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• To provide exposure to the breadth and depth of the surgical sciences by enabling students to function, under guidance of a precepting surgeon, as a contributing member of the surgical team.
• To introduce the principles of surgery and the rationale behind surgical therapeutic intervention through self-directed learning activities.
• To provide students with the knowledge and skills necessary to provide patient care: to diagnose surgical diseases, and to determine criteria for surgical referral while fostering the development of life-long learning skills.
• To foster student growth in the areas of communication skills, practice-based learning, medical ethics and moral reasoning, professionalism and social and community context of health care.
At the completion of the 12-week surgery clerkship, the student should be able to achieve the following course objectives:
During the 12 week clerkship students will perform a focused history and physical exam on the specified number of real or simulated patients for the following presenting complaints. At the completion of the clerkship each student will be able to obtain a focused history and perform a focused physical exam for each complaint in a timely manner:
• Abdominal complaint (may include abdominal pain, abnormal bowel or bladder function, abnormal test relating to the abdomen): 5 patients
• Musculoskeletal complaint: 3 patients
• Neurological complaint: 1 patient
• Head and neck complaint: 3 patients
• Eye complaint: 1 patient
• Male genital, prostate, hernia complaint: 3 patients
• Breast complaint: 1 patient
• Vascular complaint: 1 patient
During the 12 week clerkship the student will encounter the following medical conditions/diseases in the specified number of real or simulated patients. For each medical condition/disease the student will be able to describe the common causes of the condition, how to determine if each disease or condition exists, and the appropriate initial management and/or the disposition of a patient with such a condition. When appropriate, the student should be able to describe appropriate steps to screen for and/or prevent conditions in the general population. In lieu of encountering the condition in a real or standardized patient, a simulated case covering knowledge objectives will be provided.
(Within each category a number of differential diagnoses are included. Each of these specific conditions will not be seen by every student. It is expected that when seeing a patient with a given condition such as acute abdomen, the student will also be able to learn about other conditions within the differential. Separate enabling objectives are provided to guide learning in specific areas.)
General
• Acute abdomen: 1 patient
• Non-operative sources of abdominal pain: 1 patient
• Gastrointestinal bleeding: 1 patient
• Benign gastrointestinal disease: 1 patient
• GI malignancy: 1 patient
• Anorectal disease: 1 patient
• Breast disease:1 patient
• Reflux:1 patient
• Hernias 1 patient
• Endocrine disorders: 1 patient
• Trauma / Shock: 1 patient
• Arterial vascular disease: 1 patient
• Venous disease: 1 patient
• Obesity: 1 patient
• Wound: 1 patient
• Benign or malignant lung nodule: 1 patient
• Coronary artery disease, valve disease: 1 patient
• Skin lesions: 1 patient
Musculoskeletal:
• Back Complaint: 1 patient
• Joint Complaint: 2 patients
• Foot complaint: 1 patient
• Injury, Fracture: 1 patient
• Arthritis: 1 patient
• Orthopedic Infection: 1 patient
• Orthopedic Trauma: 1 patient
Neur
• Increased intracranial pressure:1 patient
Head and Neck:
• Neck mass or malignancy:1 patient
• Hearing loss/ disequilibrium: 1 patient
• Epistaxis: 1 patient
• Tonsillitis/adenoiditis:1 patient
• Upper respiratory complaint: 1 patient
Eye:
• Acute Loss of Vision: 1 patient
• Chronic Loss of Vision: 1 patient
• Injury or Infection: 1 patient
• Ocular Symptoms: 1 patient
Urology:
• Prostate problem: 2 patients
• Urinary complaint: 1 patient
• Urologic Infection: 1 patient
• Urologic Cancer: 1 patient
• Infertility or impotence: 1 patient
• Scrotal complaint: 1 patient
• Voiding complaint: 2 patients
At the completion of the 12-week clerkship, the student should be able to correctly demonstrate performance of the following skills. For each skill, the student will have the opportunity to practice that skill on the specified number of real or simulated patients, or in lieu of the specified number, will be observed performing skill on a model.
• Endotracheal intubation / ventilation by ambu bag: 1 patient
• Dressing change: 2 patients
• Progress notes / Procedure notes: 5 patients
• Admission Orders: 5 patients
• Oral presentation of patient: 10 patients
• Skin closure, knot tying: 3 patients
• Insertion of urethral catheter: 3 patients
• Venepuncture / IV insertion: 1 patient
• NG tube insertion and removal: 1 patient
• Drain removal: 1 patient
• Gowning and Gloving: 5 patients
• Observe Informed Consent Process: 3 patients
• Interpret x rays/CT scans: one patient each for:
- abdominal films
- mammogram
- plain films of bones
- abdominal CT
- non contrast CT of head,
- plain films of the spine
- audiogram
- IVP
In addition to the above knowledge and skills objectives, students are expected to demonstrate ongoing growth in the area of interpersonal and communication skills, medical ethics and moral reasoning, practice-based learning and improvement and professionalism.
• Students will participate as members of a health care team and will effectively communicate with members of the team.(performance evaluations)
• Students will participate in one ethics conference and be able to participate in a discussion of ethical principles as they apply to surgery: (attend one conference)
• Students will effectively use the electronic medical record to record findings and plans for patients: (nurse educator to evaluate)
• Students will demonstrate the ability to acquire and apply scientific knowledge to clinical problem solving: (discussion groups)
• Students will utilize preventative health strategies as it applies to surgical problems: (discussion groups)
• Students will participate in a midcourse feedback session and will be asked to identify their own personal strengths and weaknesses and to develop a plan for continued growth.(meet with nurse educator and/or clerkship director or associate director)
• Students will demonstrate professional behavior by attending required conferences and completing electronic log. (Attendance, log records)
• Students will maintain professional dress and demeanor and develop professional relationships with peers, faculty and staff.(performance evaluations)
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