Surgery Elective Course Description

Mitchell Cahan, MD

Contact: Marilyn Lavergne

Elective Description: Goals, Methods of Teaching, Number of Patients Seen, and Supervision Level: See elective type descriptions A, B1, B2 and C for additional elective criteria.  By the end of this sub-internship, the medical student will be able to:

1. Define the roles and responsibilities of a surgical intern, and assume the role of a junior resident/intern in patient care under the direct supervision of senior residents and attending (Physician as professional)
2. Effectively communicate with all team members (students, residents, attendings) as well as all services that interact with surgery on a daily basis (Physician as communicator)
3. Perform a surgical consult (including appropriate history taking and physical exam), develop a care plan, and present to a chief resident (Physician as clinical problem solver, scientist, communicator)
4. Manage the care of 2-4 surgical patients, including having first-call responsibilities (Physician as professional, clinical problem solver, communicator)
5. Perform basic surgical procedures, including but not limited to NGT placement, urinary catheter placement, IV insertion (Physician as clinical problem solver, scientist)
6. Teach basic surgical concepts and mentor third year clerks (Physician as professional, patient & community advocate, person)
7. Respond with intern to all acute situations on the ward (sub-intern to carry service pager while on call) (Physician as professional, communicator, clinical problem solver)

The student will participate in daily morning teaching rounds run by the chief surgical resident on the service. They will also be expected to attend all surgical conferences.

The student will be responsible for preparing one formal case presentation (with PowerPoint) to be presented at Morning Report on his/her final week on service.

By the end of the sub-internship rotation, the student will have encountered and managed common perioperative situations

Pre-operative evaluation (including the following):            Post-operative management of:

• Undifferentiated abdominal pain                                       •  Pain
  (including evaluation for the following)                          
• Appendicitis                                                                       •  Fever
• Cholecystitis / Biliary colic                                                  •  Chest pain/SOB/CHF
• Mesenteric ischemia                                                          •  Mental status change
• Pneumoperitoneum                                                           •  Bleeding
• Ulcer disease                                                                     •  Low urine output
• Bowel obstruction                                                              •  Acute renal failure
• Hernia                                                                                • Assessment of wound infection
• GI malignancy
• Limb ischemia
• Sepsis of unknown origin