Electives Information
Acting Internship
Prerequisites
- Successful completion (passing) all six core clerkships.
- M4 status.
- M3s will be also eligible on a case by case basis (must be pre-approved by a student affairs dean).
Requirements
- AI must be a minimum of 4 weeks.
- All AI’s must contain a significant inpatient/hospital component.
- All AI’s must provide the student with primary care responsibility for a panel of patients with direct supervision by an attending physician or upper level resident. The student cannot be supervised by an intern.
- It is highly preferred that the AI requires the student to have call responsibilities (Emergency Medicine acting internships must include night shifts).
- AI will be in Family Medicine, General Internal Medicine, General Pediatrics, Med/Peds, Obstetrics and Gynecology, General Surgery or Emergency Medicine.
- Alternative acting internships that can satisfy the AI graduation requirement will only be allowed in specialties that students directly match into without the need of a preliminary year residency requirement (for example, Urology) and usually require multiple away rotations to be competitive for residency match.
- These AI experiences must meet all of the above AI curricular requirements and must be approved by a student affairs dean.
- AI rotations must be completed either on one of the Texas A&M College of Medicine campuses or at an outside institution that is LCME accredited and/or an ACGME accredited residency program site. If the student opts to complete the AI at an outside institution, she/he MUST submit a SIE request to a student affairs dean the who will review the goals and objectives of the AI from the other school’s course catalog or the SIE documented goals and objectives, listed faculty oversight, etc. and determine if these are of sufficient rigor, prior to approving. No AI done at an outside institution will be accepted as fulfilling the curricular graduation requirement if it was not pre-approved by a student affairs dean.
Example of an acceptable alternative AI experience
- Urology AI from Duke fulfills the above requirements:
- SURGERY-451C. Sub-Internship in Urologic Surgery. Students will participate in the diagnosis, management, and surgical treatment of patients with urologic disorders. Sub-internship students will take on intern-level responsibilities, including daily management of inpatients, clinic responsibilities, participation in surgery, and overnight call.
- Please contact Dr. Rampersaud at rampersaud@duke.edufor more information and to obtain your permission number. Prerequisite: Permission is required. Credit: 5. Enrollment max: 3. Edward Rampersaud, MD; and urology staff.
Examples of unacceptable alternative AI experiences
- Psychiatry and Neurology have a significant general medicine emphasis in PGY 1 and will not be included as alternative acting internship opportunities.
- Alternative acting internships will not include specialties that require an initial preliminary intern year before starting the specialty residency as a PGY-2 (for example, Ophthalmology).
- Alternative acting internships will not include specialties that offer integrated programs combining a traditional preliminary year with their residency, they will be treated like a specialty that require a preliminary year residency before starting the core residency (for example, Anesthesiology).
Summary lists of specialties that fulfill or do not fulfill AI requirements
List 1: AI in these specialties fulfills AI requirements
(*) indicates AI electives that must be pre-approved by a student affairs dean
- Emergency Medicine
- Family Medicine
- Internal Medicine
- Neurological Surgery (*)
- Obstetrics-Gynecology
- Orthopedic Surgery (*)
- Otolaryngology (*)
- Pediatrics
- General Surgery
- Urology (*)
List 2: AI in these specialties does not fulfill AI requirements
- Anesthesiology
- Dermatology
- Interventional Radiology
- Neurology (pediatric and adult)
- Ophthalmology
- Pathology
- Physical Medicine & Rehab
- Plastic Surgery (Integrated)
- Psychiatry
- Radiology-Diagnostic
- Thoracic Surgery
- Any specialty not listed in List 1
Rotations for Career Choices
The choice of elective rotations should be guided by the student's career goal and the Rotations suggested below for that career goal.
Note: A minimum of 36 weeks is needed to complete course work for the academic year and no more than 16 weeks may be taken in a specialty area.
Anesthesiology
All required courses/credits for fourth year | See fourth year curriculum guide for a complete list of courses. | Weeks: 14 |
Selective experiences for career choice | Student is to choose 12 hours from the following choices: Anesthesiology (Up to 12) Critical Care (ICU)* (Up to 4) Emergency Medicine (Up to 4) Surgery/Specialty Surgery (Up to 4) Cardiology (Up to 4) Ob/Gyn (Up to 4) Endocrinology/Nephrology (Up to 4) | 12 |
Electives | 6 |
*In addition to the required fourth year rotation
Child Psychiatry
All required courses/credits for fourth year | See fourth year curriculum guide for a complete list of courses. | Weeks: 14 |
Selective experiences for career choice | Student is to choose 12 hours from the following choices: Inpatient Psychiatry (Up to 4) Outpatient Psychiatry (Up to 4) Clinical Child Psychiatry (Up to 4) Clinical Pharmacology (Up to 4) Family Medicine (Up to 4) Neurology (Up to 4) Pediatrics (Up to 4) | 12 |
Electives | 6 |
Dermatology
All required courses/credits for fourth year | See fourth year curriculum guide for a complete list of courses. | Weeks: 14 |
Selective experiences for career choice | Student is to choose 12 hours from the following choices: Dermatology (Up to 12) Internal Medicine (Up to 4) Pathology (Up to 4) Plastics (Up to 4) | 12 |
Electives | 6 |
Emergency Medicine
All required courses/credits for fourth year | See fourth year curriculum guide for a complete list of courses. | Weeks: 14 |
Selective experiences for career choice | Student is to choose 12 hours from the following choices: Emergency Medicine (Up to 8) Internal Medicine (Up to 4) Surgery (Up to 8) Radiology (Up to 4) Pre-hospital Medicine (Up to 4) Anesthesiology (Up to 4) Pediatrics (Up to 4) Neurology (Up to 4) | 12 |
Electives | 6 |
‾Cardiology, Pulmonary, or other Subspecialty
^General, Plastics, Orthopedics, ENT, or Ophthalmology
Family Medicine
All required courses/credits for fourth year | See fourth year curriculum guide for a complete list of courses. | Weeks: 14 |
Selective experiences for career choice | Student is to choose 12 hours from the following choices: Family Medicine (Up to 4) Internal Medicine (Up to 8) Surgery (Up to 4) OB/GYN (Up to 4) Pediatrics (Up to 4)Radiology (Up to 4)Psychiatry (Up to 4)Sports Medicine (Up to 4) Neurology (Up to 4) Dermatology (Up to 4) Pain Management or PM&R (Up to 4) | 12 |
Electives | 6 |
* Cardiology, Pulmonary, Geriatrics, GI
^ General, Urology, Orthopedics, ENT, or Ophthalmology
General Surgery
All required courses/credits for fourth year | See fourth year curriculum guide for a complete list of courses. | Weeks: 14 |
Selective experiences for career choice | Student is to choose 12 hours from the following choices: Specialty Surgery (Up to 12) Anesthesia (Up to 4) Neurology (Up to 4) Internal Medicine (Up to 4) Radiology (Up to 8) General Surgery (Up to 12) Surgical Intensive Care (Up to 4)Gross Anatomy Elective (up to 2) | 12 |
Electives | 6 |
*Pediatric, Cardio-Thorasic, Vascular, Urology, Otolaryngology, Orthopedic, Plastic, or Neurosurgery Cardiopulmonary, Nephrology, Infectious Disease
Internal Medicine
All required courses/credits for fourth year | See fourth year curriculum guide for a complete list of courses. | Weeks: 14 |
Selective experiences for career choice | Student is to choose 12 hours from the following choices: Specialty Internal Medicine (Up to 12) General Internal Medicine (Up to 8) Neurology (Up to 4) Radiology (Up to 4) Specialty Surgery (Up to 4) Dermatology (Up to 4) Anesthesiology (Up to 4) | 12 |
Electives | 6 |
^Otolaryngology, Ophthalmology, Other
Interventional Radiology
All required courses/credits for fourth year | See fourth year curriculum guide for a complete list of courses. | Weeks: 14 |
Selective experiences for career choice | Student is to choose 12 hours from the following choices: Radiology (Up to 8) Gastroenterology (Up to 4) Urology, Orthopedic Surgery, Vascular Surgery, Cardiothoracic Surgery (Up to 4) General Surgery (Up to 4) | 12 |
Electives | 6 |
^Otolaryngology, Ophthalmology, Other
Medicine/Pediatrics
All required courses/credits for fourth year | See fourth year curriculum guide for a complete list of courses. | Weeks: 14 |
Selective experiences for career choice | Student is to choose 12 hours from the following choices: Pediatric or Adult Medicine (Up to 8) Inpatient Pediatrics (Up to 8) Radiology (Up to 4) Specialty Surgery (Up to 4) Infectious Disease (Up to 4) Dermatology (Up to 4) Psychiatry/Child Psychiatry (Up to 4) | 12 |
Electives | 6 |
*Ward, Cardiology, Neurology, Outpatient, other subspecialties Otolaryngology, Ophthalmology, Other
Neurology
All required courses/credits for fourth year | See fourth year curriculum guide for a complete list of courses. | Weeks: 14 |
Selective experiences for career choice | Student is to choose 12 hours from the following choices: Neurosurgery (Up to 4) Radiology or Neuroradiology (Up to 4) Internal Medicine (Up to 4) Psychiatry (Up to 4) Child Psychiatry (Up to 4) Child Neurology (Up to 4)Family Medicine (Up to 4) Neurology (Up to 8) Geriatrics (Up to 4) | 12 |
Electives | 6 |
*Ambulatory, Cardiology, Rheumatology, Infectious Disease, Pulmonary, Endocrinology
Neurosurgery
All required courses/credits for fourth year | See fourth year curriculum guide for a complete list of courses. | Weeks: 14 |
Selective experiences for career choice | Student is to choose 12 hours from the following choices: Neurosurgery (Up to 8) General Surgery (Up to 4) Radiology or Neuroradiology (Up to 4) Internal Medicine (Up to 4) Neurology (Up to 4) Trauma (Up to 4) Infectious Disease (Up to 4) | 12 |
Electives | 6 |
*General, Cardiology, Pulmonary, Nephrology
Obstetrics and Gynecology
All required courses/credits for fourth year | See fourth year curriculum guide for a complete list of courses. | Weeks: 14 |
Selective experiences for career choice | Student is to choose 12 hours from the following choices: Obstetrics and Gynecology* (Up to 12) Medicine^ (Up to 8) Urology (Up to 4) General Pediatrics (Up to 4) NICU (Up to 4) General Surgery (Up to 4) General Internal Medicine (Up to 4) Anesthesiology (Up to 4) | 12 |
Electives | 6 |
* Subspecialties included
^Cardiology, Pulmonary, Nephrology, Neurology, Gastrointestinal
Ophthalmology
All required courses/credits for fourth year | See fourth year curriculum guide for a complete list of courses. | Weeks: 14 |
Selective experiences for career choice | Student is to choose 12 hours from the following choices: Ophthalmology (Up to 12) Surgery* (Up to 8) Internal Medicine^ (Up to 8) Anesthesiology (Up to 4) Neurology (Up to 4) | 12 |
Electives | 6 |
*Plastics, ENT
^Ambulatory, Inpatient, Cardiology, Dermatology, Infectious Disease
Orthopedic Surgery
All required courses/credits for fourth year | See fourth year curriculum guide for a complete list of courses. | Weeks: 14 |
Selective experiences for career choice | Student is to choose 12 hours from the following choices: Orthopedic Surgery (Up to 12) General Surgery (Up to 4) Radiology (Up to 4) Anesthesiology (Up to 4) Specialty Surgery (Up to 4) *Internal Medicine (Up to 8)PM&R (Up to 4) | 12 |
Electives | 6 |
* General IM, Cardiology, Neurology, Endocrinology, Rheumatology, Infectious Disease, Rehabilitation
Otolaryngology
All required courses/credits for fourth year | See fourth year curriculum guide for a complete list of courses. | Weeks: 14 |
Selective experiences for career choice | Student is to choose 12 hours from the following choices: Otolaryngology (Up to 12) Surgery (Up to 8) Radiology (Up to 4) Medicine (Up to 4) Anesthesiology (Up to 4) Infectious Disease (Up to 4) | 12 |
Electives | 6 |
*Oral Maxillofacial, General
^ Cardiology, Pulmonary
Pathology
All required courses/credits for fourth year | See fourth year curriculum guide for a complete list of courses. | Weeks: 14 |
Selective experiences for career choice | Student is to choose 12 hours from the following choices: Pathology (Up to 8) Dermatology (Up to 2) Hematology/Oncology (Up to 4) Surgery (Up to 4) Cross Sectional Imaging (Up to 4) Infectious Disease (Up to 4) | 12 |
Electives | 6 |
Pediatrics
All required courses/credits for fourth year | See fourth year curriculum guide for a complete list of courses. | Weeks: 14 |
Selective experiences for career choice | Student is to choose 12 hours from the following choices: Pediatrics (Up to 8) Subspecialty Pediatrics (Up to 8) Pediatric ICU or Neonatal ICU (Up to 4) Psychiatry (Pediatric) (Up to 4) Infectious Disease (Up to 4) Family Medicine (Up to 4) Radiology (Up to 4) | 12 |
Electives | 6 |
*General, Otolaryngology
^In addition to required 4th year rotation
Physical Medicine & Rehabilitation (PM&R)
All required courses/credits for fourth year | See fourth year curriculum guide for a complete list of courses | Weeks: 14 |
Selective experiences for career choice | Student is to choose 12 hours from the following choices: PM&R (Up to 8) Anesthesiology (Up to 4) Neurology (Up to 4) Neurosurgery (Up to 4) Orthopedic Surgery/Sports Medicine (Up to 4) Pediatrics (Up to 4) Radiology (Up to 4) Rheumatology (Up to 4) Urology (Up to 4) | 12 |
Electives | 6 |
Plastic Surgery
All required courses/credits for fourth year | See fourth year curriculum guide for a complete list of courses. | Weeks: 14 |
Selective experiences for career choice | Student is to choose 12 hours from the following choices: Plastic Surgery (Up to 12) Surgery (Up to 8) Dermatology (Up to 4) Internal Medicine (Up to 4) Wound Care (Up to 4) | 12 |
Electives | 6 |
*General, Oral Maxillofacial
^ Subspecialty
Psychiatry
All required courses/credits for fourth year | See fourth year curriculum guide for a complete list of courses. | Weeks: 14 |
Selective experiences for career choice | Student is to choose 12 hours from the following choices: Inpatient Psychiatry (Up to 4) Outpatient Psychiatry (Up to 4) Child Psychiatry (Up to 4) Family Medicine, IMED, Critical Care (Up to 4) Neurology (Up to 4) Geriatrics, Geriatric Psychiatry (Up to 4) | 12 |
Electives | 6 |
Radiology
All required courses/credits for fourth year | See fourth year curriculum guide for a complete list of courses. | Weeks: 14 |
Selective experiences for career choice | Student is to choose 12 hours from the following choices: Radiology (Up to 8) Pediatrics (Up to 4) Internal Medicine (Up to 8) Orthopedic Surgery (Up to 4) Surgery (Up to 4) | 12 |
Electives | 6 |
*General Subspecialty
^Vascular, Trauma
Urology
All required courses/credits for fourth year | See fourth year curriculum guide for a complete list of courses. | Weeks: 14 |
Selective experiences for career choice | Student is to choose 12 hours from the following choices: Urology (Up to 8) General Surgery (Up to 8) Medicine* (Up to 8) Gynecology (Up to 4) | 12 |
Electives | 6 |
*Cardiology, Pulmonary, Nephrology, Gastroenterology
Critical Care (ICU)
Critical Care expirence must be in
- Internal Medicine
- Pediatrics
- Surgery
Students are also required to complete online course materials from the Society of Critical Care Medicine while on thier Critical Care rotation.
Remember: Acting Internships and ICU rotations must be completed as separate experiences, but may be done at an off-campus site that is LCME approved or an ACGME accredited residency program site. Review the information found on the Student Initiated Electives Scheduling page when scheduling your fourth-year electives.
Required Rotations/Course
Each student will be required to satisfactorily complete:
- A four-week Acting Internship (in Family Medicine, General Internal Medicine, General Pediatrics, Med/Peds, or General Surgery). To qualify as meeting this curricular requirement, the experience must:
- Be in Family Medicine, General Internal Medicine, General Pediatrics, Med/Peds, or General Surgery
- Contain an inpatient component
- Provide the student with primary care responsibility for a panel of his/her own patients and direct supervision by senior staff faculty and/or a senior resident (they should not "share" patients with, or be supervised by, a PGY1 trainee)
- Call component required
- Multiple Acting Internships are available at Texas A&M University Health Science Center College of Medicine campuses
- The four-week Emergency Medicine Clerkship
- A four-week Critical Care Rotation, with direct supervision by attending physicians and/or senior level residents.
- The two-week Professionalism Course
NOTE: Emergency Medicine rotations must be completed on one of the Texas A&M University Health Science Center College of Medicine campuses. Acting Internships and ICU rotations must be completed as separate experiences, but may be done at an off-campus site that is LCME approved or an ACGME accredited residency program site.