Fourth Year Electives (MS4)
Fourth year students are required to complete a fourth year surgery elective. The Department of Surgery also offers courses fulfilling the sub-internship and ICU requirements. A variety of rotations are available at OHSU and at off-campus sites. Please see the course descriptions below for further information.
Rotation sites include the following locations:
- Asante Three Rivers Medical Center, Grants Pass
- Bay Area Hospital, Coos Bay
- Curry General Hospital, Gold Beach
- Legacy Emanuel Medical Center, Portland
- Oregon Health & Science University, Portland
- Providence St. Vincent Medical Center, Portland
- Sacred Heart Medical Center Riverbend, Eugene
- Veterans Administration Portland Healthcare System (VAPOR HCS), Portland
MS4 Course Electives
Abdominal Organ Transplant
This course is designed to educate students regarding the surgical management of liver and kidney transplantation as well as hepatobiliary surgery. Exposure to transplant patients encourages appreciation of the process of abdominal organ transplantation from the patient perspective. Interactions with experts in the field allow students to expand their clinical knowledge in kidney disease, liver disease and transplant surgery. Students participate in rounds, clinic, selection committee meetings and tumor board conferences, as well as assist with surgical procedures. Students may have the option of participating in local organ procurement procedures as they occur.
The burns/general surgery rotation includes general surgery, acute burn care (including ICU and step-down care), reconstructive burn care, and a variety of complex wound management cases, such as necrotizing soft tissue infections, open abdomen/fistulas, purpura fulminanas, truncal pressure and ulcers. In addition, there are plastic admissions to our house staff service.
The cardiothoracic surgery course provides intimate exposure to all aspects of adult cardiac and thoracic surgery, including valvular and coronary heart disease, aortic surgery, surgery for arrhythmia, heart transplantation, lung resection, esophageal surgery and mediastinal procedures. Students work with house staff and faculty and are responsible for patient workups with the opportunity to scrub in on heart surgery cases and experience both didactic and one-on-one teaching with faculty.
General Surgery - Coos Bay, Eugene, Gold Beach and Grants Pass
The majority of time is spent in general surgery with the opportunity to rotate through other surgical specialties, including ENT, urology, gynecology and/or orthopedics. Students will have exposure to a rural general surgery practice and identify the differences between a rural surgery practice and a tertiary referral center, as well as learn to identify critical points in spectrum of rural general surgical procedures. Students will continue to expand their skills at evaluating, diagnosing and treating surgical patients, including experience with minor office procedures.
General Surgery - OHSU Blue
Students will be fully participating members on a Foregut and Minimally Invasive Surgery team. They will perform preoperative and postoperative care, evaluate patients in the emergency room and inoutpatient clinics, and assist in surgery.
General Surgery - OHSU Green
Students will be fully participating members on a Colorectal and Bariatric Surgery team. They will perform preoperative and postoperative care, evaluate patients in the emergency room and in outpatient clinics, and assist in surgery.
General Surgery St. Vincent and VAMC
Students will be fully participating members on a General Surgery team. They will perform preoperative and postoperative care, evaluate patients in the emergency room and in outpatient clinics, and assist in surgery.
Students will participate with faculty and house staff at a level comparable to that of an intern in the preoperative, operative and postoperative care of pediatric patients with general surgical disease.
Plastic and Reconstructive Surgery
Students are exposed to an extraordinary variety of congenital and acquired defects in both children and adults. Cranio-facial anomalies, maxillofacial trauma, microsurgery and unusual surgical problems are seen daily. Cosmetic surgery and reconstructive surgery of the hand, head, neck, torso, and lower extremities are common procedures. Students will have the opportunity to evaluate patients and actively participate in the operating room, clinics and wards. They will interact directly with attendings, residents and patients.
Plastic Surgery - Community with Dr. Nguyen
Students will learn to recognize signs of healing and infection. They will diagnose and treat conditions such as cleft lip and palate. Sewing skills are also acquired.
Plastic Surgery - Community with Dr. Wheatley
Students will work with five attending physicians on the Veterans Administration Medical Center plastic surgery service. Responsibilities include attending clinic, participating in the operating room, and rounding. There is ample opportunity to see patients with supervision and to work closely with the attending staff as a first assistant in the operating room.
Surgery - Away
Medical students are responsible for making their own arrangements for an away rotation. Approval forms must be submitted to the Education and Student Affairs office for review and approval prior to leaving for the rotation. If you wish to take this course, please print out the MS4 Surgery Elective Information Form, complete the requirements, and submit to the Dean's office in the OHSU School of Medicine.
Surgery - Community
A clinical preceptorship in general surgery is offered with a specific community surgeon. Students are responsible for making their own arrangements. Students participate in the evaluation of patients during office visits, perform pre- and postoperative care, as well as assist in surgery. To enroll in this course, please print out the MS4 Surgery Elective Information Form, complete the requirements, and submit to the Dean's office in the OHSU School of Medicine.
Surgery - Preceptorship
Clinical experience is offered in any of the surgical specialties at OHSU or the VAMC. Students participate in supervised care of surgical patients in hospital and outpatient settings. Key principles are learned in the care of surgical patients pre- and postoperatively. To enroll in this course, please print out the MS4 Surgery Elective Information Form, complete the requirements, and submit to the Dean's office in the OHSU School of Medicine.
Students participate in surgery research (arrangement made by student). At the completion of the rotation they should turn in a summary of the research performed (2-4 pages). This should include a section on the background of the process you are studying and the question you are trying to answer. Next you should include a description of your actual research experience. This should include the methods of your research project and which specific information was obtained. The summary should also describe methods used for statistical analysis. Using preliminary data to write an abstract is encouraged. Students should also include a plan for eventual submission and presentation of their work. To participate in this elective, please examine the MS4 Surgery Elective Instructions, for information regarding approval and completion.
Surgical Intensive Care Unit - OHSU
Students participate in the management of complex, critically ill general surgery, vascular and transplant patients. This is a highly educational experience that combines opportunities for patient management with excellent bedside and didactic teaching. OHSU is a quaternary care center for the state of Oregon, which serves to enhance this opportunity.
Surgical Intensive Care Unit - VAMC
Students participate in patient care in the surgical intensive care unit and learn principles for managing severely ill, injured, and postoperative patients.
Students spend 5-10 hours per week in discussion/didactic sessions with faculty in addition to 20-30 hours per week of clinical responsibilities. Students will be expected to take overnight call on a schedule determined by faculty availability. Student responsibilities include patient workups, participation in operations, and postoperative care rounds with surgical, would care, nutritional and multidisciplinary teams. Didactics and discussions will focus on topics and literature relevant to surgical nutrition. While performing clinical duties, special emphasis will be placed on care of patients with special nutritional needs. At the completion of the rotation, students will be able to design and implement a plan for nutrition management for a patient throughout the course of their surgical condition.
Students gain experience in clinical oncology through participation in radiotherapy and chemotherapy clinics, tumor clinic and tumor board, surgery conferences, and inpatient rounds.
Transition to Surgical Internship
The course teaches the basic technical and patient management skills expected of any surgical intern using a hands-on approach and case-based scenarios. It includes deliberate practice sessions of all the listed technical skills with concurrent and summary feedback provided by residents and faculty. Emphasis is placed on preparing students to manage common problems encountered while treating ward patients. Students are asked to independently assess and form a plan of action of patient care prior to conferring with the supervising resident and then undergo mock pages as the primary contact for all non-immediate life threatening occurrences. This course is offered once per year.
Trauma - Emanuel
Students participate in the care of critically injured patients at Legacy Emanuel Medical Center, which is one of two Level 1 Trauma Centers in Oregon. Students make daily rounds with trauma surgeons, fellows, residents and physician assistants.
Trauma Intensive Care Unit - OHSU
Students participate in the care of critically injured patients at OHSU, which is one of two Level 1 Trauma Centers in Oregon. Students make daily rounds with trauma surgeons, fellows, residents and physician assistants. This is an excellent educational experience includes multiple planned conferences to include Trauma Conference, Morbidity and Mortality Conference, and a didactic lecture series. Students have the opportunity to present a case they have managed at one of the Trauma Conferences.
Students function as sub-interns on the University or VAMC vascular surgery service, which includes experience in the operating room, inpatient and outpatient work. Students gain experience treating vascular surgery patients and disease.