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M4 Coursework Information This guide is intended to assist students in selecting and scheduling courses based upon their specialty of interest. Contents ANESTHESIOLOGY... 1 DERMATOLOGY... 2 EMERGENCY MEDICINE... 3 FAMILY AND COMMUNITY MEDICINE... 4 MEDICINE... 5 NEUROLOGY... 6 NEUROSURGERY... 7 OBSTETRICS/GYNECOLOGY... 8 OPHTHALMOLOGY... 9 ORTHOPAEDIC SURGERY... 10 OTOLARYNGOLOGY AND COMMUNICATION SCIENCES... 11 PATHOLOGY... 12 PEDIATRICS... 13 PHYSICAL MEDICINE AND REHABILITATION... 14 PLASTIC SURGERY... 15 PSYCHIATRY AND BEHAVIORAL MEDICINE... 16 RADIATION ONCOLOGY... 17 RADIOLOGY... 18 SURGERY... 19 UROLOGY... 20

ANESTHESIOLOGY I. Recommended courses: Cardiology Pulmonary Medicine Critical Care Medicine (Intensive Care) General Medicine Emergency Otolaryngology Anesthesiology: Pain Management Anesthesiology: Anesthesia for Trauma and Emergencies Anesthesiology Acting Internship Clinical Anesthesiology General Anesthesia Anesthesiology Pediatric Pain Management/Pediatric Anesthesiology Obstetric Anesthesia Advanced Anesthesia Research-Cardiovascular and Respiratory Regulation High Risk Anesthesia Consultation 1

DERMATOLOGY I. Recommended courses: Dermatology Rheumatology Allergy/Immunology Infectious Diseases Oncology Pathology Plastic Surgery Away rotation in dermatology 2

EMERGENCY MEDICINE I. Recommended courses: Away elective in EM Trauma surgery (if not already completed) Critical Care Medicine/Surgery Pediatric EM Cardiology Orthopedics/Sports Medicine Radiology Ophthalmology EM rotation at a site that houses a residency program An additional away elective in EM at another institution o A Pediatric EM (PEM) rotation should not supercede an additional rotation in EM, due to the variability in the needed standard letter of recommendation in PEM. For those not planning an away rotation, a PEM elective is recommended. I Additional information: If spots are filled early in the year, students may have to add themselves to a waiting list. Students on the waiting list are encouraged to contact the course coordinator to discuss options and strategy, which will include remaining on the list but also pursuing an away rotation to obtain the necessary letter of recommendation. 3

FAMILY AND COMMUNITY MEDICINE I. Recommended Courses One or more M4 course experience in Family Medicine. Options include: - Courses at our three MCW Department of Family and Community Medicine (DFCM) affiliated Family Medicine residence programs. - Courses on campus with MCW DFCM faculty - Away electives in family medicine (residency /community-based) Courses in broad content areas pertinent to scope of Family Medicine (2 or 3 months) - Medical experiences (mostly office-based): Adult and Pediatric Emergency Medicine electives, Dermatology, Cardiology, Physical Medicine and Rehabilitation, Sports Medicine, Radiology, Adolescent Medicine, and Infectious Diseases. - Surgical experience (office-based or hospital-based): Ophthalmology, Orthopaedics, Urology, Otolaryngology. - Women s health experiences: Inpatient OB/GYN and/or office-based GYN Courses in areas of special interest to you, e.g. International Health. I At least one letter of recommendation should be from a family physician. Additional clinical letters from other specialties are welcomed (and typical). Suggestions for obtaining letters of recommendation from family medicine: o Family Medicine M3 Clerkship o Acting Internships in Family Medicine o M4 Ambulatory Clerkship o Family Medicine Residency Electives o Rural Ambulatory Medicine Elective o Away Clinical Elective in family medicine All courses through DFCM will provide students with one-on-one faculty experience that will facilitate a letter; however, courses with significant clinical faculty interactions that may best facilitate letters of recommendation (see above). Elective or core rotations during July, August, and September of your M4 year are the best timing in the M4 year to obtain letters of recommendation. Please contact us if you have any questions. We can get you connected! Doug Bower, MD, Director of Med. Student Education, DFCM (dbower@mcw.edu) or Stephanie Shaw, MSM, MBA, Manager of Med. Student Education, DFCM (sshaw@mcw.edu) 4

MEDICINE Ambulatory Internal Medicine Medicine Acting Internship Second Acting Internship in one of the medical subspecialty options (MICU, Cardiology, BMT, Hospital Medicine, or Geriatric Medicine), on a surgical subspecialty (e.g. Transplant Surgery), or significant intensive care unit experience (e.g. Cardiothoracic Surgery). Combination of one or two electives within a subspecialty division of Internal Medicine (Hospital Medicine, Cardiology, Infectious Diseases, Geriatrics, Nephrology, Endocrinology, Gastroenterology, Hematology/Oncology, Pulmonary, MICU, etc) as well as 2 or 3 electives sponsored by other departments that might include: - Dermatology - Emergency Medicine - Adult Neurology - Diagnostic Radiology - Psychiatry - Orthopaedics (esp. office-based or sports medicine) - Synecology (esp. office-based) - Surgical subspecialty rotations (ENT, ophthalmology, urology) - Physical medicine and rehabilitation Electives that allow students to pursue particular interests (research, medical humanities, teaching, advanced physical exam, international health) I Other early course suggestions for obtaining letters of recommendation (completed by July or August if possible): Medicine Acting Internship Ambulatory Internal Medicine Second Medicine-based Acting Internship All students are strongly encouraged to meet with a Department of Medicine faculty member for individual counseling and advice during the M3 year. Contact the M3 Clerkship Coordinator or M4 Coordinator to make an appointment. You will also need to schedule a meeting with the Chair to discuss the Department of Medicine Chair Letter which is required by most IM residency programs. 5

NEUROLOGY Medical subspecialties (esp. cardiology, renal medicine, rheumatology, pulmonary medicine, intensive care or infectious diseases) Pediatric subspecialties (esp. cardiology, child development or neonatal medicine) Neuro-radiology Rehabilitation Medicine Liaison Psychiatry Neurology I Exposure to neurosurgery, neuroradiology, and medical subspecialties such as cardiology and infectious diseases Successful completion of the required clerkship is prerequisite for an elective in Neurology All students interested in a career in Neurology should contact Jennifer Her, Coordinator. 6

NEUROSURGERY Internal Medicine Neurology Interventional Neuroradiology Cardiology Endocrinology Neurocritical Care Trauma Neurosurgery The letters of recommendations would come from the recommended courses. 7

OBSTETRICS/GYNECOLOGY Ambulatory Internal Medicine or Family Medicine Internal Medicine Acting Internship ICE (Medicine or Surgery) Emergency Medicine I Other early course suggestions for obtaining relevant experience and/or letters of recommendation: Adolescent Medicine (Department of Pediatrics) Advance Clinical Human Anatomy Anesthesiology (esp. Obstetric) Cardiology Consult Psychiatry Dermatology Female Urology Genetics Infectious Diseases Master Clinician: Adv. Skills for Residency and Beyond Medical Consults Medical Endocrinology Multi-disciplinary Management of Breast Disease Neonatology Nephrology Radiology Surgical Pathology Away elective in Obstetrics and Gynecology A broad schedule with a variety of courses in different disciplines is recommended Students should not take more than one course in obstetrics/gynecology except in special circumstances and after consultation with the Chair. 8

OPHTHALMOLOGY Multidisciplinary Applications such as infectious diseases, radiology, allergy/immunology Conditions that Overlap with Ophthalmic disease such as otorhinolaryngology, dermatology, endocrinology, rheumatology, and neurology. I Broad-based medical experiences Clinical and research subspecialty areas of ophthalmology Students should contact their advisor as early as possible for a curriculum planning discussion as ophthalmology residencies participate in a separate match program with an earlier application deadline than the National Residency Match Program. Interested students should seek electives during the months of July through October as interviews for ophthalmology residency programs are usually held in November and December. Contact the Ophthalmology Department Coordinator for additional information. 9

ORTHOPAEDIC SURGERY Orthopaedic Surgery (2 months) Intensive Care Unit or Emergency Medicine (1 month) Anesthesiology, Plastic Surgery, or Radiology (1 month) I Sub-Internships and electives at Froedtert East Clinic and Children s Hospital of Wisconsin Integrated elective courses The Sub-Internship and 4-week elective at Froedtert from August through mid-october are used as MCW students interview for the Match to our Orthopaedic Surgery Residency Program. 10

OTOLARYNGOLOGY AND COMMUNICATION SCIENCES Adult and Pediatric Sleep Medicine Anesthesiology Emergency Medicine Critical Care Medicine Neurology Neurosurgery Plastic Surgery Pulmonary Medicine Pediatrics Vascular Surgery Any students who are interested in Otolaryngology should contact Dr. Jonathan Bock (jbock@mcw.edu) to discuss their strategy/plan for scheduling coursework. I General Surgery Away Otolaryngology rotation (please contact Dr. Bock to discuss this further). 11

PATHOLOGY Pathology Rotation at MCW (Anatomic Pathology, Clinical Pathology/Hematopathology, Blood Bank-Transfusion Medicine, Forensic Pathology, Advanced Anatomic Pathology) Away Rotation in Pathology I Away Rotation in Pathology Medical Hematology/Oncology, Radiation Oncology, Orthopaedic Oncology or Gynecologic Oncology Subspecialty surgical services: thoracic, colorectal, ear/nose/throat or transplant Gynecology (non-oncologic) Gastroenterology/Hepatology Urology Dermatology General Surgery (beyond basic requirements) Additional training in General Medicine Our department welcomes students with a strong interest in Pathology to secure a faculty mentor or research advisor within the department. 12

PEDIATRICS Allergy Anesthesiology Radiology Dermatology Orthopaedics ENT Neurology Neonatology Acting-Internship Pediatric Acting-Internship I In addition, consider that you will need to make the decision to specialize or go into primary care very early in your residency program, typically by the end of your 2nd year of training. Considering that most residency programs offer only 1 or possibly 2 electives during your intern year, you will want to use your fourth year to do various specialty electives for career exploration, if that is something you are considering. If a student is not yet certain he/she wishes to go into Pediatrics, it is recommended that the student take an elective in a community pediatric practice, an acting internship or a pediatric subspecialty elective early in the senior year. We suggest taking an elective at that program (e.g. a subspecialty elective or acting internship). This elective should ideally occur before November or December. This might include a research elective or an elective in another country. Third world experiences are particularly valuable. 13

PHYSICAL MEDICINE AND REHABILITATION Neurology Geriatrics Orthopaedic Surgery/Sports Medicine Medicine Sub-Internship Neurosurgery Urology Rheumatology Palliative Medicine Cardiology Plastic Surgery Vascular Surgery Radiology I Physical Medicine & Rehabilitation It would be well-advised to discuss the specifics of their elective schedule with a member of the Department of PM&R so that the goals of the individual can be well served by the elective. Our department welcomes students with a strong interest in PM&R to secure a faculty mentor or research advisor within the department. Interviews for PM&R residency applicants commonly occur November through January. If you are interested in applying to a PM&R residency program, there may be value in choosing an elective early, allowing time to procure a letter of recommendation. 14

PLASTIC SURGERY Plastic Surgery Sub-Internship General Surgery Sub-Internship Emergency Medicine Dermatology Infectious Diseases Radiology Orthopaedic Surgery Anesthesiology Surgical ICU Pediatric Surgery Otolaryngology I Take the Plastic/Hand Surgery elective or Craniofacial & Pediatric Plastic Surgery Integrated Elective early in the year if you are unable to schedule a Plastic Surgery Sub-Internship 15

PSYCHIATRY AND BEHAVIORAL MEDICINE Consultation/liaison psychiatry at Froedtert Memorial Lutheran Hospital Inpatient child and adolescent psychiatry at Milwaukee County Behavioral Health Division (MCBHD) Emergency psychiatry at Psychiatric Crisis Service (MCBHD) Outpatient and consultation in child and adolescent psychiatry at Children s Hospital of Wisconsin Acting Internship at the Clement J. Zablocki Veteran s Administration Medical Center I Please feel free to contact us with any questions. Marika Wrzosek, M.D. Assistant Professor, Medical Student Education Department of Psychiatry and Behavioral Medicine 414 955-8992 mwrzosek@mcw.edu Kristine James Education Program Coordinator Department of Psychiatry and Behavioral Medicine 414 955-8992 kkjames@mcw.edu 16

RADIATION ONCOLOGY General Medical (including Medical Oncology) Surgery (particularly surgical subspecialties such as Surgical Oncology, Otolaryngology, Urology and possibly Neurosurgery or Thoracic Surgery) Radiology (including Nuclear Medicine) Gynecology (particularly Gynecologic Oncology) Pathology Pediatric Oncology I Radiation oncologists Research in the field of radiation oncology is also extremely important in order to be a competitive applicant. The vast majority of applicants for radiation oncology do a rotation outside their own institution. Given the competitive nature of the specialty, this is essential to improve chances of matching. Most students do this early in their senior year so that they can get letters of recommendation. 17

RADIOLOGY Gastroenterology Medical oncology Neurology Neurosurgery Orthopaedic surgery Otolaryngology Pathology Pulmonary medicine Radiation oncology Surgical oncology Urology Vascular surgery Interventional Radiology Pediatric Radiology I 18

SURGERY Acute Care Surgery Trauma & Critical Care Transplant Surgery Cardiothoracic Surgery Vascular Surgery Pediatric Surgery General Surgery Pediatric Surgical Intensive Care Multi-Disciplinary Management of Vascular Disease Multi-Disciplinary Management of Breast Disease Multi-Disciplinary Management of Inflammatory Bowel Disease Multi-Disciplinary Management of Morbid Obesity I Senior students interested in a career in surgery should complete a surgical acting internship early in the 4th year, preferably before October. This will allow students to gain relevant experience and have the opportunity to obtain letters of recommendation. It is also highly recommended that students gain experience in the management of patients in the ICU by taking an acting internship or elective on a critical care service. Other valuable rotations for a surgical career include: Radiology, Anatomic Pathology, and Cardiology. Other valuable rotations to consider are: Anesthesiology, Radiology, Critical Care, Emergency Medicine and Surgical Pathology. 19

UROLOGY MCW Urology Sub-Internship Away Urology Sub-Internship Radiology Surgical ICU or surgery rotation Nephrology Anesthesiology Internal medicine Emergency medicine I 20