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2024-2025 Catalog
School of Medicine: Fourth Year
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In contrast to the first three years of the medical school curriculum, during which students follow a fixed schedule, the M4 year provides considerable flexibility. Although the M4 curriculum contains some required elements, students have considerable latitude to design their educational programs to fit their individual needs and interests. The M4 year is intended to provide each student with a well-rounded educational experience, building on the knowledge and experiences of the first three years and preparing the student for postgraduate training.
Descriptions of electives appearing in this catalog were prepared by the faculty of the department offering the elective and by the Office of Medical Education. At present, the information in this book is accurate to the best of our knowledge. However, policies, procedures, and faculty listings may change from time to time. Any questions regarding descriptive material of a particular elective should be directed to the appropriate departmental elective course director.
Role of the Student
Each student should have identified a clinical faculty advisor. It is the responsibility of the student to contact the advisor to discuss possible career choices and other factors that might directly or indirectly affect the 4th year elective schedule. Each student is responsible for developing a 4th year schedule that is a well-rounded educational experience meeting all graduation and site compliance requirements. The student should be proactive in communicating in a timely and honest manner with the M4 coordinator and Office of Medical Education regarding scheduling of interviews and elective rotations.
Role of the Faculty Advisor
The advisor should play more than a passive or permissive role and should be able to supply perspective to developing the student’s educational program. In most instances the most satisfying programs result from a strong collaboration between student and advisor. The role of the advisor is dual, combining personal, supportive counseling with study and career guidance; helping the student to develop an overall plan for the entire elective year and assisting with interviewing skills and evaluating residency programs. The advisor should be available for periodic consultation and should take an active interest in the success of the elective program and the student’s performance.
Role of the Elective Course Director(s)
The student must negotiate with the intended directors to reach agreement on the extent of supervision and the resources required to achieve the objectives. If the directors cannot provide the resources or feel that the objectives for the elective are unable to be obtained due to time needed away from the rotation for interviews, the student must seek an alternative elective course. The Course Director is responsible for completing the final evaluation for the student. At the director’s discretion another faculty member can be assigned to this role.
Role of the Department Chairman
The Department Chairmen have an important role in ensuring that the resources - faculty, space, time and interest - are available for both intramural and extramural electives. The Elective Course Director must notify his/her department chairman prior to agreeing to supervise an elective to ensure that there is no infringement on the educational or other resources required for the core curriculum.
Role of the Associate Dean for Clinical Education
The Associate Dean for Clinical Education, in cooperation with the Vice Dean for Academic Affairs and the Medical Education Committee (MEC), oversees the operation of the electives program. The Associate Dean for Clinical Education will review and approve each student’s planned program, and may return an unsatisfactory program to the student for revision, or may prohibit a student from taking an extramural elective if it is felt to be inappropriate. When necessary, the Associate Dean of Clinical Education will seek the advice and counsel of the Vice Dean for Academic Affairs and the Medical Education Committee.
Role of the Director of Experiential Learning Education
The Director of Experiential Learning Education develops and maintains relationships with our clinical education partners to facilitate course offerings and student onboarding. The Director will work with sites and students to ensure appropriate course development and pre-rotation compliance activities have been completed, allowing students to earn credit for their elective experiences. Non-compliant students and activities will be escalated to the Associate Dean for Clinical Education for formal attention to deficiencies. The Director facilitates the course scheduling process and approves scheduling changes in coordination with the Associate Dean. All schedule changes require approval prior to the start of the course.
Role of the Career Advisor
The Career Advisor develops, maintains, and/or gives access to resources such as specialty sheets, residency databases and information on where students have completed extramural electives. The Career Advisor provides students professional development counseling including CV review, personal statement review, and specialty advisor selection.
Role of the Manager of Clinical Student Scheduling
The Clinical Student Scheduling Manager manages the student placement processes for M4 elective phase rotations. The Manager of Clinical Scheduling facilitates the application process for EVMS students applying to away electives through VSAS as well as the process of visiting students applying to EVMS electives. The Manager of Clinical Student Scheduling should be contacted with any questions about the application process and assistance needed with obtaining application requirements.
United Competency Objectives for the MD Degree
The civic and medical leaders who founded Eastern Virginia Medical School envisioned an institution that would champion improving the health of the region. Decades later the school celebrated its record of training physicians who are committed to knowledge and skill and doubly committed to the service of others.
Distinctive characteristics of the institution have evolved over its lifetime:
- Education is central to its mission, not peripheral to the research and clinical enterprises.
- Principles of humanism in medicine and the biophysical model of disease and health are emphasized, promoting the values of altruism and duty.
- An ethic of community service moves students beyond formalized educational settings.
- The learning atmosphere emphasizes cooperation among students, faculty, other health care professionals, local and international care providers and policy makers.
- Lifelong learning and the practice of evidence based medicine are accepted as professional responsibilities.
- The environment promotes collaboration, creativity, leadership and service.
Within the context of this institutional philosophy and culture, the faculty have articulated the following Unified Competency Objectives as the goals and objectives of the curriculum: unified competency objectives
Requirements for Promotion to M4
- All clerkships must be completed with a passing score prior to beginning the M4 year
- Family Medicine
- Internal Medicine
- Psychiatry
- Obstetrics & Gynecology
- Pediatrics
- Surgery
- Advanced Cardiac Life Support Course (ACLS)
- Compliance with EVMS health requirements
The M4 Year
The M4 year is designed to promote a well-rounded educational experience (NOT a preliminary internship). Use the M4 year as an opportunity to broaden your horizons, not to get an early start on specialty training.
- Includes 34 weeks of full-time, scheduled, supervised, and evaluated educational experiences.
- 26 weeks of electives (Minimum of 14 weeks MUST be clinical rotations)
- 8 weeks of required courses
- Community-Engaged Learning Capstone (4 weeks)
- Clinical Skills Capstone ( 2 weeks)
- Transition in Practice Series: Residency (2 weeks)
- 12 weeks of unscheduled time for professional development and personal use
- Includes 12 weeks of unscheduled time for professional development and personal use:
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Elective Rotations
Many of the electives in the catalog meet the requirements of multiple categories. Requirements can overlap to meet graduation requirement. Example: ERM400 meets the requirements of Acting Internship, Ambulatory and Critical Care. By taking that one 4-week course, all three requirements are met. The remaining 22 weeks of electives would not need to meet specific category requirements.
- 2-week or 4-week rotations can be used to satisfy the category requirement (AI, AMB, CC, Elective) AND the clerkship clinical makeup requirement.
- An M4 rotation MAY NOT be used to remediate a failed M3 clerkship.
- Students may not schedule electives in which they will be directly supervised or graded by preceptors with whom they have any clinical, personal, or familial relationship, including providing health services. See the Non-Involvement of Student Healthcare Providers in Education Policy in the MD Student Handbook.
- Students should plan “full-time” electives based on four-week sessions whenever possible. Some electives have two-week options which can be scheduled anytime during a four-week session in coordination with the course coordinator. Electives may not be planned for less than two weeks in duration. (NOTE: Two-week rotations should include AT LEAST 10 scheduled work days.)
- Other electives that meet the definition of the listed course categories may be submitted for approval to fulfill a requirement using the M4 Non-Catalog Course Request.
Away Electives
Your critical care, ambulatory and elective courses may be completed at sites other than EVMS-affiliated institutions; however, your Acting Internship and Clinical Clerkship Makeup Requirement must be completed at an EVMS-affiliated institution listed previously. In planning for these rotations, you should be aware of the following rules:
Students may do a maximum of 16 weeks of away electives (xxx999 courses)
Away rotations must be done at an LCME accredited U.S. Medical School or under the supervision of a physician holding a faculty appointment at an LCME accredited US Medical School.
If your desired rotation is described in the catalog of the host school, that description can be used to complete the EVMS Non-Catalog Course Request form. If the elective is not described in the host school’s catalog, students should follow the instructions for developing elective rotations below.
The majority of U.S. medical schools now require that applications from visiting students be submitted through the Visiting Student Learning Opportunities service (VSLO) managed by the Associate of American Medical Schools (AAMC). Information is available from the Manager of Clinical Student Scheduling (Jill Haught) or directly from the AAMC. Some medical schools use their own individual applications. Information for each school can be obtained from the school’s website.
Most schools accept applications from visiting students in the spring, but may not confirm your acceptance until late spring or early summer. Most schools, including EVMS, make every effort to accommodate their own students before accepting visiting students. Once you accept an away elective, please submit the EVMS Non-Catalog Course Request for review and approval.
Creating Your Own Away Elective
Identify the site. All non-VSLO away electives require an affiliation agreement between EVMS and the site. Obtaining agreements can be a lengthy process spanning several months. Please plan accordingly and have a back-up plan should the legal teams of EVMS and the proposed site not be able to agree on the terms of the agreement. VSLO electives do not require an affiliation agreement unless the school you are applying to requests one be executed.
Consult with your advisor, the appropriate department chair, Associate Dean of Clinical Education, or the Vice Dean for Academic Affairs regarding your goals and objectives.
- Complete a Non-Catalog Course Request Form describing the skills, knowledge or values/attitudes the student wishes to achieve. Use the following links to help you write objectives: New Bloom’s Taxonomy and Learning Objectives Easy Generator.
- Review the objectives with the proposed course director, who must be a board certified physician or other comparably credentialed individual and must hold a faculty appointment with EVMS or another LCME accredited institution.
- Complete a Non-Catalog Course Request by selecting a 998/999 course code in the M4 catalog. You will need to upload a document describing the skills, knowledge or values/attitudes the student wishes to achieve along with documentation of your acceptance. Once submitted the proposed elective will be routed for review. The affiliation agreement and faculty status will be verified during the review process.
- This process should be completed more than 30 days prior to the start of the elective.
- An email notification of final approval must be received prior to participating in any non-catalog elective at EVMS or any other LCME accredited school. If you do not receive an approval for your elective, you may not receive credit for the experience and your graduation date could be affected.
Please note that submission of the Non-Catalog course request is not an automatic approval for you to receive credit for the experience. It is one step in a multi-step review and approval process.
Schedule Submission and Approval
In reviewing a student’s proposed program, the Associate Dean of Clinical Education, Vice Dean for Academic Affairs, and the Medical Education Committee will use the following guidelines:
- The program shall be well conceived and consistent with respect to fulfillment of the educational needs of the student.
- The program shall be commensurate with the capabilities of the student.
- The educational opportunities selected shall be of a quality sufficient to justify the expenditure of time requested.
- The required rotations listed must be included in each student’s planned program.
Schedule Changes
- Drop requests must be submitted no less than 30 days in advance of the scheduled rotation start date unless there are extenuating circumstances approved by the Associate Dean for Clinical Education. Last minute drops are unprofessional as the preceptors may have made adjustments to their schedule to have you rotate with them. Last minute drops have also prevented another student from completing that elective.
- Courses dropped after the course has begun will receive an “I” for incomplete. The course will either need to be completed at a later date or the student will receive a “W” for withdrawn.
- Add requests other than Sentara must be submitted at least 45 days in advance of the course start date. This allows time for the multi-step review and approval process as well as the student onboarding processes at our affiliated sites (which require their process to be COMPLETED 30 days in advance of your placement). Exceptions are made for short notice VSLO acceptances with minimal compliance requirements.
- Do not begin an elective that has not been added to your official schedule. Credit for rotations will not be given to students who fail to follow the proper procedures for changing an elective.
- Requested changes are reviewed and approved or disapproved based on the:
- balance of the student’s schedule and requirements
- faculty status of the preceptor
- status of the affiliation agreement with the site
- appropriateness of the course category to the course request
- approval from the course coordinator/course director
- If the request is approved, the student may then proceed to change the rotation. The student must forward confirmation that the elective supervisors for both the elective being dropped and the rotation being added have been notified.
No changes to schedules will be allowed after December 2, 2023.
Grading System
The requirements for Honors, High Pass, and Pass are based on departmental policy that will be discussed with the students at the initiation of the clerkship or elective. Honors, High Pass, Pass, or Fail are the only notations sent to the Registrar’s Office and appearing on transcripts.
Implications of the Grade Fail: In the event a student fails a clerkship/elective, the Course Director shall recommend both to the student and the Student Progress Committee, an appropriate remedial program. The remedial program may include taking an examination and/or repeating all or a portion of the clerkship. The recommendation is reviewed by the Student Progress Committee, which makes the final decision regarding the student’s academic progress. The Student Progress Committee uses guidelines outlined in the Policies and Procedures for Student Evaluation and Progress regarding promotion of students through the education program at the medical school. At the completion of the approved remedial activity, the student will be given a grade of pass or fail. Both grades (e.g., F/P) remain part of the student’s record and transcript.
Some departments allow students who fail the written examination but have passed other portions of the clerkship to remediate the examination before receiving a final grade for the clerkship. Remediation must occur within 2 months or a grade of “Fail” will be assigned.
Clinical Education Site Compliance
All fourth year EVMS students will be required to complete pre-rotation compliance requirements for EVMS and Sentara facilities before April 15, 2023. Students will be communicated with via Blackboard to facilitate completion. For electives taking place at facilities other than Sentara, students are required to complete all site-specific requirements a minimum of 45 days prior to the start of the elective. An email announcement will be sent out through Blackboard when the compliance requirements are available for completion.
Any student who has not completed the required compliance activities will be prohibited from starting their elective year and will be required to formally address the dereliction. This delay may impact your ability to complete the scheduled electives and may impact your ability to graduate on time.
Visiting Students
All visiting students must apply online through the AAMC Visiting Student Learning Opportunities. If a student contacts a department, the student must be referred to the Manager of Clinical Student Scheduling in the Experiential Learning Office. Confirmation for Electives is granted through VSLO by the Experiential Learning Office. Only persons currently enrolled in an LCME accredited U.S. medical school or COCA accredited U.S. osteopathic schools, are eligible to apply for electives at EVMS. At this time, EVMS does not accept applications from international medical students.
Visiting students may take only senior year electives. Third year clerkships are not open to any visiting students. A visiting student must have satisfactorily completed all basic science courses (including physical diagnosis) and, by the start date of the requested elective, the applicant must have completed satisfactorily a minimum of thirty-six (36) weeks of full-time clinical experience during which the student’s primary responsibility was to follow patients on a teaching service. This experience must include at least four (4) separate disciplines from among the following: Family Medicine; General Internal Medicine; Obstetrics and Gynecology; Pediatrics; Psychiatry; and General Surgery. Experience in each discipline must be at least four (4) weeks in duration. No elective will be approved for a discipline in which the requisite core clinical experience has not been satisfactorily completed.
A complete elective application in VSLO must be submitted for each elective requested and verified by the visiting student’s medical school official, authorizing these experiences. Applications must be submitted no later than 45 days prior to the beginning of an elective in order to be considered. Only completed application packets will be reviewed.
All elective requests must receive departmental approval before an offer can be extended. This is completed internally, once we have we have verified that your application meets the eligibility requirements. Any communication outside of VSLO is not considered an official request for an elective or confirmed placement in an elective. After a decision has been made, the Visiting Student Coordinator will notify applicants in VSLO of their acceptance or denial. Within 10 days from the date your acceptance notification is sent, you must accept or decline the offer in VSLO. Within 3-5 days of your acceptance, you will receive a welcome letter via email from the Visiting Students Coordinator. This email will provide further instructions regarding completing the post-decision requirements in VSLO before your rotation begins.
EVMS students have priority for all EVMS elective opportunities.
Visiting students are limited to a maximum of twelve weeks of electives at EVMS, except under special circumstances. (Requires approval from the Vice Dean for Academic Affairs)
A non-refundable fee of $200.00 must be submitted at least 30 days PRIOR to the start of the rotation. Each visiting student must attend a brief administrative orientation with the Visiting Student Coordinator prior to beginning the elective. A student identification card will be issued by Eastern Virginia Medical School, following orientation.
Each student is responsible for obtaining accommodations during his/her stay here.
No stipend will be paid by EVMS to visiting students taking electives for credit.
EVMS will provide evaluations to the sponsoring institutions, but credit for elective experiences will be given by the institution granting the M.D. degree to the student.
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