Electives & Selectives
Electives:-Four week courses designed, ideally, to approximate the variety and range of electives available to fourth year medical students.
-Available at the same time for everyone (typically May): the four weeks before your final 8-week rotation block of MS2.
-Graded H, HP, P, F.
Selectives:-Two week courses designed to give you an informational overview of a field/topic.
-Smaller list of choices than electives.
-You get one selective following your OB/GYN rotation and one following your PEDS rotation, so everyone has them at different times throughout the year.
-Graded P, F.
For elective and selective registration, timing is everything. No matter which rotation you are on or when the registration window opens, be at a computer because most courses in high demand will fill up within the first 30 seconds. I’m not kidding.
For the electives, a complete course bulletin, with contact information for course directors, is available on the registrar’s website: You can do 4- or 5-week (if you count spring break)international electives in MS2 during the May elective period. Unless you are in the military or you choose a location on an Indian reservation, electives at non-NC locations in the US are generally not possible in MS2 due to risk management issues. Electives at other NC medical schools (UNC in Chapel Hill, WakeForest in Winston-Salem, and ECU in Greenville) arepermitted.
You may ask yourself, what does UNC have that Duke doesn’t?
- a burn unit
-a physical medicine and rehabilitation program (a residency program that Duke doesn’t have)
-additional residency programs (for people who want to improve their chances in competitive fields, e.g., radiology, dermatology)
Previous MS2 international electives have included general internal medicine in Ecuador andSri Lanka, general surgery inThailand, hematology/oncology in Poland, and radiology in German-speaking Switzerland. For more information, contact Dr. Caroline Haynes (, 919-684-6406). See also the Hubert-YearganCenter for Global Health’s medical education page for international elective ideas:
As of April 2006, the following statements are valid:
Dr. Haynes says that any four-week ICU, ER, or anesthesia rotation taken during MS2 will fulfill the MS4 critical care requirement. This includes neurology if done in the neuroscience intensive care unit (4200). This does not include pediatric emergency medicine.
Dr. Sheline says that approved courses taken during MS2 will fulfill the outpatient clinic requirement (usually done in MS3 with a clinic; however, some mentors or scholarships may restrict participation). For a list of approved courses, see the MS4 elective course catalog available on the registrar’s website.
There is an MS3 practice course clinic requirement of 34 half-days. You are strongly encouraged to complete this requirement during MS3 if possible. Also, you have a wider range of clinics to choose from if you do MS3 clinic; e.g., possibly subspecialty clinics in fields you are considering for residency. Furthermore (and Dr. Haynes stressed this), if your scholarship or mentor does not forbid you from doing an MS3 clinic and you voluntarily choose not to do one, you will have to complete 36 credits during MS4, not just 32 credits like
(1) people who did MS3 clinic, or
(2) people whose scholarships or mentors prevented them from going to MS3 clinic.
Examples of acceptable reasons to defer MS3 clinic: Hughes, MPH, study away, mentor who doesn't like your spending a half-day per week in clinic. Note that although you might fall into one of these categories, you are not necessarily prevented from completing the clinic requirement.
If your scholarship or mentor precludes MS3 clinic, you can complete this requirement with the following MS4 courses. The MS4 elective catalog lists only the 4th year course numbers, so if you want to get this requirement out of the way during MS2, you have to compare the titles of MS4 and MS2 courses. I believe the following MS2 elective courses will fulfill the requirement. If your scholarship or mentor does not preclude MS3 clinic, that's a whole different ballgame. I recommend confirming any non-MS3 permutations with Dr. Sheline () just to be sure.
For selectives, the best bet is to contact the Office of the Registrar. They keep a binder of course directors for each course. Or go online and search Duke med registrar. Want to know more about, say, the SICU selective? Call the registrar at 684-2304 and get the course director’s name and email address (make sure you specify the two-week selective, as many have both a two-week and a four-week version). Most are more than willing to discuss the class with you if you show some enthusiasm.
What follows is student feedback from a small selection of electives and selectives. Keep in mind that the list of available electives and selectives is much longer than this and that these are student opinions that may differ from your own.
2010 Selectives Guide
Name: ANESTH - Clinical Anesthesiology
Main contact:Stuart Grant
Where to go on first day: Contact him
Reading ahead of time: None
Hours (generally): Usually you see cases starting at 7am or so and come back around 5-6
General advice:You get to pick the surgeries you want to see (though you'll do a day of cardiothoracic, neuro, general each). You learn A LOT (intubation, hands-on procedures), everyone in the department is chill and willing to teach, you'll spend some days in the sim lab. Recommend it to everyone. Also Dr. Grant is freaking HILARIOUS and anyone who's done surgery can second that. Most of his jokes center from the fact he's from Scotland and has the most absurd accent ever. ("My favorite movie's Shrek, not because my kids enjoy it, but because I sound like him" or "French doctors love to give tylenol suppositories since they love it up the bum.") By the end you will be expected to know how to run an anesthetic procedure, the drugs and dosages, and what to do if certain things go wrong, but you pick that up easily.
Name: Child Abuse
Main contact: Scott Snider
Where to go on first day: 4020 N. Roxboro Street
Reading ahead of time: None
Hours (generally): Mon-Fri - 9am-3pm (at the latest); Tuesday - 10am-3pm (at the latest) since there is case review at 10am in RM 2035. We're learning heavy stuff; they try not to keep us there too long.
General advice: Very chill hours. You definitely learn about clinical signs, physical findings, etc. of child abuse (sexual, neglect, physical). You end up watching interviews that Scott Snider, the clinical social worker, conducts with the kids. Afterwards, you will help Dr. St.Claire with conducting a physical exam. Beyond this, you may go to evaluate in-patient children with Dr. Narayan. If there is a court case that week, you will probably tag along. You are mainly observing, but you definitely learn a lot about child abuse overall (the psychology, the legal side, the medical side). You're there through the whole process, from the time social services or parents give a complaint for the child to be evaluated, to seeing how each case ends on the medical side.
Name: COMMFAM - Occupational Medicine: prevention and populations
Main contact:Carol Epling
Where to go on first day:contact Dr. Epling, but they probably will have you show up at Erwin Tower on Main st for orientation
Reading ahead of time:they don't expect you to know anything, but if you want you could look up hazards of the workplace, esp respiratory
Hours (generally):8-5 ish
General advice:There are several components: working at Employee Health at Duke (where we did our respirator fit testing), Integrative Medicine, Research Triangle Park, Ergonomics testing, and the AWNC auto manufacturing plant. It is mainly shadowing, in a lot of different locations. The fun/exciting part was seeing patterns of workplace injuries and prevention strategies that are in place. Honestly, I got pretty bored by the end of the two weeks, but if you ask to get directly involved they will probably let you.
Name: OBGYN- Introduction to reproductive endocrinology
Main contact:Millie Behera
Where to go on first day:Monday's are generally OR days at Duke North. But, just in case there is only REI clinic (by Southpoint) that day, contact Dr. Behera ahead of time.
Reading ahead of time:You could read a bit about the most common topics: fibroids, infertility, and assisted reproductive technologies. Dr. Behera's area of interest is fibroids, so this is an area that you will learn a lot about.
Hours (generally):Mondays (Duke North OR Day): 7am - 6pm; Tuesday-Thursday REI Clinic and Minimally Invasive Procedures: 8am - 5/6 pm; Friday (ASC OR Day): 7am-3/4pm.
General advice:Excellent exposure to clinical and surgical gyn. All the attendings and residents in the REI department are great and really go out of their way to teach/make you feel part of the team.
Name: OPTHAL - Opthalmology
Main contact:Horace Johnson, Jr.
Where to go on first day:Duke Eye Center, which is next to Duke North, and we just waited in the lobby until Horace Johnson showed up. The first day he didn't realize we were coming (!!!) so we just had that day off.
Reading ahead of time:None
Hours (generally):Mon-Fri: 8AM - 4PM (-ish). But the thing is so disorganized that you could probably just not show up any day you don't want to go.
General advice:Very relaxed. You get a mixture of OR, outpatient clinic, low vision, optometry, etc. There's a good variety of what you might see in Optho on this rotation. The days are split in half, so you're only in one place for half the day. You also have a couple noon lectures to help you learn more about optho. It's a good rotation, but you could just as well do Optho on your actual surgery rotation if you wanted...
Name: PEDS - Genetics
Main contact:Marie McDonald
Where to go on first day:Contact Dr. McDonald ahead of time if you wish; or just show up at Genetics Clinic on Monday at 8:30am (2nd floor Children's Health Center).
Reading ahead of time:If you want, read up on the more common genetic disorders: Down syndrome, autism (questionably genetic), Fabry disease, some of the glycogen storage disorders like Pompe's.
Hours (generally):Mon-Fri: 8AM-12:30PM - clinic. You may not have to show up right at 8am depending on when the first patient is scheduled (you can go to eBrowser the day before to look). Afternoons are for consults - you can hang out in the med student lounge and wait to get paged.
General advice:Not too much is expected of you - draw one pedigree tree, work up consults (not too busy usually), do a 5-min presentation on topic of your choice each Wednesday. You can get as involved as you'd like - go in to see patients by yourself then present, or just tag along.
Name: PEDS - pediatric neurology
Main contact:Bill Gallentine
Where to go on first day:Ask Bill (or fellow Sujay Kasangra)
Reading ahead of time:It's a selective! OK, but helpful reading = seizures, epilepsy, cerebral palsy
Hours (generally):8am-noon = inpatient wards, rounding, EEG rounds; noon = noon conference; 1-5/6pm = clinic (which is rather fun; OR if they're busy, you may get to stay on the wards to do a consult or admit a patient and then present them the next day. It's cool.)
General advice:This selective is full of incredibly nice faculty and residents. Hours are very consistent. They do not ask incredibly much of you, but the residents do a great deal of teaching. The attendings also love to teach. You will preround with them (no need to get there early), write up a note, and present to the attending daily. In clinics, you get to work up your own patients and present to the attending. UNLESS there are too many people in clinic, which is usually less than half the time. In general, I found this selective interesting, manageable, and enjoyable.
Name: RADONC - Brief exp in clinical rad/onc
Main contact:Nicole Larrier (faculty)
Where to go on first day:Subbasement of White Zone. Ask the nurses how to get to the Faculty room.
Reading ahead of time:Look over how to read CTs and how to recognize some basic anatomy on them. Also, get some basica info about some types of cancers commonly treated with XRT (prostate, breast, colorectal, anal, cervical, esophageal, pancreatic, etc..)
Hours (generally):8am to 6pm when at Duke, and til 3pm on the few days you work at the VA
General advice:This selective is great in that the residents/faculty take a genuine interest in you since they are not used to having medical students. The residents are really fun to hang out with too. BUT, if you are not interested in this field at all, I wouldn't recommend it on account of the "long hours," and sometimes slow days when you are reading CTs. If you are considering it though, it is AMAZING.
Name: RADIOL - Radiographic anatomy
Main contact:Caroline Carrico (faculty)
Where to go on first day:Radiology Dept, Duke North, 1st floor- Room 1512B2 (Bone Conference Room) at 9am; there is a brief orientation and a tour of the department
Reading ahead of time:There are modules/quizzes that are posted on BlueDocs every morning that you have to do before you report to the reading rooms. They don't take long. It may also help to review some anatomy if you are inclined...
Hours (generally):1pm- 5pm M-F (yes, only four hours! No joke!) Each day you are in a different reading room (Vascular, GI/US, Nucs, Chest CT, Chest, Bone, Body CT, Neuro CT, Neuro MR, Mammo)
General advice:People tend to love or hate this rotation. Personally, I loved it, but some people found it really boring. The thing to keep in mind is that watching someone read out is extremely different from actually doing it. I would suggest finding a resident to read out with, not the attendings, because they spend more time on each case and there are more opportunities to ask questions. Also, find out from the person who was in the reading room before you who is a good person to work with. There are some residents that are awesome and explain their thought process or let you control the images, and there are others who don't teach much. If you get stuck with someone who doesn't teach, those four hours can seem like a lot longer. Also, there are classes for the fourth year students doing the elective around 1pm everyday that are pretty helpful, so if you don't feel like you are learning anything in the reading room, go to those.
Name: SURG - Neurosurgical intervention in the modern era
Main contact: Mike Haglund (faculty) and Hamid Aliabadi (chief resident) Friedman (Elective) and Chief
Where to go on first day:Check with resident but 4200 (neuro ICU) at 5:45 will usually do it
Reading ahead of time: "Look over brain anatomy, pathways, etc. The more you know the better. Read the packets that Friedman provides. The imaging, NICU monitoring, NICU management, and intruments for the OR are all very good readings that are high yield and interesting.
Hours (generally): "5:45 AM to late afternoon (anywhere from 3 to 9PM depending)
General advice:They're not going to be too upset whether you stay or go-- the idea is that you were interested enough to sign up for a surg selective. Have fun with it-- if you show interest, they'll let you do fun stuff. All the fun of a surgery sub-rotation with none of the responsibility.
Name: SURG - From cosmesis to reconstruction, from infants to the elderly
Main contact:Dr. Hollenbeck (Chief Resident) [this will change....you'll need to contact whoever is chief resident on service when you're on]
Where to go on first day:Check with Resident, but 6300 is likely spot
Reading ahead of time:Learn the different types of flaps; Also, learn differences btw full thickness and split thickness skin grafts; learn reconstructive ladder. review anatomy relevant to cases (esp muscles, innervation, vascular)
Hours (generally):5 AM to 5 PM (can leave earlier or stay later depending on your interest level). Note from Rob: Fridays can be really long days, which is great because you will get to do quite a bit. My last Friday on the rotation we were in the OR until 4 am....not the norm, but don't be surprised if you're there late...
General advice:Know how to handle yourself in the OR, know about the anatomy for the flaps or region they are operating on and try to see as much as possible.; It's also good if you try to look up the procedure or some related study on the Plastic and Reconstructive Surgery Journal. Ask questions you legitimately want answers to.... don't ask questions with self-evident answers.....or with answers you could've gotten yourself if you waited 15 more minutes. Also, become familiar with the contents of the PSU bag....it's this bag they carry during morning rounds that has dressings, tape, etc.... learn early on what kurlex (sp?) and xeroform are, for instance, so you can be helpful during morning rounds. Always carry tape, scissors, 4x4's and maybe even some xeroform in your white coat pockets.