological sciences to the identification of health problems, risk factors, treatment strategies, resources, and disease prevention/health promotion efforts for patients and populations.
2.5	Apply principles of social-behavioral sciences to patient care including assessment of the impact of psychosocial, cultural, and societal influences on health, disease, care seeking, adherence and barriers to care.
2.6	Demonstrate an understanding of and potential for engagement in the creation, dissemination and application of new health care knowledge.
Competency Domain:	Practice-Based Learning and Improvement
Overall Goal:	“Demonstrate the ability to investigate and evaluate the care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and life-long learning.”
3.1	Identify and perform learning activities to address gaps in one’s knowledge, skills and/or attitudes.
3.2	Demonstrate a basic understanding of quality improvement principles and their application to analyzing and solving problems in patient and/or population-based care.
3.3	Accept and incorporate feedback into practice.
3.4	Locate, appraise and assimilate evidence from scientific studies related to patients’ health problems.
3.5	Obtain and utilize information about individual patients, populations or communities to improve care.
Competency Domain:	Interpersonal and Communication Skills
Overall Goal:	“Demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families and health professionals.”
4.1	Communicate effectively with patients and families across a broad range of socio-economic and cultural backgrounds.
4.2	Communicate effectively with colleagues and other health care professionals.
4.3	Communicate with sensitivity, honesty, compassion and empathy.
4.4	Maintain comprehensive and timely medical records.
Competency Domain:	Professionalism
Overall Goal:	“Demonstrate understanding of and behavior consistent with professional responsibilities and adherence to ethical principles.”
5.1	Demonstrate sensitivity, compassion, integrity, and respect for all people.
5.2	Demonstrate knowledge of and appropriately apply ethical principles pertaining to patient privacy, autonomy, and informed consent.
5.3	Demonstrate accountability to patients and fellow members of the health care team.
5.4	Demonstrate and apply knowledge of ethical principles pertaining to the provision or withholding of care.
5.5	Demonstrate and apply knowledge of ethical principles pertaining to health care related business practices and health care administration, including compliance with relevant laws, policies, regulations, and the avoidance of conflicts of interest.
5.6	Demonstrate honesty in all professional and academic interactions.
5.7	Meet professional and academic commitments and obligations.
Competency Domain:	Systems-Based Practice
Overall Goal:	“Demonstrate an awareness of and responsiveness to the larger context and system of health care as well as the ability to call on other resources in the system to provide optimal care.”
6.1	Describe the health system and its components, how the system is funded and how it affects individual and community health.
6.2	Demonstrate the ability to identify patient access to public, private, commercial and/or community-based resources relevant to patient health and care.
6.3	Incorporate considerations of benefits, risks and costs in patient and/or population care.
6.4	Describe appropriate processes for referral of patients and for maintaining continuity of care throughout transitions between providers and settings.
Competency Domain:	Interprofessional Collaboration
Overall Goal:	“Demonstrate the ability to engage in an Interprofessional team in a manner that optimizes safe, effective patient and population centered care”
7.1	Describe the roles of health care professionals.
7.2	Use knowledge of one’s own role and the roles of other health care professionals to work together in providing safe and effective care.
7.3	Function effectively both as a team leader and team member.
7.4	Recognize and respond appropriately to circumstances involving conflict with other health care professionals and team members.
Competency Domain:	Personal and Professional Development
Overall Goal:	“Demonstrate the qualities required to sustain lifelong personal and professional growth.”
8.1	Recognize when to take responsibility and when to seek assistance.
8.2	Demonstrate healthy coping mechanisms in response to stress and professional responsibilities.
8.3	Demonstrate flexibility in adjusting to change and difficult situations.
8.4	Utilize appropriate resources and coping mechanisms when confronted with uncertainty and ambiguous situations.
8.5	Demonstrate the ability to employ self-initiated learning strategies (problem definition, identification of learning resources and critical appraisal of information) when approaching new challenges, problems or unfamiliar situations.

Pre-Clerkship Curriculum (Years 1-2)

The first two years of the curriculum consists of five required courses: Scientific Principles of Medicine; Medical Skills; Society, Community, and the Individual; Masters’ Colloquium; and ICE Pre-Clerkship Prep. A table and description of each of these courses follows:

 

OSCE:	Objective Structured Clinical Examination
NBME CBSE:	Comprehensive Basic Science Examination (provided by the NBME)
ACLS:	Advanced Cardiac Life Support
TSGR:	Tankside Grand Rounds

The Scientific Principles of Medicine (SPM) is a two-year course divided into units. These units are: introduction to health and disease (5 weeks), gastrointestinal system (5 weeks), integumentary and musculoskeletal systems and introduction to the nervous systems (8 weeks), hematologic system (4 weeks), cardiovascular and respiratory systems (7 weeks), renal system (4 weeks), central nervous system and special senses (7 weeks), endocrine system (4 weeks), reproductive systems (6 weeks), and mind and human development (6 weeks). Each unit is organized around a number of clinical presentations representing the various ways a patient might present to the physician (e.g., sore throat, headache, referral for abnormal laboratory findings). The clinical presentation serves as the spring board for the study of the basic sciences (e.g., anatomy, biochemistry, microbiology, pathology, and pharmacology) needed to understand that presentation. Over a two year period, students are exposed to approximately 85 common clinical presentations associated with thousands of specific diagnoses. The scientific principles of medicine course employs a variety or teaching and learning modalities including interactive lectures, small groups, laboratory exercises, team-based leaning and self-directed study.

Medical Skills is a two year course in which students develop the knowledge, attitudes, and skills necessary for the optimal care of the patient. This course addresses communication skills, history taking, physical examination skills, and basic procedural skills. This course is aligned with the units of the scientific principles of medicine course. For example, when students learn about the patient presenting with chest discomfort in the cardiovascular/pulmonary unit of SPM, in Medical Skills they learn how to conduct a focused history and physical examination on a patient who presents to the doctor with chest discomfort, enabling them to distinguish between cardiac, pulmonary, and musculoskeletal causes of chest pain. During this period they will also learn to distinguish between normal and abnormal heart sounds and how to administer and interpret ECGs. Training in Medical Skills will take place primarily in a state-of-the-art clinical skills and clinical simulation center employing standardized patients, partial task trainers, high tech human body simulators, and virtual reality simulators.

Society, Community, and the Individual (SCI) is a two year long learning experience designed to expose students to population health, public health, the community, and the delivery of health care in the community. SCI is comprised of seven themes that are threaded throughout the first two years: biostatistics, epidemiology, community, family, culture, environmental and occupational health, and finally, Spanish. Given the medical school’s location on the Texas-Mexico border and the fact that over 80% of the population in the El Paso area is of Hispanic origins, familiarity with conversational and medical Spanish is integrated into the curriculum. In addition to language instruction, all students will learn about the border community and culture through a variety of field experiences and exercises. Through SCI, students will also learn principles of evidence based medicine and they will be given opportunities to participate in service learning projects, and community based research.

The Masters’ Colloquium rounds out the four concurrent courses spanning the first two years. In the Masters’ Colloquium, students discuss topics related to professionalism, ethics, controversies in medicine, and the artistry associated with the practice of medicine. Masters’ Colloquium topics will be linked to the clinical presentations in the scientific principles of medicine course. The Masters’ Colloquium will also provide a venue for students to share community experiences derived from participation in the Society, Community, and Individual course. 

The Integrated Curricular Elements (ICE) Program
The acronym ICE refers to the Integrated Curricular Elements. Although most PLFSOM curricular elements fit into one of the four M1 & M2 major courses (SCI, SPM, Master’s and Medical Skills) or a specific clinical clerkship, there are some elements that intentionally span across these courses and clerkships. ICE contains these elements. ICE requirements occur in each of the first three years with a single element occurring in the fourth year.

The table below shows ICE elements and the students/classes for which the elements are applicable.

In addition, non-curricular elements (like holidays) may be placed on the ICE calendars so that you can plan for them.

There are credit and non-credit components of the ICE program. The only for-credit component is an ICE Pre-Clerkship Prep Course that occurs at the end of the MS2 year, and that includes the elements highlighted in light blue in the two immediately preceding tables above (ACLS, Tankside Grand Rounds, the end of year MS2 OSCE and an NBME Comprehensive Basic Science Examination). The ICE Pre-Clerkship Prep Course is new, and the full instructional plan, course identifier, and credit are still being finalized. These issues will be addressed in a catalog addendum by the end of the Fall semester of AY 2015-16.

The integrated curricular elements are graduation requirements and students are expected to complete them as scheduled within the years as indicated and in the framework as described. As with all of the courses and requirements, please consult the relevant syllabi and descriptions in the curriculum management system for additional information.

The Scholarly Activity and Research Requirement
The Paul L. Foster School of Medicine Scholarly Activity and Research Program provides medical students with an opportunity to design and execute an independent scholarly project or research project under the guidance of an expert faculty mentor. A wide variety of topics and research areas are available in three broad categories allowing for a project to be tailored to a student’s background and interests: basic, clinical, and translational research; epidemiology, community-based, behavior, public, and environmental health; and medical humanities, qualitative research, and medical education research. This is a 3 credit (pass/fail) mandatory curriculum requirement, with one credit awarded for selection of a mentor and preparation of a project plan, one credit for execution of the project itself, and a final credit awarded for a poster summarizing the project presented at an annual student symposium held in the fall semester. Students can choose between one of two tracks: Track 1 concentrates execution of the project into the summer between the first and second year with a poster presented in the Fall of the second year; whereas Track 2 provides the student more flexibility, allowing execution of the project anytime during the first 3 years followed by a poster presentation at the next student symposium. For both Tracks, selection of a mentor and preparation of a Project Plan is due at the end of the first year. Students in both Tracks have the option of writing an Honors Thesis on their project in the fourth year. This introduction to the methodology and analytic thinking involved with scholarly activity and research is designed to enhance the medical training experience and provide an appreciation for the tight integration between scholarship, research and clinical practice. Students who excel in scholarly activities and research, based on the judgment of a faculty panel, are eligible for special recognition at graduation with the notation of graduating with Distinction in Research and Scholarship on the diploma.

Year 1 and 2 Courses:                                                              Credits

Scientific Principles of Medicine 1                                                   14

Scientific Principles of Medicine II                                                   10

Scientific Principles of Medicine III                                                  10

Scientific Principles of Medicine IV                                                   8

Society, Community, and Individual I                                                6

Society, Community, and Individual II                                               1

Society, Community, and Individual III                                              2  

Society, Community, and Individual IV                                              1

Medical Skills I                                                                                2

Medical Skills II                                                                               1

Medical Skills III                                                                              2

Medical Skills IV                                                                              1

Masters’ Colloquium I                                                                       2

Masters’ Colloquium II                                                                      1

Masters’ Colloquium III                                                                     1

Masters’ Colloquium IV                                                                     1

Scholarly Activity Project I                                                                1

Scholarly Activity Project II                                                               1

Scholarly Activity Project III                                                              1                                      

Pre-Clerkship Prep (ICE Program)                                                    TBA  

Additional detail is provided in the following chart (revised 01-08-2016):

Note regarding the Scholarly Activity and Research Project (SARP) listings in the chart above: SARP is a 3 credit course, though there are additional offerings of SARP II and III to accommodate variability in student schedules. 

Clerkship Curriculum (Years 3-4)
The organization of the third and fourth year curriculum is illustrated in the following schematic:

Year 3 Curriculum
In year 3 students participate in the following clerkships: Internal Medicine (10 weeks), Family Medicine (6 weeks), Obstetrics and Gynecology (8 weeks), Pediatrics (8 weeks), Surgery (10 weeks), and Psychiatry (6 weeks).  Subspecialty “selective experiences” are built into the third year schedule in two ways: as 2-4 week blocks including both ambulatory and inpatient experiences; and in two 16 week long longitudinal experiences, one half day a week, in ambulatory settings. The Longitudinal selective experiences will be drawn from the disciplines of internal medicine, family medicine, surgery, and psychiatry.  During the 16 week period during which students complete the Obstetrics and Gynecology and Pediatrics blocks, a Maternal/Fetal/Neonatal experience substitutes for the longitudinal selective.  The clinical presentations addressed in years 1-2 are revisited in the third year with an emphasis on therapeutics and management.

Additional information regarding the content and administrative structure of the third-year clerkship blocks is provided in the following tables:

 

Year 3 Clerkship Descriptions:

Surgery (10 credit hours)
This clerkship exposes students to the pathophysiology of surgical diseases and to the principles and techniques of surgical approaches to the diagnosis and management of diseases. As members of the surgical team consisting of attending physicians and residents, students participate in pre-operative, operative, and post-operative patient care.  This clerkship is paired with the discipline of family medicine in an integrated 16 week block, of which 6 weeks focuses on general surgery and 4 weeks is allocated to a surgical subspecialty selective experience (e.g., orthopedic surgery, plastic surgery, and neurosurgery). Shared teaching and learning experiences spanning the disciplines of surgery and family medicine are provided to expose students to interdisciplinary approaches to patient care and management.

Family Medicine (7 credit hours)
This clerkship exposes students to the care of the undifferentiated ambulatory patient across the life span. The emphasis of this clerkship is on the diagnosis and management of common acute problems and the longitudinal management of patients with chronic conditions. Health promotion and prevention are also stressed. This clerkship is paired with the surgery clerkship in a 16 week block, of which 6 weeks is devoted family medicine. In addition, during the 16 week block, students spend one half day per week in a longitudinal family medicine selective experience designed to give the student opportunities to explore particular areas within the discipline of family medicine such as chronic disease management, sports medicine, geriatrics, community medicine, or pre-natal care. Students will also have opportunities to participate in a community service activity during the clerkship. Finally, shared teaching and learning experiences are provided in both family medicine and surgery (e.g., wound care, pre and post-operative care, sports medicine, etc.)

Internal Medicine (10 credit hours)
In this 10 week experience, students participate as members of the ward team performing histories and physical examinations and in the integration and documentation of data derived from laboratory investigation and imaging studies leading to the accurate diagnosis of disease. Students are also exposed to standards of care in the treatment of acute and chronic illnesses of adults. Eight weeks of this experience are devoted to general internal medicine and two weeks are set aside for a subspecialty selective in a variety of areas including cardiology, pulmonology, infectious diseases, and rheumatology. The internal medicine clerkship shares an integrated 16 week block with the psychiatry clerkship. A variety of shared teaching and learning opportunities are provided to explore the mental health implications of various diseases and the medical implications of psychiatric disorders.

Psychiatry (7 credit hours)
This clerkship is designed to expose students to the diagnosis and management of common psychiatric illness across the life span in both ambulatory and in-patient settings. The psychiatry clerkship is paired with the internal medicine clerkship in a 16 week block of which 6 weeks is devoted to experiences in the discipline of psychiatry. In addition, students also participate in a one half day per week longitudinal selective experience throughout the 16 week block in such areas as child and adolescent psychiatry, sleep medicine, neurology, psychiatric emergency medicine, and consultation-liaison psychiatry. Shared teaching and learning opportunities, including joint medicine psychiatry rounds, are held to permit students to explore the overlap between the disciplines of medicine and psychiatry.

Obstetrics-Gynecology (8 credit hours)
In this 8 week clinical rotation, students participate in the comprehensive care of women and include experiences in pre and post-natal care, labor and delivery, and the medical and surgical management of diseases in women. In-patient and ambulatory experiences are provided. The Ob/Gyn clerkship is paired in an integrated 16 week block with pediatrics. These disciplines share a mother/baby experience in which students participate in the care of a pregnant patient, participate in that patient’s delivery, and then follow the care of the infant as part of the pediatric component of the clerkship.

Pediatrics (8 credit hours)
This is an 8 week clinical experience that is paired with Ob/Gyn in a 16 week integrated block.  Students are exposed to a comprehensive approach to the care of children in the pediatric in-patient, neo-natal, and ambulatory settings. As members of ward teams and working under the supervision of faculty physicians in ambulatory settings, students participate in the evaluation and management of children suffering from a variety of acute and chronic health care problems. Wellness and prevention are also stressed. Shared learning opportunities with Ob/Gyn are provided over the 16 week block including a mother/baby experience in which students are assigned to a pregnant patient, participate in the delivery of that patient’s infant, and then follows the infant into the pediatric care setting.

Year 4 Curriculum
The fourth year curriculum, consists of four required clerkship experiences; a sub-internship, critical care medicine, emergency medicine, and neurology. During the fourth year, students also are provided time for elective experiences (both at home and away) and time to travel to other medical centers to interview for residency positions. Finally, all fourth year students will participate in a four week long boot camp experience designed to tie together the clerkship phase of the curriculum and to prepare for the transition from medical student to first year resident.

Year 4 Clerkship Descriptions:

Emergency Medicine (4 credit hours)
This is a required four week clerkship that will be taken in most instances in year 4. In unusual circumstances this clerkship may be taken in year 3 but only with the concurrence of the senior associate dean for medical education and that of the associate dean for student affairs. This clerkship provides students opportunities to participate in the care of undifferentiated acutely ill patients presenting to the emergency department.

Clinical Neurosciences (4 credit hours)
This is a required four week clerkship that will be taken in most instances in year 4. In unusual circumstances this clerkship may be taken in year 3 but only with the concurrence of the senior associate dean for medical education and that of the associate dean for student affairs. This clerkship provides students opportunities to interpret the significance neurological signs and symptoms, perform neurological examinations, recognize neurological diseases, and participate in the treatment of patients with neurological problems.   

Critical Care Medicine (4 credit hours)
This is a required 4 week experience in the management of critically ill patients who have complex medical problems requiring extensive monitoring and intervention. This experience is only available to students who have completed all required third year clerkships. Students will be assigned to any one of the following critical care units to meet the requirements of this clerkship: medical intensive care, cardiovascular intensive care, pediatric intensive care, surgical intensive care or neonatal intensive care.

Boot Camp (4 credit hours)
This 4 week elective is designed to completely manage simulated patients with a variety of issues including IM, pediatric, surgical, obstetric, neurological and orthopedic problems. Students will also receive specific task training and resuscitation measures.

Students are also required to complete one, four week acting internship from the following :

Internal Medicine (4 credit hours)
This ward-based, primary care sub-internship provides the student an individualized, case oriented experience as a sub-intern on a general medicine ward service, designed to be the natural extension of the third year clerkship. Each student will work closely with a senior resident, have primary patient responsibility, take night call with his/her team, have patient care responsibilities like an intern with close supervision by the senior resident, be assigned readings and give mini-lectures on selected subjects, and attend the regularly scheduled teaching conferences of the Department of Internal Medicine. This sub-internship is strongly recommended for students planning to pursue a career in internal medicine.

Pediatrics (4 credit hours)
The student will work as a member of a team caring for patients admitted to the pediatric inpatient service. During this elective, the student will have an opportunity to learn to formulate problem lists, management, and follow-up plans for hospitalized pediatric patients. The student assumes the role of extern and takes call with the residents.

Surgery (4 credit hours)
The student will serve as an extern on the surgical service and participate in the care of surgical patients in the emergency room, surgical wards, operating room, and clinic. Pre and post-operative care and the management of patients in the surgical intensive care units will be stressed. Assignments to selected faculty preceptors are also available. Students will take in-house call.

Family Medicine (4 credit hours)
The acting internship in family medicine is a four week rotation on the inpatient service at University Medical Center and weekly continuity clinic at the family medicine clinic. The student will be an integral part of the inpatient team which consists of a family medicine attending, family medicine residents (PGY-1, PGY-2 and PGY-3) a PharmD and the inpatient ancillary staff (nursing, social workers and physical therapy). The student will be exposed to a broad spectrum of acutely ill patients. Student responsibilities include initial evaluation of patients, taking a detailed history and physical, selective of appropriate therapeutics, and presentation of the patient to the team and subsequent care during the patient’s hospitalization. This includes family medicine patients admitted to the medicine, pediatric, or labor and delivery floors.

Obstetrics and Gynecology (4 credit hours)
This elective will further advance the student’s understanding of care of the female patient. It will include ambulatory, hospital, and surgical care of the female patients, from adolescent to the older female patient. Over the course of four weeks, students will participate on an intern level in the care of obstetrical and gynecological patients.

Elective Course Descriptions by Department

PANE 8010 – Anesthesiology Elective
This elective is for students interested in anesthesiology and the insights this discipline gives into the application of physiological and pharmacological principles to the care of patients in acute life threatening situations. Daily lectures, laboratory demonstration, and the preoperative and postoperative care of patients undergoing anesthesia will enable the student to acquire the basic skills necessary to care for the unconscious and critically ill patient during anesthesia and other similar situations. These skills include airway management, ventilatory support, cardiovascular support, fluid replacement, and intravenous techniques. The student will also have an opportunity to learn the fundamentals of respiratory therapy and its application to patient care. (2 or 4 weeks, July - May)

PEDI 8010 – Advanced Gross Anatomy I
This elective is an in-depth, self-directed review of a selected area of gross anatomy including: head and neck, thorax and abdomen, pelvis and perineum, extremities and back, or anatomical imaging depending on the needs of the student. (2 or 4 weeks)

PEDI 8011 – Surgical Anatomy
This course is coordinated by the anatomy faculty. It is, in essence, a surgery boot camp.  The course will consist of lecture, cadaver dissection, laparoscopic surgery simulation, and surgical skills. If you are entering a surgical residency and can arrange your schedule to participate in this course, you will be glad you did. This elective is typically offered only once per academic year – check with the Year 3-4 coordinators’ office regarding the schedule. (2 weeks)

PEDI 8014 - Putting the Patient Protection and Affordable Care Act (PPACA) into Practice
The goal of this four week elective is to provide the students with an understanding of the health policies inherent in the PPACA legislation and how these policies, when put into practice, impact physician/patient care and reimbursement. Students completing the elective will have a basic understanding on theoretical methods to implement strategies to obtain health policy compliance and sufficient reimbursement to financially thrive in practice. Students who are interested should contact Dr. Wagner for more information. (4 weeks, July - May)

PEME 8100 – Emergency Medicine Research
Students with an interest in research in emergency medicine will spend time in the departmental research division participating in some phase of a research project (design and development, literature review, data gathering and interpretation, write-up) under the supervision of a faculty member directing the project. (2 or 4 weeks)

PFAM 8016 – Clinical Research in Primary Care
Students interested in clinical research, particularly those considering careers in academic medicine, will especially find this elective beneficial. Students will spend time within the research division, participating in an ongoing research project under the guidance of a mentoring research faculty and research associate. (4 weeks)

PFAM 8017 - Contributions of Societal Elements to Community Health
This four week elective will review some of the key societal elements contributing to the health of many of our communities, and thus enable learners to see the patient as an individual often shaped by such forces. (4 weeks, August – November, February, May)

PFAM 8018 – Community Geriatrics in an Underserved Setting
Students will be able to practice, apply, and demonstrate geriatric competencies learned during years 1 - 3 to geriatric populations throughout El Paso and surrounding communities: PACE unit, senior citizen centers, assisted living centers, Hospice, social service agencies, adult protective services. The elective student will interact with elder law specialists, nutritionists, and exercise physiologists and geriatricians. (4 weeks, July - May)

PFAM 8100 – Community-Based Research
Students interested in community-based research, particularly those considering careers in academic medicine, will especially find this elective beneficial. Students will spend time within the research division, participating in an ongoing research project under the guidance of a mentoring research faculty and research associate. (4 weeks, July – November, January - May)

PIDP 8010 – Biomedical Info. Management Elective
This elective is designed to provide the student with basic competencies in biomedical information management. The student is primarily taught the basics of searching the biomedical literature via PubMed. Searching EBM Reviews, MICROMEDEX, PDQ, TOXNET, and other biomedical literature databases are addressed as needed. The student is assigned take-home practice exercises to strengthen their literature searching skills. At the end of the rotation, the student is given a brief practical examination of his/her abilities to search these tools.

PINT 8011 – Cardiology Elective
This ward-based consult service elective consists of daily review of electrocardiograms and echocardiograms, cardiology consultation rounds, cardiac care unit teaching rounds, weekly cardiology teaching conferences, and cardiac catheterization conferences. The student will prepare a review of an assigned topic for the weekly cardiology conferences. Bedside cardiovascular examination and management will be stressed.

PINT 8013 – Gastroenterology Elective
This elective provides opportunities for learning office practice of gastroenterology including evaluation of patients with peptic ulcer disease, malabsorption, liver disease, etc. Extensive outside reading will be required. The student may be involved in direct patient care in a hospital setting.

PINT 8014 – Infectious Disease Elective
This ward-based elective offers the student an opportunity to evaluate and care for patients with infectious diseases and to gain an understanding of the clinical microbiology procedures important in the care of these patients. HIV and AIDS will be discussed. Each student will be encouraged to prepare and present one seminar or write a paper on a subject of his/her choice. Time for independent study will be allowed.

PINT 8015 – Oncology/Hematology Elective
This elective provides exposure to clinical and laboratory diagnosis as well as management of neoplastic and hematologic disorders. Representative case reviews are used to supplement current clinical material where appropriate. Peripheral blood, bone marrow, and tumor morphology are emphasized as well as clinical staging and chemotherapy. There will be exposure as to how new investigational drugs are tried and protocol treatments are given to cancer patients. Students can also obtain concept in bone marrow transplantation including both clinical and laboratory processing of bone marrow cells. Options are available for major focus in ambulatory or ward setting, or both.

PINT 8016 – Nephrology Elective
This elective offers clinical experience in the diagnosis and management of patients with acute and chronic renal failure, hypertension, fluid and electrolyte imbalances, acid base disturbance, parenchymal renal diseases, etc.

PINT 8025 – Nutrition Support
During this elective, the student will be exposed to a spectrum of conditions that are present in hospitalized patients or could be the reason for hospitalization and will learn first hand about pathophysiology, treatment approaches including enteral and parenteral nutrition approaches and pharmacologic options to control symptoms. The elective is offered as a two or four week elective and is available August – April. (2 or 4 weeks, August - May)

PINT 8100 – Internal Medicine Research
Students with an interest in research in internal medicine will spend time in the departmental research division participating in some phase of a research project (design and development, literature review, data gathering and interpretation, write-up) under the supervision of a faculty member directing the project. 

PNEU 8100 – Neurology Research
Students with an interest in research in neurology will spend time in the departmental research division participating in some phase of a research project (design and development, literature review, data gathering and interpretation, write-up) under the supervision of a faculty member directing the project. 

PNEU 8010 – Neurology Senior Rotation
This rotation exposes the student to basic principles of diagnosis and management of common neurologic conditions. Students learn skills in conducting neurologic exams, identifying signs and symptoms of neurologic disorders, and integrating signs and symptoms into syndromes. Students learn about basic neurologic disorders and neurologic complications of systemic conditions. (2 or 4 weeks, July – May)

POBG 8010 – Ob/Gyn Senior Rotation
This elective offers further growth, improvement in skills, and broadening of knowledge in benign gynecologic problems, the performance of gynecologic procedures, and an introduction to office management. The student will participate in the preoperative and postoperative management of patients (both in clinic and in the inpatient setting), in evaluating and treating patients (both in an emergency room and clinic settings), and in gynecologic surgery. Postoperative care will provide an opportunity to learn wound care, respiratory support, rehabilitation, and resolution of postoperative ileus. In surgery, the student will learn suturing, knot tying, wound closure techniques, hysteroscopy, and dilation and curettage. The outpatient clinic training will include clinical medicine, as well as the business of medicine. Assessment and treatment of vulvar/vaginal infections, STDs, and chronic pelvic pain will be stressed. Endometrial biopsy will be taught. Colposcopy procedures for cervical lesions will be covered. This elective is also applicable to students who plan a career in primary care specialties such as internal medicine or family medicine. Emphasis will be directed towards developing competency in pelvic examination, obtaining and interpreting Pap smears, diagnosing and treating vaginitis, prescribing hormone replacement therapy, and managing patients on oral contraception. The student will be expected to make rounds with the GYN team daily. Lectures and resident education conferences will be attended as well as discussion with the attending physician and resident physicians of the GYN team of assigned reading topics.

POBG 8012 - Gynecological Oncology/Surgery
This elective is for students interested in becoming more familiar with gynecologic operations and the multidisciplinary care of women with gynecologic malignancies. Specifically, experience will be obtained in the complex peri-operative and operative management of women with pelvic neoplasms. In addition, radiation treatment and planning the administration of chemotherapy will be practiced. Emphasis will also be placed on histopathologic diagnosis and correlation. The students will participate in the pre-operative and post-operative management of patients (both clinic and inpatient settings), in evaluating and treating patients (both in an emergency room and clinic setting), and gynecologic surgery. Post-operative care will provide an opportunity to learn wound care, respiratory support, rehabilitation, and resolution of post-operative ileus. The outpatient clinic training will include clinical medicine, as well as the business of medicine.  Periodic pathology conferences will be attended. Colposcopy procedures for cervical lesions will be covered. The student will be expected to make rounds with the GYN oncology team daily.  Lectures and resident education conferences will be attended, as well as discussion with the attending physician and resident physicians of the GYN oncology team on assigned reading topics. (4 weeks)

POBG 8015 – General OB/GYN Senior Elective
This is a clinical independent study elective in which the student, in consultation with the supervising faculty member, identifies the topics he/she wishes to address and negotiates elective goals, objectives, and activities with the faculty and the Office of Student Affairs. (2 or 4 weeks)

POBG 8100 – OB/GYN Research
This elective is designed to teach medical students selected fundamentals of research, as well as the provide opportunity to learn laboratory skills, and potentially participate in a research topic that will be presented at a national meeting. Students will learn how to perform hormone assays, radioimmunoassay, ELISAs, etc., data entry, and fundamentals of experimental design and statistics and be involved in a manuscript presentation. The opportunity to be involved in patient enrollment in studies also exists. Lectures and resident education conferences will be attended as well as discussions with the director of clinical research on assigned reading topics.

POPH 8010 – Clinical Ophthalmology Elective
This elective will consist of an extensive exposure to clinical ophthalmology in a private practice setting. The student will be exposed to acute and chronic eye disease in addition to ophthalmic surgery. The main objective of this elective will be to teach the student how to conduct a thorough examination of the eyes and to orient the student to the common eye conditions that every physician should be able to diagnose and treat.

POPH 8011 – General Ophthalmology Senior Elective
This is a clinical independent study elective in which the student, in consultation with the supervising faculty member identifies the topics he/she wishes to address and negotiates elective goals, objectives, and activities with the faculty and the Office of Student Affairs. (2 or 4 weeks)

POPH 8100 – Ophthalmology Research
This elective introduces the student to the wide range of research possibilities in the area of visual sciences. A number of projects are available. Ongoing projects include visual psychophysics and electrophysiology, machine vision, artificial intelligence applications, digital imaging, cell growth acceleration, including work with defensins and Substance P, cell growth inhibition, including work with cell growth factor receptor blockers, glaucoma, glaucoma drug design, cornea surgery, vitreoretinal surgery, instrument development and design, and retrospective clinical studies.

PORS 8010 – Orthopaedic Surgery Elective
Students will be assigned to an orthopaedic faculty member and participate as a member of the orthopaedic team in inpatient and outpatient care, emergency room, and operating room activities. Students should perform history and physical examinations upon all patients admitted by the attending surgeon and present these workups for evaluation. Each student will prepare a presentation for the teaching conference on a subject assigned by a faculty member. The student will attend all orthopaedic conferences. This elective is for those students interested in surgical specialties or an in-depth experience in orthopaedic surgery.

PORS 8012 – General Orthopaedics Senior Elective
This is a clinical independent study elective in which the student, in consultation with the supervising faculty member identifies the topics he/she wishes to address and negotiates elective goals, objectives, and activities with the faculty and the Office of Student Affairs. (2 or 4 weeks)

PORS 8100 – Orthopaedic Research
Students with an interest in conducting musculoskeletal research will be assigned to one of the full time orthopaedic faculty members. Under the guidance of this faculty member (and possibly in cooperation with other members of the full time faculty and clinical faculty), the student will be required to directly participate in a research project. The nature and extent of this project is to be agreed upon prior to participation, and credit will not be given unless the agreed upon objectives are accomplished. If the project is completed during the elective, the student is expected to present a written and oral report to the orthopaedic residents and faculty. If it is agreed that the research cannot be completed in the allotted time, the student will be expected to present a report of the progress that has been accomplished during the elective.

PPAT 8010 – Anatomic and Clinical Pathology
The student will rotate through the sections of the clinical laboratory as follows: hematology, learn how to evaluate electronic differential counts and how to evaluate peripheral smears; microbiology, learn proper specimen collection/preservation techniques and how to interpret gram stains; chemistry/special chemistry, learn how to interpret chemistry tests in the clinical context; serology, learn about interpretation/indications for serologic tests; and blood bank, learn about pretransfusion testing, indications for T/S vs. T/X match, and proper blood product handling and storage. Procedures and skills include: learn about handling of cytology/histology specimens and how to perform simple gross tissue examinations; learn basics of histology and routing cytology; and observe FNA procedures and understand the indications.

PPAT 8011 – General Pathology Senior Elective
This is a clinical independent study elective in which the student, in consultation with the supervising faculty member, identifies the topics he/she wishes to address and negotiates elective goals, objectives, and activities with the faculty and the Office of Student Affairs. (2 or 4 weeks)

PPAT 8100 – Pathology Research
Students with an interest in research in pathology will spend time in the departmental research division participating in some phase of a research project (design and development, literature review, data gathering and interpretation, write-up) under the supervision of a faculty member directing the project.

PPED 8010 – Adolescent Medicine
This elective is designed to help students acquire good interviewing skills, a basic knowledge of  adolescent physical and psychosocial development, an understanding of adolescent gynecology, basic skills in evaluation and management of sexually transmitted diseases, knowledge of nutrition and eating disorders in teenagers, management of common skin disorders, ability to identify common orthopaedic problems, knowledge of psychosocial disorders common in adolescents, and insight into the common medical complaints and problems in this age group as well as chronic illnesses seen in adolescents. Students will also gain insight into the legal issues and become familiar with the interface between the adolescent health facility, community agencies, and institutions.

PPED 8011 – Ambulatory Pediatrics
The purpose of this elective is to familiarize the student with preventive pediatrics and parent education, acute intervention in common childhood diseases and follow-up visits, evaluation of patients in an outpatient consulting service, and interactions with faculty and residents about the many facets of ambulatory pediatrics. Students will participate in ambulatory clinics and various conferences and rounds associated with pediatrics. At the end of the rotation, the student will present a topic in ambulatory pediatrics to residents and faculty.

PPED 8012 – Pediatric Endocrinology/Metabolism
This elective provides exposure to outpatient management of common pediatric endocrine problems. Included will be growth assessment, Type 1 diabetes, congenital hypothyroidism, acquired hypothyroidism, hyperthyroidism, precocious puberty, delayed puberty, congenital adrenal hyperplasia, diabetes insipidus, and disorders of calcium regulation. Limited exposure to inpatient consultations is anticipated. Indications for common endocrine laboratory tests and their interpretation will be reviewed.

Endocrine aspects of common pediatric clinical situations will be discussed.

PPED 8013 – Pediatric Diabetes Camp
This elective offers a unique opportunity to learn day-to-day management of Type 1 diabetes. The student attends a one or two week session at a camp for children with diabetes and takes a direct primary care responsibility for a group of children at the camp. Training is provided under the camp medical directors who are highly trained and thoroughly experienced in managing diabetes in children. Duties include supervision and monitoring of daily blood sugar testing and insulin injections. Precamp training and reading assignments will be provided. Daily meetings during the camp will provide some additional educational opportunities.

PPED 8014 – Pediatric Infectious Disease
The objective of this elective is to familiarize the student with the clinical and microbiologic approach to common pediatric infectious disease problems. The student will become familiar with the different classes of antimicrobial agents and learn when and how to select appropriate empirical antibiotic therapy. The student will participate in the differential diagnosis of pediatric patients presenting with signs and symptoms of an infectious disorder. The student will learn the appropriate laboratory tests and culture techniques for isolation and identification of bacterial, viral, fungal, and parasitic pathogens. Epidemiology and infection control of specific infectious pathogens will be discussed. This elective is primarily an inpatient consultation rotation involving the teaching hospital and two private hospital services with one weekly outpatient clinic for follow-up and consultation. Opportunities for research projects may be available if desired.

PPED 8015 – Pediatric Cardiology
Students will be provided many opportunities to learn a variety of cardiac problems in pediatric patients. The student will observe or participate in any activities that the pediatric cardiologist will perform in the diagnosis and management of children with cardiac diseases. The student will become familiar with the interpretation of normal and abnormal cardiac manifestations and physical findings of cardiac defects in children. The student will observe noninvasive and invasive diagnostic procedures and will be encouraged to interpret electrocardiograms, echocardiograms, and cardiac catheterization data. The student will also have an opportunity to observe cardiac surgery and follow the patient postoperatively with the cardiologist. Sufficient physiopathological background will be provided to make the cardiac problems more comprehensible through lectures, case discussions, and review of pathologic specimens.

PPED 8019 – Pediatric Hematology & Oncology
The purpose of this elective is to provide clinical experience to common problems in hematology and oncology by direct contact with patients. At the end of the rotation, students will be able to learn the essential knowledge in evaluating, diagnosis and managing patients with hematologic and oncologic problems, including those related to anemia, coagulation, lymphomas, leukemias, certain solid tumors, and hematologic and oncologic emergencies. The emphasis will be placed on establishing the rapport with patients, logical approach for differential diagnosis, planning the management according to evidence-based medicine for each clinical situation and condition. Students may also participate in diagnosis procedures including lumbar puncture and bone marrow examination.

PPED 8020 – Pediatric Senior Elective
This is a clinical independent study elective in which the student, in consultation with the supervising faculty member, identifies the topics he/she wishes to address and negotiates elective goals, objectives, and activities with the faculty and the Office of Student Affairs. (2 or 4 weeks)

PPED 8100 – Pediatric Research
The clinical study guidelines are: ask a scientific question, to review the literature, formulate a hypothesis, write introduction, materials and methods, result submitted to the IRB, and learn to obtain consent.

PPSY 8010 – Psychiatry Senior Rotation
This elective is designed to give the student an opportunity to work with hospitalized inpatients suffering from major psychiatric disorders (affective disorders, schizophrenia, and organic mental disorders). Special emphasis is placed on diagnosis and formulation of treatment plan. In addition, the student will be exposed to those treatment modalities not provided as an outpatient. This would include electroconvulsive therapy (ECT). The student also will have an opportunity to be a part of a multidisciplinary approach to the diagnosis and treatment of inpatient population.

PPSY 8011 – Community Services/Child Psychiatry
This elective offers the opportunity to participate in the evaluation and treatment of children and adolescents with emotional and developmental disorders in a variety of community agencies. At least 75 percent of the time will be spent as consult service on the ward and approximately 25 percent of time will be in the clinic.

PPSY 8012 – Forensic Psychiatry
The student will be able to identify the basic concepts of forensic and legal psychiatry. The student will also be involved in the actual evaluation procedure for court-referred cases with forensic implications and will attend actual trials and observe psychiatric expert testimony.

PPSY 8013 – Sleep Disorder Medicine
This elective must be combined with another topic of interest during the rotation. This elective reviews the basics of sleep physiology and gives clinical exposure to a wide range of sleep pathology. The student will become acquainted with polysomnography procedures in the Sleep Disorders Center. Disorders such as insomnias, sleep apneas, narcolepsy, and parasomnias will be seen. Students will be expected to observe polysomnographies at night.

PPSY 8016 – Nutrigenetics/Nutrigenomics
This two week elective is an in-depth survey of the nutrigenetics and personalized nutrition which are components of the concept that in the future genotyping will be used as a means of defining dietary recommendations to suit the individual. (2 or 4 weeks, August – May)

PPSY 8017 – Pharmacogenetics in Human Common Diseases
This two week elective is an in-depth survey of the genetic basis of inter-subject variability in response to drugs and will introduce the student to the tools, methodologies, and goals of genomic medicine. (2 or 4 weeks, August – May)

PPSY 8018 – Advances in Human Genetics and Disease
This two week elective will provide medical students with an overview of current problems and technical approaches in human genetics. Areas of focus will be analysis of disease mutations/variants, epigenetics, or gene regulation using advanced technologies, such as next generation sequencing technology. (2 or 4 weeks, August – May)

PPSY 8100 – Psychiatric Research Elective
Students with an interest in research in psychiatry will spend time in the departmental research division participating in some phase of a research project (design and development, literature review, data gathering and interpretation, write-up) under the supervision of a faculty member directing the project. 

PRAD 8010 – Radiology Elective
The student will observe and participate in all phases of radiological diagnosis to include fluoroscopy, plain film interpretation, special procedures, nuclear imaging, diagnostic ultrasound, and computed tomography where available. A radiological teaching file is provided for study purposes, and the student is expected to spend a portion of the time reviewing this file. Attendance at intradepartmental conferences is expected.

PRAD 8012 – Advances in Neuroanatomy and Neuroradiology
Students will spend 2 – 4 hours a day participating in patient care under the supervision of the elective director, and they will also spend time reviewing the instructor’s teaching files. In addition, students will participate in didactic lecture/seminar sessions, complete assigned readings in neuroanatomy, and they will also access information on selected websites as directed by the instructor. Students will also spend at least one day participating in the activities of the neuroangiography suite.

PRAD 8013 – Radiology Senior Elective
This is a clinical independent study elective in which the student, in consultation with the supervising faculty member, identifies the topics he/she wishes to address and negotiates elective goals, objectives, and activities with the faculty and the Office of Student Affairs. Students can enroll in this sub-specialty elective once they have completed the four week general radiology elective. (2 or 4 weeks, July - May)

PRAD 8014 – Pediatric Radiology
Students can enroll in this sub-specialty elective once they have completed the four week general radiology elective. (2 or 4 weeks, July - May)

PRAD 8015 – Interventional Radiology
Students can enroll in this sub-specialty elective once they have completed the four week general radiology elective. (2 or 4 weeks, July - May)

PRAD 8100 – Radiology Research
Students with an interest in research in psychiatry will spend time in the departmental research division participating in some phase of a research project (design and development, literature review, data gathering and interpretation, write-up) under the supervision of a faculty member directing the project. 

PSUR 8011 - Otolaryngology/Head/Neck Surgery
This is an advanced experience in the management of patients with diseases of the ear, nose, and throat. This includes diseases of the airway, esophagus as well as head and neck cancer. Included are a series of lectures, rounds, and clinical experiences with a review of pathology. The course is of value to both a primary care physician as well as a student interested in a career as a surgeon.

PSUR 8012 – Pediatric Surgery
The student will be permitted to review and participate in the care of surgical diseases of infants and children, including the operative management of premature infants with congenital defects, pre and postoperative care in the neonatal unit, pediatric intensive care unit, and diagnostic radiology in acute pediatric surgical disease. The student will be introduced to the delicate techniques and manipulative skills necessary in the care of these patients.

PSUR 8013 – Plastic Surgery
The elective is designed to acquaint the student with the basic principles of plastic and reconstructive surgery including burns, cosmetic surgery, and trauma to extremities. Also included is an introduction to the principles of microsurgery. The student observes as well as participates in the pre and postoperative and follow-up for such patients.

PSUR 8015 – Neurosurgery
This elective is designed to allow the student to "wear the moccasins" of a neurosurgeon for one month. There will be exposure to outpatient and inpatient consultations including review of radiological and neurophysiologic studies, and the neurological decision making process. There will be the opportunity to participate in the operating room, intensive care unit, and regular ward care of neurosurgical patients.

PSUR 8016 – Female Breast Disease/Treatment
This elective is designed to expose the fourth year medical student to and educate him/her in all aspects of female breast disease. The student will participate in the outpatient clinics evaluating patients and participate in the diagnosis and treatment of benign and malignant disease. The student will assist on breast biopsies in the outpatient clinic and will assist at hospital operative procedures. The student will spend time with the medical oncologist in the outpatient setting and at the infusion center. The student will also spend time at the breast imaging center assisting with mammography and ultrasound.

PSUR 8017 – Senior Surgery Elective
This is a clinical independent study elective in which the student, in consultation with the supervising faculty member identifies the topics he/she wishes to address and negotiates elective goals, objectives, and activities with the faculty and the Office of Student Affairs. (2 or 4 weeks)

PSUR 8100 – Surgical Research
The clerk will receive an introduction to the design and conduct of a laboratory investigation and will participate in one or more ongoing projects.