An eight-week, eight-credit-hour required clerkship in the third year consisting of primarily inpatient and outpatient experiences with opportunities for outpatient experiences as well. Under the supervision of attending staff physicians and residents, students spend variable amounts of time on general surgery, vascular surgery, trauma, and critical care. Students continue to develop skills in medical history-taking, physical examination, and the use of laboratory data in an organized fashion to understand surgical diseases. During this clerkship, students should develop an understanding of the metabolic and physiologic effects of injury and trauma; correlate disordered physiology with the surgical pathologic process; recognize surgical illness and the place of operative intervention in treatment of diseases; understand the impact of surgery on the patient and family, including the psychological and socioeconomic changes that result from an operation; and acquire surgical techniques and skills basic to all physicians, including wound care, suture technique, and the ability to assist in the operating room. Primary methods of instruction include lecture, case-based discussion/presentation, suture laboratory, conferences, small-group discussion, and teaching rounds. Modes of assessment include the Surgery NBME subject examination, 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.

Introduce the student to the pre-operative and post-operative care of the vascular surgery patient as well as expose the student to a wide variety of open surgical and endovascular procedures. Demonstrate the essential skills in the pre-operative evaluation of the vascular surgery patient, including a good vascular history and physical, function efficiently as a first assistant in surgery, understand the basic principles of wound healing and learn more about endovascular catheters and the indications for choosing open versus endovascular intervention, be exposed to a broad scope of vascular surgery including peripheral arterial disease stenting, open and endovascular AAA repair, thrombectomy, AV-fistula creation and revision, amputations and other less common procedures.

To gain clinical experience with admission, evaluation, diagnosis and consultation, pre-, intra-and postoperative care for patients of all ages to correct or treat various conditions, diseases, disorders, and injuries.

Optimal patient care in the perioperative period requires that all physicians become familiar with preoperative evaluation, options for intraoperative management, and principles of postoperative care. Students will be expected to participate in the care of surgical patients with emphasis on intraoperative management, and will gain expertise in techniques of airway management, endotracheal intubation, and vascular access. Exposure to regional anesthetic techniques, obstetric anesthesia, pediatric anesthesia, and cardiac anesthesia is expected. Topics in pharmacology, physiology and critical care will be addressed. The Department will provide a handout of required reading covering basic anesthesia related topics. Evaluations will reflect the student's daily participation in departmental activities, and a quiz at the end of the rotation will give the student objective feedback on his/her assimilation of important topics. Students also will be expected to take call 2 or 3 times during the month. This can be set up at the student's convenience.

This course is designed to teach the student the basic components of Emergency Medicine through primary responsibility for patient evaluation and treatment. Opportunities are available for the student to evaluate patients as the first physician contact to develop differential diagnoses and formulate treatment plans. All patients will be presented and discussed with a senior emergency medicine resident or attending and determination of appropriate treatment made. Clinical experiences will encompass the full gamut of illness and injuries presenting to a busy urban Emergency Department. The student will gain experiences in the fundamentals of diagnosis, stabilization, and management of emergency conditions. Five hours of lectures are presented weekly to reinforce important concepts. Other educational opportunities include online lectures, simulation labs, and toxicology workshops.

The purpose of this course is to provide the student with an introduction to clinical otolaryngology, head and neck surgery. Anatomy, physiology, and the pathogenesis of disease will be emphasized. The student will become familiar with the use of the otoscope, laryngeal mirrors and the head mirror or head light used for indirect laryngoscopy. He/She will observe and assist with surgical procedures. The student will have the opportunity to see otolaryngologists working in their private practice settings.

M4 students will participate in Neuro ICU rounding, present patients, help collect data, examine patients allotted to them, practice neurological exam, assess comatose patients. Participate/ assist in all ICU procedures: ventilator management, EVD management, management of cerebral edema. Night call every 4th night, help with cross coverage of new admissions and learn to review neuro imagery.

The elective is designed to integrate the student in the practice of an academic surgeon, provide one-on-one interaction between the student and faculty mentor, involve the student in the pre-operative and post-operative care of the plastic surgery patient, involve the student in a wide variety of plastic and reconstructive surgery procedures, and introduce the student to the plastic surgery literature and help the student to develop a critical analysis of recent publications. Following the rotation, the student will demonstrate the essential skills in the pre-operative evaluation of the plastic surgery patient, function efficiently as a first assistant in surgery, understand the basic principles of wound healing, be able to select appropriate suture material and method of closure for surgical incisions and traumatic wounds, be exposed to the entire scope of plastic and reconstructive surgery including treatment of burns, skin cancers, facial trauma, congenital deformities, breast surgery, microsurgery, and aesthetic surgery, and assist in the design of additional educational objectives of particular interest to the student. The student will work closely with the faculty mentor, functioning as an acting intern in the clinical setting. Additional objectives will be developed with each student based on their special interest or future career orientation. Students will participate in a self-evaluation process of their performance. Evaluation will be based on progress accomplished and completion of the objectives. Cognitive performance, surgical skills and professional behavior will be assessed.

The student will be required to complete twenty 8 hour shifts in the ED and perform a minimum of 100 bedside ultrasounds on ED patients. Instruction and supervision will be provided by faculty noted above. Indications for ED ultrasound, the limitations of ultrasound, knobology, and image acquisition will be emphasized. The student will focus on, but is not limited to, imaging of the following: gallbladder and biliary tract, kidneys, heart, aorta, and pelvic organs. In addition, ultrasound will be used during guided procedures, examining for intra-abdominal fluid in traumas, and for foreign body imaging. The student will be required to keep a log of ultrasounds performed with follow up on confirmatory studies obtained. Twenty ultrasounds performed will be digital video and reviewed with the instructor who is present on shift. The student is to be present and participate at ED ultrasound video review sessions and lectures. One online case will be produced during the rotation, with the aide of the course director, to be distributed to the EM residents, fellows, and faculty. Suggested archived video will be reviewed by the student.

The student will get a deep appreciation of emergency medicine that leads to clinical observation, like chest pain and syncope/TIA amongst other diagnosis, as well as the continuum of psych patients from their initial presentation through their observation to either psych in-patient care or out-patient care. In the rapid assessment we will see plenty of patients and learn the differential to not anchor bias. We will attend to lacerations and abscesses, read on average 8 ECGs as we are responsible for physician in triage ECG patient care.