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Surgery Clerkship Rotation

GENERAL SURGERY & SUBSPECIALTIES

Surgery Clerkship Statewide Director: Alan Ladd, M.D.

Surgery Clerkship Regional Directors: Mary Aaland, M.D.

Alan Yahanda, M.D.

To view the current schedule for Surgery or Subsurgery Specialties, please vist the ANGEL website at: https://angel.medicine.iu.edu. The schedule can be found in the Fort Wayne folder under the Surgery Clerkship. If you need assistance accessing ANGEL, please contact Gina Bailey by phone at (260) 481-6731 or by email at baileyg@ipfw.edu.

Goal:

Third year medical students participating in the surgical clerkship will be given a broad view of the principles and practices of surgery as they relate to the whole of medicine. Students will be introduced to problem solving as well as decision-making and through practical hands on experience, will become comfortable with caring for the common surgical problems that arise in a primary care practice. Finally, the clerkship experience hopes to stimulate student interest in the pathophysiology of surgical disease processes and the treatment modalities that accompany them.

Textbook[s]:

Essentials of General Surgery [4th edition], 2005 by Peter Lawrence - Primary textTextbook of Surgery by Sabiston Principles of Surgery by Schwartz

Didactics:

Monday and Friday teleconferenced problem based learning seminars. Topics include:

Complications

Breast masses

Endocrine

Esophagus

Ulcer disease

Biliary

Pancreas

Liver disease

Colon disorders

Hernia

Cognitive Outcomes:

After completing this rotation, students will have gained experience in:

developing a differential diagnosis for patients with the following:

- abdominal pain - GI bleed

- abdominal wall mass -jaundice

- abnormal mammogram* - perianal abnormality

- bowel obstruction - neck mass

- breast mass / nipple discharge - trauma

- difficulty swallowing - wound complication

* Students should go to https://iubcrc.iupui.edu/ccm/login.jsp?id=student for education on mammogram/breast ultrasound interpretation and to review a PowerPoint presentation on breast biopsy techniques. Click on "Medical Students" tab on upper right.

differentiating the following conditions:

- appendicitis versus a pelvic abnormality

- ulcerative colitis versus Crohn's disease

- gallstones versus kidney stones

- upper versus lower GI hemorrhage

- reducible versus incarcerated versus strangulated hernias

- gall bladder disease versus peptic ulcer disease

constructing an appropriate knowledge base in:

- preoperative preparation, including informed consent

- postoperative care and follow up

- basic pathology and physiology of common surgical disease

- surgical procedure & protocol

(tubes placed, drains placed, lines placed, scrubbing, gowning, etc.)

- surgical decision-making principles

- potential complications that might result from particular surgical operations

accessing and evaluating medical literature related to patients' health problems

demonstrating the ability to care for assigned patients

Affective Outcomes:

After completing this rotation, students will have gained experience in:

putting into practice self-directed learning habits

demonstrating professional judgment in caring for patients

putting into practice appropriate communication skills with patients, family members, and other medical personnel

showing the ability to function as a member of a surgical care team

demonstrating reliability and dependability for patient care

discussing patient work ups effectively with preceptor

Psychomotor Outcomes:

After completing this rotation, students will have gained experience in:

demonstrating appropriate history taking and physical exam skills

showing appropriate written documentation skills

demonstrating appropriate skills in preparing for surgery (OR protocol)

observing / assisting in the performance of surgical operations with attending

demonstrating the ability to apply surgical principles to case scenarios

recording and performing various surgical procedures including:

peripheral venipuncture / phlebotomy (1)

peripheral venous catheter insertion (1)

total parenteral nutrition management (1)

Foley catheter insertion (2)

injection (subcutaneous, intravenous, intramuscular) (1)

lesion biopsy / incision and drainage of abscess (1)

nasogastric tube insertion (1)

suture of laceration (2)

breast exam observed by faculty member (1)

inguinal exam observed by faculty member (1)

problem focused history observed by faculty member (1)

rectal exam observed by resident or faculty member (1)

recording and observing various surgical procedures including:

central venous catheter insertion (1)

ventilator management (1)

esophagogastroduodenoscopy (EGD) / Colonoscopy (1)

blood glucose check (1)

Requirements:

Develop a personal program of self-study and professional growth

Attend ward rounds

Document duty hours

Dress professionally and maintain good personal self-care

Participate in effective and compassionate patient care

Complete evaluation forms and all other documents requested

Duty Hour Logs:

Students are required to log their duty hours using the E*Value system while on General Surgery. It is the student's responsibility to stay current with this log throughout each rotation. Any student found delinquent in their Duty Hour entries will lose a professionalism point. See the Surgery Handbook for complete information.

Required trips to Indianapolis Campus:

Intersession only

Call requirements:

Night call x2

Methods for evaluating clerk performance:

Required H&P exam due mid-rotation

Faculty sign-off of procedural skills and encounters

Logging of skills/encounters

Mid-rotation feedback

Professionalism points

Assessment:

Mid-rotational feedback [due by end of 3rd week of rotation] via Feedback cards.

Based on clinical evaluations of General Surgery and Subspecialty rotations.

Preceptor evaluates the students' clinical performance by completing the online Surgery Department Student Clinical Performance evaluation.

The NBME surgical shelf exam will assess the student's surgical knowledge base. A minimum score of 60 points on the exam is required in order to pass the course.Preceptor evaluates the student's problem solving capacity by completing the Competency 8-Level 2 evaluation.Preceptor evaluates the students' participation in the small group conferences by completing the small group evaluation. ?

Final grades in surgery are weighted as follows:

Clinical Evaluation on General Surgery Component: 30%

Clinical Evaluation on Surgical Subspecialty: 30% 60% required in

NBME Final Examination: (Last day of rotation) 30% * each to pass

Evaluation in the small group conferences: 10% ?

*Subspecialty questions generally account for @ 15% of the examination. Students should be advised that they are responsible for obtaining knowledge regarding practical problems involving all subspecialty surgical problems. Surgical subspecialties include CARDIOVASCULAR, NEUROSURGERY, ORTHOPEDICS, OTOLARYGOLOGY, TRAUMA/ICU, UROLOGY

[Students must also assess their experience by using the E*Value System. This includes faculty evaluation, student perception evaluation and conference evaluation. Evaluations must be done within one week of the end of the rotation to complete the forms.]

2101 E. Coliseum Blvd. | Fort Wayne, IN 46805 | Ph: (260) 481-6730 | Fax: (260) 481-6408