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. Students are offered a choice of two two-week-long rotations in the surgical specialties and academic and clinical experiences in anesthesia, cardiothoracic surgery, neurosurgery, ophthalmology, orthopaedic surgery, otolaryngology, pediatric surgery, plastic surgery, and urology. Both office and hospital-based experiences permit the study of disease processes unique to each of the special areas of surgery, the techniques of diagnosis, the understanding of pathophysiology, and therapy. Management of ambulatory patients is emphasized. During this clerkship, students diagnose diseases particular to the selected surgical specialty and develop the techniques utilized for diagnosis. In addition, students learn to understand the pathophysiology and management of these disease processes, recognize indicated surgical therapy and expected results from the surgical procedures for these diseases, understand and decide when the patient should be evaluated by a surgical specialty related to the disease process, and understand the impact of surgical care on the patient and the family. Students complete a critical analysis for each rotation on a topic of interest. Primary methods of instruction include clinical preceptorship, clinical correlations, and teaching rounds. Modes of assessment include an internal final examination, clinical evaluations, and a review of the quality of the written paper by the course director.
A four-week, four-credit hour required clerkship in the fourth year. Students are required to complete the Acting Internship (AI) in one of the following: Family Medicine, Internal Medicine, Pediatrics, Psychiatry, Obstetrics and Gynecology, or Surgery. 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 Palmetto Health Richland, the Dorn Veterans Affairs Medical Center, or the Greenville Hospital System University 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.
The student on this elective will rotate with the doctors in their pediatric surgical practice. The student will work in both private offices and in the hospital setting. Learning experiences will include evaluation of pediatric surgical patients from neonate through adolescence; participation in pediatric surgical conferences and in clinical material; diagnosis and treatment of congenital abnormalities; evaluation and management of pediatric trauma including burn patients; experience in the management and monitoring mechanisms of preoperative and postoperative acutely ill pediatric patients; and exposure to the specialized techniques necessary for management of neonatal patients.
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.
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.
This elective is designed to teach the basics of Emergency Medicine through 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 an emergency attending. Students will work in the adult areas of the Emergency Department. Patients of all types may be seen - pulmonary, cardiac, and trauma. The student will gain experiences in the fundamentals of diagnosis, stabilization, and management of emergency conditions. Time in the simulator center doing airways, wound care and procedures is included.
This elective offers the student an opportunity to work closely with pediatric surgeons in the office and hospital practice using the preceptor method to provide an exemplary approach to the management of problems in surgical pediatrics. The main emphasis of the course is to provide a basis for the comprehensive care of children requiring surgical intervention. The student will be exposed to the basic surgical techniques and be given the opportunity to participate during certain procedures. Patients presenting with complaints ranging from management of para-surgical congenital anomalies will be seen in this setting. The student will work as part of a team of the pediatric surgery service, participating in preoperative, intraoperative, and postoperative care. The patient population will consist of age groups from the premature newborn to the young adolescent. Exposure to a broad spectrum of cases needing surgical intervention, and/or management, will be provided. Hospital rounds, lectures, and conferences will be scheduled for the student to parallel the surgeon.
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, pediatric anesthesia, and cardiac anesthesia is expected. Topics in pharmacology, physiology and critical care will be addressed. Evaluations will reflect the student's daily participation in departmental activities.
This four-week acting internship provides students with additional experience in the concepts and diagnostic procedures used in surgical critical care. Students are assigned to the surgical critical care service at Greenville Memorial hospital, where they provide consultative care for trauma, vascular, neurosurgical, and general surgery patients admitted to the Intensive Care Unit. Students also participate in trauma resuscitations in the Emergency Room and the initial workup of trauma patients. Students care for patients as their primary caregiver under the supervision of the team's residents and faculty. Students take call every fourth night participating in the care of the patients in the Intensive Care Unit and trauma resuscitations. Students evaluate all assigned patients completing consultation reports including physical diagnosis, diagnostic assessment and plan of care. Students round on their assigned patients daily, presenting their patients and therapeutic plan to the team on morning rounds. Students will also attend Green Surgery (Trauma) morning report each morning to coordinate care with the trauma team on assigned trauma patients. Clinical learning is supplemented with The Society of Critical Care Medicine's Intensive Care course slides available for the students to review online. The student will participate in surgical morning conferences as assigned.
During a rotation with the otolaryngology – head and neck service, students will have the opportunity to experience clinical and surgical patient care. The course content may be adapted to facilitate more time in the clinic if desired, particularly important for those going into primary care fields who will need to be adept at a good head and neck exam. All students will be expected to participate in some operative exposure as well. Students may expect to see a variety of cases including: pediatric ENT, nasal and sinus, head and neck tumors, facial trauma and reconstruction, and otology. They will have the opportunity to learn about basic audiology and allergy as well. Daily participation is expected unless other arrangements are made with the course director.
Minimal access, laparoscopic, or minimally invasive surgical procedures are rapidly gaining in popularity. This subspecialty of general surgery implements a different approach to common surgical maladies. During this rotation the student will be an active participant of the minimal access team and will be exposed to complex foregut (including bariatric), biliary, solid organ, and hernia surgeries. The student will be responsible for rounding and following patients on the inpatient service, and participating as an assistant during surgery.