This one week elective is designed for M1/M2 students interested in learning the basic skills of history taking and examination of acute and chronic musculoskeletal condition. At the completion of this objective student should be able demonstrate these basic skills as well understand the underlying principle of musculoskeletal ultrasound and electrodiagnosis. This elective is held virtually through Microsoft Teams.

The required Internal Medicine Core Clerkship provides medical students with a comprehensive introduction to the field. Students will experience various facets of internal medicine, including ambulatory care, academic medicine, hospitalist medicine, and night shifts. The curriculum features preparatory sessions to enhance clinical skills, interdisciplinary activities for collaborative learning, and weekly student conferences focused on clinical reasoning and relevant medical topics. This course aims to immerse students in the clinical environment, preparing them for future growth as competent and knowledgeable clinicians.

Students may develop an individualized research plan of their choice under the direction of a faculty member. Students should work with a faculty member to submit the form Elective Proposal to Educational Affairs at least eight weeks prior to the projected start date. This elective requires prior approval.

Students may develop an individualized course on a topic of their choice under the direction of a faculty member. Students should work with a faculty member to submit the form Elective Proposal to Educational Affairs at least eight weeks prior to the projected start date. This elective requires prior approval.

The purpose of this elective is to provide support to core clerkship students transitioning into the Internal Medicine clerkship. Student Chiefs will orient core clerkship students to expectations of the Internal Medicine clerkship and student roles. The chiefs are the student leaders expected to be available to the core clerkship students on the Medicine rotation for support with knowledge and skills required to successfully complete the clerkship. Students interested in being a Student Chief need to apply and will be selected by the faculty. This elective is available for Rotations 1, 2 and 3 only.

The overarching goal of this elective is to introduce medical students to the foundational knowledge of addiction medicine. This elective aims to increase awareness of substance use disorders along with basics of diagnosis and medical care of persons with a substance use disorder and substance use related health conditions. This is a two-week virtual, asynchronous elective via internet modules.

Cardiac disease impacts morbidity and mortality in adults, with coronary artery disease the leading cause of death in Americans. Patients in both the inpatient and outpatient setting may have concomitant cardiovascular disease such as coronary artery disease, cardiomyopathies, congestive heart failure, arrhythmias, and valvular heart disease.

Gastrointestinal diseases, both acute and chronic, are common complaints of the adult patient. Students will become more familiar with the evaluation and management of those GI conditions that have not been able to be managed by patient's primary care physician.

According to the Centers for Disease Control, the population of the United States is aging at an unprecedented rate; by 2030, approximately 72 million members of the population, or nearly 20%, will be age 65 or older. Along with the aging of the population will come a great need for physicians and providers trained in the special needs of the older population, from the physical and medical changes that accompany aging to the unique psychosocial needs of older adults. Older people over age 65 also account for more than half of the nation's hospital usage and a significant share of other medical services as well. An older patient may see an average of ~15 physician visits across various specialties and sites each year. In order to care for the unique needs of this rapidly growing audience, graduating medical students must have the knowledge and understanding of geriatric medicine. Providing effective and compassionate care in various settings and restoring health and function of older patients through various therapies is essential. Goals of care and care plans must be based on each individual patient, with an understanding that function and quality are usually the most important aspects (calling for palliative care vs. aggressive treatment). The geriatrics elective offers students an opportunity to evaluate geriatric patients with a variety of medical problems. Students will have the opportunity to provide comprehensive and team-based care to older adults, as well as have more focused problem-based encounters. Through this unique experience, the medical students will be equipped with a body of knowledge and experiences to carry forward into future professional endeavors (e.g. residency).

Hematologic and oncologic diseases cover a wide array of conditions in adult patients. In this rotation, the student is exposed to the types of patients referred to these specialists for further evaluation and management.

Infectious diseases is a broad field that encompasses the evaluation and management of acute infectious processes as well as the management of patients with chronic infectious processes such as human immunodeficiency virus. Infectious disease specialists play a role in public health, hospital infection control programs/policies and are the champions of antibiotic stewardship.

Nephrologists play a vital role in the hospital setting as they see patients with renal issues on the critical care, medicine and surgery services. They also oversee inpatient hemodialysis. In the outpatient setting, they diagnose and manage patients with a variety of renal diseases and oversee outpatient chronic dialysis therapy.

Physical medicine and rehabilitation is a medical specialty where clinicians may have both an inpatient and outpatient practice. Their focus is on enhancing and restoring functional ability and quality of life to patients with various impairments or disabilities. Many patients who are cared for by a PM&R physician (aka physiatrist) have neurological disabilities such as brain injury (non-traumatic and traumatic), spinal cord, stroke, multiple sclerosis, polio, and other musculoskeletal problems. On this rotation, students will have the opportunity to care for patients in an inpatient setting. These settings are also referred to as "high intensity" rehabilitation settings in that a patient can expect to spend at least 3 hours per day participating in their rehabilitation. Physiatrists work as part of a multidisciplinary team to meet the needs of the "whole" patient in achieving maximal recovery.

Pulmonary medicine focuses on the evaluation and management of acute and chronic lung disease. Many pulmonologists have additional expertise in critical care medicine and sleep medicine. The student will gain familiarity with understanding with disorders of the lungs, upper airways, thoracic cavity, and chest wall seen in either the inpatient or outpatient setting, depending on their elective site and preceptor.

Nutritional sciences is a broad term encompassing the multi-disciplinary outreach of nutrition form the biological sciences to the social and physical sciences. Nutrients play a role in maintenance and disruption of normal biochemical and physiologic processes in a number of disease conditions, including the development of types of malnutrition. Nutrients may impact drug metabolism and drug-nutrient interactions, as well as nutrient-nutrient interactions. From a population/public health perspective, food availability and the composition of those foods can play a role in the overall health of a community. Physicians are uniquely positions to incorporate nutritional sciences into their own scholarly activities and clinical practice. This elective allows the student to design their own curriculum with potential applications to either basic medical and/or clinical sciences. The student will work closely with the course director or other faculty member to derive their program of study, identify specific objectives, attend relevant WMed lectures/conferences, and pre-determine the summative tasks to be accomplished to fulfill the objectives of the elective. In addition, general basic clinical nutrition readings will be assigned.

Palliative care focuses on improving quality of life and providing comfort to people of all ages with serious, chronic and life-threatening illnesses. While many think of "hospice" as being synonymous with palliative care, it is not as hospice primarily serves the patient whose life expectancy is less than 6 months. During this elective, the student will observe the spectrum of palliative care, from helping families and the patient understand and cope with the diagnosis of a serious illness that may or may not be able to be cured, with end-of-life discussions including goal setting, with symptom relief management to offer comfort, and with the transition to hospice care when appropriate. A palliative care service is a multidisciplinary team consisting of the physician, advanced practice provider, and medical social worker. Chaplain services as well as rehabilitation and nutrition specialists may be consulted if needed to fulfill the overall care plan. At Bronson, their program is called "Advanced Illness Management".

Sleep medicine is a subspecialty devoted to the diagnosis and therapy of sleep disturbances and disorders. Disordered and disturbed sleep are associated with up to 1/3 of fatal motor vehicle fatalities as daytime sleepiness is a common symptom. Abnormal sleep can be associated as well as impact chronic medical conditions such as hypertension, obesity and mood disorders. Chronic obstructive sleep apnea, sleep deprivation, insomnias, narcolepsy, restless leg syndrome and hypersomnias may be treatable. Sleep Medicine is a multidisciplinary specialty and physicians who seek certification may be internists, pulmonologists, pediatricians, neurologists, or otolaryngologists.

This elective will teach basic point of care ultrasound skills for use in primary care and hospital settings including emergency room, inpatient medicine, and critical care through an on-line curriculum using text and videos and will include a two hour ultrasound lab each day. Modules will include: 1) Ultrasound Physics, 2) Gall Bladder and liver, 3) Kidneys and Bladder, 4) Aorta, pancreas and spleen, 5) Lung and Pleura, 6) Echocardiography, 7) Basic Musculoskeletal US. 8) Thyroid, Cardotids and Lymph nodes, 9) Eyes, Skin and Basic Venous US. An optional module with lab is US guided procedures. Optional modules without associated labs include OB, Gyn, Breast, Testicular Pediatrics, and Tropical Medicine. The ultrasound labs will involve scanning of student volunteers enrolled in the elective. To optimize the scanning experience of everyone enrolled in the elective most students should anticipate volunteering to be scanned by their colleagues at each 2 hour lab. Volunteering is not required and modesty will be optimized. Since most students are young and relatively healthy the lab will be focused on acquisition of images rather than interpretation. Learning the interpretation of images will be from reading and videos.

The Ambulatory Medicine elective occurs in a clinical environment in an outpatient clinic setting. Students will gain a foundation for the principles of primary care including differential diagnosis, periodic health examinations, screening for disease, psychosocial aspects of health and illness, nutrition and medicine. Students will actively participate in discussions of common ambulatory problems. Students will work closely with an attending physician and can assume responsibility for clinical decision making at a level appropriate to his/her experience

This elective will combine management of psychiatric conditions and medical management of comorbid conditions in the psychiatric inpatient setting. The integration of psychiatric and medical management in the inpatient setting creates an opportunity for students to continue developing integration strategies across disciplines. Significant interprofessional collaboration will be involved.

Advanced Hospital Medicine provide the opportunity for students to assume greater responsibility for patient care of the hospitalized patient, with oversight from supervising residents and attending physicians. Students expand upon competencies they develop during the third year as they care for one to two patients at a time. Additional expectations include responsibility for developing management plans, writing orders, patient handovers and transfers of care, recognizing the policies that support patient safety, and developing competency in procedures that they will perform independently as residents. Fourth year students also assist in teaching third year students. Hospital medicine is a growing professional track for internal medicine physicians. The Society for Hospital Medicine defines a hospitalist as a physician "who engages in clinical care, teaching, research, or leadership in the field of general hospital medicine. In addition to their core expertise managing the clinical problems of acutely ill, hospitalized patients, hospital medicine practitioners work to enhance the performance of hospitals and healthcare systems." The M4 selective in hospital medicine exposes the student to the medical problems commonly seen in hospitalized adult patients and permits the student to have a greater role in the evaluation and management of these patients than they had during the M3 clerkship.

This rotation offers students the opportunity to accelerate their learning by spending a four week block in the intensive care unit. The rotation provides the student the opportunity to diagnose and treat of a wide range of clinical conditions common among critically ill patients. Students will enhance their knowledge and skill in caring for the sickest patients in the hospital. The Clinical site utilized for the Pediatric Advanced Critical Care is the pediatric ICU at Bronson Children's Hospital. Students will be paired with interns and residents, and will participate in the ICU in a dedicated fashion; the intent is for students to function as a "subintern" and will result in a high level learning experience. Students will be expected to participate on rounds, will continue to perfect the gathering and synthesis of data, and expand on their ability to make diagnoses and develop care plans. The student will be expected to gather a history based upon interview of patients/families, evaluate laboratory and radiographic material, and generate differential diagnoses and management plans. They will also be expected to improve their documentation skills by writing patient notes in the electronic medical record. This is a 4 week block rotation, and will correspond to the calendar set forth by the Western Michigan University School of Medicine. This varies on the time of year and the rotation site. The medical ICU consists of patients with primarily medical diseases affecting the major organs.

This rotation offers students the opportunity to accelerate their learning by spending a four-week block in the Neuro Intensive Care Unit at Bronson Hospital. The rotation provides the student the opportunity to diagnose and treat of a wide range of clinical conditions common among critically ill patients. Students will enhance their knowledge and skill in caring for the sickest patients in the hospital. Students will participate in the ICU in a dedicated fashion; the intent is for students to function as a "sub-intern" and will result in a high-level learning experience. Students will be expected to participate on rounds, will continue to perfect the gathering and synthesis of data, and expand on their ability to make diagnoses and develop care plans. The student will be expected to gather a history based upon interview of patients/families, evaluate laboratory and radiographic material, and generate differential diagnoses and management plans. They will also be expected to improve their documentation skills by writing patient notes in the electronic medical record.