Specialty/Subspecialty: Developmental Behavioral Pediatrics

Inpatient vs. Outpatient vs. both: Outpatient

Inpatient Consult Service: N/A

Operating Rooms: N/A

Days/Hours: During outpatient, 7:15 a.m. - 5 p.m. daily, weekends off.

Any calls? / (nights): No required overnight call responsibilities

Primary interaction with residents/fellows vs. faculty? Fellows and faculty; some resident interaction

Any required test or preparations? DBP Rotation Pre/Post Quiz

Brief Rotation Description

Medical students will receive comprehensive clinical experience diagnosing and treating children with diverse neurodevelopmental disabilities and special health care needs autism spectrum disorder, complex attention-deficit-hyperactivity disorder, developmental delay, learning disorders, intellectual disability, neuromuscular disorders, cerebral palsy, behavioral problems, behavioral health concerns, and a range of genetic disorders. They will further get to participate in several multidisciplinary clinics within Developmental Behavioral Pediatrics (DBP) including Infant Toddler Clinic, Neuromuscular Clinic, NICU Follow Up Clinic, Combined Congenital Cardiac Clinic, Autism Spectrum Disorders Clinic, and Complex Behavioral Clinic. Students will work one on one with fellows and staff in Autism Referral Clinic, PCMH STAT Clinic (PCMH Autism Clinic), Fellow Continuity Clinic and Staff Clinics. Students will also be introduced to a variety of developmental and neuropsychological testing.

The Madigan DBP fellowship is co-located with the General Pediatric Residency, and rotators will receive teaching from residents, faculty, and fellows. All medical students will attend Pediatrics Morning Report form 7:30 - 8 a.m. each morning, a variety of resident lectures, noontime medical student lectures, as well as Thursday Morning Didactics (including any simulation sessions during academics and sports/athletics following the didactics); they will be invited to any resident and fellowship social events occurring during the rotation period. At least two Structured Clinical Observations (SCO) will be completed during the rotation. Students will be provided direct feedback on the SCO and the results. Every patient evaluation in Devo Peds performed by a student will be precepted by an attending or a fellow and students’ performance will be evaluated, and he/she will receive feedback at the time of the encounter.

While there is no overnight call on this rotation; however, all students have the option to volunteer for inpatient call with the Pediatric Residents in the NICU, nursery, ward or PICU.

Rotation length: Usually four weeks length in the outpatient clinic but can be modified from two to six weeks. Students rotating in Pediatrics or Family Medicine are welcome to participate in Developmental Pediatrics for a shorter experience if interested.

Specialty/Subspecialty: Emergency Medicine

Inpatient vs. Outpatient vs. both: Outpatient

Inpatient Consult Service: N/A

Operating Rooms: N/A

Days/Hours: 12-14 total shifts per 4-week rotation, 8-hours

Any calls? / (nights): No call shifts, mix of day, evening and night shifts (waterfall scheduling for easy transition)

Primary interaction with residents/fellows vs. faculty? Residents, fellows and faculty. Dedicated attending-only shifts to work one-on-one with students.

Any required test or preparations? EM Applicants required to take end-of-rotation exam

Brief Rotation Description:

Medical students will rotate at Madigan Army Medical Center’s Emergency room, a 38 ER bed level 2 trauma center with over 50,000 yearly patient visits and over 300 annual trauma activations. Students will be supervised by senior EM residents and EM attending physicians as they learn the fundamentals of Emergency Medicine. Students will pick up patients during their shift, conduct a history and physical exam, give oral patient presentations with assessment, plans, and dispositions. Students will have the ability to order supervised medication and treatment interventions, perform supervised procedures and fully manage the patient while in the emergency department. Students will be supervised by a dedicated and diverse EM faculty with vested interest in superior education while following our core values of prioritizing family and wellness. Students will attend Weekly Grand Rounds/EM Academics and morning report with EM residents. Students will have the opportunity to join dedicated procedure lab, Emergency Ultrasound didactics with Ultrasound Fellowship-trained faculty/fellows, and high-fidelity resuscitation simulations at MAMC’s state of the art Andersen Simulation Center. Medical students will be encouraged to explore all the PNW has to offer with organized events with residents and staff showcasing the importance of work life balance while in an educational setting.

Specialty/Subspecialty: Emergency Ultrasound

Inpatient vs. Outpatient vs. both: Inpatient and Outpatient

Inpatient Consult Service: No

Operating Rooms: N/A

Days/Hours: Daily, 9 a.m. - 4 p.m., 2.5 days off per week

Any calls? / (nights): No oversight call responsibilities

Primary interaction with residents/fellows vs. faculty? Residents, fellows, and faculty

Any required test or preparations? 10-minute presentation on interesting ultrasound case

Brief Rotation Description:

Medical students will participate in ultrasound scanning shifts, ultrasound quality assurance sessions and all ultrasound didactic sessions. Students may also assist with some ultrasound teaching during ultrasound workshops provided for other units and/or departments. Medical students are expected to have knowledge of point of care ultrasound (POCUS) applications. The students will participate in acquisition of POCUS images on emergency room patients and inpatients under the direct supervision of residents, fellows, and faculty. A 10-minute ultrasound presentation is given by the student at the end of the rotation (topic determined by student). Assistance with the presentation will be given through an appropriate faculty or fellow mentor.

Specialty/Subspecialty: General Surgery

Inpatient vs. Outpatient vs. both: Both

Inpatient Consult Service: Yes

Operating Rooms: 50 % OR time

Days/Hours: Daily 6 a.m. - 6 p.m., 1-2 day(s) off per week

Any calls? / (nights): One overnight call

Primary interaction with residents/fellows vs. faculty? Residents and faculty

Any required test or preparations? 10-minute presentation

Brief Rotation Description:

Medical students will be assigned to one of seven teams spanning general surgery, trauma/critical care, emergency general surgery, and/or vascular surgery. Students will participate in outpatient clinics, multidisciplinary cancer conferences, inpatient rounds, service-specific quality, and educational conferences, and assist in the operating room. Students are expected to know relevant musculoskeletal, vascular, hollow viscus, solid organ, soft tissue and endocrine anatomy and physiology, as well as the workup and perioperative care of common emergencies, acute and chronic surgical disease processes. Students will be expected to perform accurate history and physical examinations, give concise and appropriate patient presentations and respond to questions from residents and attending surgeons. Students will attend weekly academics and skills labs with the residents. While no formal presentations are required, students may give presentations at their discretion and with attending surgeon coordination. Assistance with the presentation will be available.

Specialty/Subspecialty: Family Medicine

Inpatient vs. Outpatient vs. both: Both

Inpatient Consult Service: N/A

Operating Rooms: N/A

Days/Hours:

• Outpatient:  7:15 a.m. - 5 p.m. daily, weekends off
• Inpatient: 6 a.m. - 6 p.m., 1 day off per week

Any calls? / (nights): No overnight call responsibilities

Primary interaction with residents/fellows vs. faculty? Residents and faculty

Any required test or preparations? 1 case presentation during morning report

Brief Rotation Description:

Medical student rotations are available for both 3rd year clerkships and 4th year/interview rotations. Medical students will participate in full-scope family medicine during this rotation including caring for patients of all ages in the outpatient medicine, inpatient medicine, obstetrics, and procedures. They will participate in the care for patients with a wide range of issues addressed by general medicine and primary care. In the outpatient clinic they will partner with senior residents and faculty to see the breadth of patients in primary care, including for acute symptoms, chronic conditions, and wellness visits. They will further get to participate in several of the specialty clinics within family medicine including procedures (skin procedures, IUDs, vasectomies, first-trimester ultrasounds, OMT, and botox for migraines) as well as sports/musculoskeletal medicine. On the inpatient service, students, will work with the resident, faculty, pharm-D and multidisciplinary team to care for patients admitted to Madigan Army Medical Center including participation in obstetrical care and inpatient pediatric patients when such patients are admitted.

The Madigan FM residency Is co-located with the Faculty Development and Leadership Fellowship and Clinical Informatics Fellowship, and rotators will receive teaching from residents, faculty, and fellows. All medical students will attend morning report from 7:15 - 7:45 a.m. each morning as well as Wednesday afternoon academics (including any simulation sessions during academics and sports/athletics following the didactics); they will be invited to any residency social events occurring during the rotation period. On Thursday mornings, students have time set aside for reading/studying as well as an additional high-yield sports medicine teaching session and professional development sessions with the program director/assistant program director. Feedback will be provided daily by the resident/faculty a student is working with, and formal cumulative feedback will be provided at the mid-point and end of rotation.

Rotation length: Usually of 4-weeks length but can be modified from 2 to 6 weeks. Most rotations consist of 3 weeks in the outpatient clinic and 1 week on the inpatient service, though students completing a sub-internship will primarily work on the inpatient team.

Specialty/Subspecialty: Inpatient Internal Medicine Wards

Inpatient vs. Outpatient vs. both: Inpatient

Inpatient Consult Service: Admitting and Consult Service

Operating Rooms: N/A

Days/Hours: Daily 6 a.m. - 6 p.m., 1-2 day(s) per week

Any calls? / (nights): No overnight call responsibilities 

Primary interaction with residents/fellows vs. faculty? Residents and faculty

Any required test or preparations? N/A

Brief Rotation Description:

Medical students on the inpatient internal medicine rotation are expected to see patients on an inpatient medicine teaching team comprised of medical students, interns, residents, and a supervising attending. Care on this service is provided to patients admitted to the hospital on the inpatient ward. While participating in the care of these patients, students will be expected to have read about the patient, understand indications for hospitalization, perform a history and focused physical exam, and present the patient on daily inpatient rounds. Students will attend daily morning didactics with the internal medicine residency and attend weekly didactic lectures from the internal medicine residents at the discretion of their team leadership.

Specialty/Subspecialty: Critical Care

Inpatient vs. Outpatient vs. both: Inpatient

Inpatient Consult Service: Admitting and Consult Service

Operating Rooms: N/A, frequent bedside procedures

Days/Hours: Daily 6 a.m. - 6 p.m., 1-2 day(s) off per week

Any calls? / (nights): No overnight call responsibilities 

Primary interaction with residents/fellows vs. faculty? Residents and faculty

Any required test or preparations? N/A

Brief Rotation Description:

Medical students on the critical care rotation are expected to see patients admitted to the Madigan medical-surgical ICU. They will participate in daily inpatient rounds as a member of a teaching team comprised of medical students, interns, residents, and a supervising attending physician. While participating in the care of these patients, students will be expected to have read about the patient, understand indications for hospitalization, perform a history and focused physical exam, and present the patient on daily inpatient rounds. Students will attend daily morning didactics with the internal medicine residency at the discretion of the supervising attending and attend weekly didactic lectures from the internal medicine residents at the discretion of their team's workflow.

Specialty/Subspecialty: Cardiology

Inpatient vs. Outpatient vs. both: Both

Inpatient Consult Service: Yes

Operating Rooms: Frequent exposure to the Cardiac Cath Lab

Days/Hours: Monday - Friday, 7 a.m. - 4 p.m.

Any calls? / (nights): No overnight call responsibilities

Primary interaction with residents/fellows vs. faculty? Residents and Faculty

Any required test or preparations? N/A

Brief Rotation Description:

Medical students on the cardiology rotation are expected to see patients on the inpatient cardiology service and participate in inpatient rounds, with additional opportunity to see clinic patients in the outpatient setting. While participating in the care of these patients, students will be expected to have read about the patient, understanding indications for consultation or follow up, perform a history and focused physical exam, and present the patient on either inpatient rounds or to the outpatient attending. Students will attend daily morning didactics with the internal medicine residency, apart from a “Cardiac Cath conference” on Thursday mornings. Students will also attend weekly cardiology didactics at the discretion of the cardiology service faculty.

Specialty/Subspecialty: Infectious Disease

Inpatient vs. Outpatient vs. both: Both

Inpatient Consult Service: Yes

Operating Rooms: N/A

Days/Hours: Monday - Friday, 7 a.m. - 4 p.m.

Any calls? / (nights): No overnight call responsibilities 

Primary interaction with residents/fellows vs. faculty? Residents and faculty

Any required test or preparations? N/A

Brief Rotation Description:

Medical students on the infectious disease rotation are expected to see patients on the inpatient infectious disease consult service and participate in inpatient rounds, with additional opportunity to see clinic patients in the outpatient setting. While participating in the care of these patients, students will be expected to have read about the patient, understanding indications for consultation or follow up, perform a history and focused physical exam, and present the patient on either inpatient rounds or to the outpatient attending. Students will attend daily morning didactics with the internal medicine residency.

Specialty/Subspecialty: Nephrology

Inpatient vs. Outpatient vs. both: Both

Inpatient Consult Service: Yes

Operating Rooms: N/A

Days/Hours: Monday - Friday, 7 a.m. - 4 p.m.

Any calls? / (nights): No overnight call responsibilities

Primary interaction with residents/fellows vs. faculty? Residents and faculty

Any required test or preparations? N/A

Brief Rotation Description:

Medical students on the nephrology rotation are expected to see patients on the inpatient nephrology consult service and participate in inpatient rounds, with additional opportunity to see clinic patients in the outpatient setting. While participating in the care of these patients, students will be expected to have read about the patient, understanding indications for consultation or follow up, perform a history and focused physical exam, and present the patient on either inpatient rounds or to the outpatient attending. Students will attend daily morning didactics with the internal medicine residency.

Specialty/Subspecialty: Neurology

Inpatient vs. Outpatient vs. both: 2 weeks inpatient, 2 weeks outpatient

Inpatient Consult Service: Yes

Operating Rooms: N/A

Days/Hours: 6:30 a.m. - 4 p.m., weekends off

Any calls? / (nights): No

Primary interaction with residents/fellows vs. faculty? Residents and faculty

Any required test or preparations? 1 brief (5-10 minute) presentation to inpatient consult team on topic of choice

Brief Rotation Description:

The 3rd and 4th year medical students rotating through the neurology service will have exposure to two weeks of inpatient neurology consults as well as two weeks of outpatient neurology. The inpatient consult team is comprised of an attending, neurology resident, and a variable number of off-service rotators. Students will be responsible for pre-rounding on their assigned patients daily, attending daily morning lectures, and presenting their patients on rounds each day. As new consults are received, rotators will be assigned patients to interview, examine, and evaluate. Rotators can expect exposure to the breadth of neurology to include acute stroke evaluations, altered mental status/encephalopathy, status epilepticus, and peripheral nervous system disorders. During their outpatient week, rotators will be assigned to a resident or attending clinic to interview, examine, and evaluate patients in the outpatient setting. Additionally, there are opportunities to participate in subspeciality clinics for neurodegenerative, neuro-oncology, neuro-ophthalmology, neurophysiology, and pediatric neurology. There is structured curriculum built into the rotation daily, a reading list for self-directed learning, and an opportunity to deliver a 5–10-minute presentation during inpatient consult weeks.

Specialty/Subspecialty: Ophthalmology

Inpatient vs. Outpatient vs. both: Both (MAMC)

Inpatient Consult Service: Yes

Operating Rooms: 30%

Days/Hours: Monday - Friday, 6:30 a.m. - 5 p.m. / two days off per week

Any calls? / (nights): Yes, 1 at-home call per week with residents

Primary interaction with residents/fellows vs. faculty? Residents and faculty

Any required test or preparations? 5-10 minute presentations

Brief Rotation Description:

Medical students will rotate with the multiple ophthalmology teams to include acute care, inpatient/outpatient trauma, general ophthalmology, glaucoma, retina, cornea and refractive surgery, pediatrics, neuro, and oculoplastic. Medical students are expected to have knowledge of ophthalmic and periocular anatomy, common ophthalmic conditions, relevant history taking, and basic general ophthalmic physical exam skills. When participating in surgery, the student will also be expected to scrub in, safely maintain a sterile field, and have a basic understanding of the applicable anatomy. The students will be allowed to participate in the care of ophthalmic patients under the direct supervision of residents and faculty surgeons. Students will attend weekly academics and skills labs with the residents. A short presentation is given by the student at the end of the rotation on an ophthalmology topic. Assistance with the presentation will be available.

Specialty/Subspecialty: Orthopaedic Surgery

Inpatient vs. Outpatient vs. both: Both

Inpatient Consult Service: Yes

Operating Rooms: 75% OR time

Days/Hours: Daily, 6 a.m. - 6 p.m., One to two day(s) off per week

Any calls? / (nights): Option for overnight call responsibilities one night per week

Primary interaction with residents/fellows vs. faculty? Residents and faculty

Any required test or preparations? Seven-minute presentation

Brief Rotation Description:

Medical students will participate in inpatient rounds, assist with surgeries, assist in daytime call with residents, optional overnight call one night per week, assist with minor procedures and fracture reductions in the ER, and see patients in clinic. Medical students are expected to have knowledge of musculoskeletal anatomy, common musculoskeletal injuries and conditions, relevant history taking and physical examination skills, and basic surgical skills in tissue handling, suturing and knot tying. In clinic, medical students will see patients prior to faculty, present the patient to faculty and go back in together to complete the encounter. When participating in surgery, the student will be expected to have read about the patient and indications for surgery, scrub-in with understanding of the sterile field, and understand the relevant musculoskeletal anatomy. The students will participate in the care of Orthopaedic surgery patients under the direct supervision of residents and faculty surgeons. Students will attend daily inpatient rounds, daily morning conference/didactics, and weekly core lectures/skills labs with the residents. A 7-minute Orthopaedic presentation is given by the student at the end of the rotation (topic determined by student). Assistance with the presentation will be given through an appropriate senior resident and faculty mentor.

Specialty/Subspecialty: Otolaryngology - Head and Neck Surgery

Inpatient vs. Outpatient vs. both: Both

Inpatient Consult Service: Yes

Operating Rooms: 50%

Days/Hours: Monday - Friday, 6 a.m. - 5 p.m., 2 days off per week

Any calls? / (nights): No

Primary interaction with residents/fellows vs. faculty? Residents and faculty

Any required test or preparations? 20-minute presentation

Brief Rotation Description:

Medical students and graduate applicants will be expected to perform at the level of an intern. In the clinic, they will begin by following either the attending or a senior resident. Then, after a brief period, they are expected to see patients independently and present them to the attending or the senior resident. While the process of their education is important, they should make every effort to keep the clinic running on schedule. Students/applicants should have MHS Genesis access and will be expected to write a clinic note for otolaryngology patients. Students/applicants are expected to attend all academic conferences including Grand Rounds, Tumor Board, Case Presentations, Pre-Op/Post-Op Conference, Morbidity & Mortality (M&M) Conference, Trauma Conferences, and any other lectures, labs, and academic courses that occur during their rotation. They will participate in morning reports and chief resident-led didactics that incorporate daily readings. A short presentation will be given by the applicant at the end of the rotation on an Otolaryngology topic. Assistance with the presentation will be available through an appropriate faculty member.

Third-year Medical Students

As they are less experienced in the clinical setting, 3rd-year students are encouraged to see patients with the attending or senior resident for a longer period. They will be transitioned into seeing patients and presenting them according to their ability.

Operating Room Expectations

Each student/applicant will be assigned to surgical cases by the chief resident. They should come prepared for the case, having met the patient, and read about the disease, operation, and anatomy in which they will be participating.

Ward Expectations

The chief resident of the service will determine the specifics regarding student/applicant responsibilities. The chief residents are encouraged to have the student/applicant pre-round and present to the resident. They should also assist with clinical data collection and maintain awareness of the patients on their service.

Specialty/Subspecialty: Diagnostic Radiology

Inpatient vs. Outpatient vs. both: Both

Inpatient Consult Service: N/A

Operating Rooms: N/A

Days/Hours: Monday-Friday, 7:30 a.m. - 1 p.m.

Any calls? / (nights): No

Primary interaction with residents/fellows vs. faculty? Primary interaction with other rotating medical students, residents and faculty

Any required test or preparations? One 10-minute case presentation if on an interview rotation

Brief Rotation Description:

Medical students spend one month in the radiology department observing faculty and residents in their day-to-day activities throughout the different sections of our department: neuroimaging, thoracic imaging, musculoskeletal imaging, body imaging, interventional radiology, pediatric imaging, ultrasound, and nuclear medicine. If interested, you will also have the opportunity for hands-on dictation to actively participate in generating radiology reports yourself.

Those on an interview rotation will be required to present a 10-minute PowerPoint case presentation on the last Thursday of the rotation. The typical duty day for medical students begins at 7:30 a.m. and ends at 1 p.m. We encourage rotators to seek out faculty or resident mentorship and engage in scholarly activities during their afternoons. Rotators who are applying to radiology residency programs are encouraged to reach out to the Program Coordinator to schedule a face-to-face interview. We look forward to meeting you!

Specialty/Subspecialty: Urology

Inpatient vs. Outpatient vs. both: Both

Inpatient Consult Service: Yes

Operating Rooms: 75% OR time

Days/Hours: Daily 6 a.m. - 6 p.m., 1-2 day(s) off per week

Any calls? / (nights): No overnight call responsibilities

Primary interaction with residents/fellows vs. faculty? Residents and faculty

Any required test or preparations? One 10-minue presentation

Brief Rotation Description:

Medical students will participate in inpatient rounds, assist with surgeries, take some daytime call with residents, assist with clinical procedures, and see patients in clinic. Medical students are expected to have knowledge of genitourinary anatomy, common urology conditions, relevant history taking, and physical examination skills. In clinic, medical students will see patients prior to faculty, present the patient to faculty and go back in together to complete the encounter. When participating in surgery, the student will be expected to have read about the patient and indications for surgery, to scrub in with understanding of the sterile field, and have a understand the relevant, and training appropriate, anatomy. The students will participate in the care of urology patients under the direct supervision of residents and faculty surgeons. Students will attend weekly academics and skills labs with the residents. A 10-minute urology presentation is given by the student at the end of the rotation (topic determined by student). Assistance with the presentation will be given through an appropriate faculty mentor.