A twelve-week, twelve-credit-hour required clerkship in the third year consisting of 2 weeks of Neurology inpatient consults and ambulatory clinics, 4 weeks of inpatient general medicine, 4 weeks of subspecialty elective, and 2 weeks of ambulatory general or subspecialty medicine. During the inpatient portions of the rotation, students perform as active members of the student / resident / fellow / attending physician team. In some cases, the team is a consultative service (subspecialty electives and Neurology) and in others, the team is the primary patient care service (general medicine wards and the intensive care unit). Students are assigned patients, obtain medical histories, perform physical examinations, evaluate laboratory data, and analyze the information in order to define patients’ problems and formulate a diagnostic and therapeutic care plan. Performance is reviewed both during specific preceptor-student contacts and during student presentations on rounds with the team. During the ambulatory portion of the rotation, students work closely with resident, fellow and attending preceptors, discussing each patient encounter in depth and participating in didactic sessions. Students become familiar with concepts of time management and performance of focused patient assessments. Throughout this clerkship, emphasis is placed on the interpretation of clinical findings in terms of the pathophysiologic mechanisms of disease and the subsequent translation of this information into rational decisions about management. The clerkship provides students, through their active participation, with opportunities to observe the diagnostic process as it unfolds and to develop competence in evaluating broad clinical problems. For Neurology in particular, the focus will be to broaden students’ basic neuroscience knowledge and learn to apply this knowledge clinically. Students will also develop skills in taking a focused neurological history and conducting a thorough neurological examination. Primary methods of instruction include lecture, case-based self-study and discussion, clinical preceptorship, educational conferences, standardized/simulated patients, small-group discussion, and teaching rounds. Modes of assessment include the Internal Medicine NBME subject examination, Neurology departmental exam, case presentations, clinical evaluations, and an Objective Structured Clinical Examination (OSCE). Demonstration of mastery of a prescribed set of clinical skills, included on the Clinical Skills Attainment Document, is required for successful completion of this clerkship.

A four-week, four-credit hour required clerkship in the fourth year. The AI emphasizes basic generalist competencies, is predominantly an inpatient experience, and includes night call. Acting interns are essential members of the ward teams, although students’ patient loads can be adjusted according to their aptitude. Some of the selectives also provide a minor amount of ambulatory clinical learning. The student has primary and direct responsibility for the continuing care of patients in the community or in one of the University of South Carolina School of Medicine programs at Prisma Health Richland, or the Dorn Veterans Affairs Medical Center. Alternatively, a student may elect to complete the AI as an extramural rotation but must have prior approval for this rotation from the USCSM AI director. The primary mode of instruction is clinical preceptorship. Other educational material may be presented via attending rounds, didactic lectures, subspecialty lectures, weekly grand rounds, resident case presentations, rounds with residents, clinical pathologic conferences, etc., and is dependent upon the specific rotation. Assessment will focus on core clinical skills, including, but not limited to, history and physical examinations, clinical decision making, case presentation, communication with patients, test selection and interpretation, and therapeutic decision making.

A four-week, four-credit hour required clerkship in the fourth year. The AI emphasizes basic generalist competencies, is predominantly an inpatient experience, and includes night call. Acting interns are essential members of the ward teams, although students’ patient loads can be adjusted according to their aptitude. Some of the selectives also provide a minor amount of ambulatory clinical learning. The student has primary and direct responsibility for the continuing care of patients in the community or in one of the University of South Carolina School of Medicine programs at Prisma Health Richland, or the Dorn Veterans Affairs Medical Center. Alternatively, a student may elect to complete the AI as an extramural rotation but must have prior approval for this rotation from the USCSM AI director. The primary mode of instruction is clinical preceptorship. Other educational material may be presented via attending rounds, didactic lectures, subspecialty lectures, weekly grand rounds, resident case presentations, rounds with residents, clinical pathologic conferences, etc., and is dependent upon the specific rotation. Assessment will focus on core clinical skills, including, but not limited to, history and physical examinations, clinical decision making, case presentation, communication with patients, test selection and interpretation, and therapeutic decision making.

This elective will provide clinical experience in the diagnosis and management of acute and chronic problems related to the respiratory system, including but not limited to disease processes such as pneumonia, COPD, interstitial lung disease, pulmonary hypertension, lung cancer, and sleep related breathing disorders. The student will learn the interpretation of arterial blood gases, pulmonary function studies and radiographic studies. The student will perform inpatient and outpatient consultative services under the supervision of the pulmonary attending. The student will participate in procedures such as thoracentesis, fiberoptic bronchoscopy and transthoracic needle biopsies. Attendance at other internal medicine conferences, ICU rounds and Wednesday pulmonary conference is encouraged.

Medical students participate in the evaluation and management of patients with metabolic, endocrine, and hormonal problems under the supervision of faculty members. History-taking and physical examination skills are emphasized, along with interpretation of laboratory data and radiologic and imaging studies. Students care for both ambulatory and hospitalized patients at Prisma Health Richland and Dorn Veterans Affairs Medical Center, and attend the daily teaching rounds, weekly clinical case conferences, journal club, and didactic lectures. They encounter a wide variety of endocrine and metabolic disorders such as diabetes, obesity, metabolic syndrome, endocrine hypertension, dyslipidemia, thyroid disease, calcium problems, osteoporosis, pituitary gland abnormalities, adrenal disease, hypogonadism, , erectile dysfunction, and menopausal, reproductive and infertility issues. Formulation of differential diagnoses, a critical thinking approach, and use of the relevant medical literature is encouraged.

The goal of this rotation is to enhance the student's ability to recognize, evaluate, and treat patients with digestive diseases, diseases of the hepatobiliary system, and disorders of nutrition. To accomplish this goal, the student will perform the initial evaluation on consults submitted to the gastroenterology (GI) service. Consults will be presented and the pertinent radiographic and histologic data reviewed on daily attending rounds. Experience with outpatient care of patients with digestive disease will be gained during a weekly outpatient clinic. The student will also care for a limited number (1-2) of patients with gastroenterologic disease on the inpatient service. Observation of procedures performed on the student's consults is encouraged. Increased knowledge of digestive diseases will be gained through in-depth reading in pertinent textbooks and the current medical literature as well as interaction with staff personnel. The student is required to attend all conferences, i.e., GI radiology, GI pathology, Endoscopy Conference, topic review, and journal review. If the student is interested in research, he/she will have the opportunity to observe the performance of various clinical research studies. This elective will include 2 weeks at PHR and 2 weeks at the DVAMC. Each student is expected to call the course director’s office one week prior to starting the elective for assignment either to PHR or DVAMC.

This elective will involve activities in clinical medicine on the Hematology/Oncology service and will include supervised patient care experiences with in-patients and out-patients, as well as teaching rounds, conferences, Tumor Board meetings and ancillary teaching sessions involving drug pharmacology.

This elective will provide in depth experience in interpretation of electrocardiograms and some experience with exercise electrocardiography.

This course will provide the student with clinical experience in infectious diseases. The student will see patients on the infectious diseases consultation service and in outpatient settings (including the Ryan White HIV clinic 2 mornings a week) under the supervision of the infectious disease attending physician. Emphasis will be on the correlation of basic microbiologic principles with clinical expressions of diseases. The combined clinical and didactic experience should enable the student to: (1) use antimicrobial drugs rationally, (2) diagnose and treat patients with HIV/AIDS, and (3) acquire an approach to the diagnosis and treatment of varied infections.

This elective will provide clinical experience in the diagnosis and management of acute and chronic cardiac problems, including but not limited to disease processes such as hypertensive urgency, heart failure, arrhythmias, syncope, cheat pain, and myocardial infarction. The student will learn interpretation of electrocardiograms, echocardiography, and chest x-ray. The student will perform inpatient consultative services, including management of critical cardiac patients, will round with the CCU team each morning, and participate in the management of floor cardiac patients under the supervision of the cardiology attending. The student will participate in procedures such as transesophageal echocardiography, cardiac catheterization, pacemaker placement, cardioversion, central venous accesses placement, and arterial line placement. The student will be in attendance at all cardiology conferences, as well as other internal medicine conferences such as grand rounds. The student will also have the opportunity to participate in various outpatient cardiology clinics, including heart failure, pacemaker, and chest pain clinics if desired.

This rotation will offer the student clinical experience in the delivery of affirming health care to gender minorities. The student will rotate in the interdisciplinary subspecialty/specialty clinics as well as observe in the OR with our plastic surgeon and urologist. The participating specialties will include but not limited to primary care, gynecology, clinical pharmacy, psychiatry, infectious diseases, plastic surgery and urology. Clinical exposure will include but not limited to hormone management, basic primary care, HIV treatment and prevention, STI, mental health and gender affirming surgeries and post op care. Students are expected to complete the assigned reading task as synchronous learning as well.

This course will provide clinical experience in the care of patients with acute and chronic renal failure, nephrotic syndrome, various fluid and electrolyte disorders and refractory hypertension. Hemodialysis and peritoneal dialysis will be discussed and utilized. The students will follow selected patients and will round daily with the attending faculty.

This is a clinical rotation about common, chronic diseases affecting both children and adults. This elective will be beneficial for medical students who are in the third or fourth year of their training.

The goal of this rotation is to enhance the student's ability to recognize, evaluate and treat patients with renal diseases, electrolyte disorders and hypertension. To accomplish this goal, the student will have an active role in the evaluation of consults presented to the Renal Service. Consults will be presented, and the pertinent laboratory and radiographic data will be reviewed on daily attending rounds. Routine patient management of patients with hypertension, electrolyte disorders and renal disease will be discussed using a problem solving approach on daily rounds. Difficult or interesting cases will be reviewed on weekly Renal Grand Rounds. The student will also participate in the outpatient care of patients with renal disease in the weekly clinic. Also, in order to acquaint the student to problems in care of patients with chronic renal failure such as electrolyte imbalance, hypertension, nutrition, etc., he or she will be encouraged to attend weekly rounds on patients in the chronic hemodialysis program. Fluid electrolyte, acid-base problems will be assigned and reviewed twice weekly with the renal attendings. If the student is interested in clinical research, he/she will have the opportunity to observe the performance and or participate in various clinical research studies.

The purpose of this rotation is to provide additional training in geriatric medicine. Students will receive individual supervision as they assess geriatric patients in various settings Patients may be encountered in the office, nursing home, home and hospital settings All rotations will involve a structured reading program designed to provide the student with a broad range of knowledge of the subjects more common in the Geriatric population. Students also take both a pre and post test on this rotation.

This elective will provide the student with experience in evaluating and managing patients with rheumatic diseases. Outpatient clinics as well as inpatient consults will allow the student to experience a broad spectrum of rheumatic diseases. Daily teaching sessions will be devoted to covering major clinical topics in rheumatology. The student will also gain experience in reading x-rays and performing joint aspirations.

The student will function as a member of a multidisciplinary team providing palliative medicine consultations to patients throughout the hospital and in our outpatient clinic. Students will learn advanced communication skills such as breaking bad news, conducting family meetings, and discussing prognosis. Students will interact with intensive care teams, social workers, chaplains, nurse practitioners, and physicians. Students will receive a didactic series on the fundamentals of palliative medicine including communication skills, pain control, symptom management, and spiritual assessment. Students will be asked to write a brief reflection on their experience on the rotation. This could include a reflection on a patient encounter or how they plan to use skills learned during this rotation to their training moving forward. Students will also be expected to prepare a 5-10 minute presentation on a palliative care topic to present the palliative care group on the last day of their rotation.

The Hospital Medicine elective at Lexington Medical Center is a four week, unopposed, experience that provides comprehensive exposure to complex medical patients with acute and chronic medical illness. The primary objective is to provide the medical student with a focused introduction to the growing specialty of Hospital Medicine. Coupled with didactic reading assignments and case presentations, the student will have the opportunity to initiate the admission process in the Emergency Department, establish continuity of care and patient rapport, and develop a plan for inpatient medical management and discharge disposition. The breadth of exposure will focus on adherence to the most current standard of care, supported by evidence-based medicine. Most commonly encountered acute medical illnesses include, but are not limited to, acute respiratory failure due to COPD and pneumonia, hypertensive urgency and emergency, multi-systemic sepsis, acute stroke, acute renal failure, hepatic failure, acute pancreatitis, diabetic ketoacidosis, cellulitis, acute heart failure, and acute delirium.