Blank schedule page to help you plan your Electives

Rotation Dates # of Wks

Credit due

Elec. Num Title Location & Supervisor Credit

rcv’d.

16-17 2/29- 3/11 2 2 9795 DxRx

R13/14-4/9

R1a 3/14-3/26

R1b 3/28-4/9

R 24/11-5/7

R2a 4/11-4/23

R2b 4/25-5/7

R 35/9-6/4

R3a 5/9-5/21

R3b 5/23-6/4

R 46/6-7/2

R4a 6/6-6/18

R4b 6/20-7/2

R 57/4-7/30

R5a 7/4-7/16

R5b 7/18-7/30

R 68/1-8/27

R6a 8/1-8/13

R6b 8/15-8/27

R 78/29-9/24

R7a 8/29-9/10

R7b 9/12-9/24

R 89/26-10/22

R8a 9/26-10/8

R8b 10/10-10/22

R 910/24-11/19

R9a 10/24-11/5

R9b 11/7-11/19

R 1011/28-1/7

R10a 11/28-12/10

R10b 12/12-12/17 & 1/2-1/7

R 111/9-2/4

R11a 1/9-1/21

R11b 1/23-2/4

R 122/6-3/4

R12a 2/6-2/18R12b 2/20-3/4

R133/6-4/1

R13a 3/6-3/18R13b 3/20-4/1

R144/3-4/29

R14a 4/3-4/15R14b 4/17-4/29

Introductory Information

Director of the 4th Year Program: Dr. Meg KeeleyE-mail: mmg4z@virginia.edu

Electives Program Administrator: Jill ClarkePhone: 924-5579; E-mail: jillc@virginia.edu

The current Elective opportunities offered at the University of Virginia Health Sciences Center, its affiliated hospitals and all the Elective forms are available at the following web site:

http://www.med-ed.virginia.edu/ handbook/electives/

Goals and Objectives of the Electives Program:The general goals and objectives of the Electives program can be defined broadly as follows:

1. To allow students the opportunity to fashion intellectually stimulating educational programs.

2. To broaden students' educational horizons beyond narrow specialty areas and to permit students to gain valuable experiences in areas peripheral to their main areas of interest.

3. To assist students who are uncertain about career specialty decisions by offering a broad selection of opportunities.

4. To provide opportunities to explore one or more specialty areas in depth.

5. To allow students who feel deficient in their training opportunities to gain additional experience in these areas.

All medical students, who have successfully completed their core clerkship clinical rotations, are eligible to participate in the Electives Program.

Attendance

Attendance at Elective activities & the Geriatrics Clerkship is mandatory.

No time off is allowed during an Elective scheduled as an ACE.

No time off is allowed during the Geriatrics Clerkship

During an Elective, with the supervisor's pre-approval, time off to participate in ACLS or

PALS is allowed.

ACLS and PALS cannot be taken during a required course (ACE & Geriatrics Clerkship)

Anyone who is ill or has a personal or family emergency must contact Student Affairs and the Attending on Service.

Exceptions: (do not apply to ACE)

Requests for excused absences must go to the Student Affairs Deans. If excused, these days must be pre-approved by the course supervisor and the attending on service. The course supervisor will determine if days missed must be made up and if so, how that will be scheduled.

Students are allowed to take up to 1 day per week off (or 4 days during a 4-week rotation) to interview between October 1 and February 1. Some Electives do not allow time off to interview - remember to check the description or with the supervisor. Specific days missed must be pre-approved by the course supervisor and attending on service. The course supervisor will determine if days missed must be made up and if so, how that will be scheduled.

USMLE: Students may schedule a day off for the USMLE exam during Electives that are not scheduled as an ACE or don't indicate that no time can be taken off during the rotation. The day off must be pre-approved by the course supervisor and attending on service.

Elective Requirements1. For the Class of 2017, a minimum of 46 credits is required for graduation –

a. 38 Elective credits

b. a 4 credit Advanced Clinical Elective (ACE)c. the 2 credit required DX-RX Course (Feb. 29- March 11, 2016)d. Geriatrics Clerkship (2 weeks/credits)

2. CREDIT WILL NOT BE GRANTED RETROACTIVELY. All arrangements for Elective experiences must be submitted to the Electives Administrator/Director for approval before the Elective begins.

3. Scheduling forms for Specially Arranged, International, Research in Humanities & Research rotations must be submitted at least a month in advance.

4. You must comply with paperwork deadlines, published on the calendar, even if you are away from the University.

5. No concurrent credit will be granted with the exceptions: with the pre-approval of the rotation supervisor, ACLS, PALS or the Interdisciplinary Humanities Seminars may be taken during a non-required rotation (not during an ACE or Geriatrics).

6. Elective credit is equivalent to the number of weeks worked unless otherwise indicated and should be equivalent to a minimum of 40 hours of work and maximum of 80 hours of work.

7. Each student must complete one rotation designated as an Advanced Clinical Elective (ACE) see description below - refer to the title of the Elective or view the list of ACEs: http://www.med-ed.virginia.edu/handbook/electives/ace.cfm.

8. A minimum of 8 elective credits (including an ACE) must be earned at UVA.9. A minimum of 16 elective credits (including an ACE) must be earned in an AAMC/LCME

approved US or Canadian Medical School (check AAMC list: http://www.aamc.org/students/medstudents/electives/start.htm).

10. Electives are of four weeks duration, unless otherwise indicated. If a student is interested in doing less than 4-weeks, they must get approval from the elective supervisor. Electives can be arranged during scheduled vacation times or across rotation dates, with elective supervisor approval.

11. No credit is given for Elective experiences of less than two weeks duration, with the noted exceptions of ACLS, PALS and the Interdisciplinary Humanities Seminars that are approved for one credit.

12. The medical school will not pay for BLS, ACLS or PALS course registration. 13. No more than 12 credits may be earned in one clinical or research area (e.g.,

Cardiology, Orthopedics, Anesthesia) Clinical and research rotations in the same area are counted separately. A student may participate in more than 12 weeks in one area, but the additional time will not earn credit towards graduation

14. Credit will be given for no more than 8 weeks in Electives in Humanities and Ethics in Medicine, as well as no more than 8 weeks in Med-Ed Teaching Electives.

15. Credit will not be given for reading or studying per se unless it is under the rubric of one of the Medical Education Electives.

16. Electives must be dropped by the published deadline for each rotation. Any drop after the deadline will result in loss of one credit for each week or portion of a week after the deadline. Students who drop after the deadline cannot earn credit for other Elective work they do during that rotation.

17. No stipends should be accepted for any Elective taken for credit. Reimbursement for travel and/or room and board is acceptable in connection with Elective Programs at other institutions. When a student, who incurs a later military obligation, takes an Elective at a military institution, the student may be reimbursed at the regular rate and still receive credit.

18. The Director of the Electives Program may consider elective credit for work for which students received a monetary award in open competition. The work must have been scheduled previously for Elective credit (RETROACTIVE CREDIT WILL NOT BE ALLOWED), and the award should be used to defray expenses of the work for which the student is seeking credit.

Residency Advisor Form Students must select a residency advisor and submit the Residency Advisor Form to Student

Affairs by March 11th ,2016 If you are not decided on specialty choice by that date, indicate on the form that your Student

Affairs Dean will serve in that role until you make your decision. If you change career goals or for other reasons wish to change your residency advisor, you

can complete a Residency Advisor Change Form at any time. Only designated physician faculty members are eligible to serve as residency advisors. The student will develop an Elective program after consultation with their Student Affairs Dean

and their faculty residency advisor. Students should discuss adds/drops with their residency advisor prior to making changes. The Block A Form (due March 11th, 2016) does not require a signature and will be reviewed

by your Student Affairs Dean The Block B (due June 3rd, 2016) & Block C (due October 21st, 2016) Forms must be signed

by your residency advisor. Secretarial signatures and rubber stamps will not be accepted. Faxed signatures and email approval of attached forms are acceptable.

o If your residency advisor is not available, you should contact the Electives Director, Dr. Meg Keeley (mmg4z@virginia.edu) to sign in lieu of your residency advisor and then submit the signed form as soon as your residency advisor is available.

The residency advisor has several responsibilities in addition to signing required forms. o Your residency advisor should be available for periodic consultation and should take

an active interest in the success of the selected program, in your performance and your residency application process including CV preparation, review of personal statement, planning for letters of recommendation, program selection, interview preparation, rank list and Match outcome.

Residency Advisor Form Due: March 11th, 2016

STUDENT:

My career choice/s are:

As a residency advisor, I agree to: Discuss the elective schedule. Be available for periodic reviews and to sign required Block Forms: Block B due

June 3, 2016 and Block C due October 21, 2016 Review the student’s Curriculum Vitae and Personal Statement. Provide specialty

appropriate advice regarding Letters of Recommendation and Interviews.

Be available to advise the student on questions regarding program selection and ranking for the Match/SOAP.

RESIDENCY ADVISOR’S SIGNATURE:

Please print Name:

Department:

Messenger mail address:

Phone: Fax:

E-mail: Date:

RETURN TO: Office for Student Affairs; PO Box 800739, Charlottesville VA 22908-0739, (3rd Fl. Claude Moore Med-Ed Building, Suite 3188, Rm. 3129) FAX: (434) 982-4073

Scheduling

Lottery Electives –The Lottery will only schedule Electives for the published 4-week rotation dates. You cannot schedule an OASIS Lottery Elective for less than 4 weeks through the Lottery. You will be notified when the OASIS Lottery results are available. After you receive your lottery results, beginning on January 25 th , 2016 you will be able to add or drop the Lottery Electives through OASIS. Any drop after the drop deadline will result in a loss of

credit unless approved by Dr. Meg Keeley. Any adds after the 28 day deadline must be completed in OASIS by the Electives Administrator.

Electives listed as Arranged –beginning on January 25th, 2016, you may email the course supervisor or designated signer to request a spot. Once they approve of your request, they will notify the Electives Administrator, and it will be scheduled in OASIS. Adds and drops for these arranged electives will require you to contact the course supervisor or coordinator and their approval should come to the Electives Administrator to add/drop in OASIS. Any drop after the drop deadline will result in a loss of credit unless approved by Dr. Meg Keeley. Any adds after the 28 day deadline must be completed in OASIS by the Electives Administrator.

Specially Arranged – these include rotations at UVA that are not listed in the Student Source and Electives at non-LCME approved sites – a Specially Arranged elective form must be submitted to the Electives Administrator for Dr. Keeley’s review at least one month prior to the elective start date.

Research – the Research Proposal Form must be submitted to the Electives Administrator for Dr. Keeley’s review at least one month prior to the elective start date.

Away – to schedule Electives at other LCME-approved sites, you must submit your acceptance letter (or email) to Jill Clarke at least one month prior to the elective start date. ***VSAS does not automatically notify this office when you are accepted for an away rotation that you applied for through VSAS. Students must forward acceptance letter/email to Jill Clarke to get it on their OASIS schedules***

International – submit the UVA SOM International Elective Form to the Electives Administrator at least one month in advance of trip. Also, submit the International Studies Office on-line form; have an appointment with Student Health to meet CDC vaccination requirements and have evacuation insurance. You must also attend any required orientation.

When the rotation is approved for credit, it will be entered in OASIS. You should check your schedule BEFORE you begin a rotation to make certain that your rotation has been approved and scheduled.

Credit will NOT be granted retroactively, so complete any changes BEFORE the rotation begins.

University of Virginia School of Medicine Specially Arranged Elective FormDue at least one month prior to beginning rotation.

Print Student’s Name: Dates: to

Print Supervisor’s Name: Phone:

Print Supervisor’s Address:

Elective Title: Credit Requested:

Student’s Signature - My dean/residency advisor has approved this rotation:

Elective proposal (typed or written legibly): Describe the goals, content and product of the program in detail-use additional sheets as needed. Will it involve? (Check all that apply)

Direct patient care - estimated hours per week ________

Indirect patient care - estimated hours per week ________

Rounds (clinical teaching & case discussions) - estimated hours per week

Didactic sessions - estimated hours per week ________

Night call Weekend call Weekend rounds

Days per week (circle): Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Typical day: begins: _________ ends: _________

Work specific tasks: (e.g., H & Ps, assisting in OR, writing orders, counseling families, etc.); related reading,

presentations, lectures, papers:

Content:

Goals:

Product:

MEDICAL SCHOOL APPROVAL – required for rotations away from UVAThe medical student named above is a fourth year student in good standing at the University of Virginia School of Medicine. S/He will pay tuition at our school during the period indicated. The student is covered by malpractice insurance while away from our school. S/He is required to carry personal health insurance and to complete annual OSHA Standard Precautions and HIPAA training. The student will provide an evaluation form.

SIGNATURE: DATE: Electives Administrator, Office for Student Affairs

Student will report to: Person:

Place: Time:

Supervisor’s Signature: Date:

PHONE # where medical student can be reached in an emergency:

Please return to: OFFICE FOR STUDENT AFFAIRS; UNIVERSITY OF VIRGINIA SCHOOL OF MEDICINE; P O Box 800739 CHARLOTTESVILLE, VA 22908-0739; E-mail: jillc@virginia.edu; Phone: (434) 924-5579; FAX: (434) 982-4073

Research

Research proposals may be the completion or continuation of earlier research, participation in an on-going clinical or laboratory research project, or a retrospective chart review, or may be a project designed by a student with faculty supervision. If you are designing or assisting in designing a research project that involves chart review or patient questionnaires or contact, you will need to follow the procedures of the Institutional Review Board: http://www.virginia.edu/vpr/irb/. Elective

proposal must include a copy of the IRB approval notification with approval & expiration dates. DO NOT include the entire IRB proposal/submission.

Given the nature of most medical research, the student should not expect to plan and execute an original research project, with the intention of producing a publishable paper, in the time span available for electives.

A serious interest in research entails significant involvement and forethought prior to the Elective rotation dates as well as work beyond the rotation dates.

Case reports and review articles may be appropriate for research credit but credit will not be given for reading or studying per se unless there is a scholarly product.

In general, Research Elective requests should be for a minimum of 4 weeks and a maximum of 12 weeks.

o In designating the number of weeks of credit requested, please keep in mind that one week of credit should be equivalent to a minimum of 40 and maximum of 80 hours/work/week for each student involved in a project.  All research elective proposals will need to include a detailed timeline outlining the student time commitment during the weeks of credit requested.

There is no retroactive credit and the credit granted is for the work done during the weeks that the elective is on your schedule.  It is possible to request additional weeks to a previously approved project with the approval of the research elective supervisor and a detailed timeline outlining the additional time commitment submitted to Dr. Keeley for review.

A student may participate in more than 12 weeks of research, but will not earn more than 12 Elective credits toward graduation.

Credit for research in a specialty area is considered separately from clinical credits in terms of the 12 week limit in any one specialty area.

A Research Elective Form is due at least one month prior to beginning to earn credit for the project.Exceptions: GSP Research (9796) is scheduled with your GSP preceptor and the weeks should be

submitted to the Electives Administrator. Research in Medical Humanities (3509) or Research in Biomedical Ethics (3527) are

scheduled and approved through the department, The proposal must be submitted to the Electives Administrator at least a month prior to beginning the elective. There is a limit of 8 weeks of any type of credit in Humanities and Ethics in Medicine.

The Research Elective Form is reviewed and is either approved for credit or the student and/or faculty supervisor is contacted to revise or clarify the proposal.

A proposal will not be reviewed without IRB approval. If it is pending within the month prior to starting your elective, inform the Electives Director, and the proposal will be reviewed but it will not go on your schedule until the approval or exemption letter is received. DO NOT SUBMIT THE IRB PROPOSAL, ONLY THE APPROVAL/EXEMPTION LETTER.

When it is approved for credit, the research elective will be entered on your schedule in OASIS.

Because detailed and thoughtful planning is critical to the credibility and success of any research proposal, both the proposal format and the deadline will be strictly enforced.

You cannot begin earning Elective credit for research until at least one month after the proposal is received.

If for whatever reason, a previously approved research elective cannot be carried out—IRB approval not granted, equipment/materials not available, etc. –it is possible to replace that elective time with another project. However, this must be proposed and approved. The one month in advance proposal will be waived if necessary. If you carry out another project, even with the same supervisor but without approval by the Electives Director, you will not receive credit for the work.

In order to receive credit for any research elective, an evaluation form must be received from the supervisor, the research final credit form and a detailed final report must be submitted.  This can be a written summary of the work done during the elective, a completed manuscript, poster presentation, powerpoint , etc. and should be submitted to the Electives Administrator for the Director’s review within one month of completing the research elective.

For students doing research from Rotation 1-11, if the final report is not received by Match Day (March 17th, 2017), students will be penalized one week of lost credit for each part of a week past that deadline. For students doing research in Rotations 12-14, final reports as well as all evaluations must be received by May 5th, 2017.

University of Virginia School of Medicine Research Elective FormDue at least one month prior to beginning rotation.

Print Student’s Name: Email:

Print Supervisor’s Name:

Department: Phone:

Title of Research Project:

Inclusive Dates: to

Total number of weeks: (one week of credit=min 40/max 80 hours/work/week)

1. Specific aims and significance of the project, including a clear statement of the scientific or clinical research question being addressed. (Use additional pages, if necessary)

2. Describe the previous work on this project done by the student (if any) and by the research elective supervisor’s laboratory. (Use additional pages, if necessary)

3. Perform a literature search. Describe the pertinent literature and the results obtained by others. Include a bibliography at the end of the proposal.

4. Research description – (2-3 typed pages) which should include: The population to be investigated; Number of subjects or animals; Use of controls; Study protocols; Techniques to be used; Specific methods for data analysis including any statistical analysis

5. Describe the student’s role in the project and expected product if any (publication, abstract,

poster, presentation, review, etc):

____________

6. Include a detailed timeline outlining student time commitment during weeks of credit requested.

7. If the study is a retrospective chart review, design and include a form to be used for data collection.

8. If you are designing or assisting in designing a research project that involves chart review or patient questionnaires or contact, have you followed the procedures of the Institutional Review Board (IRB)? YES NO

COPY OF IRB APPROVAL OR EXEMPTION LETTER MUST BE INCLUDED WITH PROPOSAL. DO NOT INCLUDE ALL IRB PAPERWORK—APPROVAL ONLY.

9. HIPAA Information

Using a patient’s protected health information (PHI) in research requires additional protections. Read your protocol for complete information. Some important details are listed below:

You are not allowed to use PHI in research without an IRB approval. This means you may not even view medical records to determine who your subjects might be or talk to a potential subject about a study until you have an IRB approval.

University policies do not allow you to store identifiable PHI on devices like personal computers, memory sticks, CD’s, smartphones without both encryption (not merely password protection), and written permission of the IRB and your Dean.

You are also not allowed to store data on Drop Box or equivalent iCloud storage sites unless the University has a contract with the iCloud service through Procurement Services and there are proper security safeguards (e.g., encryption).

Hard copies of PHI must be stored in a secure locked location. Do not take identifiable PHI home and do not contact subjects using your personal

cell phone. • There are strict penalties for you as an individual, and to the institution for loss and

misuse of identifiable PHI.

• Your status at the University may be impacted.

• Contact the IRB-HSR if you have any questions (434-924-9634).

We have discussed and my advisor has approved this research elective.

Student’s Signature: Date:

I have reviewed this proposal and agree to supervise this research project:

Research Supervisor’s Signature: Date:

Away Electives

Electives at AAMC/LCME approved US or Canadian Medical Schools o Check http://www.med-ed.virginia.edu/handbook/electives/otherSchools.cfm to

determine if it is an AAMC/LCME site. Military rotations.

o Military rotations at Naval Hospital Bethesda, Walter Reed, Malcolm Grow and Wilford Hall are LCME sites

o All other military sites are non-AAMC/LCME. Electives listed as “away”

To obtain medical records for away rotations, follow the directions on the Student Health web page: http://www.virginia.edu/studenthealth/records.html.

VSAS: Visiting Student Application System (AAMC): Many medical schools & hospital centers participate in the AAMC’s Visiting Student Application System (VSAS). This system allows you to apply online for away rotations.

The list of host schools for the 2015-2016 academic year is in VSAS, meaning that you can log into VSAS to see which “host schools” participate in the VSAS system.

https://www.aamc.org/students/medstudents/vsas/

***Keep in mind, not ALL medical schools participate in VSAS. So, if a school you wish to visit is not on the list, the best thing to do is go to that school’s website to find out if they take visiting students and how to apply. ***

International Electives

(Only UVA International Program Council faculty sponsored international electives will be approved for credit)

http://www.med-ed.virginia.edu/handbook/electives/globalHealth/index.cfm

The SOM International Add Form is used to schedule any Elective outside the United States. This is the form indicating that you have completed the International Studies Office On-line Application http://www.studyabroad.virginia.edu/, your appointment with Student Health and have evacuation insurance must be submitted one month in advance. You will also need to have:

An appointment with Student Health so they can review the CDC guidelines and check vaccination requirements.

Evacuation insurance – is recommended for anyone traveling abroad and is required for students doing electives in developing countries. Available through: Aetna at 1-800-966-7772. They will send the application (cost is $36) Students 26 or younger may purchase the ISIC (International Student Identity Card for

approximately $25. It is available online at myISIC.com. It covers you for a year and also provides some discounts (airfare as well as museums, hostels, etc.)

Travel Alert: Students cannot utilize University funding or receive University credit for study in a country where there is a travel warning in effect.Where to check for travel warnings? http://travel.state.gov/travel/cis_pa_tw/tw/tw_1764.html

UNIVERSITY OF VIRGINIA SCHOOL OF MEDICINE INTERNATIONAL ELECTIVE FORM

Type or print clearly – due at least one month prior to beginning rotation.

Name: Elective Dates:

Passport number: Amount of credit requested:

Elective Title:

City: Country:

Medical Sponsor/Mentor in host country:

Email/phone number for sponsor:

Phone number where you can be reached in an emergency:

Emergency contact person: Phone:

I have Evacuation Insurance: Aetna at 1-800-966-7772. They will send the application (cost is $36) or students 26 or younger may purchase the ISIC (International Student Identity Card for approximately $25.  It is available online at myisic.com. It covers you for a year and also provides some discounts (airfare as well as museums, hostels, etc.)

I had an appointment with Student Health (meet CDC immunization requirements)

I have completed the required ISO/Studio Abroad On-line Forms

I have discussed the rotation with my dean/residency advisor and he/she has approved this elective.

Signature: Date:

Required Block A, Block B and Block C Forms

Any student planning to graduate in May and participating in Electives during the block must submit Block Forms that indicate their PLANS for the specified rotation dates.

The Block Forms do not change your schedule in any way - they only indicate your plans and the appropriate scheduling procedures must be completed to schedule an Elective for credit.

It is the student’s responsibility to ensure that your form is received by the Electives Administrator prior to the deadline.

Forms will be considered late, even if you left it with your advisor and your advisor failed to submit it on time.

Failure to submit a Block Form by the deadline will result in the loss of credit. Beginning the day after the deadline, you will lose one credit from the next scheduled

rotation for each week (or part thereof) that your Block Form is late. The Block Forms only indicate your plans. You will schedule Elective in Oasis and

schedule Specially Arranged, Research, and International electives using the appropriate scheduling form. The scheduling forms can be printed from the web: http://www.med-ed.virginia.edu/handbook/electives/info/forms.cfm.

Your scheduling forms do NOT need to be submitted by the Block Form deadline but must be completed by the add/drop deadlines for those rotations.

You must turn in a Block A Form (Rotations 1-4) by March 11, 2016 The Block A Form cannot be submitted until after you indicate your Geriatrics and Lottery

Electives as determined by the Oasis Lottery The Block A Form will be reviewed and approved by your Student Affairs Dean. No signature

is required but you are encouraged to discuss your plans with your faculty Residency Advisor as well.

You must turn in a Block B Form (Rotations 5-9) by June 3 rd , 2016 The Block B From must be signed by your faculty Residency Advisor Plan ahead – Your residency advisor may not be available to sign the Block Form on the

day it is due - Schedule a time to meet with your residency advisor ahead of the deadline. Faxed signatures are acceptable (434-982-4073) .

If your residency advisor cannot sign the Form by the deadline, contact the Electives Director, Dr. Meg Keeley, (mmg4z@virginia.edu It is your responsibility to have your residency advisor sign and submit a form as soon as possible after the deadline.

You must turn in a Block C Form (Rotations 10-14) by October 21 st , 2016 Block C Forms must be submitted even if you are not making any changes to your schedule. The Block C Form must be signed by your faculty Residency Advisor Plan ahead - Your residency advisor may not be available to sign the Block Form on the day

it is due - Schedule a time to meet with your residency advisor ahead of the deadline. Faxed signatures are acceptable (434-982-4073) .

If your residency advisor cannot sign the Form by the deadline, contact the Electives Director, Dr. Meg Keeley, (mmg4z@virginia.edu. It is your responsibility to have your residency advisor sign and submit a form as soon as possible after the deadline.

Block Form Directions

Print Block Form: http://www.med-ed.virginia.edu/handbook/electives/info/forms.cfm

Type or print clearly in large letters in black ink.

Indicate what you plan, at this time, for each block (Block A, Rotations 1-4)(Block B, Rotations 5-

9) & (Block C, Rotations 10-14)

Indicate the dates of your required Geriatrics Clerkship.

Indicate which Advanced Clinical Elective (ACE) you plan to take and during which rotation.

Indicate any Electives scheduled during this block through the OASIS Lottery

For a planned Arranged, Away, Specially Arranged, Research or International Electives, write what Elective and where you intend to do the rotation.

If you plan to take vacation, interview or take time for USMLE during any rotation, write “Time Off” in that box.

Indicate the dates of rotations that are not for the published 4-week dates (e.g., if the Elective is only the middle 2 weeks of the rotation or if it overlaps 2 rotation dates)

On the Block C Form, you must indicate your plans or completed Electives for rotations 1 – 14. Be sure that you have planned a total of at least 46 credits - 38 Elective credits; the 4-credit ACE; the 2 credit required DX-RX Course; and the 2-credit Geriatrics Clerkship

If you have any questions, email jillc@virginia.edu or call 924-5579

Class of 2017 – Block B Form

Email: Name:

Period Dates # of Wks

Credit due

Elective No. Title Location & Supervisor

R 57/4-7/30

R68/1-8/27

R78/29-9/24

R89/26-10/22

R910/24-11/19

My career specialty goals at present are:

_____ a) totally undecided

_____ b) indefinite, but slanted in certain directions

_____ c) narrowed to three possibilities or less

_____ d) decided

If answer is b, c or d list areas of interest

I am scheduled for (or plan) the following required ACE, required Geriatrics Clerkship & completed the required DxRx Course:

My ACE is in rotation

Geriatrics Clerkship is (scheduled for) dates: _____________________________________

DxRx Course (required) dates: ______________________________________________

Print Residency Advisor’s Name: I assisted with and approve this proposed schedule for Block B – Rotations 5-9 (7/4 -11/19/16). Please note that scheduling forms require the student’s signature indicating that they have discussed their plans with you, but Block forms must be signed by you.

Residency Advisor’s Signature: Date

**** Block B Form - must be signed by residency advisor – due June 3 rd , 2016 **

Drop/Add Deadlines

Electives: There are published deadlines for dropping each rotation 28-days prior to the beginning date of the Elective- see the Calendar for the drop deadlines for each rotation.

You will lose one credit for each week (or part thereof) that your drop request is past the deadline.

Students who drop after the deadline cannot earn credit for other Elective work they do during that period – even if they have scheduled a second elective prior to the deadline.

o Replacing all or part of the scheduled Elective with another Elective is considered a drop of the original and an add of the replacement.

Schedule changes after the deadline, without loss of credit, will rarely be permitted. Exceptions require approval: Contact Dr. Meg Keeley, Electives Director

At the discretion of the elective supervisor you may add into an unscheduled rotation after the deadline for that rotation - up until the Friday prior to beginning the elective (unless it is a Specially Arranged, International or Research elective which must be scheduled at least a month in advance).

How to Receive CreditElectives: Credit for Elective rotations is granted when a “pass” evaluation is completed in OASIS. All rotations are Pass/Fail. The evaluation must be completed by the Course Supervisor. Elective evaluations can be viewed in OASIS. Individual Elective rotations and grades never show on your UVA transcript - the entire Elective Program year is given a grade of Pass when you complete the graduation requirements.

For AWAY ROTATIONS: It is the student’s responsibility to provide an Elective Evaluation Form to the supervisor and to verify that completed forms are received by the Electives Administrator. The Elective Evaluation Form can be printed from the web: www.med-ed.virginia.edu/handbook/electives/info/forms.cfm. You should arrange an exit interview with the supervisor to have the evaluation signed and then deliver it to the Electives Administrator within two weeks of the end of the rotation.

Fill in your Name, Elective Name, Dates and Supervisor’s Name before you give the form to your supervisor.

In order to receive credit for any research elective, an evaluation form must be received from the supervisor, the research final credit form and a detailed final report must be submitted.  This can be a written summary of the work done during the elective, a completed manuscript, poster presentation, powerpoint , etc. and should be submitted to the Electives Administrator for the Director’s review within one month of completing the research elective.

For students doing research from Rotation 1-11, if the final report is not received by Match Day (March 17th, 2017), students will be penalized one week of lost credit for each part of a week past that deadline. For students doing research in Rotations 12-14, final reports as well as all evaluations must be received by May 5th, 2017.

The Advanced Clinical Elective (ACE) The Advanced Clinical Elective (ACE) is a required 4-week clinical experience involving the highest level of patient care allowed a medical student. The purpose of the ACE is to better prepare the student for residency. The exercise of clinical thinking and patient care skills (e.g. diagnosis, prognosis, management) under the direct supervision of attending physicians and senior residents is central to the ACE experience. It is expected that a special professional relationship develop between the attending and the student, modeling the principles and commitments of the physician’s professional life. The ACE must be one of the designated rotations.

You may complete more than one Elective designated as an ACE. You may not take time off during any Elective scheduled as an ACE. An ACE must be 4 contiguous weeks in duration. Any rotation that is designated as an ACE can also be scheduled as a non-ACE rotation with

approval of the elective supervisor.o You may take pre-approved time to interview during the non-ACE Elective, unless the

description/supervisor indicates that no time off can be taken during the rotation.

Each ACE is a clinical experience with primary emphasis placed on enhanced involvement with medical or surgical patients. Each student will work up and manage, together with the residents and attending physicians, the medical or surgical care of selected patients. The ACE may also entail supervised follow-up of discharged patients.

The goal of the ACE is enhancement of the student’s training in clinical medicine by undertaking an important supportive role in the medical management of patients under appropriate physician supervision and guidance. Students will be placed on the same call schedule as an intern and will participate with the upper level resident on assignment. For example, the student will have, if possible, the same night call, weekend call and weekend rounds as the intern.

Objectives:a. The student will participate in the exercise of advanced clinical thinking and patient care skills

under direct supervision of physicians.b. The student will learn and practice advanced H&P skills and be taught basic procedures

depending on the selected ACE. The student will become more proficient in patient presentations, selection of appropriate diagnostic studies, data gathering, data assimilation and patient management. The student will learn how multiple, simultaneous clinical tasks and problems are managed. In the surgical and obstetrical specialties the student will assist the attending physician in surgeries and in births. The student will participate in the diagnosis, preoperative care, surgery and postoperative care of these patients. They will receive advanced instruction in surgical techniques.

c. Students are expected to improve their knowledge base through individual reading and didactic sessions. The experience is patient-centered and based on the patients encountered by the student.

d. The student will demonstrate the qualities of commitment, trustworthiness, integrity, compassion and respect of the patient’s autonomy, confidentiality and need for information. The student will demonstrate professional attributes with regard to professional responsibility.

Directory of ACE ElectivesBelow is a list of the ACE Electives for the Class of 2016. You will be notified by e-mail of any changes and the web will be updated prior to the OASIS Lottery.

Externship in Critical Care Medicine (SICU) Lottery 1002 E04bFamily Medicine – Inpatient Arranged 1401 E14aFamily Medicine - Outpatient Arranged 1409 E14iInternal Medicine Arranged 1512 E20hExternship in Clinical Neurology Arranged 1701 E48aNeurosurgery Lottery 1801 E50aMaternal-Fetal Medicine Arranged 1901 E52aAmbulatory Gynecology – Student Health Arranged 1902 E52cGynecology/Oncology Arranged 1904 E52bAdult Orthopaedics Arranged 2107 E56dAmbulatory Pediatrics Lottery 2409 E62iNeonatology Lottery 2411 E62hACE- A.I. in Pediatrics (Inpatient) Lottery 2420 E62mPediatric Critical Care Lottery 2424 E62rClinical Plastic Surgery Arranged 2601 E68aPlastic Surgery Arranged 2604 E68ePlastic Surgery Preceptorship AI Arranged 2608 E68hClinical Psychiatry - WSH Lottery 2717 E70hPediatric Surgery Arranged 3016 E76lGeneral Surgery - Orange Service Lottery 3018 E76aGeneral Surgery - Blue Service Lottery 3019 E76bTrauma Surgery/Critical Care Arranged 3020 E76nGeneral Surgery - Green Service Lottery 3022 E76pGeneral Surgery – Red Service Arranged 3024 E76rGeneral Surgery – Emergency General Surgery (EGS) Arranged 3026 E76tUrology Lottery 3101 E78a

Malpractice Coverage

Medical students who have completed the appropriate process to schedule Electives, whether for credit or for experience, have professional liability coverage provided by the Commonwealth of Virginia self-insurance program. The policy limits are $2.2 M per claim with unlimited aggregate. The coverage is provided for any claim arising out of the students’ scheduled training program at the University of Virginia Health System and at any approved national or international clinical rotation sites.

Elective Credit for Advanced Degree Work

At the discretion of the MD/PhD Program Committee, students may receive Elective credit for work performed in advanced degree programs in fields related to medicine. Students enrolled in medical school, and engaged in a UVA dual-degree program (M.S.; MPH, MBA; Ph.D. or JD), may be given some Elective credit. The MD/PhD Program Committee is responsible for approving the individual Elective program for each student in the combined MD/PhD program and for acting upon all other requests for Elective credit for work performed in advanced degree programs. An Application for Advanced Standing for Elective Credit can be obtained from Student Affairs. This form, a letter of support from your thesis advisor and a copy of the signature page from your dissertation must be submitted to the Office for Student Affairs for consideration by the MD/PhD Program Committee. MD/MBA, MD/MPH & MD/JD students must complete the appropriate elective credits forms and may receive up to 8-weeks of credit towards their MD-degree.

What to do if you get a blood/body fluid exposure: Policy: http://www.med-ed.virginia.edu/handbook/policy/index.cfm

Procedures for blood/body fluid exposure:

For rotations at UVa:1. Report the incident to the faculty supervising the clinical service. All exposures should be reported immediately to the person on call for Bloodborne Pathogen Exposures by paging (pic #1523) to report the exposure. This pager will be covered by employee health except during off hours, in which case the nursing supervisor covers this pager. The person covering this pager will initiate the triage process and contact individuals involved in the process.2. If a medical student has been exposed to a patient’s blood or body fluids in a manner that may transmit HIV or hepatitis B or C, the Medical Center will test the source patient’s blood for HIV and hepatitis B and C. The source patient’s treating physician or designee will order the source patient’s tests and provide or arrange for any necessary treatment.  Employee Health will order the exposed healthcare workers tests and provide all necessary prophylactic treatment except during off hours, in which case the Emergency Department will do the same.

For away rotations:1. Report the incident to the faculty supervising the clinical service. For hospital rotations, follow the

procedure for that facility.2. Page the Dean on Call (924-0000, pic 1416) for instructions.  The decision will be made at that

time whether to seek care locally or return to the University.3. If a medical student has been exposed to a patient’s blood or body fluids in a manner that may

transmit HIV or hepatitis B or C, the source patient’s treating physician or designee will order the source patient’s testing.

For all students:All students who have been evaluated and or treated for exposure to blood and body fluids will be referred to the Student Health Center for follow-up. The student will be advised to call Student Health (434-982-3915) to be seen 48 Hours after exposure. All paperwork and laboratory reports will be faxed from Employee Health prior to this visit.

The Student Health triage physician will review the needlestick and blood and body fluid report forms at the 48 hour visit follow-up visit after the exposure Post-test counseling will be provided at this time. An appointment schedule will be developed with the assistance of the triage nurse for 6 weeks, 3 month and 12 month visits. The “Agreement for follow-up of Needlestick/Blood or Body Fluid Exposure” form will be completed by the triage nurse, and the student asked to sign it. The student signature indicates their understanding of the recommendation to comply with the schedule, especially if graduation occurs before the final 12 month assessment.Policies and procedures related to exposure to infectious agents are available through Student Health and are based on CDC and OSHA guidelines.

BillingAll costs for testing, immunization, diagnostics, and prophylactic medications as a result of occupational exposure will be covered by fees for the first month (insurance will be billed thereafter).Students who sustain exposures on away rotations should have billing fees charged to their personal insurance policies, and whatever is not covered will be billed to the School of Medicine via Student Health.

After significant clinical exposure to other infectious agents such as tuberculosis or varicella, the student should report to Student Health during the next regularly scheduled clinic hours.Policies and procedures related to exposure to infectious agents are available through Student Health and are based on CDC and OSHA guidelines.

What Do I Need To Do To Begin Electives? – Check List

Read the Introductory Materials (either in hard copy or on the web)

_____ Discuss your Elective choices with your Dean, focusing on Block A (Rotations 1 – 4) and on Lottery Electives for the entire year.

_____Attend the 4th year Orientation Meeting Friday November 13 th at 4:00pm _____ Enter your Geriatrics Clerkship date choices in OASIS: Friday, January 15th- 8am

Monday, January 18th._____ Enter your Lottery Elective choices in OASIS – after Geriatrics results are

released (no later than 12noon on Monday, January 18th) - 8am Friday, January 22nd.

_____ Elective lottery results will be available on Monday, January 25th. You will be allowed to begin adding and dropping Electives in OASIS on that date.

_____ On January 25th, you may also begin scheduling Specially Arranged, Research, Away Rotations & International Electives. Proposals for these electives must be received at least one month in advance of the elective start date.

_____ Block A Form due by March 11 th , 2016 . This will be reviewed by your Dean._____Choose a residency advisor from the approved list and submit the Advisor

Form by March 11 th , 2016 . If you are not yet able to identify a residency advisor, indicate on the form that your Dean will serve in that role until you identify your residency advisor.

Due between January and August 1:_____ NetLearning – All assigned modules. Email from Student Affairs will let you know once these annual retraining modules are available (typically in March/April) The Occupational Safety and Health Administration (OSHA) have stated that it is the legal duty of health care providers to provide annual retraining in the practice of universal precautions to students who have potential exposure to blood and body fluids. Adherence to the practice of universal precautions is mandatory both by Hospital Policy as well as State and Federal OSHA Regulations.

_____ PPD must be placed and read, 3 days later, by Student Health prior to August 1 and again prior to graduation (during Match week is always a great time to get this done). You need to schedule an appointment at Student Health: https://www.healthyhoos.virginia.edu/

Frequently Asked Questions

◙ How do I know whether it is a Lottery Elective? If an OASIS number is listed, it is lottery. Arranged, Research, or Away Electives will indicate that in the parenthesis.

◙ What should I do if I realize I’m going to miss a deadline? Contact Dr. Meg Keeley, (mmg4z@virginia.edu and explain why you’re missing the deadline and find out what your options are. We accept email or faxed approvals.

◙ How do I know if an Elective is available? You can check in OASIS. The supervisor will determine if additional students can be added.

◙ Who makes certain that all my forms and evaluations have been received by the Electives Administrator? You do. Even if you are away during deadlines. It is your responsibility to have all forms printed, filled out, signed, and turned in. If you will be away during deadlines, then you are advised to plan ahead.

◙ How can I be sure that my Elective has been approved for credit? You can check your schedule in OASIS.

◙ Can I lose credit? Yes. If you missed the announced deadline to drop an Elective did not submit a completed Block A, Block B or Block C form by the due date did not complete the scheduling procedures before you started an Elective did not complete a Research Form, the Specially Arranged Elective Form or the International

Elective Form a month prior to beginning.◙ When I fill out my Block Forms, what if I am unsure about what Elective I plan to take? You must

indicate Electives that you are planning to schedule. Your scheduling forms/OASIS will let us know what you actually decided to schedule. The Block Forms only indicate your plans and do not alter your schedule.

◙ Do I need to turn in all my scheduling forms before I submit my Block forms? No, they are due by the deadline for each rotation.

◙ How do I know if it is an LMCE site? Check out this site:http://www.med-ed.virginia.edu/handbook/electives/otherSchools.cfm

◙ Where can I review my evaluations? Elective evaluations can be viewed in OASIS. ◙ Where would I get a copy of my evaluations? Elective evaluations can be printed from OASIS. ◙ How does the Office of Student Affairs communicate with me? Mostly through e-mail. You are advised

to check your e-mail on a regular basis. You will be notified of important deadlines, announcements and problems in this manner.

◙ How does my friend at another medical school do an Elective at UVA? AAMC/LCME approved US and Canadian Medical schools can use the web information (they will need to apply through VSAS). International students are currently not accepted. Applications are accepted from osteopathic students from schools that have an affiliation agreement between institutions.

◙ If I decide to do a different Elective or change the rotation dates, do I need to complete any paperwork? Yes, any change to your schedule must follow the appropriate scheduling procedures.

◙ What are some unacceptable excuses for missing deadlines/paperwork? My e-mail wasn’t working I didn’t know I had to submit that form I didn’t know there was a deadline I was out of town I didn’t have a form I thought my advisor did it It was on my Block Form I couldn’t get in touch with my advisor I couldn’t get in touch with the supervisor The supervisor said it was ok and I didn’t need to do any paperwork (without paperwork, you can

not receive credit and you are not covered by malpractice insurance!)◙ If I can’t receive credit why do I have to do paperwork? Without paperwork, you are not covered by

UVA’s liability insurance policy– how much liability insurance do you carry?◙ Who should I contact if I have other questions? Email jillc@virginia.edu or stop by Student Affairs or call

924-5579 for answers.

Addresses and Phone Numbers

Medical School Office for Student Affairs Phone: 434-924-2133Fax: 434-982-4073ERAS fax: 434-924-5739

Mailing address: The University of Virginia School of MedicineOffice for Student AffairsPO Box 800739Charlottesville VA 22903-0739

Dean of Dunglison College: Meg Keeley M.D mmg4z@virginia.eduDean of Hunter College: John Densmore M.D., Ph.D. jjd2q@virginia.eduDean of Pinn College: Christine Peterson M.D. cmp8x@virginia.eduDean of Reed College: Sean Reed, M.D. sr5fb@virginia.edu Registrar: Katherine Yates, M.Ed. kam5vd@virginia.edu Credentialing/Registrar Associate: Alane Celli, 924-2875, acelli@virginia.eduElectives Program Administrator: Jill Clarke 924-5579, jillc@virginia.edu

Medical School Financial Aid Office: Tonya Shifflett 924-0033Margaret Baxton (S-Z) 924-0375Dennis Snyder (A-H) 924-8414Melissa LiVoti (I-R) 924-8413

Medical School Office for Diversity: Judy Pointer 924-1867

Careers in Medicine (AAMC Sponsored) https://www.aamc.org/students/medstudents/cim/

USMLE Scores: National Board of Medical Examiners (NBME)3750 Market St.Philadelphia PA 19104phone: 215-590-9500fax: 215-590-9555

University of Virginia Registrar’s Office: Phone: 434-924-4122To obtain verification of attendance/insurance letters or University of Virginia transcripts: - (http://www.virginia.edu/registrar/ ). Transcripts will not be provided for students with financial or other obligations (i.e. parking tickets or overdue library books). Mailing address: Office of the Registrar

University of VirginiaCarruthers Hall, 1001 N Emmet St.Charlottesville VA 22904-4203

Fourth Year Electives Calendar 2017

Enter Geriatric Clerkship Choices – Friday, Jan. 15th, 2016– 8am Monday, Jan.18th.

Enter Lottery Elective Choices – after Geriatrics results are available (no later than 12noon Monday Jan. 18th) – 8am Friday, January 22nd.

Monday January 25th, – Elective lottery results available, and you may begin to make changes to your schedule in Oasis, as well as begin scheduling Arranged Electives, Research Electives, Away rotations, etc.

Advisor Form due: Friday March 11th 2016- required paperwork

DxRx: Health Care Policy: Feb. 29 – March 11, 2016 required

USMLE Step 2 CK & CS: MUST be complete by November 1st, 2016 required***Students MUST pass both Step 2 CK & CS to graduate***

Block A form due: Friday, March 11th 2016 - required paperwork

NOTE: All evaluations due in Student Affairs within 2 weeks of completion of rotation.

BLOCK A:Rotation 1: March 14, 2016 – April 9, 2016(1a: 3/14-3/26; 1b: 3/28-4/9)

drop deadline: February 14Rotation 2: April 11, 2016 – May 7, 2016 (2a: 4/11-4/23; 2b: 4/25-5/7)

drop deadline: March 14Rotation 3: May 9, 2016 – June 4, 2016 (3a: 5/9-5/21; 3b: 5/23-6/4)

drop deadline: April 11Rotation 4: June 6, 2016–July 2, 2016 (4a: 6/6-6/18; 4b: 6/20-7/2)

drop deadline: May 9

Block B form due: Friday, June 3rd 2016 - required paperwork

BLOCK B: Rotation 5: July 4, 2016– July 30, 2016 (5a: 7/4-7/16; 5b: 7/18-7/30)

drop deadline: June 6Rotation 6: August 1, 2016 – August 27, 2016 (6a: 8/1-8/13; 6b: 8/15-8/27)

drop deadline: July 4Rotation 7: August 29, 2016 – September 24, 2016 (7a: 8/29-9/10; 7b: 9/12-9/24)

drop deadline: August 1Rotation 8: September 26, 2016 – October 22, 2016 (8a: 9/26-10/8; 8b: 10/10-10/22)

drop deadline: August 29Rotation 9: October 24, 2016 -November 19, 2016 (9a: 10/24-11/5; 9b: 11/7-11/19)

drop deadline: September 26

Thanksgiving Break: November 20 - November 27, 2016Winter Break: December 18, 2016 - January 1, 2017

Block C form due: Friday, October 21st 2016- required paperwork

BLOCK C: Rotation 10: November 28, 2016 - January 7, 2017 (10a: 11/28-12/10; 10b: 12/12-17 & 1/2-1/7)

drop deadline: October 24Rotation 11: January 9, 2017 – February 4, 2017 (11a: 1/9-1/21; 11b: 1/23-2/4)

drop deadline: November 28Rotation 12: February 6, 2017 – March 4, 2017 (12a: 2/6-2/18; 12b: 2/20-3/4)

drop deadline: January 9Rotation 13: March 6, 2017 – April 1, 2017 (13a: 3/6-3/18; 13b: 3/20-4/1)

drop deadline: February 6Rotation 14: April 3, 2017 – April 29, 2017 (14a: 4/3-4/15; 14b: 4/17-4/29)

drop deadline: March 6

Match Day Holiday: March 17th, 2017All evaluations due by May 5, 2017

Graduation: May 21st, 2017