Northwestern University Feinberg School of Medicine
MD Education

Surgery Clerkship

This eight-week clerkship is designed to train students to recognize physical conditions and disease processes that represent surgical emergencies, to provide an understanding of when surgical consultation is appropriate for patients and to introduce the student to the principles of surgery as practiced by all surgeons regardless of specialty. The clerkship is administered by the clerkship directors as an interdepartmental effort of the departments of Surgery, Orthopedic Surgery and Urology.

During the clerkship, the student will have a four-week rotation in abdominal surgery and a four-week, in-depth "selective" subspecialty experience. Students can be assigned to NMH, Lurie Children's Hospital or the VA during the clerkship.

The didactic curriculum that supplements the clinical experiences includes a series of presentations on Wednesday and Friday afternoons. There will be interactive sessions, physical exam sessions, case-based sessions and lectures. Students also participate in faculty-led seminars that cover topics affecting surgeons in all specialties. Small-group skills sessions are led by our nurse educator during the clerkship. Complementary experiences include a suture and tubes and drains session during orientation, an OR Simulation during orientation, IV/ABI skills instruction, an online learning module for order writing and a discussion on ethics in surgery.

 Goals & Objectives

Detailed Goals and Objectives

Find comprehensive Surgery Clerkship Goals and Objectives.

 Grading & Evaluation

The breakdown of grading is:

Practical Objective Structured Clinical Exam (OSCE) skills examination:
This exam will take up to three hours and features 10 standardized patient stations  
30%
Faculty evaluations:30%
National Board of Medical Educators (NBME) shelf exam:
Multiple-choice exam given on the final day of the clerkship
20%
Seminar sessions participation:10%
Professionalism and participation complains:10%

There will be a midterm, multiple-choice exam that reflects on the clerkship objectives posted in the electronic syllabus on eMERG. Your score is not factored into your final great, but it will help identify students at risk of failure and help target areas that need improvement prior to the NBME exam. Students will also have the opportunity to participate in a midterm OSCE station that will be recorded and reviewed by the clerkship faculty. Feedback will be given with scores on the checklists and a direct observation of the standardized patient interaction.

In the fifth week of the clerkship, students will receive formal feedback via email or during a meeting with the associate clerkship director or the clerkship director. We will provide counseling to students who have marginal performance on clinical appraisals and/or on the midterm examination in order to rectify issues prior to the final examinations and overall grade assignment.

Each student is given the maximum 10 points for professionalism and participation at the start of the clerkship.  Points are decreased for each occurrence of: absence/tardiness, poor response to critique, inappropriate dress, working poorly with others, lack of initiative, poor communications, inappropriate statements or language and failure to complete forms.

At the end of each four-week block of abdominal surgery and selective surgery, your preceptor and residents will submit an evaluation of your performance.

If you have a question about your clerkships grade, please contact the clerkship director directly.

 Tools and Readings

Download the Clerkship Clerklog

Books

  • Lawrence, Peter F., Richard M. Bell, and Merril T. Dayton. Essentials of General Surgery. Baltimore: Lippincott Williams & Wilkins, 1999.
  • Lawrence, Peter F., Richard M. Bell, and Merril T. Dayton. Essentials of Surgical Specialties. Philadelphia, PA: Lippincott Williams & Wilkins, 2007.

Recommended Resources

  • Doherty, Gerard M. Current Diagnosis & Treatment Surgery. New York: McGraw-Hill Education, 2015.
  • Silen, William, and Zachary Cope. Cope's Early Diagnosis of the Acute Abdomen. Oxford: Oxford UP, 2010.
  • Bell, Richard and Dixon Kaufman. Northwestern Handbook of Surgical Procedures.
  • Surgery 101 Podcasts
  • Case files

 Frequently Asked Questions

What are the daily expectations for a M3 on this clerkship?

Students are expected to know about their patients, this includes (but is not limited to) PMHx, PSHx, home meds, current meds, allergies, SHx, what post-op day they are, what antibiotic day they are (and what is being treated with that antibiotic), what tubes and lines are present, today’s labs, trends of abnormal labs, etc. Students should also follow-up on studies that have been ordered and check on patients throughout the day. Students should come to the operating room prepared, this means looking up the patient in the computer and reviewing the films (and any other pertinent pre-op testing) before the case. Students should review patient anatomy and steps involved in performing the procedure to understand why the surgery is being done and how it will improve the patient’s condition.  Finally, students should come to their preceptor’s clinic on non-OR days and take advantage of opportunities to spend time with other services and in the trauma bay.

What is the typical schedule (number of days worked/hours per day) for this clerkship?

Students will typically work Monday through Friday and either Saturday or Sunday depending on the team in which you are rotating. Weekend shifts are determined by the day you come in to round with your team and/or the call schedule. Students will not work more than 80 hours per week while on the surgery clerkship. The maximum number of hours per day is 16 and there must be 10 hours off between shifts.

What is pre-rounding? Rounding? Note writing expectations for this particular clerkship?

Morning rounds typically begin between 5:30 and 6 a.m., prior to going to the operating room for the day. There may also be afternoon rounds. The purpose of morning rounds is to formulate a plan of care for that day. The purpose of afternoon rounds is to assess whether the goals set on morning rounds were accomplished and to formulate a plan for the night float team.

Pre-rounding consists of checking:

  • Patient’s vital signs
  • Ins and Outs
  • Any orders or notes written overnight
  • Medication Administration Record (MAR) to see what medications were actually given (not just ordered)
  • Students are expected examine their assigned patients prior to rounding
  • Students are expected to write a daily progress note on patients to whom they are assigned. These notes must be co-signed by a resident.
  • Additional tasks may be assigned to the student by the resident, which may vary by service

What does “Call” mean on this particular clerkship?

Students will take call a maximum of two times during their abdominal month during the surgery clerkship with the trauma team. On call shifts are Saturday day from 6 a.m. to 6 p.m., Saturday night from 6pm-6pm (unless you are rounding you will be there until 10 a.m.), Sunday day from 6 a.m. to 6 p.m., and Sunday night from 6 p.m. to 6 a.m.  Selective rotation call shifts will be determined by the team in which you are rotating.

What do I do if I have a question about my clerkship grade?

If you have a question about your clerkship grade you should discuss this directly with the clerkship director.  

What do I do if I have experienced or witnessed Student Mistreatment during this clerkship?

If you have experienced or witnessed student mistreatment there are many avenues to report this.  You can discuss this with the clerkships director, mentor, any of the deans or Lisa Rone, MD, the ombudsperson

What do I do if I feel burnt out or overwhelmed during this clerkship?

If you feel burnt out or overwhelmed during a clerkship there are a number of people you can speak with. The clerkship leadership, your mentor or anyone in the dean’s office are available to talk. CAPS can also be extremely helpful in this situation. You can contact CAPS at 847-491-2151.

Learn more about wellness at Feinberg.

Who do I contact if I am sick or have a personal appointment?

If you are sick or have a personal appointment please email the clerkship director and copy Anna Reczynski, clerkship coordinator. It is also important that you notify your team.

Any required equipment?

Stethoscope, comfortable close-toed shoes

Contacts

Amy Halverson, MD
Director
In the event of an emergency:
Phone: 312-227-6250
Pager: 312-227-5000 x76257

David Odell, MD
Associate Director

Jason Burke
Coordinator
Galter 3-150
Phone: 312-926-9411
Fax: 312-926-7404