Medical Program
Course Descriptions

Basic Sciences:
Anatomical Sciences
Behavioral Sciences
Biochemistry and Genetics
Bioethics
Clinical Skills
Microbiology
Pathology
Pathophysiology
Pharmacology
Physiology and Neuroscience
Public Health and Preventive Medicine
Selectives
Clinical Years

 

The medical program curriculum is divided into two segments, the Basic Medical Sciences and the Clinical Years.

Basic Sciences Courses
The following descriptions are overviews of the Basic Medical Sciences courses. The subject matter and course objectives will continually change to reflect advances and new directions within the discipline, as well as growth and new dimensions within the faculty and academic community of the School.

Anatomical Sciences

Marios Loukas, MD, PhD, Chair

Histology and Cell Biology
ANAT 531
This course presents the structure and function of the human body as revealed by light and electron microscopy, as well as cell biological techniques, such as immunocytochemistry. The course commences with a discussion of the cell and its internal structures. Students are introduced to the concepts of how cells interact with each other and their external environment. Cell signaling, cell secretion, the cell cycle, and the extracellular matrix are some of the topics presented in the analysis of cell structure and function.

Students’ mastery of cell structure and function leads to the organization of cells into the four basic tissues of the body. Each of these is presented with emphasis on the role of cells in tissue organization and function. The cellular nature of the tissues and the interactions of cells with the extracellular matrix are stressed so that students have a firm understanding of the concept of a histological tissue. An understanding of the four basic tissues is paramount to students becoming complete and modern physicians.

The basic tissues of the body are then arranged into the organs and organ systems. Once again, the cellular aspects of organ structure and function are emphasized because cells in the various organs are the main contributors to the function of those organs.

The emphasis on the cell in histology and cell biology cannot be overly stressed since all diseases occur at the cellular level. Thus, students must understand the basic science of the cell and its mechanisms before they can understand how pathologies work. In addition, cell structure and function as presented in this course serves as preparation for the elaboration of these concepts in the physiology and pharmacology courses, and will prepare students to be lifelong learners of medicine.

The students are taught learning skills and gain knowledge about information that is an absolute necessity for the modern physician.

Human Gross and Developmental Anatomy
ANAT 550
The course in human gross and developmental anatomy consists of approximately 160 scheduled class hours devoted to cultivating an appreciation of a three-dimensional visual image of the human body and its development.

Formal lectures present integrated general and applied anatomy, imaging, clinical anatomy, developmental anatomy, and clinical embryology. Specific objectives are provided to facilitate learning, in addition to reading the required text and anatomical atlas. All lectures and laboratory sessions are available through the University website on ANGEL, which also provides online testing. Both midterm and final examinations are in a USMLE board format.

• Laboratory Exercises
  Study of the cadaver is achieved through prosected cadaveric specimens and follows a traditional sequence of the back, upper extremity, thorax, and abdomen prior to midterm. The sequence continues with the pelvis, perineum, lower extremity, head, and neck for the final examination. Instructions for studying the prosections are given in a prosection manual. Small groups of no more than four students are rotated through several prosected specimens with the guidance of faculty.
• Small Group Discussion
  The Human Gross and Developmental Anatomy course is further highlighted by several two-hour small group discussion sessions. With the guidance of clinical tutors, small groups of no more than eight students per group have the opportunity to learn the initial steps of physical examination, such as inspection, percussion, auscultation, and so forth, through a problem-based environment. In addition, relevant core clinical cases are presented to the students in order to facilitate basic interpretation of clinical anatomy, congenital defects, contemporary imaging, professional competencies, team-based interpersonal skills, and research articles. The course is specifically designed to enhance clinical integration of Basic Sciences material.

Behavioral Sciences

David L. Brown, MD, PhD, Co-Chair
John P. Pettus, PhD, Co-Chair
In addition to the courses listed below, the Behavioral Sciences Department routinely teaches the course, Directed Study in Data Analysis (BEHS 818), which is listed in the Graduate Course Descriptions.

MODULE: Behavioral Sciences and Medicine
BEHS 640
The course introduces students to the fundamental principles of human behavior and development, with particular emphasis upon the role of behavior within the context of illness and the medical encounter. Theories contributing to the understanding of normal human development and psychopathology are examined.

An overview of several major psychological theories of human behavior is provided, including psychodynamic, behavioral, cognitive, and biological models. Exposition of these systems leads to discussion of a number of topics, including systems of psychotherapy, behavior modification, biological/genetic bases of behavior, psychological assessment, complementary/alternative treatment approaches, and psychopharmacological intervention. An evidence-based approach is adopted in assessing treatment effectiveness, and data supporting the importance of a biopsychosocial approach to patient care is presented.

There is an emphasis upon behavioral medicine/health psychology and the role of cognitive/behavioral approaches in the modification of risky health behavior. Special attention is given to the crucial role of cultural factors within the doctor-patient encounter and health care setting, as well as to the importance of cultural competence in the provision of medical care. The role of the family is noted within this context, and life-disrupting disorders, such as substance abuse, domestic violence, and child abuse are discussed with reference to the physician’s role and responsibility, in terms of detection and intervention.

An additional theme of the course relates to the importance of preventive medicine. To develop this concept, students participate in lectures and group exercises in biostatistics, epidemiology, and health systems. Within the small group setting, students apply the tools of biostatistics and epidemiology to selected public health problems, with an emphasis on the goal of reading the medical literature critically. How behavior, environment, and politics influence health in different societies is also considered----an international comparison of the health systems of several countries is provided and factors underlying existing disparities in health care are explored. Current issues of health care financing and delivery are discussed, along with the important changes in insurance systems, cost containment, and different types of medical practice.

Finally, the fundamental concepts of law that relate to the medical profession are covered in this course. The concerns of society in the legislative, judicial, and administrative regulation of medical practice are emphasized. An overview is provided of the current and probable future expansion of society’s role in the regulation of medical practice of medicine. The basic principles of malpractice are discussed, in addition to topics, such as informed consent, medical ethics, and confidentiality. The course surveys the history of medical ethics and compares the major perspectives on such issues as the conflicts between different types of benefits to patients, the duties of a physician, patient autonomy, termination of pregnancy, end-of-life decisions, social ethics, and rationing of services. This course comprises the third component of the “Medicine in Society” course series.

Biochemistry and Genetics

John Davidson, PhD, Chair

Medical Biochemistry
BCHM 550
The Medical Biochemistry course is planned to provide students with a working knowledge, which they can use as practicing physicians to provide the biochemical basis for understanding the subsequent courses in the medical curriculum and to enable students to pass the USMLE and BSCE examinations. The first half of the course provides a background for understanding acid-base relations, structure, and function of macromolecules, the role of enzymes, and introduction to metabolism and genetics. The mechanisms of biochemical reactions involved in energy production, biosynthesis, and degradation, with attention being given to their roles in disease, are also discussed. In this half of the term, metabolism of carbohydrates and lipids and their correlation is discussed. There is emphasis on the key enzymes and regulatory steps in metabolic pathways, which are important in understanding the regulation of metabolic pathways in different physiological and pathological situations. Hormonal regulation of energy metabolism in the fed and fasting state is discussed. In the second half of the term, nitrogen metabolism is discussed. This half of the term is dominated by integrative and clinical subjects. We present and explore the biochemical roles of the major organs of the body together with an overview of the metabolic interplay between organs. Principles of energy balance, as well as the role of vitamins and minerals in maintaining good health are introduced. Many topics of clinical significance are discussed like coagulation, plasma proteins, jaundice, porphyries, diabetes, obesity, membrane diseases, under-nutrition, and clinical acid-base disorders.

In the second half of the term, students study a block of molecular biology lectures, which include structure, function, biosynthesis of RNA and DNA, protein biosynthesis, gene expression, introduction to genomics, and the use of molecular genetics in medicine. This ensures that all students have an understanding of the basic concepts and techniques of molecular biology, to be able to fully participate in the genetic-based medicine of the new millennium. Students will also participate in small group discussions, which are based on a paper clinical case. These sessions are facilitated by students with background in biochemistry or who are high achievers on the midterm exam. The groups are supervised by faculty members.

The Biochemistry course is a well-balanced course which teaches the science of biochemistry in a clinical and physiological context and addresses the needs of medical students in the 21st century.

Medical Genetics
BCHM 590
This course reviews basic genetics and its application to the study of inherited disorders. It begins with a study of the chromosomes and the disorders that result from their aberrations. Exploration of Mendelian and polygenic inheritance follows, illustrated by representatives of the major heritable disorders of man. There is coverage of molecular and clinical genetics, including prenatal diagnosis and genetic screening. The course concludes with introductions to growth points in modern genetics, cancer genetics, gene therapy, and the Human Genome Project.

Bioethics

Cheryl Macpherson, PhD, Chair
Our Bioethics Department is charged with centralizing and strengthening training in ethical and professional thought and action. This department offers programs and courses to stimulate critical thinking and ethical discourse across disciplines, facilitate academic exchange, and contribute to professional development of students, faculty, visiting scholars, and Caribbean health professionals.

The department contributes to the White Coat Ceremony, organizes lecture series, conducts Institutional Review Board training, and coordinates the development of professionalism on campus through the SGU Professionalism Panel and its associated professionalism committees.

Bioethics and the Professional: Medicine in Society I
BIOE 501
This course aims to strengthen students’ ability to recognize and critically analyze ethical concerns in medical situations. It provides opportunities to develop professional competencies and skills. Students will begin to access credible information (medical informatics), formulate and express reasoned opinions, manage uncertainty, and communicate collegially.

Bioethics is a discipline grounded in the reasoning and objectivity necessary to beneficial health outcomes and patient satisfaction. It provides structure and tools with which to address the numerous moral conflicts in medicine. Bioethical concepts and terminology introduced in the course center on professionalism, principles, and theories, which are applied to patient scenarios and current medical controversies.

Interactive participation occurs through group discussions, online activities, and during lectures. The course encourages students to monitor their own professional development. It is anticipated that passing this course will motivate and enable students to reflect on their own professional competencies and duties as these evolve during different stages of their medical education.

Clinical Skills

Winston Mitchell, MBBS, Chair

Communication Skills and Physical Diagnosis
CLSK 653
This course instructs students in communication skills that they will need as medical students and physicians in order to relate to senior physicians, colleagues, patients and their families, and other health care professionals. The course prepares students for their role in addressing the common problems found in delivering health care, for example, providing health care instruction and delivering “bad news.” Students will develop both oral and written communication skills and learn the components of the standard history and the art of presenting cases. The physical diagnosis portion builds on the clinical skills learned in the first year of the four-year MD program. The course uses both lectures and laboratory sessions to teach physical examination skills. The laboratory groups consist of small groups of students. The techniques of physical examination are taught by videotape demonstration, live demonstration, and supervised practice on fellow students.

Introduction to Clinical Medicine
CLSK 654/CLSK 655
This course teaches students in small groups at the hospital or an outpatient setting, as well as on campus using volunteer patients. The overall objective of the Introduction to Clinical Medicine course is to ensure that students understand the process of taking histories, conducting physical examinations on patients, and organizing their findings into a written or oral presentation. Students should develop sufficient interpersonal and clinical skills in this course in order to integrate rapidly into the clinical hospital setting when they start their clinical terms. This course requires students to develop clinical thought processes leading to the art and science of problem solving in clinical medicine.

Microbiology

David Lennon, PhD

Medical Microbiology
MICR 570
The microbiology and pathology courses are presented simultaneously and are closely integrated with each other. Microbiology appears as a balanced combination of formal classroom instruction, practical laboratory experience, and case-based exercises. The didactic portion is divided into two consecutive sections. The first of these covers the basic principles of microbiology, including classification and taxonomy, microbial physiology and genetics, genetic engineering, control of microorganisms through the use of physical and chemical agents, antibiotics, host-parasite relationships, and epidemiological concepts. Bacterial, fungal, and viral infectious organisms are all represented in this series.

In the second section, the pathogens are discussed according to the human organ system, where they most often cause clinical disease. Clinical vignettes are used to illustrate the epidemiology, pathogenesis, virulence properties, symptoms, laboratory diagnosis, and therapy of the various agents. The presentation is coordinated with the concurrent pathology course so that the organ systems are dealt with in a fully integrated fashion. After each organ system, representative cases are presented by a practicing clinician to anchor a comprehensive understanding of the pathogenesis and disease.

Laboratory
During the laboratory sessions, students gain problem-solving experience with pathogenic microorganisms. The laboratory work includes the practical application of staining techniques, antisepsis and disinfection, and isolation and identification of infectious agents from clinical specimens along with the determination of appropriate chemotherapeutic agents. Additionally, students are given a case history along with a relevant clinical specimen, and from these they isolate and identify the microorganism, perform antibiotic sensitivity tests, and report their results. Case-based instruction founded on medical vignettes of infectious disease is considered in small-group discussions several times each term. Near the end of the laboratory portion of the course, clinical conferences are presented by visiting infectious disease specialists. Computer-assisted case presentations are used throughout the laboratory portion of the course.

Students who engage in approved research programs under the supervision of the staff can gain an elective in research microbiology, and one or two academic credits per term. Registration requirements for this course are determined by the instructor. At the present time, research is being conducted in the area of antibiotic-resistant microorganisms, microorganisms in the local environment, and epidemiological studies in bacteriology, virology, and parasitology. The average amount of work required per one credit hour is based on attitude, quality of work, reliability, technique, adherence to laboratory protocol, effort, and results.

Medical Immunology
MICR 580
This course is designed to provide students with an understanding of the major principles and mechanisms underlying the elements of the immune system. There is an emphasis on the interaction between innate and acquired immunity in the response to infection, mechanisms by which immunological compartments interact, and clinically related topics are also emphasized. In addition to classroom instruction, students spend ten hours solving patient-oriented clinical simulations, including small-group discussions.

Medical Parasitology
MICR 660
Emphasis is balanced between parasitic infections that frequent the tropics and those that are being increasingly recognized in the temperate zones. Approximately half of the course deals with medical protozoology, including the amoebas, flagellates, ciliates, and sporozoa that are capable of infecting living human tissue. The second part of the course covers medical helminthology (the Nematoda, Platyhelminthes, and Acanthocephala). Arthropods of medical significance are also discussed. Presentations of the various organisms emphasize the epidemiology, symptomatology, pathogenesis, laboratory diagnosis, and treatment of each.

Laboratory
Lectures are supplemented by laboratory sessions that include stool examinations for ova and cysts of parasites. Slide presentations are used extensively in the consideration of all the parasites.

Pathology

Shivayogi Bhusnurmath, MD, FRCPath, Chair

Pathology
PATH 640
The Pathology course is taught in two segments—General Pathology and Systemic Pathology. The main emphasis of the course is on active learning by students based on clinically oriented lectures and daily clinical problem solving by students in groups of ten during lab hours. This is accomplished by targeted discussions using pathology images (about 400) representing patients and clinical vignettes with built-in questions. The images are posted on the University website and made available to students. Periodically, gross specimens and glass slides from current hospital material are also discussed. The discussions are closely monitored by the faculty and students are evaluated on a daily basis.

The General Pathology segment deals with how tissues respond to injury, cell death, inflammation, ischemia, thrombosis, embolism, infarction, and so forth. It also deals with response to infections, environmental pollutants, and disease states related to abnormal immune responses. Mechanisms of tumor development and how tumors spread are studied under “neoplasia.” This is followed by a special course on Molecular Pathology techniques as applied to clinical practice.

The Systemic Pathology segment involves similar principles but applied in detail to individual organ systems like cardiovascular, respiratory, and so forth. It will also include interpretation of laboratory data for some of the major disease processes. A short course on Forensic Pathology is taught in the Systemic Pathology module. Several clinicopathological conferences, including difficult case seminars, are also discussed by students.

Students are mandated to draw concept maps each week and submit them for evaluation. A total of 480 test items are administered through three quizzes and three exams, including 105 based on images. All the questions are clinical problem-solving MCQs.

Laboratory
The lab sessions are conducted as group activities in student groups of 10 to 12 monitored by a clinical tutor. The students discuss gross and microscopic pathology images, electron micrographs, radiographic images, and clinical cases, which correlate with the concurrent lecture manual. The process involves active learning with guided discovery of etiology, pathogenesis, structural changes, clinical symptoms and signs, relevant investigations, and course of the disease for the common and prototype diseases. The students are also encouraged to learn how to distinguish between related entities.

Medical Nutrition
PATH 693
Medical Nutrition focuses on the relevance of nutrition in the prevention and treatment of disease. Presented in this course are those components of human pathophysiology in which diet on the basis of current knowledge is believed to be important in either a causative or contributory way. The application of dietary knowledge to prevention of disease and the management of established disease are also discussed. Also addressed are clinical topics such as infant, maternal, and geriatric nutrition; problems of obesity and related subjects; and the principles of the management of diseases such as diabetes mellitus, renal failure, and atherosclerosis.

Pathophysiology

Shivayogi R. Bhusnurmath, MD, FRCPath, Interim Chair

Pathophysiology I/Pathophysiology II
PATH 670/PATH 674
Pathophysiology I and II are amalgamated into 18 uninterrupted weeks of study. The objectives of the courses are structured to explore why and how diseases occur, as well as to develop students’ deductive reasoning and synthesis of information skills. Understanding the process by which one approaches disease(s), arrives at a diagnosis based upon clinical information, and then applies this information to the institution of appropriate therapeutic interventions is the major goal. By presenting the course concomitantly with Pharmacology and Introduction to Clinical Medicine in an integrated fashion, the goals and objectives of the course are achieved. This integration is further achieved by the presentation of the “case of the week.” The “cases” are prepared by the department faculty with the assistance of visiting professors. Students meet in small groups to discuss specific questions relative to each case. The lectures include discussions on several clinical vignettes, which provide a basis for exploring the basic science concepts to explain symptoms, signs, investigations, and complications. In addition, about 50 USMLE Step 1-type questions are provided online as test and study material on the topics of the week.

The courses are divided into three six-week sections with an examination at the end of each section. An organ systems (cardiology, pulmonology, gastroenterology, nephrology, hematology, endocrinology, dermatology, neurology, and ophthalmology) and interdisciplinary (clinical immunology, rheumatology, infectious diseases, psychiatry, pediatrics, obstetrics and gynecology, sexuality, clinical nutrition, and
oncology) approach is used. Lectures are delivered by visiting professors or full-time faculty who are outstanding clinicians/academicians in their fields. These lectures present a cohesive pathophysiology course, which is preparatory to students’ entry into the Clinical Years.

Basic Science Foundation for Clinical Reasoning
PATH 675/PATH 676
Student should be able to recapitulate the important basic science concepts using clinical vignettes. It is a two-credit course with two lecture hour sessions usually on Fridays. The lecture hour sessions will be in the format of modified term-based learning. Students will be seated in groups of 12 to 14. Each group will be provided with a different clinical vignette related to the topics taught in the pathophysiology course that week. A number of basic science-related questions will be linked to the vignettes. The student groups get 10 to 12 minutes to discuss and find answers to the questions. At the end of that time, the plenary session will start. One by one, each vignette and the related questions are projected. The concerned group will respond with the answers. The rest of the class can then join in with any other relevant comments/disagreements. These sessions will be supplemented by online tasks in the form of MCQs or a similar format that the students will do under supervision. This course should enable the students to actively learn the application of Basic Sciences in the analysis and problem solving of clinical vignettes.

Pharmacology

Andreas Reymann, MD, Chair

Pharmacology I/Pharmacology II
PHAR 680/PHAR 681
A profound knowledge of the pharmacological basis of therapeutics will be essential throughout a productive clinical career in all medical disciplines. This will allow physicians to keep abreast of new developments in drug therapy. The Pharmacology courses begin with an introduction to principles and basics, including pharmacokinetics (the ways in which the human body handles drugs) and pharmacodynamics (the ways in which drugs affect the human body). Lectures on comprehensive therapeutic issues focus on treatment strategies (for example, so-called consensus recommendations) for some major diseases. Joint lectures, in a conference-style teaching format coordinated by clinicians and Basic Sciences professors in Grenada that will cross-reference topics covered in previous terms with the current course materials, are being implemented.

Our aim is to emphasize the interdisciplinary position of pharmacology in medicine and to utilize students’ enormous motivation to learn what is clinically relevant. Throughout the course, students will be alerted to the clinical relevance of drug classes discussed. Of special interest are precautions in drug treatment, especially in childhood, old age, and during pregnancy and lactation. Ultimately, students will be introduced to the delicate process of therapeutic decision making.

For advanced discussion of selected topics, the class will be divided into small groups, each assigned to a tutor. Pharmacology small group sessions use a series of short, simplified therapeutic scenarios to elaborate on the clinical pharmacology of drugs addressed in preceding lectures. “Case of the week” studies provide insight into principles of evidence-based medicine by means of a detailed case scenario and reading of some assigned peer-reviewed clinical publications. This is a joint program with Pathophysiology. Under the auspices of Pathophysiology faculty, each series of group sessions is concluded by a plenary “case of the week” discussion. Within the demanding schedule for students in

medical training, there is little room to discuss the massive public use of nonprescription drugs, folk remedies, and quackery; however, students will not draw a blank when it comes to substance abuse, mood-enhancing drugs, diet pills, or anti-baldness drugs; the concluding Pharmacology lecture addresses “lifestyle drugs.”

Physiology and Neuroscience

Walter Kolbinger, PhD, Chair

Neuroscience
PHY 510
This course is an interdisciplinary study of the function of the nervous system entailing almost simultaneously its anatomy, histology, physiology, biochemistry, and some pharmacology and pathophysiology. Whenever feasible, the course presents concomitantly, rather than sequentially, the basic structures, mechanisms, and functions of the various interrelated neural systems. Neurological case studies presented as disorders of normal function are included as an integral component wherever possible.

The first few weeks of the course include a general overview of basic elements, gross structure, and basic vocabulary in the modules of neuroanatomy and cellular neuroscience. A module on the development of the central nervous system includes the embryological basis, as well as the underlying molecular and genetic mechanisms. The systems and functions presented cursorily at first are re-introduced and dealt with in a more rigorous fashion, covering the basic electrical properties of cells, developing from membrane potentials through myoneural and synaptic transmission. They are followed by the study of modules on sensory systems, motor systems, autonomic control systems, and complex brain functions and
disease processes, including higher cortical functions and neuropathology.

Small Group Practical Sessions
Small group practical sessions of no more than six students per group are targeted toward facilitating the awareness and development of professional competencies, which include clinical reasoning, components of clinical skills used in neurological examinations, basic interpretation of modern imaging techniques, and team-based interpersonal skills.

Hands-on small group sessions on neuroanatomy before midterm help students to match the three-dimensional structures of the central nervous system with sections produced by modern imaging techniques, such as CT-scans and MRIs. After the midterm, students are taking their first steps to perform neurological examinations, while reviewing the underlying mechanisms and discussing the expected outcomes under physiological and pathological conditions.

Each of the small group sessions includes a clinical case discussion related to the core material presented in these sessions.

Physiology
PHY 560
The aim of this course is to provide students with a clear understanding of the most important concepts and principles of medical physiology. The course has three principal components—lectures, laboratories, and clinical cases. The lectures provide the information base while the laboratories and case studies provide the student with an opportunity to assimilate and integrate the material within a small group setting. The course is divided into two equal sections. The first half covers cardiovascular, endocrinology, and reproductive physiology. The second half covers gastrointestinal, renal, pulmonary, and integrative physiology. The integrative component consists of acid-base regulation, temperature regulation, and exercise physiology. Appropriate clinical perspectives are presented throughout the course. Review sessions are scheduled on a regular basis.

Laboratory
Four human laboratory exercises pertaining to cardiovascular, respiratory, and exercise physiology are included in the course. Computer-assisted applications are regularly used. For each of the laboratories, students work in groups of 12 to 15. Each group is assisted by a faculty member.

Clinical Case Studies
Six clinical case studies pertaining to cardiovascular, endocrine, respiratory, renal, and acid-base regulation are included in the course. For this portion of the program, classes are broken up into small discussion groups of 12 to 15 students.

Public Health and Preventive Medicine

Omur Cinar Elci, MD, PhD, Chair

Topics in Community and Preventive Medicine:
Medicine in Society II
PUBH 501
This course focuses on disease prevention, health promotion, and population health, as well as on the integration of each in the practice of medicine. The course focuses on three areas: the evidence base of practice, community aspects of practice, and clinical preventive services and health promotion. Themes running throughout the course will include the scientific foundation upon which practice guidelines and recommendations are made, the role and contribution of both clinical and community prevention efforts, and the applicability of these topics to the practicing physician. The principles of community and preventive medicine will be illustrated using examples from a wide range of health topics such as child health, health of the elderly, health disparities, infectious and chronic diseases, and health topics in the news. The overarching goal of this course is to demonstrate that community medicine and preventive medicine can be and should be an integral part of the practice of medicine.

Online Course Management System
Student learning is facilitated by an electronic course management system, where course materials and supplemental materials can be reviewed online, and students can take self-assessment quizzes and participate in discussions for each of the lecture modules.

Selectives
Selectives are offered to Basic Sciences students during the first two years of the four-year medical program. The objective is to provide a structured learning experience in diverse clinical and scholarly areas. They give students the opportunity to integrate Basic Sciences knowledge into clinical areas and may provide a transition into clinical medicine. Selectives are offered by various departments and coordinated through the Office of the Dean of Basic Sciences. There is a cost associated with some of the following electives.

American Sign Language (ASL)
Robert Hage, MD, PhD, DLO, MBA
This one-credit selective is offered once a semester and will fall within the start/stop dates of the first term semester. Ten sessions are scheduled per semester. Students are expected to attend and actively participate twice a week in a one-hour session during which a teacher from the School for the Deaf will teach American Sign Language (ASL). Guest speakers will cover topics such as speech training, causes of deafness, prevention of deafness, and hearing aids. This will add to each session an element of theory and practical information related to deafness. Students are expected to practice their acquired sign language skills with each other between sessions and demonstrate some of their skills during each session. Video cassettes are available for viewing in the library. Visits to the School for the Deaf are recommended.

Anatomical Education—Dissection and Multimedia
Marios Loukas, MD, PhD
The key objective of this one-term, two credit-hour selective is furthering the development and enhancement of online and offline anatomical sciences education and dissection of multimedia materials. The primary goal is to expand the competency of students involved by allowing them to sharpen both their computing and their anatomy dissection skills. Participants may produce high-quality prosections and educational materials for any anatomical sciences course, including gross anatomy, histology, embryology, and undergraduate anatomy, or a combination thereof, and develop a multimedia presentation. The multimedia presentation includes 3D reconstructions, flash animations, cadaveric prosected animations, and so forth.

Applied Anatomy Using Ultrasound and Nerve Mapper
Donny Shanahan, PhD
Brian Curry, PhD
This selective improves the anatomical knowledge of students in the second term of the four-year medical program by using cadaveric material to revisit the basic anatomy, and then using an ultrasound machine to view the internal structure on live volunteers of vital areas such as the neck and femoral triangle, and a nerve mapper to show the position of nerves and vessels in the living body in areas such as the neck, cubital fossa, and femoral triangle. The course uses new technology to show students the position of vital structures and reinforces the relevance of clinical anatomy.

Applied Cell Biology and Histology
Jacques Gilloteaux, PhD
Using basic knowledge acquired in Cell Biology and Histology during the first term of the four-year medical program, selective students during their second term explore in more depth some of the topics related to medical applications in applied cell biology, histology of the human body, as well as applying advanced morphological and related ancillary techniques. The Applied Cell Biology and Histology selective will review six major areas of cell, tissue, and organ system investigations, as they can be relevant to reinforce cell biology and histology knowledge. Students are also introduced to principles of clinical histopathology. Students are given the opportunity to critically read publications in these topics to discuss and review the reports or presentations of morphological data acquired in view of understanding their clinical implications.

Bioethics Today
Cheryl Macpherson, PhD
The selective is designed for students with an interest in bioethics who want to further develop their knowledge and professional competencies. It deals with newsworthy concerns in medicine, public health, research, environment, and more. Fifteen contact hours can be spread over several semesters in Grenada. Five or more hours each term will be led by faculty, visiting professors, and students. Students in the Keith B. Taylor Global Scholars Program are encouraged to enroll and options for written assignments, sonic foundry, and/or teleconferencing will be developed as needed. Students are required to lead one seminar or journal club discussion during their last year in Grenada. Most sessions are held at noon.

Clinical Professionalism in Sweden
Cheryl Macpherson, PhD

This intensive selective is held at Uppsala University in Sweden over two weeks. It provides an opportunity to develop professional competencies while learning about medicine, professionalism, and the Swedish health care system. Students interact with patients, doctors, and other medical students in clinical and classroom settings. Students participate in a briefing and de-briefing on campus before and after the Uppsala experience. Students must cover their own costs and arrangements for travel, accommodation, meals, and incidental expenses. Advice about accommodation will be provided.

Cardiopulmonary Life Support (ACLS)
Aris Scott, RN/BSN, Med
During this advanced selective, students will enhance their skills in the treatment of adult victims of cardiac arrest or other cardiopulmonary emergencies. Students will learn current American Heart Association (AHA) algorithmic approaches to managing patients from both a cognitive and skills-based approach using didactic video presentations and small groups. This course emphasizes the importance of basic life support CPR to patient survival, the integration of effective basic life support with advanced cardiovascular life support interventions, and the importance of effective team interaction and communication during resuscitation. Cardiopulmonary Life Support (ACLS) is based on simulated clinical scenarios that encourage active, hands-on participation through learning stations where students will practice essential skills individually, as part of a team, and as team leader. Realistic simulations reinforce key concepts, such as proficiency in basic life support care, recognizing and initiating early management of periarrest conditions, managing cardiac arrest, identifying and treating ischemic chest pain and acute coronary syndromes, recognizing other life-threatening clinical situations (such as stroke) and providing initial care, ACLS algorithms, and effective resuscitation team dynamics. Students who successfully pass both the skills-based and written evaluation will be awarded AHA ACLS certification.

Clinical, Ethical, and Neuroscience Aspects of Pain
Katherine Yearwood, MBBS
Pain is an important symptom in medicine. However, until recently, pain management education has been minimal. The one-credit selective will introduce pain as a public health problem. It will cover the definition of pain, the neuroanatomy and neurophysiology of pain, and psychological, sociological, and anthropological aspects of pain. The students will be taught to do pain histories and to assess pain and pain relief. There will be an introduction to treatment options and discussion of ethical issues related to pain management.

Community Health
Chamarthy Subbarao, BSc, MBBS
In this four-week one-credit selective, students attend three lectures about orientation of the course including health care systems in Grenada, history taking and communication skills. Students attend the clinics under guidance of a Medical Officer. They participate in taking history from patients and observe the examination of these patients followed by discussions with the attending physician. They are required to keep a log of their activities and submit one detailed case history. A one-credit version with less time commitment is offered during the school term.

Complementary and Alternative Medicine
Jacqueline Stanley, PhD
This is a one-credit pass/fail Complementary and Alternative Medicine selective that provides a comprehensive survey in various areas of complementary and alternative medicine. The primary goals and underlying methodologies of each of the complementary health care areas are addressed.

In addition, the strengths/weaknesses and the risk/cost of each area from patients’ and health care points of view are examined. An important aspect of the Complementary and Alternative Medicine selective is to have students understand how these health care areas can interact with and complement conventional medicine for optimal patient care. This selective relies heavily on visiting professors, as well as on local practitioners to deliver the material in a cohesive manner based on their own experiences in the various areas. The selective consists of three consecutive modules. Although each module is open to everyone, students who wish to receive credit on their transcript for this selective must register and attend three full modules. Each module consists of four lectures in the morning and two different afternoon workshops. Furthermore, registered students must pass a short quiz that will be given at the end of each day.

Forensics for First Responders
Peter Giesler and Fred Jordan, MD
This selective acquaints future physicians, veterinarians, and law enforcement personnel with the underlying principles and concepts of modern forensic procedure. Emphasis is on preservation of evidence, securing of crime scenes, and proper maintenance of chain-of-custody of evidence. Through lectures, demonstrations, and practical exercises, students who successfully complete the course should be able to recognize a crime scene, take appropriate steps to secure the area, and preserve the integrity of the scene. Students learn about types of physical evidence that may be found, how it is obtained, and how it is analyzed. The course covers legal procedures in the forensic sciences and specific groups that are involved in the scientific analysis of legal evidence.

Gross Anatomy Special Dissection
Ewarld Marshall, MD
This one-term two-credit course will give participants the opportunity to undertake detailed, professional-quality dissections of the human body. The ultimate objective is to allow students to dissect specific regions and/or organs of the human body in order to create “museum quality” specimens for teaching purposes. In so doing, students will learn the various techniques involved in the preparation of cadaveric material for display and teaching. These include dry bone/ligamentous preps, plastic embedding, and various plastination procedures. Ultimately, the students’ overall knowledge of anatomy will be enhanced.

Integrated Approach of Basic Science Related to the Head and Neck Area
Robert Hage, MD, PhD, DLO, MBA
This one-credit selective is offered twice a year. Students will have two sessions per week for five weeks at the beginning of each semester. Visits to outside institutions are arranged during the semester according to preference and availability. Students will receive a total of five case studies by email, and are expected to attempt to solve the problems before these cases are presented on Monday afternoons. On Thursday afternoons there will be sessions covering maxillofacial surgery, radiology, examination technique, and demonstrations. Visits to the General Hospital operating room, Radiology Department, School for the Deaf, ENT Clinic, and special homes are opportunities for students to gain valuable experience. A CD or ZIP disk must be provided by students so that material related to the selective (clinical pictures, video clips, text) can be made available for home study.

International Health and Human Rights in Honduras
Angela Gomez, PhD
This is a one-credit selective that takes place in Honduras. As there are fundamental differences between health care provision in developed and underdeveloped countries, a recognition and understanding of some of these issues should help to build partnerships and support international health efforts. Human rights are essential to the full attainment of health. Most traditional medical curriculums do not address this subject. This selective is designed to give students a fuller comprehension of the global aspects surrounding health and human rights. This selective is designed to promote a better understanding of the broad determinants of individual and population health, which can be applied to issues in Honduras and regionally to other developed countries. The core of the selective will be facilitated in Honduras by our relationship with ASONOG (Asociación de Organismos No Gubernamentales, the Association of Non-Governmental Organizations), a nonprofit organization which works throughout Honduras. ASONOG was founded in 1988 and works on the coordinating of objectives strengthening primary health services, developing local capacities in the prevention of illnesses, and health promotion.

International Spanish Experience
Debbi Johnson, MA
The one-credit selective allows students to build and expand on medical Spanish language skills by participating in hands-on patient interaction in health care settings located in international settings. The course director assists with the identification and selection of a program that best meets student needs from a large variety of approved options available to them. All international programs have some degree of Spanish language immersion and practice opportunities throughout the selective. Settings will primarily focus on students applying those skills to patient interviews and basic medical care in clinics and hospital settings, participating in community health initiatives.

International Trauma Life Support (ITLS)
Theresa McCann, PhD, MPH
Aris Scott, RN/BSN, MEd
This selective is offered at two levels: Advanced Level for students who are health care professionals; Basic Level for all other students. During this course, students will enhance their knowledge and skills necessary to efficiently and effectively manage patients who are affected by trauma. Students will learn current International Trauma Life Support (ITLS) algorithmic approaches to managing patients from both a cognitive and skills-based approach using didactic presentations, interactive skills stations, and case scenarios. The ITLS selective covers the skills necessary for rapid assessment, resuscitation, stabilization, and treatment or transportation of trauma patients. Emphasized are the evaluation steps, sequencing and techniques for resuscitation, and packaging a patient. Realistic simulations reinforce the key concepts, such as proficiency in basic life support care, basic and advanced airway, chest decompression and fluid resuscitation, spinal restriction and rapid extrication, short back board, helmet management, log roll and long back board, traction splints, and patient assessment and management. Students who successfully pass both the skills-based and written evaluation will be awarded ITLS certification.

Medical Response to Disasters
Theresa McCann, PhD, MPH
Aris Scott, RN/BSN, MEd
During this selective, students will enhance their knowledge and skills necessary to efficiently and effectively manage situations with multiple injured or ill persons in varied environments, such as natural and man-made disasters. This program is designed to give medical professionals the skills needed to identify and respond to major terrorist events including chemical, biological, radiological, and nuclear (CBRN) incidents, as well as to major natural disasters such as earthquakes, hurricanes, and tsunamis. This program will cover the medical implications of these events and introduce current strategies for response. Realistic simulations reinforce key concepts, such as the use of personal protective equipment (Level D and Level C), recognition of and decontamination of patients affected by CBRN materials, and triage and incident command. Students who successfully pass both the skills-based and written evaluation will be awarded Basic Responder CBRN certification.

Medical Spanish for Health Care Professionals
Debbi Johnson, MA
This one-credit selective, which will meet once a week for the entire term, is designed primarily to meet the needs of medical students who anticipate contact with Spanish-speaking patients in their future. In the United States, particularly, it has become an absolute necessity for health care providers to have at least a minimal understanding of the Spanish language in order to reduce frustrations stemming from the lack of ability to communicate with the nation’s fastest-growing non-English speaking group. In addition to the significant lack of control that health care providers feel at not being in command of the language of their patients, the predicament of non-English-speaking patients in need of medical care is of crucial concern as well. The course, which will be offered at the University’s main campus, will provide students with a basic introduction to Spanish grammar and sentence structure, as well as an overview of vocabulary for specific medical purposes. Students will be expected to have had some exposure to Spanish-language instruction, as well as be in good academic standing in order for the more specialized medical instruction to be beneficial. The course will cover such topics as basic grammar skills, emergency medicine, a visit to the family practitioner, basic anatomy, and dealing with sensitive cultural issues.

Microbiology Selective
Ateef Qureshi, PhD, Joanna Rayner, PhD
The laboratory component of the Medical Microbiology (MICR 570) course is the minimum required for future physicians who intend to practice in developed countries with automated, professional laboratory support. Students planning to serve in developing nations will benefit from the extra laboratory experience that will be provided by this two-credit selective. Students who have an interest in infectious disease and diagnostic microbiology will also benefit from this selective. The objectives of the selective are to provide extensive practical hands-on laboratory-based experience and foster an appreciation of the safe handling of infectious materials and/or microorganisms. Students must have a minimum GPA of 3.0, and either General Microbiology (BIOL 401) or Medical Microbiology (MICR 570) (pre- or co-requisite), as well as the permission of both the course director and Dean of Students. A minimum of four to five students should register for the course to be offered.

Pediatric Life Support (PALS)
Aris Scott, RN/BSN, Med
During this advanced selective, students will enhance their knowledge and skills necessary to efficiently and effectively manage critically ill infants and children, resulting in improved outcomes. Students will learn current American Heart Association (AHA) algorithmic approaches to managing patients from both a cognitive and skills-based approach using didactic, video presentations, and small groups. This course emphasizes the importance of basic life support CPR to patient survival, the integration of effective basic life support with pediatric advanced life support interventions, and the importance of effective team interaction and communication during resuscitation. PALS is based on simulated clinical scenarios that encourage active, hands-on participation through learning stations where students will practice essential skills individually, as part of a team, and as team leader. Realistic simulations reinforce the following key concepts: proficiency in basic life support care; recognizing and initiating early management of peri-arrest conditions, recognition and treatment of infants and children at risk for cardiopulmonary arrest, the systematic approach to pediatric assessment, effective respiratory management, defibrillation and synchronized cardioversion, intraosseous access and fluid bolus administration, providing initial care, PALS algorithms, and effective resuscitation team dynamics. Students who successfully pass both the skills-based and written evaluation will be awarded AHA PALS certification.

A Practical Experience in Tropical Medicine in Kenya
Calum Macpherson, PhD
This selective provides an introduction to tropical medicine, and its impact and means of control within the available health care and service settings in an East African cultural context. The course is a two-week field-based experience for students enrolled in the MD/MSc in tropical medicine, and the remaining places are available for Basic Sciences medical students from St. George’s University, with preference given to students in the Keith B. Taylor Global Scholars Program. This experience offers direct observation of the epidemiology, public health, clinical, control, and economic impact of tropical diseases in a country where many such infections are endemic. Through interaction with Kenyan medical students who take the selective, AMREF staff, and visits to rural areas, students gain an understanding and appreciation of people and cultures in Kenya. Students will become familiar with tropical medicine as practiced in the region through a combination of lectures, site visits, seminars, case discussions, and ward rounds.

The Prague Experience in Medicine
Martin Stransky, MD
This popular two-credit selective takes place in Prague in the Czech Republic during the last three weeks of July. Students are introduced to three teaching hospitals and a private practice clinic with 25 physicians. The students gain exposure to both adult and pediatric settings, and participate in team discussions, teaching rounds, lectures, and direct patient interaction. The thinking process that clinicians use when examining patients is introduced and discussed. Students assess the medical, cultural, and economic forces impacting different medical systems. After this selective, students will have developed an increased awareness of the globalization of medicine, expanding their perspectives and knowledge bases in patient care.

Radiological Anatomy
Robert Hage, MD, PhD, DLO, MBA
This two-credit selective will give participants the opportunity to review the normal gross anatomical structure of the human body as seen in various radiological films such as x-ray film, MRIs, and CT scans. A major emphasis will be placed on the clinical application of gross anatomy as it relates to the various imaging methods. Ultimately, the students’ overall knowledge of clinical anatomy will be enhanced.

Regional Anatomical Dissection
Abhishek Yadav, MBBS
William Merbs, BS
This one-term, two-credit selective will give participants the opportunity to undertake four detailed regional dissections of the human body. These regions include head and neck; back and thorax; extremities; and abdomen, pelvis, and perineum. Each regional dissection will be limited to the appropriate area but need not be a complete dissection of all the structures within the topic area. The ultimate objectives are to give students the opportunity to dissect regions of the human body of particular interest to obtain a deeper understanding of the anatomy of selected areas and for detailed anatomical preparation to be created for future clinical aspirations.

Research Ethics
Cheryl Macpherson, PhD
This selective fosters professional development, strengthens ethical sensitivity and reasoning ability, and enhances knowledge and understanding of the complexities of existing research ethics guidelines. This course focuses on the role of human participants and the intersection of research with clinical practice and public health. Students participate in seminars and case discussions involving international guidelines, therapeutic misconception, use of stored tissues, and cultural and socioeconomic factors that bear on international research collaborations. The ethics of authorship and plagiarism are explored. The course expands upon the SGUSOM required curriculum, enabling students to gain substantial insight into research ethics. Students responded favorably to the initial offering of the course in 2007.

Surgery
Chamarthy Subbarao, BSc, MBBS
In this four-week, one-credit selective, students attend three lectures about history taking, communication skills, and the history and running of the Grenada Health Services. Students attend clinics and surgical operations under guidance of a surgeon. They participate in taking histories from patients and observe the examination of these patients followed by discussions with the attending surgeon. They observe the examinations and surgical operations in different specialties. They are required to keep a log of their activities and submit detailed case histories. A one-credit version with less time commitment is offered during the school term.

Thailand Medical Experience
Michael Weitzman, Theresa McCann, PhD, MPH
The one-credit Thailand Medical Experience selective provides an introduction to the practice of health care and service in a Southeast Asian cultural context. The selective is a two-week experience for Basic Sciences medical students during the summer, comprising a mixture of modern and traditional Thai medicine. It provides opportunities for students to observe alternative ways of practicing medicine within the Thai health care system and allows application of core knowledge to diverse modalities of care. Such an experience should increase cultural understanding of the similarities and differences between Western and Eastern health care delivery. Opportunities for interaction and discussion with medical faculty, medical students, and/or residents will be an important component of the selective. One week is spent at Mahidol University Faculty of Medicine and Siriraj Hospital, a modern facility in Bangkok. A second week is completed in a rural area learning Thai traditional massage.

Clinical Years

There are 80 weeks of clinical training. Every student takes 42 weeks of core clinical rotations in the five major specialty areas—12 weeks of internal medicine, 12 weeks of surgery, and 6 weeks each of obstetrics/gynecology, pediatrics, and psychiatry. In addition to the core rotations, all students must complete four weeks of primary care, a four-week medicine sub-internship, a four-week medicine elective, and a four-week pediatric sub-internship or elective. To complete the clinical requirements, every student takes 22 weeks of electives.

Internal Medicine
John Sensakovic, MD, PhD, Chair
The 12 weeks of the internal medicine rotation are designed to expose students to a wide variety of medical problems. Students are expected to develop a logical approach to the diagnosis and treatment of patients’ complaints. Some of the skills that must be acquired and refined are how to elicit and assess patient information, how to perform a complete and accurate physical examination, how to formulate a differential diagnosis and problem list, how to construct a diagnostic workup and a plan of management, and how to write up and present cases. Students thoroughly study at least two new patients per week, present them on teaching rounds, follow them throughout their hospital stay, and use patient problems as a basis for reading. The end of the rotation should accumulate large amounts of experience-based knowledge as students are assigned cases in various major areas of medicine such as cardiology, gastroenterology, and endocrinology. Self-learning techniques, as well as compulsory attendance at lectures, conferences, and teaching rounds, in concert with a careful study of patients, should foster a sound pathophysiological approach to medical diseases and a concern for and awareness of patient needs.

Surgery
Gordon Lutchman, MD, Chair
The goal of the surgery rotation is to acquaint students with those clinical problems that require surgery as part of the therapeutic management. The emphasis of this rotation is not primarily on surgical technique, but on the understanding of the pathophysiology of surgical disease, as well as on the management of pre-operative and post-operative therapy. Besides the many short histories and physical examinations done during this rotation, students are required to perform detailed histories and physical examinations on at least two patients admitted to the surgical service each week, and to follow these patients through surgical and post-operative therapy.

Attendance in the operating room is required when surgery is performed on a patient for whom students obtained an admission history and performed a physical examination. Students must assist in the operating room to gain an understanding of basic surgical techniques, surgical discipline in relation to asepsis, and care of the unconscious patient. The more common post-operative complications must be recognized. Student follow-ups of patients are required (for example, pathology, radiology, rehabilitation medicine). Procedures that involve manual skills, such as venipuncture, placing and removing sutures, and urethral catheterization are incorporated into the surgical rotation. Initially, students are under direct supervision. After demonstrating proficiency, they are indirectly supervised.

Obstetrics/Gynecology
Paul Kastell, MD, Interim Chair
The goals of the clinical rotation in obstetrics/gynecology are to provide students with knowledge and experience in managing the normal and abnormal changes that occur during pregnancy, labor, delivery, and the puerperium, and in diagnosing and treating gynecological disorders. Students become proficient in taking histories from and examining such patients, learning to perform pelvic examinations, including how to pass a speculum and obtain a cervical smear, as well as in attending to their patients in the operating and delivery rooms. Additional student experiences include the observation of labor, delivery of cases, installation of intravenous infusions, recording of partograms, helping with problems of anesthesia, and attendance at special clinics such as pre- and post-natal care, family planning, infertility, and high-risk cases. Students attend conferences, lectures, and teaching rounds. They are expected to follow their patients carefully, read textbooks and literature referable to their patients’ problems, and pay special attention to public health aspects of reproductive medicine, especially as they relate to maternal and perinatal morbidity and mortality, sexually transmitted disease, cancer detection, and human sexuality.

Psychiatry
Amy Hoffman, MD, Interim Chair
The purpose of the rotation is to convey psychiatric concepts, attitudes, and skills that are needed by all students, regardless of their future career plans. By the conclusion of the rotation, students should be able to elicit, organize, and present a full psychiatric history, perform a mental status examination and a differential diagnosis, and suggest methods of treatment. Students will have improved their ability to establish a physician-patient relationship and will have acquired knowledge of psychological factors in physical illness. Students will demonstrate improved interviewing skills and know the major indications, uses, and side effects of commonly used psychotropic drugs. They will become familiar with the major
psychiatric syndromes in children and adolescents, as well as with the effects on the child/adolescent/family of the life-disrupting syndromes of child abuse and substance abuse.
Students will learn detection and treatment of these syndromes, as well as how to evaluate and manage psychiatric emergencies. The goal is for students to feel more comfortable with psychiatric patients, and, ultimately, possess an understanding of biological, psychological, and social determinant behavior. Students must fully work up at least one patient a week. The history and mental status examination are presented to the preceptor and the case is discussed. Students must follow each patient’s progress throughout the duration of the rotation. Students must attend ward rounds and outpatient sessions. Attendance will be expected at case conferences and seminars.

Special experiences are recommended. These include attendance at Alcoholics Anonymous meetings and visits to local mental health facilities, county, and/or state hospitals, addiction programs, and any other special programs in the vicinity of the hospital. Observation and participation in group therapy, pre discharge, and post-discharge group management are required.

Pediatrics
Phyllis Weiner, MD, Chair
The goal of the rotation in pediatrics is to allow students to acquire the basic knowledge of the normal physical, mental, and emotional development of children. Students learn how this development is influenced by medical, social, and educational factors, as well as understand the common disorders and diseases of childhood, especially their diagnosis, management, and prevention. Students will be taught to be aware of the special needs of the newborn, the handicapped child, and the adolescent.

An integral part of the rotation is the opportunity to acquire the necessary skills of taking a pediatric history, to examine children of all ages, and to acquire experience in evaluating the essential clinical information so that a coherent plan of management can be formulated and explained to the parents and, as appropriate, to the child. Students learn to appreciate the value of a confident but sympathetic approach to the child and the family while recognizing and accepting the limits of that unit’s expectations and understanding. Student reading is structured during the six weeks so that they first become acquainted with the normal child and then learn history taking and physical examination, reactions of children to illness and hospitalization, the principles of infant feeding, and fluid and drug therapy.

Emergency Medicine
Theodore Gaeta, DO, MPH, Chair
The goal of the rotation in emergency medicine is to teach medical students the necessary skills to take care of patients with a wide variety of undifferentiated urgent and emergent conditions. Students learn how to approach patients with common and potentially life-threatening complaints (such as chest pain, headache, abdominal pain, and many others). Emphasis is placed on teaching how to develop a working differential diagnosis and how to appropriately narrow it.

During the rotation, students have the opportunity to gain proficiency in rapidly collecting data and performing focused physical examinations appropriate for the acutely or emergently ill patient. Students function as an effective and essential part of the emergency medical team in the patient assessment, stabilization, and management of a variety of acute medical and surgical conditions. Students learn to formulate appropriately organized and succinct medical records and problem lists. Students are familiarized with the indications, limitations, and methodology of emergency department (ED) diagnostic procedures and introduced to the multifaceted psychological, social, and economic challenges faced in an
emergency medical setting.

Students function under the direct supervision of the ED faculty. During the rotation, students attend departmental conferences, lectures, skills labs, and teaching rounds. Evaluations are based on clinical performance, written examination, and case-log presentations.

Family Medicine and General Practice
Everett Schlam, MD, Chair
The goals of the family medicine and general practice rotation are to ensure that all medical students have a full understanding and appreciation of an integrative approach to the care of patients, families, and communities. Students will be introduced to the aspects of family medicine that are applicable to all fields of medical practice, including comprehensive and continuous care provided by family physicians to patients of all ages.

The importance of family systems and the impact of chronic illness on patients and their families will be incorporated into patient care. Students will accompany precept physicians performing patient care in the office setting, nursing home, and house calls. Participation in community services involving health care will be encouraged.

By the end of the rotation, students will be expected to perform and present a focused patient history and physical examination to diagnose and manage patients. Students will be able to provide effective patient education and utilize evidence-based decision making in clinical practice. Students will use the Fifth Edition of Sloan’s Essentials of Family Medicine as a text for the rotation.