Clinical Phase

During supervised clinical practice experiences (SCPE), students apply the knowledge, technical and critical thinking skills aquired in the didactic phase of the program to patients in various health care settings.

Under the supervision of clinical preceptors, students acquire the competencies needed for clinical PA practice. They are exposed to diverse patient populations across the life span in the disciplines of family medicine, internal medicine, pediatrics, surgery, obstetrics/gynecology, emergency medicine, long term care, and behavioral health.

Beginning in the fifth semester, students participate in 10 supervised clinical practice experiences (SCPEs) over approximately 15 months. Two of the ten SCPEs (clinical rotations) are electives. Clinical rotation assignments are made by the program; students are not required to arrange for their own clinical placements. 

During each five- week SCPE (clinical rotation), physician assistant students obtain exposure to the scope of practice in medical or surgical disciplines. As an integral part of the inter-disiplinary health-care team, the PA student is assigned to and supervised by a clinical preceptor. The PA student obtains medical histories, performs physical examinations, develops working differential diagnoses/assessments, orders and interprets appropriate laboratory and other diagnostic tests, performs therapeutic procedures, arrives at a final diagnosis and develops a comprehensive treatment plan. 

Supervised clinical practice experiences occur within out-patient and in-patient settings such as hospitals, clinics, private practices, emergency departments, and long term care facilities. We have a wide variety of excellent clinical sites in the greater New York metropolitan and Long Island area where students interact with diverse patient populations.

SEMESTER V (SPRING)

PACN 660-PACN 687 | Rotation #1 (5 Credits)

PACN 660-PACN 687 | Rotation #2 (5 Credits)

PACN 660-PACN 687 | Rotation #3 (5 Credits)

Total Credits = 15

SEMESTER VI (SUMMER)

PACN 660-PACN 687 | Rotation #4 (5 Credits)

PACN 660-PACN 687 | Rotation #5 (5 Credits)

PACN 660-PACN 687 | Rotation #6 (5 Credits)

MPAN 643 - Medical Ethics, Health Policy, and Professional Practice (2 Credits)

In seminar format, topics in medical ethics that develop the analytical skills and reflective sensitivity required for responsive, responsible and productive decision-making between patients and professional. Topics discussed include ethical decisions at both the beginning and the end of life, risk/benefit decision-making in medicine, confidentiality and privacy. Students also discuss and analyze a variety of professional practice issues, such as privilege and confidentiality in communicating with patients, political and legal issues, credentialing and licensure, professional liability, and the physician-PA team relationship.

Total Credits = 17

SEMESTER VII (FALL)

PACN 660-PACN 687 | Rotation #7 (5 Credits)

PACN 660-PACN 687 | Rotation #8 (5 Credits)

PACN 660-PACN 687 | Rotation #9 (ELECTIVE ROTATION) (5 Credits)

MPAN 665 - Evidence-Based Medicine (2 Credits)

This course introduces physician assistant students to principles of evidence-based practice and policy, national practice guidelines and other best-practice paradigms. Various medical practice areas will be studied in an effort to demonstrate applicability of the evidence-based approach. This course teaches students to discern evidence-based approaches in the literature and apply appropriate findings to their future practice. The exercises, discussions and readings offered in this course guide students in their development as clinicians capable of mindful critique. Furthermore, the course provides strategies for integrating this new information into the student\'s own, personalized approach to clinical practice.

Total Credits = 17

SEMESTER VIII (SPRING)

HSBN 668 - Community Service (1 Credit)

In keeping with the Touro College mission to serve the larger community, students in the School of Health Sciences are required to complete an independent study that involves a minimum of twenty-five (25) hours of community service with individuals disadvantaged due to illness, disability, or other circumstance. The purpose of this requirement is to (1) provide students in the School of Health Sciences with an opportunity to learn from, and give back to, the larger community; (2) enhance awareness of how a disability or illness impacts the individual, family, friends, caregivers, and community. Through this experience, students may interact with people from different cultural and socioeconomic backgrounds, with people who have impairments leading to functional limitations in the physical, cognitive, and/or social-emotional domains, or with people who struggle with issues related to poverty, homelessness and hunger. The specifics of the experience and project undertaken are negotiated on an individual basis between the student and the department faculty advisor. HS 669 may be taken as an additional elective, upon approval of the student\'s advisor, in the same or subsequent semesters.

MPAN 642 - Health Care Delivery Systems (3 Credits)

The course is designed to instruct students on general concepts of health care delivery and the characteristics and functions of some important delivery systems. Emphasis will be placed on decentralized, community-based and primary care systems, ambulatory care systems, as well as long term care systems. The student will be exposed to financial and ethical issues that challenge today’s system and ways to address it.

MPAN 659 - Master's Capstone Project (3 Credits)

This course is designed as a “capstone” to the program. Students will work with a faculty advisor, to formulate a clinical question and perform a literature search on the topic. This will allow an opportunity to demonstrate analytical ability and comprehensive understanding of a subject. The research work will allow the student to conduct a literature review, explore and analyze a problem, and design a study to answer a clinical question.

PACN 700 - Culminating Elective (4 Credits)

This is a second elective learning experience of 4 weeks\' duration, scheduled during the last semester of the program, where the student develops a one-on-one relationship with the supervising physician. The student has the opportunity to gain a more advanced level of clinical experience in an area or specialty of future employment. Students are expected to analyze and synthesize medical information, to reason independently, and to apply the concepts of medical decision-making and problem-solving to complex patient presentations.

Prerequisites: Any one of PAC 680 - PAC 690

PAMN 637 - Clinical Skills/Summative Evaluation (1 Credit)

The Clinical Skills/Summative Evaluation course is designed to evaluate a student’s readiness for the NCCPA board certification examination and for entry into clinical practice. This course includes the following components: a formative 200 question summative examination, patient logging requirements for each rotation, an Objective Structured Clinical Examination (OSCE), clinical writing documentation and attendance of a Board Review Course sponsored by the institution. The summative exam is based on the NCCPA content blueprint task and content areas. It is an exam that is given in the final semester of the clinical year, and is designed to provide students with feedback in content area strength and weakness. The clinical skills portion of PAM 637, the OSCE, will assess history taking skills, physical examination skills, patient-clinician communication as well as clinical reasoning and critical thinking. General principles of clinical observation, assessment, establishing of treatment goals, report writing, documentation and professional preparation will also be addressed. Students are required to successfully complete all medical documentation and writing assignments as required for each clinical rotation. Graduation from the BS/MS PA program and certification eligibility is contingent on the successful completion of this course.

Total Credits = 12

 

Required Core Discipline

PACN 670 - Family Medicine

Students are assigned to an out-patient department, family medical clinic or office practice, and work under supervision of licensed family medicine physicians and/or physician assistants and in conjunction with the health care team. This core rotation provides students with the opportunity to acquire the skills and knowledge necessary to serve a diverse cross-section of the patient population, and to treat patients of all ages in an ambulatory care setting. Students learn psychosocial aspects of health care as well as how to provide family-oriented primary care services, such as acute and chronic disease management, health promotion, maintenance, patient education and disease prevention. Students incrementally develop the ability to analyze and synthesize medical information, to reason independently, and to apply the concepts of medical decision-making and problem-solving to complex patient presentations. In addition, students are familiarized with the differences in the coordination, management and follow-up of the outpatient as compared to the hospitalized patient, and with recognizing when to refer the patient for hospital admission. Students will be required to take a comprehensive exam upon completion of the rotation.

PACN 671 - Pediatrics

Students are assigned to work under the supervision of licensed physicians and/or physician assistants and in conjunction with the healthcare team, either in an inpatient or an outpatient pediatric department, clinic, or office. This core rotation emphasizes the care of the child from birth to adolescence. Students learn to recognize and manage common childhood illnesses, assess variations in normal growth and development, and provide preventive health care services including immunizations, routine screening, parental and interventional counseling. Students incrementally develop the ability to analyze and synthesize medical information, to reason independently, and to apply the concepts of medical decision-making and problem-solving to complex patient presentations. Students are required to attend daily rounds, grand rounds, scheduled lectures and conferences while on the pediatrics in-patient service. Students will be required to take a comprehensive exam upon completion of the rotation.

PACN 672 - Emergency Medicine

Students are assigned to work under the supervision of licensed physicians and/or physician assistants and in conjunction with the healthcare team in the emergency room setting. In this core rotation, students rotate through the various areas of the Emergency Department, including medical, surgical, pediatric, orthopedic, and fast track. Students learn to systematically evaluate and manage patients with acute medical and surgical emergencies, perform diagnostic and therapeutic procedures, and participate in cardiac and trauma resuscitations. Students incrementally develop the ability to analyze and synthesize medical information, to reason independently, and to apply the concepts of medical decision-making and problem-solving to complex patient presentations. Students are expected to attend grand rounds and scheduled lectures. Students will be required to take a comprehensive exam upon completion of the rotation.

PACN 673 - Surgery

Students are assigned to work under the supervision of licensed surgeons and/or physician assistants and in conjunction with the healthcare team in the Department of Surgery. In this core rotation, students become involved in all phases of diagnosis and treatment of the surgical patient, including pre-operative, operative, and post-anesthesia care. They learn the practical management of fluid, electrolyte and nutritional disturbances, post-operative infections, as well as wound healing and wound care. They scrub into the operating room and observe and assist in a variety of surgical procedures as assigned by the preceptor(s), and also become involved in the management of the critically ill surgical patient. Students incrementally develop the ability to analyze and synthesize medical information, to reason independently, and to apply the concepts of medical decision-making and problem-solving to complex patient presentations. Students are expected to attend daily rounds, grand rounds, morbidity & mortality conferences and scheduled lectures while on the surgery service. Students are assigned to work directly with attending physicians and / or resident - PA staff in the Department of Surgery. Students will be required to take a comprehensive exam upon completion of the rotation.

PACN 674 - Internal Medicine

Students are assigned to the Department of Medicine and work directly under the supervision of the medical house staff or work in an outpatient internal medicine setting. Emphasis is placed on the hospitalized, acute, non-surgical adult patient

In this core rotation, students medically evaluate hospitalized patients and follow their daily progress. By doing so, students learn how to correlate history and physical findings with the patient’s physiological and laboratory data and emotional state, in order to arrive at a differential diagnosis, formulate a treatment plan and appreciate how to provide continuity of care. Students develop skills and demonstrate competency in performing and interpreting a variety of medical procedures and tasks. Attendance at daily rounds, grand rounds, medical conferences and orientation to the medical intensive care unit is required. In certain settings, there are opportunities to work with the house-staff who are assigned to the medical clinic area, to monitor and follow up patient management problems, and to participate in the formulation of their management plans. If the student is an out-patient setting, they will participate in in-patient rounds with the MD/ DO/PA/NP. Students incrementally develop the ability to analyze and synthesize medical information, to reason independently, and to apply the concepts of medical decision-making and problem-solving to complex patient presentations. Students will be required to take a comprehensive exam upon completion of the rotation.

PACN 675 - Geriatric Medicine

Students are assigned to work under the supervision of licensed physicians and/or physician assistants in conjunction with the healthcare team to gain practical clinical experience in working with the elderly and those patients who are suffering from chronic diseases. In this core rotation, students are exposed to a wide variety of common geriatric and long-term care problems. This rotation stresses characteristics of the normal aging process, so that students may better identify and address deviations from the norm. Students gain exposure to end-of-life issues and psychosocial dynamics. Students incrementally develop the ability to analyze and synthesize medical information, to reason independently, and to apply the concepts of medical decision-making and problem-solving to complex patient presentations. students should be able to differentiate the care of elderly and those suffering from chronic diseases. Emphasis is placed on the geriatric patient for both acute and on-going care. Students are assigned to work directly with attending physicians and / or resident - PA staff while they gain practical clinical experience in working with patients across the life-span. Students are exposed to a wide variety of common geriatric problems. Students are required to attend rounds, grand rounds, scheduled lectures and conferences while on Geriatric Medicine. Students will be required to take a comprehensive exam upon completion of the rotation.

PACN 676 - Obstetrics/Gynecology

Students are assigned to work under the supervision of licensed physicians and/or physician assistants in conjunction with the healthcare team, either in an inpatient or an outpatient OB/GYN department, clinic, or office. In this core rotation, students gain practical experience in evaluating obstetrical and gynecological patients. Students become familiar with the care and management of ante-partum and post-partum patients, and occasionally assist in deliveries. Students perform pre-natal care, including routine examinations of expectant mothers as they progress through their pregnancies. Students also become familiar with the care and management of a wide variety of gynecological problems, as well as health promotion and disease prevention of the female reproductive tract. Students develop competency in the performance of annual exams and Pap smears, counseling for birth control, infertility, menstruation, and sexuality. Students incrementally develop the ability to analyze and synthesize medical information, to reason independently, and to apply the concepts of medical decision-making and problem-solving to complex patient presentations. Students are expected to attend inpatient rounds, conferences and scheduled lectures while on an inpatient service. Students will be required to take a comprehensive exam upon completion of the rotation.

PACN 678 - Behavioral Medicine

Students are assigned to work under the supervision of licensed physicians and/or physician assistants in conjunction with the healthcare team in an inpatient and or outpatient behavioral health setting where they will learn a biopsychosocial approach to psychiatric, cognitive and behavioral problems. In this core rotation, students will evaluate and manage patients with a variety of behavioral health problems. The student will perform basic psychiatric evaluations, develop skills in performing mental status examinations and psychiatric interviews while incorporating behavioral dynamics in this patient population. The student will review and monitor medications and support the clinical management plan for patients receiving psychiatric evaluation and treatment. Students will incrementally develop the ability to analyze and synthesize medical information, to reason independently, and to apply the concepts of team-based medical problem-solving and patient-centered care decisions. Students are expected to attend interdisciplinary meetings, patient rounds and scheduled lectures.

Main Discipline Electives (Each student will choose 1 elective and 1 advanced elective)

PACN 660 - Family Medicine Elective

Students are assigned to an out-patient department, family medical clinic or office practice, and work under supervision of licensed family medicine physicians and/or physician assistants and in conjunction with the health care team. This is a repeat of a core rotation in Family Medicine that provides students with another opportunity to acquire the skills and knowledge necessary to serve a diverse cross-section of the patient population, and to treat patients of all ages in an ambulatory care setting. Students learn psychosocial aspects of health care as well as how to provide family-oriented family medicine services, such as acute and chronic disease management, health promotion, maintenance, patient education and disease prevention. Students incrementally develop the ability to analyze and synthesize medical information, to reason independently, and to apply the concepts of medical decision-making and problem-solving to complex patient presentations. In addition, students are familiarized with the differences in the coordination, management and follow-up of the outpatient as compared to the hospitalized patient, and with recognizing when to refer the patient for hospital admission. Students will be required to take a comprehensive exam upon completion of the rotation.

PACN 661 - Pediatrics Elective

Students are assigned to work under the supervision of licensed physicians and/or physician assistants and in conjunction with the healthcare team, either in an inpatient or an outpatient pediatric department, clinic, or office. This is a repeat of a core rotation in Pediatrics that emphasizes the care of the child from birth to adolescence. Students learn to recognize and manage common childhood illnesses, assess variations in normal growth and development, and provide preventive health care services including immunizations, routine screening, parental and interventional counseling. Students incrementally develop the ability to analyze and synthesize medical information, to reason independently, and to apply the concepts of medical decision-making and problem-solving to complex patient presentations. Students are required to attend daily rounds, grand rounds, scheduled lectures and conferences while on the pediatrics in-patient service. Students will be required to take a comprehensive exam upon completion of the rotation.

PACN 662 - Emergency Medicine Elective

Students are assigned to work under the supervision of licensed physicians and/or physician assistants and in conjunction with the healthcare team in the emergency room setting. In this repeat of a core rotation in Emergency Medicine, students rotate through the various areas of the Emergency Department, including medical, surgical, pediatric, orthopedic, and fast track. Students learn to systematically evaluate and manage patients with acute medical and surgical emergencies, perform diagnostic and therapeutic procedures, and participate in cardiac and trauma resuscitations. Students incrementally develop the ability to analyze and synthesize medical information, to reason independently, and to apply the concepts of medical decision-making and problem-solving to complex patient presentations. Students are expected to attend grand rounds and scheduled lectures. Students will be required to take a comprehensive exam upon completion of the rotation.

PACN 663 - Surgery Elective

Students are assigned to work under the supervision of licensed surgeons and/or physician assistants and in conjunction with the healthcare team in the Department of Surgery. In this repeat of a core rotation in Surgery, students become involved in all phases of diagnosis and treatment of the surgical patient, including pre-operative, operative, and post-anesthesia care. They learn the practical management of fluid, electrolyte and nutritional disturbances, post-operative infections, as well as wound healing and wound care. They scrub into the operating room and observe and assist in a variety of surgical procedures as assigned by the preceptor(s), and also become involved in the management of the critically ill surgical patient. Students incrementally develop the ability to analyze and synthesize medical information, to reason independently, and to apply the concepts of medical decision-making and problem-solving to complex patient presentations. Students are expected to attend daily rounds, grand rounds, morbidity & mortality conferences and scheduled lectures while on the surgery service. Students will be required to take a comprehensive exam upon completion of the rotation.

PACN 664 - Internal Medicine Elective

Students are assigned to the Department of Medicine and work directly under the supervision of the medical house staff or work in an outpatient internal medicine setting. Emphasis is placed on the hospitalized, acute, non-surgical adult patient

In this repeat of a core rotation in Internal Medicine, students medically evaluate hospitalized patients and follow their daily progress. By doing so, students learn how to correlate history and physical findings with the patient’s physiological and laboratory data and emotional state, in order to arrive at a differential diagnosis, formulate a treatment plan and appreciate how to provide continuity of care. Students develop skills and demonstrate competency in performing and interpreting a variety of medical procedures and tasks. Attendance at daily rounds, grand rounds, medical conferences and orientation to the medical intensive care unit is required. In certain settings, there are opportunities to work with the house-staff who are assigned to the medical clinic area, to monitor and follow up patient management problems, and to participate in the formulation of their management plans. If the student is an out-patient setting, they will participate in in-patient rounds with the MD/ DO/PA/NP. Students incrementally develop the ability to analyze and synthesize medical information, to reason independently, and to apply the concepts of medical decision-making and problem-solving to complex patient presentations. Students will be required to take a comprehensive exam upon completion of the rotation.

PACN 665 - Long Term Care Elective

Students are assigned to work under the supervision of licensed physicians and/or physician assistants in conjunction with the healthcare team to gain practical clinical experience in working with the elderly and those patients who are suffering from chronic diseases. In this repeat of a core rotation in Long Term Care, students are exposed to a wide variety of common geriatric and long-term care problems. This rotation stresses characteristics of the normal aging process, so that students may better identify and address deviations from the norm. Students gain exposure to end-of-life issues and psychosocial dynamics. Students incrementally develop the ability to analyze and synthesize medical information, to reason independently, and to apply the concepts of medical decision-making and problem-solving to complex patient presentations.

Students are assigned to work directly with attending physicians and / or resident - PA staff while they gain practical clinical experience in working with patients across the life-span. There is a strong focus on long term care. Students should be able to differentiate the care of elderly and those patients who are suffering from chronic diseases. Emphasis is placed on the geriatric patient for both acute and on-going care. Students are exposed to a wide variety of common geriatric and long term care problems. Students are required to attend rounds, grand rounds, scheduled lectures and conferences while on the Geriatric / Long Term Care service. Students will be required to take a comprehensive exam upon completion of the rotation.

PACN 666 - Obstetrics and Gynecology Elective

Students are assigned to work under the supervision of licensed physicians and/or physician assistants in conjunction with the healthcare team, either in an inpatient or an outpatient OB/GYN department, clinic, or office. In this repeat of a core rotation in OB/GYN, students gain practical experience in evaluating obstetrical and gynecological patients. Students become familiar with the care and management of ante-partum and post-partum patients, and occasionally assist in deliveries. Students perform pre-natal care, including routine examinations of expectant mothers as they progress through their pregnancies. Students also become familiar with the care and management of a wide variety of gynecological problems, as well as health promotion and disease prevention of the female reproductive tract. Students develop competency in the performance of annual exams and Pap smears, counseling for birth control, infertility, menstruation, and sexuality. Students incrementally develop the ability to analyze and synthesize medical information, to reason independently, and to apply the concepts of medical decision-making and problem-solving to complex patient presentations. Students are expected to attend inpatient rounds, conferences and scheduled lectures while on an inpatient service. Students will be required to take a comprehensive exam upon completion of the rotation.

General Electives

PACN 677 - Psychiatry

Students are assigned to work under the supervision of licensed physicians and/or physician assistants in conjunction with the healthcare team in an inpatient psychiatric setting, where they will learn a biopsychosocial approach to mental illness. In this elective rotation, students will evaluate and manage patients with a variety of psychiatric problems, do follow-up evaluations of those patients seen in the Psychiatric Emergency Room, and develop skills in the performance of mental status exams and psychiatric interviews. Students study the diagnoses and treatment plans of child and adolescent patients, and the daily, intensive long-term treatment of severely disturbed out-patients, to gain an understanding of psychopathology, therapeutic community and team functioning. Students incrementally develop the ability to analyze and synthesize medical information, to reason independently, and to apply the concepts of medical decision-making and problem-solving to complex patient presentations. Students are expected to attend scheduled.

Prerequisite: PACN 678 Behavioral health

PACN 680 - Pediatric Subspecialty

This elective rotation provides students with another pediatric clinical experience in a neonatal unit, and is available to those who have completed the required Pediatrics rotation. Students are assigned to work directly with pediatricians in a hospital setting. Students gain experience in analyzing historical and physical findings and diagnostic tests to formulate differential diagnoses, treatment plans, and counseling strategies in a neonatal unit. Students are expected to analyze and synthesize medical information, to reason independently, and to apply the concepts of medical decision-making and problem-solving to complex neonatal patient presentations. Students will be required to take a comprehensive exam upon completion of the rotation.

Prerequisite: PACN 671 Pediatrics

PACN 681 - Infectious Diseases

This elective clinical learning experience takes place in both in-patient and out-patient settings. Students are assigned to work directly with attending physicians and/or physician assistants in conjunction with the health care team in the Department of Infectious Diseases. Students develop proficiency in anti-microbial therapy, immunizations, and the work-up and management of infectious diseases, with special emphasis on AIDS and AIDS-related illnesses. Also, students learn and apply infectious disease control measures. Students may attend rounds, grand rounds, scheduled lectures and conferences while on the Infectious Diseases service. Students are expected to analyze and synthesize medical information, to reason independently, and to apply the concepts of medical decision-making and problem-solving to complex patient presentations. Students may be required to write a clinical research paper on a relevant topic or case or take a comprehensive exam.

Prerequisites: PACN 674

PACN 682 - Orthopedics

This elective clinical learning experience takes place in both the clinic and hospital settings. Students are assigned to work directly with attending physicians and/or physician assistants in conjunction with the healthcare team in the Department of Orthopedic Surgery. Students develop proficiency in the evaluation, diagnosis, and management of orthopedic problems in the adult and pediatric populations. They have the opportunity to observe and "scrub in" to assist in orthopedic surgical cases, to reinforce knowledge of sterile technique and the proper use of surgical instruments, and to participate in preoperative and postoperative management of the orthopedic patient. Students attend rounds, grand rounds, scheduled lectures and conferences while on the Orthopedic Surgery service. Students are expected to analyze and synthesize medical information, to reason independently, and to apply the concepts of medical decision-making and problem-solving to complex patient presentations. Students are required take a comprehensive exam upon completion of the rotation.

PACN 683 - Surgical Subspecialty

This elective rotation is available to students who have completed the General Surgery rotation. The surgical subspecialty rotations provide students the opportunity to concentrate on learning the work-up, diagnosis and medical management of patients in a variety of surgical subspecialties, such as cardiothoracic surgery, plastic and reconstructive and neurosurgery and surgical intensive care unit. Students are assigned to work directly with surgeons and/or physicians assistants in conjunction with the healthcare team. They have the opportunity to "scrub in" to assist in surgical cases, and develop proficiency in the surgical work-up, intra-operative intervention and post-operative management of patients. They also follow patients in the critical care setting and on the floors. Students are required to attend rounds, grand rounds, scheduled lectures and conferences while on the service. Students are expected to analyze and synthesize medical information, to reason independently, and to apply the concepts of medical decision-making and problem-solving to complex patient presentations.

In CT surgery students will have the opportunity to observe and scrub in to assist in cardio-thoracic surgical cases. Students will develop proficiency in the surgical workup, intra-operative intervention and post-operative management of cardio-thoracic patients. Students will follow patients in the critical care setting and on the floors. While in the critical care setting, students will become familiar with the placement, maintenance, monitoring and removal of central venous lines, Swan-Ganz Catheters, chest tubes and arterial lines. Students will understand fluid & electrolyte management, become familiar with the management of ventilator patients and the interpretation of arterial blood gas measurements. Students will also become familiar with the pharmacological agents utilized in the care of the critically ill. Students are required to attend rounds, grand rounds, scheduled lectures and conferences while on the Cardio-thoracic Surgery service as well as any subspecialty service that the course requires. Students will be required to take a comprehensive exam in the respective surgical subspecialty.

PACN 684 - Medical Subspecialty

This elective rotation is available to students who have completed the required Internal Medicine or Family Medicine rotation. The medicine subspecialty rotations provide students the opportunity to concentrate on learning the work-up, diagnosis and medical management of patients with dermatological, gastrointestinal, endocrine, or neurological diseases respectively. Students work directly with attending physicians and/or physician assistants in conjunction with the health care team. Students attend rounds, grand rounds, scheduled lectures and conferences while on the service. Students are expected to analyze and synthesize medical information, to reason independently, and to apply the concepts of medical decision-making and problem-solving to complex patient presentations. Students are assigned to a clinic or private office practice in assigned medical subspecialty, and work directly with attending physicians and / or resident – P.A. staff. Students are required take a comprehensive exam in the respective discipline upon completion of the rotation.

PACN 685 - Critical Care Medicine

This elective clinical learning experience is available to students who have completed the General Surgery rotation and takes place in the Surgical Intensive Care Unit. Students are assigned to work directly with attending physicians and/or physician assistants in conjunction with the health care team in the Surgical ICU, where they develop proficiency in the management of critically-ill surgical patients. Students become familiar with the placement, maintenance, monitoring, and removal of central venous lines, Swan-Ganz catheters, chest tubes and arterial lines. Fluid and electrolyte management, the management of ventilator patients, the interpretation of arterial blood gas measurements, and the pharmacological agents utilized in the care of the critically ill, are also practiced. Students may attend rounds, grand rounds, scheduled lectures, and conferences while assigned to the Surgical Intensive Care Unit. Students are expected to analyze and synthesize medical information, to reason independently, and to apply the concepts of medical decision-making and problem-solving to complex patient presentations. Students are required take a comprehensive upon completion of the rotation.

Prerequisite: PACN 673.

PACN 686 - Forensic Medicine

This elective rotation provides students with a clinical experience in which there is an interface between medicine and the law, especially regarding patient deaths, some of which will fall under the jurisdiction of the Medical Examiner. This rotation provides students with the opportunity to observe and perform the tasks associated with PA\'s who work as Forensic (medico-legal) Investigators. Working with Forensic Pathologists, students are exposed to and participate in the forensic autopsy, and also spend time in the forensic serology and toxicology labs. They are introduced to forensic anthropology, forensic odontology and forensic photography. Through this rotation, students become familiar with the modern medical examiner system, the role of the Medical Examiner, and his/her relation to the criminal justice system. Students also learn the interpersonal skills necessary in dealing with families who are coping with sudden and unexpected death, public health and safety issues, and medicolegal issues. Students attend daily case review, scheduled lectures, and conferences while on the Forensic Medicine rotation. Students are required take a comprehensive exam upon completion of the rotation.

PACN 687 - Cardiology

This elective rotation is available to students who have completed the required Internal Medicine rotation. The rotation provides students the opportunity to concentrate on learning the work-up, diagnosis and medical management of patients with cardiac diseases. Students work directly with attending physicians and/or physician assistants in conjunction with the health care team. Students attend rounds, grand rounds, scheduled lectures and conferences while on the service. Students are expected to analyze and synthesize medical information, to reason independently, and to apply the concepts of medical decision-making and problem-solving to complex patient presentations.

Students are assigned to a Cardiology Department / clinic or private cardiology office practice, and work directly with attending physicians and / or resident – P.A. staff. This rotation will provide students with the opportunity to concentrate on learning the work-up, diagnosis and medical management of patients with cardiac disease. In addition, time may be spent in a cardiac catheterization laboratory. Students are required take a comprehensive exam upon completion of the rotation.

Advanced Elective

PACN 700 - Culminating Elective

This is a second elective learning experience of 5 weeks duration, scheduled during the last semester of the program, where the student develops a one-on-one relationship with the supervising physician. The student has the opportunity to gain a more advanced level of clinical experience in an area or specialty of future employment. Students are expected to analyze and synthesize medical information, to reason independently, and to apply the concepts of medical decision-making and problem-solving to complex patient presentations.

Prerequisites: Any one of PACN 660 - PACN 689

PACN 650 - Behavioral Health Elective

This elective clinical learning experience is available to students who have elected to complete the Behavioral Health Track and who have already completed the Psychiatry core rotation and the Behavioral Health Elective rotation. This elective rotation provides students with additional in-depth clinical training in the treatment of patients with behavioral health problems. Students learn with the supervision of licensed physicians and psychiatric physician assistants as well as other mental health professionals in clinical settings such as the Comprehensive Psychiatric Emergency Program (CPEP), and Behavioral Health Primary Care Outpatient Clinics. Students continue to build on the knowledge and skills they have acquired in their Behavioral Health Elective.

Prerequisite: PACN 678.