Objective: This elective will familiarize fourth year medical students with the functional properties and techniques for implantation of pacemakers for treatment of bradycardia and defibrillators for control of ventricular tachycardia and ventricular fibrillation. Application of temporary biventricular pacing to acute low output states during and after cardiac surgery and biventricular pacing optimization are included in the curriculum.
Learning Experience: The course will include review of the indications for insertion of these devices as well as the pathophysiology of the arrhythmias in question, Complications of surgery, pre- and postoperative care, and device programming will also be reviewed.  The student will be expected to participate in all aspects of patient care, including participation in surgery and device programming.  The patient base in a typical month will include 10 pacemaker implants (including four pediatric cases), and five defibrillator implants. Teaching conferences to be attended will include the weekly Clinical Electrophysiology Conference and Thoracic Surgery Rounds.  
Feedback: Continuous throughout the elective. 
Evaluation: Will be based on a consensus of the preceptor and involved house staff.

Contact Coordinator

Provides clinical experience in management of surgical patients, working as part of the house staff team on one of the general surgery services. 
Objectives: to develop skills in surgical problem solving; acquire knowledge and its application in evaluating patients with surgical disease; provide broad exposure to operative technique and an opportunity to develop technical skills.
Learning Experience: focus of learning is evaluation and treatment of surgical inpatients in shortened time course over which most surgical problems develop and the rapid feedback which operative intervention provides.  Student will participate in both clinical and educational activities on the service (work‑ups, rounds, conferences, operations).  Degree of assumption of responsibility may vary with the initiative and capability of the individual, and the educational goal is for increasing responsibility with responsive
supervision. 
Feedback: Continuous throughout the elective. 
Evaluation: will be done twice during the elective both by house officers and the attending Chief of Service.

Objective: This elective is designed to introduce fourth year medical students to the surgical management of breast cancer.
Learning experience: The student will gain experience in learning about the natural history, diagnosis, pretreatment evaluation and surgical management of breast cancer. There is opportunity to attend clinical conferences, journal club and other seminars as well as participate in the operating room, clinic and office hours, as well as to gain exposure to clinical and basic science research related to breast diseases.
Evaluation: Will be based on a consensus of all faculty members involved in the student's education in this course.
Faculty: Drs. Mahmoud El-Tamer, Dr. Laura Klein and Kathie-Ann Joseph.

Provides an opportunity for students to work with a group of private practitioners in the practice of surgery. 
Objective: Learn deductive diagnostic reasoning based primarily on history and physical examination in an office setting with appropriate follow-up and complementary laboratory data. 
Learning Experience: would include broad exposure to a wide range of surgical problems as present in a community, rather than a university hospital. It would also include a close working arrangement between student and preceptor with whom working. 
Feedback: One on one discussion with preceptor on a biweekly basis. 
Evaluation:  Primarily subjective; no examination shall be given.

First weekday of the month, contact course coordinator for time arrival.

Ms. Doris Leddy, (212) 305-9596, dl642@columbia.edu

CUMC, Herbert Irving Pavilion, 161 Ft. Washington Ave., 8th Floor,
room 821.

Objective: Provides exposure to the practice of an active general surgeon specializing in gastrointestinal problems.
Learning Experience: Special emphasis on laparoscopy, colonoscopy, and colonoscopic polypectomy.  Clinical research activity is obligatory. 
Feedback: Continuous throughout the elective. 
Evaluation: Will be based on a consensus of all faculty members involved in the student's education in this course.

ALL P&S STUDENTS MUST CONTACT THE COURSE DIRECTOR FOR PERMISSION BEFORE REGISTERING FOR THE ELECTIVE.

Objective: Multidimensional approach designed to develop in‑depth appreciation of pathophysiology of, and corrective surgery for, peripheral vascular disease. 
Learning Experience: Includes participation in activities in non‑invasive vascular laboratory, angiography, in patient and outpatient vascular medicine management and both endovascular and open surgery.  Horizontal time course on limited number of patients emphasized. 
Feedback: Continuous throughout the elective. 
Evaluation: Will be based on a consensus of all housestaff and faculty members involved in the student's education in this course.

Ms. Charise Acevedo, (212) 305-9612, acevedoc@nyp.org

CUMC, Irving Pavilion 601

Dr. Nicholas Morrissey, (212) 305-1165, njm2106@columbia.edu

First weekday of the month, time to be arranged (contact coordinator)

Multidimensional approach designed to develop in‑depth appreciation of pathophysiology of, and corrective surgery for, peripheral vascular disease. 
Learning Experience: Includes participation in activities in non-invasive vascular laboratory, angiography, and at surgery.  Horizontal time course on limited number of patients emphasized. 
Feedback: Continuous throughout the elective. 
Evaluation: Will be based on a consensus of all faculty members involved in the student's education in this course.

Dr. Nicholas Morrissey, (212) 305-1165, njm2106@columbia.edu

First weekday of the month, time to be determined (contact coordinator)

Herbert Irving Pavilion 161 Ft. Washington Ave. 6th Floor

Exposure to design and conduct of surgical research.  Opportunity to develop, submit IRB unique surgical clinical research.  Provides the opportunity to assess student interest in a future in clinical research.  Five-day a week elective, 9AM to 5PM.  Work intimately with the Principal Investigator and Clinical Coordinator, attend weekly and monthly research progress meetings.  Potential for ongoing research involvement at Columbia.
Objective: To prepare the student to be an academic surgeon.  Allow the student to develop skills in surgical clinical research design which will allow them to continue academic research interests during residency.  Familiarize student with procedures and techniques obtaining funding for clinical research.
Learning Experience: Focus is design and implementation of clinical research, at present involving but not limited to; advances in wound management, endovascular surgery, vascular bypass surgery and hemodialysis access.  Potential for ongoing research involvement. 
Feedback: Continuous.
Evaluation: will be done twice during the elective both by the house staff and the attending.
Faculty: Dr. Nicholas Morrissey and staff

Acting internship on a busy Surgical/Trauma Service. 
Objective: To acquire more advanced experience in a broad range of general surgical procedures, including trauma, transplantation, vascular, bariatric and GI surgery. 
Learning Experience: This one month subinternship will emphasize direct patient care by providing practical opportunities for learning in the operating room, emergency department, outpatient clinics and on the patient floors.  Hands-on exposure and team involvement will be emphasized.  Participation in several weekly teaching conferences, including Morbidity and Mortality, Surgery Grand Rounds, Trauma Conference, and others will be encouraged. 
Feedback: A close attending-resident-student relationship will be maintained and provide ongoing feedback. 
Evaluation: At the conclusion of the elective, a comprehensive written evaluation of all aspects of the student’s performance will be provided.

Call one night per week, one weekend call during the rotation.  Student reports at 6:00 AM – 6:00 PM.