Elective Opportunities

Rationale

BSOM encourages students to gain exposure to a variety of medical specialties and to pursue individual interests. The Brody School of Medicine provides students with the opportunity to select courses that will enhance their medical education. The school makes available extensive resources that enable students to gain deeper insight into their field of choice, as well as to delve deeper into areas that may enhance their overall educational experience. Electives should both broaden and balance the overall professional development of each student, while allowing for career exploration and assuring that students are prepared for graduate medical education and residency training. BSOM offers each student flexibility in planning an individual program. This procedure communicates the requirements for elective courses and clerkships.

Scope

This procedure affects students, faculty members, and course directors of the Brody School of Medicine who offer and oversee electives and advise students.

Definitions

Elective: Any course/clerkship that is chosen by the student as opposed to being required. These courses are approved by the Clinical Curriculum Committee and Executive Curriculum Committee and described in the Course Catalog. These are further described as “clinical” or “non-clinical” in the course catalogue.

Individually Designed Elective: An educational experience/rotation that is not offered as a course by BSOM, another medical school, residency program or the military can be designed by the student (i.e. education, research, primary care, specialty, or international elective).

Away Rotation: An education experience taken at another institution. Away electives must be approved by the Assistant Dean for Student Affairs to ensure the site meets LCME requirements. Away electives may count as an Acting Internship if they meet the requirements defined to qualify as an Acting Internship.

Flex Time: Unstructured 2-week blocks. Intended to be used for step preparation, interviews, or exam remediation. May also be used for things like house hunting and other activities related to transitioning to residency.

LCME: Liaison Committee for Medical Education is the accrediting body medical education programs leading to the M.D. degree in the United States and Canada.

The Visiting Student Learning Opportunities (VSLO): The Visiting Student Learning Opportunities program is an AAMC application designed to streamline the application process for away electives. VSLO enables medical students to submit just one application for all institutions, reducing paperwork, miscommunication and time. Visit the VSLO site for more information.

Responsibilities

Office of Medical Education (OME)

Provides oversight, organization, and structure to the electives.

Office of Student Affairs

Assures fair and consistent implementation of the electives’ curriculum, including scheduling and collects all student grading and evaluation information.

The Executive Curriculum Committee and the Clinical Curriculum Committee

Review all submitted electives and approves implementation as appropriate. Review electives on a periodic basis to ensure quality of learning experiences.

Procedures for Implementation and Review

Elective courses are offered in clinical practice, education, research, the humanities, leadership, and career exploration. They broaden the student’s involvement in their medical education. Elective courses also provide each student with opportunities to strengthen areas of weakness, pursue subjects of special interest, explore career interests, and prepare for the next phase of education.

The goals of the Elective Program are tailored to the individual interests and needs of each student and may include:

• Facilitating the student’s increasing responsibility for self-determination in education and lifelong learning.
• Providing an opportunity for the student to augment previous experience in clinical, foundational and health delivery areas.
• Enabling the student to experience the practice of medicine in its various forms in a university and/or community setting and to be exposed to opportunities for careers in medicine.
• Allowing the student to gain deeper knowledge and experience in the care and treatment of ambulatory and acute problems.
• Providing the student with opportunities to acquire and use skills that will be helpful in his/her next phase of clinical training and beyond.
• Providing the student with opportunities to enhance medical knowledge in areas that may complement his/her career aspirations.
• Providing special experiences to meet the needs of students with specific goals, such as research experience, postgraduate or graduate education and/or special training outside the state or country.

Elective Courses

The elective catalog lists courses that are offered on a regular basis and provides the students with the information necessary to allow them to make choices that fit their schedule and their educational needs. Each elective has been carefully reviewed and approved by the Clinical Committee and Executive Curriculum Committee. The catalog is reviewed annually to make sure that information is up-to-date and accurate. Each elective course has a course number, title, description and learning objectives.

Elective Parameters and Duration

*M1 and M2 students independently select and explore clinical specialties as a component of the Foundations of Medicine courses.

** In addition to 26 weeks of general electives, students must complete electives in Intensive Care and an Acting Internship.

• Students have 4 weeks of elective time in the M3 year and 22 weeks in M4.
• Students must take a minimum of 14 weeks of clinical electives in the 4th year. The determination of whether an elective is clinical or non-clinical will be made by the curriculum committee.
• Non-clinical elective time in the M4 year is limited to 8 weeks, no more than 6 weeks of which may be in electives designated as “online” in the catalogue.
• Students may opt to schedule additional electives in excess of the limits outlined above instead of using flex time. This does not reduce the minimum number of clinical electives required.
• Distinction track students may be subject to requirements and restrictions beyond those outlined in this policy. Students should refer to their distinction track leadership for further details.

M3 Electives

Pre-requisites: None

Duration: 2 weeks per elective

Elective time: All students are provided 4 weeks of career exploration electives during the first 12 months of the clinical curriculum (M3 year).

• During the M3 year, students must complete two 2-week electives.
• These elective blocks follow the OB/GYN and Psychiatry clerkships.
• Students have the option of pursuing electives within any discipline they choose.
• While students are encouraged to choose electives in a clinical discipline, the M3 elective catalogue includes a range of elective opportunities. If a student has already firmly selected a career choice, they could elect to pursue some aspect of that discipline in depth or they could spend time in a more “systems” oriented experience designed to enhance their understanding of health economics, health care systems, evidence-based medicine, public health, preventive medicine or similar topics.
• Clinical research could also serve as the basis of an elective, but needs to be part of a broader context of research for the student. A letter from the research mentor is required for students selecting a research elective.
• Elective paperwork must be submitted to the Office of Student Affairs 8 weeks in advance of the elective. Students must contact the Office of Student Affairs if there are barriers to submitting paperwork within this timeframe. The following components are required:
  • Elective site and primary preceptor
  • Educational objectives for the experience
  • Paperwork submission, including signature of preceptor
• Students will not be allowed to do international rotations to fulfill the M3 elective requirements.
• The M3 electives will receive pass/fail grades in the official student transcript.
• If a student seeks an educational experience or rotation that is not offered as an official elective course by BSOM, another medical school or institution, or the military, an Individually Designed Elective (IDE) can be proposed by the student (i.e. education, research, primary care, specialty, or international elective). The student will be required to do the following:
  • Meet with an appropriate preceptor to design a course description that includes educational goals and objectives using the IDE form.
  • Submit the completed and signed IDE form to the Office of Student Affairs at least 60 calendar days prior to the start of the rotation.
  • The IDE form will be reviewed and approved by the Clinical Curriculum Committee to determine if it is an acceptable senior experience that will meet graduation requirements. No credit will be allowed for an IDE taken without the approval and documentation indicated above.

Advanced Electives (M4)

Pre-requisites: All core M3 clerkships must be completed prior to completing advanced electives in the M4 year

Duration: 2-4 weeks per elective

Offerings: The elective catalog includes all available advanced electives. If a student would like to complete an advanced elective which is not formally offered through the catalog, the student must submit an Individually Designed Elective (IDE) proposal to the Office of Student Affairs. These are approved by the Clinical Curriculum Committee.

Placement: The scheduling lottery is run once per academic year. The Optimizer is run in the second half of the third year. Students may add or drop advanced electives up to 30 calendar days before the start of the elective.

• The final year of medical school is designed to strengthen areas of weakness, explore, finalize specialty selection, enhance clinical insight, and develop skills to enhance professional growth and development.
• The senior year of medical school is designed to improve readiness for residency training through advanced learning experiences with increased clinical responsibility.
• Electives range in length from 2 to 4 weeks based on the course and some are longitudinal (i.e. the student receives 2 weeks of credit for a course they completed over an entire semester)
• Students may choose from a variety of non-clinical and research electives to explore individual interests.
• The grading scale is designated in the course catalog.
• In addition to 26 weeks of General Electives, students must complete 4 weeks of an ICU elective and 4 weeks of an Acting Internship during the M4 year.
  • General Electives (26 weeks): Elective courses are offered in clinical practice, education, research, the humanities, leadership, and career exploration that can be tailored to the student’s individual needs and interests. No more than 12 weeks can be completed in a single specialty unless permission is granted by the Clinical Curriculum Committee.
  • Intensive Care (4 weeks): Designed to expose students to critically ill patients and prepare them to recognize, evaluate, and manage patients requiring emergent care.
  • Acting Internship (4 weeks): A clinical experience completed at ECU or an LCME accredited institution and prepares students for the responsibility of an intern in their desired specialty. Away Acting Internships may be considered on a case-by-case basis if they meet all the criteria included in the definition.

Transition to Residency (3 weeks): All students will complete this mandatory experience in the same blocks. These blocks are not available for electives or flex time. This course further prepares students for their chosen specialties through a number of experiences, many of which occur in small groups based on specialty choice.

M4 Scheduling Guidelines

• No rotation may be taken more than once at the same site except for specifically designated 2-week rotations that can be converted to 4-week rotations.
• Students may list specifically designated 2-week rotations twice in the same month making a 4-week course. Check the catalog for specific courses that permit this. Some may require special permission to do so.
• Each specialty describes specialty specific recommendations for electives that are listed on the Student Affairs website.
• Students are limited to 16 weeks in any one specialty unless given special permission by the Clinical Curriculum Committee and Associate Dean for Student Affairs. ICU and Ambulatory Primary Care Electives are not counted in the specialty total.
• Students are limited to 16 weeks at other institutions (medical schools, residency programs, military) unless special permission is obtained from the Clinical Curriculum Committee and Associate Dean for Student Affairs.
• Students who are in poor academic standing may not do away rotations until the deficiency has been removed. Students may also be denied approval for away rotations due to code of conduct issues.
• Students may take a maximum of eight weeks of non-clinical electives of which six weeks may be online electives (the determination of whether an elective is clinical or nonclinical will be made by Curriculum Committee).
• If a student seeks an educational experience or rotation that is not offered as an official elective course by BSOM, another medical school or institution, or the military, an Individually Designed Elective (IDE) can be proposed by the student (i.e. education, research, primary care, specialty, or international elective). The student will be required to do the following:
  • Meet with an appropriate preceptor to design a course description that includes educational goals and objectives using the IDE form.
  • Submit the completed and signed IDE form to the Office of Student Affairs at least 8 weeks prior to the start of the rotation.
  • The IDE form will be reviewed and approved by the Clinical Curriculum Committee to determine if it is an acceptable senior experience that will meet graduation requirements. No credit will be allowed for an IDE taken without the approval and documentation indicated above.
• All schedules are reviewed by the Associate Dean for Student Affairs, who is additionally responsible for career advising, to ensure that each student’s schedule meets the requirements for graduation, is broad enough to prepare the student for generalist practice, and is appropriate preparation for matching into the student’s specialty choice.
• Some community Primary Care site may be subject to additional time requirements. Check with the Office of Student Affairs at least 60 days in advance of attempting to schedule these rotations.

Flex Time

• Students have a maximum of 8 weeks of flex time to be used in the M4 year.
• This is unscheduled time and is intended for studying and interviewing. It may also be used for house hunting and other necessary activities related to students’ next phase of medical training.
• This time does not count as educational time. As such, no more than 4 weeks may be used after January 1st of the M4 year.
• Students may elect to take more elective time in lieu of using flex time.
• To allow for more flexibility, and more appropriate use of elective time, students may opt to change from another course to flex time up until close of business the Friday before the elective begins with the following caveats:
  • The currently scheduled course is a local elective. This option is not available for mandatory experiences (ICU, AI, Neuro/PM&R, or EM)
  • There is no guarantee the original elective will be available later in the year and the student may need to choose a different experience on a first-come, first-served basis.
  • The student has enough flex time available to make the change.

Schedule for Review

This procedure is reviewed and approved by the Curriculum Committees, including the Executive Curriculum Committee, and the Clinical Curriculum Committee every three years.

The Elective Opportunities policy is posted to the OME website to allow learners and teaching faculty/Administration to reference at anytime.

Related Policies

None

Applicable Laws, Regulations & Standards

LCME 6.5 Elective Opportunities