Surgery Electives and Selectives

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 more details.

Location: CRMH

Available: August – May

Duration: 4 weeks, starting any Monday and ending Friday

Number of students per rotation: 1

Prerequisites: 

• USMLE Step 1 Required
• Letter of Recommendation

Overview: The student will gain experience in the evaluation and management of acute general surgery problems on a busy surgical consult service. This elective allows for increased patient care responsibilities. Night shifts may be required.

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

1. Evaluating and managing acute general surgery problems on a busy surgical consult service
2. Managing post-operative care, including antibiotic coverage, fluid management, mobility issues and wound care in a patient who has returned from the OR
3. Assuming increased patient care responsibility
4. Demonstrating growing knowledge of and skill with surgical instruments

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 more details.

Location: CRMH and Carilion Clinic Cardiothoracic Surgery

Available: August – May

Duration: 2 weeks, starting any Monday listed above and ending Friday

Number of students per rotation: 1

Prerequisites: 

• USMLE Step 1 Required
• Letter of Intent from chair/advisor stating applicant’s interest in Surgery residency

Overview: Students become part of the surgical team caring for patients undergoing cardiac procedures in the OR and participate in evaluation and follow-up of cardiac surgical patients in inpatient and outpatient settings. Students will check with the night-time P.A. and review X-rays, labs and vitals in order to pre-round on their patients.

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

1. Differentiating between benign and congenital esophogeal and lung and cardiac conditions
2. Evaluating esophageal cancer pre-operatively and describing various surgical approaches
3. Developing differential diagnosis for mediastinal masses based on location and age
4. Evaluating pleural effusion and using a pleurevac
5. Differentiating between wedge, segment, lobectomy and pneumonectomy
6. Describing and applying appropriate techniques in resuscitation and endotracheal intubation and mechanical ventilation
7. Using arterial, central venous pressure, and pulmonary artery catheters for hemodynamic monitoring
8. Monitoring nutritional support including total parenteral nutrition
9. Interpreting blood gas and other monitoring data
10. Managing major postoperative problems such as bleeding and sepsis
11. Describing and recognizing organ system failure and shock

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 more details.

Location: CRMH and Carilion Clinic MOB 3 Riverside

Available: August – May

Duration:  2 weeks, starting any Monday and ending Friday

Number of students per rotation: 1

Prerequisites: 

• USMLE Step 1 Required
• Letter of Recommendation

Overview: The student will work with general surgeons with interest/expertise in colorectal surgery, managing a broad range of problems, including neoplasm, diverticulitis, inflammatory bowel disease and anorectal disorders. The student will gain experience in colorectal disease and management.

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

1. Discussing workups (labs, procedures such as imaging or colonoscopy), management (surgical vs. medical) and prognosis of colorectal and anal disease processes
2. Participating in rounds as well as in the office setting as applicable
3. Conducting pre-rounds to develop clinical and communication skills in patient care and interprofessionalism on the wards, in the operating room and during management (operating room, consults with other specialties such as oncology)
4. Determining appropriate surgical instrument to use
5. Demonstrating growing knowledge of and skill with surgical instruments
6. Practicing appropriate technique in office anoscopy
7. Assessing and differentiating the various causes of anal pain and anal bleeding

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 more details.

Location: CRMH, CRCH Wound Care Clinic and Carilion Clinic MOB 3 Riverside

Available: August – May

Duration: 2 or 4 weeks, starting any Monday and ending Friday

Number of students per rotation: 1

Prerequisites: 

• USMLE Step 1 scores required (Step 2 if available)
• Letter of Intent from Surgery chair/advisor validating applicant’s intent to pursue residency in Plastic Surgery

Overview: TThis Acting Internship provides senior medical students with immersive exposure to reconstructive surgical care across the lifespan in inpatient and outpatient settings. Students evaluate and manage a broad range of reconstructive conditions, including trauma, oncologic, congenital, and complex wound presentations. Students function as integral members of the plastic surgery team through participation in rounds, clinics, operative cases, and specialty conferences. Under supervision, students identify surgical indications, formulate diagnostic and management plans, write orders, apply the reconstructive ladder in clinical decision-making, and perform basic suturing and surgical assistance techniques while demonstrating applied anatomical knowledge. Each student develops and delivers an educational presentation on a reconstructive surgery topic in collaboration with residents and faculty. This elective is designed for students pursuing plastic surgery or seeking advanced preparation in clinical reasoning, operative readiness, and professional responsibilities prior to residency.

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

1. Model professional, ethical, and conscientious behavior in complex surgical setting, demonstrating accountability, integrity, and recognition of when to seek assistance or resources that support well-being and growth. 
2. Collect accurate and relevant histories and physical examinations, tailoring the approach to the patient, family, and system needs while incorporating preventative care recommendations when appropriate. 
3. Evaluate common reconstructive surgical problems across the lifespan and indications for reconstructive procedure across diverse anatomic regions, congenital conditions, and acute and chronic disorders, incorporating relevant surgical anatomy.  
4. Formulate evidence-based diagnostic and management plans for reconstructive scenarios by applying the reconstructive ladder and selecting the appropriate grafts, flaps, and implantable materials. 
5. Demonstrate procedural competence by performing basic suturing techniques and fulfilling technical and assistive roles during plastic surgery procedures, while adhering to sterile technique and patient safety principles. 
6. Practice communicating clinical reasoning and evidence-based recommendations through concise oral case presentations, topic-focused discussions, and accurate clinical documentation and order entry relevant to plastic and reconstructive surgery. 

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 more details.

Location: CRMH

Available: August – May

Duration: 4 weeks, starting any Monday and ending Friday

Number of students per rotation: 1

Prerequisites: 

• USMLE Step 1 Required
• Letter of Recommendation

Overview: Students will learn how to assess critically ill patients and participate in patient admission to and discharge from the ICU. Students will participate in daily rounds in the ICU and function as sub-interns presenting assigned patients on rounds, attending all lectures and conferences and reading required material. Students will also have the opportunity to do procedures under close supervision. Students may be required to spend time rotating on a night shift working with the ICU night float team.

Students will become progressively proficient and knowledgeable in the following:

1. Describing criteria for admission to and discharge from the ICU
2. Assessing critically ill patients
3. Discussing the basic physiology of shock and how to manage it using appropriate monitoring devices
4. Defining the common modes of ventilation and explaining how to manage ventilated patients
5. Determining the differential diagnosis of renal failure and the modes of renal replacement therapy
6. Describing indications for blood and blood products
7. Identifying and managing infections in ICU patients
8. Listing indications for enteral and parenteral nutrition
9. Analyzing ethical issues in the ICU, including advance directives, medical futility, and withholding and withdrawing therapy
10. Carrying out common procedures in the ICU

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 more details.

Location: CRMH and Carilion Clinic MOB 3 Riverside

Available: August – May

Duration: 4 weeks, starting any Monday and ending Friday

Number of students per rotation: 1

Prerequisites: 

• USMLE Step 1 Required
• Letter of Recommendation

Overview: Students will participate in the initial evaluation of trauma patients, including trauma alerts and consultations and management of post-trauma problems. Students will participate in the assessment and resuscitation of acutely injured patients in the emergency room; call (to be arranged); longitudinal management of selected patients through the emergency department, operating room and intensive care units, to recovery; observation of pre-hospital care by accompanying rescue squads on their calls; and selected readings in resuscitation, critical care and trauma management. Students will participate on the trauma service as student members of the trauma team responding to Trauma Alerts and Gold Alerts and will be introduced to the general pattern of trauma resuscitation for major trauma patients and ATLS procedures. Students will perform a minimum of two histories and physicals on trauma patients, present trauma patients on rounds providing information on clinical course and proposed treatment, and attend weekly patient management conferences, monthly Critical Care Conferences and monthly Gold Alert Conferences. Time for regular attendance at scheduled trauma conferences and individual preceptorial conferences is provided.

Students will become progressively proficient and knowledgeable in the following:

1. Describing basic fluid and electrolyte problems encountered during early days of intensive care
2. Performing initial rapid assessment and describing appropriate treatment for trauma patients
3. Performing minor procedures such as suturing, changing CVP catheter and arterial line, and other procedures as determined by the supervisor