Clerkship Objectives

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Learn to evaluate patients with surgical problems, understanding the approach to workup and preparation of patients for anesthesia and surgical intervention

Curriculum: Students will regularly evaluate patients together with residents and attendings in the clinic, in the ER, and on the wards (as consults).

Standard: Students will be expected to perform initial patient evaluation (prior to evaluation by resident or attending) in each of these settings on a weekly (at minimum) basis; each student is required to complete 3 detailed patient write-ups, including thorough history and physical as well as a focused discussion of the patients disease process and management.

Test: Student write-ups are turned in to whichever attending is responsible for the patient; the write-up is reviewed by the attending, who is required to grade it and is expected to discuss it directly with the student for one-on-one feedback.

Learn what constitutes appropriate surgical referral by recognition of which problems are clearly surgical, potentially surgical, and those which do not require surgical intervention

Curriculum: Students will regularly discuss evaluations with residents and attendings and receive feedback and guidance concerning differential diagnosis, triage, and care plans.

Standard: All students are expected to discuss patients and cases on a regular basis with their resident/attending team as part of the patient-evaluation process, as in item 1.

Test: The clinical grade includes evaluation of students' problem-solving ability and knowledge as it applies to patients whom they have evaluated.

Learn to perform a thorough abdominal exam, evaluating for pain and tenderness, abdominal distension, abdominal masses, hernias, and bruits

Curriculum: Students will directly observe multiple abdominal exams performed by residents and attendings during initial patient evaluations.

Standard: Each student is required to complete one thorough abdominal exam mini-CEX in the presence of an attending or chief resident.

Test: Abdominal exam mini-CEX cards, signed by the reviewing attending or chief resident, are turned in to the clerkship coordinator.

Become familiar with specific surgical problems in the following categories:

Acute abdomen, Bowel obstruction, GI hemorrhage, Hepatobiliary & pancreatic disease, Endocrine disease (thyroid, parathyroid, and adrenal), Breast disease, Vascular disease (carotid, aortic, and peripheral vascular), Cardiac & Thoracic disease, Trauma, Burns, and Surgical Critical Care, Pediatric surgery, Plastic surgery

Curriculum: A lecture series is given throughout the clerkship covering each of the above topics, which the students are required to attend

Standard: Students are expected to attend each of the lectures, and are asked to maintain a Patient Case Log indicating that they have directly participated in the care of a patient in each category (clinic, ER, or consult evaluation, directly caring for a patient on the wards, or scrubbing into the case in the operating room). Because different clerkship sites have varied offerings in terms of case experience, web-based case scenarios will be offered for each category. Students will be expected to complete the case scenarios by the last week of their clerkship for those categories in which they have not been involved in direct patient care.

Test: Student case logs will be turned in at the end of the clerkship to the clerkship coordinator, indicating that they have either participated in the care of a patient in each category, or completed the relevant web-based case scenario.

Learn some basic surgical technique, particularly basic suturing skills and general wound management

Curriculum: Students will attend a wound closure skills lab early in the clerkship, in which they will learn suturing and knot-tying techniques. Opportunities to further develop these techniques will be an integral part of their operating room experience. Additionally, wound management skills will be learned through activities on the wards and in clinic.

Standard: Students are required to attend the wound closure lab, as well as to participate in cases in the OR.

Test: Assessment of technical skills is a component of the clinical grade for the clerkship.

Learn to evaluate and critique surgical literature

Curriculum: Self study, with attending feedback.

Standard: Students will each choose one article from the recent surgical literature (published within the previous 3 years), and write a one-page review consisting of a summary of the content and relevance of the article as well as an evaluation of the methodology and validity of the findings and conclusions.

Test: The review is to be turned in to an attending from the service on which the student is rotating for grading. It is expected that the student will meet one-on-one with that attending to discuss the review and the grade.

Work Hours Policy
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The goals of the medical students and the faculty of the School of Medicine are one and the same: to get the best medical education possible while not ignoring overall health and happiness. Attention needs to be paid to both duty/work hours and personal time.

Work hours rules have been developed for residents, but similar rules have not been developed for medical students. There are obvious differences in terms of goals, reimbursement, and responsibilities between residents and students. Nonetheless, some guidelines for students apply.