Emergency Medicine Electives and Selectives
Acting Internship – Emergency Medicine (EM4 901E-4)
Attendance: Students must attend check-in and system orientation with Visiting Student Affairs on their first day. They must contact the designated EM representative at least two weeks before arrival to schedule EM orientation and arrange a work schedule. Students may not take off any scheduled workdays. See the attendance policy for other details.
Location: CRMH Emergency Department; some shifts may be at Carilion Clinic Franklin Memorial Hospital and/or Carilion Clinic New River Valley Hospital
Available: July – December
- We will consider applications for all dates, but the preferred start dates for 2025 are 7/7, 8/4, 9/1 and 9/29.
Duration: 4 weeks, starting any Monday and ending Friday
Number of students per rotation: 6
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 the VSLO application.
Overview: The Acting Internship (AI) is an intensive 4-week experience in the Emergency Department of Carilion Clinic Roanoke Memorial Hospital. Students will work a schedule similar to that of a first-year Emergency Medicine resident, maintaining comparable clinical expectations.
Students will be responsible for patient assessments and presenting their findings to attending physicians. They will also develop independent management plans, enhancing their skills in rapid assessment and initial management of Emergency Department patients. Students will learn how to appropriately disposition Emergency Department patients and are expected to manage a patient load of 2 – 3 at any given time.
In addition to approximately 14 – 16 shifts, students will participate in simulation experiences and procedure labs at our state-of-the-art Center for Simulation, Research and Patient Safety. Students will additionally participate in weekly residency didactics when not working a clinical shift.
All visiting students accepted for the Acting Internship in EM will be eligible for a $500 housing stipend.
The student will become progressively proficient and knowledgeable in the following:
- Obtain comprehensive history and physical information efficiently and in a prioritized manner
- Identify situations where management may take precedence over gathering historical data
- Initiating management for unstable patients
- Developing presentation skills that are concise and efficient
- Create treatment and management plans to prioritize evidence-based guidelines, patient comfort, and safety
- Order laboratory and imaging studies based on evidence-based guidelines, being mindful of resource utilization
- Interpreting ordered studies accurately
- Perform emergency department (ED) procedures under the supervision of the attending physician
- Communicate effectively with other care team members, including nurses, technicians, and assistants
- Conduct adequate patient handoffs to consultants and fellow ED physicians
- Appropriately determining the disposition of ED patients
Emergency Ultrasound (EM4 901B-2)
Attendance: Students may not take time off on the start date but 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: August – June
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:
- Describing the physics of ultrasonography
- Performing the standard scan protocols for FAST and e-FAST studies
- Performing real-time interpretation of FAST and e-FAST ultrasounds under direct supervision
- Listing and defining standard cardiac views and perform limited echocardiography
- Performing transabdominal assessment of intrauterine pregnancies
- Describing sonographic anatomy of the liver, gallbladder, kidney, and aorta
- Performing point-of-care limited sonograms for pathology of the liver, gallbladder, kidneys and aorta
- Creating a portfolio of all studies performed during the rotation for review during the exit interview
Pediatric Emergency Medicine (EM4 901D-4)
Attendance: Students may not take time off on the start date but 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: August – June
Duration: 4 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
Wilderness Medicine (MED 901F-2)
Attendance: 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: Roanoke, Va.
Available: September 14-27, 2025 (only offered once a year)
Duration: 2 weeks
Number of students per rotation: 10
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, discover scuba, and the opportunity to earn FAWM credits for the two day Wilderness Medicine 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 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 Course
Textbook:
Auerbach Wilderness Medicine, 5th Edition. Mosby Elesevier, 2007.
WMS Practice Guidelines (Free, open source)
Pre-Hospital Medicine/EMS (MED 901C-2)
Attendance: Students may not take time off on the start date but 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
Available: August – June
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 clinicians, transport methods, capabilities, limitations and costs associated with prehospital transport.
Objectives:
- Describe the various options available for prehospital medical care in terms of training, capabilities and transportation methods
- Discuss indications for various levels of prehospital care, including helicopter critical care
- Discuss how prehospital clinicians complement in-hospital care
- Understand medicolegal implications of prehospital care
- Describe limitations of prehospital care
- Observe call taking and dispatching of 911 EMS response vehicles and system management
- Observe prehospital clinicians during observational shifts
Elective Curriculum/Schedule: (Based on a 2 week time slot)
Student will do 8 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 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 7 a.m. – 5 p.m., 8 a.m. – 6 p.m. or 7:30a.m. – 7:30 p.m. (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.
