Course Catalog

The goal of this elective is to increase the knowledge of students in prosection in specific anatomical areas.  Objectives are to identify and prosect an area of anatomic interest, identify one pathological condition associated with the area dissected and describe findings, describe clinical significance of dissected area during the course of a clinical procedure, describe age-related variations in the dissected area, describe how an age-related difference would affect clinical care, and identify normal variations, if any.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Curricular Component(s) Met: None
• Availability: Limited to three students per rotation

This elective provides advanced exposure to forensic pathology through participation in death investigations at the Western Office of the Chief Medical Examiner. Students observe and assist in the determination of cause and manner of death by applying autopsy techniques, reviewing medical records, analyzing scene and investigative data, and interpreting gross and microscopic findings. Learners gain practical experience in completing death certificates consistent with medical and legal standards, contributing to medico-legal autopsies under supervision, and understanding the ethical and procedural responsibilities of physicians involved in death investigation. The course also emphasizes the physician’s role in expert testimony, interprofessional communication, and the contribution of forensic pathology to public health surveillance and community safety.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Enrollment is limited to a combined total of two students at any given time across any two pathology electives.

This elective introduces students to the practice of anatomic pathology and clinical laboratory medicine. Students will review gross and microscopic specimens with attending pathologists, observe autopsies (as available), participate in intraoperative consultations, and attend multidisciplinary conferences. They will also gain experience with the operation of the clinical and histology laboratories. Through these experiences, students will correlate clinical history, physical findings, laboratory data, and radiologic studies with pathologic specimens to develop differential diagnoses, plan diagnostic testing strategies, and evaluate the impact of pathologic diagnoses on patient management and outcomes.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 or 4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Enrollment is limited to a combined total of two students at any given time across any two pathology electives.

This elective introduces medical students to the essential role of anatomic pathology and clinical laboratory medicine in patient care. Students will learn how tissue specimens and laboratory tests and ancillary tests are processed, what factors affect test accuracy and interpretation, and how to select and submit specimens appropriately. Emphasis is placed on understanding test limitations, recognizing what information pathologists and laboratory professionals need to provide meaningful results, and applying findings to generate a differential diagnosis. Students will also practice effective consultation with pathologists and laboratory staff as part of interprofessional patient care. By the end of the course, students will appreciate how appropriate test utilization, including ancillary testing, improves patient outcomes, supports collaborative care, and contributes to cost-conscious healthcare.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Enrollment is limited to a combined total of two students at any given time across any two pathology electives.

This advanced elective provides medical students with residency-level exposure to anatomic pathology and clinical laboratory medicine. Students will analyze gross and microscopic specimens, recognize histologic patterns, and integrate clinical history, physical examination, radiologic studies, and laboratory findings to formulate differential diagnoses. Emphasis is placed on justifying diagnostic test selection, applying principles of test performance, and incorporating recent literature to connect pathologic diagnoses with patient outcomes. Students will also practice basic grossing techniques, apply workflow systems for specimen organization, and engage in interprofessional collaboration to optimize diagnostic accuracy and efficiency, while demonstrating professional, ethical, and conscientious behavior appropriate to clinical pathology practice. Participation includes autopsy pathology, multidisciplinary conferences, and supervised on-call experiences with attending pathologists.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Enrollment is limited to a combined total of two students at any given time across any two pathology electives.

This advanced elective is designed for students preparing for surgical or procedure-based specialties who want to deepen their understanding of clinical anatomy. Students will perform detailed prosections of selected regions with a focus on surgical relevance, safety, and procedural application. The course emphasizes identifying normal structures, variations, and age-related changes, and analyzing how these factors influence surgical decision-making and patient outcomes. Students will also examine related pathological conditions, interpret the clinical significance of the dissected region in common surgical contexts, and apply their knowledge to operative planning, teamwork, and procedural safety. By linking anatomy directly to surgical practice, this elective supports a stronger transition into residency.

• Prerequisite(s): Successful completion of Phase 1 and 2 + 9B01
  
• Co-requisite(s): None
  
• Duration:  4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Enrollment is limited to three students per rotation.

How do we make decisions?  What thought processes occur when a physician assimilates multiple pieces of information to arrive at a plan of action, a diagnosis, or a treatment modality?  What are sources of error in our thought processes, and how can we learn to overcome them to be more effective decision makers?  This two-week elective will consist of several readings, discussions, and direct observation of physician decision-making in the Emergency Department setting.  The location is Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Enrollment is limited one student on MED 9108 or MED 9101 at a time.

This two-week elective will consist of learning to perform basic limited point-of-care ultrasound examinations on patients who are in the Emergency Department at Carilion Roanoke Memorial Hospital.  The medical student will perform bedside ultrasounds under supervision and create a portfolio of studies and interesting cases that were performed.  From these studies, the medical student will develop an understanding of ultrasound physics, learn standard ED scan protocols, and learn to interpret positive and negative findings in real time.  The location is Carilion Roanoke Memorial Hospital. 

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation

This elective will consist of didactics and observational ride-along shifts with EMS units in the Roanoke area.  The medical student will receive education in the principles of pre-hospital medicine, including capabilities, limitations, skill levels, and costs associated with pre-hospital transportation methods.  Over the course of two weeks, the student will receive several hours of didactic education as well as participate in 8-10 shifts with EMS and fire units in multiple locations.  The locations are Carilion Roanoke Memorial Hospital and area EMS services.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation

This elective will consist of shifts in the Pediatric Emergency Department at Carilion Roanoke Memorial Hospital.  The medical student will do the patient’s chart review, history taking, and physical examination.  From this information, the medical student will develop a differential diagnosis, plan the diagnostic evaluation, and design the acute management of the patient.  The medical student will then observe and/or participate in the medical care and procedures that make up the patient’s management plan.  Emphasis will be placed on age-appropriate exam techniques and treatment modalities for acutely-ill and injured children.  This elective is meant to be an intensive clinical experience in Pediatric Emergency Medicine.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 or 4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation

The four-week Acting Internship (AI) in Emergency Medicine elective is meant to complement an EM clerkship.  While it is not required, it is recommended that students have had a prior clerkship experience to gain the baseline fund of knowledge.  The AI is meant to serve as a month-long “interview” rotation, and therefore students are expected to have an interest in pursuing a career in Emergency Medicine with Carilion Roanoke Memorial Hospital as a possible residency destination.  Students will work a schedule similar to that of an intern in our Emergency Medicine residency in the Emergency Department at Carilion Roanoke Memorial Hospital.  Students will be responsible for initial patient assessment, presentation to attending physicians, as well as developing independent management plans.  Focus will be on multitasking skills and development of plans of care appropriate for the student’s educational level.  Opportunities will exist for students to gain extra exposure to an area of interest (ultrasound, pre-hospital, tactical, wilderness medicine, academic/educational development), and students are encouraged to contact us ahead of time to allow time to arrange these experiences.

• Prerequisite(s): Successful completion of Phase 1 and 2 + 9811 Clerkship - Emergency Medicine
  
• Co-requisite(s): None
  
• Duration: 4 weeks
• Curricular Component(s) Met: Medical Subspecialty, Advanced Clinical Rotation
• Availability: Limited to one student per rotation

This elective will be an immersive experience in Wilderness Medicine. This elective will be a two-week elective offered once a year. Each two-week elective will be limited to 10 students. Over the course of the two weeks the students will develop the skills and knowledge necessary to practice medicine in an austere environment. They will also learn the skills necessary to survive in such environments and the means by which they can bring patients to definitive care. Their experience will include small group learning, hands-on work stations, and immersive trips to the outdoors. This curriculum will meet the criteria for Advanced Wilderness Medicine (AWS) certification. Students will have the option to pay for full certification, but this will not be required for successful completion of the course and the course curriculum and activities will be identical for all students. There is an approximate cost of $500 for this course.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to 10 students. Available September 13-26, 2026 (rotation 3b)

The Emergency Department is a unique environment in the hospital because unselected patients with undifferentiated chief complaints arrive with no appointment.  Physicians need to rapidly triage, stabilize, rule in and rule out diagnoses, and determine appropriate destination for further work-up or definitive treatment.  This elective is designed for the student who is interested in emergency medicine as a career and needs earlier exposure to this field.  For example, the student has changed career choice and did not complete EM clerkship in M3 year.  Acceptance to the elective is based on application directly to the emergency medicine clerkship director.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s):  None
  
• Duration:  2 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation

Why did we order that test?  What is the evidence for ordering a CBC on a patient with belly pain?   Why would you reflexively order a CT scan on a patient older than 65 with new onset abdominal pain?  These questions and many others will be answered as you search for the primary literature for support of medical decisions made in the Emergency Department.  This two-week elective will consist of several readings, discussions, and direct observation of physician decision-making in the Emergency Department setting.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s):  None
  
• Duration:  2 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Enrollment is limited one student on MED 9108 or MED 9101 at a time.

This elective will introduce the medical student to a more rural population of individuals with a wide variety of Emergency Department presentations.  The student will become familiar with a different hospital system in this more rural setting.  It will be expected that the medical student will further develop their skills of history taking, physical examination, critical thinking, and knowledge of emergency room medicine, including pharmacology, while becoming competent and confident in the diagnosis and management of these issues.  This elective is to assist the student in understanding the type of care that can be offered in a rural setting.  More specifically, the student will see the contrast in the rural and urban setting in managing patients in terms of onsite specialists, onsite medical equipment, and onsite ancillary services.  The student will learn that these limited resources may determine the need to transfer the patient to a higher level of care in an urban medical center where their core Emergency Medicine clerkship has been completed.

• Prerequisite(s): Successful completion of Phase 1 and 2 + 9811 Clerkship - Emergency Medicine 
  
• Co-requisite(s):  None
  
• Duration:  2 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation

This four-week elective is an immersive residential experience in wilderness medicine.  Over the course of the four weeks, the students will develop the skills and knowledge necessary to practice medicine in an austere environment.  They will also learn the skills necessary to survive in such environments and the means by which they can bring patients to definitive care.  Their experience will include small group learning, hands-on work stations, and immersive trips to the outdoors.  Students will be eligible for Wilderness First Responder Certification at the completion of the course.  The course will be taught by nationally known wilderness medicine faculty. There is a cost associated with this coures. Cost for 2025 was $3200 see wms.org for details.

• Prerequisite(s): Successful completion of Phase 1 and 2 + 9811 Clerkship - Emergency Medicine
  
• Co-requisite(s): None
  
• Duration:  4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to six students per rotation. Available February 2 - March 1, 2026 (rotations 8a/b)

The medical student will do inpatient chart review, history taking, and physical examination.  From this information and based on sound geriatric principles, the medical student will develop a differential diagnosis, plan the diagnostic evaluation, and design the geriatric management of the patient.  The location is Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 or 4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation. Available July 6 - December 20 (rotation 1a-6b)

The overall goal of this course is to immerse students in primary care as practiced in a setting distant from immediate access to a tertiary care center.  The focus is on the following themes: 

• Development of autonomy dealing with common and serious conditions in rural primary care 
• Exploration of roles played by physicians in the community • Service learning, particularly as applied to rural underserved care 
• Understanding referral and consultation relationships in a rural environment  

The location is an outpatient practice.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 or 4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to two students per rotation

The Acting Internship in Family Medicine is designed to engage fourth-year medical students in learning a high level of responsibility for primary, inpatient care from a unique family medicine approach and to understand the family physician’s role in the hospital setting.  Other opportunities for student learning may include assisting with or performing, under supervision, simple procedures; participating in the evaluation of patients in the emergency room under the supervision of an upper-level resident; working in the antepartum service, labor and delivery, and the obstetrical wards, as these areas relate to family medicine training.  The preceptor is the Family Medicine inpatient attending and the location is Carilion Roanoke Memorial Hospital. 

• Prerequisite(s): Successful completion of Phase 1 and 2
• Co-requisite(s): None 
• Duration: 4 weeks 
• Curricular Component(s) Met: Medical Subspecialty, Advanced Clinicall Rotation
• Availability: Limited to one student per rotation

The Acting Internship in Family Medicine is designed to engage fourth-year medical students in learning a high level of responsibility for primary, inpatient, and outpatient care from a unique family medicine approach and to understand the family physician’s role in the hospital and ambulatory settings.  Other opportunities for student learning may include assisting with or performing, under supervision, simple procedures; participating in the evaluation of patients in the emergency room under the supervision of an upper-level resident; working in the antepartum service, labor and delivery, and the obstetrical wards, as these areas relate to family medicine training.  The students may also work in the pediatric wards, the newborn nursery, and the intensive care unit, as these are all areas where the Family Medicine service cares for patients in the hospital.  The preceptors are the attendings in the various settings.  The locations are the outpatient practice and Carilion Roanoke Memorial Hospital.   

• Prerequisite(s): Successful completion of Phase 1 and 2
• Co-requisite(s): None 
• Duration:  4 weeks 
• Curricular Component(s) Met: Medical Subspecialty, Advanced Clinical Rotation
• Availability: Limited to two students per rotation

Burnout is a long-term stress reaction marked by emotional exhaustion, depersonalization, and a lack of sense of personal accomplishment. In this course, conditions and situations that promote burnout and psychological distress in physicians will be extensively explored. Resilience-building strategies and the development of resilience networks that will be applicable throughout a medical career and will be discussed. Students will learn how to apply these strategies to all aspects of their lives and will be able to create resilience networks throughout their practice and systems. Several work and home scenarios will be explored via discussion and role-playing. Adaptive and maladaptive responses to such scenarios will be explored. The majority of the course will be conducted online. Please note, this class is taught virtually, but you will be required to attend daily Zoom meetings.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Curricular Component(s) Met: None
• Availability: Dependent on enrollment in these courses 9P03, 9M02, 9946, 9947, and 9950  as only two of these courses will be offered at a time. Available during rotations
  •  September 28 - October 11 (rotation 4a) 
  • October 12-25 (rotation 4b) 
  • January 4-17 (rotation 7a) 
  • January 18-31 (rotation 7b) 
  • March 1-14 (rotation 9a)
  • March 29 - April 11 (rotation 10a) 
  • April 12-25 (rotation 10b)

This two-week elective equips medical students to address spiritual issues that arise in patient care. Students examine how spiritual and religious orientations influence patients, physicians, and caregivers in clinical decision-making, health, and healing. The course emphasizes recognition of caregiver attitudes, appropriate use of spiritual histories, and consultation with chaplains or other advisors. Students also have the option to spend time shadowing a member of the pastoral care team. Topics include spirituality in medicine, specialty-specific applications, research on spirituality and health outcomes, pastoral care models, and clinical approaches to integrating spirituality into patient care. Learning occurs through case narratives, facilitated discussions, and reflection. Please note, this class is taught virtually and is asynchronous. There are no set meetings, but you do have an option of spending time with the chaplain team at RMH.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Curricular Component(s) Met: None
• Availability: Limited to two students per rotation

This elective is a course primarily focusing on development of medicine in the western world from antiquity to the later 19th century.  The course will highlight individuals, theory, and practice.  The course will also explore the role of social, cultural, and religious forces in influencing the practice of medicine.  The contents of this course are offered uniquely in the discussions and readings of the course and provide a background to the path of medicine as we know it and practice it today. Please note this course requires meeting in-person on the first and second Mondays, asynchronous other days with essays submitted for weekly readings. 

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 weeks
• Curricular Component(s) Met: None
• Availability: Limited to three students per rotation. Available November 9 - March 14 (rotations 5b-9a).

This course is designed to provide exposure to important aspects of both patient safety and healthcare quality.  The student will spend time shadowing experts in the fields of human factors, infection prevention, process improvement, event reporting, and root cause analysis.  Students will participate in deep dives to understand the root causes of healthcare associated infections (Referred to as HAIs moving forward) and can identify ways for performance to improve.  In addition, the students will spend time with physicians who are quality improvement leaders in their sub-specialties.  The student will join safety huddles and various patient safety meetings as their schedule allows.  The student will present an article of their choosing at a hospital-wide quality meeting. 

• Prerequisite(s): Successful completion of Phase 1 and 2
• Co-requisite(s): None 
• Duration:  2 weeks 
• Curricular Component(s) Met: None
• Availability: Limited to one student per rotation

This elective will focus on understanding neurosurgery from the perspective of a global view.  Immersive experience in which students will work with the neurosurgery team at the Bir Hospital (National Academy of Medical Sciences), Nepal.  Beyond acquiring knowledge and skills related to complex neurosurgical cases, insight into the dynamics of an alternative healthcare landscape, a nuanced understanding of the challenges and solutions unique to global healthcare contexts will be experienced.  Students will learn to foster global citizenship and learn effective communication skills needed in crosscultural health care settings.  Students will gain an appreciation for diverse healthcare landscapes and the importance of adapting medical practices to different cultural and socioeconomic contexts. 

• Prerequisite(s): Successful completion of Phase 1 and 2
• Co-requisite(s): None 
• Duration:  4 weeks 
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to two students per rotation. Available March 29 - April 25 (rotation 10a-b) with site approval.

The goal of this course is to expose students to the applications and context of clinical ethical issues. This elective aims to deepen students' understanding of medical ethics, enhance their skills in evaluating ethical dilemmas, and provide practice in analyzing situations within a multidisciplinary team context. Additionally, students will develop clinical ethics consultation skills and explore ethical issues from individual, organizational, and societal perspectives. Over this two-week elective, students will improve their ability to navigate ethical challenges in clinical scenarios, apply ethical principles effectively, and engage in ethical decision-making across multiple levels of healthcare practice. Students are required to participate in all clinical ethics consults at Carilion Roanoke Memorial Hospital as well as other relevant ethics educational activities as appropriate.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Curricular Component(s) Met: None
• Availability: Limited to one student per rotation

This elective course offers a “boots on the ground” experience in health policy. Students will explore policy in action through a two-or four-week placement at the Roanoke City Health Department that includes development and execution of an independent project involving health policy. The independent project may include directly working with VTC partners such as Carilion Clinic, Bradley FreeClinic, or other community-based organizations. Supervised by the Course Director, students may also collaborate with policy partners (e.g., a local elected official or executive director of a local community based organization, local, state, and federal policy making bodies, or other agents of change). Please note this course is hybrid with in-person meeting and asynchronous work. 

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 or 4 weeks
• Curricular Component(s) Met: Medical Subspecialty, Advanced Clinical Rotation
• Availability: Open for enrollment during all rotations

The goal of this course is to prepare senior medical students for a successful transition to residency by integrating the knowledge, skills, and professional experiences gained throughout medical school into a cohesive plan for residency application, match, and early career development. Through focused instruction and guided practice, students will learn to craft competitive residency applications, strengthen interview and communication skills, and strategically approach program selection and the Match process. The course also emphasizes personal reflection, professional identity formation, and preparation for the expectations of residency, supporting students in making a confident and successful transition to graduate medical education. Over this two-week elective, students will engage in structured activities and guided reflection to prepare for the residency application and Match process. They will refine their personal statement and CV, develop strategies for obtaining strong letters of recommendation, and complete the residency application. Students will meet with speciality specific advisors, prepare for and participate in mock interviews, explore residency programs and specialty competitiveness, and practice building a balanced application list. In addition, they will review NRMP rules, prepare contingency plans including SOAP, and reflect on their professional identity formation. Students are required to actively participate to complete didactic requirements, and will be expected to apply the knowledge gained from the longitudinal career advising program. Throughout the elective, students will work closely with the student affairs team to complete the residency application and prepare for residency interviews. 

• Prerequisite(s): Successful completion of Phase 1, Step 1 completion preferred. Must obtain approval is Step 1 not complete
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Curricular Component(s) Met: None
• Availability: Available during the following rotations
  • July 6-19 (rotation 1a)
  • August 17-30 (rotation 2b)

This elective will consist of consulting on patients who are hospitalized with infections. The medical student will do the patient’s chart review, history taking, and physical examination.  From this information, the student will develop a differential diagnosis, plan the diagnostic evaluation, and design the infectious disease management of the patient, based on sound microbiological, antibiotic, and physiological principles.  The preceptor is the attending on the inpatient service and the location is Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation

The Cardiology Consult elective will give the medical student an introduction in rendering consultative advice on a wide variety of cardiovascular issues in a hospital setting.  Typical patients will include pre-operative clearance for non-cardiac surgeries, post-operative complications including arrhythmias and hemodynamic instability, or patients with acute coronary syndromes, heart failure, or other cardiovascular issues admitted to non-cardiology services.  The student will perform complete reviews of the patient’s electronic medical record, take an independent history, and perform a complete physical examination.  From this information, the student will develop a differential diagnosis, plan the diagnostic studies including laboratory tests and imaging studies, and design the cardiovascular management plan for the patient.  The student will be part of the rounding team that will include the attending, cardiology fellow, and often one or more medical residents.  The student will review his/her management plan with the fellow and/or resident before presenting it to the attending.  The preceptor is the attending on the inpatient service and the location is Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 or 4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation

This two- or four-week elective provides students with clinical experience in the evaluation and management of musculoskeletal and rheumatologic diseases, primarily in the outpatient setting. Students will perform patient-centered histories, physical examinations, and electronic documentation, and will develop differential diagnoses and diagnostic plans. Through supervised patient encounters, students will refine their ability to distinguish mechanical and degenerative conditions from systemic inflammatory and autoimmune diseases, interpret laboratory and imaging studies, and observe musculoskeletal ultrasound. The course emphasizes outpatient consultation, clinical reasoning, and concise case presentation.

• Prerequisite(s): Successful completion of Phase 2
  
• Co-requisite(s): None
  
• Duration: 2 or 4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation. Not available October 26 - December 6 (rotation 5a-6a)

Students will learn how to assist individuals who have permanent impairments (paralysis, sensory loss, cognitive dysfunction, alteration of consciousness, decreased endurance, etc.) in identifying their remaining abilities and developing them to their maximum potential.  There is a strong emphasis on the team approach, with communication as the vital link between team members, most importantly the patient and the patient's family.  We will try to focus on issues that students will likely see in their primary practices.  The location is the Rehabilitation Unit at Carilion Roanoke Community Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 or 4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation between any Physical Medicine and Rehabilitation electives. Not available July 6 - August 2 (rotation 1a-b). 

This elective provides students with exposure to the inpatient and outpatient evaluation and management of pulmonary diseases at Carilion Roanoke Memorial Hospital and affiliated clinics. Students will conduct chart reviews, obtain patient histories, and perform physical examinations. Using physiopathological principles, students will develop differential diagnoses, propose treatment plans,and apply diagnostic testing in the context of pulmonary disorders. The course emphasizes history taking, physical examination, clinical reasoning, and the application of evidence-based diagnostic and therapeutic measures in pulmonary medicine, including considerations of the patient's quality of life in clinical decision-making and communication. Students will also prepare and delivercase presentations that demonstrate their ability to synthesize clinical findings, diagnostic data, and management strategies.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 or 4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation. Not available July 6 - August 2 (rotation 1a-b).

Students will be paired with a faculty member in Internal Medicine.  Students will be exposed to a wide array of patients with diseases and conditions typically seen in an outpatient internal medicine setting, such as diabetes, hypertension, and chronic lung disease.  Students will learn to do a focused history and physical exam pertinent to the patient’s reason for being seen.  Students will then report their findings to the attending physician and together formulate a management plan for the patient.  The preceptor is the ambulatory faculty attending and the location is Carilion Clinic Riverside complex.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 or 4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation. Not available September 28 - December 20 (rotation 4a-6b)

This elective will consist of consulting on patients who are hospitalized with serious illnesses.  The medical student will do the patient’s chart review, history taking, and physical examination.  From this information, the student will be able to synthesize information to develop an interdisciplinary plan of care incorporating palliative care principles for the patient and family that address comprehensive views of suffering.  The location is Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 or 4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation

The Internal Medicine Acting Internship (AI) elective seeks to provide the senior medical student an inpatient learning experience similar to that of a PGY1 internal medicine resident.  The student will be assigned to an inpatient faculty internal medicine teaching team comprised of an attending physician, a PGY2 or PGY3 resident, two PGY1 residents, and possibly one or two other medical students.  The student will be assigned patients who are admitted to their team and will assume an integral role in providing care for that patient during their hospitalization.  The student on the AI elective will be assigned duties and responsibilities very similar to those of the PGY1 residents.  These duties include, but are not limited to, taking a complete history and performing a complete physical on the patients assigned to them, initiating appropriate orders on their patients, which will require co-signature, following the patient throughout their hospitalization, and assisting with discharge planning.  The AI student may also be involved in procedures on their patients when indicated. The student will be expected to be on call when their team is on call, including overnight call similar to other PGY1 residents, as well as follow all duty hour rules of the program.  The student will also be expected to participate in teaching activities including contributions to teaching rounds and morning report.  The student will be expected to attend the didactic conferences provided to the students and residents.  The preceptor is the inpatient attending and the location is Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 4 weeks
• Curricular Component(s) Met: Medical Subspecialty, Advanced Clinical Rotation
• Availability: Limited to 3 students per rotation. Available during the following rotations
  •  July 6 - August 2 (rotation 1a-b)
  • August 3 - August 30 (2a-b)
  • August 31 - September 27 (3a-b)

The fourth-year medical student who takes this elective will be immersed in a busy inpatient cardiology service with exposure to a wide spectrum of cardiovascular diseases including acute coronary syndromes, valvular heart diseases, cardiomyopathies, and common dysrhythmias.  He/she will also help manage an outpatient cardiology observation unit.  Most patients in the observation unit will be low-risk patients with chest pain or those with heart failure exacerbations.  Chest pain patients will be ruled out for myocardial necrosis, then undergo appropriate non-invasive studies such as exercise treadmill testing, exercise or dobutamine stress echocardiography, nuclear cardiology study (e.g. Lexiscan), or cardiac computed tomographic angiography study.  The Acting Intern (AI) will be involved in deciding the most appropriate noninvasive/imaging modality for the patient as well as participate in analyzing the electrocardiogram (ECG) and imaging aspects of the study.  Patients with heart failure will be investigated for etiology of HF exacerbation and have appropriate diagnostic studies and adjustment of medical regimens.  Some of the patients from the observation unit will be admitted to the AI’s inpatient service.  The AI will work closely with the attending, mid-level provider, and resident.  On most rotations, a cardiology fellow will also be involved in teaching the AI and intern.  The preceptor is the inpatient attending and the location is Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  4 weeks
• Curricular Component(s) Met: Medical Subspecialty, Advanced Clinical Rotation
• Availability: Limited to one student per rotation

The Coronary Care Unit (CCU) provides intensive care for a wide range of cardiovascular issues.  The student will be exposed to unstable acute coronary syndromes, cardiogenic shock, decompensated heart failure, unstable rhythms, hypothermia protocol, and many other unstable cardiac conditions requiring intensive care.  The elective occurs in the CCU of Carilion Roanoke Memorial Hospital, and the student will work with the CCU team to provide care for the patients in the unit.  The student will participate in cardiac catheterizations and other procedures as warranted.  The preceptor is the CCU faculty attending.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 or 4 weeks
• Curricular Component(s) Met: ICU
• Availability: Limited to one student per rotation

The medical student will do the patient’s chart review, history taking, and physical examination.  In consultation with the attending, the student will develop a differential diagnosis, plan the diagnostic evaluation, and design a management plan for the patient’s skin disease.  The locations are Carilion Clinic Riverside complex and Carilion Roanoke Memorial Hospital. 

• Prerequisite(s): Successful completion of Phase and 2
  
• Co-requisite(s): None
  
• Duration:  2 or 4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation. Not available July 6 - August 2 (rotation 1a-b).

Students will be exposed to a wide array of common and unusual gastrointestinal conditions.  Additionally, students will attend procedures in the endoscopy suite.  They will review the patient’s chart, obtain a pertinent history, and perform an appropriate physical examination.  In consultation with the attending, students will develop a differential diagnosis, plan the diagnostic evaluation, and design management options for the patient’s gastrointestinal disease.  The locations are Carilion Clinic Riverside complex and Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 or 4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation

This elective will consist of working primarily in the outpatient setting in conjunction with the faculty hematologist/oncologist.  The medical student will do the patient’s chart review, history taking, and physical examination.  From this information, the student will develop a differential diagnosis, plan the diagnostic evaluation, and discuss the patient’s management options with the attending. The location is Blue Ridge Cancer Care.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
• Duration: 2 or 4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation

This elective is intended to expose medical students to a wide variety of acute and sub-acute medical pathologies and to enable them to provide physiologic support for patients who have suffered acute catastrophic insult. Students will gain experience in daily examinations of critically ill patients and in ventilator management, coordinating care of patients with multiple health care providers. They will apply evidence-based concepts to diagnosis, care, and outcome prediction of critically ill patients. The preceptor is the ICU attending and the location is Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 or 4 weeks
• Curricular Component(s) Met: ICU
• Availability: Limited to one student per rotation. Not available July 6 - August 2 (rotation 1a-b).

This elective will consist of inpatient/outpatient work in conjunction with the nephrologist.  The medical student will learn about fluid management as well as dialysis management and the illnesses that typically accompany renal disease such as hypertension (HTN).  The preceptor is the attending of record from Valley Nephrology and the location is Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 or 4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation

In this elective, the student will learn how to assist individuals who have permanent impairments (paralysis, sensory loss, cognitive dysfunction, alteration of consciousness, decreased endurance, etc.) in identifying their remaining abilities and developing them to their maximum potential.  There is a strong emphasis on the team approach, with communication as the vital link between team members, most importantly the patient and the patient's family.  We will try to focus on issues that the student will likely see in their primary practice.  On the Advanced Physical Medicine and Rehabilitation rotation, the student will be engaged in discharge planning and follow-up planning and is expected in general to have a wider knowledge base of how to care for patients on the service.  The student will make an oral  presentation to the preceptor on a topic agreed upon by the preceptor and the student.  The M4 student will be expected to gain a level of independence on the Advanced PM&R elective that is indicative of their prior experience in a PM&R setting.  The location is the Rehabilitation Unit at Carilion Roanoke Community Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2 + 9304
  
• Co-requisite(s): None
  
• Duration:  4 weeks
• Curricular Component(s) Met: Medical Subspecialty, Advanced Clinical Rotation
• Availability: Limited to three students (July only, rotation 1a). All other rotations limited to one student per rotation between any Physical Medicine and Rehabilitation electives.

The medical student will do the patient’s chart review, history taking, and physical examination.  In consultation with the attending, the student will develop a differential diagnosis, plan the diagnostic evaluation, and design a management plan for the patient’s skin disease.  The student will review the literature and make a 15-minute oral presentation to the attending on a relevant topic agreed upon by the attending and the student.  The student will be expected to be more actively engaged in diagnosis and treatment planning with skills congruent to having had a previous dermatology elective and will be expected to be more involved in the management of procedures in the office setting.  The locations are Carilion Clinic Riverside complex and Carilion Roanoke Memorial Hospital. 

• Prerequisite(s): Successful completion of Phase 1 and 2 + 9312 or 9322
• Co-requisite(s): None
  
• Duration: 4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to three students. Available in July only (rotation 1a-b). 

Students will make home visits with home health nurses, a physician, and a nurse practitioner.  They will attend the interdisciplinary team rounds on Thursday mornings and will learn the regulations around eligibility for hospice services.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation

Students will learn the principles of radiation oncology as well as communication skills with patients who have been determined to have a malignancy which may be responsive to radiation.  Students will also learn interprofessionalism through communication with techs, nursing staff, and possibly oncologists.  The location is Blue Ridge Cancer Care.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 or 4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation

The Elective is an online dermatology course for students who may utilize the skills learned in any specialty of clinical practice.  Included in this course are terminology for describing the morphology of basic skin lesions, the appropriate conduction of a skin exam, forming a differential diagnosis based on morphologic diagnosis, recognizing characteristic appearances of benign and malignant skin lesions, describing drug reactions, and identifying therapies for dermatologic illnesses or lesions. This is a virtual course. 

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Unlimited openings per rotation

Throughout the course, the student will be exposed to the variety of hormonally active conditions in a clinical setting.  The student will examine patients while practicing empathy and identify endocrine problems to include by not limited to diabetes, thyroid disease, metabolic bone disease, and adrenal and pituitary disease.  The student will utilize appropriate laboratory and radiological data.  Supplementing this will be a series of didactic presentations led by experts in the field of Endocrinology to complete a review of the common conditions encountered and their treatment. 

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation

This two-week elective provides the student insight into incorporating acupuncture and integrative medicine into modern medical practice, as well as practical applications for the use of Botulinum toxin injections for spasticity and other approved diagnoses.  Students will also learn the basic principles of electromyography and nerve conduction study, and pain management in a Physical Medicine and Rehabilitation stetting. 

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation between any Physical Medicine and Rehabilitation electives. 

This acting internship provides Phase 3 VTCSOM students with advanced clinical experience in inpatient hospital medicine under the direct supervision of a hospitalist attending physician. Students will assume graduated responsibility in the evaluation and management of acutely ill adult patients across intensive care (ICU), progressive care (PCU), and medical-surgical units.

Learners will perform focused and comprehensive histories and physical examinations, synthesize clinical data to develop problem lists and differential diagnoses, and formulate patient-centered management plans that incorporate evidence-based practices and patient safety principles. The rotation emphasizes effective interprofessional communication, collaborative care coordination, and culturally responsive engagement with patients and families.

Students will participate in direct patient admissions, overnight coverage, and emergency responses, including Code Blue and Rapid Response events. Through this immersive experience, students will refine clinical judgment, professionalism, and readiness for residency-level responsibilities in internal medicine.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): none
  
• Duration:  4 weeks
• Curricular Component(s) Met: Medical Subspecialty, Advanced Clinical Rotation
• Availability: Limited to one student per rotation

This four-week elective allows Phase 3 medical students to broaden their clinical knowledge and cultural competence through supervised clinical experiences at Wonju College of Medicine in South Korea. Students participate in patient care, review diagnostic data, engage in clinical skills training, and explore the structure and function of Korea’s healthcare system. The experience emphasizes global health disparities, interprofessional collaboration, and reflective practice, while fostering professional development in an international medical education environment.

• Prerequisite(s): VTCSOM students in good standing who have completed Phase 1 and 2, the Elective Selection process, and comply with the Global Health Elective Policy
  
• Co-requisite(s): None
  
• Duration:  4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to two students per rotation. Available during the following rotations
  • February 1-28 (rotation 8a-b)
  • March 29 - April 25 (rotation 10a-b)

This four-week elective offers Phase 3 VTCSOM students the opportunity to broaden their medical knowledge through supervised clinical experiences in Taiwan. Students will engage in inpatient and outpatient care at MacKay Medical University and MacKay Memorial Hospital and its affiliates, participate in interprofessional and culturally informed healthcare, interpret diagnostic imaging and lab results, practice procedural skills as appropriate for chosen specialty, and reflect on system-level differences in practice. The elective also emphasizes globalhealth, cultural exchange, and health equity, allowing students to explore Taiwanese approaches to care in a modern urban setting.

• Prerequisite(s): VTCSOM students in good standing who have completed Phase 1 and 2, the Elective Selection process, and comply with the Global Health Elective Policy
  
• Co-requisite(s): None
  
• Duration:  4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to two students per rotation for a max of four students across 9G09, 9G10, 9G11. Available March 29 - April 25 (rotation 10a-b)

This four-week elective allows Phase 3 VTCSOM students to broaden their medical knowledge through supervised inpatient andout patient clinical experiences at E-DA Hospital and I-SHOU University in Kaohsiung City, Taiwan. In addition to exposure to Western clinical care, students may participate in an integrated course in Traditional Chinese Medicine (TCM), learning about acupuncture, herbal medicine, and Eastern medical philosophies. Students will also interpret diagnostic images and lab results, explore healthcare disparities, global health systems, and medical tourism. The experience is tailored to individual student interests and provides aunique urban and cultural immersion.

• Prerequisite(s): VTCSOM students in good standing who have completed Phase 1 and 2, the Elective Selection process, and comply with the Global Health Elective Policy
  
• Co-requisite(s): None
  
• Duration:  4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to two students per rotation for a max of four students across 9G09, 9G10, 9G11. Available March 29 - April 25 (rotation 10a-b)

This four-week elective allows Phase 3 VTCSOM students to engage in supervised clinical rotations across two distinct locations in Taiwan: E-DA Hospital/I-SHOU University in Kaohsiung and MacKay Medical Univeristy and MacKay Memorial Hospital in Taipei/New Taipei. Students will observe inpatient and outpatient care, participate in team-based rounds, and explore both Western and Traditional Chinese Medicine across general and specialty areas. This rotation includes exposure to healthcare disparities, cultural influences on medicine, and systems-based practice in a unique international setting.

• Prerequisite(s): VTCSOM students in good standing who have completed Phase 1 and 2, the Elective Selection process, and comply with the Global Health Elective Policy
  
• Co-requisite(s): None
  
• Duration:  4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to two students per rotation for a max of four students across 9G09, 9G10, 9G11. Available March 29 - April 25 (rotation 10a-b)

This four-week international elective provides Phase 3 VTCSOM students the opportunity to engage in clinical observation and practice at Wroclaw Medical University in Poland. Students will gain exposure to inpatient and outpatient care, including surgical and diagnostic techniques, and laboratory studies related to selected clinical case, across a variety of medical disciplines. The experience also includes exploration of healthcare delivery in a European public academic medical center, as well as the cultural, systemic, and educational dimensions of healthcare in Poland.

• Prerequisite(s): VTCSOM students in good standing who have completed Phase 1 and 2, the Elective Selection process, and comply with the Global Health Elective Policy
  
• Co-requisite(s): None
  
• Duration: 4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to two students per rotation. Available during the following rotations     
  • February 1-28 (rotation 8a-b)
  • March 29 - April 25 (rotation 10a-b)

During the online application process to the International Health Central American Institute (IHCAI), the student’s Spanish proficiency will be evaluated through standardized oral and written exams to ensure placement in the correct level of coursework. Instruction will focus on Spanish grammar, vocabulary, pronunciation, and comprehension, supported by regular homework assignments. Students will also engage in clinical patient interactions and attend lectures and seminars on the Costa Rican health system and the diseases and challenges of tropical medicine. Instructional methods will include simulated patients, medical chart analysis, and medical interviews of increasing complexity. Through this training, students will develop the ability to interview Spanish-speaking patients, formulate a presumptive diagnosis, and provide appropriate recommendations. Please note, requires student to pay tutition to IHCAI.

• Prerequisite(s): VTCSOM students in good standing who have completed Phase 1 and 2, the Elective Selection process, and comply with the Global Health Elective Policy
  
• Co-requisite(s): None
  
• Duration:  4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Available during the following rotations     
  • February 1-28 (rotation 8a-b)
  • March 29 - April 25 (rotation 10a-b)

This elective, offered in partnership with the University of Cincinnati Department of Surgery, focuses on providing an immersive general surgery experience in a global health context. Students will work closely with the surgical team at Mzuzu Central Hospital in Malawi. The elective aims to broaden participants' understanding of global healthcare, develop their surgical skills in a resource-limited environment, and foster an appreciation for diverse medical practices. Participants will leave the elective with a deeper appreciation for global health issues, improved surgical skills, and enhanced cultural competence, prepared to adapt medical practices to various healthcare settings worldwide. Outpatient setting and the treatment plans for surgical consults.

• Prerequisite(s): VTCSOM students in good standing who have completed Phase 1 and 2, the Elective Selection process, and comply with the Global Health Elective Policy
  
• Co-requisite(s): None
  
• Duration:  4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation. Available February 1-28 (rotation 8a-b) with acceptance through the University of Cincinnati

This elective will focus on Altitude Medicine, a subspecialty of Wilderness Medicine. This elective will be a 4-week immersive experience in which students will prepare for and trek to Everest Base Camp, visiting several of the rural medical clinics along the way. Students will learn about altitude physiology, pathophysiology, and prevention of acute mountain sickness. They will also have an opportunity to participate in and help teach a wilderness medicine workshop to medical students from Tribhuvan Institute of Medicine in Kathmandu as well as to Girls In Action, a group for secondary school-aged girls in Kathmandu. The course will be offered in late Spring (April) during peak summit season for Mt. Everest, where Everest ER is functional. The first week is cultural and expedition education as well as planning. In the last 3 weeks, students will trek to Everest Base Camp and visit Lukla Hospital, Khunde Hospital, the Medical Clinic at Namche Bazaar, the HRA clinic at Pheriche, and of course Everest ER. This elective requires some fairly intense physical training. It is suggested that students read the course requirements in Canvas before committing to this elective.

• Prerequisite(s): VTCSOM students in good standing who have completed Phase 1 and 2, the Elective Selection process, and comply with the Global Health Elective Policy
  
• Co-requisite(s): None
  
• Duration:  4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation. Available February 1-28 (rotation 8a-b) with approval from course directors.

This elective will focus on understanding neurosurgery from the perspective of a global view. Immersive experience in which students will work with the neurosurgery team at the Bir Hospital (National Academy of Medical Sciences), Nepal. Beyond acquiring knowledge and skills related to complex neurosurgical cases, insight into the dynamics of an alternative healthcare landscape, a nuanced understanding of the challenges and solutions unique to global healthcare contexts will be experienced. Students will learn to foster global citizenship and learn effective communication skills needed in cross-cultural health care settings. Students will gain an appreciation for diverse healthcare landscapes and the importance of adapting medical practices to different cultural and socioeconomic context.

• Prerequisite(s): VTCSOM students in good standing who have completed Phase 1 and 2, the Elective Selection process, and comply with the Global Health Elective Policy
  
• Co-requisite(s): None
  
• Duration:  4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to two students per rotation with approval from the course directors. Available during the following rotation
  • March 29 - April 25 (rotation 10a-b)

This elective allows Phase 3 VTCSOM students to design and complete an individualized global health experience. Students will work with the Director, Community Engagement and the Phase 3 Director to develop a tailored global health learning plan that aligns with the scope, requirements, and educational goals of both VTCSOM and the selected site. Depending on the host institution, students may engage in clinical observation, supervised patient care, team-based rounds, outpatient or inpatient practice, procedural training, health systems exploration, or community-based health initiatives. The elective emphasizes adaptability in diverse healthcare environments, awareness of global health disparities, and development of culturally responsive medical practice. Students will deepen their understanding of healthcare delivery across settings, enhance their clinical and communication skills, and gain insight into the sociocultural and systemic influences that shape health worldwide. Each student’s experience will vary based on the clinical discipline, host country or region (if applicable), and site-specific opportunities. Final approval of goals, activities, and learning outcomes will be granted by the Medical Curriculum Committee in accordance with VTCSOM policies.

• Prerequisite(s): VTCSOM students in good standing who have completed Phase 1 and 2, the Elective Selection process, and comply with the Global Health Elective Policy
  
• Co-requisite(s): None
  
• Duration:  4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Available  February 2-28 (rotation 8a-b) March 29 - April 25 (rotation 10a-b) with approval from the course directors. Subject to availability at the host medical school or affiliated academic medical center

This two-week elective engages students in the principles and practices of medical education, providing structured opportunities to apply educational theory within clinical and academic contexts. Students will facilitate small and large group learning using adult learning and feedback principles, design educational and evaluative cases that integrate curricular content and assessment methods, and contribute to curriculum design and review as members of the medical education team. Instructional activities include co-facilitation of problem-based learning sessions, participation in curriculum and assessment committee meetings, and authorship of a detailed teaching case. Students will also reflect on professional development and systems awareness in medical education settings.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Curricular Component(s) Met: None
• Availability: Limited to two students per rotation. Not available November 23 - December 20 (rotation 6a-6b)

This course explores the nature of medical errors, the malpractice litigation process, medical-legal reporting systems, malpracticeinsurance, and their psychological and professional impact on the practitioner. Students will analyze the role of malpractice lawsuitswithin the healthcare system, evaluate risk-reduction strategies, and practice deposition testimony. Students will discuss real-life examples and practice testifying in deposition. This class will review other major medical-legal entities that a physician mightencounter in his/her career as well as the importance of maintaining wellness throughout the stressful medical-legal process. Please note, this is a virtual course. However, you will be required to attend daily virtual meetings. 

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Curricular Component(s) Met: None
• Availability: Dependent on enrollment in these courses 9P03, 9M02, 9946, 9947, and 9950 as only two of these courses will be offered at a time. Available during rotations
  • August 31 - September 13 (rotation 3a)
  • September 14-27 (rotation 3b)
  • October 26 - Novemberr 8 (rotation 5a)
  • November 19-22 (rotation 5b)
  • November 23 - December 6 (rotation 6a)
  • February 1-14 (rotation 8a)
  • February 14-28 (rotation 8b)

The Academic Medicine Leadership elective provides medical students an opportunity to engage in and learn core principles of academic medicine and leadership. This longitudinal elective (equivalent to a two-week elective, minimum 30 hours) will provide individuals the opportunity to actively engage in the change management process of the medical school by working directly with leaders who are responsible for leading change within the education mission of VTCSOM. Participants will learn through several methods: (1) participating in an observing strategic planning meetings related to curricular reform, (2) contributing to the development of strategic planning workshop design and data collection, (3) attending meetings with the Senior Associate Dean for Medical Education to synthesize findings and explore questions related to change management in medical education, (4) attending meetings with other senior leadership at VTCSOM who are involved in the change process, and (5) designing and completing a final reflection project that integrates lessons learned with influence on future career. Please note this is a longitudinal elective. You will see the course listed on your schedule as 10b.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
• Duration:  2 weeks
• Curricular Component(s) Met: None
• Availability: Limited to two students. This is a longitudinal elective and will be listed on schedule as 10b.

This elective provides clinical experience in the diagnosis, treatment, and prevention of cerebrovascular disease. Students will participate in acute stroke response, inpatient consultations, and outpatient stroke prevention clinics. Clinical exposure includes participation in “Stroke Alerts,” interpretation of neuroimaging, formulation of management plans for acute ischemic and hemorrhagic stroke, and implementation of secondary prevention strategies. Students will also observe interventional neuroradiology procedures and attend multidisciplinary stroke case conferences. The course emphasizes evidence-based management, systems-based transitions of care, and interprofessional collaboration in comprehensive stroke treatment.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation. 
  • Available July 20 - August 2 (rotation 1b)
  • August 31 - September 13 (rotation 3a) 
  • October 12 - 25 (rotation 4b)
  • November 23 - December 6 (rotation 6a)
  • January 18 - 31 (rotation 7b) 
  • March 1 - 14 (rotation 9a)  
  • April 12-April 25 (rotation 10b)

This elective provides advanced clinical experience in inpatient neurology through participation in the neurology consult service at Carilion Roanoke Memorial Hospital. Students will evaluate and manage hospitalized patients with acute or complex neurologic disorders, including stroke, encephalopathy, seizures, neuromuscular disorders, and neurologic complications of systemic illness. Under the supervision of attending neurologists, students serve as the primary interviewer and examiner for new consults, interpret diagnostic data, and present findings and management plans on rounds. The course emphasizes evidence-based management, critical care exposure, and interprofessional communication within a multidisciplinary team. This elective is ideal for students pursuing neurology, neurosurgery, emergency medicine, or hospital-based specialties seeking a deeper understanding of neurologic consultation and inpatient care.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation. 
  • Available July 20 - August 2 (rotation 1b)
  • August 31 - September 13 (rotation 3a) 
  • October 12 - 25 (rotation 4b)
  • November 23 - December 6 (rotation 6a)
  • January 18 - 31 (rotation 7b) 
  • March 1 - 14 (rotation 9a)  
  • April 12-April 25 (rotation 10b)

This elective provides advanced, individualized outpatient neurology training for Phase 3 medical students seeking a broader understanding of neurologic disorders encountered in ambulatory settings. Students work one-on-one with attending neurologists in general and subspecialty clinics, including movement disorders, epilepsy, neuromuscular disease, multiple sclerosis, cognitive disorders, and general neurology consultations. Learners perform patient evaluations, interpret diagnostic studies, and develop management plans under direct supervision. The course emphasizes evidence-based practice, patient-centered communication, and professional collaboration within multidisciplinary teams. Students are expected to function with progressive independence, integrating diagnostic reasoning and clinical judgment in the longitudinal care of patients with neurologic disease.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation. 

This Acting Internship in Neurology provides advanced clinical experience for Phase 3 VTCSOM students preparing for residency in Neurology or related fields such as Neurosurgery or Psychiatry. Students serve as active members of the inpatient and outpatient neurology teams, assuming supervised primary responsibility for patient care. Clinical duties include performing comprehensive and focused neurologic evaluations, developing differential diagnoses, ordering and interpreting diagnostic studies, and formulating evidence-based management plans. Rotation experiences include two weeks on the general neurology consult service, one week on the stroke team, and one week in the outpatient clinic. Students gain exposure to a wide range of neurologic disorders, including cerebrovascular, demyelinating, movement, neuromuscular, and seizure disorders. The elective emphasizes diagnostic reasoning, clinical documentation, interprofessional collaboration, and readiness for residency-level responsibility.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  4 weeks 
• Curricular Component(s) Met: Medical Subspecialty, Advanced Clinical Rotation
• Availability: Limited to two students per rotation. 

The goal of this course is to provide medical students with a comprehensive understanding of headache disorders, focusing on their pathophysiology, diagnosis, and management. Students will gain the necessary skills to assess and manage both acute and chronic headaches, utilizing evidence-based treatment strategies and procedural interventions. This course will also emphasize the importance of patient education and multidisciplinary collaboration while navigating complex clinical scenarios. Over this four-week elective students will engage in both didactic and hands-on learning, including patient interactions, case discussions, and procedures. They will have the opportunity to assess real-world headache cases in clinical settings, collaborate with specialists, and enhance their diagnostic and treatment planning skills. Additionally, students will be introduced to advanced therapeutic techniques, including OnobotA injections and nerve blocks for headache management. Students are required to actively participate to complete didactic requirements, patient assessments, diagnostic workups, and treatment planning discussions. They will also be expected to apply their knowledge from previous clerkships and coursework. Throughout the elective, students will work closely with Neurology and Pediatric Neurology team to ensure holistic patient care, while refining their clinical, procedural, and communication skills.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  4 weeks 
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Unavailable for 2026-2027. For 2027-2028 only available May and June.

This elective is designed for a student interested in obstetrics and gynecology or primary care with a strong emphasis on women’s health or a surgical subspecialty.  This elective will expose the student to the evaluation and management of patients with pelvic organ prolapse and urinary incontinence.  The student will be involved in the outpatient management of patients with the above conditions.  They will become familiar with medical and surgical management options.  The student will have an opportunity to participate in fitting pessaries and observing urodynamics and outpatient cystoscopy.  At least one day a week will be spent in the operating room and the student will be responsible for following post-operative patients during their hospital stay.  Students will also participate in Friday morning didactics with the residents.  The locations are the outpatient clinic and Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Curricular Component(s) Met: Surgery Subspecialty
• Availability: Limited to one student per rotation across all Urogyecology electives.

This is a sub-internship elective designed for a student interested in obstetrics and gynecology or a surgical subspecialty.  The student will gain experience in the outpatient evaluation of patients with potential gynecologic malignancies.  The student will observe and assist with surgical cases including robotic cases.  The student will gain an understanding of post-operative management of complicated surgical patients and will round on these patients with the gynecologic oncology team as an acting sub-intern.  The student will be expected to present a topic of their choosing to the team at the end of the rotation or participate in an oral exam given by one of the gynecologic oncologists.  The fourth-year student will participate in the same didactic curriculum with the residents.  There is no on-call responsibility, but the student will be expected to participate in inpatient rounds during two of the four Saturdays.  The locations are Carilion Clinic Riverside complex and Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 4 weeks
• Curricular Component(s) Met: Surgery Subspecialty, Advanced Clinical Rotation
• Availability: Limited to two students per rotation

This elective is designed to provide the participating student with exposure to the breadth of high-risk obstetrics.  The student will evaluate and manage high-risk obstetrical patients in the office and hospital setting.  In the outpatient setting the student will participate in genetic counseling sessions, ultrasound and Maternal Fetal Medicine consultations including conditions of anemia, diabetes mellitus, urinary tract disorders, infectious diseases, asthma, surgical abdomen, and chronic hypertension.  The student will participate in the care of patients with preterm labor, in the care of patients when fetal anomalies are identified, and in the care of patients with multifetal gestations.  The student will interact with the Maternal Fetal Medicine attendings, OB residents, genetic counselors and sonographers. The student will participate in the management of acute and high-risk obstetrical conditions by rounding daily on the antepartum service with the residents and faculty.  The student will participate in intrapartum management during this rotation.  There is no call requirement for this rotation. 

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 4 weeks
• Curricular Component(s) Met: Surgery Subspecialty, Advanced Clinical Rotations
• Availability: Limited to one student per rotation across all Maternal Fetal Medicine electives.

This 2-week elective is designed for 4th year medical students who will enter an obstetrics and gynecology residency after graduation.  Students will review and manage obstetrical and gynecologic conditions.  This elective is modeled after the CREOG-APGO Step Up to Residency curriculum, and will include self-study, didactics, computer modules, simulation, and clinical time.  The goal of this elective is for each student to be prepared for entering residency, with the following national objectives set by CREOG-APGO: enhance knowledge of applications of simulated patient cases; practice skills helpful in early stages of residency; discuss critical skills necessary for success in residency.  If there are fewer than three students enrolled, then the elective will include self-study, computer modules, and clinical time but there will not be simulation or didactic time. 

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 weeks
• Curricular Component(s) Met: Surgery Subspecialty
• Availability: Limited to 10 students per rotation. Available March 29 - April 11 (rotation 10a)

This course is designed for exposure to the assessment and treatment of advanced gynecologic pathology.  This experience will provide experience in both the clinic and operating room for patients with chronic pelvic pain symptoms.  The student will participate directly in all aspects of care including initial outpatient consult and workups in clinic, decision analysis of treatment modalities including but not limited to physical exam assessment, surgical planning, medical regimens, incorporations of pelvic physical therapy, trigger point injections, and amendment of treatment plans.  Emphasis will also be placed on intra-operative exposure and participation in laparoscopic and hysteroscopic surgeries each week.  The student will be required to observe the duties of an on-call physician (home call for one weekend) during the clerkship.  Travel will be involved to Carilion Stonewall Jackson Hospital in Lexington, VA and to Carilion Franklin Memorial Hospital in Rocky Mount, VA. 

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 4 weeks
• Curricular Component(s) Met: Surgery Subspecialty, Advanced Clinical Rotation
• Availability: Limited to one student per rotation

This course is designed as a well-rounded exposure to the assessment and treatment of pelvic floor disorders, clinically and surgically within the specialty of Obstetrics and Gynecology (OBGYN).  The student will participate directly in all aspects of care including initial outpatient consult and workups in clinic, decision analysis of treatment modalities including but not limited to physical exam assessment, surgical planning medical regimens, incorporations of pelvic floor physical therapy, and amendment of treatment plans.  Emphasis will also be placed on intra-operative exposure and participation in surgeries each week, and students will round postoperatively on patients on remain inpatient.  In the inpatient and outpatient setting, the student is required to function at the level of an acting intern. The student will have the opportunity to observe pelvic floor physical therapy, urodynamics, and other office-based procedures.  Attendance and participation in multidisciplinary conferences and didactics will also be expected. Students will be required to give a brief presentation at the end of the rotation on a literature review of a pertinent urogynecologic topic of their choice. Travel will be involved to Carilion New River Valley Medical Center, Christiansburg, VA. 

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 4 weeks
• Curricular Component(s) Met: Surgery Subspecialty, Advanced Clinical Rotation
• Availability: Limited to one student per rotation across all Urogyecology electives. Available July 6 - September 27 (rotation 1a-3b)

This course is designed to raise awareness and highlight opportunities to learn about equitable care in maternal health.  The course will also focus on discussing policies at a system level and government/state level that dictate maternal health care and evaluate ways to advocate for our patients.  The student will be an added member of the clinical team on Labor and Delivery (performing basic obstetrical skills) during the two-week rotation.  The student will participate in all aspects of care including triage, management and clinical-decision making of antepartum and labor and delivery patients.  Emphasis will be placed on evaluating each patient’s antepartum course and determinants of health through an equity lens.  The student will learn the basics of advocacy as a physician by analyzing current system, local, state, and national policies, and will be able to identify opportunities for advocacy.  Students will be required to give one brief presentation at the end of the rotation.  The presentation will be a literature review of a pertinent policy, law, or bill of their choice that has a direct impact on maternal health care.  There will be no travel necessary. 

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Curricular Component(s) Met: Surgery Subspecialty
• Availability: Limited to one student per rotation for 9509, 9510, and 9512. 

This course is designed to raise awareness and highlight opportunities to learn about equitable care in maternal health.  The course will also focus on discussing policies at a system level and government/state level that dictate maternal health care and evaluate the various ways to advocate for our patients.  The student will be an acting intern on the clinical team on Labor and Delivery.  The student will participate in all aspects of care including triage, management and clinical-decision making of antepartum and labor and delivery patients.  Emphasis will be placed on evaluating each patient’s antepartum course and determinants of health through an equity lens.  The students will evaluate a patient’s medical course and identify opportunities for advocacy.  The students will be required to give two brief presentations, one at the end of week two and one at the end of the rotation.  For the first presentation the student will select a patient encounter and give a presentation about possible healthcare disparities based on social determinants of health and offer more equitable choices of care.  The second presentation will be a literature review of a pertinent policy of their choice that has a direct impact on maternal health care.  There will no travel necessary. 

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  4 weeks
• Curricular Component(s) Met: Surgery Subspecialty, Advanced Clinical Rotation
• Availability: Limited to one student per rotation for 9509, 9510, and 9512. 

This elective is designed to provide the participating student with exposure to the outpatient high risk obstetrics.  The student will evaluate and manage high risk obstetrical patients in the office including conditions of anemia, diabetes mellitus, urinary tract disorders, infectious diseases, asthma, surgical abdomen, and chronic hypertension.  In the outpatient setting the student will participate in genetic counseling sessions, ultrasound, and Maternal Fetal Medicine consultations.  The student will interact with the Maternal Fetal Medicine attendings, OB residents, genetic counselors and sonographers.  There is no call requirement for this rotation. 

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Curricular Component(s) Met: Surgery Subspecialty
• Availability: Limited to one student per rotation across all Maternal Fetal Medicine electives. Not available July 6 - August 30 (rotation 1a-2b)

This course is designed to raise awareness and highlight opportunities to learn about equitable care in maternal health.  The student will learn to define and identify health inequities in maternal care, identify social determinants of health in obstetrical care, and will learn how to improve the quality of care delivered to all.  The course will also focus on discussing policies at a system level and government/state level that dictate maternal health care and evaluate the various ways to advocate for our specialty.  The student will be an added member of the clinical team on Labor and Delivery during the two weeks.  The student will participate in all aspects of care including triage, management and clinical decision making of antepartum and labor and delivery patients.  Emphasis will be placed on evaluating each patient’s antepartum course and determinants of health through an equity lens.  The student will learn practical ways to actively deliver more equitable care.  Students will be required to give a brief presentation based on a patient case of their choosing and discuss healthcare disparities based on social determinants of health and offer more equitable choices of care.  There will be no travel necessary. 

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Curricular Component(s) Met: Surgery Subspecialty
• Availability: Limited to one student per rotation for 9509, 9510, and 9512. 

This course is an interdisciplinary elective combining Obstetrics and Gynecology and Addiction Medicine, specifically related to the care of pregnant women with substance use disorder.  The elective is designed to give the student well-rounded exposure to the assessment and treatment of substance use disorder in the setting of obstetrical care, and exposure to the assessment and treatment of advanced obstetric pathology complicated by the medical and socioeconomic implications of substance use disorder.  The student is expected to participate directly in all aspects of care including office-based opioid treatment (OBOT) group sessions, outpatient management of substance use disorder, outpatient prenatal and postnatal obstetrical care workshops, decision analysis of treatment modalities including but not limited to physical exam assessment, medical regimens, group-based therapy, and individual psychiatric care, and amendment of treatment plans.  Emphasis will also be placed on the collaborative effort required in the treatment of substance use disorder in the setting of obstetrics between psychiatry and OB/GYN healthcare teams.  The student will be able to discuss the racial, geographical, and socioeconomic implications of substance use disorder in obstetrical patients.  Attendance and participation in OBOT group and didactics will also be expected.  The student’s hours will match those of the attending with whom they are scheduled to work.  Travel will be involved to Carilion New River Valley Medical Center in Christiansburg, VA and to Carilion Franklin Memorial Hospital in Rocky Mount, VA. 

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation. This course is for students applying in the field of OBYN or Psychiatry. Available during the following rotations
  • August 17- 30 (rotation 2b)
  • October 12-25 (rotation 4b)
  • December 7-20 (rotation 6b)
  • February 15-28 (rotation 8b)

To improve understanding of the spectrum of care required for orthopaedic patients and the concept of continuity of care, the hybrid elective in orthopaedics/musculoskeletal (MSK) will include operating room exposure at least one day per week with the goal of an integrated understanding of perioperative assessment, rationale of surgical intervention for a specific subset of patients and orthopaedic issues, surgical anatomy, and post-operative management.  Exposure to anesthesia principles and acute care pain management are also components of this elective.  The preceptor is an orthopaedic faculty member and the locations are the orthopaedic outpatient facilities and Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s):  None
  
• Duration: 2 or 4 weeks
• Curricular Component(s) Met: Surgery Subspecialty
• Availability: Limited to one student per rotation

This elective is designed for those students considering a career in orthopaedic surgery.  It is available from July-December only and priority is given to students who have completed a MS3 orthopaedic elective.  It is designed to allow increased exposure to orthopaedic subspecialties and/or one-on-one faculty interaction, if requested and mutually agreeable to student and faculty.  Each 2- or 4-week block will have students assigned to a cross section of faculty and with one week of  one-on-one faculty interaction, if requested.  Students will follow the attending schedule (including on-call when applicable).  ALL rotations include a mandatory one-week trauma/fracture service rotation.  Students may select a one-week specific subspecialty rotation or they may be assigned to a number of providers to broaden the subspecialty exposure.  The option of a one-week rotation will be offered only to students who have done a four-week MS3 orthopaedic elective.  The preceptor is an orthopaedic faculty member and the locations are the orthopaedic outpatient facilities, Carilion Roanoke Memorial Hospital, Carilion Roanoke Community Hospital and Roanoke Ambulatory Surgery Center.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 4 weeks
• Curricular Component(s) Met: Surgery Subspecialty, Advanced Clinical Rotation
• Availability: Limited to one student per rotation. Available during the following rotations
  • July 6 - August 2 (rotation 1a-b)
  • August 3-30 (rotation 2a-b)

This elective is designed for those students considering a career in specialties that will have clinical overlap with orthopaedics and musculoskeletal care.  It is available from November-May and previous orthopaedic elective exposure is not required.  It is designed to allow increased exposure to orthopaedic subspecialties and a large number of orthopaedic faculty.  Each 2- or 4-week block is divided into rotations with students assigned to a subspecialty for each week when possible.  Students will be assigned to faculty and office or operating room on a day-by-day schedule.  While there are no mandatory rotations, time on the trauma/fracture service rotation is advised.  Students may select specific subspecialty rotation(s) and every effort will be made to honor requests.  Rotation selection and one-week options are dependent on faculty availability and coordination with MS3 rotations.  The preceptor is an orthopaedic faculty member and the locations are the orthopaedic outpatient facilities, Carilion Roanoke Memorial Hospital and Carilion Roanoke Community Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 or 4 weeks
• Curricular Component(s) Met: Surgery Subspecialty
• Availability: Limited to one student per rotation

This elective is designed for the student who is interested in primary care or emergency medicine.  It is designed to give acute orthopaedic injury exposure to the student who may see this type of injury in the above noted settings.  The location is Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s):  None
  
• Duration: 2 or 4 weeks
• Curricular Component(s) Met: Surgery Subspecialty
• Availability: Limited to one student per rotation

This elective will expose students to common pediatric musculoskeletal pathologies including plicas, bone and soft tissue cysts, pes planus (flat foot), developmental dysplasia of the hip, tendon contractures, and more.  Students will spend time in the clinic and operating room working alongside a fellowship-trained pediatric orthopaedic surgeon.  Students will have an opportunity to strengthen their history taking and physical exam skills, as well as their orthopaedic fund of knowledge.  Students will be allowed to attend surgeries with the expectation that they have a strong knowledge of the patient’s history and the procedure they are undergoing.  The location is Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s):  None
  
• Duration:  2 weeks
• Curricular Component(s) Met: Surgery Subspecialty
• Availability: Limited to one student per rotation

This elective will be primarily an outpatient experience, evaluating patients presenting for consultation or follow-up to the Pediatric Endocrinology Clinic.  Students may also participate in inpatient consultations when they are available and educationally relevant.  Common problems encountered will include type 1 and type 2 diabetes, obesity and the metabolic syndrome, disorders of the thyroid, pituitary, and adrenal glands, and disorders of growth, puberty, and bone/calcium.  The locations are the outpatient clinic and Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 or 4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation

The mission of this elective is to provide an in-depth learning experience in the field of non-invasive pediatric cardiology.  Emphasis will be placed on outpatient management of children with heart disease.  Students will be participating in non-invasive testing for heart disease including electrocardiography (ECG), echocardiography, fetal echocardiography, and stress testing.  Students will become familiar with the work-up and management of pediatric patients with murmurs, chest pain, palpitations, and syncope.  Students will evaluate patients with suspected cardiovascular abnormalities with special emphasis on the longitudinal management of patients with congenital heart disease.  Students will develop clinical skills in cardiac auscultation and interpretation of pediatric ECGs.  Students will attend teaching and patient care conferences.  The locations are the outpatient clinics and Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 or 4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Temporarily unavailable

Students will rotate in the inpatient ward, the pediatric intensive care unit (PICU), the neonatal intensive care unit (NICU), and the outpatient clinics, as well as experience the bronchoscopy lab and pulmonary function testing (PFT) lab.  Rotations will include rounding with the physicians in these areas.  In some instances, students will examine patients, perform physical examinations, and develop a differential diagnosis and a proposed work-up and treatment plan in both an inpatient and outpatient setting.  Goals and curriculum components for this elective will be similar to those of the pediatric residency program.  The locations are the outpatient clinic and Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
• Co-requisite(s): None
  
• Duration: 2 or 4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation

This elective is intended to develop the medical students’ clinical skills and enhance their fund of knowledge in the evaluation and management of inpatient and outpatient gastroenterology (GI), hepatology, and nutrition disorders.  The locations are the outpatient clinic and Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation

This elective will consist of caring for patients on the pediatric inpatient service.  The fourth-year medical student will work with the pediatric inpatient team in direct patient care of hospitalized patients on the general pediatric inpatient service.  The student will take the history and perform the physical examination at the time of admission.  From this information, the student will develop a differential diagnosis, plan the diagnostic evaluation, and design the management of the patient.  The student will then take primary responsibility of the patient until they are discharged from the hospital.  They will be directly supervised by an upper level (PGY2, PGY3) resident and the pediatric attending physician.  The location is Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 4 weeks
• Curricular Component(s) Met: Medical Subspecialty, Advanced Clinical Rotation
• Availability: Limited to one student per rotation. Available during the following rotations
  • July 6 - August 2 (rotation 1a-b)
  • August 3-30 (rotation 2a-b)
  • August 31 - September 27 (rotation 3a-b)
  • September 28 - October 25 (rotation 4a-b)
  • October 26 - November 22 (rotation 5a-b)

The mission of this elective is to provide an in-depth learning experience in the setting of a busy outpatient pediatric clinic.  This elective will emphasize preventive and anticipatory care as well as sick office care within the setting of a pediatric medical home.  Students will learn about pediatric growth and development, perform and document history and physicals on well and sick children, provide age specific anticipatory guidance for pediatric patients and their families, and manage the care of sick infants and children over serial office visits to promote and understand continuity of care, including the evaluation, diagnosis, and treatment of common acute pediatric diseases.  The location is the outpatient clinic.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation

This elective will introduce the medical student to the evaluation and management of special needs children by participation in the Child Development Clinic.  The student will share in the patient’s chart review, history taking, and physical examination.  From this information, the student will generate a differential diagnosis, plan the diagnostic evaluation, and create a management plan in consultation with the attending physician.  The location is the outpatient clinic.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation

This elective will consist of consulting on patients with known or suspected genetic disorders.  The medical student will do the patient’s chart review, history taking, and physical examination.  From this information, the student will generate a differential diagnosis, plan the diagnostic evaluation, and create a management plan in consultation with the attending physician.  The location is the outpatient clinic.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 or 4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation. Not available July 6 - August 16 (rotation 1a-2a), November 23 - December 20 (rotation 6a-b), March 1-14 (rotation 9a)

The general objectives of this elective are to obtain a broad understanding of the medical problems afflicting infants during the first month of life and to learn generally applicable principles in the neonatal intensive care unit (NICU) setting.  The location is Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 weeks
• Curricular Component(s) Met: ICU
• Availability: Limited to one student per rotation. Only available to students applying to Pediatrics, Family Medicine, or OBGYN. 

This elective will consist of consulting on patients with hematological and oncological conditions.  The medical student will do the patient’s chart review, history taking, and physical examination.  From this information, the student will develop a differential diagnosis, plan the diagnostic evaluation, and design the management of the patient.  The student may observe lumbar punctures and bone marrow tests as scheduled during their rotation.  They will also be required to give a 15-minute talk on a topic agreed upon by the attending if on the four-week rotation.  The locations are the outpatient clinic and Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 or 4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation

The student will spend the elective time in the intensive care unit (ICU) and will have potential exposure to a wide range of illnesses from multiple organ systems.  The student will be expected to develop skills in interacting with critically ill children and also with the parents of these children.  The location is Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 weeks
• Curricular Component(s) Met: ICU
• Availability: Limited to one student per rotation across 9612 and 9619.

This elective will consist of consulting on patients with the pediatric neurologists.  The medical student will do the patient’s chart review, history taking, and physical examination.  From this information, the student will develop a differential diagnosis, plan the diagnostic evaluation, and design the management of the patient.  The student will make a presentation to the preceptor if doing the four-week rotation.  The locations are the outpatient clinic and Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 or 4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation

This elective highlights experiential learning in the local community by focusing on exposure to agencies who work with the underserved communities with significant health care disparities.  Students have clinical time in primary care settings or a hospital-based setting with low socioeconomic patient populations and will learn about social determinants of health and the impact on patients.  Field experiences expose them to real life scenarios and the interprofessional approach to management, prevention, and issues related to populations needs.  This may include but is not limited to visits to Children’s Trust, the Health Department, free clinics, Department of Social Services, and the Child Health Investment Partnership (CHIP).  There will also be time spent with a social worker, on interprofessional rounds, and with a Care Coordinator.  The interprofessional nature of care management will be highlighted.  This may be varied to provide exposure to broader primary care content and to the interest of students with emphasis on participation and analyses of various systems and their impact on health care and interprofessional management. 

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation

This Acting Internship in General Pediatrics provides advanced clinical training in outpatient pediatric care, preparing students for the responsibilities of a pediatric residency. Students will independently evaluate patients, formulate differential diagnoses, and develop evidence-based management plans for common outpatient pediatric conditions under the supervision of attending pediatricians. The rotation emphasizes communication skills with patients, families, and healthcare team members while fostering professionalism and ethical decision-making. Clinical experiences will occur primarily at the Botetourt and Tanglewood outpatient pediatric offices, offering exposure to diverse patient populations and a variety of conditions commonly encountered in community pediatrics. In addition to these outpatient settings, participants will also have the opportunity to gain exposure to the resident clinic, further enhancing their understanding of pediatric residency training. Students will gain experience documenting encounters using the electronic medical record system and reflecting on the continuum of pediatric healthcare.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Curricular Component(s) Met: Medical Subspecialty, Advanced Clinical Rotation
• Availability: Limited to two students per rotation. Available during the following rotations
  • August 31 - September 27 (rotation 3a-b) 
  • September 18 - October 25 (rotation 4a-b)

The Fourth-Year Pediatric Medical Student Chief Role is a longitudinal elective over the fourth year for selected medical students pursuing a future career in Pediatrics. This course focuses on students who are interested in furthering their leadership and education skills to help optimize the third year medical student experience at VTCSOM. As part of this role, medical student chiefs will provide resources to third year medical students during their clerkship including collecting and updating resources to help during the rotation, office hours for concerns and mentorship as well as individualized educational support, holding review sessions prior to the NBME and will also act as a liaison between medical students and faculty leadership for the Pediatrics Clerkship. They will also have the opportunity to lead a self-directed project or scholarly activity aimed at improving the medical student experience. The elective will culminate with presenting their project results. As part of the course, students will receive educational and leadership exposure,  mentorship and foster career development for future success within academic medical education.  This course can hold one to four students a year. This is a longitudinal course for 4 credits.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to four students per rotation. This is a longitudinal course for 4 credits and will be listed on schedule as rotation 10a-b

This Acting Internship provides an advanced clinical experience in the Neonatal Intensive Care Unit (NICU) at Carilion Children’s Hospital. Students function with graduated responsibility as members of the NICU team, managing the care of premature and critically ill newborns under the supervision of attending neonatologists and senior residents. Students refine their ability to assess, diagnose, and manage complex neonatal conditions while integrating physiologic principles, evidence-based medicine, and interprofessional communication. The rotation emphasizes independent clinical decision-making, prioritization of patient care, and readiness for residency-level performance. Through daily rounds, direct patient care, procedures, and family discussions, students demonstrate competence in neonatal resuscitation, fluid and nutritional management, and systems-based coordination of care. Professionalism, ethical awareness, and leadership within the multidisciplinary NICU team are core expectations of this acting internship.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  4 weeks
• Curricular Component(s) Met: Medical Subspecialty, Advanced Clinical Rotation
• Availability: Limited to one student per rotation 

In this advanced elective, students join the Pediatric Intensive Care Unit (PICU) team to care for critically ill children with a wide range of life-threatening conditions. Under supervision students will take part in complex clinical situations, performing histories and physical examinations, interpreting laboratory and physiologic data, and developing patient-centered management plans that reflect system needs and evidence-based practice. Through daily rounds, procedures, and bedside learning, students will explore the pathophysiology, management, and complications of major organ system diseases while gaining familiarity with life-support technologies and monitoring modalities. The rotation emphasizes communication and teamwork, working closely with interprofessional teams, patients, and families to build therapeutic relationships and support shared decision-making. Students will also present a researched, case-based topic and apply feedback throughout the elective to enhance patient outcomes, care coordination, and overall quality of care..

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  4 weeks
• Curricular Component(s) Met: Medical Subspecialty, Advanced Clinical Rotation
• Availability: Limited to one student per rotation across 9612 and 9619.

This elective is based in the Psychiatry Department Outpatient Child and Adolescent Clinic.  Students will see children between the ages of 5 and 17 under the close supervision of a child psychiatry fellow and board-certified child psychiatrist.  Students will also interact with patient family members and caretakers.  Some exposure to liaison with public social service agencies will occur. Problems likely to be encountered in this patient population include mood disorders, behavioral dyscontrol disorders, reactive attachment disorders, attention disorders, and learning disabilities.  Students will be able to observe psychotherapy and pharmacotherapy with the pre-adult patient and learn about the importance of family interactions.  The location is Carilion Roanoke Memorial Hospital, Rehabilitation Center.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 or 4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation

This elective is based in a 12-bed unit taking children and adolescents between the ages of 5 and 17.  The student will function as an integral member of the treatment team including a board-certified child psychiatrist, child psychiatry fellow, general psychiatry resident, psychologist, social worker, and nursing staff.  The student will participate in rounds and will meet with patients in group and individual settings.  Close supervision will be given by the child psychiatry fellow and attending.  Problems likely to be encountered in this patient population include mood disorders, substance use disorders, behavioral dyscontrol disorders, reactive attachment disorders, attention disorders, and psychosis.  The student will be able to observe psychotherapy and pharmacotherapy with the pre-adult patient and learn about the importance of family interactions.  The location is Carilion Roanoke Memorial Hospital, Rehabilitation Center.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 or 4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation

This elective will focus on patients in medical, surgical, and rehabilitation units who are in need of psychiatric care and are seen under the supervision of a board-certified psychosomatic psychiatrist.  Ages of this population are 18 and older.  Problems likely to be encountered include mood disorders, psychosis, substance use disorders, adjustment to acute medical problems, delirium, and exaggeration of symptoms.  The student will accompany a board-certified psychosomatic psychiatrist during the course of providing inpatient consultation.  A first- or second-year psychiatry resident may also be involved in the teaching.  The student will be able to observe how the psychiatrist can usefully contribute to the care of medically or surgically hospitalized individuals. The location is Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 or 4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation

This elective will be an immersive experience in geriatric psychiatry. Over the course of the two weeks or four weeks, students will develop the skills and knowledge necessary to diagnose, manage, and treat a broad range of mental health disorders in older adults. Students will gain hands-on experience in outpatient geriatric psychiatry clinics, long-term care facilities, and geriatric medical/surgical consultation settings. Emphasis will be placed on clinical interviewing skills tailored to the geriatric population. Their experience will include small group learning, direct patient care, and interdisciplinary collaboration with geriatric psychiatry specialists, fellows, and general psychiatry residents. By the end of the course, students will have the opportunity to observe both psychotherapy and pharmacotherapy approaches in the geriatric population. They will also explore key aspects of aging, including the physiological and metabolic changes that impact treatment, the importance of family support, professional obligations regarding elder abuse, and end-of-life care considerations.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 or 4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation

During this elective, the student will work with the assigned attending, resident, and students as an active member of the treatment team on the inpatient psychiatry units.  The student will be assigned a maximum of six patients and will be an active team leader on the treatment team under the supervision of the resident and attending physicians.  The location is Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  4 weeks
• Curricular Component(s) Met: Medical Subspecialty, Advanced Clinical Rotation
• Availability: Limited to one student per rotation. Not available July 6 - August 30 (rotations 1a-2b), September 28 - October 25 (rotations 4a-b)

During this elective, the student will work with the assigned attending and resident as an active member of the treatment team on the inpatient psychiatry units.  The student will be assigned a maximum of six patients and will be an active team leader on the treatment team under the supervision of the resident and attending physicians.  Duties will include leading daily treatment team meetings in discussion of patients, writing notes, making recommendations for the treatment plan, reviewing labs and imaging results, and communicating with consultants.  The location is the Veterans Affairs Medical Center. 

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  4 weeks
• Curricular Component(s) Met: Medical Subspecialty, Advanced Clinical Rotation
• Availability: Limited to one student per rotation

This elective will allow students who have previously completed outpatient child and adolescent psychiatry to experience community psychiatry services offered in the Roanoke Valley in addition to participating in standard outpatient clinics.  Students will have the opportunity to work in the community with Carilion providers and experience multiple psychiatric services that are unavailable during the introductory outpatient/inpatient child and adolescent psychiatry rotation.  Each student will have the opportunity to customize their learning experience based on individual interests and learning goals.  During this rotation, students will be encouraged to take additional responsibility in patient management with emphasis placed on initial diagnosis, pharmacological treatment, and patient disposition following each encounter.  At the conclusion of the rotation, students who choose the four-week option are expected to do a 5-10 minute presentation on a topic of personal interest related to child and adolescent psychiatry.  Locations include Pediatric Neurodevelopment Clinic, Community Teen Clinic, Intercept Youth Services, and Roanoke City Department of Social Services.  

• Prerequisite(s): Successful completion of Phase 1 and 2 + 9701
  
• Co-requisite(s): None
  
• Duration:  4 weeks
• Curricular Component(s) Met: Medical Subspecialty, Advanced Clinical Rotation
• Availability: Limited to one student per rotation

This elective provides advanced clinical experience on adult inpatient psychiatry units. Students serve as active members of the multidisciplinary team, performing comprehensive psychiatric interviews and mental status examinations, interpreting clinical data, and managing up to six patients under supervision. Learners develop individualized bio-psychosocial treatment plans incorporating pharmacologic, psychotherapeutic, and social interventions, while assessing patient safety, decisional capacity, and medical-legal considerations. Clinical exposure includes mood, psychotic, and personality disorders, as well as dementia, delirium, eating disorders, and substance use disorders. The course emphasizes diagnostic reasoning, interprofessional collaboration, and readiness for residency-level psychiatric care.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation. Not Available September 28 - October 25 (rotation 4a-b)

During the acting internship (AI), the student will work with the assigned attending, resident, and students as an active member of the treatment team on the child and adolescent inpatient psychiatry unit. Presentations may include diagnoses of ADHD and autism, mood disorders, PTSD and stressor-related disorders, normal sleep and sleep disorders, personality traits and risk of personality disorders, substance use, and learning disorders. Considerations for school accommodations and/or child and adolescent laws and processes governing inpatient and outpatient treatment. Perform and document a complete mental status exam, be involved in management plans, assess risk, discuss medicolegal issues, and explain the balance of personal and professional life. Family meetings will be held for crisis stabilization and the student will participate in those meetings. The student will utilize available resources to understand and treat patients and work within an interprofessional and multidisciplinary setting.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  4 weeks
• Curricular Component(s) Met: Medical Subspecialty, Advanced Clinical Rotation
• Availability: Limited to one student per rotation

The Emergency Psychiatry elective offers fourth-year students the opportunity to practice caring for patients presenting with acute psychiatric complaints. The elective provides a comprehensive look at the multidisciplinary team involved in the care of these patients. Students will participate in patient interviewing, risk assessment, diagnostic evaluation, emergency management of psychiatric disorders, psychopharmacologic intervention, as well as management of patients with concurrent medical and psychiatric complaints. Students will gain familiarity with psychosocial topics central to Emergency Psychiatry and will gain confidence interviewing and intervening in a fast-paced setting.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 or 4 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation.

The acting internship rotation is based primarily at Carilion Medical Center. It will involve four weeks of consultation-liaison (CL) psychiatry. The student will assume duties as an acting intern (AI) in this setting. The AI will care for patients on medical, surgical, and rehabilitation units who are in need of psychiatric care under the supervision of a consultation-liaison psychiatrist. Age range of this population is 18 to 100. A psychiatry trainee may also be involved in the teaching. The student will be able to observe how the psychiatrist can usefully contribute to the care of medically or surgically hospitalized individuals. The experience provides an opportunity to see patients with delirium, catatonia, somatic symptom disorders, adjustment disorders, substance use disorder in context with medical illnesses.   Students also gain experience caring for patients with “typical” disorders such as schizophrenia, bipolar or depression who are facing medical illness.  Consideration of the interplay between somatic and psychiatric disorders is a focus.  Trainees gain experience in hospital systems issues, communication across different specialties and teams, and advocacy for patients with mental illness in a non-behaviorally oriented environment.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 4 weeks
• Curricular Component(s) Met: Medical Subspecialty, Advanced Clinical Rotataion
• Availability: Limited to one student per rotation

This elective will consist of further clinical experience in the subspecialty of interventional radiology to include management of conditions in genitourinary, gastrointestinal, vascular, biliary, neurological, and oncologic interventions in the spectrum of various clinical conditions.  Students will be exposed to daily teaching sessions with interventional radiologists and attend multidisciplinary conferences that incorporate patient management issues.  The location is Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 weeks
• Curricular Component(s) Met: Surgical Subspecialty
• Availability: Limited to one student per rotation between 9801 and 9806. Not available February 15-28 (rotation 8b)

This elective will consist of further clinical experience in the subspecialty of breast imaging to include the modalities of screening and diagnostic mammography, ultrasound, and magnetic resonance imaging (MRI) in the imaging diagnosis of benign and malignant diseases of the breast.  Students will be exposed to daily teaching sessions and attend multidisciplinary conferences that incorporate patient management issues.  The location is the Carilion Breast Care Center.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 weeks
• Curricular Component(s) Met: None
• Availability: Limited to one student per rotation.

This elective will consist of further clinical experience in the subspecialty of musculoskeletal radiology to include the modalities of computed tomography (CT), magnetic resonance imaging (MRI), and arthrography in the imaging diagnosis of musculoskeletal diseases.  Students will be exposed to daily teaching sessions with radiologists and attend multidisciplinary conferences that incorporate patient management issues.  The location is Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 weeks
• Curricular Component(s) Met: None
• Availability: Limited to one student per rotation. Not available July 6 - July 19 (rotation 1a)

This two-week elective is for the student with an interest in pursuing a residency in the neurosciences or a career in neuroimaging.  The intent is to provide an environment that provides the student an opportunity and time to work on a focused project in neuroimaging.  This might be a case report, limited research project, preparation of a grand rounds topic, or adding cases to a teaching file or online database. It is required that the interested student meet with the neuroradiologist several months ahead of time to discuss and choose a project so the elective time can be spent most productively.  This is especially important if the project involves the use of resources that may not be immediately available or involves a cooperative effort with other researchers or technical staff.  The location is Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 weeks
• Curricular Component(s) Met: Medical Subspecialty
• Availability: Limited to one student per rotation. Not available August 3-16 (rotation 2a), August 31 - September 13 (rotation 3a) 

This two-week elective will allow students who have previously completed the interventional radiology elective to learn more advanced aspects of interventional radiology including neurointerventional and oncological interventional radiology.  Students will observe and gain knowledge in advanced neurointerventional procedures such as acute stroke, intracranial aneurysms, and arteriovenous malformations (AVM).  Students will also observe and gain knowledge in radiofrequency ablation and catheter-directed therapies.  The location is Carilion Roanoke Memorial Hospital. 

• Prerequisite(s): Successful completion of Phase 1 and 2 + 9801
  
• Co-requisite(s): None
  
• Duration: 4 weeks
• Curricular Component(s) Met: Surgical Subspecialty, Advanced Clinical Rotation
• Availability: Limited to one student per rotation between 9801 and 9805.

This four-week elective is designed for students applying to residency in interventional radiology.  The AI is intended to give the prospective IR applicant an understanding of what a rotation will be like in residency.  The focus will be on understanding management and appropriateness of procedures rather than simply being exposed to the types of procedure IR performs.  Students will develop procedural skills, including ultrasound guidance with paracentesis, thoracentesis, and vascular access.  Students will be expected to perform at least eight jugular venous accesses with ultrasound guidance, five paracenteses, and prepare the list of procedures for rounds each morning.  The location is Carilion Roanoke Memorial Hospital. 

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 4 weeks
• Curricular Component(s) Met: Surgical Subspecialty, Advanced Clinical Rotation
• Availability: Limited to one student per rotation between 9801 and 9805.

This elective provides Phase 3 VTCSOM students with the opportunity to perform focused and comprehensive neurologic and neurosurgical evaluations across emergency, inpatient, and outpatient settings. Students will participate in patient assessment, interpret neuroimaging and diagnostic studies (CT, MRI, angiography), and formulate differential diagnoses and evidence-based management plans for patients presenting with neurosurgical conditions. Through immersive experiences at the Institute for Orthopaedics and Neurosciences and Carilion Roanoke Memorial Hospital, students will gain exposure to common neurosurgical disorders and procedures, including degenerative spine disease, spinal tumors, and trauma-related conditions. Students participate in the perioperative management of patients and observe and assist in operative procedures relevant to the rotation, applying anatomical knowledge, technical understanding, and safety principles under supervision. The elective emphasizes communication of clinical findings and procedural risks, professional conduct, clinical reasoning, and multidisciplinary collaboration in neurosurgical care. Each student will also present an oral or written summary of a neurosurgical topic or case integrating current evidence and clinical relevance. Participation in academic sessions, rounds, and operative care is expected throughout the rotation.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
• Duration:  2 weeks
  
• Curricular Component(s) Met: Surgical Subspecialty
• Availability: Limited to one student per rotation. Max of two students across all Neurosurgery electives 9901 to 9909 and 9916 to 9918.

This elective provides Phase 3 VTCSOM students with supervised experience in pediatric neurosurgery across emergency, inpatient, and outpatient settings. Students perform focused neurologic and neurosurgical evaluations, interpret neuroimaging and diagnostic studies, and develop prioritized differential diagnoses and evidence-based management plans for congenital and acquired pediatric neurosurgical conditions. Clinical experiences at Carilion Roanoke Memorial Hospital and the Carilion Children’s Pediatric Neurosurgery Clinic offer direct mentorship from pediatric neurosurgery-oriented attending surgeons. Students gain exposure to a broad range of disorders including hydrocephalus, spina bifida, tethered cord, Chiari malformation, craniosynostosis, brain and spinal tumors, traumatic and non-accidental injuries, skull masses, and craniofacial deformities. When pediatric case volume varies, selected adult neurosurgical cases may supplement the experience. Students participate in the perioperative management of pediatric patients and observe and assist in operative procedures relevant to the rotation, applying anatomical knowledge, technical understanding, and safety principles under supervision. The elective emphasizes compassionate, family-centered communication; professionalism; ethical practice; and collaboration within multidisciplinary teams involving pediatrics, neurology, anesthesia, and critical care. Each student presents an oral or written summary of a pediatric neurosurgical topic or case integrating current evidence and clinical relevance. Participation in academic sessions, rounds, and operative care is required throughout the rotation.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Curricular Component(s) Met: Surgical Subspecialty
• Availability: Limited to one student per rotation. Max of two students across all Neurosurgery electives 9901 to 9909 and 9916 to 9918.

This elective provides advanced clinical experience in the management of critically ill neurosurgical patients within the intensive care setting. Students will work closely with neurosurgical faculty, the neurosurgical “hospitalist,” and the neurosurgical ICU resident at Carilion Roanoke Memorial Hospital to care for patients with severe and complex neurologic conditions, including traumatic brain and spinal cord injuries, intracranial hemorrhage, ischemic stroke, brain and spinal tumors, central nervous system infections, and postoperative complications. Through direct participation in patient evaluation, diagnostic interpretation, and daily ICU rounds, students will develop proficiency in neurologic assessment, critical care monitoring, and evidence-based management of acute neurosurgical emergencies. Experiences include performing procedures such as central and arterial line placement, ventriculostomy, and lumbar puncture under supervision. The course emphasizes synthesis of neuroanatomical and pathophysiologic knowledge with radiologic and clinical data, clear and compassionate communication with families and care teams, and the development of professional judgment in a high-acuity environment. Students will present an oral or written case or topic integrating current evidence and clinical relevance. Participation in interdisciplinary rounds, academic sessions, and operative observations is expected throughout the rotation.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks 
• Curricular Component(s) Met: ICU
• Availability: Limited to one student per rotation. Max of two students across all Neurosurgery electives 9901 to 9909 and 9916 to 9918.

The Neurosurgery Operating Room Track provides advanced operative experience for medical students pursuing neurosurgery, surgery, or related procedural fields. Students refine their ability to perform neurologic and neurosurgical evaluations, interpret preoperative imaging, and formulate evidence-based surgical management plans. Through active participation in pre-, intra-, and postoperative care, learners apply neuroanatomic and pathophysiologic knowledge to real surgical cases while observing and assisting in operative procedures. Emphasis is placed on professionalism, teamwork, and effective communication within the surgical team to support safe, patient-centered care in complex operative environments. 

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Curricular Component(s) Met: Surgical Subspecialty
• Availability: Limited to one student per rotation. Max of two students across all Neurosurgery electives 9901 to 9909 and 9916 to 9918.

This elective provides students with mentored experience in neuroscience research, emphasizing the development of scientific inquiry, critical analysis, and professional communication. Students will join an active research team under the guidance of faculty and resident mentors to engage in ongoing or newly proposed neuroscience projects. Activities include study design, literature review, data collection, and synthesis, fostering competency in research methodology and ethical scientific practice.

Students will participate in regular laboratory meetings, academic discussions, and neuroscience sessions, with opportunities to observe clinical rounds and neurosurgical cases. Emphasis is placed on formulating research questions, generating and interpreting data, and presenting findings clearly and accurately to scientific and clinical audiences. By the end of the elective, students will demonstrate readiness for scholarly contribution through abstracts, posters, or manuscripts coauthored with their mentors.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 or 4 weeks
• Curricular Component(s) Met: Surgical Subspecialty
• Availability: Limited to one student per rotation. Max of two students across all Neurosurgery electives 9901 to 9909 and 9916 to 9918.

This elective provides advanced clinical experience in the evaluation and management of patients requiring emergency and inpatient neurosurgical consultation. Students partner with the neurosurgical hospitalist and resident team to perform focused and comprehensive neurologic and neurosurgical assessments, interpret neuroimaging studies, and formulate prioritized differential diagnoses and management plans for patients with acute and complex neurosurgical conditions. Learners refine clinical reasoning, procedural awareness, and communication skills through active participation in consultations, patient care discussions, and interdisciplinary collaborations. Students independently evaluate assigned patients, review radiologic studies, develop evidence-based treatment plans, and present findings to attending neurosurgeons for feedback and refinement. The rotation emphasizes professionalism, accountability, and teamwork in fast-paced neurosurgical environments while fostering an understanding of systems-based and multidisciplinary care. Students also engage in academic discussions and are encouraged to follow patients through inpatient management, rounds, and operative cases to gain a comprehensive understanding of neurosurgical care.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Curricular Component(s) Met: Surgical Subspecialty
• Availability: Limited to one student per rotation. Max of two students across all Neurosurgery electives 9901 to 9909 and 9916 to 9918.

This elective provides an intensive, hands-on experience in the care of neurosurgical patients at Carilion Roanoke Memorial Hospital. Acting at the level of a neurosurgical intern, students work closely with neurosurgical faculty, the hospitalist, and residents to evaluate and manage patients with neurologic conditions. Clinical activities include daily rounds, operative participation, resident clinic, supervised neurosurgical call, and performance of procedures. Students refine skills in neurologic assessment, interpretation of neuroimaging and diagnostic data, and formulation of evidence-based, patient-centered management plans. The course emphasizes professional and ethical conduct, teamwork, and compassionate communication with patients, families, and interprofessional teams. Each student presents an oral or written case or topic integrating current evidence and neurosurgical standards, while incorporating feedback and self-assessment to enhance clinical reasoning, procedural proficiency, and professional growth.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  4 weeks
• Curricular Component(s) Met: Surgical Subspecialty, Advanced Clinical Rotation
• Availability: Limited to one student per rotation. Max of two students across all Neurosurgery electives 9901 to 9909 and 9916 to 9918. Available during the following rotations
  • July 6 - August 2 (rotation 1a-b)
  • Augusts 3-30 (rotation 2a-b)

This advanced elective offers an intensive, hands-on experience in the evaluation and management of neurosurgical patients at Carilion Roanoke Memorial Hospital and the Institute for Orthopedics and Neurosciences. Acting at the level of a neurosurgical intern, students work with faculty, residents, and interprofessional teams across emergency, inpatient, and outpatient settings. Students refine advanced skills in neurologic assessment, interpretation of imaging and diagnostics (CT, MRI, angiography), and formulation of evidence-based management plans for complex neurosurgical conditions. The course emphasizes perioperative participation, multidisciplinary collaboration, patient safety, and professional communication. Each student presents an oral or written case or topic integrating current evidence and clinical relevance, demonstrating accountability, ethical conduct, and readiness for residency-level practice.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 4 weeks
• Curricular Component(s) Met: Surgical Subspecialty, Advanced Clinical Rotation
• Availability: Limited to one student per rotation. Max of two students across all Neurosurgery electives 9901 to 9909 and 9916 to 9918.

This advanced elective provides intensive, hands-on experience in pediatric neurosurgery at Carilion Roanoke Memorial Hospital and Carilion Children’s Clinic. Acting at the level of a neurosurgical intern, students work with pediatric neurosurgery faculty, residents, and interprofessional teams across emergency, inpatient, and outpatient settings. Students perform focused neurologic assessments, interpret imaging (CT, MRI, ultrasound), and develop evidence-based management plans for congenital and acquired neurosurgical disorders such as hydrocephalus, spina bifida, Chiari malformation, craniosynostosis, and pediatric tumors. The course emphasizes perioperative participation, family-centered communication, professionalism, and multidisciplinary collaboration. Each student presents a case or topic integrating current evidence and neurosurgical standards, demonstrating accountability and readiness for residency-level practice.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  4 weeks
• Curricular Component(s) Met: Surgical Subspecialty, Advanced Clinical Rotation
• Availability: Limited to one student per rotation. Max of two students across all Neurosurgery electives 9901 to 9909 and 9916 to 9918.

This advanced elective provides intensive, hands-on experience in the management of critically ill neurosurgical patients in the Neurosurgical Intensive Care Unit at Carilion Roanoke Memorial Hospital. Acting at the level of a neurosurgical intern, students collaborate with faculty, residents, and ICU teams to care for patients with acute neurologic injuries, hemorrhage, stroke, tumors, and postoperative complications. Students perform focused neurologic assessments, interpret imaging and monitoring data, and develop evidence-based management plans that integrate multidisciplinary and systems-based resources. The course emphasizes clinical reasoning, procedural proficiency, compassionate communication, and professional accountability. Each student presents a case or topic integrating current evidence and neurosurgical critical care principles, demonstrating readiness for residency-level practice.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s):  None
  
• Duration:  4 weeks
• Curricular Component(s) Met: ICU, Advanced Clinical Rotation
• Availability: Limited to one student per rotation. Max of two students across all Neurosurgery electives 9901 to 9909 and 9916 to 9918.

This advanced elective offers an intensive, hands-on experience in operative neurosurgery at Carilion Roanoke Memorial Hospital. Acting at the level of a neurosurgical intern, students work closely with neurosurgical faculty, residents, and operating room teams to evaluate patients, interpret preoperative imaging, and participate in surgical planning, procedures, and postoperative management. Students refine advanced skills in neurologic assessment, diagnostic reasoning, and evidence-based surgical decision-making while applying neuroanatomic and pathophysiologic knowledge to real operative cases. The course emphasizes professionalism, technical understanding, patient safety, and effective communication within multidisciplinary surgical teams. Each student presents an oral or written case or topic integrating current evidence and neurosurgical standards, demonstrating accountability, ethical conduct, and readiness for residency-level performance.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s):  None
  
• Duration:  4 weeks
• Curricular Component(s) Met: Surgical Subspecialty, Advanced Clinical Rotation
• Availability: Limited to one student per rotation. Max of two students across all Neurosurgery electives 9901 to 9909 and 9916 to 9918.

This advanced elective offers an intensive, hands-on experience in neurosurgical consultation and inpatient management at Carilion Roanoke Memorial Hospital. Acting at the level of a neurosurgical intern, students collaborate with the neurosurgical hospitalist, residents, and faculty to evaluate patients with acute and complex neurologic conditions. Students perform focused neurologic assessments, interpret imaging and diagnostic studies (CT, MRI, angiography), and develop prioritized differential diagnoses and evidence-based management plans. The course emphasizes clinical reasoning, professional communication, and multidisciplinary collaboration. Each student presents a case or topic integrating current evidence and neurosurgical standards, demonstrating professionalism, accountability, and readiness for residency-level practice.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s):  None
  
• Duration:  4 weeks
• Curricular Component(s) Met: Surgical Subspecialty, Advanced Clinical Rotation
• Availability: Limited to one student per rotation. Max of two students across all Neurosurgery electives 9901 to 9909 and 9916 to 9918.

The goal of the rotation is to provide you, the medical student, a “hands on” exposure to the field of Anesthesia and Anesthesiology and can be taken by a third- or fourth-year student. You will work predominantly with Anesthesiologists, but may also work with Certified Registered Nurse Anesthetists as the month presents itself for scheduling purposes. At the end of the rotation, you should have a basic understanding of the principles of pre-anesthetic evaluation, preparation, and anesthetic care, including history, physical examination, assessment of physiologic state, categorization of anesthetic risk, and care throughout the perioperative period. You will have participated with your anesthesiologist preceptors in placement of monitors, conduction of anesthetics including induction, intubation, maintenance, emergence, extubation and post anesthetic recovery care. You may also have opportunities to gain experience in regional anesthesia and sub-specialty anesthesia areas such as pediatric, obstetric, thoracic, cardiac, and neurosurgical anesthesia. The preceptor is the Anesthesia faculty and the location is Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s):  none
  
• Duration:  2 or 4 weeks
• Curricular Component(s) Met: Surgical Subspecialty
• Availability: Limited to one student per rotation

The goal of the rotation is to provide you, the medical student, a “hands on” exposure to the field of Anesthesia and Anesthesiology. This is essentially considered as a rotation to build upon your broad knowledge of the third year utilizing knowledge of, for example, fluid balance. You will work predominantly with Anesthesiologists, but may also work with Certified Registered Nurse Anesthetists as the month presents itself for scheduling purposes. At the end of the rotation, you should have a basic understanding of the principles of pre-anesthetic evaluation, preparation, and anesthetic care, including history, preceptors in placement of monitors, conduction of anesthetics including induction, intubation, maintenance, emergence, extubation and post anesthetic recovery care. You may also have opportunities to gain experience in regional anesthesia and sub-specialty anesthesia areas such as pediatric, obstetric, thoracic, cardiac, and neurosurgical anesthesia. The preceptor is the Anesthesia faculty and the location is Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2 + 9920
  
• Co-requisite(s): None
  
• Duration: 4 weeks
• Curricular Component(s) Met: Surgical Subspecialty, Advanced Clinical Rotation
• Availability: Limited to one student per rotation

The purpose of this two-week elective is to allow the student an ability to work with the General Surgery/Trauma services which handle surgical intervention and perioperative patient care. The student will gain not only knowledge/patient care skills but time management skills to offer quality care while managing multiple aspects of patient care. The location is Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s):  None
  
• Duration:  2 weeks
• Curricular Component(s) Met: Surgical Subspecialty
• Availability: Limited to one student per rotation. Available during the following rotations. 
  • July 6-19 (rotation 1a)
  • Augusts 3-30 (rotation 2a or 2b)
  • September 14-27 (rotation 3b)
  • September 28-October 11 (rotation 4a)
  • October 26 - November 22 (rotation 5a or 5b)
  • December 7-20 (rotation 6b)
  • January 4-17 (rotation 7a)
  • February 1-28 (rotation 8a or 8b)
  • March 29 - April 11 (rotation 10a)

The student is expected to participate in daily rounds in the ICU and function as a sub-intern. The student will present assigned patients on rounds, attend all lectures and conferences and read required material. Students will also have the opportunity to do procedures under close supervision. There may be night and weekend call, and on duty hours will follow resident duty hours. Night time duties should be expected. The location is Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 4 weeks
• Curricular Component(s) Met: ICU, Advanced Clinical Rotation
• Availability: Limited to one student per rotation. Limited to a max of two students across 9924 and 9943

The elective will consist of working both in the outpatient and inpatient settings in conjunction with the faculty urologists. In the outpatient setting, the medical student will do the patient’s chart review, history taking, and physical examination. From this information the medical student will develop a differential diagnosis, plan the diagnostic evaluation and discuss the management with the faculty urologist. In the inpatient setting, the student will be expected to participate in surgical procedures under direct supervision of the faculty physicians. Additionally, the student will have the opportunity to see urologic consults in the inpatient setting. In this case, the student will be expected to do a chart review, obtain the relevant history and data, perform a physical examination, develop a differential diagnosis, and formulate a management plan to discuss with the attending physician.

• Prerequisite(s): Successful completion of Phase 1 and 2
• Co-requisite(s):  None
• Duration:  2 or 4 weeks
• Curricular Component(s) Met: Surgical Subspecialty
• Availability: Limited to one student per rotation

The purpose of this elective is for students to gain familiarity with the causes of chronic wounds, principles of wound healing, and advanced wound management techniques. The student will gain broad exposure to the field wound care through a busy multidisciplinary wound care service. This should be particularly useful for students interested in any specialty, from primary care to surgical subspecialties. This will be a “hands on” rotation, with bedside interventions involved in the care of most patients, as well as involvement in a uniquely interdisciplinary service. Th location is Carilion Roanoke Community Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 or 4 weeks
• Curricular Component(s) Met: Surgical Subspecialty
• Availability: Limited to one student per rotation. Not available July 6-19 (rotation 1a), August 3-30 (rotation 2a-b), September 14 - October 11 (rotation 3b-4a)

This two-week elective with the breast service managing patients with benign and malignant breast disease allows the student to gain experience in the management of breast disease with a focus on surgical care in a multidisciplinary patient care setting. The second week of the rotation is spent gaining experience on the plastic and reconstructive aspect of breast patient care. The locations are the outpatient clinic and Carilion Roanoke Memorial Hospital. 

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s):  None
  
• Duration: 2 weeks
• Curricular Component(s) Met: Surgical Subspecialty
• Availability: Limited to one student per rotation

This elective consists of a two-week, intensive set of training to prepare graduating medical students for their residencies. Over the course of two weeks, students will obtain certification in Advanced Trauma Life Saving (ATLS), Pediatric Advanced Life Saving (PALS), and Critical Care skills (Fundamental Critical Care Support, FCCS). If time and interest allow, students will also obtain Basic Disaster Life Support training and certification (BDLS). Please note, there is a cost associated with this course (approx $1,500).

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s):  None
  
• Duration:  2 weeks
• Curricular Component(s) Met: Surgical Subspecialty
• Availability: Limited to 16 students per rotation. Available during the following rotation: March 1-14 (rotation 9a)

Welcome to the cardiothoracic surgical service. This is new for all of us but we are very excited to have you. We operate every day of the week, and one surgeon has office each day. Below is a list of topics that we feel represents the basic knowledge base in CT surgery. It is certainly not all-inclusive, but is likely more than you will need to know to do well on the exam. This is often a very busy service, so you may have to actively pursue us and your knowledge acquisition. All topics will not, and cannot, be covered in a didactic format in 2 weeks. Student will gain experience in operative and perioperative management of cardiac and thoracic surgical problems. The location is the outpatient clinic and Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 or 4 weeks
• Curricular Component(s) Met: Surgical Subspecialty
• Availability: Limited to one student per rotation

The medical students will enhance their diagnostic and clinical skill sets by participating in inpatient, outpatient and operating room care. Such care will focus on total patient management through record review, medical and dental clinical evaluation, assimilation and correlation of information leading to differential diagnoses and treatment. The elective will focus on the clinical application of material learned in years one through three as part of the comprehensive VTCSOM Oral Health I Oral Medicine curriculum.  

• Prerequisite(s): Successful completion of Phase 1 and 2
• Co-requisite(s):  None
• Duration:  2 weeks
• Curricular Component(s) Met: Surgical Subspecialty
• Availability: Limited to two students per rotation. Not Availabe July 6 - August 2 (rotation 1a-b)

The student will gain experience in surgery as practiced in a smaller community hospital setting with a mix of elective and emergent patient care. The location is Carilion New River Valley Medical Center.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 or 4 weeks
• Curricular Component(s) Met: Surgical Subspecialty
• Availability: Limited to one student per rotation

The Acting Internship in Emergency General Surgery is designed for fourth-year medical students with a strong interest in Surgery and who intend to pursue residency training in Surgery. The goal of this rotation is to give the student an opportunity to take an active role on the Emergency General Surgery team. The student will evaluate and recognize patients with emergent surgical conditions, synthesize notes, manage orders, communicate with patients and other healthcare team members, participate in procedures as appropriate to level of training, and see patients in the outpatient setting after emergent surgical care. The locations are the outpatient clinic and Carilion Roanoke Memorial Hospital. 

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
• Duration: 4 weeks
• Curricular Component(s) Met: Surgical Subspecialty, Advanced Clinical Rotation
• Availability: Limited to one student per rotation

This 2-week elective with General Surgeons with interest/expertise in colorectal surgery managing a broad range of problems including neoplasm, diverticulitis, inflammatory bowel disease, anorectal disorders. The student will gain experience in colorectal disease and management. The preceptor is the faculty attending and the location is Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 weeks
• Curricular Component(s) Met: Surgical Subspecialty
• Availability: Limited to one student per rotation

The overall goal of the Otolaryngology elective (specialty clerkship) is to provide medical students preliminary exposure to the specialty of Otolaryngology, Head and Neck Surgery. This includes an introduction to subspecialties within the field such as otology, neurotology, audiology, head and neck surgery, pediatrics, laryngology, allergy, facial plastic and reconstructive surgery, and maxillofacial trauma. The elective will provide medical students with information about the diagnosis and management of disorders of the ear, nose, and throat in an inpatient and outpatient setting. It will also provide exposure to various patient populations with acute and chronic head and neck pathologies. The locations are the outpatient clinic and Carilion Roanoke Memorial Hospital. 

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 or 4 weeks
• Curricular Component(s) Met: Surgical Subspecialty
• Availability: Limited to one student per rotation

The Surgical Readiness rotation aims to increase students’ proficiency with surgical skills and techniques in order to increase confidence when entering the intern year. Students will spend time in the anatomy lab at Jefferson College of Health Sciences and the special projects lab at VTCSOM. Other locations may be utilized as needs arise. Students will have an opportunity to strengthen their suturing and knot tying skills. The course will be tailored to acquiring requisite surgical skills essential to the specialty that interests the student, such as surgical subspecialties, Emergency Medicine or Family Medicine. 

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 weeks
• Curricular Component(s) Met: None
• Availability: Limited to three students per rotation

The elective will consist of working in the outpatient setting in conjunction with the faculty ophthalmologist. The medical student will do the patient’s chart review, history taking, and physical examination. From this information the medical student will develop a differential diagnosis, plan the diagnostic evaluation and discuss the management with the faculty ophthalmologist. The location is the outpatient office.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 or 4 weeks
• Curricular Component(s) Met: Surgical Subspecialty
• Availability: Limited to one student per rotation. Not available July 6 - August 30 (rotation 1a-2b)

This two- or four-week rotation will introduce the medical student to common surgical problems seen in the neonate, infant, and younger children. Emphasis will be placed on efficiently working up and treating pyloric stenosis, abdominal pain, necrotizing enterocolitis, intestinal obstruction, and inguinal hernia in this age group. The student will also be introduced to more common congenital problems including abdominal wall defects, head and neck lesions, thoracic masses, and GU and GI tract anomalies. Common pediatric hematologic and oncologic conditions will also be reviewed. The physiology and nutrition of babies and children will also be emphasized as it relates to the surgical care of these patients. Common procedures specific to this age group like venous cut down and airway management will be covered as well. Students will gain experience in the surgical management of common and less common pediatric surgical issues. The locations are the outpatient clinic and Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 or 4 weeks
• Curricular Component(s) Met: Surgical Subspecialty
• Availability: Limited to one student per rotation

The elective on the Plastic Surgery service affords students the ability to further their development by being involved in the care of both elective and emergent patients who are cared for by the plastic surgeons. This is both an inpatient and outpatient four-week rotation. The locations are the outpatient clinic and Carilion Roanoke Memorial Hospital

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 or 4 weeks
• Curricular Component(s) Met: Surgical Subspecialty
• Availability: Limited to two students per rotation. Available during the following rotations
  • January 1-31 (rotation 7a-b)
  • February 1-28 (rotation 8a-b)
  • March 1-14 (rotation 9a)
  • March 29 - April 25 (rotation 10a-b)

The student is expected to participate in daily rounds in the ICU. The student will present assigned patients on rounds, attend all lectures and conferences and read required material. Students will also have the opportunity to do procedures under close supervision. There will be night duty hours and on duty hours will follow resident duty hours regulations.

• Prerequisite(s): Successful completion of Phase 1 and 2
• Co-requisite(s): None
• Duration: 2 or 4 weeks 
• Curricular Component(s) Met: ICU
• Availability: Limited to two students per rotation. Limited to a max of two students across 9924 and 9943

The purpose of this course is to gain familiarity in initial evaluation of trauma patients including trauma alerts and consultations, management of post trauma problems. Activities include: attendance and participation in the assessment and resuscitation of acutely injured patients in the emergency room; call (to be arranged); longitudinal management of selected patients through the emergency department, operating room and intensive care units, to recovery; observation of pre-hospital care by accompanying rescue squads on their calls; and selected readings in resuscitation, critical care and trauma management. The student will participate on the trauma service as a student member of the trauma team. Time for regular attendance at scheduled trauma conferences and individual preceptorial conferences is provided. The locations are the trauma clinic and Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 or 4 weeks
• Curricular Component(s) Met: Surgical Subspecialty
• Availability: Limited to one student per rotation

Student will gain experience in diagnosis and surgical management of vascular disease and perioperative patient care. The locations are Jefferson Surgical Clinic and Carilion Roanoke Memorial Hospital.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 or 4 weeks
• Curricular Component(s) Met: Surgical Subspecialty
• Availability: Limited to one student per rotation

In this case-based course, students will study the pathophysiology, diagnosis, neuroimaging, and management of clinical neuroscience entities and then online via a computer manage patients with representative neurological disorders. Students will apply scientific skepticism to pre-conceived diagnostic notions, recognizing cognitive and systemic bias, and management algorithms surrounding the care of these patients. Online sessions will involve students evaluating and addressing multiple clinical neuroscience and management dilemmas. Cases studied will include the conditions of dementia, MS, Parkinsons, depression, psychosis, coma, severe brain injuries, seizures, epilepsy, sudden onset of severe headache, gait disturbance, hydrocephalus, stroke, infection, and spinal cord syndromes. Students will consider multiple outcomes with every step of their diagnostic and management decision-making. Outcome analysis and complication-avoidance will be emphasized in this evidence-based medicine approach. Students will be required to write several papers on topics related to the day’s case histories. Discussions will include related socioeconomic, ethical, and medical-legal considerations of the cases presented. Please note, this class is taught virtually, but you will be required to attend daily Zoom meetings.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Curricular Component(s) Met: None
• Availability: Dependent on enrollment in these courses 9P03, 9M02, 9946, 9947, and 9950  as only two of these courses will be offered at a time. Available during rotations
  •  September 28 - October 11 (rotation 4a) 
  • October 12-25 (rotation 4b) 
  • January 4-17 (rotation 7a) 
  • January 18-31 (rotation 7b) 
  • March 1-14 (rotation 9a)

Students will review the evaluation and management of common neurological emergencies encountered in both neurologically and non-neurologically related disciplines (particularly primary care). This is a case-based course where students will work with an instructor through a number of typical emergent neurological situations including initial evaluation and care, general and neurological exam, coordination with other emergency services, ordering of appropriate laboratory tests and imaging, differential diagnosis, interpretation of diagnostics, definitive management, complication management, rehabilitation considerations, and socioeconomic/ethical/medical-legal considerations. Cases will include but will not be limited to head injury, coma, brain death, and other altered states of consciousness, increased intracranial pressure, cerebral herniation syndromes, strokes, hydrocephalus, hemorrhagic disorders of the brain, infections, seizures, spine injury, myelopathy, severe pain syndromes. They will review and become comfortable with neruo-Imaging modalities (example-CT scan, MRI) and other critical diagnostics (example- CT angiography, angiography). Please note, this class is taught virtually, but you will be required to attend daily Zoom meetings.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Curricular Component(s) Met: None
• Availability: Dependent on enrollment in these courses 9P03, 9M02, 9946, 9947, and 9950  as only two of these courses will be offered at a time. Available during rotations
  • August 31 - September 27 (rotation 3a or 3b)
  • October 26 - November 22 (rotation 5a or 5b)
  • December 7-20 (rotation 6a)
  • February 1-28 (rotation 8a or 8b)

This elective is designed for students interested in pursuing a career in urology. The Acting Internship (AI) is intended to give the students an opportunity to take an active role on the urology team and ensure a smooth transition to internship. The rotation emphasizes diagnosis, and management plans for adult and pediatric urological pathology. Students will gain an understanding of the focused genitourinary history, examination, and interpretation of urological labs and imaging studies necessary to make thorough differential diagnoses, assessments, and management plans for patients with urological pathology.

• Prerequisite(s): Successful completion of Phase 1 and 2 + Urology elective
  
• Co-requisite(s): None
  
• Duration:  4 weeks
• Curricular Component(s) Met: Surgical Subspecialty, Advanced Clinical Rotation
• Availability: Limited to one student per rotation

This 2-week elective is designed for 4th year medical students who will enter a general surgery or surgical subspecialty residency after graduation. This elective is modeled after the American College of Surgeons resident prep curriculum.

Surgery Bootcamp is an intensive elective designed to prepare senior medical students for the demands of surgical residency. The course focuses on advancing clinical decision-making, procedural skills, sterile technique, management of electrolyte abnormalities, and professional communication through interactive lectures and simulation labs. Emphasizing the transition to graduate medical education, students develop the confidence and competence necessary to safely and effectively participate in surgical teams and manage perioperative patient care during residency.

• Prerequisite(s): Successful completion of Phase 1 and 2 + Surgery Match
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Curricular Component(s) Met: None
• Availability: Limited to 18 students per rotation. Available during the following rotation
  • April 12-25 (rotation 10b)

This course provides a comprehensive overview of the non-clinical and non-biomedical dimensions of a career in surgery. Through a combination of topical discussions, assigned readings, and reflective writing exercises, students will explore essential aspects of surgical training and practice, including career management strategies, diverse practice settings, and keys to successful residency and professional development. The course will examine the structure of the American healthcare delivery system, reimbursement models, the financial mechanisms underpinning surgical care, and the medicolegal landscape, including malpractice risk mitigation and deposition preparedness. Students will gain insights into the day-to-day life of a practicing surgeon and develop communication skills for engaging in difficult conversations with patients, families, and teams. In addition, the course will address emotional resilience, strategies for managing surgical complications, wellness and burnout prevention, and opportunities for professional advancement through involvement in institutional, regional, and national organizations. By the end of the course, students will possess a well-rounded, “eyes wide open” perspective on the personal and professional realities of a career in surgery. Please note, this class is taught virtually, but you will be required to attend daily Zoom meetings.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Curricular Component(s) Met: None
• Availability: Dependent on enrollment in these courses 9P03, 9M02, 9946, 9947, and 9950  as only two of these courses will be offered at a time. Available during rotations
  •  September 28 - October 25 (rotation 4a or 4b)
  • January 4-31 (rotation 7a or 7b) 
  • March 29 - April 25 (rotation 10a or 10b)

This two- or four-week elective is designed for medical students who have completed their core surgery clerkship and are preparing for surgical residency. The rotation provides an immersive experience on a busy Elective General Surgery service, offering both inpatient and outpatient exposure. Students will actively participate in patient rounds, outpatient clinics, operative procedures, and surgery-specific conferences. Through this hands-on clinical engagement, students will refine essential competencies including patient evaluation, clinical documentation, order management, perioperative decision-making, interprofessional communication, workflow organization, and safe patient handoffs. The course supports the transition to graduate medical education by strengthening clinical judgment, time management, and professionalism in surgical settings.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Curricular Component(s) Met: Surgical Subspecialty
• Availability: Limited to one student per rotation between 9951 and 9953 at a time.

This 2-week outpatient elective introduces students to the multidisciplinary management of chronic pain conditions. Students will evaluate patients with pain complaints, conduct focused physical exams, develop multimodal treatment plans, and observe interventional procedures in the clinic and operating room. Emphasis is placed on integrating pharmacologic and non-pharmacologic strategies, understanding pain perception and modulation, applying differential diagnoses, understanding procedure-based care, and working within interprofessional teams to optimize outcomes.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Curricular Component(s) Met: Surgical Subspecialty
• Availability: Limited to one student per rotation

This advanced elective provides a four-week immersive Acting Internship experience on a General Surgery service for students preparing to enter surgical residency. Building upon the foundational skills gained during the core surgery clerkship, this rotation advances the student’s clinical independence, critical thinking, and professional accountability within a high-functioning surgical team. Students assume near intern-level responsibilities in evaluating, managing, and communicating about patients with elective surgical conditions across inpatient, outpatient, and operative settings. They will conduct comprehensive histories and physical examinations, formulate evidence-based management plans, enter and manage clinical orders, and produce concise, accurate documentation using institutional standards. The course emphasizes integration of patient-centered values, professionalism, and ethical reasoning in complex clinical environments. Students will refine operative preparation and postoperative decision-making skills, determine appropriate levels of care, and participate in daily rounds, outpatient clinics, operative cases, and interprofessional conferences. Through consistent engagement in patient care continuity and structured feedback, participants will strengthen clinical judgment, time management, and self-directed learning necessary for the transition to residency and the practice of independent surgical care.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  4 weeks
• Curricular Component(s) Met: Surgical Subspecialty, Advanced Clinical Rotation
• Availability: Limited to one student per rotation between 9951 and 9953 at a time.

This acting internship provides senior medical students with comprehensive exposure to reconstructive surgical care across the lifespan, including pediatric, adolescent, adult, and geriatric populations. Through immersive experiences in both inpatient and outpatient settings, students will develop the clinical skills necessary to evaluate and manage a broad spectrum of reconstructive challenges. These include facial trauma, complex soft tissue injuries, skin cancer reconstruction, wound management, breast reconstruction, head and neck reconstruction, congenital anomalies, lymphovascular malformations, and hand disorders. Students will participate in daily rounds, outpatient clinics, and operative cases, gaining proficiency in identifying surgical indications, writing orders, and applying basic suturing and surgical assistance techniques. Emphasis will be placed on understanding and applying the reconstructive ladder, including the classification and use of tissue grafts, flaps, and implantable materials commonly utilized in plastic surgery. Each student will collaborate with residents and faculty to develop and deliver an educational presentation on a relevant reconstructive topic. Additionally, students are expected to attend all plastic surgery-specific teaching conferences and demonstrate anatomical knowledge during operative procedures. This elective is ideal for students pursuing a career in Plastic Surgery and seeking to strengthen their clinical reasoning, operative preparedness, and foundational technical skills ahead of residency.

• Prerequisite(s): Successful completion of Phase 1 and 2 + Plastics Elective
  
• Co-requisite(s): None
  
• Duration:  4 weeks
• Curricular Component(s) Met: Surgical Subspecialty, Advanced Clinical Rotation
• Availability: Limited to two student per rotation. Only for students planning to pursue plastic surgery. Available during the following rotations
  • July 6 - August 2 (rotation 1a-1b)
  • August 3-30 (rotation 2a-2b)
  • August 31 - September 27 (rotation 3a-b)

his elective is intended to build upon the preliminary experiences obtained in the general ophthalmology elective that is available to both 3rd and 4th year medical students.  It is designed specifically for students pursuing a career in ophthalmology, growing understanding of the different subspecialties, and deepening familiarity with the unique responsibilities and skills of both the clinic and surgical environments.  The student will work with the faculty ophthalmologists during this rotation, assisting with chart review, history taking, physical examination, and surgery.  The elective will allow the students to participate in the treatment of clinical and surgical cases as well as hospital consults.  While single students can take the elective, it is preferable to coordinate schedules so as to have at least one other student for the sake of working with each other.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  4 weeks
• Curricular Component(s) Met: Surgical Subspecialty, Advanced Clinical Rotation
• Availability: Limited to two student per rotation. Only for students planning to pursue plastic surgery. Available during the following rotations
  • July 6 - August 2 (rotation 1a-1b)
  • August 3-30 (rotation 2a-2b)

This elective notates students enrolled in senior away electives at U.S. Liaison Committee on Medical Education (LCME) accredited medical schools and independent academic medical centers that are members of the Council of Teaching Hospitals and Health Systems (COTH).

• Prerequisite(s): Successful completion of Phase 1 and 2 + Medical Curriculum Committee Approval
  
• Co-prerequisite(s):  None
  
• Duration:  2, 4, or 6 weeks
• Curricular Component(s) Met: Determined on an individual basis in collaboration with the Phase 3 Director, based on the scope and requirements of the approved away rotation
• Availability: Subject to availability at the host medical school and affiliated medical center

The focus of this elective is to provide structured study time and educational resources for students who have been required to delay their Step 2 examination due to not achieving a target practice test score or for students who have taken and failed the Step 2 examination. Students will create a structured study plan and will work with the Senior Dean for Academic Affairs (or designee) in collaboration with the Senior Dean for Student Affairs and appropriate faculty to implement this independent study plan.

• Prerequisite(s): Successful completion of phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Curricular Component(s) Met: None
• Availability: Open to all eligible students

This elective is for the student who will be spending time working on their research project.  The student will complete two weeks of independent research.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 weeks
• Curricular Component(s) Met: None
• Availability: Open to all eligible students

Special Studies courses are designed to be used when a course is being developed or tried for feasibility.  Special Studies courses can be created as needed and then a proposal for a permanent course can be submitted through governance. 

• Prerequisite(s): Successful completion of Phase 1 and 2 +  Associate Dean for Clinical Science years 3 and 4 approval
  
• Co-requisite(s): None
  
• Duration: 2 or 4 weeks
• Curricular Component(s) Met: Determined on a case-by-case basis, depending on the objectives and structure of the course under development
• Availability: Offered as needed, contingent upon development and approval of the Special Studies course