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Thus, NEC in our case is likely to be derived from the preceding adenocarcinoma and therefore had common origin.In conclusion, we succeeded in performing radical surgery using TPE with plastic reconstruction for advanced NEC with PS. Reconstructive plastic surgery using the gracilis muscle flap also proved useful for treating the enlarged perineal defect. This is also an important case for helping clarify the origin of the NEC. REFERENCES 1. Anthony LB, Strosberg JR, Klimstra DS, Maples WJ, O'Dorisio TM, Warner RR, et al. The NANETS consensus guidelines for the diagnosis and management of gastrointestinal neuroendocrine tumors (nets): well-differentiated nets of the distal colon and rectum. Pancreas 2010;39:767–74.Google r DA, Wong WD, Madoff RD. Malignant tumors of the anal canal: the spectrum of disease, treatment, and outcomes. Cancer 1999;85:1686–93.Google ScholarCrossrefPubMed 4. Guo L, Kuroda N, Miyazaki E, Jin Y, Toi M, Hamauzu T, et al. Anal canal neuroendocrine carcinoma with pagetoid extension. Pathol Int 2004;54:630–5.Google ScholarCrossrefPubMed 5. Aytac E, Ozdemir Y, Ozuner G. Long term outcomes of neuroendocrine carcinomas planning 2. Careers in Emergency Medicine 3. Medical school rotations 4. Application preparation 5. Interview skills 6. Research exposure The Department of Emergency Medicine at Johns Hopkins is particularly interested in those students who wish to pursue academic careers, but department members will be happy to advise students contemplating community hospital or private practice careers. Medical student rotations should emphasize a well-balanced program including: emergency medicine, pediatric emergencies, general surgery and trauma, internal medicine, cardiology, anesthesia, general pediatrics, obstetrics & gynecology, and intensive care rotations. Other recommended rotations include: psychiatry, ophthalmology, orthopaedics, plastic surgery, otolaryngology, neurology, and pulmonary/critical care medicine. Research experience is highly recommended, and opportunities are offered through the Johns Hopkins Department of Emergency Medicine. Those interested in applying for the Emergency Medicine training program at Johns Hopkins are advised to arrange elective time in late third year or early fourth year. Since specialty training in Emergency Medicine is among the 9 DEPARTMENTAL RECOMMENDATIONS most competitive in the country, it may be wise to arrange an elective at another institution also. Faculty members in the Department of Emergency Medicine can advise in this regard. Dr. G. D. Kelen Director Department of Emergency Medicine GYNECOLOGY & OBSTETRICS For those students who are considering a career in Obstetrics and Gynecology or who desire additional experience in Women’s Health, a Subinternship in Obstetrics and/or Gynecology is available. Successful completion of a core clerkship in Obstetrics and Gynecology is a prerequisite for all subinternships. If the student wishes to take subspecialty electives within the department, there is a choice of gynecology, gynecologic pathology, gynecologic oncology, reproductive endocrinology and infertility, maternal-fetal medicine, family planning, and pelvic medicine and reconstructive surgery, as well as many opportunities for research. Clinical electives are primarily offered when a core clerkship is not in session. Core clerkship dates may be found on the department’s medical student website: www.hopkinsmedicine.org/gynecology_obstetrics/education/medstudents/ Since Obstetrics and Gynecology is a primary care field, the most appropriate use of elective time for students who are committed to specialty training in Obstetrics and Gynecology involves completion of the various subspecialty medical or surgical electives. Although the student is welcome, it is not necessary to take elective courses within the Department of Gynecology and Obstetrics. All requests for subinternships and electives from the Registrar’s Office are initially screened through the department’s Office of Medical Student Education (contact Rebecca Slattery at 410-614-0088). All requests for research electives may be directed toward individual faculty, or the student may contact Dr. Silka Patel or Ms. Rebecca Slattery for assistance in finding the appropriate research mentor. Dr. Andrew J. Satin Dr. Betty Chou Chair Director of Resident Education Department of Gynecology & Obstetrics Department of Gynecology & Obstetrics Dr. Silka Patel Women’s Health Clerkship Director Department of Gynecology & Obstetrics INTERNAL MEDICINE We are looking for people who will become healers and leaders in Internal Medicine. Most successful applicants to the Osler Medical Housestaff Training program will have performed in an outstanding fashion on multiple internal medicine rotations and will have explored beyond the boundaries of the traditional curriculum, e.g., becoming involved in research or community service. We offer a commitment to outstanding patient care, a collegial environment, and an intellectually stimulating experience. Dr. Sanjay V. Desai Director Osler Residency Training Program NEUROLOGY CORE CLINICAL CLERKSHIP Neurology is part of the core curriculum at the Johns Hopkins University School of Medicine. It is preferred, but not required that students complete their Medicine clerkship before taking Neurology. The clerkship includes both inpatient and consultation services as well as an outpatient experience. For those with an interest in the area of Pediatric Neurology, a request may be made to be placed on that service. 10 DEPARTMENTAL RECOMMENDATIONS Several Neurology electives are available which students who are interested in a residency in Neurology have found to be a rewarding experience. For students with further interest, an elective and sub-I rotations in both Adult and Pediatric Neurology are now available. Dr. Rachel Salas, Director Dr. Doris Leung, Co-director Neurology Core Clerkship NEUROLOGY RESIDENCY The residency is a three-year program that follows a required Medicine Internship year. The major goal of the program is to prepare neurologists for a career in academic medicine, beginning with the acquisition of excellent clinical skills. A rich and diversified clinical experience is assured by exposure to several distinct inpatient services, consultative services, and
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