Cardiology Electives and Selectives
Acting Internship - Cardiology (IM4 903J-4)
Attendance: Students may not take time off on their start date and must attend check-in and system orientation with Visiting Student Affairs. Time off is not permitted during this acting internship. See the attendance policy for additional details.
Location: CRMH
Available: August – June
Duration: 4 weeks, starting any Monday and ending Friday
Number of students per rotation: 1
Prerequisites
- Letter of Intent from IM Chair/Advisor validating applicant's intent to pursue residency in Cardiology or IM
Overview:
The student will be immersed in a busy inpatient cardiology service with exposure to a wide spectrum of cardiovascular diseases including acute coronary syndromes, valvular heart diseases, cardiomyopathies and common dysrhythmias.
The student will also help manage an outpatient cardiology observation unit. Most patients in observation unit will be low-risk patients with chest pain or those with heart failure exacerbations. Chest pain patients will be ruled out for myocardial necrosis, then undergo appropriate non-invasive studies such as exercise treadmill testing, exercise or dobutamine stress echocardiography, nuclear cardiology study (e.g. Lexiscan) or cardiac computed tomographic angiography study. The Acting Intern will be involved in deciding the most appropriate noninvasive/imaging modality for the patient as well as participate in analyzing the ECG and imaging aspects of the study. Patients with heart failure will be investigated for etiology of HF exacerbation, have appropriate diagnostic studies and adjustment of medical regimens.
Some of the patients from the observation unit will be admitted to the AI’s inpatient service. The AI will work closely with the attending, an MLP and with an intern. On most rotations, a cardiology fellow will also be involved in teaching the AI and intern.
The AI will attend medicine grand rounds and didactic cardiology core curriculum and case-based designed for cardiology fellows. The student will be offered the opportunity to present interesting cases at the clinical conference.
The student will become progressively proficient and knowledgeable in the following:
- Applying admission criteria
- Screening cases for admission and discussing questionable cases for admission with the attending
- Performing history, physical examination, order writing, and medical record documentation
- Discussing the cases with the attending, fellows, practitioners, consultants, talking with families, and with ancillary staff
- Working effectively with fellow, practitioners, intern, and medical students on the service
- Responding to questions from nursing staff, students, interns, residents, etc.
- Formulating a diagnostic and treatment plan
- Discharge/transfer planning
- Presenting and discussing care with fellow and attending physician
- Performing appropriate procedures under supervision
- Planning appropriate diagnostic tests in discussion with fellow and faculty attending
Cardiology Consults (IM4 903B-2)
Attendance: Students may not take time off on their start date and are required to attend check-in and system orientation with Visiting Student Affairs. See the attendance policy for details.
Location: CRMH
Available: August – June
Duration: 2 weeks, starting any Monday and ending Friday
Number of students per rotation: 1
Prerequisites
- Letter of Intent from IM Chair/Advisor validating applicant's intent to pursue residency in Cardiology or IM
Overview: The Cardiology Consult elective will give the medical student an introduction in rendering consultative advice on a wide variety of cardiovascular issues in a hospital setting. Typical patients will include pre-operative clearance for non-cardiac surgeries, post-operative complications including arrhythmias and hemodynamic instability, or patients with acute coronary syndromes, heart failure, or other cardiovascular issues admitted to non-cardiology services. The student will perform complete reviews of the patient’s electronic medical record, take an independent history, and perform a complete physical examination. From this information, the student will develop a differential diagnosis, plan the diagnostic studies including laboratory tests and imaging studies, and design the cardiovascular management plan for the patient. The student will be part of the rounding team that will include the attending, cardiology fellow, and often one or more medical residents. The student will review his/her management plan with the fellow and/or resident before presenting it to the attending. The preceptor is the attending on the inpatient service and the location is Carilion Roanoke Memorial Hospital.
The student will become progressively proficient and knowledgeable in the following:
- Taking a thorough history for cardiovascular diseases spanning a wide array of conditions from acute coronary syndrome to heart failure to hypertension to infectious endocarditis
- Performing a comprehensive physical examination for cardiovascular diseases
- Developing a differential diagnosis for chest pain and other cardiovascular conditions
- Performing a fundamental interpretation of the ECG especially to evaluate rhythm and ischemic changes
- Interpreting ancillary tests such as BNP, troponin, CK-MB
- Describing the appropriate use of stress imaging studies such as echocardiography and nuclear cardiology studies
- Listing the mechanism of action, dosing, adverse events and appropriate use of cardiovascular agents
- Determining the optimal use of stress testing for patients presenting with chest pain
Coronary Care (IM4 903K-2)
Attendance: Students may not take time off on their start date and are required to attend check-in and system orientation with Visiting Student Affairs. See the attendance policy for details.
Location: CRMH
Available: August – June
Duration: 2 weeks, starting any Monday and ending Friday
Number of students per rotation: 1
Prerequisites
- Letter of Intent from IM Chair/Advisor validating your intent to pursue residency in Cardiology or IM
Overview: The Coronary Care Unit (CCU) provides intensive care for a wide range of cardiovascular issues. The student will be exposed to unstable acute coronary syndromes, cardiogenic shock, decompensated heart failure, unstable rhythms, hypothermia protocol, and many other unstable cardiac conditions requiring intensive care. The elective occurs in the CCU of Carilion Roanoke Memorial Hospital, and the student will work with the CCU team to provide care for the patients in the unit. The student will participate in cardiac catheterizations and other procedures as warranted. The preceptor is the CCU faculty attending.