Surgery Clerkship
Director: Yee Men Wong, MD, Clerkship Director, and Assistant Professor, Surgery
Clerkship Description: The Surgery clerkship goal is to ensure students acquire the skills and knowledge that all physicians need to know in order to manage patients with conditions commonly treated by surgeons.
Boonshoft SOM Educational Objectives/Competencies
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Code |
What competencies will this unit address? |
|---|---|
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Foundational Knowledge – Medical Knowledge |
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1.1 |
Master fundamental biomedical concepts, terms, processes, and system interactions |
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Foundational Knowledge – Medical Knowledge |
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1.2 |
Describe the determinants of health |
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Foundational Knowledge – Medical Knowledge |
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1.3 |
Utilize evidence in making clinical decisions |
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Application – Patient Care (Clinical Skills) |
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2.1 |
Conduct patient interviews and physical examinations |
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Application – Patient Care (Clinical Skills) |
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2.2 |
Diagnose patient health problems |
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Application – Patient Care (Clinical Skills) |
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2.3 |
Propose evidence-based health maintenance and therapeutic treatments |
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Integration – System-Based Practice |
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3.1 |
Connect knowledge of patient populations and health delivery processes in making diagnoses and therapeutic recommendations |
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Integration – System-Based Practice |
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3.2 |
Advocate for the humane, just, safe and prudent care of persons |
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Integration – System-Based Practice |
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3.3 |
Adapt to the complex economic and social structure of health care delivery |
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Human Dimension – Personal and Interpersonal Professional Development Goals |
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4.1 |
Reflect upon one’s personal strengths and weaknesses to make changes in one’s behavior |
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Human Dimension – Personal and Interpersonal Professional Development Goals |
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4.2 |
Find one’s own meaning in medicine |
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Human Dimension – Personal and Interpersonal Professional Development Goals |
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4.3 |
Take care of oneself |
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Human Dimension – Personal and Interpersonal Professional Development Goals |
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4.4 |
Deliver effective patient presentations and document accurately in the medical record |
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Human Dimension – Personal and Interpersonal Professional Development Goals |
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4.5 |
Communicate and work effectively with others |
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Human Dimension – Personal and Interpersonal Professional Development Goals |
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4.6 |
Demonstrate leadership skills in a variety of settings |
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Caring/Valuing – Professionalism Goals |
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5.3 |
Value and behave in a manner consistent with the highest ethical standards of the profession |
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Learning How to Learn – Practice-Based Learning |
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6.1 |
Develop a personal plan to become a better medical professional |
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Learning How to Learn – Practice-Based Learning |
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6.3 |
Appropriately utilize evidence-based resources to address uncertainty in medicine and gaps in knowledge/skills |
Clerkship-Level Objectives
|
Code |
What are the clerkship-level objectives for this course? |
Boonshoft SOM Objectives |
|---|---|---|
|
LO1 |
Frame a patient encounter in an organized fashion, reinforcing etiology, pathophysiology, clinical manifestations, diagnostic strategies and therapeutic interventions. |
1.1, 2.1 |
|
LO2 |
Explain disease specific treatment strategies and associated prognosis and complications. |
1.1, 2.1 |
|
LO3 |
Evaluate patients’ presenting clinical problems, including: abdominal pain, breast mass, colorectal disease, biliary tract disease, ventral/inguinal hernia, skin and soft tissue lesions, and traumatic injury. |
1.1, 2.1 |
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LO4 |
Diagnose and manage surgical conditions in patients with acute and chronic conditions including: substance abuse, altered mental status, malignancy, DM, hypertension, and obesity. Participate in surgical procedures including, but not limited to: appendectomy, breast surgery, colon/small bowel surgery, cholecystectomy, hernia repair, tracheostomy, PEG tube placement, surgery of skin and/or soft tissue, and technical skills (Foley catheter placement, suturing and know typing, wound care). |
1.1, 2.1, 2.2, 2.3 |
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LO5 |
Apply the fundamentals of surgical care to coordinate the care of acutely and chronically ill adults as well as traumatically injured patients. |
1.1 |
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LO6 |
Demonstrate systematic approach to adult patients utilizing sound skills in gathering components of the history and physical exam. |
2.1, 4.4 |
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LO7 |
Demonstrate appropriate interpretation of labs and testing. |
2.2 |
|
LO8 |
Begin to formulate diagnostic reasoning, and justify therapeutic decision-making. |
1.3, 2.2, 2.3 |
|
LO9 |
Demonstrate clear and concise oral presentations and written documentation reflecting a systematic approach to adult patients. |
2.1, 4.4 |
|
LO10 |
Identify the social determinants of health for a specific patient, and develop a plan to coordinate care to include community resources to try to improve the health of the individual. |
1.2, 3.1, 3.2 |
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LO11 |
Consider patient, physician, and system barriers to successfully negotiate treatment plans and patient adherence; and identify strategies that may be used to overcome these barriers. |
1.2, 3.1, 3.2 |
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LO12 |
Identify the role of each team member to the care of the patient, and call on interdisciplinary resources to provide optimal and comprehensive care. |
3.3, 4.5, 4.6 |
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LO13 |
Establish professional relationships and effectively communicate with patients, their families, instructors, colleagues and staff. |
4.1, 4.3, 4.5, 4.6 |
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LO14 |
Work effectively with the broad, interdisciplinary team in patient care and appropriately incorporate their unique care skills. |
4.1, 4.3, 4.5, 4.6 |
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LO15 |
Demonstrate the ability to act with honesty/integrity while maintaining ethical duties to patients and others. |
5.3 |
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LO16 |
Demonstrate the ability to act in a manner that is dependable, dedicated and punctual. |
5.3 |
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LO17 |
Demonstrate the ability to act with patience, altruism and equanimity. |
5.1, 4.1, 4.6 |
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LO18 |
Recognize when additional information is needed to care for the patient and demonstrate ongoing commitment to self-directed learning. |
6.3 |
|
LO19 |
Demonstrate effective skills in navigating the medical literature to answer clinical care questions. |
6.3 |
|
LO20 |
Demonstrate the ability to acquire and soundly manage knowledge, identify knowledge deficiencies and create a plan for knowledge gains |
4.2, 6.3 |
|
LO21 |
Demonstrate the ability to seek out and listen to feedback on performance, accept it positively, and respond to it constructively by improving performance. |
4.5, 4.3, 4.1 |
Required Clinical Experiences
During your Surgery Clerkship, you will be involved in the preoperative, operative, and postoperative care of patients – all very important aspects in the delivery of care! It is required that you log all of your patients and cases in the logger in BAMS. You will need to select your “level of participation” when you log your cases: observation, moderate participation, or full participation. To ensure a breadth of exposure during your clerkship, it is expected that you will need the minimum defined cases with the level of responsibility indicated.
|
Encounter Log Items |
Target |
Expected Level of Responsibility |
Examples (if applicable) Including but not limited to: |
|---|---|---|---|
|
Cancer |
1 |
Moderate participation | |
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Diabetes |
1 |
Moderate participation | Participation in the management of a patient with DM as a complicating comorbid condition and/or sequelae |
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Hypertension |
1 |
Moderate participation | Participation in the management of a patient with HTN as a complicating comorbid condition and/or sequelae |
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Obesity |
1 |
Moderate participation | Participation in the management of a patient with obesity as a complicating comorbid condition and/or sequelae |
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Abdominal pain – evaluation and workup |
1 |
Moderate participation | |
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Breast mass – evaluation and workup. Benign or malignant. |
1 |
Moderate participation | Breast cyst, fibroadenoma, breast cancer |
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Colorectal disease – evaluation and workup. Benign or malignant. |
1 |
Moderate participation | Appendicitis, bowel obstruction, GI bleeding, inflammatory bowel disease, diverticular disease, ischemic colitis, gastrointestinal malignancies |
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Biliary tract disease – evaluation and workup |
1 |
Moderate participation | Acute and chronic cholecystitis, jaundice |
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Hernia (ventral, incisional, or inguinal) – evaluation and workup. |
1 |
Moderate participation | Ventral, umbilical, incisional, inguinal hernias – with and without acute incarceration and/or strangulation |
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Skin and soft tissue –evaluation and workup. Benign or malignant. |
1 |
Moderate participation | Skin lesions (benign and malignant), soft tissue masses (benign and malignant), abscesses |
|
Procedure Log Items |
Target |
Expected Level of Responsibility |
Examples (if applicable) Including but not limited to: |
|
Minimally invasive surgery |
1 |
Assisted in the procedure |
Any laparoscopic or robotic surgery |
|
Open surgery |
1 |
Assisted in the procedure |
Exploratory laparotomy, open vascular surgery, thoracotomy |
|
Breast/skin/soft tissue surgery |
1 |
Assisted in the procedure |
Breast mass excision, drainage of breast abscess, mastectomy, lipoma or cyst excision, excision of skin lesion/skin cancer, drainage of abscess, debridement of skin and soft tissue |
|
Small bowel surgery |
1 |
Assisted in the procedure |
Small bowel resection, lysis of adhesions, repair of enterotomy |
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Colorectal surgery |
1 |
Assisted in the procedure |
Colon resection, appendectomy, ostomy creation, low anterior resection, hemorrhoidectomy, drainage of peri-rectal abscess |
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Hepatobiliary surgery |
1 |
Assisted in the procedure |
Cholecystectomy, liver resection, Whipple procedure, hepatorrhaphy |
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Hernia repair |
1 |
Assisted in the procedure |
Ventral, incisional, umbilical, inguinal, femoral hernia repair, with or without mesh |
|
Technical skills: suture |
2 |
Fully performed procedure |
Repair of lacerations, closure of port sites or incisions, simple interrupted, simple running, subcuticular, or mattress stitch |
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Technical skills: knot tying |
2 |
Fully performed procedure |
Instrument tie, two-handed or one-handed tie |
|
Other surgery *** |
10 |
Assisted in the procedure |
|
Observation: Student is observing encounter
Moderate Participation: Student completes the History and Physical (either complete or focused) and participates in the differential diagnosis. (*Student directly interacts with the patient)
Full Participation: Student completes History and Physical (either complete or focused), participates in the differential diagnosis, and then completes a therapeutic treatment plan, which can include documentation.
For procedures:
Observation
Assisted in the procedure
Fully performed the procedure
