Elective time generally occurs in the PGY-4 year but can be scheduled earlier at the discretion of the Training Director. The amount of elective time is variable, determined by what is needed to achieve the goals and objectives for the proposed clinical experience, but averages 1.5 days/ week for 12 months. Residents can utilize this time to pursue a number of clinical electives or research opportunities. They may opt to work within the Medical Center with any departmental faculty or outside the facility. Some residents have also done international electives. Through electives, the residents are able to refine their expertise in an area of interest. The resident is responsible for developing an acceptable proposal to pursue elective options. The educational method depends upon the rotation in which the resident is involved.