Emergency Medicine Electives and Selectives

Attendance: For the AI in EM portion, students must attend check-in and system orientation with Visiting Student Affairs on their first day. EM schedule will be given by EM coordinator prior to start of rotation. For the WM portion, students will be given a schedule 2 weeks prior to rotation start. They are expected to attend all activities. Written permission should be obtained to miss any rotation activity.

Location: For WM portion - Roanoke, Virginia and surrounding areas. For EM portion - CRMH Emergency Department; some shifts may be at Carilion Clinic Franklin Memorial Hospital and/or Carilion Clinic New River Valley Hospital

Available: August 31 – September 25, 2026 or September 14 - Oct 9, 2026

Duration: 4 weeks

Number of students per rotation: 3

Prerequisites:            

• Previous EM rotations preferred but not required 
• USMLE preferred but not required 
• Upon acceptance, complete all requirements as directed by Visiting Student Affairs. 
• Letter of Intent from the Chair/Advisor is NOT required for this application. You can upload a blank page to the VSLO application. 
• Personal Statement is NOT required for this application.  You can upload a blank page to VSLO or briefly share your interest in Wilderness Medicine or EM or our residency program (limit to 1 paragraph).

Overview: This combines a two-week acting internship in Emergency Medicine and a two-week elective in Wilderness Medicine. This course is designed for students who are interested in pursuing a career in Emergency Medicine and have an interest in Wilderness Medicine. Students will be eligible for an eSLOE after completion of this course.

This unique elective combines the immersive clinical experience of an Emergency Medicine Acting Internship with specialized training in Wilderness Medicine. Visiting medical students will spend two intensive weeks working alongside VTC EM faculty and residents and also complete a two week WM elective.

Students will function at the level of an acting intern, with clinical responsibilities mirroring those of a first-year Emergency Medicine resident. They will perform patient assessments, present cases to attendings, formulate independent management plans, and manage a consistent patient load of 2–3 patients. Clinical training includes approximately 7-8 shifts, supplemented by high-fidelity simulation experiences, procedure labs at the Center for Simulation, Research, and Patient Safety, and participation in residency didactics.

In addition to clinical immersion, students will gain hands-on experience managing environmental emergencies and providing care in austere settings through wilderness medicine sessions. These sessions will cover the diagnosis and treatment of injuries and illnesses in resource-limited environments, personal survival skills, and field safety. Emphasis will be placed on how the principles of wilderness medicine can enhance patient care strategies both in the field and within the hospital.

Cost: $495, this includes two weeks of high-quality, hands-on education in wilderness medicine, select meals for day trips, final day cookout dinner, swift water rescue course and certification, technical rope course, discover scuba, and the opportunity to earn FAWM credits for the two day Wilderness Medicine Provider Course.

Objectives:

1. Demonstrate primary and secondary assessment skills in a wilderness environment.
2. Use improvisational techniques to treat common wilderness injuries including sprains, dislocations, soft tissue injuries, and environmental injuries.
3. Instruction in survival and pre-hospital patient assessment and evacuation.
4. Complete a swift water rescue course demonstrating ability with swimming in current and use of throw ropes.
5. Complete BRAM Wilderness Medicine Provider course and associated FAWM credits
6. Obtain comprehensive history and physical information efficiently and in a prioritized manner.
7. Initiating management for unstable patients.
8. Create treatment and management plans to prioritize evidence-based guidelines, patient comfort, and safety.
9. Order laboratory and imaging studies based on evidence-based guidelines, mindful of resource utilization.
10. Perform common emergency department (ED) procedures under the supervision of the attending physician.
11. Communicate effectively with other care team members, including nurses, technicians, and assistants.
12. Conduct adequate patient handoffs to consultants and fellow ED physicians.

Attendance: Students will be given a schedule 2 weeks prior to rotation start. They're expected to attend all activities. Written permission should be obtained to miss any rotation activity.

Location: Roanoke, Va.

Available: September 14-27, 2026 (only offered once a year)

Duration: 2 weeks

Number of students per rotation: 8

Prerequisites:             

• Upon acceptance, complete all requirements as directed by Visiting Student Affairs. 
• Letter of Intent from the Chair/Advisor is NOT required for this application. You can upload a blank page to the VSLO application. 
• Personal Statement is NOT required for this application.  You can upload a blank page to VSLO or briefly share your interest in Wilderness Medicine (limit to 1 paragraph).

Overview: The goal of this elective is for the student to experience and gain knowledge in the treatment of environmental emergencies. Upon completion of the elective, the student will have gained the knowledge and ability to care for patients with limited resources. They will experience first-hand through experiential sessions how to manage a variety of illnesses and injuries in the wilderness environment. They will learn the skills necessary for their own survival and personal safety in the wilderness. Students will also learn how the practices and principles of wilderness medicine can be applied to their interactions with patients within the hospital environment.

Cost: $495, this includes two weeks of high-quality, hands-on education in wilderness medicine, select meals for day trips, final day cookout dinner, swift water rescue course and certification, technical rope course, marine medicine, and the opportunity to earn FAWM credits for the two-day Wilderness Medicine Provider Course.

Objectives:

1. Demonstrate primary and secondary assessment skills in a wilderness environment.
2. Use improvisational techniques to treat common wilderness injuries including sprains, dislocations, soft tissue injuries, and environmental injuries.
3. Instruction in survival and pre-hospital patient assessment and evacuation.
4. Formal lectures of Wilderness Medicine principles and specific topics by leaders in the field.
5. Complete a swift water rescue course demonstrating ability with swimming in current and use of throw ropes.
6. Complete BRAM Wilderness Medicine Provider course and associated FAWM credits

Daily Schedule:

The daily schedule will vary and consist of didactics, days in the field and an overnight trip. Students will be expected to be prepared to be outdoors in various weather conditions.

Exam:

Wilderness Medicine Provider Course

Textbook: 

Auerbach Wilderness Medicine, 5th Edition. Mosby Elesevier, 2007.

WMS Practice Guidelines (Free, open source) 

Attendance: Students may not take time off on the start date and must attend check-in and system orientation with Visiting Student Affairs.  Students will contact designated EM representative at least 2 weeks prior to arrival to schedule EM orientation and arrange work schedule. Students may not take off any scheduled workdays.  See the attendance policy for other details.

Location: CRMH  

Available: July – December

Duration: 2 weeks, starting any Monday and ending Friday

Number of students per rotation: 1

Prerequisites: 

• Previous EM rotations preferred, but not required
• USMLE preferred, but not required
• Upon acceptance, complete all necessary requirements as directed by Visiting Student Affairs

Overview: The student will perform basic limited point of care ultrasound examinations on patients who are in the emergency department at Carilion Roanoke Memorial Hospital and will perform bedside ultrasounds under supervision and create a portfolio of studies and interesting cases that were performed.  From these studies, the student will develop an understanding of ultrasound physics, learn standard ED scan protocols, and learn to interpret positive and negative findings in real time. 

The student will become progressively proficient and knowledgeable in the following:

1. Describing the physics of ultrasonography
2. Performing the standard scan protocols for FAST and e-FAST studies
3. Performing real-time interpretation of FAST and e-FAST ultrasounds under direct supervision
4. Listing and defining standard cardiac views and perform limited echocardiography
5. Performing transabdominal assessment of intrauterine pregnancies
6. Describing sonographic anatomy of the liver, gallbladder, kidney, and aorta
7. Performing point-of-care limited sonograms for pathology of the liver, gallbladder, kidneys and aorta
8. Creating a portfolio of all studies performed during the rotation for review during the exit interview 

Attendance: Students may not take time off on the start date and must attend check-in and system orientation with Visiting Student Affairs. Students will contact designated EM representative at least 2 weeks prior to arrival to schedule EM orientation and arrange work schedule. Students may not take off any scheduled workdays. See the attendance policy for other details. 

Location: CRMH  

Available: July – December

Duration:  2 weeks, starting any Monday and ending Friday

Number of students per rotation: 1

Prerequisites: 

• Previous EM rotations preferred, but not required
• USMLE preferred, but not required
• Upon acceptance, complete all necessary requirements as directed by Visiting Student Affairs

Overview: This elective is an intensive clinical experience meant to introduce Medical Students to a diverse population of acutely ill and injured infants, children, and adolescents and consists of shifts in the Pediatric Emergency Department. The Medical Student will do the patient’s chart review, history taking, and physical examination. From this information the Medical Student will develop a differential diagnosis, plan the diagnostic evaluation, and design the acute management of the patient. The Medical Student will then observe and/or participate in the medical care and procedures that make up the patient’s management plan. Emphasis will be placed on age-appropriate exam techniques and treatment modalities for acutely ill and injured children.

The student will become progressively proficient and knowledgeable in the following:

1. Interpreting vital signs with respect to age-specific norms
2. Taking focused histories from children, adolescents, and family members
3. Prioritizing differential diagnoses based on the history, physical examination, baseline laboratory results, imaging studies and knowledge of classic pediatric illnesses and injuries
4. Listing the indications for use of laboratory and radiographic studies in pediatric patients
5. Accurately evaluating trauma in young patients
6. Demonstrating age-appropriate exam techniques
7. Participating in common pediatric procedures
8. Demonstrating improved presentation skills 

Attendance: Students may not take time off on the start date and must attend check-in and system orientation with Visiting Student Affairs. Students will contact designated EM representative at least 2 weeks prior to arrival to schedule EM orientation and arrange work schedule. Students may not take off any scheduled workdays. See the attendance policy for other details. 

Location: CRMH, Roanoke Valley EMS Services and/or Life Guard Helicopter Service

Available: July – December 

Duration: 2 weeks, starting any Monday and ending Friday

Number of students per rotation: 1

Prerequisites: 

• Previous EM rotations preferred, but not required
• USMLE preferred, but not required
• Upon acceptance, complete all necessary requirements as directed by Visiting Student Affairs

Summary of Elective Course:

The Elective will consist of didactics and observational ride-along shifts with EMS units in the Roanoke area.  The Medical Student will receive education in the principles of prehospital medicine, including capabilities, limitations, skill levels, and costs associated with prehospital transportation methods. Over the course of 2 weeks, the student will receive several hours of didactic education as well as participate in 8-10 shifts with EMS and fire units in the multiple locations. 

Goal:

To introduce Medical Students to the field of prehospital medicine so they can further understand the various levels of prehospital providers, transport methods, capabilities, limitations, and costs associated with prehospital transport.

Objectives:

1. Describe the various options available for prehospital medical care in terms of training, capabilities, and transportation methods
2. Discuss indications for various levels of prehospital care, including helicopter critical care.
3. Discuss how prehospital providers complement in-hospital care.
4. Understand medicolegal implications of prehospital care.
5. Describe limitations of prehospital care.
6. Observe call taking and dispatching of 911 EMS response vehicles and system management.
7. Observe prehospital providers during observational shifts.

Elective Curriculum/Schedule: (Based on a 2 week time slot)

Student will do eight 10-hour shifts with an EMS unit in the city of Roanoke Fire/EMS, Salem Fire/EMS, Botetourt Fire, Operational Medical Directors Vehicle and Life Guard Helicopter if they desire and meet the weight requirement.   They will also have the opportunity to observe in the 911 call center as well as med com to round out the experience.   During this shift, students will have observational status only. The shifts vary from 7a-5p, 8a-6p or 7:30a-7:30p (helicopter), there are no overnights. In addition, students will participate in any EMS unit training experiences that occur during the time of the elective block. 

Textbook: 

Krohmer and Brennan. “Principles of EMS Systems,” 3rd ed.