Rotations

• Cardiothoracic Surgery

• Emergency Medicine

Cardiothoracic & Vascular Surgery

The student rotation is designed to introduce the student PA to the role of cardiothoracic and vascular surgery PA. Its purpose is to extend the PA resident’s skills into the clinical, administrative and academic roles available in cardiac surgery. It is intended for all PA’s interested in a career in cardiothoracic surgery. The SJMH student rotation will expand upon the basic training of the PA to encompass the diagnosis and management of diseases and conditions common to the cardiothoracic and vascular surgical patient in both the operative and peri‐operative phases of care. In addition, the training is to be accomplished in the tradition of the Sisters of Mercy and according to their values of service, respect, social justice, compassion and excellence.

Emergency Medicine PA

Trinity Health Hospital in Ann Arbor is a 548‐bed hospital. We have a 64‐bed Emergency Department with a 12‐bed Emergency Department Observation Center. We are a level II trauma center with over 70,000 ED visits a year. The ED also has a joint Emergency Medicine Residency with the University of Michigan. The rotation is mostly spent on the adult side of the ED. We cover the fast track area where we do many procedures, the main emergency department and the Senior ED. We cover the residents while they are in conference. We will try to give students a broad emergency department experience, with as many procedures as available. We have a highly rated program for students and now also have a Post Graduate PA Fellowship in Emergency Medicine.

Available 4th Year Medical Student Rotations

• Acute Care Surgery (ACS)
• Anesthesiology
• Cardiology
• Colorectal Surgery
• Coronary Care Unit (CCU)
• Dermatology
• Emergency Medicine
• ENT
• Family Medicine
• General Surgery
• Hospitalist
• Infectious Disease
• Internal Medicine – Inpatient

• Internal Medicine – Outpatient Academic Clinic
• Medical Intensive Care Unit (MICU)
• Nephrology
• OBGYN
• Orthopedic Surgery
• Palliative Care (must be career end goal)
• Physical Medicine & Rehab (no rotations Jul/Aug)
• Plastic Surgery
• Pulmonary Critical Care Consults
• Radiology
• Surgical Intensive Care Unit (SICU)
• Vascular Surgery

Acute Care Surgery (ACS)

This is a 4 week rotation. Students function as an integral part of the team and will actively be involved inpatient care. Responsibilities will be tailored by the chief resident, typically including taking part in surgical procedures, suturing, daily inpatient rounding, and presenting detailed daily management plans for their patients. Independent and proctored responsibilities will be balanced during the rotation. Additionally, there is frequent contact and instruction to maximize the learning experience to prepare for shelf examinations, oral exams, and ultimately medical practice.

Anesthesiology

This can be a 2 or 4 week rotation. Students will be introduced to clinical anesthesiology in a busy tertiary hospital setting. Students participate in the evaluation and preparation of patients prior to surgery and in the induction and maintenance of patients undergoing surgery. Experiences include invasive line placement, non‐invasive and invasive airway management and a review of the pharmacology and physiology of perioperative patient care.

Cardiology

This can be a 2 or 4 week rotation. Most students are treated as interns who are allowed to fully evaluate the patient independently, for inpatient consults and inpatient evaluations. The goal is for the student to function as independently as possible. Students are expected to perform a full history and exam, review all relevant evaluations and to synthesize the data and develop a differential diagnosis and management plan. Students are directly supervised by the attendings and residents. Students attend morning report and noon conference. The cardiology curriculum includes a list of 10 highest impact journal articles that students, interns, and residents rotating through cardiology are expected to read.

Coronary Care Unit (CCU)

This is a 4 week rotation. Under supervision, students take on the responsibility of first year residents for a limited number of patients with primarily acute problems including myocardial infarction, heart failure, and arrhythmias. Teaching work rounds are held seven times a week and attending conferences are held three times a week. Students will also attend twice weekly student conferences and share one of their patients in a case presentation to the student group.

Colorectal Surgery

This is a 4 week rotation. Students function as an integral part of the team and will actively be involved inpatient care. Responsibilities will be tailored by the chief resident, typically including taking part in surgical procedures, suturing, daily inpatient rounding, and presenting detailed daily management plans for their patients. Independent and proctored responsibilities will be balanced during the rotation. Additionally, there is frequent contact and instruction to maximize the learning experience to prepare for shelf examinations, oral exams, and ultimately medical practice.

Dermatology

This is a 5 day virtual rotation that consists of a mix of didactic learning. Students receive an introduction to dermatology lectures, grand rounds, and journal clubs. Attend round table discussions with faculty members and residents, as well as an individual meeting with the Program Director.

Emergency Medicine

This is a 4 week rotation. Students will complete 15 clinical shifts. Students will be exposed to basic principles of EM, including triage, resuscitation, and evaluation of undifferentiated patients, both adult and pediatric. Students will be provided with exposure to emergency practice in a busy community hospital setting that handles a wide variety of medical and trauma cases.

ENT

This can be a 2 or 4 week rotation. Students will have exposure to a wide scope of otolaryngologic problems. They will take part in diagnosis, decision making, and treatment through experience in the clinic and on inpatient consult rounds. Students will also be introduced to the fundamentals of the head and neck examination including otoscopy (handheld and microscopic), fiberoptic nasal endoscopy and laryngoscopy. Students may attend and assist in surgical cases both in the operating rooms and in the office treatment room setting. Students will also learn to interpret appropriate diagnostic tests such as imaging studies and hearing tests. Students may spend time with a variety of providers depending on schedule and interest including physicians, PAs, audiologists, and speech pathologists. Students will be expected to learn common diagnoses and treatment in otolaryngology and learn when to refer for specialty care.

Family Medicine

This can be a 2 or 4 week rotation. The Family Medicine rotation is located in Brighton, MI and is designed to educate students on the principles and practice of Family Medicine. Students will be directly supervised by Family Medicine faculty and assist in the care and treatment of patients at the Family Medical Center. Students will learn the principles and treatment of preventative care, continuity, common medical problems, and office procedures in Family Medicine. Students will participate in didactic lectures with the residents.

General Surgery

This is a 4 week rotation. Students function as an integral part of the team and will actively be involved inpatient care. Responsibilities will be tailored by the chief resident, typically including taking part in surgical procedures, suturing, daily inpatient rounding, and presenting detailed daily management plans for their patients. Independent and proctored responsibilities will be balanced during the rotation. Additionally, there is frequent contact and instruction to maximize the learning experience to prepare for shelf examinations, oral exams, and ultimately medical practice.

Hospitalist

This is a 4 week rotation. Students will act primarily as an intern, independently evaluating and following patients from admission to discharge. Students will work directly with the academic attending physician. This rotation provides an excellent opportunity to learn how to manage the vast array of problems seen in general medical hospitalist patients. Students will spend most of their time doing direct patient care with opportunities for procedures. There will be educational presentations as well as daily morning report and noon conferences. Students will be expected to work 5 days a week and carry an average patient load of 4‐5. Students will work more closely with the attending physician as compared to most other rotations and will therefore be given more autonomy and direct feedback. The student will develop efficient clinical skills.

Infectious Diseases

This can be a 2 or 4 week inpatient consultative service. The caseload is moderate with an excellent mixture of clinical problems. Adequate time for self‐study is usually available. Students will be expected to assume a significant degree of responsibility. Students have ID courses on site (weekly micro plate rounds, weekly ID didactics, ID grand rounds, and journal club once a month). Close interaction with the resident and fellow on the elective and the instructor.

Internal Medicine - Inpatient

This is a 4 week rotation where students are expected to function at the level of an intern and carry their own patients without a co‐intern. They are expected to perform the initial H+P, come up with their own differential diagnoses, and create a plan for that patient's subsequent work up and treatment. Students will work closely with the senior resident as well as the internal medicine attending. Faculty is expected to observe the students interacting with patients at the bedside over the course of the rotation.

Internal Medicine – Outpatient Academic Clinic

This can be a 2 or 4 week rotation. It is designed to educate fourth year medical students on the principles and practice of outpatient Internal Medicine. Students will be directly supervised by Internal Medicine Faculty and assist in the care and treatment of patients at the AIM Center working in tandem with a resident. Students will learn the principles and treatment of chronic disease management, preventive medicine, and team-based care with collaborative care models working with embedded social work, behavioral health care managers and a financial navigator. Students will have opportunities to rotate through our specialty clinics in Lifestyle Medicine, Skin clinic, Diabetic group and Musculoskeletal Sports Medicine clinics utilizing point of care ultrasound skills. Student will participate in didactic lectures in the Internal Medicine Residency during morning report and noon conferences.

Medicine Intensive Care Unit

This is a 4 week rotation where, under supervision, students take on the responsibility of first year residents for a limited number of patients with acute ICU/level problems. Multidisciplinary educational rounds are held seven times a week. Students will learn about the entire array of acute pulmonary and intensive care medical problems, including vent management, sepsis treatment, pressers, electrolyte and fluid management, and other common ICU issues.

Nephrology

This can be a 2 or 4 week rotation. Students are responsible for performing initial evaluations of both nephrology inpatients and outpatients. They will also be responsible for following the inpatient patients daily. Students are expected to present and discuss patients with faculty daily. Topics discussed during the month include electrolyte management, acid‐base, glomerulonephritis, interstitial renal disease, hypertension, acute renal failure, chronic renal failure, dialysis, and transplant. Students are encouraged to attend the Internal Medicine morning report and noon conferences. There is no call. Students are expected to be present Monday - Friday from 8:00am-5:00pm.

OBGYN

This 4 week rotation is designed for the student who is seriously considering OB/GYN as their residency choice or who desires additional exposure to the specialty to help them decide upon their career choice. Students may tailor the experience by spending additional time with MFM, uro‐gynecology, addiction medicine specialists in OB/GYN, and ultrasound or gynecological pathology. There are two required overnight Friday call shifts. It should be emphasized that this is not a designated sub‐internship but will provide greater exposure to the specialty and greater clinical responsibilities for the interested student.

Orthopedic Surgery

This can be a 2 or 4 week rotation.

Palliative Care

This can be a 2 or 4 week rotation. This rotation is designated for students who have a career goal of practicing palliative care. Students will have the opportunity to work with an interdisciplinary team, including physicians, nurse practitioners, social workers, nurses, and chaplains. They will learn expert symptom management to minimize suffering and promote quality of life within the context of the patient’s goals. They will also be involved in goals-of-care discussions, family meetings and end-of-life care.

Physical Medicine & Rehab

This 4 week rotation focuses on giving the learner experience in the broad field of PM&R. This rotation provides a broad exposure to a range of musculoskeletal and neurologic pathologies. Students will see a multitude of spine conditions, sports injuries, traumatic brain injuries, concussions, spinal cord injury. Additional opportunities to observe peripheral joint injections, ultrasound‐guided procedures, physical therapy, and regenerative med interventions are available. Students will rotate with a variety of our group's physicians, physician assistants, and physical therapists.

Plastic Surgery

This is a 4 week rotation.

Pulmonary Critical Care Consults

This 4 week rotation offers students that are interested in pulmonary and critical care medicine exposure to all aspects of modern pulmonary medicine. In addition to pulmonary and critical care inpatient consultations; students will acquire basic skills in interpreting chest x‐rays, reading pulmonary function tests, and blood gas analysis. A comprehensive bibliography of suggested readings on a multitude of pulmonary and critical care topics is provided.

Radiology

This can be a 2 or 4 week rotation. It involves observing radiology in a large referral community hospital with all of the imaging technology (and an optional experience at a community primary care facility). Interdepartmental patient conferences and lectures will be included in the experience. Students will be required to complete at least one case for the teaching file.

Surgical Intensive Care Unit (SICU)

This is a 4 week rotation. Students function as an integral part of the team and will actively be involved inpatient care. Responsibilities will be tailored by the chief resident, typically including taking part in surgical procedures, suturing, daily inpatient rounding, and presenting detailed daily management plans for their patients. Independent and proctored responsibilities will be balanced during the rotation. Additionally, there is frequent contact and instruction to maximize the learning experience to prepare for shelf examinations, oral exams, and ultimately medical practice.

Vascular Surgery

This is a 4 week rotation. Students function as an integral part of the team and will actively be involved inpatient care. Responsibilities will be tailored by the chief resident, typically including taking part in surgical procedures, suturing, daily inpatient rounding, and presenting detailed daily management plans for their patients. Independent and proctored responsibilities will be balanced during the rotation. Additionally, there is frequent contact and instruction to maximize the learning experience to prepare for shelf examinations, oral exams, and ultimately medical practice.