Uniformed Services University of the Health Sciences (F. Edward Hébert School of Medicine)

The F. Edward Hébert School of Medicine has a year-round, four-year curriculum. This curriculum is nearly 700 hours - or about 20 weeks - longer than found at other U.S. medical schools. These extra hours focus on epidemiology, health promotion, disease prevention, tropical medicine, leadership and field exercises, and other subjects that relate to the unique requirements of career-oriented military physicians. Of the 3,912 physician alumni, over 75 percent currently serve on active duty in the U.S. Army, Navy, Air Force and U.S. Public Health Service.

Doctoral and masters degrees in the biomedical sciences and public health are awarded by interdisciplinary and department-based graduate programs within the School of Medicine. Program strengths include infectious disease, neuroscience, and preventive medicine research. A large number of graduates are military officers and/or serve the federal biomedical research enterprise.

The Uniformed Services University of the Health Sciences is the Nation's federal health sciences university and is committed to excellence in military medicine and public health during peace and war. We provide the Nation with health professionals dedicated to career service in the Department of Defense and the United States Public Health Service and with scientists who serve the common good. We serve the uniformed services and the Nation as an outstanding academic health sciences center with a worldwide perspective for education, research, service, and consultation; we are unique in relating these activities to military medicine, disaster medicine, and military medical readiness.

The teaching staff of the medical school comprises approximately 2,076 full-time basic and clinical science faculty members; there are 1,433 part-time appointments. The mix of military and civilian faculty varies among departments, and students can expect both military and civilian faculty at all levels of instruction.

The University is located on the grounds of the National Naval Medical Center in Bethesda, Maryland. It is close to major federal health facilities; cooperative agreements
between these facilities and the University allow for expanded placements and additional resources that enhance the educational experience of USUHS students.
The university complex, completed in 1979, contains 500,000 square feet of space and has a full range of modern laboratories, teaching halls, seminar rooms, student study areas, and faculty and staff offices. The lecture halls have recently undergone an extensive renovation. In addition, the School has installed state-of-the-art presentation equipment for use by faculty and students.

The Center for Multidisciplinary Services refers to the multidisciplinary laboratory (MDL), a facility that houses a complex of laboratory/teaching rooms in which
USUHS students spend a great deal of time during their four years at the School. For example, in most schools, students report to the physiology department for laboratory exercises. At USUHS, every student goes to the MDL for all departmental laboratory exercises; MDL staff members set up the equipment and supplies used in these exercises. In addition, the MDL facility is open 24 hours a day, except when committed for teaching purposes.

First-year medical students spend a significant amount of time in the Anatomical Teaching Laboratory (ATL), which provides an excellent teaching environment for all anatomy courses. Four students are assigned per cadaver. Students each receive a human skeleton for study. Additional models are available in the ATL for correlation to the dissection being conducted. Each lab bay contains a closed circuit television set for teaching. Computers with anatomical teaching programs and digitized radiographs are also available to students. When anatomy courses are in session, the ATL is
open 24 hours a day for study and dissection.

Students receive part of their clinical training at four main teaching hospitals affiliated with the University: Walter Reed Army Medical Center, the National Naval Medical Center, and Malcolm Grow USAF Medical Center, all in the Washington, D.C., metropolitan area, and Wilford Hall USAF Medical Center, in San Antonio, Texas.
These institutions are recognized as among the military’s finest.

In addition to teaching the usual biomedical sciences that prepare students for careers in preventive and curative healthcare, the medical school also trains students for work in adverse physiological and psychological environments. In this way, the School of Medicine’s educational program is unique.
Because of the need for broadly trained uniformed services physicians, the School of Medicine offers a comprehensive curriculum. Designed to ensure clinical and academic rigor within the School, its teaching hospitals, and various military operational environments,
the program includes core instruction in human biology. Although initial emphasis is on the basic sciences, clinical sciences are progressively integrated, beginning
with patient care activities in the first year. This integration allows students to see not only the physical and biological factors affecting the human body but also the complex social factors affecting individuals.
Two concepts underscore the USUHS curriculum: that medicine exists to serve society and that physicians must be humanists.

The School of Medicine’s four-year program, which culminates in the doctor of medicine degree, aims to transform students into competent and compassionate
uniformed services physicians; create and foster an environment of learning and investigative curiosity; and provide a setting that supports the development of uniformed service medical professionalism.

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F. Edward Hébert School of Medicine Medical School Location

F. Edward Hébert School of Medicine Courses

FIRST YEAR

Before coming to the School of Medicine in August, freshman students are assigned to a four- to six-week service-specific orientation program.
During these orientations, administrative records are initiated for students entering active duty. Students buy uniforms and are informed of their proper wear; learn basic information about their services; gain an understanding of one’s responsibilities as an officer; and begin to develop an ésprit de corps. Those students not accustomed to life in a uniformed service typically find that orientation is both educational and challenging
while providing a smooth transition to the uniformed services.
Medical officer candidates with prior commissioned service may not be required to attend the Army Officer Basic Course (OBC), the Navy Officer Indoctrination School (OIS), or the Air Force Commissioned Officer Training (COT) course, as determined by each respective service. The army does require that students who are graduating from the United States Military Academy and ROTC programs attend the OBC in San
Antonio. Those individuals who did not graduate from the AMEDD course are required to attend prior to matriculation. The navy and air force do not require service academy and ROTC graduates to attend the summer orientation program.
Following the service-specific orientation, students report directly to the School of Medicine. Brigade orientation begins the second week of August. During this period, administrative requirements for registering students with the University and local military are completed. Academic orientation begins the third week of August. Students are encouraged to have finalized living arrangements by the start of academic orientation.
Upon completing orientation at the School of Medicine, students begin a 40-week academic program devoted to the basic biomedical sciences, the psychosocial aspects of health and disease, and an introduction to military medicine and patient care techniques.
Each one-course credit involves approximately 22 hours of course contact.

COURSES :

- Biochemistry : The molecular mechanisms of human biology are described and explained. Major areas
covered are: (1) the structure and function of proteins, nucleic acids, carbohydrates, and lipids; (2) bioenergetics; (3) membranes and transport; (4) intermediary metabolism of biological fuels, vitamins, and minerals; and (5) signal transduction. Mendelian and
population genetics are also presented as a foundation for understanding heritable metabolic disorders. Emphasis is placed on the biochemical basis of disease and nutrition throughout the course; however, clinical correlation lectures are included that are devoted to relating various aspects of biochemistry, molecular biology, and human genetics to specific human diseases.

- Clinical Head, Neck, and Functional Neuroscience : Module II of the Anatomy, Physiology, and Genetics MS-I curriculum consists of integrative learning of basic and applied anatomy of the head and neck region with
functional neuroscience and histology and physiology of the special senses. This course stresses a core of basic science information of practical clinical value and emphasizes the development of skills in clinical reasoning by involving the students in problem-solving
clinical case studies.

- Diagnostic Parasitology and Medical Zoology : The major protozoan, helminth, and arthropod parasites of humans as well as their respective reservoir hosts and vectors are covered in a series of lectures, laboratories, and demonstrations. Emphasis is placed on diagnostic methods, geographic distribution, means of transmission, methods for prevention of disease, and control strategies.
Venomous vertebrate and invertebrate animals likely to be encountered by the military are also discussed.

- Fundamentals of Epidemiology and Biometrics : This course is designed to give the student a working knowledge of basic clinical biostatistics as well as fundamental epidemiological principles and concepts. Applications to evidence-based clinical decision-making, epidemiological study design, and disease outbreak investigation are covered in lectures, seminars and labs. The objective is to provide a solid foundation in the epidemiological approach to clinical and public health practice.

- Human Context in Health Care : This course is designed to introduce the student to the clinical approach in health care through readings, panel presentations, and discussion groups. It examines the role of context—individual life experience, beliefs, and values—of both physician and patient in determining the quality of care provided, demonstrating how these factors influence care independently of the nature of the patient’s illness and the specialty of the physician.
Presentations emphasize the crucial role of the physician’s self-awareness in facilitating effective patient care.

- Introduction to Clinical Medicine I : Introduction to Clinical Medicine I is designed to provide an initial experience in clinical skills needed in the care of a patient. The course is conducted in the second half of the first year and includes the teaching of basic communication skills and interviewing techniques. Coursework includes conducting a history with standardized patients, videotape review with faculty, and a variety of interviews with inpatients and ambulatory patients with direct observation and feedback from experienced faculty.

- Introduction to Structure and Function : This module consists of three sections: Module 1a, 1b, and 1c. Module 1a teaches first year medical students the fundamental concepts of structure and function that are most important to their understanding. This curriculum combines: (1) topics on cell biology with relevant segments of basic physiology, (2) the study of human basic tissue structure and function (physiology), and (3) early embryogenesis and basic tissue formation. Modules 1b and 1c: (1) introduce the medical student to anatomical and medical terminology; (2) teach basic information on form, structure, and function by dissection of the body and normal radiology; and (3) correlate the development of organ systems and the etiology of congenital abnormalities.

- Medical Psychology : Medical psychology is the study of mind and behavior as they relate to physical and mental health. This course presents important topics in medical psychology, including tobacco use, stress, eating disorders, pain, psychological assessment, behavioral cardiology, substance abuse, sexual assessment, medical decision-making, and compliance. Presentations integrate basic psychological and behavioral principles with modern life sciences and relevant treatment strategies.

- Military Studies and Medical History : This course describes the historical development of Western medicine with emphasis on medical practice, patient care, and interactions between medicine and society. The development of military, naval, and aviation medicine is presented in the context of the social and military events of the period. Particular attention is given to the growth of medicine in America from colonial times to the present.

- Military Medical Field Studies-Summer : Students receive training in military field and leadership skills, including weapons familiarization skills, land navigation, small-unit leadership and team problem solving,
field sanitation, and basic field medical skills while deployed during one week of Field Training Exercise Kerkesner at the Marine Corps Base in Quantico, Virginia. Immediately following this week in the field, students spend four weeks with an operational
unit of their parent service to enrich their understanding of the working environment and people for which they will have future medical responsibility.

- Structure and Function of Systems : This course examines the anatomy and physiology of the organs of the human body, beginning at the level of cellular and subcellular structures comprising organ systems.
Students learn how these cellular components form the anatomical organs and study the function and physiology of whole organs. The course approaches the material by dividing organs into six organ systems: cardiovascular, immune, renal, gastrointestinal,
respiratory, and endocrine. Material is presented both in lecture format and as laboratory/ small group exercises designed to strengthen student understanding of major
concepts in this field. Clinical correlations and pathology cases emphasize the practical aspects of this material.

SECOND YEAR

The second year involves 35 weeks of instruction in which courses continue to emphasize the basic sciences (pathology, pharmacology, and microbiology) as well as the psychosocial aspects of disease, patient care techniques, and military medicine. During
the second year, emphasis is given to preparation for third-year clerkships by integrating the basic sciences with diagnosis of clinical problems and their management. Students have a three-week period for review before taking step one of the U.S. Medical Licensing Examination (USMLE).

COURSES :

- Introduction to Clinical Reasoning : This course introduces students to principles of diagnostic reasoning and clinical problem solving. A series of common, primary-care topics germane to the disciplines of
medicine, pediatrics, obstetrics/gynecology, and surgery are introduced through clinicaloriented lecture followed by small group case studies, in which students are expected to lead discussions under the guidance of a faculty preceptor. Students learn the vocabulary of clinicians and appropriate terms that are understood by patients, as well as gain a broadened ability to relate patient symptoms and signs to pathophysiologic principles.

- Ethical, Legal, and Social Aspects of Medical Care : The course provides a framework for using diverse perspectives in analyzing current ethical problems in medicine at both institutional and individual levels. Current issues are discussed from legal, ethical, sociological, and economic perspectives and include
neonatal care, military medicine, informed consent, experimentation, active and passive euthanasia, reproductive choices, genetic screening and counseling, and macro and micro allocations.

- Human Behavior : The format for this course involves lectures and small group discussions (attendance
mandatory) on normal human development and psychopathology. The first segment of the course focuses on psychological growth and development from infancy to late adulthood. The second segment introduces major psychiatric disorders and emphasizes
biological, psychosocial, and social factors in diagnosing and treating these disorders.
Six small, group sessions held throughout the course emphasize learning objectives through case discussions and are intended to provide clinical correlations to lecture materials.

- Introduction to Clinical Medicine II : ICM II, taught at the beginning of the second year, concentrates on learning the essentials of a complete physical examination. Mastering the mechanics and sequence of examination for a normal, healthy subject is achieved through sessions devoted to individual sections of the body and the cumulative performance of a complete physical
examination. Specific, sensitive portions of examination techniques are taught by using standardized patients and teaching associates.

- Introduction to Clinical Medicine III : Taught in the spring semester, ICM-III prepares students for MS3 clerkships by consolidating basic clinic skills learned in ICM-I (Medical Interviewing) and ICM-II (Physical Examination). After successfully completing ICM-III, students are able to perform a comprehensive history and physical exam.

- Microbiology and Infectious Diseases : The course objective is to provide an understanding of the scientific basis for prevention, pathogenesis, diagnosis, and treatment of infectious human diseases. The course
surveys the immunobiology of human hosts and the biology of pathogenic bacteria, viruses, fungi, and parasites. It presents a broad introduction to immunology, general and pathogenic microbiology, and host responses to infectious agents. Students develop
an understanding of the biological characteristics of pathogenic microorganisms, the course of their infections, the functions of the immune system, and the actions of antibiotics against these pathogens. Students learn techniques for collecting and inoculating specimens from patients and the common laboratory tests used to diagnose infectious and immunological diseases.

- Military Studies II : The second year course in military studies, conducted by the Department of Military and
Emergency Medicine, focuses on two general areas, casualty care and medical planning.
Introduction to Combat Casualty Care (ICCC) builds on the principles of physiological responses to abnormal environments, learned in Military Applied Physiology (MAP), and the mechanics of wounding, learned in Introduction to Military Medicine (IMM), to educate second-year medical students about the pathophysiology of injuries sustained in the combat environment (e.g., ballistic, blast, burn, chemicals). Introduction to Joint Medical Planning (IJMP) focuses on the command and staff functions of military medicine
in joint commands (e.g., medical planning, medical logistics, medical evacuation systems, and blood programs) to help students understand the complex relationship between medical planning and military missions.

- Pathology : This course initiates study of human disease. Part I, introductory and basic pathology,
illuminates some of the major primary disease processes and mechanisms of cell and tissue damage by means of gross and microscopic correlations. Part II, organ system pathology, expands upon the effects of disease in major tissue systems and emphasizes specifics of causation, pathophysiology, biochemical alterations, progression, and complications. Throughout the course, integration of pathology and clinical medicine is
accomplished through studies of multisystem diseases and case analysis with emphasis upon clinicopathologic correlations and differential diagnosis from the perspectives of both pathologic anatomy and clinical pathology.

- Pharmacology : This course covers the principles of drug action and the properties of the major drug
groups used in the treatment of disease. The course begins with a review of the basic principles of drug action and a survey of drug-delivery methods followed by discussion of drug absorption, distribution, and metabolism and an overview of toxicology.
Students are given a systematic review of drug effects and pharmacotherapeutic approaches to disease states in major physiological systems, including the central and
peripheral nervous systems (including drug abuse) and the immune, cardiovascular, renal, and endocrine systems. A review of drug applications in cancer chemotherapy and in the treatment of viral, bacterial, and parasitic infections follows. The final section of the course offers an introduction to the use of drugs in specific clinical populations, including surveys of neonatal, developmental, and geriatric pharmacology.
The course objective is to provide a solid basis for understanding the therapeutic application of drugs, to be studied in the third and fourth years of medical school.

- Preventive Medicine : This course reviews the principles of disease and injury prevention applicable to both military and community public health environments. Fundamental skills learned in epidemiology, biostatistics, and other basic science courses are used to examine specific disease and injury risk patterns. Emphasis is on identifying preventive medicine interventions that contribute to the health and fitness of military personnel and their families. The course also provides students with the fundamentals of health policy in general and the military system in particular. Approaches to primary prevention and health promotion are introduced in lectures, seminar discussions, and laboratory
sessions. Students develop the necessary skills to recognize common public health problems, to formulate practical solutions, and to make recommendations for implementing those solutions during laboratory exercises.

- Radiographic Interpretation : This course is a basic introduction to radiology. The course is taught by using didactic lectures supplemented with CD-ROM and web-based materials and through “openbook”
quizzes. Module I (Fall) stresses the systematic evaluation of the chest film and culminates in an oral examination.

THIRD YEAR

In the third year, students engage in 48 weeks of required clinical clerkships in family practice, medicine, obstetrics and gynecology, pediatrics, psychiatry, and surgery. Leave periods are provided in December and late June.

COURSES :

- Family Practice : The family practice clerkship is designed to acquaint all medical students with the
knowledge, attitudes, and skills fundamental to the specialty of family medicine.
Students are exposed to a model of comprehensive primary health care with particular emphasis on the family unit, where the physician’s continuing responsibility is not limited by the patient’s age or sex nor by a particular organ system or disease entity. The
six-week rotation is predominantly ambulatory, with time divided between the family practice clinic, hospital in-patient service, and on-call experiences, during which students have direct contact with patients and provide supervised primary care. Supervision
is provided by family practice departmental preceptors and other staff and resident members of the health care team. Lectures, clinical case discussions, clinical and ward rounds, behavioral science seminars, required readings, and assigned family interviews enrich this in-depth exposure to family medicine.

- Medicine : The medical clerkship focuses on the care of adult patients. It fosters clinical problem solving for and with patients as they experience a wide variety of problems, allowing students to become clinicians who embrace complexity, yet act with simplicity. Students
spend six weeks at two of the following hospitals: National Naval Medical Center, Bethesda (Maryland); Walter Reed Army Medical Center (Washington, D.C.); Wilford Hall Air Force Medical Center (Texas); Wright-Patterson Air Force Medical Center
(Ohio); Naval Medical Center, Portsmouth (Virginia); Malcolm Grow Air Force Hospital (Maryland); and Tripler Army Medical Center (Hawaii). One rotation is in an
outpatient setting, the other is on inpatient service.
Clinic students work directly with faculty in the care of patients. Students on wards are junior members of teams consisting of attending physicians, residents, interns, and students.
Under supervision, they participate actively in patient care, including nighttime and weekend call. All students attend teaching conferences and work directly with teaching preceptors in the analysis and synthesis of clinical information. Professional growth of students is the core goal of this clerkship. In both settings, students are expected to become reliable “reporters” who are making a transition to active “interpreters” for their patients; some students may progress to the “manager/educator” level.

- Obstetrics and Gynecology : The clinical clerkship in obstetrics and gynecology is designed to fulfill the dual objectives of providing all students with the core knowledge and skills required to address the health
needs of women in primary care settings as well as to stimulate in some students a longterm interest in the clinical and academic excitement and challenges of this surgical and primary-care specialty. During the six weeks, students are members of the health care
team through the traditional inpatient and outpatient services of obstetrics, gynecology, reproductive endocrinology, and gynecologic oncology.
Additionally, at all five clerkship sites (National Naval Medical Center; Walter Reed Army Medical Center; Brooke Army Medical Center; Wilford Hall, USAF Medical Center; Tripler Army Medical Center; DeWitt Army Hospital; and Washington Hospital Center), students have ample opportunity to evaluate patients and develop management skills in the ambulatory care setting. Core lecture series, case discussions on rounds, and independent study assignments assure exposure to the knowledge and principles of the specialty. The on-site clerkship coordinators are responsible for the cognitive and noncognitive assessments of students’ performance. A final standardized National Board subject examination is administered on the last day of the clerkship. The on-site coordinators and the department chairperson are readily available to provide career counseling to further stimulate the interest
of students in the numerous professional challenges in obstetrics and gynecology.

- Pediatrics : The pediatric clerkship addresses issues unique to childhood and adolescence by focusing on human developmental biology and by emphasizing the impact of family, community, and society on child health and well being. Additionally, the clerkship focuses on the impact of disease and its treatment on the developing human and emphasizes growth and development, principles of health supervision, and recognition of common health problems. The experience emphasizes those aspects of general pediatrics important for all medical students and provides a foundation for those students who elect further study in the health care of infants, children, and adolescents.
Students have an opportunity to participate in clinical activities of both general and subspecialty pediatric services, but the emphasis in all services is placed on basic problems and common issues. The six-week rotation occurs at one to three of the teaching hospitals representing three of the uniformed services (U.S. Army, U.S. Air Force, and U.S. Navy) and is divided into three weeks of primarily outpatient general pediatrics with some exposure to subspecialty care, two weeks of inpatient ward, and one-week of newborn medicine. The Department of Pediatrics utilizes a nationally
accepted curriculum that guides students through knowledge acquisition concerning the diverse areas of pediatric medicine. Throughout the clerkship, the essentials of pediatric history taking and physical examination are stressed. Additionally, the department
places a heavy emphasis on clinical problem solving and provides students with structured learning in problem solving through clinical teaching by highly motivated
preceptors as well as through computer-simulated case studies. The educational goal of the department is to provide each student with a comprehensive learning experience and the self-directed learning skills necessary to provide a lifetime of current, compassionate, and committed health care.

- Psychiatry : Students participate in practical clinical work, individual supervision, and seminars and
case conferences. In their daily work on inpatient, partial hospital, consultation-liaison, and/or outpatient services, students are supervised by psychiatry residents and staff. The department strongly emphasizes the biopsychosocial model, integrating biological,
psychological, and socio-cultural knowledge in understanding behavior and disease. The
development of clinical interviewing, diagnostic, and treatment planning skills are central to the clerkship. Particular attention is given to disorders often seen in the international focus of military medicine. Each student meets weekly with a senior clinician preceptor for review and discussion of case histories. Mandatory seminars and case conferences consider both practical and theoretical aspects of emotional disorders.

- Surgery : The clerkship begins with a three-day orientation to the fine art and science of surgery.
This includes didactic and hands-on experience in the lab using surgical instruments, suturing, knot tying, manipulating tissue, and exposure to emerging surgical technologies such as videoendoscopic surgery and ultrasound. Students then become members of surgical teams of interns, residents, supervising surgical staff, and other health care providers at one of the participating military medical centers. They work in clinics, make ward rounds, assist in the operating room, take night call, and attend departmental conferences related to all aspects of care of the surgical patient. Students do independent histories and physical examinations, which are reviewed and discussed. Lectures on disease and injuries managed surgically are given using a departmental handbook as a reading guide. Distinguished professor lectures (bimonthly) and quarterly one-day surgical seminars are provided at USUHS. Each student prepares a topic or case-based
formal presentation. Clinical performance is evaluated by the teaching staff and final written and oral examinations are given.

FOURTH YEAR

Following one week of instruction in Military Preventive Medicine, students have 40 weeks of required clerkships and electives, including a required four weeks in both Military Contingency Medicine and Military Emergency Medicine. Leave periods are scheduled for late December and April. Students graduate in May. Step two of the USMLE is taken in the fourth year.

COURSES :

- Military Preventive Medicine : The course is a problem-solving exercise based on a scenario cast in a combat zone in a tropical third-world nation. Based on relevant lectures and laboratory sessions, students
must evaluate medical intelligence, identify disease threats, determine practical countermeasures, and brief senior officers on problem solutions. The course prepares students for the field preventive medicine exercises in “Operation Bushmaster.”

- Military Contingency Medicine : The capstone course for the four-year integrated military medicine curriculum, Military Contingency Medicine (MCM) is four weeks long and features both classroom didactic teaching and the field training exercise “Operation Bushmaster.” The course utilizes lectures, labs, small-group discussions, and clinical encounters to build upon topics introduced in first- and second-year courses. In MCM, the approach is at the clinical level, focusing on clinical management, decision-making, and problem solving. As in both medicine and war, students are often faced with situations for which there are no perfect, textbook answers. Lecturers from the Department of Military and Emergency Medicine teach core lectures. Within the course, the Advance Trauma Life Support (ATLS) course is given under the guidance of the Department of Surgery. Many distinguished guest speakers outside the department also contribute, and information from recent or ongoing conflicts is integrated whenever possible.

- Military Emergency Medicine : This required course provides senior medical students with an opportunity to learn unique aspects of the specialty of emergency medicine. The four-week clinical rotation is completed
at one of a number of participating military and civilian emergency departments in the national capital region and across the country. Students learn the initial approach to patients of all ages for whom a diagnosis is not already established or narrowed down to a short list
of possibilities. Under the on-site supervision of practicing emergency physicians, students evaluate acute presentations of common injuries and illnesses, devise management plans, and formulate disposition decisions within a variety of health care systems. Basic and advanced life support skills are reinforced and technical abilities performing common procedures are augmented. Students are provided with core reading materials prior to the course. Small group discussions covering important clinical presentations and led by
residency-trained emergency physicians further prepare students for their clinical rotation.

- Neurology : Students select assignments by lottery number. Rotation sites are available in adult neurology
on an inpatient service (Walter Reed Army Medical Center), a consultation service (Walter Reed Army Medical Center or National Naval Medical Center), or an outpatient service (Kaiser/Permanente). Rotations are also available in child neurology, neurosurgery, or neurorehabilitation.
A few students are allowed to select sites outside of the national capitol area. Students evaluate and participate in the management of patients as part of a team consisting of other medical students, residents, and attending staff. Depending on the rotation site, students participate in teaching rounds, conferences, and lectures/seminars; the latter are specifically designed to cover critical areas of neurological knowledge. To ensure adequate exposure to a breadth of neurological topics, a student objective list and
other educational material are provided to guide independent study. At the end of the four-week clerkship, a formal written examination is given based on these materials. The exam counts for half of the grade. Students must achieve a minimum of 70 points to pass.

- Subinternships

- Medical Selective Block (to be chosen from Internal Medicine, Pediatrics, Family Practice, Radiology,
Dermatology, Preventive Medicine)

- Surgical Selective Block (to be chosen from General Surgery, Surgical Subspecialties, Anesthesiology,
Obstetrics/Gynecology)

- Behavioral Sciences Selective Block

- Elective Clerkships

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