Emergency Medicine Selective provides experiences with a diverse set of patients spanning all ages and experiencing many pathological conditions that present to the emergency department. Students are expected to perform the initial patient assessment, formulate a differential diagnosis and problem list, present the patient to a senior resident or attending physician, write orders, interpret diagnostic studies, discuss patients with consultants, perform or assist with procedures under supervision, write discharge instructions, and facilitate admissions and transfers.

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.

Advanced hospital selectives 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.

Designed for the 4th year medical student with a potentially strong interest in pursuing orthopaedic surgery as a career. Patient care involvement will be both in the outpatient clinics and operating room. There will also be opportunities to be involved with emergency department and in-patient consultations. Students will be required to take evening call and will be paired with a resident. Students will have opportunities to work with a variety of faculty that are fellowship trained in the different subspecialties of orthopaedic surgery. There will also be opportunities to work closely with orthopaedic residents. Students will learn musculoskeletal history taking skills, the details of a musculoskeletal physical examination, interpretation of radiographs and advanced imaging techniques, treatment options including both nonoperative and operative management, surgical approaches to include both soft tissue and bone handling techniques, and implant specifics. There will be a lectureship series for students given by the faculty. A fundamental knowledge of musculoskeletal anatomy will be important.

Pediatric Endocrinology is a primarily ambulatory 4th year elective based at the WMed Pediatric Subspecialty Clinic on Oakland Drive. Students will also have the opportunity to participate in consultations at the Bronson Children's Hospital in downtown Kalamazoo, MI. Students may spend two or four weeks in our active academic pediatric endocrinology program. The site available is WMed Pediatric Subspecialty Clinic.

Pediatric Pulmonary Medicine is primarily an outpatient experience, but student will participate in all Pediatric activities including Morning report and resident block conferences. The student will have ample opportunity to interview patients, perform physical examinations and discuss management of the most common pulmonary disorders. The student will participate in inpatient rounds and consults on patient admitted at Bronson hospital. They will have opportunity to observe a multidisciplinary team during the Cystic Fibrosis and Ventilation clinics. The student will observe bronchoscopy and spirometry or other pulmonary function testing. Emphasis is also placed on general pediatric issues: growth, immunization, risk of smoking or exposure to tobacco smoke, and infection control, patient education, safety and planning of care. The sites available are WMed Pediatric Subspecialty Clinics.

Ambulatory clerkships provide the opportunity for students to assume initial responsibility for the evaluation of patients in the ambulatory setting. Supervision will be provided by faculty preceptors in the academic setting as well as community private practices. Students expand upon competencies they developed during the third year as they team with residents and/or preceptors to provide preventive health services as well as acute and chronic illness management. The faster pace of ambulatory care provides an environment that strengthens patient and family communication skills, rapport development, and oral presentations. The use of evidence to inform treatment and counseling of patients and their caregivers are additional competencies that are highlighted in the outpatient setting.Ambulatory Pediatrics is an outpatient pediatric rotation that utilizes the WMed Pediatric Clinic as well as a community pediatric office as potential clinical sites. Fourth year students who have successfully completed all Year 3 required clerkships are eligible to register for this course. During this rotation, students will focus on understanding the normal progression of growth and development from infancy through adolescence. Students will also develop their diagnostic and management skills of common acute pediatric complaints, with a focus on respiratory, abdominal and dermatologic problems, as well as common behavioral and mental health disorders. Faculty will all have appointments in the Department of Pediatric and Adolescent Medicine.

Advanced hospital selectives 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.

Advanced Hospital Pediatrics is a hospital based pediatric rotation that utilizes Bronson Children's Hospital as its clinical site. This center is the tertiary care referral center for pediatric disorders in Southwest Michigan. Fourth year students who have successfully completed all Year 3 required clerkships are eligible to register for this course. During this rotation, students will focus on the development of patient management skills as they assume primary responsibility for patient care.

Faculty for this rotation are the Bronson Children's Hospital Pediatric Referral Service.

Advanced hospital selectives 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.

Students work directly with a faculty psychiatrist, usually a psychiatry resident, and a multi-disciplinary team in an inpatient setting with older adult patients. Students perform initial evaluations and help manage patients throughout their hospitalization (if desired, the student may participate in the ECT Service). The site available is Borgess Medical Center.

Advanced hospital selectives 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.

The advanced general surgery rotation is designed for students who are interested in a general surgery residency. They will manage patients as independently as possible with oversight from the general surgery chief resident and an attending surgeon. They will be assigned to the general surgery service at either Borgess or Bronson. Assistance with teaching 3rd year students will also be expected. They will gain operative experience as well as have increased responsibilities managing patients in the inpatient and outpatient setting.