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 pre-operative and post-operative 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.

This elective is designed to expose the student to a wide variety of dermatologic conditions with the expectation that at the conclusion of the experience common disorders will be recognizable. The student will participate in clinics (few inpatient consults) observing a variety of dermatologic disorders and dermatologic procedures in both the adult and pediatric patient population. Also offered is exposure to dermatopathology and dermatologic surgery, thus allowing clinicopathologic correlation.

This elective is designed to give 4th year medical students exposure to and experience in dermatopathology.

This elective is an introduction to emergency medicine and the evaluation of common emergencies. Instead of focusing on a single age group, a defined severity of illness or a discrete body of medical knowledge, the student will be expected to look at the big picture. The student will be asked to make decisions regarding management based upon available clinical information and limited laboratory or radiological tests in a limited time environment. Given these restrictions, emphasis will be on the approach to the problem, its management and disposition, rather than a precise diagnosis.

This rotation prepares students for the transition into a residency program by increasing exposure to the care of patients in the outpatient clinic setting. Students will provide care to a broad range of patients of all ages while refining their examination, diagnostic and communication skills. The clinical experience is combined with seminars focusing on various patient care topics, including a diabetes workshop and self-study, to enhance the learning experience.

Patients of all ages, of both sexes, and with diverse medical problems will be managed in this sub-internship. Emphasis will be given to the total management of the patient, beginning with the ambulatory presentation, continuing through hospitalization and following dismissal from the hospital-coordinated, comprehensive, continuing medical care. The student will be responsible for complete evaluation of the patient, including initial history and physical examination, cost effective utilization of laboratory, x-ray and other procedures and the formulation and pursuit of the management plan, including cogent utilization of consultation/referral services. Emphasis will also be given to participation in community resources, which provide ongoing care of the patient, including Hospice and community health centers. Experience is afforded in the Family Practice Center, the inpatient service of family medicine, certain area nursing homes, and on occasion, in the home of the patient. The student will function with Family Practice residents under the direction of the Family Medicine faculty member assigned to the inpatient service and other Family Medicine faculty members.

Students are assigned to a variety of practices within the urban or rural area for a supervised exposure to day-to-day practice problems. Emphasis is on the application of clinical skills within the demands and limits of actual practice. Program is sponsored by the Texas Academy of Family Practitioners. Applications must be completed several months in advance.

At the beginning of the elective, each student will be assigned to a nurse coordinator and will be increasingly involved in working with that coordinator on the studies they are running. An opportunity will be given for the students to choose between various ongoing studies, but this must be done early since they must have passed the CITI training program and have IRB approval to participate in individual studies. Each student should be involved both with studies involving human subjects and those involving chart reviews. It would be anticipated that the students would receive authorship on any publication resulting from studies on which they are involved, provided that their participation is meaningful. Early in the elective, there will be an emphasis on didactic material beginning with discussions about the regulations and ethical considerations related to research in humans, the background for these and the role played by the IRB and an Office of Research Integrity. This will be followed by sessions on how to develop the proposal for a research project from conception of the idea through formulation of a hypothesis and specific aims, compiling the background, constructing the appropriate methods and analysis of results and, finally, a discussion of the potential significance. It will be expected that each student will develop a proposal/protocol during the elective with an ongoing active critique process.

This selective/elective utilizes patients admitted to the intensive care units within various teaching hospitals. The student will gain experiences in managing common medical emergencies, including cardiopulmonary arrest, drug overdose, hypertension, acute myocardial infarction, cardiogenic shock, congestive heard failure, renal failure, and diabetic ketoacidosis. The student is also expected to become proficient in the evaluation and management of common chest problems, including asthma, chronic obstructive pulmonary disease, pleural effusions, peri-operative complications, pneumonia, atelectasis, respiratory failure, pulmonary function tests, and chest x-rays, and to become familiar with the various types of mechanical ventilators, oxygen delivery systems, and methods of delivering inhaled medication.

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 thirdyear 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.

This elective is designed for both the student interested in internal medicine and the student interested in other specialties who would like to strengthen his/her background in medicine. The primary emphasis of this elective is on diagnostics, preventive medicine, and successful outpatient management of chronic, progressive diseases such as diabetes mellitus and hypertension. Selected areas such as geriatrics, home care, office ENT, ophthalmology, gynecology, and orthopaedics may be added as suits the needs of the student.

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.

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.

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.

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.

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.

This elective is offered to the student for clinical experience in pulmonary disorders, emphasizing acute and chronic respiratory failure, intensive respiratory care, and interpretation of pulmonary function tests and chest x-rays.

This elective offers an in-depth look at the clinical array of rheumatologic disorders. Students will be exposed to inpatients and outpatients with emphasis on diagnosis and long-term management of common rheumatic diseases. Depending on the student's level of proficiency and interest, the student may be allowed to participate in procedures such as joint aspiration and injection, and will interpret synovial fluid studies. Students will learn the correct indications and monitoring of common rheumatic drugs and the fundamentals of rheumatic rehabilitation.

The field of radiation oncology is an intellectually challenging field, providing curative therapy and close longitudinal doctor-patient relationship. This elective may be taken by itself or combined with the hematology-oncology elective.

The student will gain experience in managing common medical emergencies, including cardiopulmonary arrest, hypertension, acute myocardial infarction, cardiogenic shock, and congestive heart failure. The student will also become familiar with the various types of mechanical ventilators, aortic balloon pumps, cardiac valve replacement surgeries, extracorporeal membrane oxygenation, oxygen delivery systems, and methods of delivering inhaled medication.

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.

This two or four week elective is a compilation of the spectrum of patients seen in the ambulatory ob/gyn clinic (gynecology, antenatal care, high risk obstetrics, urogynecologic, and infertility) and will be tailored to fit the individual requests of the fourth year student. Hands on opportunities include preparing for and performing the following office gynecologic procedures: cervical cytology and cultures, colposcopy, endocervical curettage, cervical, and endometrial biopsy. The student will be expected to present in organized succinct fashion ob/gyn patients seen in clinic to the supervising physician, counsel patients concerning various contraceptive options, complications, and contraindications, and review the evaluation and management of the abnormal cervical cytology screen. The student will also be expected to formulate a treatment plan for peri- and postmenopausal bleeding, complicated obstetrical patients and work on proper communication with nursing and ancillary staff in order to efficiently and effectively coordinate ambulatory patient care.

This four week Sub Internship will provide the student the opportunity to function as a first year resident on the MFM service. The student will gain ample exposure on the rotation in order to develop the skills to recognize the clinical and laboratory diagnosis of medical, surgical, and obstetric complications of the high-risk pregnancy. The student will review the literature on and develop the skills to manage the fetal/neonatal complications of post term pregnancy. including the indications for induction of labor, and review the evaluation and management of the following conditions which complicate pregnancy: preterm labor, hypertension, and diabetes.

This four week Sub Internship will provide the student the opportunity to function as a first year resident on the Gynecologic service. The student will evaluate, present, and manage patients that present to clinic and the EC with gynecologic complaints and participate in and care for patients that undergo gynecologic surgery. On days assigned to the operating room the student will be expected to: prepare for and perform as a surgical assistant for assigned gynecologic cases, communicate with operating room nursing and ancillary staff, and become proficient in preoperative ‘time out’, and illustrate proper aseptic technique, and patient positioning in the operating room. Prior to surgical cases the student will review the surgical steps for and complications of commonly performed gynecologic surgeries as well as recent literature in regard to surgical outcomes. The student will gain experience in eye-hand coordinated movements relevant to basic laparoscopy in the simulation lab and with knot tying using a self-directed suture curriculum. The student will demonstrate effective communication skills regarding patient sign out and hand off, recognize and participate in systems improvements, and communicate with nursing and ancillary staff to promote teamwork, and patient care. The student will prepare for and attend Friday afternoon didactics including the participation in preoperative surgical conference.

This elective will introduce the student to high-risk obstetrics with specific exposure to the clinical and laboratory diagnosis of medical, surgical, and obstetric complications of the "high-risk" pregnancy. The course is not intended to generate surgical manual skills, but rather cerebral and interpretive knowledge. Emphasis will be placed on ultrasonographic interpretation, invasive fetal testing, and antepartum care of this patient group, both in the clinic and hospital setting. Specific readings will be assigned in the areas of obstetrical anesthesiology, premature labor, and suppression of said labor, induction of labor, metabolic diseases of pregnancy, hypertension and cardiac diseases in pregnancy, etc. Lectures and resident education conferences will be attended as well as discussion with the attending physician and resident physician of the OB team on assigned reading topics.

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 student 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. Postoperative 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.

Students will be given opportunities to participate in the clinical care of patients with reproductive endocrine and infertility disorders and will improve the clinical knowledge base necessary for recognizing the problems of these patients as individuals. Students will be provided both clinical exposure to patients and the laboratory aspects of reproductive endocrine and infertility care and will be exposed to the emotional and psychological problems of the reproductive endocrine/infertility patient. Students will participate in all scheduled surgeries, see private patients with attending physician, consult in resident reproductive endocrinology clinic, learn to do inseminations, ovulation monitoring and induction protocols, participate in hysterosalpingogram, and observe management of in vitro fertilization. Lectures and resident education conferences will be attended as well as discussions with attending physicians and resident physicians of the REI team on assigned reading topics.

This elective includes experience in office and hospital obstetrics and gynecology, family planning, gynecological surgery, and formal and informal conferences. The schedule is flexible to accommodate special interest of the student.

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.

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.

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 work-ups 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.

This rotation will introduce the basic concepts of physical medicine and rehabilitation. The student will learn techniques of obtaining a complete medical history for patients experiencing musculoskeletal pain. The rotation will also stress the development of an efficient and complete neurological and musculoskeletal examination that will assist the student in developing a differential diagnosis for future patients they may see. The student will be exposed to the total spectrum of the specialty.

This elective will introduce the student to the role of tissue examination in modern medicine. The student may be involved in a variety of experiences, including Gross examination of surgical pathology specimens, Processing and staining tissue, Frozen-section examination, Light microscopic diagnosis, Cytopathology, Autopsy pathology, and Electron microscopy. Clinical correlation of gross and microscopic findings is emphasized, and there will be a close affiliation with the surgical services and subspecialties. The proportion of time spent in these areas will be tailored to the student's interests. One formal presentation on a laboratory topic of the student's interest will be required in the four-week experience. Attendance and participation in a variety of surgical pathology and inter-service conferences are encouraged. Call is not generally required, but it may enhance the autopsy and surgical pathology experiences.

The student will rotate through the sections of the clinical laboratory as follows: (a) Hematology - learn how to evaluate electronic differential counts and how to evaluate peripheral smears; (b) Microbiology- learn proper specimen collection/preservation techniques and how to interpret Gram stains; (c) Chemistry/Special Chemistry- learn how to interpret chemistry tests in the clinical context; (d) Serology- learn about interpretation/indications for serologic tests; and (e) Blood Bank- learn about pre-transfusion testing, indications for T/S vs. T/X match, and proper blood product handling and storage. Procedures and skills include: (a) Learn about handling of cytology/histology specimens and how to perform simple gross tissue examinations; (b) Learn basics of histology and routing cytology and (c) Observe FNA procedures and understand the indications for this procedure.

The purpose of this rotation is to familiarize the student with preventive pediatrics and parent education, acute intervention in common childhood diseases and follow-up visits, and evaluation of patients in an outpatient consultation service.

This selective/elective is designed to familiarize the student with perinatal-neonatal physiology, high-risk factors associated with neonatal disease pathophysiology diagnosis and management of common neonatal problems, dealing with acute neonatal emergencies, and communicating with parents of high-risk neonates. The students¿ primary responsibility will be the total management and supervision of assigned patients. Students will also be expected to participate in daily rounds, night call, weekly discussion group on neonatal-perinatal diseases and presentation of a review on a selected aspect of neonatal-perinatal medicine towards the end of the rotation.

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.

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.

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.

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.

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.

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 non-invasive 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 post-operatively 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.

This elective provides an opportunity for the student to participate in the diagnostic evaluation and management of pediatric patients with gastrointestinal and liver disease. The elective is in a private practice setting and will expose the student to a wide variety of diseases through both clinic and hospital consultations. The student will become familiar with the appropriate use of laboratory, radiology, and endoscopy (including review of histology) in the evaluation and management of pediatric patients. There will also be an opportunity for the student to become familiar with the use of diagnosis and management coding as well as general office procedures in the private practice setting.

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 and certain solid tumors, and hematologic and oncologic emergencies. The emphasis will be place 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.

This elective is designed to help students understand drug therapy in the management of adult as well as pediatric patients. During this rotation, the student will present several cases from among inpatients either in the Departments of Internal Medicine or Pediatrics. This will be followed by a discussion of the different medication used. By the end of this rotation, the student should be familiar with pharmacokinetics, mechanism of action, indications, contraindications, side effects, dosage, and drug interactions of the most commonly used medications.

The purpose of this elective is to develop basic methodology in the evaluation of pediatric lung disease by the rational use of appropriate clinical skills, by interpreting blood gases and pulmonary function tests, and by reading chest radiographs in order to be able to develop a reasonable differential diagnosis, disease evaluation, and therapy (including familiarizing with ventilator). This elective will provide the types of pediatric pulmonary problems encountered at the general pediatric inpatient facility, as well as those referred to a subspecialty, outpatient chest and/or cystic fibrosis clinic complemented by occasional consultation on critically ill children.

This elective provides exposure to outpatient management of common pediatric neurology problems. Included will be delays in developmental milestones, ataxia, change in sensorium, diplopia, headache, head trauma, hearing concerns, gait disturbance, hypotonia, lethargy, seizure, tremor, vertigo, visual disturbances, and weakness. Limited exposure to inpatient consultations is anticipated. Indications for common neurologic laboratory tests and their interpretation will be reviewed. Neurological aspects of common pediatric clinical situations will be discussed. At the end of the rotation, the student should be able to recognize common neurologic disorders and their presentations.

This 4-week rotation offers students the opportunity to participate in all aspects of a comprehensive clinical genetics program including clinical consultations and laboratory testing. The student will participate in genetic evaluation/counseling sessions and observe the cytogenetic/molecular testing that ensues from patient interactions. Students are encouraged to select one patient/family of interest and compile a short case presentation or report by the end of their rotation.

This rotation is designed to give students experience in evaluation, diagnosis, and management of psychiatric illnesses in a variety of settings. Students may select Adolescent Psychiatry, Inpatient Psychiatry, or Outpatient Psychiatry.

This selective/elective is designed to give the student clinical experience with outpatient evaluation of child and adolescent patients seen at the TTUHSC Department of Neuropsychiatry and Behavioral Sciences.

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.

Student will work closely with a Board Certified Geriatric Psychiatrist to learn psychiatric diagnosis and treatment of geriatric patients in both an outpatient and inpatient setting.

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 intra-departmental conferences is expected.

This elective exposes the fourth year medical student to the most critically ill and injured surgery patients. The student will be an integral part of a team of residents from surgery, anesthesia and other departments, led by an attending specialized in intensive care medicine. Medical student will be assigned patients appropriate for their level of training and under direct supervision of the attending, will learn to thoroughly evaluate their overall condition, develop a management plan, and get experience in executing the plan including performing several bedside procedures. The student is expected to round twice a day with the attending and the team, attend daily multidisciplinary conference and take in house call once a week including one weekend day. The student is expected to participate in educational activities including ICU lectures, M&M and Ground Rounds within the Department of Surgery.

This selective/elective is designed to provide basic and advanced clinical experience in the management of burn and wound patients to include critical care, burn and wound evaluations, and management. It will include the diagnosis and management of complex acute and chronic wounds as well as nutrition support for critically ill or injured patients. The student will learn basic and advanced techniques in wound healing. They will have the opportunity to become experienced with writing total parenteral nutrition orders as well as decisions using enteral nutrition for nutritional support. The course experience is structured to be of value to students interested in both primary care as well as surgical specialties.

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 clinical faculty preceptors are also available. Students will take in-house call.

The Neurological Surgery Sub-I offers fourth year medical students with a strong interest in the Neurological Surgery subspecialty, an opportunity to acquire and assimilate advanced clinical responsibilities at an intern level, by exposure to neurological patients in various clinical settings: inpatient, outpatient, and operating room. This four-week elective rotation will. Provide an educational curriculum that emphasizes teaching of fundamental concepts of total patient care. The sub-intern will be assigned to a faculty mentor each week in order to learn and apply information for a variety of neurological disorders, based on the patient group for which he/she is responsible. This will assist in maximizing academic preparation for postgraduate clinical performance as an intern. The sub-intern will present lecture(s) specific for their team along with hospital rounds and take call at least once per week with the call day established by the neurosurgical staff and discuss ER cases to further enhance the sub-interns educational experience.

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.

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-/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.

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-, post-operative and follow-up or such patients.

This elective is an advanced experience in the management of disorders of the urinary tract and is designed to provide the student with an understanding of the principles of urological diagnosis and treatment. Included with this elective are a series of lectures, ward rounds, operating room 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 an urologist.

This elective exposes the medical student to patients with diseases of the vascular system including peripheral arterial occlusive disease, carotid stenosis, diseases of the venous and lymphatic system. The student will gain advanced knowledge of the pathophysiology of these diseases and the workup and management. The student will learn to evaluate these patients clinically, using non-invasive tests such as Duplex and invasive evaluation including angiography. The student will see and take care of vascular patients and this includes initial evaluation, management plan and participating in the treatment endovascular or operative. The student will follow these patients postoperatively in the intensive care until discharged.

This elective is designed to expose the students to the specialty of neurosurgery. The student will be exposed to both outpatient and inpatient care. During this rotation the student will have the opportunity to participate in the management of patients with various neurosurgical diseases including brain tumors, aneurysms, and disorders of the spine. The student will also have strong exposure to neurosurgical trauma including operative management of intracranial bleedings and management of increased intracranial pressure. The student will actively participate in the patient's care pre-, intra- and postoperatively and make daily rounds with the neurosurgery service both on the floor and in the intensive care.

By direct involvement in the clinical practice, the 4th year student will be exposed to cancer patients at all stages of presentation, during treatment and surveillance, and at relapse and or with advanced disease. A series of didactic lectures regarding basic principles in oncology, screening recommendations, and clinical and pathologic staging supplements the office and bedside evaluation of cancer patients so that the objectives of understanding adult cancer issues as listed above can be met. Patients are referred to the surgical oncology division and will be evaluated by the 4th year student in the presence of the surgical oncology division Faculty. Thorough history evaluation, review of previously obtained imaging studies and laboratory results, and review of previously obtained pathology slides will be incorporated into a general discussion for that particular patient's cancer or tumor. The 4th year student will be directly involved in patient discussions regarding evaluation and treatment. There will be a continuity of care inasmuch as pathology slides are reviewed, ordered imaging studies are reviewed and applied to ongoing or definitive decision-making, and the 4th year student will have the opportunity to evaluate patients on the hospital wards and during return visits to the clinical office practice. The close shadowing relationship with division of surgical oncology Faculty allows for a comprehensive experience and continuity. The 4th year student will be present during office practice hours on specific days including Monday afternoon at the VA Medical Center, Tuesday morning at the Texas Tech Office Practice, and Thursday afternoon at the Texas Tech Office.

This elective is designed to expose the 4th 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.

This rotation exposes the fourth-year medical student to the most critically ill patients with neurological pathology. The student will be an integral part of a team from neurosurgery, anesthesia, and other departments, led by an attending physician. Medical students will be assigned patients appropriate for their level of training. The students will learn to thoroughly evaluate the overall condition of the patient and develop and implement a management plan. The students will become familiar with common neurological conditions including vascular pathology and hemorrhage, closed and open head trauma, and increased intracranial pressure, as well as neuro-oncology and management of intracranial pressure monitors and external ventricular drains. Additionally, the student will become familiar with common ICU management practices including central lines, arterial lines, and ventilator management. The student will be expected to round daily with the attending and the team. The student may participate in additional educational activities within the Departments of Surgery including ICU lectures, Morbidity and Mortality conferences and Grand Rounds.

The Neurological Surgery Sub-I elective offers fourth year medical students with a strong interest in the Neurological Surgery subspecialty, an opportunity to acquire and assimilate advanced clinical responsibilities at an intern level, by exposure to neurological patients in various settings: inpatient, outpatient and operating room. This four-week elective rotation will provide an educational curriculum that emphasizes teaching of fundamental concepts of total patient care. The sub-intern will be assigned to a faculty mentor.