Fourth-Year Electives

This is an elective for students considering residency in Family Medicine.

Course Director: Florence Laforest (Flafores@bu.edu)
Course Instructor: Sara Tepperberg, MD MPH
Number of Student: One or Two 4th year medical student(s)
Period: Blocks as available
Locations: Two of three possible out-patient sites: Codman Square Health Center, South Boston Community Health Center, East Boston Neighborhood Health Center

OBJECTIVE:  To gain exposure and experience full-spectrum ambulatory family medicine in an academic community health center setting

GOALS

• Understanding the role of the family physician in underserved urban communities
• Exposure to Family medicine residency training environment
• To improve history taking and physical examination skills
• Development of a focused differential diagnosis based on patient interview and examination
• Determining if and what further testing modalities are needed based on the differential diagnosis

 FACULTY

Sara Tepperberg, MD MPH
Heather Miselis, MD MPH
Rachel Mott-Keis, MD

ADDITIONAL FACULTY  

Students will work with a variety of Family Medicine faculty and residents at each site

CURRICULUM

Students who are entering the field of family medicine are the target for this elective. Students will see ambulatory patients at one or two of the affiliated residency sites, including South Boston Community Health Center, East Boston Neighborhood Health Center and Codman Square Health Center. The student will work with a variety of Family Medicine residents and preceptors, and as such will not likely have opportunity for significant summative assessments and advanced accolades from faculty. With appropriate supervision, students will be expected to have first contact with patients and to do the initial work-up. Students will advance their skills in the diagnosis of the undifferentiated patient, and the assessment and management of acute and chronic problems which commonly present in family medicine. Instruction in patient education and preventive medicine in the family context will be emphasized. Students will participate in staff conferences and may attend rounds, conferences and lectures that are part of the BMC Family Medicine Residency Program.

This elective is also available through the Boston Medical Center Minority Recruitment Program.

EVALUATION

The student will be evaluated by the same BU SOM assessment tool that is used for BU Family medicine clerks or by the Elective evaluation supplied by their sponsoring institution.

For information on how to apply, please contact Chenille Hogan at chenille@bu.edu.

Title: Maternal/Child Health – Boston Medical Center (032.1H)
Instructor: Sarah Hale, MD- Sarah.Hale@bmc.org 
Course Administrator: Chenille Hogan- Chenille@bu.edu
Location: Boston Medical Center, Boston, MA
Number of Students Per Block: One
Period to be offered: Selective Blocks, Please Inquire
Housing: Not available

This elective gives students a true family medicine-centered experience to include prenatal/perinatal care (including labor and delivery), inpatient postpartum care for women, as well as newborn nursery care for their infants. The student will spend mornings on the postpartum floor caring for women and their infants- you will focus on issues such as breastfeeding (including spending time with our lactation consultants), the newborn exam, routine postpartum care, maternal counseling and anticipatory guidance. Afternoons will be spent either seeing primary care patients in clinic (including as many prenatal/pediatric visits as possible), or researching a maternal/child health topic of your choice to be presented at the end of the elective. Students take call overnight on labor and delivery one night per week, allowing them an opportunity to be actively involved in deliveries and all aspects of labor and delivery care. Each student chooses one weekend to work with the postpartum/nursery rounder to get more direct clinical experience. Participation in this elective provides you with a wonderful opportunity to be an active and important team member with a lot of independence. Students who will derive the most benefit from this rotation are self-motivated and active learners.

References

Sample Student Presentations:

Hypothyroidism (PowerPoint presentation, 3.93 MB)

Postpartum Contraception (PowerPoint presentation, 1.03 MB)

Title: Subinternship in Internal or Family Medicine – Boston Medical Center (030.1i)

Instructor: Chris Manasseh, MD
Course Administrator: Chenille Hogan, chenille@bu.edu
Location: East Newton Pavilion. Boston University Medical Center
Team: East Newton Family Medicine Inpatient Service
Students per Block:  One
Period offered: Selective Blocks, Please Inquire
Orientation: First day of the rotation

Overview

Students will work as interns with the family medicine inpatient team. They will care for a wide variety of patients from the HealthNet Rounder system, acting as the primary care-giver for their patients. They will have all the responsibilities of an intern, including daily management of their patients, new admissions, attending conferences and participating in daily teaching.

Description

• Location: E6W, team meets in the FM conference room 6269 by the nurse manager’s office
• Daily schedule: Generally 7am to 6pm 6 days per week, one day per week will be extended until 7pm to allow for independent admission. Team sign-out 7am, teaching 7:30-8, bedside rounds 8:30, daily noon conferences, pm sign-out at 6pm
• Students are expected to work 3 weekend days during the month, arranged in discussion with the senior resident. NOTE: students follow the holiday/vacation schedule of the team not of Boston University, speak with the team prior to making any travel arrangements
• Students will be directly supervised by the 2^nd or 3^rd year resident in addition to the family medicine ward attending.
• Students will be primarily responsible for the care of their patients, they will participate in all conferences, daily teaching

Curriculum

• Daily bedside and teaching rounds, new admissions, morning teaching sessions
• Presentations for 2 morning teaching sessions
• Focused H&P review with course instructor
• Conferences:
• Monday – Family medicine resident noon conference, Dowling 5^th floor south wing, dept. of family medicine;
• Tuesday: Family medicine grand rounds, FGH conference room;
• Wednesday : Family medicine afternoon seminar, twice per month, 1 p.m. to 4 p.m., Dowling 5 south;
• Thursday : HealthNet firm conference, ENP 2^nd floor, 12 NOON, lunch provided

Objectives

• Assess, formulate a differential diagnosis, and propose initial evaluation and management for patients with common acute ambulatory presentations (U,R)
• Manage a chronic illness follow up visit for patients with common chronic diseases
  (U, C, R, S)
• Develop an evidence-based health maintenance plan for a patient of any age or either gender (U, R)
• Discuss the principles of family medicine care (B, U, C, E, S)
• Demonstrate competency in advanced history-taking, communication, physical examination, and critical thinking skills (B, C, A)
• Discuss the value of the provision of primary care by family physicians to any health care system (U, S) 

Evaluation:

• Evaluation based on above goals and standard BU student evaluation worksheets completed by supervising resident and all FM inpatient attendings for the 4 week rotation.
• Summative evaluation by course instructor, Rebecca Juliar, pager#8944 will be reviewed with student in mid-rotation feedback and at the conclusion of the rotation

 Guidelines for Absences

Students are reminded to maintain standards of professionalism, courtesy and common sense when scheduling residency interviews that take place during fourth year rotations.  Try to schedule interviews during vacation blocks whenever possible. In general, a student may, with advance permission from the rotation director, be away for no more than four days during the four-week rotation.

Please take note of the following guidelines:

• Students must work a minimum of two continuous weeks with no absences in order to pass the rotation.

• If a student is absent for more than four days, those missed days must be made up in order to pass the rotation. In some cases, a student may be required to repeat the rotation.

• Students follow the holiday/vacation schedule of the team, not of Boston University. Speak with the rotation director prior to making any travel arrangements during the rotation.

 

Title: Family Practice Preceptorship – Central Maine Medical Center (030.1c)
Instructor: Dr. Raj Woolever
Location: Central Maine Medical Center Family Practice Residency, 76 High Street, Lewiston, ME 04240
Number of Students Per Block: One
Period to be offered: Blocks 12-20
Housing: Available
Food: Cafeteria Pass for Unlimited Food Provided

Description: Students will learn about the specialty of Family Practice and what makes Family Physicians unique in the way they care for patients and families. The clerkship is primarily an outpatient experience (includes 1 week of Family Practice Inpatient Service) in which the student works in a busy community hospital family practice center which serves as the continuity site for the residents and faculty. There is also an opportunity to spend some time in a rural family practice office if requested by the student. Clinical clerks will see outpatients independently and generate a history, appropriate physical exam, assessment and plan before presenting the patient to the family practice preceptor. This combination of caring for rural families plus an inner-city under-served population at the Residency provides rich learning opportunities encompassing a variety of medical, psychiatric and social concerns. Students will also have exposure to Family Practice inpatient care, attend deliveries, participate in outpatient procedures and home visits. Students will take call with a senior resident and residency faculty attending over the course of their preceptorship. Students will participate in a comprehensive didactic curriculum presented at the noon hour.

Title: Latino Health Elective for 4th year medical students
Course Director: Elizabeth Ferrenz, MD
Course Administrator: Chenille Hogan
Number of Students Per Block: One
Period to be offered: Selective Blocks, Please Inquire
Location: East Boston Neighborhood Health Center

SUMMARY

The Latino Health Elective is geared towards students with an intermediate-to-advanced level of Spanish who want a focused experience caring for Spanish speaking patients and studying the health of Latino communities.  To participate, students should be able to take a history and conduct a physical examination in Spanish.  Students will work in a variety of clinical settings including outpatient primary care, chronic disease management clinic, and specialty care.  Students will explore health disparities, as well as educate themselves regarding barriers to health care and community resources available to Latino patients throughout Boston.  During the four-week rotation, the student will be expected to investigate and present a topic agreed upon with the course director.

You must contact the course director before signing up for this elective to determine the appropriateness of the elective for you and your level of Spanish proficiency.

DESCRIPTION OF ELECTIVE

The Latino Health Elective is an opportunity for fourth year medical students to improve their ability to provide medical care in Spanish, to increase their understanding of Latino health issues and disparities, and to research a topic of relevance to the health of Latino communities.

The elective experience will take place at East Boston Neighborhood Health Center (EBNHC), Boston Medical Center, and Boston area community agencies.

Students will participate in clinical sessions in Family Medicine and Chronic Disease Management at EBNHC.  Specialty clinical sessions will take place at BMC.  Students will be responsible for conducting history and physical examinations in Spanish and presenting their findings in standard oral presentation format in English.

At community agencies, students will learn about outreach to the Latino community around issues of immigration, housing, education, and more.  Latino elder care will be explored with an adult day health program.

Selected readings will be provided to students to expand their knowledge of Latino communities in the United States and health disparities facing Latinos.  These readings will be reviewed independently and discussed with the course director.

During the four week rotation the student will select a topic of interest relevant to the Latino community and prepare an oral presentation to be shared in the final week.

Students will be evaluated on the basis of their participation in clinical sessions and engagement with community agencies and independent readings.  The final presentation will be evaluated on the basis of relevance to Latino health and skills in oral presentation.

Students must contact the course director before signing up for this elective to ensure that their level of Spanish proficiency will be adequate for a successful experience on this rotation.

OBJECTIVES

By the end of the Latino Health Elective, the BUSM student will be able to:

• Improve her/his proficiency in providing medical care in Spanish (B, C, A)
• Assess her/his own ability to provide medical care in Spanish and identify how to continue to improve this capability (B, C, A, E)
• Define the role of interpreters in clinical encounters (C, S)
• Describe the most significant health disparities affecting selected Latino communities (R, E, S)
• Explain the barriers Latino communities face in the United States healthcare system (R, E, S)
• Discuss available community resources for Latinos living in the Boston area (S)
• Describe particular challenges faced by Latino elders (U, R)
• Present project on a health topic of relevance to the Latino community (C, R, E)

CURRICULUM

The curriculum includes (see also separate document with the block’s template):

• Clinical sessions – two sessions each week at EBNHC Family Medicine, one session each week in specialist clinics at EBNHC or BMC, chronic disease management individual and group visits twice a block at EBNHC, interpreter services session
• Community agencies – two sessions each week with community based groups serving Latinos
• Literature review – topic selected jointly with course director in second week of the clerkship with time provided for investigation throughout block and oral presentation in fourth week
• Language skills – up to one session each week can be devoted to independent Spanish language study, course director has available languages books for loan and recommendations for conversational practice opportunities
• Selected readings – provided at start of the clerkship for independent reading and analysis followed by discussion with course director; this discussion will allow the course director to assess your understanding of the material and will be a component of your evaluation:

Population Health

Healthy People 2020

• http://www.healthypeople.gov/2020/
• Select tab – 2020 Topics & Objectives
• Select tab – Social Determinants of Health

The Institute of Medicine. Disparities in Health Care: Methods for Studying the Effects of Race, Ethnicity, and SES on Access, Use, and Quality of health care, 2002. Available from http://www.iom.edu/~/media/Files/Activity%20Files/Quality/NHDRGuidance/DisparitiesGornick.pdf [PDF – 108 KB]

Latino Health Issues – National

Centers for Disease Control – Hispanic or Latino Populations

• overview of demographics, causes of death, disparities
• http://www.cdc.gov/minorityhealth/populations/REMP/hispanic.html

Healthy People 2010 snapshot for the Hispanic Population

–     goals for improvement and disparities updates

–     http://www.cdc.gov/nchs/data/hpdata2010/hispanic_snapshot.pdf

Unnatural Causes – documentary series and discussion guide

• Video clip – http://unnaturalcauses.org/video_clips_detail.php?res_id=215
• http://unnaturalcauses.org/assets/uploads/file/UC_DiscussionGuide_3.pdf

Latino Health – Massachusetts

Health Status of Hispanic Adults in Massachusetts by Spoken Language Preference

• medical conditions and perceptions of health
• http://www.mass.gov/eohhs/docs/dph/behavioral-risk/hispanic-language.pdf

Migration

Torres JM, Wallace SP.  Migration circumstances, psychological distress, and self-rated physical health for Latino immigrants in the United States.Am J Public Health. 2013 Sep;103(9):1619-27.

Cultural Competency

Kutob RM, Bormanis J, Crago M, Senf J, Gordon P, Shisslak CM.  Assessing culturally competent diabetes care with unannounced standardized patients.  Fam Med. 2013 Jun;45(6):400-8.

Group Medical Visits

Homer CS, Ryan C, Leap N, Foureur M, Teate A, Catling-Paull CJ.  Group versus conventional antenatal care for women.  Cochrane Database Syst Rev. 2012 Nov 14.

Housden L, Wong ST, Dawes M.  Effectiveness of group medical visits for improving diabetes care: a systematic review and meta-analysis.  CMAJ. 2013 Sep 17;185(13):E635-44.

Medical Conditions

Asthma

Environmental Protection Agency summary http://www.epa.gov/epahome/sciencenb/asthma/HD_Hispanic_Asthma.pdf

ADHD in Children

Morgan PL, Staff J, Hillemeier MM, Farkas G, Maczuga S.  Racial and ethnic disparities in ADHD diagnosis from kindergarten to eighth grade.  Pediatrics. 2013 Jul;132(1):85-93.

Adolescents/STIs

Lee YM, Dancy B, Florez E, Holm K.  Factors related to sexual practices and successful sexually transmitted infection/HIV intervention programs for Latino adolescents.  Public Health Nurs. 2013 Sep-Oct;30(5):390-401. doi: 10.1111/phn.12039. Epub 2013 Apr 29.

Obesity

Statistics on prevalence

http://minorityhealth.hhs.gov/templates/content.aspx?lvl=3&lvlID=537&ID=6459

Taveras EM, Gillman MW, Kleinman KP, Rich-Edwards JW, Rifas-Shiman SL.  Reducing racial/ethnic disparities in childhood obesity: the role of early life risk factors.  JAMA Pediatr. 2013 Aug 1;167(8):731-8.

Language Proficiency

Bauer AM, Alegría M.  Impact of patient language proficiency and interpreter service use on the quality of psychiatric care: a systematic review.  Psychiatr Serv. 2010 Aug;61(8):765-73.

González HM, Vega WA, Tarraf W.  Health care quality perceptions among foreign-born Latinos and the importance of speaking the same language. J Am Board Fam Med. 2010 Nov-Dec;23(6):745-52.

Lion KC, Thompson DA, Cowden JD, Michel E, Rafton SA, Hamdy RF, Killough EF, Fernandez J, Ebel BE.  Clinical Spanish use and language proficiency testing among pediatric residents.  Acad Med. 2013 Oct;88(10):1478-84.

Spanish Language Resources – Books loaned during clerkship

 The Boston Women’s Health Collective Nuestros Cuerpos, Nuestras Vidas.  2000.

Dozier, Eleanor and Iguina, Zulma Manual de gramatica, Grammar reference for students of Spanish, 3rd edition 2003.

Murkoff, Heidi and Mazel, Sharon Que puedes esperar cuando estas esperando 2010.

Werner, David, Thuman, Carol, Maxwell, Jane Donde no hay doctor 2012.

EVALUATION

In the final week of the course the student will have a formal evaluation with Dr. Elizabeth Ferrenz of her/his achievement of the stated objectives.  The student will have an observed clinical encounter with observation checklist completed.  The final project presentation will be evaluated based on depth of investigation and oral presentation skills.

FACULTY

Course Director – Elizabeth Ferrenz, MD, Family Medicine

Clinical Faculty – may vary depending on availability each block

Carol Singletary, Registered dietician, EBNHC

Dr. Sonia Ananthakrishnan, Endocrinology

Dr. Jose Betances, Pediatrics

Dr. Charles Bliss, Gastroenterology

Dr. Miriam Hoffman, Family Medicine

Dr. Jessica Levi, Pediatric Otolaryngology

Dr. Jose Romero, Neurology

Dr. Peter Smith, Chronic Disease Education and Management (CDEM), EBNHC

Title: Elective in Advanced Healthcare Communication
Instructor: Suzanne Mitchell, MD MS
Location: BUMC/Hancock Manor Nursing Home
Number of Students Per Block: 6
Period to be offered: Selective Blocks, Please Inquire
Housing: Not available

During this four-week elective, students will cultivate a deeper understanding of the complex interactions between patients, healthcare providers and healthcare systems and the relationship to health outcomes. Topics to be explored include:

• Cross cultural communications and the influence of clinical uncertainty, stereotyping and unconscious bias in physician decision-making and the propagation of health disparities.
• Communicating with “difficult patients”.
• Building skills in Patient Activation
• Healthcare communications, Health Literacy and Patient Safety
• Physician self-disclosure in the clinical setting
• Efficient relationship-centered care

Learning Objectives:

1. Gain awareness of issue of health and healthcare disparities,
2. Appreciate effects of unconscious bias, clinical uncertainty and stereotyping on patient care decisions.
3. Learn and practice new skills in cross cultural communication
4. Learn and practice key competencies in healthcare communication, including effective provider-patient dialog for information gathering and trust and relationship building, eliciting the explanatory model, expression of compassion and empathy, and negotiation of care plans.
5. Acquire skills in managing difficult and sensitive clinical scenarios such as addressing lifestyle behaviors (ie, substance abuse, high-risk sexual behaviors, smoking cessation, domestic violence), eliciting advanced directives, navigating a “difficult” patient encounter.

Learning Experiences:

1. Students enrolled in the elective will meet with the course director once per week for a 2-3 hour workshop session addressing a topic in advanced healthcare communications. A discussion on an assigned reading or film clip will facilitate discussion on key topics. Other workshop activities include role play, reflective writing, use and discussion of the Implicit Association Test.
2. At the beginning of the elective, each student will be paired with a patient to follow for the month. The student will follow the patient from the inpatient setting to discharge including making a home visit and accompanying the patient to follow up outpatient visits with specialists, PCP or other allied health visits. The student’s responsibility is to learn and report back on the patient’s experience in transitions of care and correlate how healthcare communications is hindering or facilitating the patient’s quality of care experience.
3. Clinical care: Student will be assigned to participate in either an ambulatory care clinic or inpatient ward team one to two times per week for interviewing opportunities only. (Ongoing patient care will be the responsibility of the ward team.)

Learning Tools:

1. Video with Debriefing: World’s Apart
2. Clinical care experience with preceptor
3. Reading, Tuesdays with Morrie, Kitchen Table Wisdom
4. Student-Patient Pairing Experience
5. Role plays/Clinical precepting for practice in eliciting advanced directives, assessing health literacy, motivational interviewing, difficult conversations or managing difficult patient scenarios.
6. Relevant articles from the medical literature
7. Small group discussions for issues of health disparities, clinical uncertainty in decision-making and implicit bias in patient care.

Suzanne E. Mitchell M.D. is a board certified family physician, medical educator and consultant in physician-patient communication. In addition to her research activities in healthcare disparities, Dr. Mitchell provides training for medical professionals in cross cultural communication, patient-centered care and patient activation. She has served as course director for the Healer’s Art course at Tufts University. Dr. Mitchell received her doctorate degree from Wake Forest University School of Medicine and completed post-graduate training in Family Medicine at White Memorial Medical Center Family Medicine Residency Program. Dr. Mitchell holds a Masters of Science in Clinical Research from the University of California, Los Angeles. Her research interests are in health disparities in transitions of care, healthcare and cross cultural communications and healthcare access. Dr. Mitchell is an academic faculty fellow in the Boston University School of Medicine Department of Family Medicine.

Title: Primary Care Sports Medicine 4th Year Medical Student Elective
Department of Family Medicine
Course Director: Chenille Hogan (chenille@bu.edu)
Office phone:  617-414-6237
Course Instructor: Alysia L. Green, MD
NUMBER OF STUDENTS: One 4^th year BU medical student
PERIOD:Block 12, 13, 14, 15, 18, and 19

LOCATIONS: Boston Medical Center, BU Ryan Center for Sports Medicine, South Boston Community Health Center, East Boston Neighborhood Community Health Center (Winthrop location), BU Athletic Training Room and various athletic fields/venues for event coverage

OBJECTIVE:  To gain exposure and experience in the field of primary care sports medicine

GOALS

• To improve history taking and physical examination skills
• Development of a solid musculoskeletal examination
• Development of a focused differential diagnosis based on history of injury and physical examination findings
• Determining what further testing modalities are needed based on the differential diagnosis
• Exposure to athletic training and rehabilitation of the injured athlete
• Understanding the role of the team physician, student athlete and athletic trainer
• Game coverage experience (may be unavailable for academic 2021-2022 due to COVID)

FACULTY

Alysia L. Green, M.D-Family Medicine/Primary Care Sports Medicine

Nathan Cardoos, MD-Family Medicine/Primary Care Sports Medicine

Christopher Ma, MD-Family Medicine/Primary Care Sports Medicine

ADDITIONAL FACULTY  

Mark Laursen, Director of Athletic Training Services, Boston University

Jennifer Chadburn. Assistant Director of Athletic Training Services, Boston University

Primary Care Sports Medicine Fellow

CURRICULUM

The curriculum will include multiple experiences in primary care sports medicine. A sample of a weekly schedule of clinic time and other experiences would be the following:

-8 half days of Primary Care Sports Medicine which could be in any of our multiple clinic locations. You must be able to get to any of the clinic locations listed above. You will be required to travel to all locations.

-1 full day in BMC orthopedics with Dr. Green in my non operative orthopedic clinic

-Wednesday Morning Sports Medicine Conference 7 am (Likely via Zoom)

-1/2 day BU Athletic Training Room physician clinic working one on one with one of the primary care sports medicine physician as they evaluate BU student athletes (May not be available 2021-2022 due to COVID)

-1/2 day of reading time

-Game coverage: There may be no game coverage opportunities for academic year 2021-2022 due to COVID. If there are I cannot guarantee coverage for every block the elective is offered. If available game coverage will vary depending on the time of year and block possibility of 1-2 game coverage opportunities per week of the elective.

Please note much of the game coverage occurs in the evening and/or the weekends so student needs to be aware they may have to work late and possibly on the weekends.

 

EVALUATION

The student will have a mid-block evaluation of their achievement of the above stated goals, done by Alysia L Green M.D with the written/verbal input of the other physicians and additional staff members. They will further be evaluated throughout their rotation on their musculoskeletal examination skills. The student will be responsible for a literature review to be completed during their 4 week rotation on a topic to be determined by Primary Care Sports Medicine Staff.

POLICY 

Student will have to provide at least 30 days’ notice if they are going to drop the elective otherwise it will not be allowed unless they are able to find someone to take over their spot. NO EXCEPTIONS.

Title: DynaMed
Location: Danvers, MA
Description:
DynaMed is a company that produces evidence-based medicine point-of-source information. Student will research, write, and evaluate medical evidence of relevance to practicing physicians. Opportunities possible for publication (check ahead of time).

Title: Family Medicine Lesotho Elective
Instructor: Dr. Rudolf Schumacher, MD, PhD
Location: Motebang District Hospital, Lesotho, Southern Africa
Period: Selective Blocks, Please Inquire
Housing: Available

Description: A family medicine elective opportunity in northern Lesotho (Lĕ-SOO-too), Southern Africa. Rotations are based at Motebang District Hospital. A commitment of 6-8 weeks is required for this rotation. Motebang Hospital is located in a town called Leribe in the Leribe district of Lesotho about 90 km north of Maseru, and 20 km from Maputsoe, a major border crossing to Ficksburg, South Africa. Motebang is one of two regional referral hospitals in the country and serves the northern districts.

Motebang is a 196-bed hospital that serves the second largest catchment population of any district hospital (the national referral hospital also serves as the district hospital for Maseru). There are over 55,000 outpatient visits at the hospital and nearly 5,300 inpatient admissions with wide ranging presentations of illness.

This program is administered by the Lesotho Boston Health Alliance that is based in the Department of Family Medicine at Boston University Medial Center.

Living: Students are accommodated at a convent guest house near the hospital. The convent offers a private room with a shared kitchen and bathroom. It costs R175 (~$25)* per night, which includes three meals. A lower cost may be available if meals are not included. If you elect to buy your own food, it will cost about $25-$35/week.

*this rate may be more depending on the time you travel to Lesotho.

Language: Patients primarily speak Southern Sesotho. All staff are fluent in English. If needed, hospital staff can serve as interpreters.

Medical Experience: Students will have extensive opportunities in Pediatrics, Adult Medicine, Obstetrics/Gynecology including cesarean section, and Surgery including Urology and Ophthalmology. Common medical problems include HIV-AIDS and opportunistic infections, tuberculosis, orthopedic trauma, and maternal-child health including cesarean section.

Cost:

• Tuition or Fees: none
• Housing/Food Costs: $25-$35 per week
• Local Travel Costs: minimal
• Plane Ticket: $1500-$2000

Interested: Given the challenging nature of this elective, interested students are first required to meet with Suzanne Sarfaty, M.D., Director, International Health Program, BUSM, to discuss the feasibility of this elective and the application process. While BU has become an affiliated institution with this hospital, the June-August months are the most difficult time to set up this elective because U.S. schools with a more long standing affiliation get preference. Students are allowed to undertake this elective during time periods when BMC residents from Pediatrics, Family Medicine, and Internal Medicine departments are also at the hospital. Presently, two students for each time period are allowed.

Requirement: Students are required to attend a mandatory orientation session prior to travel. Students are also required to attend the BUMC travel clinic prior to departure to assure their utmost safety on this elective.

Title:Wilderness Elective
Description: The Department of Family Medicine at BU does not offer an elective in Wilderness Medicine, however, such electives can be found on The Wilderness Medical Society’s website.