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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Radiology
• Availability: All rotations; Limited to 3 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
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible: Pathology
• Availability: All rotations; Limited to 2 students per rotation.

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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Radiology, Dermatology, Internal Medicine, Ophthalmology
• Availability: All rotations; Limited to 2 students per rotation across all pathology electives 9B04, 9B05, 9B06.

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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Radiology
• Availability: All rotations; Limited to 2 students per rotation across all pathology electives 9B04, 9B05, 9B06.

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
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 2 students per rotation across all pathology electives 9B04, 9B05, 9B06.

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
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible: OB-Gyn
• Availability: All rotations; Limited to 3 students per rotation.

This elective explores the science and practice of medical decision making within the acute care environment. Through guided readings, small-group discussions, and observation of clinical reasoning in the Emergency Department, students examine how physicians process information, apply decision frameworks, and recognize common models of clinical reasoning in practice. Emphasis is placed on identifying cognitive biases, analyzing sources of diagnostic and management error, and proposing strategies to improve accuracy, safety, and efficiency in real-world clinical decisions.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 weeks
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Psychiatry
• Availability: All rotations; Limited to 1 student per rotation between 9101 and 9108.

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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Family Medicine, OB-Gyn
• Availability: All rotations; Limited to 1 student per rotation.

This two-week elective introduces students to the principles and practice of pre-hospital medicine through didactic instruction and structured observational field experiences. Students will complete 8-10 ride-along shifts with emergency medical services (EMS) units in the Roanoke Valley, including city and county EMS, fire units, Operational Medical Directors, and, when available, air medical transport. Additional observations may include the 911 call center and medical communications (Med Com). Didactic sessions and available EMS training activities provide context for analyzing the capabilities, limitations, and skill levels of pre-hospital providers; comparing ground and air transport systems; and appraising operational, financial, and medicolegal considerations in pre-hospital care. Students will hold an observational role throughout all field activities, with an emphasis on understanding how EMS integrates with and complements hospital-based emergency and acute care.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 weeks
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Emergency Medicine
• Availability: All rotations; Limited to 2 students per rotation.

This elective provides an immersive clinical experience in the Pediatric Emergency Department at Carilion Roanoke Memorial Hospital. Students will evaluate acutely ill and injured infants, children, and adolescents by conducting chart reviews, collecting focused histories, and performing age-appropriate physical examinations. Using clinical findings, students will appraise differential diagnoses, identify appropriate diagnostic testing, and participate in the development of acute management plans. Under supervision, students will perform pediatric procedures and trauma evaluations, integrating evidence-based and age-specific approaches to emergency care. The course emphasizes rapid clinical reasoning, effective teamwork, and clear communication with patients, families, and interprofessional team members.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 or 4 weeks
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Pediatrics
• Availability: All rotations; Limited to 1 student per rotation.

This advanced elective in Emergency Medicine provides an advanced, immersive clinical experience designed for students preparing to enter residency training. Students function at the level of an early postgraduate trainee under direct supervision by VTC EM Faculty in the Carilion Roanoke Memorial Hospital Emergency Department (ED). Students will perform focused and comprehensive patient evaluations, present findings to attending physicians, and develop independent, evidence-based management plans for patients. The experience emphasizes rapid assessment, multitasking, procedural competence, interprofessional communication, and patient safety in high-acuity settings. This advanced clinical rotation is intended for students with a demonstrated interest in Emergency Medicine and serves as an opportunity to develop residency-level readiness and professional growth in a supervised environment. The primary site will be based at the Carilion Roanoke Memorial Hospital ED, but some shifts may occur at other Carilion EDs based on preceptor availability and student interest.

• Prerequisite(s): Successful completion of Phase 1 and 2 + 9811 Clerkship - Emergency Medicine
  
• Co-requisite(s): None
  
• Duration: 4 weeks
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 1 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 andknowledge necessary to practice medicine in an austere environment, including primary and secondary assessment of patientsin wilderness settings. 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible:
• Availability: Rotation 7b only (September 13-26, 2027); Limited to 10 students.

This elective explores the evidence underlying diagnostic and management decisions in the emergency department (ED). Through observation of physician decision-making, guided literature review, and case-based discussion, students will examine how evidence-based medicine informs evaluation and treatment of common ED presentations, such as chest pain, abdominal pain, and headache. The course emphasizes the application of primary research, critical appraisal of diagnostic accuracy metrics, and translation of evidence into clinical practice.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s):  None
  
• Duration:  2 weeks
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 1 student per rotation between 9101 and 9108.

This elective provides medical students with clinical experience in a rural emergency department setting. Students will evaluate and manage patients presenting with a broad range of acute conditions at a rural Carilion Emergency Department (ED), developing adaptability and confidence in applying clinical reasoning and evidence-based management within a resource-limited environment. Through direct patient care, students will refine skills in history taking, physical examination, differential diagnosis, oral and written patient presentations, clinical documentation, and disposition planning. Emphasis is placed on understanding the systems, workflow, and interprofessional collaboration that characterize rural emergency medicine, including the decision-making processes that guide patient transfer to higher levels of care. The rotation will be based at Carilion Franklin Memorial Hospital but may also include shifts at other Carilion rural EDs (Rockbridge, Giles, or Tazewell) based on preceptor availability and student interest.

• Prerequisite(s): Successful completion of Phase 1 and 2 + 9811 Clerkship - Emergency Medicine 
  
• Co-requisite(s):  None
  
• Duration:  2 weeks
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Anesthesiology, Family Medicine, OB-Gyn, Ophthalmology, Orthopedic Surgery
• Availability: All rotations; Limited to 1 student per rotation.

This four-week advanced elective offers an immersive experience in high-acuity pediatric emergency medicine within a tertiary Pediatric Emergency Department. Students will evaluate and manage critically ill and injured infants, children, and adolescents while working alongside pediatric emergency medicine faculty, residents, nurses, and subspecialists. During the rotation, students will obtain age-specific histories, interpret age-adjusted vital signs and physiologic data, develop prioritized differential diagnoses, and create patient-centered management plans grounded in evidence-based practice and patient safety principles. Students will perform common pediatric emergency procedures under appropriate supervision, coordinate admissions and interfacility transfers, and contribute to consultative discussions and team-based decision-making. The rotation emphasizes advanced clinical reasoning, developmentally appropriate care, effective interprofessional collaboration, safe transitions of care, and professional accountability to support your preparation for residency.

• Prerequisite(s): Successful completion of Phase 1 and 2 + 9811 Clerkship - Emergency Medicine 
  
• Co-requisite(s):  None
  
• Duration:  4 weeks
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible: Pediatrics
• Availability: All rotations; Limited to 1 student per rotation.

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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Orthopedic Surgery
• Availability: Rotations 5a-10b (Jul 5 - Dec 19); Limited to 1 student per rotation.

This elective provides students with clinical and population-based public health experiences across community settings. The course examines how environmental, social, and structural factors influence individual and population health outcomes and inform public health interventions. Learners explore the roles of local and state health departments in disease surveillance, prevention, and population health management. Public health principles are applied to gathering a focused patient history and the diagnosis and management of common infectious diseases and sexually transmitted infections, as well as to the development of evidence-based counseling strategies related to preconception health, family planning, and disease prevention. The elective includes evaluation of public health programs, such as nutrition assistance, refugee health services, and reproductive health programs, to understand their impact on community health outcomes. Students use public health data and surveillance systems to assess community health needs, collaborate with interprofessional public health teams, and examine how scholarly or quality-focused work can inform patient care, public health practice, and population-level outcomes.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 or 4 weeks
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: 
• Availability: All rotations; Limited to 1 student per rotation.

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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: OB-Gyn, Ophthalmology, Psychiatry
• Availability: All rotations; Limited to 2 students per rotation, with a maximum of 6 students total.

This advanced elective in Family Medicine provides Phase 3 medical students with an immersive inpatient experience that emphasizes progressive responsibility for the care of hospitalized patients from a family medicine perspective. Students function at an advanced clinical level, participating in the evaluation and management of patients presenting through the emergency department or admitted to the family medicine inpatient service. Under supervision, students conduct focused histories and physical examinations, initiate diagnostic evaluations, and formulate evidence-based diagnostic and treatment plans. Throughout hospitalization, students analyze clinical data, assess patient progress, and modify management plans in response to changing clinical conditions. Students assume primary responsibility for presenting assigned patients during daily inpatient rounds and for accurate, timely clinical documentation. The rotation also emphasizes the role of family physicians within hospital-based care teams. Students collaborate with interprofessional healthcare professionals and gain exposure to a broad range of inpatient settings relevant to family medicine practice, which may include obstetrics, pediatrics, newborn care, and critical care as appropriate to the service. Educational activities include presentation of an evidence-based topic integrating basic science principles with inpatient clinical decision-making, supporting readiness for residency-level family medicine practice.

• Prerequisite(s): Successful completion of Phase 1 and 2
• Co-requisite(s): None 
• Duration:  4 weeks 
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: Rotations 1a-4b (Feb 15 - Jun 6, 2027) and 12b-14b (Feb 14 - Apr 30, 2028); Limited to 1 student per rotation.

This advanced clinical rotation (ACR) elective provides an immersive clinical experience in Family Medicine with structured participation on the inpatient service and supervised exposure to outpatient clinical care. Students function as active members of the care team and demonstrating responsibility under the guidance of attending physicians and upper-level residents. In the inpatient setting, students participate in admissions, daily rounds, and ongoing management of hospitalized patients, serving as first responders for Emergency Department admissions and consults. Students follow assigned patients throughout their hospitalization and contribute to developing differential diagnoses, care planning, clinical documentation, and communication with interprofessional team members. In the outpatient setting, students participate in supervised Family Medicine clinics, engaging in patient evaluations, follow-up visits, preventive care, and chronic disease management. Outpatient experiences reinforce continuity of care and allow students to observe and participate in transitions between inpatient and ambulatory settings. This elective emphasizes clinical reasoning, patient-centered care, effective communication, professionalism, and readiness for residency-level responsibilities.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 4 weeks
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible: 
• Availability: Rotations 3a-7a (Apr 12 - Sep 12, 2027) and 14a-14b (Apr 3 - 30, 2028); Limited to 1 student per rotation.

This advanced clinical rotation (ACR) elective provides an immersive clinical experience in outpatient Family Medicine with emphasis on advanced clinical responsibility and patient-centered care. Students function as active members of the ambulatory care team, performing comprehensive histories and physical examinations, incorporating preventive care recommendations, and evaluating acute and chronic conditions across diverse patient populations. Students formulate differential diagnoses and develop evidence-based management plans that integrate appropriate diagnostics, specialty-specific standards, and patient safety principles. Through supervised clinical participation, students manage longitudinal care, coordinate follow-up, and contribute to continuity of care within the healthcare system. The elective emphasizes effective communication, shared decision-making, interprofessional collaboration, and professional identity formation. Students demonstrate accountability, ethical practice, and appropriate help-seeking behaviors while refining clinical reasoning and documentation skills. This course prepares students for residency-level responsibilities in outpatient and primary care settings.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 4 weeks
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible: 
• Availability: Rotations 2b-4b (Mar 29 - Jun 6, 2027) and 13a-14b (Feb 28 - Apr 20, 2028); Limited to 1 student 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible:
• Availability: 
  • 1a-3b (Feb 15 - May 9, 2027)
  • 6b-10a (Aug 16 - Dec 5, 2027) 
  • 12a-14b (Jan 31 - Apr 30, 2028)
  • No student limit
  • However, only 2 of the following electives may be offered during any given rotation: 9P03, 9M02, 9946, 9947, and 9950. Once 2 electives have been selected, the remaining electives will become unavailable for that rotation.

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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 4 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible:
• Availability: Rotations 1a–2a (Feb 15 - Mar 28, 2027) and 9b-13a (Nov 8, 2027 - Mar 12, 2028); limited to 2 students per rotation.

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 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 
• Required Curricular Component(s) Fulfilled:
• Specialty Specific Bundle Eligible: Pathology
• Availability: All rotations; Limited to 1 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 
• Required Curricular Component(s) Fulfilled:
• Specialty Specific Bundle Eligible: Family Medicine
• Availability: Rotation 14a-14b (Apr 3-30, 2028) only; Limited to 2 students per rotation.

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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible:
• Availability: Rotations 2b-4b (Mar 29 - Jun 6, 2027) and 5b-14b (Jul 19, 2027 - Apr 30, 2028); Limited to 2 students 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 Free Clinic, 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 1 student per rotation.

This elective provides medical students with supervised experience in infectious diseases consultation for hospitalized patients at Carilion Roanoke Memorial Hospital. Students participate in patient chart review, focused history-taking, and physical examination, and apply these findings to develop prioritized differential diagnoses for infectious conditions. Through engagement with diagnostic testing, including microbiologic and serologic studies, students interpret clinical data and contribute to evidence-based antimicrobial management plans grounded in microbiologic, pharmacologic, and physiologic principles. The elective exposes students to a diverse patient population with a broad range of infectious diseases and emphasizes clinical reasoning, diagnostic evaluation, antimicrobial stewardship, and effective oral communication within the healthcare team. This course supports the development of skills essential for residency-level readiness in the diagnosis and management of infectious diseases.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: General Surgery, Dematology, Internal Medicine, Orthopaedic Surgery
• Availability: All rotations; Limited to 2 students per rotation.

This inpatient elective introduces medical students to the practice of consultative cardiology. Students evaluate patients admitted to non-cardiology services who present with diverse cardiovascular conditions, including pre-operative assessments, postoperative arrhythmias, acute coronary syndromes, and decompensated heart failure. Under supervision, students practice comprehensive cardiovascular histories and physical examinations, construct differential diagnoses, and interpret diagnostic data such as electrocardiograms (ECGs) and cardiac biomarkers. They select and justify appropriate imaging modalities, explain the pharmacologic management of common conditions, and apply evidence-based literature to patient care. Students actively contribute to consult rounds, present cases clearly to fellows and attending physicians, and demonstrate professionalism in all clinical interactions.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 weeks
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Anesthesiology, Emergency Medicine, Family Medicine, Internal Medicine, Ophthalmology, Physical Med & Rehabilitation, General Surgery
• Availability: All rotations; Limited to 2 students 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 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 or 4 weeks
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Dermatology, Family Medicine, Internal Medicine, Ophthalmology, Physical Med & Rehabilitation
• Availability: All rotations; Limited to 1 student per rotation.

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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Family Medicine, Neurology, Orthopaedic Surgery
• Availability: All rotations; Limited to 3 students per rotation between 9304 and 9318. 

Electrocardiography is widely used as a method for aiding the evaluation of heart health or disease in all patient populations, often as an important laboratory test included along with history and physical findings. Part of evaluating patients who are healthy or who may have cardiac disease rests upon the accurate interpretation of ECGs. The medical student ECG elective will introduce the student to the basic technical aspects of electrocardiography and reading or interpretation of the electrocardiogram (ECG). The material to be covered in this elective will increase the students ability to recognize important findings in the normal ECG, and in the ECG which is abnormal due to chronic or acute cardiac conditions. This is an online asynchronous course. 

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: 
• Availability: All rotations; No student limit

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 deliver case 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Anesthesiology, Family Medicine, Internal Medicine, Physical Med & Rehabilitation, General Surgery
• Availability: Rotations 1a-4b (Feb 15 - Jun 6, 2027) and 6a-14b (Aug 2, 2027 - Apr 30, 2028); Limited to 2 students per rotation.

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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Dermatology, Neurology, OB-Gyn, Ophthalmology, Pathology, Physical Med & Rehabilition
• Availability: All rotations; Limited to 1 student per rotation. 

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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Family Medicine, Internal Medicine, OB-Gyn,  Physical Med & Rehabilitation, Psychiatry, General Surgery
• Availability: Rotations 1a-4b (Feb 15 - Jun 6, 2027) and 6b-14b (Aug 16, 2027 - Apr 30, 2028); Limited to 1 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
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• SSpecialty Specific Bundle Eligible: Radiology
• Availability: All rotations; Limited to 2 students per rotation. 

This elective immerses Phase 3 medical students in the care of patients with a wide range of cardiovascular diseases through participation on a busy inpatient cardiology service and an observation unit. Students conduct comprehensive cardiovascular histories and physical examinations, formulate differential diagnoses, and interpret electrocardiograms, cardiac biomarkers, and hemodynamic parameters. They evaluate non-invasive imaging studies, including stress testing, echocardiography, nuclear cardiology, and CT angiography, and contribute to management plans that integrate pharmacologic and non-pharmacologic strategies with safe discharge planning. Learners may observe cardiology procedures such as stress testing, coronary angiography, percutaneous coronary intervention, as well as transesophageal echocardiography, communicate clinical reasoning effectively during interprofessional rounds and conferences, and analyze current literature to guide patient care. Opportunities include participation in cardiology core didactics, case-based fellow conferences, and grand rounds. Professionalism, ethical behavior, and collaboration with patients, families, and healthcare teams are emphasized throughout, preparing students for residency-level responsibilities in cardiovascular medicine.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  4 weeks
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 1 student per rotation.

This elective provides intensive training in the management of critically ill patients in the Coronary Care Unit (CCU) at Carilion Roanoke Memorial Hospital. Students perform comprehensive cardiovascular histories, physical examinations, and critical care assessments, as well as construct differential diagnoses for acute presentations such as chest pain, hypotension, and arrhythmias. Under supervision, they interpret electrocardiograms (ECGs), hemodynamic parameters, and laboratory data, and formulate evidencebased diagnostic and therapeutic plans that adapt to evolving clinical status. Learners apply pharmacology, basic science principles, and current literature to individualized patient care while communicating findings through accurate documentation and concise oral presentations. The course emphasizes professionalism, interprofessional collaboration, and patient- and family-centered communication. Students may observe or assist with bedside procedures such as central lines, arterial lines, and swan ganz catheter placement. They may also observe cardiac catheterizations and learn about the indications and management of mechanical circulatory support devices. The four-week option incorporates scholarly engagement, requiring a formal case-based presentation and greater demonstration of teamwork, situational awareness, and integration of scientific evidence in clinical decision-making.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 weeks
• Required Curricular Component(s) Fulfilled: ICU
• Specialty Specific Bundle Eligible: Emergency Medicine
• Availability: All rotations; Limited to 1 student per rotation between 9311 and 9328.

This clinical elective immerses students in dermatologic care through outpatient clinics at Carilion Riverside Complex and inpatient consults at Carilion Roanoke Memorial Hospital. Students will conduct focused dermatologic histories and physical exams, including identification and description of primary and secondary skin lesions, describe and document cutaneous findings, and participate in the development of differential diagnoses and treatment plans. Under the supervision of attending physicians, students will perform dermatologic procedures, interpret histopathology, and evaluate potassium hydroxide (KOH) preparations used to diagnose fungal infections. They will also communicate clinical findings in both inpatient and outpatient settings. The elective emphasizes diagnostic reasoning, procedural proficiency, and interprofessional communication in the context of skin disease.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 or 4 weeks
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Family Medicine, Internal Medicine, Plastic Surgery
• Availability: Rotations 1a-4b (Feb 15 - Jun 6, 2027) and 8a-14b (Septemer 27, 2027 - Apr 30, 2028); Limited to 1 student per rotation.

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
• Required Curricular Component(s) Fulfilled: ICU
• Specialty Specific Bundle Eligible: Family Medicine, General Surgery, Internal Medicine
• Availability: All rotations; Limited to 1 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Internal Medicine, Ophthalmology, Pathology, Radiology, Urology
• Availability: All rotations; Limited to 1 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
• Required Curricular Component(s) Fulfilled: ICU
• Specialty Specific Bundle Eligible:
• Availability: Rotations 1a-4b (Feb 15 - Jun 6, 2027) and 6a-14b (Aug 2, 2027 - Apr 30, 2028); Limited to 2 students per rotation.

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
• Required Curricular Component(s) Fulfilled: ICU
• Specialty Specific Bundle Eligible: Internal Medicine, Urology
• Availability: All rotations; Limited to 1 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
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 3 students per rotation between 9304 and 9318. 

This advanced elective provides Phase 3 medical students with immersive clinical experience in both outpatient dermatology clinics and hospital-based consultations at Carilion Clinic. Students will refine their skills in patient history-taking, physical examination, and morphologic diagnosis while working closely with dermatology attendings to develop differential diagnoses and individualized management plans. The course emphasizes procedural dermatology, including cryotherapy, skin biopsies, and exposure to Mohs micrographic surgery. Students will also prepare and deliver an evidence-based oral presentation on a dermatologic topic, reinforcing critical appraisal and scholarly communication skills. This elective builds upon prior dermatology training, promoting independence in clinical reasoning and procedural competence.

• Prerequisite(s): Successful completion of Phase 1 and 2 + 9312 or 9322
• Co-requisite(s): None
  
• Duration: 4 weeks
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: Rotations 1a-4b (Feb 15 - Jun 6, 2027) and 8a-14b (Septemer 27, 2027 - Apr 30, 2028); Limited to 1 student per rotation.

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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Family Medicine
• Availability: Rotations 1a-4b (Feb 15 - Jun 6, 2027) and 7a-14b (Aug 30, 2027 - Apr 30, 2028); Limited to 1 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Otolaryngology, Radiology, Urology
• Availability: All rotations; Limited to 1 student per rotation.

This 2-week online elective introduces medical students to foundational dermatologic principles with broad clinical relevance, including the structure and function of normal skin. Through asynchronous engagement with the American Academy of Dermatology (AAD) Basic Dermatology Curriculum, students will build core competencies in performing complete skin exams, describing dermatologic findings using standardized terminology, and developing morphology-based differential diagnoses. Course content includes the evaluation and initial management of common dermatologic conditions such as inflammatory, infectious, and neoplastic skin diseases, as well as dermatologic drug reactions and disorders seen in pediatric and sexual and gender diverse (SGD) populations. Students will also be introduced to essential therapeutic interventions, including topical therapies, phototherapy, and dermoscopy. This is a virtual course. 

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 weeks
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Emergency Medicine, Family Medicine, Plastic Surgery
• Availability: All rotations; no student limit.

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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Family Medicine, Internal Medicine, Psychiatry
• Availability: All rotations; Limited to 1 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible:
• Availability: Not available during the 2027–2028 academic year.

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
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 3 students per rotation.

This four-week Advanced Clinical Rotation offers medical students an immersive experience on the Cardiology Consult Service at Carilion Roanoke Memorial Hospital and affiliated sites. Students will function as near-interns, refining clinical reasoning, diagnostic synthesis, and patient management skills under faculty supervision. Learners will evaluate patients with acute and chronic cardiovascular conditions, perform targeted histories and physical examinations, interpret diagnostic data, and develop evidence-based management plans. The rotation includes active participation in inpatient consults, CCU and telemetry rounds, outpatient cardiology clinics, and multidisciplinary case discussions. Emphasis is placed on professionalism, patient safety, and interprofessional collaboration in managing complex cardiovascular cases.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): none
  
• Duration: 4 weeks
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 2 students per rotation.

This four-week Advanced Clinical Rotation provides Phase 3 medical students with intensive exposure to the management of patients in the Coronary Care Unit (CCU). Students assume near-internship responsibilities, including supervised patient assessment, diagnostic interpretation, and development of evidence-based management plans for acute coronary syndromes, arrhythmias, heart failure, and other critical cardiac conditions. Learners work closely with faculty and house staff, participate in daily multidisciplinary rounds, and contribute to procedural care and consultative decision-making. Emphasis is placed on advanced clinical reasoning, communication across interprofessional teams, and systems-based practice principles that ensure safe, high-quality cardiovascular care. Students are expected to manage patient flow, prioritize tasks, and demonstrate professionalism consistent with the expectations of graduate medical trainees.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): none
  
• Duration:  4 weeks
• Required Curricular Component(s) Fulfilled: ICU, Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 1 student per rotation between 9311 and 9328.

This four-week Advanced Clinical Rotation in Infectious Disease provides immersive inpatient and outpatient experience in the evaluation and management of complex infectious conditions. Students participate in consultation services, antimicrobial stewardship activities, microbiology review (“plate rounds”), outpatient HIV and specialty clinics, and interdisciplinary case conferences. Emphasis is placed on advanced clinical reasoning, formulation of evidence-based management plans, integration of patient safety principles, systems-based antimicrobial stewardship, and professional accountability in complex clinical environments. Students assume progressive responsibility in oral case presentation, documentation, diagnostic interpretation, and care coordination under faculty supervision. This rotation supports transition to residency by strengthening independent clinical judgment, communication skills, and systems awareness in infectious disease management.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  4 weeks
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 2 students 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Family Medicine
• Availability: Rotation 14a-14b (Apr 3-30, 2028) only; Limited to 2 students per rotation.

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 global health, 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Family Medicine
• Availability: Rotation 14a-14b (Apr 3-30, 2028) only; Limited to 2 students per rotation.
  • A maximum of 4 students may be in Taiwan at any given time. If fewer than 4 students can be accommodated, students will be selected based on the order in which they signed up.

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 a unique 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Family Medicine
• Availability: Rotation 14a-14b (Apr 3-30, 2028) only; Limited to 2 students per rotation.
  • A maximum of 4 students may be in Taiwan at any given time. If fewer than 4 students can be accommodated, students will be selected based on the order in which they signed up.

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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Family Medicine
• Availability: Rotation 14a-14b (Apr 3-30, 2028) only; Limited to 2 students per rotation.
  • A maximum of 4 students may be in Taiwan at any given time. If fewer than 4 students can be accommodated, students will be selected based on the order in which they signed up.

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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Family Medicine
• Availability: Rotation 14a-14b (Apr 3-30, 2028) only; Limited to 2 students per rotation.

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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Family Medicine
• Availability: Rotation 14a-14b (Apr 3-30, 2028) only; Limited to 2 students per rotation.

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. 

• 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Family Medicine
• Availability: Not available during the 2027–2028 academic year.

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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Family Medicine
• Availability: Rotation 14a-14b (Apr 3-30, 2028) only; Limited to 4 students 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 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Family Medicine
• Availability: Rotation 14a-14b (Apr 3-30, 2028) only; Limited to 2 students per rotation.

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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Family Medicine
• Availability: Rotation 14a-14b (Apr 3-30, 2028) only; No student limit.

This two- or four-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 or 4 weeks
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: OB-Gyn
• Availability: All rotations; Limited to 2 students per rotation.

This course explores the nature of medical errors, the malpractice litigation process, medical-legal reporting systems, malpractice insurance, and their psychological and professional impact on the practitioner. Students will analyze the role of malpractice lawsuits within 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 might encounter 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible:
• Availability: 
  • 1a-3b (Feb 15 - May 9, 2027)
  • 6b-10a (Aug 16 - Dec 5, 2027) 
  • 12a-14b (Jan 31 - Apr 30, 2028)
  • No student limit
  • However, only 2 of the following electives may be offered during any given rotation: 9P03, 9M02, 9946, 9947, and 9950. Once 2 electives have been selected, the remaining electives will become unavailable for that rotation.

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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible:
• Availability: Assigned to Rotation 14b; however, this is a longitudinal elective requiring ongoing work throughout the elective year; no student limit.

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,” performance of focused and comprehensive neurologic evaluations, 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 incomprehensive stroke treatment.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Emergency Medicine, Neurosurgery, Physical Med & Rehabilitation
• Availability: All rotations; Limited to 1 student per rotation.

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 application of evidence-based medicine principles, 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Anesthesiology, Emergency Medicine, Internal Medicine, Neurosurgery, Ophthalmology, Otolaryngology, Psychiatry, Radiology
• Availability: All rotations; Limited to 1 student per rotation.

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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Family Medicine, Neurosurgery, Ophthalmology, Physical Med & Rehabilitation, Psychiatry
• Availability: All rotations; Limited to 1 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 grounded in pathophysiologic and pharmacologic principles. 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 professional, ethical, and conscientious behavior in preparation for residency-level responsibility.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  4 weeks 
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 1 student per rotation.

This two-week clinical elective provides students with an overview of headache disorders, emphasizing the pathophysiology, classification, diagnosis, and evidence-based management of acute and chronic headaches. Students apply the International Classification of Headache Disorders, 3rd edition (ICHD-3), to clinical evaluation and treatment planning and gain exposure to procedural interventions, including onabotulinumtoxinA injections and peripheral nerve blocks. The course emphasizes multidisciplinary care, patient education, and clinical decision-making in the evaluation and management of complex headache disorders.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  4 weeks 
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Physical Med & Rehabilitation
• Availability: All rotations; Limited to 1 student per rotation.

Advanced Headache Medicine is a four-week immersive clinical experience focused on the evaluation and management of complex primary and secondary headache disorders across adult and pediatric populations. Students assume an advanced clinical role in applying the International Classification of Headache Disorders, 3rd edition (ICHD-3), to real-world diagnostic and management challenges. Students develop increasing independence in clinical reasoning, longitudinal patient management, and procedural care. Emphasis is placed on differentiating complex headache presentations, identifying red flags, and implementing evidence-based acute and preventive treatment strategies, including pharmacologic and interventional approaches such as OnabotulinumtoxinA injections and nerve blocks. The rotation emphasizes multidisciplinary care, patient education, and systems-based practice, preparing students for residency-level responsibility in neurology and related specialties.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  4 weeks 
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 1 student per rotation.

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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: OB-Gyn, Urology 
• Availability: Rotations 4a-14b (May 10, 2027 - Apr 30, 2028); Limited to 1 student per rotation between 9502 and 9508.

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
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 2 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
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 1 student per rotation between 9504 and 9511.

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
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible: Anesthesiology
• Availability: Rotations 1a-4a (Feb 15 - May 23, 2027) and 10b-14b (Dec 6, 2027 - Apr 30, 2028); Limited to 1 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
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: Rotations 4a-10b (May 10, - Dec 19, 2027); Limited to 1 student per rotation between 9502 and 9508.

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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible:
• Availability: Rotations
  • 1a-1b (Feb 15 - Mar 14, 2027)
  • 2b-3a (Mar 29 - Apr 25, 2027)
  • 4a-4b (May 10 - Jun 6, 2027)
  • 5b-6b (Jul 19 - Aug 29, 2027)
  • 7b-8a (Sep 13 - Oct 10, 2027)
  • 9b-14b (Nov 8, 2027 - Apr 30,  2028)
  • Limited to 1 student per rotation

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
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: 
  • 1a-1b (Feb 15 - Mar 14, 2027)
  • 2b-3a (Mar 29 - Apr 25, 2027)
  • 4a-4b (May 10 - Jun 6, 2027)
  • 5b-6b (Jul 19 - Aug 29, 2027)
  • 7b-8a (Sep 13 - Oct 10, 2027)
  • 9b-14b (Nov 8, 2027 - Apr 30,  2028)
  • Limited to 1 student per rotation    

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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Family Medicine, OB-Gyn, Pediatrics
• Availability: All rotations; Limited to 1 student per rotation between 9504 and 9511.

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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible:
• Availability: 
  • 1a-1b (Feb 15 - Mar 14, 2027)
  • 2b-3a (Mar 29 - Apr 25, 2027)
  • 4a-4b (May 10 - Jun 6, 2027)
  • 5b-6b (Jul 19 - Aug 29, 2027)
  • 7b-8a (Sep 13 - Oct 10, 2027)
  • 9b-14b (Nov 8, 2027 - Apr 30,  2028)
  • Limited to 1 student per rotation

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 as well as experience with the care of infants with neonatal abstinence syndrome. Participation 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 workups, 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 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Family Medicine, OB-Gyn, Psychiatry
• Availability: Rotations 1b-9a (Mar 1 - Sep 7, 2027) and 10b-14b (Dec 6, 2027 - Apr 30, 2028); Limited to 1 student per rotation.

This elective offers hands-on experience in the outpatient evaluation and management of patients with musculoskeletal and orthopaedic conditions. Students will participate in ambulatory clinic care while learning to perform focused orthopaedic histories and physical examinations and interpret imaging studies such as X-rays, CTs, and MRIs. The course emphasizes applying physiologic, pathophysiologic, and biomechanical concepts to understand injury patterns, fracture healing, and implant mechanics. Students will develop differential diagnoses and propose treatment plans that incorporate both surgical and nonsurgical approaches. They will also learn principles of outpatient perioperative planning, wound management, rehabilitation, and the recognition of orthopaedic conditions requiring urgent referral, such as infections, compartment syndrome, and vascular injury. Throughout the rotation, students will explore how factors such as comorbidities, metabolism, and nutrition affect healing and recovery, while strengthening their communication skills, teamwork, and professionalism in all aspects of patient care. This course is intended for students who are not pursuing a career in orthopaedic surgery. The focus of this course is on outpatient evaluation and management of common musculoskeletal conditions. Operating Room care is not included in this course.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s):  None
  
• Duration: 2 or 4 weeks
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Emergency Medicine, Family Medicine, Physical Med & Rehabilitation
• Availability: All rotations; Limited to 1 student per rotation.
  • No more than 4 students across 9910, 9911, 9913, 9914, 9956 (Sports Med).

This four-week elective offers Phase 3 medical students an advanced, hands-on experience in orthopaedic surgery designed to strengthen clinical reasoning, procedural skills, and professional readiness for surgical residency. Students will work closely with faculty mentors and residents while rotating two weeks each on the Hand and Trauma services at Carilion Roanoke Memorial Hospital and affiliated sites, including the Institute for Orthopaedics and Neurosciences. During the elective, students will participate in inpatient consultations, outpatient clinics, and operative procedures to gain exposure to a wide range of musculoskeletal conditions and surgical approaches. Daily sign-outs, interprofessional rounds, and teaching conferences provide opportunities to refine students diagnostic, management, and communication skills in a collaborative clinical environment. The rotation emphasizes mentorship, professionalism, and accountability while helping students apply their understanding of anatomy, biomechanics, and pathophysiology to real-world patient care. Students will also complete two 24-hour weekend call shifts for exposure to “on-call orthopaedics” and conclude the rotation by presenting a 15-minute, evidence-based case topic to faculty and residents.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 4 weeks
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 1 student per rotation.
  • No more than 4 students across 9910, 9911, 9913, 9914, 9956 (Sports Med).

This elective provides medical students with a hands-on experience in the evaluation and management of acute orthopaedic injuries encountered in emergency and trauma settings. Students will rotate on the Orthopaedic Trauma Service at Carilion Roanoke Memorial Hospital and gain exposure to both inpatient and emergency care of patients presenting with fractures, dislocations, and musculoskeletal trauma. Through participation in consultations, bedside procedures, splinting, fracture reduction, and surgical observation, students will strengthen their understanding of emergent orthopaedic decision-making and multidisciplinary collaboration. The rotation also emphasizes pain management, radiographic interpretation, and communication with emergency and orthopaedic teams. Students are required to attend weekly fracture and trauma conferences and will complete a 15-minute case-based presentation at the end of the rotation. This course is intended for students pursuing a career in emergency medicine and focuses on musculoskeletal conditions presenting to the Emergency Department.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 or 4 weeks
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Emergency Medicine, Physical Med & Rehabilitation, Radiology, 
• Availability: All rotations; Limited to 1 student per rotation.
  • No more than 4 students across 9910, 9911, 9913, 9914, 9956 (Sports Med).

This elective offers medical students hands-on clinical experience in the evaluation and management of pediatric musculoskeletal and orthopaedic conditions. Students will work alongside pediatric orthopaedic surgeons in both outpatient clinics and operating rooms to assess children with congenital, developmental, and traumatic disorders of the bones, joints, and soft tissues. During the rotation, students will strengthen their skills in performing age-appropriate musculoskeletal examinations, interpreting pediatric imaging, and developing differential diagnoses for common orthopaedic presentations. Clinical experiences include participation in surgical procedures, inpatient and emergency consultations, and multidisciplinary care planning with physical therapists, pediatricians, and other specialists. Through guided mentorship and direct patient interaction, students will apply core orthopaedic principles to the unique needs of pediatric patients, refine their communication and professionalism, and enhance readiness for residency-level clinical care.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s):  None
  
• Duration: 2 weeks
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Emergency Medicine, Physical Med & Rehabilitation, Radiology
• Availability: All rotations; Limited to 1 student per rotation.
  • No more than 4 students across 9910, 9911, 9913, 9914, 9956 (Sports Med).

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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Pediatric
• Availability: All rotations; Limited to 1 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Pediatrics
• Availability: Not available during the 2027–2028 academic year.

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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Pediatrics
• Availability: All rotations; Limited to 1 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Pediatrics
• Availability: All rotations; Limited to 1 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
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible: 
• Availability: Rotation 3a-9b (April 12 - Nov 21, 2027)  Limited to 3 students rotations 3a-4a; and 1 student rotations 4b-9b.

This elective offers students an in-depth clinical experience in an outpatient rural pediatric practice, emphasizing growth and development, preventive care, and management of common childhood illnesses. Students will apply principles of normal and abnormal growth to assess and monitor pediatric patients across developmental stages. Through hands-on participation, they will document well and sick visits, provide age-appropriate anticipatory guidance on immunizations, screening tests, nutrition, safety, and psychosocial well-being, and manage acute conditions within the pediatric medical home model. The rotation also promotes continuity of care and interprofessional collaboration with pediatricians, nurse practitioners, and other healthcare professionals to support comprehensive, evidence-based pediatric care. This elective takes place in Rocky Mount.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 weeks
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Pediatrics, Psychiatry
• Availability: All rotations; Limited to 1 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Family Medicine, Pediatrics
• Availability: All rotations; Limited to 1 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: OB-Gyn
• Availability:
  • 1a-2b (Feb 15 - Apr 11, 2027)
  • 3b-4a (Apr 26 - May 23, 2027)
  • 7a-9b (Aug 30 - Nov 21, 2027)
  • 10b-14b (Dec 6, 2027 - Apr 30, 2028)
  • Limited to 1 student per rotation
    

In this elective, students join the Neonatal Intensive Care Unit (NICU) team at Carilion Children’s Hospital and participate in the care of premature and critically ill newborns. Working alongside physicians, nurses, and respiratory therapists, students gain hands-on experience in neonatal assessment, delivery room management, and daily patient care. Students refine their ability to gather pregnancy and newborn histories, perform focused physical examinations, and recognize the unique physiologic transitions of the newborn, including cardiopulmonary, metabolic, and temperature regulation changes. The course also introduces essential principles of neonatal nutrition, fluid management, and the initial management of common neonatal conditions such as respiratory distress, infection, metabolic disorders, and congenital anomalies. Throughout the rotation, students practice professional communication, teamwork, and family-centered care in a high-acuity setting while exploring the medical, psychosocial, and ethical aspects of prematurity and high-risk pregnancies.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 weeks
• Required Curricular Component(s) Fulfilled: ICU
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 1 student per rotation.

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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Pediatrics
• Availability: 
  • 1a-3a (Feb 15 - Apr 25, 2027)
  • 4a (May 10 - May 23, 2027) 
  • 5a (Jul 5 - Jul 18, 2027)
  • 6a-7b (Aug 2 - Sept 26, 2027)
  • 8b-14b (Oct 11, 2027 - Apr 30, 2028)
  • Limited to 1 student per rotation

This two-week elective introduces students to the principles and practice of pediatric critical care medicine. Students will participate in daily rounds, perform focused histories and physical examinations, and assist in developing patient-centered management plans under faculty supervision. Learning activities emphasize recognition of acute illness, interpretation of laboratory and physiologic data, and understanding the indications and basic mechanisms of life-support and monitoring technologies. Students will observe stabilization and interventions for life-threatening conditions, explore the pathophysiology of major organ system diseases, and engage with interprofessional teams to understand the systems and communication skills necessary for effective care delivery in the Pediatric Intensive Care Unit (PICU).

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 weeks
• Required Curricular Component(s) Fulfilled: ICU
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 1 student per rotation between 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Pediatrics, Physical Med & Rehabilitation, Neurosurgery, Neurology
• Availability: 
  • 1a-4a (Feb 15 - May 23, 2027)
  • 5b-9b (Jul 19 - Nov 21, 2027)
  • 10b-14b (Dec 6, 2027 - Apr 30, 2028)
  • Limited to 1 student per rotation

The goal of this course is to expose students to the applications and context of social determinants of health and physician advocacy within pediatric healthcare settings. This elective aims to deepen students' understanding of how social, economic, environmental, and structural factors influence health outcomes for infants, children, and adolescents, enhance their skills in identifying health disparities, and provide practice in developing advocacy strategies within a multidisciplinary context. Over this two-week elective, students will improve their ability to analyze social determinants of health affecting pediatric patients and families, and apply advocacy principles effectively in clinical and community settings. Students are required to participate in relevant clinical, community-based, and advocacy-related activities focused on pediatric populations at Carilion Roanoke Memorial Hospital and affiliated community sites.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 weeks
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Family Medicine, OB-Gyn, Psychiatry
• Availability: Temporarily unavailable for 2027-2028 academic year.

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 employ preventative care guidelines, 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
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: Rotations 6a-6b (Aug 2 - 29, 2027); Limited to 1 student per rotation.

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 rotation materials, hosting office hours for concerns and mentorship, offering individualized educational support, and leading review sessions prior to the NBME. They will also act as liaisons between medical students and faculty leadership for the Pediatrics Clerkship. In addition to these responsibilities, students will be expected to model and promote professional behavior and effective communication with patients, families, and the healthcare team. They will also have the opportunity to lead a self-directed projector scholarly activity aimed at improving the medical student experience, culminating in a presentation of their project results. The elective provides educational and leadership exposure, mentorship, and fosters career development for future success within academic medical education. This course can accommodate one to four students per year.  This course can hold one to three 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Pediatrics
• Availability: Assigned to Rotation 14a-14b (Apr 3-30, 2028); however, this is a longitudinal elective requiring ongoing work throughout the academic year; Limited to 3 students.

   

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
• Required Curricular Component(s) Fulfilled: ICU, Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 1 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
• Required Curricular Component(s) Fulfilled: ICU, Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 1 student per rotation between 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Family Medicine, Pediatrics
• Availability: All rotations; Limited to 1 student per rotation between 9701 and 9709.

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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Pediatrics
• Availability: All rotations; Limited to 1 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Emergency Medicine, Internal Medicine, Physical Med & Rehabilitation, Neurology
• Availability: All rotations; Limited to 1 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Emergency Medicine, Family Medicine, Internal Medicine, Neurology
• Availability: All rotations; Limited to 2 students 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
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: Rotations 1b-9a (Mar 1 - Nov 7, 2027) and 10b-14b (Dec 6, 2027 - Apr 30, 2028); Limited to 1 student per rotation.

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
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 4 students 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 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
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 1 student per rotation between 9701 and 9709.

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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Family Medicine, Internal Medicine, Neurology 
• Availability: Rotations 1b-9a (Mar 1 - Nov 7, 2027) and 10b-14b (Dec 6, 2027 - Apr 30, 2028); Limited to 1 student per rotation.

Addiction Medicine is an elective clinical experience focused on harm reduction, patient-centered care, and low-barrier engagement for individuals with substance use disorders, including opioid use disorder, alcohol use disorder, and stimulant use disorder, and co-occurring medical and psychiatric conditions. Students develop practical skills to establish therapeutic alliance, assess safety and readiness for change, and implement evidence-based interventions that reduce overdose risk and other health harms regardless of a patient’s treatment goals. Students practice trauma-informed, stigma-free communication; participate in supervised initiation and monitoring of medications for opioid use disorder when indicated; counsel on evidence-based strategies for alcohol and stimulant-related harms; and connect patients to community and recovery resources. The clerkship emphasizes real-world care delivery across ambulatory, consultative, and community-linked settings with attention to equity, chronic disease management, and systems-based practice.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Emergency Medicine, Family Medicine, Internal Medicine, OB-Gyn, Psychiatry
• Availability: Rotations 3a-14b (Apr 12, 2027 - Apr 30, 2028); Limited to 1 student per rotation.

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
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 1 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Emergency Medicine
• Availability: All rotations; Limited to 1 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
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 1 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: General Surgery, Neurology, Otolaryngology, Physical Med & Rehabilitation, Radiology, Urology
• Availability: Rotations 1a-3b (Feb 15 - May 9, 2027) and 4b-14b (May 24, 2027 - Apr 30, 2028); Limited to 2 students per rotation.

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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Pathology, Radiology
• Availability: Rotations 1a-3b (Feb 15 - May 9, 2027) and 4b-14b (May 24, 2027 - Apr 30, 2028; Limited to 1 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Emergency Medicine, Family Medicine, Orthopedic Surgery Physical Med & Rehabilitation, Radiology
• Availability: Rotations 1a-3b (Feb 15 - May 9, 2027) and 4b-14b (May 24, 2027 - Apr 30, 2028; Limited to 1 student per rotation.

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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Emergency Medicine, Internal Medicine, Neurosurgery, Neurology, Ophthalmology, Otolaryngology, Pathology, Physical Med & Rehabilitation, Radiology
• Availability: Rotations 1a-3b (Feb 15 - May 9, 2027) and 4b-14b (May 24, 2027 - Apr 30, 2028; Limited to 2 student per rotation.

• Prerequisite(s): Successful completion of Phase 1 and 2 + 9801
  
• Co-requisite(s): None
  
• Duration: 4 weeks
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible: Radiology
• Availability: Rotations 1a-3b (Feb 15 - May 9, 2027) and 4b-14b (May 24, 2027 - Apr 30, 2028; Limited to 2 students per rotation.

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
  
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Anesthesiology, Orthopedic Surgery, Physical Med & Rehabilitation
• Availability: All rotations; Limited to 1 student per rotation. 
  • Max of 3 students across 9901, 9902, 9903, 9904, 9905, 9906, 9907, 9908, 9909, 9916, 9917, 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Physical Med & Rehabilitation
• Availability: All rotations; Limited to 1 student per rotation.
  • Max of 3 students across 9901, 9902, 9903, 9904, 9905, 9906, 9907, 9908, 9909, 9916, 9917, 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 
• Required Curricular Component(s) Fulfilled: ICU
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 1 student per rotation. 
  • Max of 3 students across 9901, 9902, 9903, 9904, 9905, 9906, 9907, 9908, 9909, 9916, 9917, 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Anesthesiology, Neurology, Otolaryngology, Physical Med & Rehabilitation, Plastic Surgery, Radiology
• Availability: All rotations; Limited to 1 student per rotation. 
  • Max of 3 students across 9901, 9902, 9903, 9904, 9905, 9906, 9907, 9908, 9909, 9916, 9917, 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 co-authored with their mentors.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 or 4 weeks
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 1 student per rotation. 
  • Max of 3 students across 9901, 9902, 9903, 9904, 9905, 9906, 9907, 9908, 9909, 9916, 9917, 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Emergency Medicine, Neurology
• Availability: All rotations; Limited to 1 student per rotation. 
  • Max of 3 students across 9901, 9902, 9903, 9904, 9905, 9906, 9907, 9908, 9909, 9916, 9917, 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
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 1 student per rotation. 
  • Max of 3 students across 9901, 9902, 9903, 9904, 9905, 9906, 9907, 9908, 9909, 9916, 9917, 9918

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
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 1 student per rotation.
  • Max of 3 students across 9901, 9902, 9903, 9904, 9905, 9906, 9907, 9908, 9909, 9916, 9917, 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
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible: Pediatrics
• Availability: All rotations; Limited to 1 student per rotation. 
  • Max of 3 students across 9901, 9902, 9903, 9904, 9905, 9906, 9907, 9908, 9909, 9916, 9917, 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
• Required Curricular Component(s) Fulfilled: ICU, Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 1 student per rotation. 
  • Max of 3 students across 9901, 9902, 9903, 9904, 9905, 9906, 9907, 9908, 9909, 9916, 9917, 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
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 1 student per rotation.
  • Max of 3 students across 9901, 9902, 9903, 9904, 9905, 9906, 9907, 9908, 9909, 9916, 9917, 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
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 1 student per rotation. 
  • Max of 3 students across 9901, 9902, 9903, 9904, 9905, 9906, 9907, 9908, 9909, 9916, 9917, 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: General Surgery, Emergency Medicine, Neurosurgery, OB-Gyn, Ophthalmology, Orthopedic Surgery, Otolaryngology, Physical Med & Rehabilitation, Plastic Surgery
• Availability: All rotations; Limited to 2 students per rotation.
  •     Max of 2 students across 9920 and 9921 

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
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 2 students per rotation.
  •     Max of 2 students across 9920 and 9921

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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Emergency Medicine
• Availability: All rotations; Limited to 2 students per rotation.

This Acting Internship in the Surgical Intensive Care Unit (SICU) provides advanced medical students with an immersive experience in the multidisciplinary management of critically ill surgical patients. Students function at a near-intern level under supervision, assuming responsibility for comprehensive patient assessment, formulation of evidence-based management plans, and participation in bedside procedures. The rotation emphasizes interpretation of hemodynamic and ventilator data, integration of ICU standards for diagnostics, nutrition, renal replacement, transfusion, and infection control, and engagement in ethical decision-making related to antimicrobial stewardship, end-of-life care, and medical futility. Students will develop professionalism, accountability, and teamwork while adhering to patient safety principles and institutional protocols. Active participation in daily rounds, structured handoffs, and interprofessional collaboration prepares students for the responsibilities and expectations of residency-level critical care practice.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 4 weeks
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 1 student per rotation. 
  • Max of 2 student 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
• Required Curricular Component(s) Fulfilled:
• Specialty Specific Bundle Eligible: General Surgery, Physical Med & Rehabilitation
• Availability: 
  • 1a-1b (Feb 15 - Mar 14, 2027)
  • 2b-4b (Mar 29 - Jun 6, 2027)
  • 5a (Jul 5 - Jul 18, 2027)
  • 6a-14b (Aug 2, 2027 - Apr 30, 2028)
  • Limited to 1 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
• Required Curricular Component(s) Fulfilled:
• Specialty Specific Bundle Eligible: Dermatology, Family Medicine, General Surgery, Internal Medicine, OB-Gyn, Otolaryngology
• Availability: All rotations; Limited to 1 student per rotation.

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
• Required Curricular Component(s) Fulfilled:
• Specialty Specific Bundle Eligible: General Surgery, Plastic Surgery, Radiology
• Availability: All rotations; Limited to 2 students per rotation.

During this elective, the student will gain experience in operative and perioperative management of cardiac and thoracic surgical problems.  This includes illnesses of the esophagus, motility disorders, Boerhaave Syndrome, hiatal hernias, reflux disease, infections, benign neoplastic masses, malignancies, mediastinal masses, lung masses, aortic dissections, and trauma.  The student will also learn about surgical approaches.  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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Anesthesiology
• Availability: All rotations; Limited to 1 student per rotation.

During this elective, 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, and 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/oral medicine curriculum.  The locations are Carilion Clinic Dental Care and Carilion Roanoke Memorial Hospital.  

• Prerequisite(s): Successful completion of Phase 1 and 2
• Co-requisite(s):  None
• Duration:  2 weeks
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Otolaryngology
• Availability: 
  • 1a-4b (Feb 15 - Jun 6, 2027)
  • 6a-7a (Aug 2 - Sep 12, 2027)
  • 8a-14b (Sept 27, 2027-Apr 30, 2028)
  • Limited to 2 students per rotation

During this elective, 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 student will work with the community hospital general surgery service handling a broad range of issues.  Experience will be gained in how to care for surgical patients pre‑operatively and post‑operatively.  The student will also learn when a referral needs to be made to an outside facility such as a level 1 trauma center.  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
• Required Curricular Component(s) Fulfilled:
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 4 students per rotation.

This elective provides clinical exposure to pediatric otolaryngology through evaluation and management of ear, nose, and throat disorders in infants, children, and adolescents across inpatient and outpatient settings. This elective includes performance of focused pediatric histories and physical examinations, including head and neck assessment, and application of relevant anatomy to clinical care. This elective includes identification of common pediatric otolaryngologic conditions, including infections, airway disorders, congenital anomalies, and abnormalities of the oral cavity and pharynx, as well as causes of stridor, rhinorrhea, nasal obstruction, and hearing concerns. Diagnostic approaches, including audiologic testing and flexible laryngoscopy, are incorporated into clinical decision-making. This elective includes determination and description of management strategies for common conditions and pediatric otolaryngologic emergencies, including airway compromise, foreign body aspiration, deep neck infections, and maxillofacial trauma, with attention to patient safety. Clinical experiences in ambulatory, inpatient, and operative settings introduce surgical principles and procedural considerations in pediatric otolaryngology.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Required Curricular Component(s) Fulfilled:
• Specialty Specific Bundle Eligible:
• Availability: Rotations 1b-9b (Feb 29 - Nov 21) and 11a-14a (Jan 3 - April 16, 2028); Limited to 1 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
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 1 student per rotation.

The purpose of this 2-week elective is to allow the student an ability to work with general surgeons with interest/expertise in colorectal surgery managing a broad range of problems including neoplasms, diverticulitis, inflammatory bowel disease, and anorectal disorders.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 weeks
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: General Surgery, Radiology, Urology
• Availability: Rotations 1a-4a (Feb 15 - May 23, 2027) and 7a-14b (Aug 30, 2027 - Apr 30, 2028); Limited to 1 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
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible: Anesthesiology, General Surgery, Neurosurgery, Otolaryngology, Plastic Surgery
• Availability: All rotations; Limited to 1 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: OB-Gyn
• Availability: All rotations; Limited to 3 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Emergency, Otolaryngology
• Availability: Rotations 3a-14b (Apr 12, 2027 - Apr 30, 2028); Limited to 1 student per rotation.

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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Orthopedic Surgery, Pediatrics, Plastic Surgery, Urology
• Availability: Rotations 1a-8b (Feb 15 - Oct 24, 2027) and 10a-14b (Nov 22, 2027 - Apr 30, 2028); Limited to 1 student per rotation.

This elective introduces medical students to the principles and clinical practice of plastic and reconstructive surgery through supervised inpatient, outpatient, and operative experiences. Students observe and participate in the evaluation and management of patients with congenital, traumatic, oncologic, and degenerative conditions affecting form and function across the lifespan. Emphasis is placed on foundational clinical skills, exposure to common reconstructive problems, basic procedural techniques, and understanding the role of plastic surgery within multidisciplinary care teams. This elective is particularly well suited for students exploring a potential career in plastic surgery or related surgical and procedural specialties, including but not limited to dermatology, orthopedics, otolaryngology, and general surgery; however, no formal prerequisite or career commitment is required.

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration: 2 or 4 weeks
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Dermatology, General Surgery, Neurosurgery, Ophthalmology,  Orthopedic Surgery, Otolaryngology
• Availability: Rotations 1a-4b (Feb 15 - Jun 6, 2027) and 7b-14b (Sep 13, 2027 - Apr 30, 2028); Limited to 2 students per rotation.
  • Max 2 students across 9942 and 9954    

This elective offers hands-on experience in the multidisciplinary care of critically ill surgical patients in the Surgical Intensive Care Unit (SICU). Students take an active role in daily rounds, patient assessments, and care planning while learning to interpret hemodynamic data, diagnostic studies, and ventilator settings, including the recognition and management of shock. Through guided clinical participation, students manage common ICU challenges such as pain, agitation, and delirium, and apply evidence-based approaches to supportive therapies, including nutrition, renal replacement therapy, and transfusion support, as well as the prevention and management of infectious complications. Opportunities are provided to perform supervised procedures, including intubation, central line placement, and chest tube insertion. Students also explore ethical aspects of critical care, such as end-of-life decisions and medical futility, through case-based discussion and bedside reflection. The elective emphasizes clinical reasoning, teamwork, and professionalism as students prepare for the transition to residency.

• Prerequisite(s): Successful completion of Phase 1 and 2
• Co-requisite(s): None
• Duration: 2 or 4 weeks 
• Required Curricular Component(s) Fulfilled: ICU
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 1 student per rotation. 
  • Max of 2 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Anesthesiology, Emergency Medicine, General Surgery, Neurosurgery, Orthopedic Surgery, Physical Med & Rehabilitation, Plastic Surgery, Radiology
• Availability: All rotations; Limited to 1 student per rotation.

During this elective, students will gain experience in diagnosis and surgical management of vascular disease and perioperative patient care.  Students will also develop knowledge of anatomy and utilizing surgical techniques to safely operate utilizing the atomic knowledge.  Students will learn when to use medical versus surgical intervention.  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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: General Surgery, Neurosurgery, Plastic Surgery, Radiology, Urology
• Availability: All rotations; Limited to 2 students per rotation.

In this case-based course, students will study the pathophysiology, diagnosis, neuroimaging, and management of clinical neuroscience entities. Students will 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible:
• Availability: Rotations 
  • 1a-3b (Feb 15 - May 9, 2027)
  • 6b-10a (Aug 16 - Dec 5, 2027) 
  • 12a-14b (Jan 31 - Apr 30, 2028)
  • No student limit 
  • However, only 2 of the following electives may be offered during any given rotation: 9P03, 9M02, 9946, 9947, and 9950. Once 2 electives have been selected, the remaining electives will become unavailable for that rotation.

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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Emergency Medicine, Neurosurgery, Neurology
• Availability: 
  • 1a-3b (Feb 15 - May 9, 2027)
  • 6b-10a (Aug 16 - Dec 5, 2027) 
  • 12a-14b (Jan 31 - Apr 30, 2028)
  • No student limit
  • However, only 2 of the following electives may be offered during any given rotation: 9P03, 9M02, 9946, 9947, and 9950. Once 2 electives have been selected, the remaining electives will become unavailable for that rotation.

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
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 1 student per rotation.

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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible:
• Availability: 
  • 1a-3b (Feb 15 - May 9, 2027)
  • 6b-10a (Aug 16 - Dec 5, 2027) 
  • 12a-14b (Jan 31 - Apr 30, 2028)
  • No student limit 
  • However, only 2 of the following electives may be offered during any given rotation: 9P03, 9M02, 9946, 9947, and 9950. Once 2 electives have been selected, the remaining electives will become unavailable for that rotation. 

This two-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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Anesthesiology, Dermatology, Neurosurgery, OB-Gyn,  Orthopedic Surgery, Otolaryngology, Plastic Surgery, Urology
• Availability: All rotations; Limited to 2 students per rotation.
  • Max of 2 student across 9951 and 9953

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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Anesthesiology, OB-Gyn, Physical Med & Rehabilitation
• Availability: All rotations; Limited to 1 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
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 2 students per rotation. 
  • Max of 2 students across 9951 and 9953

This advanced elective provides Phase 3 medical students with immersive exposure to reconstructive surgical care across the lifespan in inpatient and outpatient settings. Students obtain histories, perform physical examinations, and evaluate and manage a broad range of reconstructive conditions, including trauma, oncologic, congenital, and complex wound presentations. Students function as integral members of the plastic surgery team through participation in rounds, clinics, operative cases, and specialty conferences. Under supervision, students identify surgical indications, formulate diagnostic and management plans, write orders, apply the reconstructive ladder in clinical decision-making, and perform basic suturing and surgical assistance techniques while demonstrating applied anatomical knowledge. Each student develops and delivers an educational presentation on a reconstructive surgery topic in collaboration with residents and faculty. This elective is designed for students pursuing plastic surgery or seeking advanced preparation in clinical reasoning, operative readiness, and professional responsibilities prior to residency.

• Prerequisite(s): Successful completion of Phase 1 and 2 + Plastics Elective
  
• Co-requisite(s): None
  
• Duration:  4 weeks
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: Rotations 1a-4b (Feb 15 - Jun 6, 2027) and 7b-14b (Sep 13, 2027 - Apr 30, 2028); Limited to 1 student per rotation.
  • Max 2 students across 9942 and 9954

This 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
• Required Curricular Component(s) Fulfilled: Advanced Clinical Rotation
• Specialty Specific Bundle Eligible:
• Availability: All rotations; Limited to 2 students per rotation.

The purpose of the course is to expose medical students to the practice of sports medicine in multiple specialties. Students will work with orthopaedic, PM&R and primary care sports medicine faculty in the clinical setting to gain exposure to the evaluation, diagnosis and treatment of sports injuries and concussions. This will also include instruction in ultrasound applications within orthopedic sports medicine. They will observe surgical management of injuries with orthopaedic faculty, and see operative patients for follow up after treatment to understand the recovery and rehabilitation associated with these injuries. Students will participate in seasonal sports coverage to develop an understanding of the role of a team physician. They will become familiar with the types of healthcare professionals who take care of athletes including different physician specialties, physical therapists and athletic trainers. 

• Prerequisite(s): Successful completion of Phase 1 and 2
  
• Co-requisite(s): None
  
• Duration:  2 weeks
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible: Family Medicine, Orthaepidic Survery, Physical Med & Rehabilitation
• Availability: All rotations; Limited to 1 student per rotation.
  • No more than 4 students across 9910, 9911, 9913, 9914, 9956 (Sports Med)

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
• Required Curricular Component(s) Fulfilled: Determined on an individual basis in collaboration with the Phase 3 Director, based on the scope and requirements of the approved away rotation
• Specialty Specific Bundle Eligible:
• 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 Associate Dean for Medical Education in collaboration with the Associate 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible:
• 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
• Required Curricular Component(s) Fulfilled: 
• Specialty Specific Bundle Eligible:
• 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 + Director of UME-GME Transition and Electives Curriculum (Phase 3)
  
• Co-requisite(s): None
  
• Duration: 2 or 4 weeks
• Required Curricular Component(s) Fulfilled:  Determined on a case-by-case basis, depending on the objectives and structure of the course under development
• Specialty Specific Bundle Eligible:
• Availability: Offered as needed, contingent upon development and approval of the Special Studies course

• 2024-2025
• 2023-2024
• 2022-2023
• 2021-2022
• 2020-2021

• 2019-2020
• 2018-2019
• 2017-2018
• 2016-2017
• 2015-2016
• 2014-2015
• 2013-2014