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Rotations

PA Rotations
Cardiothoracic Surgery
Emergency Medicine
M3 Rotations Available
Family Medicine
General Surgery
Internal Medicine
Neurology
Obstetrics and Gynecology
Pediatrics
Psychiatry
Vascular
M4 Rotations Available
Anesthesiology
Cardiology
Dermatology
Emergency Medicine
Gastroenterology
General Surgery
Hospitalist
Internal Medicine
Infectious Disease
Nephrology
Obstetrics and Gynecology
Pulmonary
Radiology
SICU
Vascular

Cardiothoracic & Vascular Surgery PA
The student rotation is designed to introduce the student PA to the role of the cardiothoracic and vascular surgery PA. Its purpose is to extend the PA resident’s skills into the clinical, administrative and academic roles available in cardiac surgery. It is intended for all PA’s interested in a career in cardiothoracic surgery.

The SJMH student rotation will expand upon the basic training of the PA to encompass the diagnosis and management of diseases and conditions common to the cardiothoracic and vascular surgical patient in both the operative and peri-operative phases of care. In addition, the training is to be accomplished in the tradition of the Sisters of Mercy and according to their values of service, respect, social justice, compassion and excellence.

Emergency Medicine PA
St. Joseph Mercy Hospital in Ann Arbor is a 537 hospital. We have a 64-bed Emergency Department with a 12-bed Emergency Department Observation Center. We are a level II trauma center with over 70,000 ED visits a year. The ED also has a joint Emergency Medicine Residency with the University of Michigan. The rotation is mostly spent on the adult side of the ED. We cover the fast track area where we do many procedures, main emergency department and the Senior ED. We cover the residents while they are in conference. We will try to give students a broad emergency department experience, with as many procedures as available. We have a highly rated program for students and now also have a Post Graduate PA Fellowship in Emergency Medicine.

Anesthesiology
This is a one month rotation that introduces the resident to Clinical Anesthesiology at a busy tertiary hospital setting. The resident will participate in the evaluation and preparation of patients prior to surgery and in the induction and maintenance of patients undergoing surgery. Experiences include invasive line placement, non-invasive and invasive airway management and a review of the pharmacology and physiology of perioperative patient care.

Cardiology
Most students are treated as interns who are allowed to fully evaluate the patient independently, for inpatient consults and inpatient evaluations. The goal is for the student to function as independently as possible. The student is expected to perform a full history and exam, review all relevant evaluations and to synthesize the data and develop a differential diagnosis and management plan. The student is directly supervised by the attending and residents. Excellent didactics: students attend morning report and noon conference. The cardiology curriculum includes a list of 10 highest impact journal articles that students, interns and residents rotating through cardiology are expected to read.

Coronary Care Unit
Under supervision, students take on the responsibility of first year residents for a limited number of patients with primarily acute problems including myocardial infarction, heart failure, and arrhythmias. Teaching work rounds are held seven times a week and attending conferences are held three times a week. Students will not be permitted to elect two 4-week periods in Intensive Care Units as part of the required Sub-internship, but may elect to do a second 4-week rotation on the general wards. Students will also attend twice weekly student conferences, and then will share one of their patients in a case presentation to the student group. Medical students may attend weekly medical student conference and present a case to their peers at this conference.

Dermatology
This elective is designed for the student who desires significant exposure to clinical Dermatology. Students should have a four-week rotation to ensure reasonable continuity of education and patient care; three-week rotations are also available at the clinic’s discretion. Students will be observing multiple skin diseases and procedures of dermatology. Students will learn a practical differential diagnosis and treatment for common skin diseases.

Emergency Medicine
All students will complete 15 clinical shifts. Students will be exposed to basic principles of EM, including triage, resuscitation and evaluation of undifferentiated patients, both adult and pediatric. St. Joseph's Hospital provides the student with exposure to emergency practice in a busy community hospital setting that handles a wide variety of medical and trauma cases.

Family Medicine
The Family Medicine rotation is designed to educate third year medical students, allopathic or osteopathic, on the principles and practice of Family Medicine. Students will be directly supervised by Family Medicine Faculty, and assist in the care and treatment of patients at the Family Medical Center. Students will learn the principles and treatment of preventative care, continuity, common medical problems, and office procedures in Family Medicine.Furthermore, as a Medical Home, the Family Medical Center will provide an educational experience on the future of health care delivery.

In addition to clinical exposure in Family Medicine, the student will participate in didactic lectures in the Family Medicine Residency. For Osteopathic medical students, the student will learn the Osteopathic Principles of Medicine and Osteopathic Musculoskeletal Therapy (OMT).

Gastroenterology
The student will actively participate in rendering consultations and providing care for inpatients on a busy gastroenterology consult service. Students will also have the opportunity to see patients in the GI clinic. A wide variety of procedures will be observed (upper endoscopy, colonoscopy, ERCP, EUS and motility studies). The student will be expected to attend daily Department of Internal Medicine noon conferences and other educational activities. In addition there will be one to one teaching sessions with the faculty on assigned topics.

Hosptialist Elective
The M4 will act primarily as an intern, independently evaluating and following patients from admission to discharge. The student will work directly with the academic attending physician. This rotation provides an excellent opportunity to learn how to manage the vast array of problems seen in general medical Hosptialist patients. Most of the time will be spent in direct patient care with opportunities for procedures. There will be educational presentations as well as daily morning report and noon conferences. The student will be expected to work 5 days a week and carry an average patient load of 4-5. The student will work more closely with the attending physician as compared to most other rotations and will therefore be given more autonomy and direct feedback. The student will develop efficient clinical skills.

Infectious Disease
The I.D. rotation is an inpatient consultative service. Caseload is moderate with an excellent mixture of clinical problems. Adequate time for self-study is usually available. Students will be expected to assume a significant degree of responsibility. Students have ID courses on site here at SJMH (weekly micro plate rounds, weekly ID didactics, ID grand rounds, and journal club once a month).  Close interaction with the Resident and fellow on the elective and the instructor.

Internal Medicine – Third Year (M3) Clerkship
Third year medical students will be assigned to a teaching team to care for general medicine inpatients at St. Joseph Mercy Hospital in Ann Arbor. MI.  This is a busy inpatient service caring for a diverse set of inpatients.  The team will consist of one or two third year students, interns, a senior resident and a teaching attending. At times, there may also be a fourth year medical student. The third year students will become an integrated member of the team.  The students will have direct patient interaction with patients they are assigned, and with supervision, will perform complete H+Ps, come up with a plan for the care of that patient and document their findings in our electronic medical record.  They will be expected to present their patients' care plan to the team each day as well as communicate with the patient and family as appropriate to their level of training.  The students will receive teaching and feedback during their work rounds and daily interactions with their team.  They will also attend weekly didactic lectures with the other students and the site director to cover topics in-depth and participate in interactive, case based learning to complement their hands-on training on the wards.  There is no overnight call, but students will do some evening shifts to pick up new patients with their teams.  The students will also have the opportunity to attend morning report, noon conferences and internal medicine grand rounds.

Internal Medicine – Sub-Internship
Sub-I's are expected to function at the level of an intern and carry their own patients without a co-intern. They are expected to perform the initial H+P, come up with their own differential diagnoses, and create a plan for that patient's subsequent work up and treatment. They are working closely with the senior resident as well as the internal medicine attending.  Faculty is expected to observe the sub-I's interacting with patients at the bedside over the course of the rotation.  Strengths: dedicated core faculty group, small teams, a good variety of general medicine cases, supportive learning environment, and excellent morning report and noon conferences.

Medicine Intensive Care Unit
Under supervision, students take on the responsibility of first year residents for a limited number of patients with acute ICU/level problems. Multidisciplinary educational rounds are held seven times a week.  Students will learn about the entire array of acute pulmonary and intensive care medical problems, including vent management, sepsis treatment, pressers, electrolyte and fluid management, and other common ICU issues.  

Nephrology
The student will be responsible for performing initial evaluations of both nephrology inpatients and outpatients. He/she will also be responsible for following the inpatients daily. The student is expected to present and discuss patients with faculty daily.  Topics discussed during the month include: electrolyte management, acid-base, glomerulonephritis, interstitial renal disease, hypertension, acute renal failure, chronic renal failure, dialysis, and transplant.  The student is encouraged to attend the Internal Medicine morning report and noon conferences. Assuming attendance at those conferences, there will approximately six hours of nephrology exposure daily. There is no call. The student is expected to be present Monday-Friday from 8am-5pm.

OBGYN Third Year (M3) Clerkship
St. Joseph Mercy hospital has an affiliation with the University of Michigan, Wayne State University and the University of Toledo to provide a clinical campus for students to complete their required third year rotation in OB/GYN. In this suburban hospital students have close interactions with residents and faculty. There is exposure to a wide range of activities including prenatal and well woman care in the resident ambulatory clinic, inpatient obstetrical care and both inpatient and outpatient gynecological surgery. Subspecialty exposure to maternal fetal medicine (high risk ob), gynecological oncology and neonatal intensive care (NICU) exposure is also provided. Students have a high level of hands on activity while on labor and delivery, in the outpatient clinic and in the operating room. There are weekly didactic sessions specifically for the students, as well as dedicated time to attend department grand rounds.  The call schedule is in accordance with the requirements of each of the above named schools. This rotation is only for students enrolled in the three medical schools named above. 

OBGYN Fourth Year (M4) Elective Rotation
 This is a one month rotation designed for the student who is seriously contemplating OB/GYN as a residency choice or who desires additional exposure to the specialty to help them decide upon their career choice. Only one fourth year student from LCME approved medical schools is offered this experience at a time, so as to permit a greater opportunity to manage OB and GYN patients along with the senior resident on the service. Students may tailor the experience by spending additional time with MFM, uro-gynecology, addiction medicine specialist in OB/GYN, and ultrasound or gynecological pathology.  There are two required overnight Friday call shifts (6pm – 8am).  It should be emphasized that this is not a designated sub-internship but will provide greater exposure to the specialty and greater clinical responsibilities for the interested student.

Pulmonary
This rotation offers the student interested in pulmonary and critical care medicine exposure to all aspects of modern pulmonary medicine. In addition to pulmonary and critical care inpatient consultations; the student will acquire basic skills in interpreting chest x-rays, reading pulmonary function tests, and blood gas analysis. A comprehensive bibliography of suggested readings on a multitude of pulmonary and critical care topics is provided.

Radiology
This community elective at St. Joseph Mercy Hospital (with an option of spending up to two weeks at Chelsea Hospital) involves observing radiology in a large referral community hospital with all of the imaging technology (and an optional experience at a community primary care facility).  Interdepartmental patient conferences and lectures will be included in the experience.  The student will be required to complete at least one case for the teaching file.

Surgery
Students rotating on the surgery service will function as an integral part of the team, and will actively be involved in patient care.  Responsibilities will be tailored by the chief resident and student, but typically include taking part in surgical procedures, suturing, daily inpatient rounding, and presenting detailed daily management plans for your patients.  Independent and proctored responsibilities will be balanced during your rotation.  Additionally, there is frequent contact and instruction to maximize the student’s learning experience to prepare for shelf examination, oral exams, and ultimately medical practice.  As a fourth year student, you have the option to rotate in general surgery, colorectal, vascular, or in the surgery intensive care unit. 

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St. Joseph Mercy Ann Arbor | 5301 McAuley Drive, Ypsilanti, MI 48197 | 734-712-3456