1. All rotations must be requested through the Student Coordinator via email at usarmy.jbsa.medcom-bamc.mbx.saushec-clerkship@health.mil. Do not contact the departments directly, as this may result in over-scheduling causing unexpected cancellations.
2. Interview season for fourth year Medical Students is from May to October each year. Rotation requests from fourth year medical students intending to interview (ADT and non-ADT) will be given the highest priority for consideration.
3. During non-interview season (October to May), students requesting ADT rotations are given a higher priority for rotation requests than non-ADT rotations.
4. Medical Students will receive a confirmation letter via email once rotation is scheduled. Read confirmation letter carefully and immediately begin submitting requested information. If requested information is not received within two months of start date your rotation will be automatically cancelled.
5. HPSP Medical Students requesting a non-ADT rotation must have a Memorandum of Affiliation in place between SAUSHEC and the student’s medical school (takes from two to six months). Student Coordinator will provide contact information when request is received.
6. Civilians, with no military affiliation, must initiate a National Agency Check with Inquiries through the BAMC Security Office as soon as possible, but no later than one month prior to rotation start date. Contact Student Coordinator for detailed instructions.
7. Rotations at SAUSHEC are very competitive! Rotation requests should be submitted on the earliest allowable date. When Medical Student limit is reached per specialty, Student Coordinator will work with Medical Students to secure an alternate date, sub-specialty rotation, or rotation in alternate specialty to ensure Medical Student is on-site for face-to-face interview.

Notice

SAUSHEC will accept rotation requests when students are within nine (9) months of their intended rotation month.

Specialty/Subspecialty:  Advanced Emergency Medicine Ultrasound (AEMUS)
Inpatient vs. Outpatient vs. both: Outpatient
Inpatient Consult service: N/A
Operating Room:  N/A
Days/Hours: Monday through Friday, 9 a.m. - 5 p.m.   
Any call? / Nights?: No
Primary interaction with fellows vs. faculty?  Fellow and AEMUS Faculty
Any required tests or presentations?  No

Brief rotation description:

Medical students will learn core point of care ultrasound modalities, including the Extended Focused Assessment in Trauma (E-FAST) Exam, point of care echocardiogram, abdominal aorta, ocular and many other core applications. Students will learn exams from the Ultrasound fellows and faculty, and then will practice exams in the Emergency Department. Students will attend weekly ultrasound academic sessions with ultrasound fellows and faculty and will review scans from the department and discuss important pathology.

Specialty/Subspecialty: Allergy/Immunology
Inpatient vs. Outpatient vs. both: Outpatient (Wilford Hall Ambulatory Surgical Center)
Inpatient Consult service: Optional
Operating Room: N/A
Days/Hours: 1-2 days per week / 9 a.m. - 4:30 p.m.
Any call? / Nights?: No
Primary interaction with fellows vs. faculty? Faculty
Any required tests or presentations? None

Brief rotation description:

Medical students will be assigned to interview, examine, and evaluate patients in the Allergy/Immunology clinic under faculty supervision. The full range of AI disorders is potentially available in these realms: allergic/non-allergic rhinitis, asthma, eczema, food and drug allergies, acute/chronic urticaria, etc. Students also be exposed to a variety of procedures, such as skin testing and spirometry. Students have the option to see inpatient allergy consults with fellows. Participation in the weekly academic conference is optional.

Specialty/Subspecialty: Anesthesiology
Inpatient vs. Outpatient vs. both:  Both (Inpatient and Ambulatory Surgery)
Inpatient Consult service: Optional (Acute Pain Service Consultations)
Operating Room: 90% (other: APS, Pre-Anesthesia Unit, Labor and Delivery)
Days/Hours:  Monday through Friday / 6 a.m. - 3 p.m. (4th Year Medical Students average 1 swing shift)
Any call? / Nights?: None required (can be requested by student)
Primary interaction: Residents and Faculty
Any required tests or presentations? End of rotation exam

Brief rotation description:

Medical students will be exposed to basic anesthesia principles including pathophysiology and pharmacology, as well as learn and practice hands on skills such as airway procedures and IV placement. During the rotation they will work with a resident and attending team (or an attending alone) with whom they will provide pre-operative, intraoperative, and post-operative care to a variety of patients from healthy outpatients to the critically ill. They will be exposed to some of our subspecialties such as pain and obstetrics. In addition to patient care, medical students will attend departmental morning conferences as well as a resident-led afternoon conference series directly geared to their level of training. There is a final evaluation at the end of the rotation.

Specialty/Subspecialty: Burn
Inpatient vs. Outpatient vs. both:  Inpatient
Inpatient Consult service: Optional
Operating Room:  50%
Days/Hours:  Daytime, 40 hours/week
Any call? / Nights?:  Optional
Primary interaction with residents/fellows vs. faculty?  Both
Any required tests or presentations? Optional

Brief rotation description:

The U.S. Army Institute of Surgical Research at Brooke Army Medical Center is the only American Burn Association-verified burn center in South Texas and in the U.S. Department of Defense. It was the second burn center established in the US (1949) and has cared for combat casualties from all of America’s conflicts since then. We provide emergency, surgical, and reconstructive/ rehabilitation care for approximately 600 patients a year in a 12-bed Burn ICU and an 18-bed Burn Ward. We admit patients with burns, inhalation injury, and a variety of necrotizing soft tissue infections and desquamating dermatologic conditions. We also provide a worldwide-deployable Burn Flight Team trained to USAF standards in aeromedical evacuation, and conduct research and development aimed at advancing the care of combat casualties with burns.

The medical student rotation is focused on care in the Burn ICU and in our two dedicated Operating Rooms. Students assess patients, present them on multidisciplinary team rounds, and join in their surgical care in the OR. The overarching goal of this rotation is to maximally support medical students in learning how to manage the complex injuries and medical problems of patients who are directly relevant to combat casualty care.

Learning objectives for this rotation include assessment and treatment of burn wounds; excision and grafting of burn wounds; management of inhalation injury; resuscitation of burn shock; multiorgan support of critically ill surgical patients (e.g. mechanical ventilation, continuous renal replacement therapy for renal failure, use of vasoactive agents, assessment of volume status); management of infections and septic shock; nutrition support concepts; management of pain, anxiety, delirium; rehabilitation concepts. Medical students participate in multiple ICU procedures such as placement of central venous and arterial lines, bronchoscopy, and point-of-care ultrasound. There are lectures on these topics at noon most days of the week.

Specialty/Subspecialty: Cardiology Consults and CCU
Inpatient vs. Outpatient vs. both: Primarily inpatient, option for outpatient can be arranged on a case-by-case scenario for the cardiology consult rotator
Inpatient Consult service: Yes
Operating Room: No
Days/Hours: Monday through Friday /CCU 6 a.m. - 5 p.m. ; Consults 7 a.m. – 4 p.m.
Any call? / Nights?: No
Primary interaction with fellows vs. faculty? Cardiology fellow and faculty primarily, IM resident rotators if also on rotation
Any required tests or presentations? 10-min informal talk on cardiology topic of your choosing encouraged at end of rotation

Brief rotation description:

Medical students rotating with cardiology will function as “sub-interns” and assigned to either the cardiology inpatient consult team or the cardiac ICU team. CCU teams generally consist of an attending cardiologist, a cardiology fellow, a senior resident, and 2-3 interns. The cardiology consult team consists of a cardiology staff, cardiology fellow and 0-2 rotators (medical students, residents, or PA students). During their rotation, students will be assigned to interview, examine, evaluate, and manage cardiac patients admitted to the hospital under fellow and/or faculty supervision. A full range of cardiovascular disease and disorders are potentially available to include acute coronary syndrome, heart failure, valvular disease, stable and unstable arrythmias, management of cardiac devices, hypertension, lipid disorders and critical care medicine. Medical students will typically be responsible for 1-3 patients. Participation in daily ECG “rounds” (7 – 7:30 a.m.) and cardiology academics (7:45 – 8:30 a.m.) is required.

Specialty/Subspecialty: Dermatology
Inpatient vs. Outpatient vs. both: Outpatient (Wilford Hall Ambulatory Surgical Center)
Inpatient Consult service: Optional
Operating Room: 1 day per month for OR laser scar treatment
Days/Hours: Monday through Friday / 7:30 a.m. – 4 p.m.; No weekends
Any call? / Nights?: No
Primary interaction with residents vs. faculty? Residents and Faculty
Any required tests or presentations? Yes. Exam based on the AAD Basic Dermatology Curriculum modules and 5-10 minute presentation at the end of the rotation

Brief rotation description:

Medical students will be oriented to the clinic and assigned a rotation schedule that includes working with residents and faculty. The rotation includes routine clinic, urgent clinic, high-risk skin cancer clinic, Mohs surgery, dermatologic surgery, and laser clinic, but the schedule can be customized to support the student's interests. Medical students may participate in inpatient consults with the resident and attending assigned to that service. Medical students will attend all academic sessions (Mondays, Tuesdays, Thursdays 11:15 a.m. - 12 p.m., and Fridays 1 - 4 p.m.) and selected dermatopathology sessions. Students are encouraged to assume greater responsibility for patient care as they advance through the clinical rotation under the direct supervision of residents or attending physicians. These responsibilities may include the following tasks:

• Shadow residents or faculty in the clinic
• Interview patients
• Examine patients
• Define and prioritize patients' dermatologic complaints
• Generate and prioritize differential diagnoses for dermatologic complaints
• Develop rational, evidence-based diagnostic and therapeutic strategies to manage and care for the patients
• Present patients to the supervising resident or attending physician in real-time
• Expand their knowledge base about symptoms, signs, diagnoses, and management of common dermatologic conditions
• Learn, perform, and become competent in common office dermatologic procedures

Specialty/Subspecialty: Emergency Medicine
Inpatient vs. Outpatient vs. both: Outpatient
Inpatient Consult service: N/A
Operating Room: N/A
Days/Hours: 12-14 total shifts per 4 week rotation, 8-hour shifts
Any call? / Nights?: No call shifts, mix of day, evening, and night shifts (waterfall scheduling for easy transition)
Primary interaction with residents vs. faculty? Medical Students work directly side by side with Residents, Fellows, and Faculty while on shift. Dedicated attending-only shifts to work one-on-one with students.
Any required tests or presentations? EM Applicants required to take end-of-rotation exam

Brief rotation description:

Medical students will rotate at Brooke Army Medical Center’s Emergency Department, a 62 ER Bed with dedicated pediatric pod and trauma pod at the DOD’s only Level I Trauma Center with >86K patient visits yearly, >4k trauma activations, and 16-18% admission rate. Students will work with a diverse EM faculty of over 50 full-time staff with training from Army, Air Force, Navy, and Civilian institutions. Students will be supervised by residents and faculty to pick up patients during their shift, conduct a history and physical exam, give oral patient presentations with assessments/plans, perform supervised procedures if indicated, and help manage patient results and dispositions. Students will attend Weekly Grand Rounds/EM Academics and morning report with EM residents. Dedicated procedure lab, Emergency Ultrasound didactics with Ultrasound Fellowship-trained faculty/fellows, and high-fidelity resuscitation simulations at BAMC’s state of the art simulation center. Organized social gatherings with the residents, staff, and medical students for wellness outside of the work environment.

Specialty/Subspecialty: Emergency Medical Services (EMS)
Inpatient vs. Outpatient vs. both: 100% Outpatient
Inpatient Consult service: No
Operating Room: N/A
Days/Hours: Monday through Friday, hours vary
Any call? / Nights?: Nights/weekends optional
Primary interaction with fellows vs. faculty? Paramedics, Fellows, Faculty
Any required tests or presentations? End of rotation presentation and/or protocol revision

Brief rotation description:

This course is designed to offer the medical student an operational experience within a busy, urban emergency medical services agency in the 7th largest city in the nation. Students will gain an understanding of the complexities of a medical practice in the prehospital environment and the role of EMS within the larger healthcare system. The student will develop skills in: analyzing an emergency scene for safety hazards; initial patient assessment, treatment, and stabilization; care necessary for appropriate transport to the emergency department; triage; HAZMAT and rescue operations; and other situations encountered in the prehospital environment. Students will spend time in the field with EMTs and Paramedics from different EMS agencies that represent contrasting delivery models, as well as alongside firefighters and law enforcement professionals. Other obligations will include cadaveric procedure labs, didactics, EMS physician ride-alongs, and other special-teams trainings and real-world incidents as opportunities arise. The student will develop an understanding of the role EMS providers and physicians play in delivering care to members of the community outside of the hospital setting.

Specialty/Subspecialty: Internal Medicine/Endocrinology
Inpatient vs. Outpatient vs. both: Outpatient
Inpatient Consult service: Yes
Operating Room: N/A
Days/Hours: Monday through Friday / 7:30 a.m. – 4:30 p.m.
Any call? / Nights?: No
Primary interaction with fellows vs. faculty? Fellows
Any required tests or presentations? 20-minute presentation

Brief rotation description:

Medical students will be assigned to interview, examine, and evaluate patients in the endocrinology clinic under fellow and faculty supervision. The full range of endocrinology disorders is potentially available in these realms: diabetes, thyroid, parathyroid, lipid, adrenal, pituitary, osteoporosis, sex hormone, etc. Students also have the option to participate in the multi-disciplinary transgender clinic, held once weekly. Students will see inpatient endocrinology consults with fellows. Participation in the weekly academic conference is required, with a 20-minute presentation on a topic of the student’s choice at the end of the rotation.

Specialty/Subspecialty: Family Medicine
Inpatient vs. Outpatient vs. both: Outpatient (Fort Sam Houston Moreno Clinic)
Inpatient Consult service: Not applicable
Operating Room: None
Days/Hours: Monday - Friday; 7:30 a.m. – 4:30 p.m.
Any call? / Nights?: None
Primary interaction with residents vs. faculty? Physician, nurse practitioners, physician assistants
Any required tests or presentations? No

Brief rotation description:

Primary care family medicine in patient centered and soldier centered medical homes caring for active duty servicemembers and family members, and TRICARE beneficiaries. Tailored rotation within primary care and military readiness to gain an understanding of the diversity of military primary care medicine. Acute and chronic medical conditions reviewed with military readiness specific nuances. Minor procedures available, no prenatal care. SAUSHEC does not sponsor a family medicine program and as such, there are no residency interviews available.

Specialty/Subspecialty: Internal Medicine / Gastroenterology
Inpatient vs. Outpatient vs. both: Both
Inpatient Consult service: Yes
Operating Room: 20%, observe procedures in the endoscopy suite
Days/Hours: Monday thru Friday / 7:30 a.m. – 4:30 p.m.
Any call? / Nights?: No
Primary interaction with fellows vs. faculty? Fellows and faculty
Any required tests or presentations? No

Brief rotation description:

On the gastroenterology rotation, medical students will be expected to examine, evaluate, and form an assessment and plan for the patients that they see in clinic and the inpatient consult service. They will work directly with fellows and attending physicians. Students will see a wide range of gastrointestinal diseases, including but not limited to inflammatory bowel disease, autoimmune hepatitis, ulcers, cancers of the GI tract (pancreatic cancer, colorectal cancer), decompensated cirrhosis, and more. They will attend weekly academics lectures and play a direct role in patient care. Students will be able to observe advanced endoscopy and traditional endoscopic procedures, such as endoscopic ultrasound with/without biopsies, endoscopic cholangiopancreatography (ERCP), colonoscopies, endoscopies, and more. Students will also have the opportunity to rotate in the Hepatology clinic and Inflammatory Bowel disease clinic if they desire while here.

Specialty/Subspecialty: Hematology and Medical Oncology
Inpatient vs. Outpatient vs. both: Inpatient
Inpatient Consult service: Yes
Operating Room: No
Days/Hours: 5 days per week, 8 hours per day
Any call? / Nights?: Yes, the medical student will be on call, no night coverage or weekend coverage required
Primary interaction with fellows vs. faculty? Fellows and Faculty equally
Any required tests or presentations? One brief journal club or hematological/malignant didactic discussion of the student’s choice (preferably from a case that they performed a clinical evaluation on)

Brief rotation description:

This is a Hematology and Oncology Consultation and Ward Rotation for fourth year medical students, a total of two medical students (one for Ward and one for Consult) per session (four weeks). It is a pre-requisite that the medical student has completed a rotation in internal medicine. The student will evaluate inpatients on other medicine and surgical services as well as new patients with classic hematology problems seen in the inpatient setting. An array of support services, including special hematology and bone marrow transplantation laboratories and aphaeresis and chemotherapy units, will be available to all students whether on the ward or consultation rotations. The student is expected to acquire an evaluation and treatment approach to patients whether presenting with malignant or hematologic problems. The appropriate selection of diagnostic studies will be emphasized as well as the basics of selecting appropriate therapy. Experience in the evaluation of peripheral blood smears and the obtaining and interpretation of marrow samples will be stressed. An evaluation will be provided at the end of the rotation.

Subspecialty: Undersea & Hyperbaric Medicine (UHM)
Inpatient vs. Outpatient vs. both: Both
Inpatient Consult service: Yes
Operating Room: None
Days/Hours: Monday through Friday, 7 a.m. – 4 p.m.
Any call? / Nights?: Not Mandatory/Optional
Primary interaction with fellows vs faculty? UHM Faculty
Any required tests or presentations? No

Brief rotation description:

Medical Students rotating at the BAMC Undersea and Hyperbaric Medicine Clinic will gain familiarity with the operational uses and clinical uses of Hyperbaric Oxygen Therapy for treatment of multiple injuries and illnesses spanning the outpatient, inpatient, and critical care sectors. The BAMC UHM clinic houses both multi-place and mono-place hyperbaric chambers, providing a broad-spectrum introduction to the field of Hyperbaric Medicine. Medical student rotators will also garner an introduction to the field of Undersea Medicine and the occupational health aspects of this career field.

Specialty/Subspecialty: Infectious Disease
Inpatient vs. Outpatient vs. both: Both
Inpatient Consult service: Yes
Operating Room: N/A
Days/Hours: Monday through Friday / 7:30 a.m. - 4:30 p.m.; No holidays/weekends
Any call? / Nights?: No call, no nights
Primary interaction with residents/fellows vs. faculty? Residents, Fellows, Faculty
Any required tests or presentations? None

Brief rotation description:

Medical students rotating on the Infectious Disease Service at Brooke Army Medical Center will have the opportunity to see a broad variety of ID syndromes in the largest military hospital in the Department of Defense. The student will spend the majority of their time on the inpatient consult service where they will have the opportunity to work closely with the ID Fellow and Faculty while evaluating patients with a wide variety of Infectious Disease complaints including but not limited to: bone and joint infections, trauma-related infections, infectious endocarditis, HIV/AIDS, device related infections (including cardiac devices), rickettsial infections, Tropical Medicine infections (including malaria, dengue fever), mycobacterial infections (including tuberculosis), Fever of Unknown origin/ID mimickers, and Fever in returning travelers. BAMC is unique in the DOD due to its co-location with the Institute for Surgical Research Burn Center, as well as having a Bone Marrow Transplant unit, and a significant Extracorporeal Membrane Oxygenation service, which ultimately provide unique opportunities to evaluate infections in immunocompromised hosts. While this is primarily an inpatient consult service rotation, there are opportunities to spend 1-2 half-days in the outpatient ID clinic seeing patients presenting for travel medicine consultation, latent tuberculosis, sexually transmitted infections, HIV, Pre-exposure prophylaxis for HIV, Non-tuberculous mycobacterial or fungal infections, tick-borne or arboviral infections, bone and joint infections, and/or suspected/unknown infectious syndromes. The student will be expected to attend ID conference academics on Tuesdays at noon, and Thursday mornings from 7:30 a.m. - 9:30 a.m. They may also have the opportunity to attend San Antonio city-wide ID Grand Rounds depending on the month of the rotation (typically October-April).

Specialty/Subspecialty: Internal Medicine Wards Sub-internship
Inpatient vs. Outpatient vs. both: Inpatient
Inpatient Consult service: N/A
Operating Room: N/A
Days/Hours: 6 a.m. – 6 p.m. daily, one day off/week
Any call / Nights?:  Every fourth day / no night call
Primary interaction with residents vs. faculty?  Residents
Any required tests or presentations? No

Brief rotation description:

Fourth year medical students will function as sub-interns, assigned to one of the inpatient internal medicine ward teams. Teams generally consist of an attending physician, senior resident, two interns, and 2-3 medical students. In the sub-intern role, students will be assigned to interview, examine, evaluate, admit, and manage patients in the hospital under resident and faculty supervision. The full range of internal medicine disorders is potentially available. Sub-interns typically manage 3-4 patients simultaneously. Participation in daily academic conferences with the residents is required.

Specialty/Subspecialty: Medical Intensive Care Unit Sub-Internship
Inpatient vs. Outpatient vs. both: Inpatient
Inpatient Consult service: N/A
Operating Room: N/A
Days/Hours: 6 a.m. - 6 p.m. daily, one day off/week
Any call / (nights)? No night call
Primary interaction with residents/fellows vs. faculty? Residents and Fellows
Any required tests or presentations? No

Brief rotation description:

Fourth year medical students will function as sub-interns, assigned to the Medical Intensive Care Unit. Teams generally consist of an attending physician, fellow, 2-3 senior residents, 3-4 interns, and 1-2 medical students. In the sub-intern role, students will be assigned to interview, examine, evaluate, admit, and manage patients in the critical care environment under resident, fellow, and faculty supervision. The full range of critical care disorders and procedures including extracorporeal membrane oxygenation is potentially available. Sub-interns typically manage 1-2 patients simultaneously. Participation in daily academic conferences and weekly simulation sessions with the residents is required.

Specialty/Subspecialty:  Internal Medicine/Nephrology
Inpatient vs. Outpatient vs. both:  Outpatient and/or Inpatient
Inpatient Consult service:  Yes
Operating Room:  N/A
Days/Hours:  Monday through Friday / 7:30 a.m. – 4:30 p.m.
Any call? / Nights?:  No
Primary interaction with fellows vs. faculty?  Faculty/Fellow
Any required tests or presentations?  20-minute presentation

Brief rotation description:

Medical students will be assigned to interview, examine, and evaluate patients in the nephrology clinic and/or on the inpatient nephrology consult service under fellow and faculty supervision. Exposure to the full range of nephrology disorders is available in these realms: acute kidney injury, chronic kidney disease with its associated complications (bone disease, anemia), glomerular diseases, acid/base and electrolyte disorders, dialysis (hemodialysis, peritoneal dialysis and continuous renal replacement modalities), kidney transplant, etc. Students will become familiar with urinalysis and urine microscopy with 1:1 supervision in micro lab. Participation in the IM academic conferences and bedside rounds (inpatient) is required, with a 10-minute presentation on a topic of the student’s choice during the rotation. Students also have the option to participate in weekly nephrology clinical conferences, journal clubs and grand rounds.

Specialty/Subspecialty:  Neurology
Inpatient vs. Outpatient vs. both: 3 weeks inpatient/1 week outpatient
Inpatient Consult service:  Yes
Operating Room: N/A
Days/Hours: 6:30 a.m. – 4 p.m., one day off/week
Any call? / Nights?: No
Primary interaction with residents vs. faculty? Residents and faculty
Any required tests or presentations? 1 brief (5-10 min) presentation to inpatient consult team on topic of choice. Those applying to neurology will complete a written test.

Brief rotation description:

3rd and 4th year medical students rotating through the neurology service will have exposure to 3 weeks of inpatient neurology consults as well as 1 week of outpatient neurology. The inpatient consult team is comprised of an attending, 2 neurology residents, 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 table rounds each day. As new consults are received, rotators will be assigned patients to interview, examine, and evaluate. As a level 1 trauma center, rotators can be expected to be exposed 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 a neuromuscular multidisciplinary clinic during which learners will be exposed to complex and rare neuromuscular disorders such as amyotrophic lateral sclerosis, myotonic dystrophy, and various myopathies. 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: Gynecologic Surgery & Obstetrics
Inpatient vs. Outpatient vs. both: Both
Inpatient Consult service: Yes
Operating Room: 30% OR time
Days/Hours: Daily/ 5 a.m. – 6 p.m., one day off/week
Any call? / Nights?: 1 week of L&D nights & 1 weekend call
Primary interaction with residents vs. faculty? Residents and faculty
Any required tests or presentations? 10-minute presentation

Brief rotation description:

Medical students will be assigned to 2 services during their 4-week rotation, each 2 weeks long. The options include Labor and Delivery days, Labor and delivery nights, Maternal Fetal Medicine, Clinic, Benign Gynecology, Minimally Invasive GYN Surgery, UroGynecology, Reproductive Endocrinology and Infertility and Gynecology Oncology. The gynecology surgical specialties will participate in inpatient rounds, assist with surgeries, and see clinics with the residents. While on labor and delivery, the medical students will see triage, assist in vaginal deliveries and cesarean deliveries and assist with post-partum rounds. Medical students are expected to have knowledge of pelvic anatomy, common gynecology complaints, relevant history taking, and physical examination 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 OBGYN patients under the direct supervision of residents and faculty surgeons. Each student will be asked to take one weekend call. Every Thursday the students will participate in our weekly department academics. Each student is asked to put together a 10-minute presentation on an OBGYN topic of their choice; guidance is available.

Specialty/Subspecialty: Ophthalmology
Inpatient vs. Outpatient vs. both: Both (Wilford Hall Ambulatory Surgical Center & BAMC)
Inpatient Consult service: Yes
Operating Room: 30%
Days/Hours: Monday - Friday/ 6:30 a.m. – 5 p.m. /two days off/week
Any call? / Nights?: Yes/ 1 at home call per week with residents
Primary interaction with residents vs. faculty? Residents and Faculty
Any required tests or presentations? 5-10 minute presentation

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 oculoplastics. 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 Room: 40% OR time
Days/Hours: Daily/ 5 a.m. – 6 p.m., one day off/week
Any call? / Nights?: Yes / average 1 overnight call per week
Primary interaction with residents vs. faculty? Residents and faculty
Any required tests or presentations? 5-minute presentation

Brief rotation description:

Medical students will be assigned to one of eight teams and will participate in inpatient rounds, assist with surgeries, take call with residents, and see patients in clinic. Medical students are expected to have knowledge of musculoskeletal anatomy, common orthopedic conditions, relevant history taking, and physical examination 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 orthopaedic 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 orthopaedic topic. Assistance with the presentation will be available.

Subspecialty: Otolaryngology-Head & Neck Surgery
Inpatient vs. Outpatient vs. both: Both
Inpatient Consult service: Yes
Operating Room: 40%
Days/Hours: Monday through Friday, 6 a.m. – 5 p.m., 1-2 days off/week
Any call? / Nights?: Yes, 1 at-home call per week w/residents
Primary interaction with residents vs. faculty?: Residents and faculty
Any required tests or presentations? 10-minute presentation

Brief rotation description:

Medical students and graduate applicants will be expected to perform at the level of an intern. In clinic, after a brief period of following either the attending or a senior resident, they should see patients 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. Student/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 to include Grand Rounds, Case Presentation Conference, Pre-Op, M&M, and other lectures, labs, and courses that occur during their rotation. They will not scrub cases during academic conferences. A short presentation will be given by the student/applicant at the end of the rotation, preferably 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. Students will arrange call with the chief resident.

Operating Room Expectations

Each student/applicant will be assigned to cases by the chief resident. They should come prepared for the case, having met the patient, and read about the disease and 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 have a hand in data collection for the patients on their service.

Specialty/Subspecialty: Multidisciplinary Pain Medicine
Inpatient vs. Outpatient vs. both: Both
Inpatient Consult service: Yes
Operating Room: 5% OR time
Days/Hours: Monday through Friday, 7:30 a.m. – 4 p.m., No weekends/nights
Any call? / Nights?: No
Primary interaction with residents/fellows vs. faculty? Residents, Fellows and Faculty
Any required tests or presentations? Pre and post-test, 15-20 minute presentation

Brief rotation description:

Medical students will be assigned to faculty pain medicine physicians to see patients in the pain management clinic. Medical students are expected to have knowledge of musculoskeletal anatomy, common chronic pain conditions, relevant history taking, and physical examination 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 pain management patients under the direct supervision of fellows and faculty physicians. Students will attend weekly academics with fellows and faculty. Pre and posttest will be given to the medical student. A short presentation is given by the student at the end of the rotation on a pain management topic. Assistance with the presentation will be available.

Pathology

Specialty/Subspecialty: Pathology
Inpatient vs. Outpatient vs. both: Inpatient and outpatient cases
Inpatient Consult service: Optional, if applicable
Operating Room: Not applicable
Days/Hours: Monday through Friday, 8 a.m. – 4 p.m.
Any call? / Nights?: No call
Primary interaction with residents vs. faculty? Residents and faculty
Any required tests or presentations? 1 presentation and 1 quiz

Brief rotation description:

Rotators will work with an assigned pathology resident to build a flexible schedule to explore the broad scope of pathology. Rotators will be exposed to surgical pathology in the grossing room and at the multiheaded microscope with staff and residents. Learners will also a portion of their rotation participating in transfusion medicine, cytopathology, hematopathology, and microbiology. There may be opportunities participate in autopsy pathology if cases are available and the student is interested. In addition, rotators are expected to attend the regularly scheduled academic lectures, interesting case conferences, and tumor boards. At the conclusion of their rotation, the student will be expected to deliver a 10-to-15-minute lecture presentation to residents and faculty on a topic they are interested in and complete a pathology quiz.

Cytopathology

Specialty/Subspecialty: Cytopathology
Inpatient vs. Outpatient vs. both: Both
Inpatient Consult service: Optional
Operating Room: N/A
Days/Hours: Monday through Friday, 7:30 a.m. – 4:30 p.m.
Any call? / Nights?: None
Primary interaction with fellows vs. faculty? Both
Any required tests or presentations? Yes

Brief rotation description:

This rotation provides an introduction to gynecologic (GYN) and non-gynecologic (non-GYN) cytology specimens through participation in daily service activities at Brooke Army Medical Center (BAMC) Cytology Laboratories. Rotating medical students will work under the supervision of cytopathology staff members, including the medical director of cytology and assistant director, as well as the cytopathology fellow. Daily service activities include interpretation of GYN and Non-GYN cytology specimens, interpretation and performance of fine needle aspiration biopsies, expanding knowledge of ancillary studies, including molecular studies related to cytopathology, and acquiring knowledge in cytopathology laboratory management. The medical student will be introduced to the various technical, diagnostic, and management aspects of cytopathology. Additionally, rotating medical students will participate in cytology interesting case conferences, didactic conferences, as well as interdisciplinary tumor board conferences.

Pediatrics

Specialty/Subspecialty: Pediatrics
Inpatient vs. Outpatient vs. both: Mixed options; can choose all outpatient, all inpatient, or combination.
Inpatient Consult service: Outpatient rotations can include pediatric subspecialties (cardiology, gastroenterology, infectious disease, neurology) that likely include inpatient consults.
Operating Room: N/A
Days/Hours: Monday through Friday, 7:30 a.m. – 4:30 p.m. for outpatient; Monday through Friday, 6 a.m. – 5:30 p.m. plus one weekend day for inpatient
Any call? / Nights?: For inpatient rotations, plan for either Saturday or Sunday day shift. All rotators (inpatient or outpatient) have option to schedule night or weekend shift on inpatient pediatric service
Primary interaction with residents/fellows vs. faculty? Mixed. If on inpatient service, rotators will have much more interaction with residents at different levels in training that are on the inpatient team. Rotators in the NICU and on adolescent medicine will have more interactions with fellows. Outpatient electives will be primarily with faculty and possibly one resident on that service for the educational block.
Any required tests or presentations?  No required tests that are part of rotation evaluations but may have tests that serve as knowledge checks. All rotating 4th year medical students will present a visual diagnosis case during their rotation to the program and share information about themselves.

Brief rotation description:

Rotation options include:
Inpatient: Pediatric ward, NICU, nursery
Outpatient: Ambulatory pediatrics clinic, adolescent medicine, genetics, infectious disease, hematology/oncology, cardiology, developmental-behavioral pediatrics, endocrinology, gastroenterology, neurology, and pulmonology. *Outpatient subspecialty rotations may have inpatient consults. Duration of most rotations is 2 or 4 weeks; in case-by-case consideration, could establish shorter experiences. Scheduling for sub-internships is first-come, first-served basis.

Prerequisites:

1. All students must have completed a basic clinical pediatric clerkship (typically taken during 3rd year of medical school) prior to a 4th year clerkship or sub-internship.
2. All students must be on active-duty orders AND/OR have a Memorandum of Understanding (MOU)/Training Affiliation Agreement (TAA) in place between your school and our hospital.
3. Third Year rotations not already arranged through our GME office will not be accepted.

Adolescent Medicine Fellowship Program

Specialty/Subspecialty: Adolescent Medicine Fellowship Clinic
Inpatient vs. Outpatient vs. both: Outpatient (Fort Sam Houston- Moreno Clinic)
Inpatient Consult service: Optional
Operating Room: N/A
Days/Hours: Monday through Friday, 7:30 a.m. – 4:30 p.m.
Any call? / Nights?: No
Primary interaction with fellows vs. faculty? Fellows/Faculty
Any required tests or presentations? None

Brief rotation description:

Fourth year medical students will be assigned to interview, examine, and evaluate patients in the Adolescent Medicine and Young Adult Clinic under fellow or faculty supervision. The full range of adolescent care is available to include: sports medicine, reproductive care, behavioral health, eating disorders, transgender care, substance use, STI and PrEP management, complex chronic medical conditions, etc. Additionally, there are opportunities to participate in several specialty clinics which include Transgender Clinic, Headache Clinic, School Based Health Clinic and the Healthy Habits (Obesity) Clinic. Students may have the option of shadowing the fellow on inpatient consults during their rotation. Participation in pediatric morning report and biweekly adolescent rotation didactics is required. Student will also participate in the fellowships Wednesday morning didactics.

Neonatal & Perinatal Medicine

Specialty/Subspecialty: Neonatology & Perinatal Medicine
Inpatient vs. Outpatient vs. both: Inpatient
Inpatient Consult service: N/A
Operating Room: Occasional delivery attendance for resuscitation in the operating room for caesarian sections
Days/Hours: Monday through Friday 6 a.m. – 5:30 p.m.; plus one weekend day
Any call? / Nights?: One weekend day shift (either Saturday or Sunday) Option to schedule night shift or night block
Primary interaction with fellows vs. faculty? Will work closely with senior resident and fellow on team. Will also have a different attending every week for additional guidance and education
Any required tests or presentations? No required tests, but some available if desired to serve as knowledge checks. All rotating 4th year medical students will present a visual diagnosis case during their rotation to the program and share information about themselves

Brief rotation description:

This is primarily an MS4 rotation with expectations to work on a team and take ownership of your infants as a sub-intern. You will have the opportunity to learn about pathophysiology and disease processes affecting critically sick and/or preterm neonates through patient management, self-directed reading, and an abundance of chalk talks, teaching, and simulations from your resident, fellow, and attending. We will encourage you to take an active role in the management of the infants and participate in delivery room resuscitations, admissions, and procedures if available. We are excited to have you as part of our team!

Specialty/Subspecialty: Psychiatry
Inpatient vs. Outpatient: Both (for MS4s; MS3s rotate only inpatient and C/L)
Inpatient Consult service: Yes
Operating Room: N/A
Days/Hours: Monday through Friday, 7:30 a.m. – 4:30 p.m.
Any call? / Nights?: No
Primary interaction with residents vs. faculty? All of the above
Any required tests or presentations? Yes – 10 min. presentation over any Behavioral Health-related topic of choice (and format of choice)

Brief rotation description:

Medical students spend two weeks on the Inpatient Psychiatry Service and two weeks on the Psychiatry Consultation Liaison service.* Medical students are expected to be fully active in all ward and consultation service patient care activities, including performing evaluations of new patients presenting to the service. Students will assist in emergency psychiatric evaluations in the Level 1 Trauma Center Emergency Department. The inpatient psychiatry teams consist of interns, a senior resident, attending psychiatrists, technicians, social workers, and mental health nurses. The Consult Liaison team consists of PGY-2 residents, a senior resident (PGY-4), attending psychiatrists, and a social worker and/or psychologist. Students will be expected to assume direct patient care of 1-3 patients with the supervision of residents and staff as their skill and experience allows. Additionally, medical students are expected to actively participate in discussions of treatment and management of other patients followed on the ward. Students will also be expected to attend the morning report, didactics, and Grand Rounds that occur during the rotation.

*MS-4s on audition rotations have the option to spend one of these weeks at the Wilford Hall Mental Health Clinic at JBSA Lackland to obtain broader exposure to the training program.

Specialty/Subspecialty: Internal Medicine/Pulmonary
Inpatient vs. Outpatient vs. both: Both
Inpatient Consult service: Yes
Operating Room: N/A
Days/Hours: Monday through Friday, 7:30 a.m. – 4:30 p.m.
Any call? / Nights?: No
Primary interaction with fellows vs. faculty? Fellows
Any required tests or presentations? No

Brief rotation description:

Fourth year medical students will be assigned to the pulmonary inpatient consultation team. The inpatient consultation team typically consists of an attending physician, fellow, resident or intern, and medical student. Additionally, students will be paired with the outpatient fellow throughout the rotation and participate in the care of new and existing clinic patients. Students will be assigned to interview, examine, evaluate, and manage patients in the outpatient and inpatient environment under fellow and faculty supervision. Participation in weekly academic conferences with the fellows is required.

Specialty/Subspecialty: Radiology
Inpatient vs. Outpatient vs. both: Both
Inpatient Consult service: N/A
Operating Room: N/A
Days/Hours: Monday through Friday, 7:45 a.m. – 1 p.m. 
Any call? / Nights?: No
Primary interaction with residents/fellows vs. faculty? Primary interaction with other rotating medical students, residents, fellows, and faculty
Any required tests or presentations? One 5-10 minute oral PowerPoint presentation

Brief rotation description:

Medical students spend one month in the radiology department shadowing residents and faculty in their choice of four, one-week-long rotations on any of the following imaging services: neuroimaging, thoracic/cardiac imaging, pediatric imaging, interventional radiology, abdominal imaging, musculoskeletal imaging, ultrasound, or nuclear medicine imaging. We require all rotators to present a 5-10 minute interesting case PowerPoint in their last week. The typical duty day for medical students begins at 7:45 a.m. and ends at 1 p.m. We provide hands-on dictation opportunities on the chest and musculoskeletal services, an opportunity for medical students to actively participate in generating radiology reports. 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 Director to schedule a face-to-face interview. We look forward to meeting you!

Specialty/Subspecialty: Internal Medicine/Rheumatology
Inpatient vs. Outpatient vs. both: Outpatient
Inpatient Consult service: Yes
Operating Room: N/A
Days/Hours: Monday through Friday, 7:45 a.m. – 4:30 p.m.
Any call? / Nights?: No
Primary interaction with fellows vs. faculty? Faculty
Any required tests or presentations? Yes, 1 post-rotation quiz

Brief rotation description:

Medical students will be assigned to interview, examine, evaluate, and attempt management plans for patients in the rheumatology clinic primarily under faculty supervision but also on occasion fellow supervision. The full range of rheumatology disorders that student will be exposed to and educated about during their rotation include but are not limited to; rheumatoid arthritis, SLE, spondyloarthropathies, gout/pseudogout, vasculitis, myositis, osteoarthritis, and fibromyalgia. Students have the option to participate in the musculoskeletal ultrasound clinic once a week. Based on case availability, students will be taught arthrocentesis skills and supervised by faculty on procedural skills. In addition, based on inpatient census, students can accompany the on-call fellow to evaluate inpatient rheumatology consults. Participation in the twice weekly academic conferences is required. During these sessions, students will engage in the fellows’ didactic sessions where specific rheumatology topics will be covered and education on how to interpret musculoskeletal imaging (to include X-rays, MRI, and ultrasound) will be taught. At the end of the rotation, students will be given a post-rotation quiz that will cover high yield rheumatology topics/concepts taught during their longitudinal rotation.

Specialty/Subspecialty: Sleep Medicine
Inpatient vs. Outpatient vs. both: Outpatient - Wilford Hall Ambulatory Surgical Center
Inpatient Consult service: No, however inpatient consults are seen
Operating Room: N/A
Days/Hours: Monday – Friday; 8 a.m. – 4 p.m.
Any call? / Nights?: No
Primary interaction with fellows vs. faculty? Fellows and faculty
Any required tests or presentations? Share one case at multi-disciplinary rounds you have seen during your rotation, or one article during Journal Club

Brief rotation description:

Medical students rotating through sleep medicine will have a rich exposure to various sleep disorders. The rotation is entirely outpatient, with an occasional inpatient consultation. Rotators will work closely with sleep medicine fellows and staff, all with a diverse background to include neurology, pulmonary & critical care, pediatrics, otolaryngology, internal medicine, anesthesia, and psychiatry. Students will learn about ordering and interpreting polysomnograms, as well as actigraphy, maintenance of wakefulness tests, mean sleep latency tests, and home sleep apnea tests. There will be opportunities to learn how to manage patients with sleep disordered breathing such as obstructive sleep apnea, central sleep apnea, and complex sleep apnea, as well as parasomnias (sleep terrors, somnambulism, nightmare disorder, REM sleep behavior disorder, etc.), central disorders of hypersomnolence (narcolepsy type 1 and 2 and idiopathic hypersomnia), insomnia, sleep movement disorders, and pediatric sleep disorders. Students will have exposure to patients with sleep disorders of all ages, from infants to seniors. Additionally, students will gain insight into the multisystem importance of sleep in the form of multidisciplinary clinics and conferences with clinical health psychology, pediatric subspecialties, and neuromuscular diseases clinic. There is a structured curriculum built into the rotation, as well as a reading list for self-directed learning.

Specialty/Subspecialty: General Surgery
Inpatient vs. Outpatient vs. both: Both
Inpatient Consult service: Yes
Operating Room: 60% OR time
Days/Hours: Daily/ 5 a.m. – 6 p.m., one day off/week
Any call? / Nights?: Yes / average 1 overnight call per week
Primary interaction with residents vs. faculty? Residents and faculty
Any required tests or presentations? None

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: General Trauma Surgery
Inpatient vs. Outpatient vs. both: Inpatient
Inpatient Consult service: No
Operating Room: Yes, varies but always possibility
Days/Hours: 5 a.m. – 6 p.m., One day off per week
Any call? / Nights?: Yes, Avg 2-4 call shifts per month
Primary interaction with residents/fellows vs. faculty? Residents, Fellows, and Faculty
Any required tests or presentations? No

Brief rotation description:

Medical students will be assigned to one of two busy general trauma teams at Brooke Army Medical Center the DOD’s only Level 1 trauma center. At BAMC we average around 5300 trauma activations each year with over 3000 admissions and over 9000 operations performed annually. Medical students will participate in inpatient rounds, take call with residents, and assist in the operating room. When participating in surgery medical students should scrub into the case, safely maintain a sterile field, and have basic understanding of relevant anatomy. Medical students will have exposure to damage control surgery and advanced resuscitative techniques for critically injured patients. Medical students will be primarily interacting with interns and PGY-5 residents but also will have exposure to trauma fellows and staff attendings. Students will participate in multiple weekly didactic sessions covering general surgery and trauma surgery related topics. No presentation is required but may be asked of the student.

Specialty/Subspecialty: Surgical/Trauma Intensive Care Unit
Inpatient vs. Outpatient vs. both: Inpatient
Inpatient Consult service: No
Operating Room: Possible
Days/Hours: 6 a.m. – 6 p.m., One day off per week
Any call? / Nights?: No
Primary interaction with residents/fellows vs. faculty? Residents, Fellows, and Faculty
Any required tests or presentations? No

Brief rotation description:

Medical students will be assigned to one of two ICU teams covering the Surgical/Trauma Intensive Care Unit at Brooke Army Medical Center the DOD’s only Level 1 trauma center. At BAMC we average around 5300 trauma activations each year with over 3000 admissions and over 9000 operations performed annually. The STICU is a 28 bed ICU with ability to overflow to other units. Medical students will participate in daily patient care, inpatient academic rounds, and assist in procedures. Medical students will have exposure to damage control resuscitation and advanced ICU level care for critically injured patients. Medical students will be primarily interacting with interns and PGY-2 or 3 residents but also will have direct exposure to trauma fellows and staff attendings. Students will participate in multiple weekly didactic sessions covering wide array of ICU related topics including trauma surgery. No presentation is required but may be asked of the student.

Specialty/Subspecialty: Urology
Inpatient vs. Outpatient vs. both: Both
Inpatient Consult service: Yes
Operating Room: 75% OR time
Days/Hours: Daily/6 a.m. – 6 p.m., 1-2 day(s) off/week
Any call? / Nights?: No overnight call responsibilities
Primary interaction with residents vs. faculty? Residents and faculty
Any required tests or presentations? 10-minute 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 min 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.