Internal Medicine

IMED 717 OMAHA VAMC - CRITICAL CARE MEDICINE 4 Credit Hours

ELECTIVE

A Nebraska faculty intensivist alternates regularly with a Creighton faculty intensivist on the VA CCM team, so depending on the rotation you may not be supervised by a UNMC faculty member. *This course may have additional credentialing requirements for the Omaha Veteran's Affairs Hospital. Objectives: Evaluate and assist in management of patients with acute presentations of common medical problems; Describe ventilator changes required for a patient on mechanical ventilation based on ABG interpretation; Define the various types of shock and describe their management; Categorize the variety of vasoactive medications and their use in clinical situations. This sub-internship offers opportunity for participation in the management of acutely ill patients, working closely with an ICU supervisory resident, the pulmonary and critical care fellow, and attending physician. As a sub-internship, clinical expectations will include primary responsibility for all patients assigned to their care, writing a note each day on their patients to be cosigned by the supervising resident and attending physician, active participation on rounds, and the option of taking in-house overnight call, with their supervising resident. Learning objectives for this rotation include management of respiratory failure, acute coronary syndrome, acute and chronic renal failure and hyperglycemia among others. The students will be expected to learn interpretations of chest radiograph and common dysrhythmias. They will participate in bedside procedures and they will be expected to be able to evaluate and recognize patients with a variety of life-threatening disorders and participate in their management. The student will be expected to attend any scheduled didactic lectures and engage in self-learning activities to expand their medical knowledge of the evaluation and management of critically ill patients. Honors work will require enthusiasm and initiative, as well as student presentations to the CCM team of clinical topics related to their patients' problems. This ICU rotation is appropriate for a motivated student seeking a moderate intensity of critical care medicine. Activity Hours/Week: Rounds-10, Didactic conferences-5, Independent learning-3 - Review literature related to patient problems, Research project-0, Independent patient care-0, Procedures-Based on student interest and competency. Any leave requests, either for residency interviews or other needs should be cleared with the attending physician by calling the contact number above.

Instructor: Dr. Craig Piquette and Omaha VA Medical Center ICU Staff.

Contact: Chelsea Hug for Attending Schedule, 402-559-4087).

Typically Offered: Each four weeks.

Capacity: 1. Location: Omaha VA.

Visiting Student Information: This course is NOT available to visiting students.

IMED 718 TEACHING ASSISTANTSHIP 4 Credit Hours

ELECTIVE

This elective is arranged through Ron Bechdolt (402-559-8689). Each Teaching Assistant (TA) will assist with various teaching and assessment activities taking place in the pre-clinical curriculum. Topics may include but are not limited to: history and physical examination, patient interviewing and communication, differential diagnosis, and healthcare systems. Activities associated with these topics include: small group facilitation, laboratory activities, assistance with clinical examinations, scoring of student essays, and providing feedback to first and second year students about completed assignments. Each TA's involvement will depend on the number of planned activities, the number of participating TAs, and the individual and group schedules. All TAs will be required to complete Student as Teacher online modules during the fall semester and to attend required trainings and debriefings throughout the academic year. Instruction for grading/assessment is provided. More TAs than are required for each event will be enrolled in the course to ensure M4s the flexibility necessary to complete graduation requirements and residency interviewing. However TA's must be active participants in scheduled activities throughout the year in order to pass the rotation.

Instructor: Dr. Regan Taylor.

Contact: Ron Bechdolt; rbechdolt@unmc.edu; 402-559-8689; MSC 4031 (Zip 5525).

Typically Offered: Year Round (July-March).

Capacity: Variable.

Visiting Student Information: This course is NOT available to visiting students.

IMED 720 ADULT CARDIOLOGY 4 Credit Hours

ELECTIVE

The student will: Begin to develop the acumen to obtain a detailed history from cardiac patients focusing on the pertinent aspects of the particular diagnosis or chief complaint as well as other medical diagnoses that either are included in the differential or will have an impact on the evaluation and treatment of the cardiac problem. Specific symptom complexes include but are not limited to: 1. History of chest pain; 2. History suggestive of heart failure; 3. Syncope; 4. Cardiac pre-operative evaluation. Learn the proper techniques for a detailed cardiac examination to include: 1. Complete cardiac examination; 2. Examination for valvular diseases; 3. Examination for heart failure symptoms. Correlate the physical examination in a "bidirectional" manner. The student will learn how the history directs the key points of the physical examination and similarly how the examination aids in coming to the correct diagnosis. Understand how to implement guideline-driven care of the cardiac patient. Develop and understand the rationale for cost-effective and appropriate testing required to confirm a diagnosis and implement treatment. Acquired Skills-The student will learn and acquire the knowledge base to: Perform a cardiac examination; Interpret an electrocardiogram; Learn how to perform and write-up a good history and physical; Learn basic coronary anatomy and the correlation to the ECG in ischemic syndromes; Learn the appropriate rationale for ordering tests for the cardiac evaluation. The Cardiology Service, The UNMC Service; The University service is both a primary and consultative service. It generally consists of a faculty member who rotates in a one-week block. The fellow(s) is/are on the service for the entire month. There are generally 4 internal medicine residents, 1 neurological resident, 1 internal medicine senior student, 2 Family Medicine residents, 1 Anesthesia resident and two International observers with the exception of July and December on the inpatient service. A nurse coordinator is also part of the team. The team usually meets for pre-rounds in the conference room on the 7th floor of the Clarkson Tower with the fellow on the service. Attending rounds usually follow but may vary depending on the faculty member. All students will have a pager for the month, which will be distributed by the Education Coordinator. Students will generally be assigned no more than 3-4 patients while on the service which they will follow until discharge or the student rotates off the service. The student should write daily notes on the patient as designated by the fellow on the service who essentially will be the "team leader." Students are expected to attend at least four conferences per month and review assigned articles. ECG review will be scheduled as time permits. Students are not required to round on the weekends but can do so if they choose. Educational resources: A list of relevant reading resources will be provided by the fellow and Tuwanda Mayberry. Everyone is expected to attend the Monday-Thursday house officer lectures 2-3 PM, list distributed during orientation. Evaluations: The faculty, fellow and residents will evaluate the student by standard process. There is no examination at the end of the rotation. The students will be evaluated on their ability to be a team member and their skills for evaluation and treatment of the patients they follow.

Prerequisite:  Pre-arrange with Tuwanda Mayberry; 402-559-9268.

Instructor: Dr. Dan Anderson and staff.

Contact: Tuwanda Mayberry, 402-559-9268.

Typically Offered: Each four weeks.

Capacity: 1.

Visiting Student Information: Visiting Students are not to contact faculty or clinical departments prior to acceptance through VSLO. Doing so is considered a professional breach and may disqualify the student from being offered a rotation.

IMED 720A ADULT CARDIOLOGY METHODIST 4 Credit Hours

ELECTIVE

Staff at Nebraska Methodist Hospital will reach out with credentialing requirements. Objectives: Learn the normal ECG as well as common arrhythmias and other abnormalities; Learn both invasive and non-invasive diagnostic and treatment strategies for cardiac arrhythmias; Learn the indications for cardiac rhythm device implantation; Participate in electrophysiologic studies as well CRM device implantation and left atrial appendage closure; Learn both inpatient and outpatient management of cardiac arrhythmias including antiarrhythmic indications, toxicities, and monitoring. The Methodist Hospital Cardiac Electrophysiology Clerkship introduces students to cardiac rhythm device implantation and management, EP studies and ablation of atrial fibrillation, supraventricular Tachycardia, and ventricular tachycardia as well as left atrial appendage closure. The rotations consists of primarily inpatient care with 1-2 days of clinic a week. Students will learn ECG interpretation, antiarrhythmic drug management, as well as have the opportunity to participate in device implantation and invasive EP studies and ablations. Students will learn the acute management of arrhythmia patients as well as long term outpatient care. Opportunities for exposure to general and structural cardiology such as stress testing, echocardiography, percutaneous coronary and valve procedures, as well as community hospital cardiology are also available as part of the rotation.

Instructor: Dr. Matthew Latacha.

Contact: Jillian McIntosh-Carnes; jill.mcintoshcarnes@unmc.edu; 402-559-6422; MSB (Zip 2055).

Typically Offered: Each four weeks with approval.

Capacity: 1.

Visiting Student Information: This course is NOT available to visiting students.

IMED 722 GENERAL MEDICINE 4 Credit Hours

ELECTIVE

In this period of one month, this elective will review basic concepts in Internal Medicine including:1.5 hours of didactics each day (i.e.-EKG, antibiotic review), Small group cases focusing on diagnostics, Dermatology experience, Pattern recognition case vignettes, Journal Club simulation. Text: Daily readings from the Mayo Board Review Book. Anticipated time requirements: The students start the day at 8 am and typically finish by 1pm. Anticipate an additional 2 hours of prep time for the next day (i.e. text/journal reading/ completing pattern recognition). Activity-Hours/Week: Rounds-0, Didactic conferences-7.5 Independent learning-4, Research project-0, Independent patient care-0, Small Groups-15.

Instructor: Dr. David O'Dell and Dr. J. Scott Neumeister.

Contact: Jillian McIntosh-Carnes; jill.mcintoshcarnes@unmc.edu; 402-559-6422; MSB (Zip 2055). Information will be sent out prior to start.

Typically Offered: April, May, July, August, and November ONLY.

Capacity: 6 min for class to be held - 15 maximum.

Visiting Student Information: This course is NOT available to visiting students.

IMED 723 DIABESTES, ENDOCRINE AND METABOLISM (D.E.M.) 4 Credit Hours

ELECTIVE

Each student will have direct management responsibility for care of patients on the Diabetes, Endocrinology and Metabolism Service under the supervision of house officers, Endocrine fellows, and staff. Particular emphasis is placed on the diagnosis and treatment of those endocrine disorders encountered with the greatest frequency in the practice of medicine; specifically, diabetes mellitus and thyroid diseases. Students may decide if they would prefer to do the rotation predominantly in the outpatient clinic, predominantly on the inpatient service, or have an equal mix of both. There will be adequate opportunity to acquire a working understanding of the complex diagnostic approaches for other endocrine disorders (adrenal, pituitary, reproductive problems, lipid disorders and osteoporosis). All students will give a 15 minute presentation on an endocrine topic of their choice by the end of the rotation. Activity-Hours/Week. Rounds-6 to 20. Didactic conferences-4. Independent learning-3. Research project-0. Independent patient care-4. Clinic-6 to 20.

Instructor: Drs. Desouza, Armas, Mack, Goldner, A. Neumeister, Shivaswamy, Boerner, Drincic, Eiland, Patel, Akkireddy, Kotwal, Johnson-Rebbett, Polavarapu, and Puri.

Contact: Grace Handleman, 402-559-4284, grace.handleman@unmc.edu.

Typically Offered: Each four weeks.

Capacity: 2.

Visiting Student Information: Visiting Students are not to contact faculty or clinical departments prior to acceptance through VSLO. Doing so is considered a professional breach and may disqualify the student from being offered a rotation.

IMED 724 GASTROENTEROLOGY 4 Credit Hours

ELECTIVE

The Gastroenterology and Hepatology elective emphasizes the correlation of the basic science principles of physiology, pharmacology, and pathologic anatomy to clinical consultative gastroenterology. The Nebraska Medicine location utilizes an inpatient consult service; neither are primary care services. Active student participation in the patient management team, in both ambulatory clinic and hospital settings, is required and will emphasize bedside discussion, as well as attendance at regularly scheduled conferences. There will be one position available monthly at UNMC. Where to Report: The Education Coordinator (Lynne Roh) at lynne.roh@unmc.edu will send you an e-mail before the rotation begins. In the e-mail you will be given the name and pager of the attending and fellow on service and instructions to call them on the first day. PLEASE LOOK FOR THIS E-MAIL. If you do not receive it, please call Lynne Roh at 402-559-4356.

Instructor: Dr. Rochling and Division Faculty.

Contact: Jillian McIntosh-Carnes; jill.mcintoshcarnes@unmc.edu; 402-559-6422; MSB (Zip 2055).

Typically Offered: Each four weeks.

Capacity: 1.

Visiting Student Information: This course is NOT available to visiting students.

IMED 726 INFECTIOUS DISEASE 4 Credit Hours

ELECTIVE

During this rotation students spend time on the general Infectious Disease consult service. They will gain practical experience in the evaluation and management of numerous common and unusual infections along with training in the pathogenesis and prevention of infections. Daily, one hour didactic sessions covering a variety of essential ID topics are presented (HIV, immunocompromised host infections, endocarditis, etc.). Clinical microbiology education is also included with both lecture and practical lab experience. Students attend and may have the opportunity to present at the weekly City-wide infectious Disease Care Conference where unusual or interesting ID cases are discussed. Time in the General ID and clinic is also a component. Activity-Hours/Week. Rounds-20. Didactic conferences-4. Independent learning-6. Research project-Negotiable. Independent patient care-10.

Instructor: Drs. Rupp, Hewlett, Ashraf, Bares, Cawcutt, Marcelin, Van Schooneveld, Hankins, Schnaubelt, Cortes-Penfield, Starlin (Adult ID).

Contact: Megan Hoesing, 402-559-8930, Dr. Van Schooneveld 402-559-8650.

Typically Offered: Each four weeks.

Capacity: 2.

Visiting Student Information: Do NOT contact any faculty or clinical department prior to your acceptance for a rotation through VSLO. Doing so is considered a professionalism breach and may disqualify you from doing rotations at UNMC.

IMED 727 RENAL 4 Credit Hours

ELECTIVE

The nephrology rotation is offered continuously as a four-week rotation at the University of Nebraska Medical Center. Students participate in the evaluation and treatment of inpatients and outpatients with renal disease, hypertension, and electrolyte/acid-base disorders. Daily inpatient rounds are oriented to bedside teaching and are supplemented by a seminar and lecture series on the range of nephrology topics important for primary care and specialists. Students see patients for initial evaluation and follow-up with the nephrology team. There are at least three scheduled conferences every week. By special request, additional students may take the nephrology rotation as a research or basic science reading course under the direction of an individual faculty member. Activity-Hours/Week. Rounds-15. Didactic conferences-3. Independent learning-5. Research project-0. Independent patient care-10. During the rotation contact Lisa Allen 402-559-9227.

Instructor: Drs. Plumb, Florescu, Hawkins, Mullane, Franz, and Naranjo.

Contact: Mackenzie Dehmer, 402-559-8501.

Typically Offered: Each four weeks.

Capacity: 3.

Visiting Student Information: Visiting Students are not to contact faculty or clinical departments prior to acceptance through VSLO. Doing so is considered a professional breach and may disqualify the student from being offered a rotation.

IMED 727A RENAL-CLARKSON 4 Credit Hours

ELECTIVE

This course is designed to introduce the student to inpatient nephrology, including the fluid and electrolyte abnormalities common in patients with acute renal failure, the clinical situations involved in development of acute renal failure, and the appropriate therapy. Chronic renal failure also will be stressed in the rotation, with everything from drug therapy to hemodialysis and peritoneal dialysis being reviewed. Activity-Hours/Week. Rounds-20. Didactic conferences-3. Independent learning-2-12. Research project-0. Independent patient care-20. Dialysis-3.

Prerequisite:  Contact Jill McIntosh-Carnes, 402-559-6422 for pre-approval into this course.

Instructor: Drs. Bauer, Gage, Poole, Bast, and Lund.

Contact: Penny Davis, 402-552-3795, pdennis@nebraskamed.com. Contact Jill McIntosh-Carnes, 402-559-6422 for pre-approval into this course.

Typically Offered: Each four weeks.

Capacity: 1. Location: Clarkson.

Visiting Student Information: This course is NOT available to visiting students.

IMED 728 INTRODUCTION TO HOSPICE AND PALLIATIVE MEDICINE 4 Credit Hours

ELECTIVE

This course may have additional credentialing requirements for the Omaha Veteran's Affairs Hospital. This elective is designed to provide students with a variety of experiences in end-of-life care. Students will improve their ability to provide competent care at the end of a person's life and increase their knowledge of available resources to assist patients and their families. Activities include: 1. Core lectures and readings include: * Family Meeting : Making a Big Decision * Common Symptoms Their Management * End of Life Care in the ICU (Withholding/Withdrawing Treatment) * Pain Management : A Pharmacist's Perspective * How to Pronounce a Patient and Complete a Death Certificate. 2. Participation with a community based hospice team by: * making home visits, nursing home visits and visiting Omaha's only Residential hospice (Hospice House) * attending interdisciplinary hospice team meeting and working with key members of the team; 3. Working with a hospice medical director; 4. Participate in the Advance Care Team at the Omaha VA. Medical Center. 5. An oral presentation (15-30 minutes) on a topic related to hospice and care of the dying is expected. This should be a topic that the student can continue to use in the future to teach others about care of dying patients. Other opportunities are available based on the interest of the student. These may include working with a pain specialist in an outpatient pain clinic, a pharmacist specializing in pain management, a radiation oncologist, visiting a local funeral home or a community bereavement resource center. Scheduling is flexible and students may arrange the schedule around interviews and other activities. Activity-Hours/Week. Rounds (Palliative Care at VA)-6. Didactic conferences-4. Independent learning-16. Oral presentation prep-2. Home Visits-9. Site Visits-2. Hospice Administration-1.

Instructor: Dr. Catherine Eberle, Dr. Natalie Manley, M.D., MPH.

Contact: Travis Weyant; tweyant@unmc.edu; 402-559-3964.

Typically Offered: Pre-approval with Tryavis Weyant ONLY.

Capacity: 1.

Visiting Student Information: This course is NOT available to visiting students.

IMED 730 ONCOLOGY/HEMATOLOGY 4 Credit Hours

ELECTIVE

To offer a comprehensive experience in the Division of Oncology/Hematology, the course now offers a one-month inpatient and outpatient rotation that emphasizes evaluation and decision-making in these two subspecialty fields. Over the one-month elective there is a two-week rotation on the general oncology inpatient service, one week on the hematology consult service and numerous outpatient clinics throughout the month. The clinics are somewhat subject-oriented and sometimes are conducted simultaneously. Areas from which to select include lymphoma, breast cancer, lung cancer, GI, GU, head and neck cancer, non-malignant hematology including coagulation disorders, and CNS/brain cancer. A half day is also spent in the cancer treatment area and radiation oncology. Opportunities to observe and perform special procedures including bone marrow aspiration, bone marrow biopsy, paracentesis and thoracentesis may also occur. Core curriculum subjects are also discussed for 30 minutes before inpatient rounds with residents several times each week. There are also one hour course conferences with the fellows once or twice a week that the student can attend. In addition, students are welcome to attend multiple multidisciplinary oncology case conferences, hematology morphology conferences and various other didactic teaching happening in the section. Students are also assigned tasks and given opportunities for independent learning and presentations. Where to Report: Buffett Cancer Center, 4th Floor. Clinic

Instructor: Drs. Al-Kadhimi, Armitage, Baljevic, Bhatt, Bociek, Cowan, D'Angelo, Ganti, Grem, Gundabolu, Holstein, Kallam, Klute, Krishnamurthy, Krishnan, Lunning, Maness, Marr, Nester, Reed, Sharma, Shonka, Tandra, Tenner, Teply, and Vose.

Contact: Norrisa Richardson, 402-559-5166, or Jake Selph at 402-559-8000. Activity-Hours/Week. Rounds-Up to 30. Didactic conferences-4-5. Independent learning-Unlimited. Research project-If desired. Independent patient care-Up to 20-30 hours in clinic. Jillian McIntosh-Carnes; jill.mcintoshcarnes@unmc.edu; 402-559-6422; MSB (Zip 2055).

Typically Offered: Each four weeks.

Capacity: 1.

Visiting Student Information: Visiting Students are not to contact faculty or clinical departments prior to acceptance through VSLO. Doing so is considered a professional breach and may disqualify the student from being offered a rotation.

IMED 733 PULMONARY MEDICINE 4 Credit Hours

ELECTIVE

Objectives: Outline the daily impatient care of a patient with pulmonary diseases. Evaluate and outline management of a patient with COPD exacerbation. Outline the work-up of a patient presenting with interstitial lung disease. Describe the evaluation of the level of control of asthma. Evaluate and outline management of a patient with chronic cough. This elective is designed to provide the student with a practical background in Pulmonary Medicine. The students on the service will evaluate hospitalized pulmonary patients with the Pulmonary Consult Team; perform inpatient pulmonary consultations and evaluate patients in the UNMC Pulmonary Clinic. The course includes experience in the management of both simple and complex pulmonary problems, including primary care of cystic fibrosis, pulmonary hypertension and lung transplant patients. The students will review interpretation of chest imaging and pulmonary function tests. Didactic lectures are scheduled at 11:00 a.m. on a broad range of Pulmonary topics. Honors work will Activity-Hours/Week. Rounds-12. Didactic conferences-2 or 3. Independent learning-Pre-andPost-test, approximately 3 hours. Research project-None. Independent patient care-Not expected. Procedures-Based on student interest and competency. Where to Report: University Tower UT 5216, Respiratory Care Services Conf. Room, 9:00 a.m. Contact Person: Chelsea Hug, 402-559-4087.

Instructor: Dr. Hershberger and staff.

Typically Offered: Each four weeks.

Capacity: 2.

Visiting Student Information: Visiting Students are not to contact faculty or clinical departments prior to acceptance through VSLO. Doing so is considered a professional breach and may disqualify the student from being offered a rotation.

IMED 734 UNMC CRITICAL CARE MEDICINE 4 Credit Hours

ELECTIVE

Objectives: Evaluate and assist in management of patients with acute presentations of common medical problems. Describe ventilator changes required for patients on mechanical ventilation based on ABG interpretation. Define the various types of shock and describe their management. Categorize the variety of vasoactive medications and their use in clinical situations. This rotation offers opportunity for management of critically ill patients, working closely with pulmonary and critical care fellows and attending physicians. Clinical expectations will include responsibility for all patients assigned to their care (Expectation of 2 patients per day), writing a student progress note each day on their patients to be cosigned by the attending physician and to actively participate on rounds. Clinical situations encountered on this rotation include management of shock, respiratory failure, renal failure, liver failure, gastrointestinal bleeding, pulmonary embolism and hyperglycemia among others. Students may also have an opportunity to assist in the care of patients with acute stroke, subarachnoid hemorrhage and septic shock. The students will be expected to learn interpretation of chest radiographs and common dysrhythmias. They will participate in many bedside procedures. Students will be expected to be able to evaluate and recognize patients with a variety of life threatening disorders and participate in their management. There are three Critical Care Medicine teams, each with an attending, a critical care fellow, as well as a mix of residents and physician extenders. Each team provides a different experience and students will be assigned based on availability and student interest. Students will rotate on the three teams. Honors work will require enthusiasm and initiative, as well as student a presentation to the CCM team of a clinical topic chosen by the student. This ICU rotation is appropriate for a motivated student seeking a high level of intensity of exposure to critical care medicine. Activity Hours/Week Activity-Hours/Week. Rounds-20. Didactic conferences-8. Independent learning-Review literature related to patient problems. Research project-None. Independent patient care-Not expected. Procedures-Based on Student Interests and Competency. Where to Report: MICU Conference Room 5th Floor University Tower, 9 a.m. Contact Person: CCM Fellow on-Perfect Serve, 402-888-7000.

Instructor: Dr. Hershberger and the Critical Care Medicine Staff.

Contact: Jillian McIntosh-Carnes; jill.mcintoshcarnes@unmc.edu; 402-559-6422; MSB (Zip 2055).

Typically Offered: Each four weeks.

Capacity: 5 (2 on Blue and White, 1 on Red).

Visiting Student Information: Visiting Students are not to contact faculty or clinical departments prior to acceptance through VSLO. Doing so is considered a professional breach and may disqualify the student from being offered a rotation.

IMED 735 HONORS PROGRAM IN INTERNAL MEDICINE (UNMC OR OVAH) 4 Credit Hours

ELECTIVE

This is a one-on-one comprehensive review of Internal Medicine. Each day the student will meet with the Chief Resident to review pertinent Internal Medicine topics. A typical day would consist of attending and participating in morning report, giving a brief presentation on the morning report topic to the residents, and meeting with the team for informal discussion. Once the Chief finds out the case for the day, the information will be passed on to the student to start to work on the next day's presentation. Additional educational opportunities may include journal articles and presentations to the chief. These topics are at the discretion of the student and the Chief Resident. They will be customized to meet the students' educational objectives. The student will also be responsible for attending morning report, noon conferences and Grand Rounds. Activity-Hours/Week. Rounds-0. Didactic conferences-20. Independent learning-20. Research project-0. Independent patient care-0.

Prerequisite:  Internal Medicine Clerkship with a grade of Honors grade or prior approval.

Instructor: Internal Medicine Chief Residents.

Contact: Jillian McIntosh-Carnes; jill.mcintoshcarnes@unmc.edu; 402-559-6422.

Typically Offered: Varies with pre-approval ONLY.

Capacity: 1 per rotation.

Visiting Student Information: This course is NOT available to visiting students.

IMED 736 ALLERGY & IMMUNOLOGY 4 Credit Hours

ELECTIVE

Allergy and immunology is a unique field in medicine that allows providers to see patients of all ages after receiving training in internal medicine, pediatrics or med-peds and then fellowship in allergy and immunology. During this elective, the student will be exposed to this unique population with a wide array of patients at various clinical locations leading to a very diverse experience in patient care. Each student will work directly with four faculty members that have differing areas of expertise in allergic diseases at three different clinical sites within Nebraska Medicine. The student will learn to evaluate, diagnose and treat common allergic diseases such as rhinitis, asthma, eczema and food allergy. These are common complaints for patients and a good foundation of knowledge in treating these diseases becomes quite helpful in all areas of medicine. In addition, the student will become familiar with the assessment and treatment options of other diseases such as urticaria, angioedema, anaphylaxis and occasionally immunodeficiency in addition to many other diseases. During the rotation, the student will be actively engaged in seeing patients in clinic and forming his or her own assessment and treatment plan. In addition, he or she will participate in allergy division lectures and present a short lecture to the allergy faculty at the end of the rotation. Evaluation of the student will be provided by all four faculty members. Activity Hours per Week Rounds-0-1. Clinic-35-40. Didactic conferences-2. Independent learning-4. Research project-NA. Independent patient care-NA.

Instructor: Dr. May.

Contact: Whitney Dailey, 402-559-4088.

Typically Offered: Each four weeks.

Capacity: 1 per rotation.

Visiting Student Information: Do NOT contact any faculty or clinical department prior to your acceptance for a rotation through VSLO. Doing so is considered a professionalism breach and may disqualify you from doing rotations at UNMC.

IMED 743 CO-MANAGEMENT MEDICINE 4 Credit Hours

ELECTIVE

This rotation provides an immersive opportunity for senior medical students to learn the principles of safe and effective perioperative medical care of neurosurgical and orthopedic surgery patients. The student will gain an understanding of pre-operative medicine, perioperative complications, and the impact of medical conditions on rehabilitation. Students will perform preoperative HPs with a focus on risk stratification in the pre-anesthesia clinic and care for post-surgical patients on the inpatient units. Lectures covering consultative medicine, perioperative medicine, and hospital medicine topics will be presented and a self-directed e-learning module will be assigned. Activity-Hours/Week. Rounds-10. Didactic conferences-6. Independent learning-10. Research project-0. Independent patient care-12 (clinic and inpatient). Where to Report: Will receive orientation email from Nicolle Peterson; contact via email, nicolle.peterson@unmc.edu, 402-552-9697.

Instructor: Drs. Nicolle Peterson, Jason Shiffermiller, and Trek Langenhan

Contact: Jillian McIntosh-Carnes; jill.mcintoshcarnes@unmc.edu; 402-559-6422; MSB (Zip 2055).

Typically Offered: March - June (additional dates may be available at a later time, please contact Jill McIntosh-Carnes for more information).

Capacity: 1.

Visiting Student Information: This course is NOT available to visiting students.

IMED 744 GERIATRIC MEDICINE 4 Credit Hours

ELECTIVE

This course is designed for students who anticipate careers in primary care and those whose careers will involve substantial outpatient responsibilities (most Internal Medicine subspecialties, neurology, psychiatry, physiatry, hospice and palliative care). Under health care reform an increasing proportion of care is occurring in outpatient settings, and individuals completing this experience will have a jumpstart on the necessary skills to thrive in outpatient care settings during residency. The medical knowledge conveyed through didactic and clinical experiences focuses on chronic disease management, team care, and health promotion. The faculty teaching and supervising this course are drawn from geriatrics and from hospice and palliative care. The venues of care are the following: Home Based Primary Care, Hospital and Palliative Care, Skilled Nursing Facility / Long Term Care, Geriatric Assessment and Primary Care Clinics and primary Care Medicine Home. Activity Hours per week: Outpatient Clinics-30. Nursing home rounds/home visits-5, Didactic conferences-3. Independent learning (Readings/Scholarly project)-2.

Instructor: Dr. Jane Potter and staff.

Contact: Travis Weyant; tweyant@unmc.edu; 402-559-3964.

Typically Offered: Each four weeks.

Capacity: Variable.

Visiting Student Information: Visiting Students are not to contact faculty or clinical departments prior to acceptance through VSLO. Doing so is considered a professional breach and may disqualify the student from being offered a rotation.

IMED 749 FIELD EPIDEMIOLOGY AT CEDAR POINT 4 Credit Hours

ELECTIVE

Practicing evidence-based medicine requires familiarity with the basic principles of epidemiology. This three-week summer course allows students to develop a background in these principles, using as its classroom the prairies, ponds, and fields of western Nebraska. Students engage in observation and experimentation while enjoying the beautiful natural setting of UNL's Cedar Point Biological Field Station, located near Ogallala and Lake McConaughy. Collecting trips, laboratory experiments and a group project offer unique, out-of-the-classroom learning opportunities. Visit http://darwin.unmc.edu/fieldepi for more information about this course and the facilities at Cedar Point. Students will need to obtain a copy of the required text (Epidemiology by Leon Gordis, fourth or fifth editions) prior to the rotation. Students will develop an understanding of the epidemiological and biostatistical principles traditionally taught in an introductory-level epidemiology course. Students will develop skills in collection, dissection and laboratory experimentation. Students will develop an understanding of how classroom principles can be translated into real-world observation and experimentation. Instructional methods will include lecture, independent reading, field collection and observation trips and laboratory experiments. Computer-based methods may be included as well. Structured class time occurs Monday through Friday. Over the time period, roughly one-third of class time will be spent in lecture format and two-thirds in field/lab exercises. Evening reading assignments will be provided for most days. Student performance will be assessed using daily quizzes over assigned reading, class/lab participation, and a final group project.

Prerequisite:  This elective is pre-arranged through Dr. Nickol in the Department of Internal Medicine.

Contact: Dr. Devin Nickol.

Typically Offered: TBA.

Capacity: Variable.

Visiting Student Information: This course is NOT available to visiting students.

IMED 751 RHEUMATOLOGY 4 Credit Hours

ELECTIVE

This course may have additional credentialing requirements for the Omaha Veteran's Affairs Hospital. This is primarily an outpatient rotation, but students will also participate in the inpatient consult educational activities. There are no student call requirements. Students will see patients in faculty ambulatory clinics at UNMC and the VA Hospital's Ambulatory Care Clinic. Our educational focus is on the diagnosis and management of rheumatic disease in a diverse mix of adult patients. Common diseases encountered are rheumatoid arthritis, osteoarthritis, lupus, myositis, scleroderma, gout and vasculitis. Students are required to participate in didactic lectures and case conferences. Activity-Hours/Week. Rounds-6. Clinic-28. Didactic conferences-8. Research project-NA.

Instructor: Drs. O'Dell, Mikuls, Cannella, Erickson, Mahajan, England, Snow, Feely, Medlin, Helget, Brittan, Thiele, and Michaud.

Contact: Jillian McIntosh-Carnes; jill.mcintoshcarnes@unmc.edu; 402-559-6422; MSB (Zip 2055).

Typically Offered: Each four weeks.

Capacity: 2.

Visiting Student Information: This course is NOT available to visiting students.

IMED 760 OFF CAMPUS ELECTIVE 4 Credit Hours

ELECTIVE

Clerkships in universities or teaching hospitals elsewhere sponsored by a member of the Department of Internal medicine and in which the instructor directing the elective is not a member of our faculty. Appropriate off-campus electives are those providing opportunities in areas in which we have no comparable programs or in which the university cannot accommodate the number of students desiring the course. An Off-Campus Elective Application form must be submitted for this experience. (See Off-Campus Elective Application procedures).

Prerequisite:  Off-Campus Approval form completed. Approval from Dr. Rae Witt.

Contact: Jillian McIntosh-Carnes; jill.mcintoshcarnes@unmc.edu; 402-559-6422.

Typically Offered: Each four weeks.

Capacity: By arrangement. Location: Variable.

Visiting Student Information: This course is NOT available to visiting students.

IMED 763 VA EMERGENCY MEDICINE 4 Credit Hours

ELECTIVE

This course may have additional credentialing requirements for the Omaha Veteran's Affairs Hospital. Patients are assigned to students and residents on a rotational basis according to when they arrive in the department. Patients will be a mix of ambulatory patients, ambulance arrivals and clearance of both the acute psychiatric patient and the patient wishing to undergo substance abuse treatment. There will be a wide variety of medical conditions seen including acute cardiac, pulmonary, gastrointestinal, neurological, and infectious disease. There will also be potential for many procedures including ABG's, arthrocentresis, paracentesis, thoracentesis, and central lines.

Prerequisite:  Pre-arranged with Dr. Menolascino and Jill McIntosh-Carnes.

Instructor: Dr. Menolascino.

Contact: Dr. Scott Menolascino, 402-995-5217, scott.menolascino@va.gov.

Typically Offered: Each four weeks.

Capacity: By arrangement.

Visiting Student Information: This course is NOT available to visiting students.

IMED 766 SUBINTERNSHIP-VA 4 Credit Hours

ELECTIVE

This course may have additional credentialing requirements for the Omaha Veteran's Affairs Hospital. Spots are extremely limited and essentially not available from July-December because they are reserved for students in the Primary Care Program. This clerkship offers an excellent opportunity for senior medical students to assume primary responsibility for the management of 4-8 general medicine patients. The student will admit, evaluate, manage and discharge typical medicine patients, all supervised directly by a senior medical resident and an attending physician. Admissions to the sub intern will be limited and the student will be expected to take 3-4 nights of in-house call during the month. Activity-Hours/Week. Rounds-50-60. Didactic conferences-Daily. Independent learning-Many opportunities. Research project-Variable. Independent patient care-Variable. Where to Report: Information will be sent out prior to the start of the rotation. Contact Person: Jill McIntosh-Carnes, 402-559-6422.

Instructor: OVAH Internal Medicine Chief Residency, Faculty, and Staff.

Contact: Jillian McIntosh-Carnes; jill.mcintoshcarnes@unmc.edu; 402-559-6422.

Typically Offered: Each four weeks.

Capacity: 3. Location: VA Hospital.

Visiting Student Information: This course is NOT available to visiting students.

IMED 766A SUBINTERNSHIP-UNMC 4 Credit Hours

ELECTIVE

This clerkship offers an excellent opportunity for senior medical students to assume primary responsibility for the management of 3-6 general medicine patients. The student will admit, evaluate, manage and discharge typical medicine patients, all supervised directly by a senior medical resident and an attending physician. Admissions to the sub intern will be limited and the student will be expected to take 2-3 nights of in-house call during the month. The student will also be responsible for attending morning teaching rounds, noon conferences, and Internal Medicine Grand Rounds during the time of the rotation. Activity-Hours/Week. Rounds-20. Didactic conferences-10. Independent learning-0. Research project-0. Independent patient care-30. Where to Report: Information will be sent out prior to the start of the rotation.

Contact: Jillian McIntosh-Carnes;jill.mcintoshcarnes@unmc.edu; 402-559-6422.

Typically Offered: Each four weeks.

Capacity: 7. (5-Meyer Team, 2-Tower-based teams, months could be limited for TBR Teams.)

Visiting Student Information: Do NOT contact any faculty or clinical department prior to your acceptance for a rotation through VSLO. Doing so is considered a professionalism breach and may disqualify you from doing rotations at UNMC.

IMED 767 AMBULATORY INTERNAL MEDICINE SUB-INTERNSHIP 4 Credit Hours

ELECTIVE

Internal Medicine: This rotation will give senior medical students the opportunity to assume increased responsibility and autonomy in the care of patients in the general internal medicine ambulatory setting compared to the Phase 2 experience. Each student will be paired with 1-2 clinical preceptors throughout the rotation and will be expected to attend 6-7 half-days of clinic per week with a possible extra half day each week dedicated to extracurricular ambulatory experiences. Students will provide acute and chronic care, pre-operative care, preventive care, and follow-up care to 2-4 patients per clinic session. Students will have progressive responsibility throughout the month. Med-Peds: This rotation gives senior medical students the opportunity to assume more responsibility and autonomy in the care of patients in the general internal medicine and pediatric ambulatory setting. Each student will rotate with multiple med-peds and pediatric clinical preceptors at the Nebraska Medicine Fontenelle Clinic and Elkhorn clinic. The student will be expected to attend 6-7 half-days of clinic per week with a possible extra half day each week dedicated to extracurricular ambulatory experiences. Students will have the opportunity to learn and practice acute and chronic care management and preventative care for both adult and pediatric patients. They will see patients, write notes and make follow-up calls under staff guidance pertinent to their patient. Students also are asked to do a 30-45min presentation at the end of the rotation regarding a Med-Peds ambulatory topic of their choosing. Available Times Each four weeks.

Instructor: Rae Witt, M.D.

Contact: Jill McIntosh-Carnes jill.mcintoshcarnes@unmc.edu 402-559-6422.

Typically Offered: FALL/SPR

Capacity: 2 (1 Internal Medicine, 1 Med-Peds).

Visiting Student Information: This course is NOT available to visiting students.

IMED 798 RSCH IN INFECTIOUS DIS 4 Credit Hours

ELECTIVE

This elective offers students the opportunity to work with faculty members in the Division of Infectious Diseases on a range of research projects. There are numerous projects available in the areas of HIV/AIDS, Transplant ID, Oncology ID, Antimicrobial Stewardship, Healthcare Epidemiology, Orthopedic ID, Microbiology, and many other areas. Any infectious disease related project will be considered under the direction of an ID staff physician. Students interested in this rotation must contact and have the approval of an ID faculty member who will serve as a mentor. Activity-Hours/Week. Rounds-0. Didactic conferences-0. Independent learning-0. Research project-40. Independent patient care-0. Where to Report: Infectious Diseases Secretary, 402-559-8650. Contact Person: Dr. Trevor Van Schooneveld, tvanscho@unmc.edu.

Instructor: Drs. Rupp, Swindells, Kalil, Freifeld, A. Hewlett, Van Schooneveld, Florescu, Bares, Zimmer, Cawcutt, and Ashraf.

Contact: Jillian McIntosh-Carnes; jill.mcintoshcarnes@unmc.edu; 402-559-6422..

Typically Offered: Each four weeks.

Capacity: Variable.

Visiting Student Information: This course is NOT available to visiting students.

IMED 799 RESEARCH IN MEDICINE 4-6 Credit Hours

ELECTIVE

This elective offers students the opportunity to work with faculty members in the Department of Internal Medicine. Students interested in this rotation must contact and have the approval of an IMED faculty member who will serve as a mentor.

Prerequisite:  Pre-Arranged with an Advisor.

Instructor: Variable.

Contact: Jillian McIntosh-Carnes; jill.mcintoshcarnes@unmc.edu; 402-559-6422.

Typically Offered: Each four weeks.

Capacity: By arrangement.

Visiting Student Information: This course is NOT available to visiting students.