Surgery
Overview:
The surgery rotation is a preceptorial rotation. Residents are required to complete 2 blocks of general surgery rotations. The rotation occurs at Memorial Hospital , in the surgeon's office, and in other locations included in the surgeon's usual practice. The teaching of surgey in the program includes this rotation as well as the surgical subspecialties rotation, experiences in the Family Medicine Center , the noon conference series, and on other rotations (See other curricula.).
Goals:
1) At the completion of this rotation, the resident will have an understanding of the practice of surgery in a community setting which will facilitate appropriate referral practices in the future.
2) At the completion of this rotation, the resident will have knowledge and skills in the areas of surgery pertinent to the practice of family medicine.
Objectives:
Rotation 1
At the completion of this rotation, the resident will have demonstrated to the satisfaction of the surgery preceptor:
--medical knowledge in surgery pertinent to the practice of family medicine, including the appropriate evaluation and treatment of (MK): peripheral vascular disease, breast masses, acute and chronic abdominal pain, gall bladder disease, appendicitis, diverticulitis, ischemic bowel, small bowel and colonic obstruction, abdominal masses, anorectal disorders, hernia, and perforation of the gastrointestinal tract. In addition, the resident will learn about the general principles of pre-operative risk assessment, post-operative care, and aseptic technique.
--the ability to perform an appropriate history and physical examination on the surgery patient and to present these findings to another physician in an appropriate manner (PC).
--communication and interpersonal skills which facilitate positive and therapeutic relationships (ICS).
--the ability to work cooperatively with other health professionals as part of a health care team (PC).
--compassion, respect, and integrity; responsiveness to the needs of patients and society that supercedes self-interest; accountability to patients, society, and the profession; a commitment to excellence and on-going professional development (P).
--a commitment to ethical principles pertaining to the provision or withholding of clinical care, confidentiality of patient information, informed consent, and business practices (P).
--sensitivity and responsiveness to a patient's culture, age, gender, and disabilities (P).
Rotation 2
In addition to the requirements of rotation 1, at the completion of this rotation, the resident will have demonstrated to the satisfaction of the surgery preceptor:
--the ability to interpret appropriate data related to the surgery patient and arrive at reasonable diagnostic and management decisions, weighing alternatives, benefits, and risks of diagnostic and therapeutic options, and co-managing patients appropriately with other specialists (PC).
--the ability to make appropriate decisions to assure high-quality care in a cost-effective manner ( SBP ).
--the ability to advise patients as to the risks and benefits of various surgical intervention for common problems seen in family medicine (ICS).
--the ability to recognize the need for emergent, urgent, and elective procedures for presenting surgical problems (PC).
There are no specific procedural requirements for this rotation. However, there is a separate Procedures Curriculum and residents may gain experience meeting these requirements during this rotation. Procedures typically performed by residents on this rotation include: first-assisting skills including sterile technique, proper exposure, hemostasis, and wound closure; central line placement; pleural tube placement; and excision of skin lesions.
Implementation:
This is a preceptorial rotation, so the resident is assigned to a particular general surgeon or general surgery group. The resident will accompany the surgeon during his/her professional activities at Memorial Hospital including the emergency department, in the surgeon's office, and in other locations involved in the preceptor's usual practice. In the course of seeing patients, the surgeon will provide experiential learning, role-modeling, and one-on-one teaching to the resident. At the discretion of the preceptor, the resident may be assigned to research specific topics in surgery.
The resident is responsible for contacting the surgeon prior to the start of the rotation to arrange a schedule for the rotation. The resident must continue to meet usual residency obligations to his/her Family Medicine Center population including attending scheduled clinics, caring for continuity patients admitted to Memorial Hospital, and rounding in the nursing home. The resident is expected to attend noon conferences and abide by duty hour restrictions in keeping with usual program policies. Upon completion of the rotation, the resident must complete and return the evaluation form provided by the program.
Evaluation:
The surgery preceptor will complete an evaluation form at the end of the rotation assessing the resident's success in meeting the rotation objectives as outlined in this curriculum.
Evalutation for Surgery Rotation I
Did the resident demonstrate medical knowledge in surgery pertinent to the practice of family medicine, including the appropriate evaluation and treatment of peripheral vascular disease, breast masses, acute and chronic abdominal pain, gall bladder disease, appendicitis, diverticulitis, ischemic bowel, small bowel and colonic obstruction, abdominal masses, anorectal disorders, hernia, perforation of the gastrointestinal tract, pre-operative risk assessment, post-operative care, and aseptic technique?
Yes No
Did the resident demonstrate the ability to perform an appropriate history and physical examination on the surgery patient and to present these findings to another physician in an appropriate manner?
Yes No
Did the resident demonstrate communication and interpersonal skills which facilitate positive and therapeutic relationships?
Yes No
Did the resident demonstrate the ability to work cooperatively with other health professionals as part of a health care team?
Yes No
Did the resident demonstrate compassion, respect, and integrity?
Yes No
Did the resident demonstrate a commitment to ethical principles pertaining to the provision or withholding of clinical care, confidentiality of patient information, informed consent, and business practices?
Yes No
Did the resident demonstrate sensitivity and responsiveness to a patient's culture, age, gender, and disabilities?
Yes No
Evaluation for Surgery Rotation II
Did the resident demonstrate the ability to interpret appropriate data related to the surgery patient and arrive at reasonable diagnostic and management decisions, weighing alternatives, benefits, and risks of diagnostic and therapeutic options, and co-managing patients appropriately with other specialists?
Yes No
Did the resident demonstrate the ability to make appropriate decisions to assure high-quality care in a cost-effective manner?
Yes No
Did the resident demonstrate the ability to advise patients as to the risks and benefits of various surgical interventions for common problems seen in family medicine?
Yes No
Did the resident demonstrate the ability to recognize the need for emergent, urgent, and elective procedures for presenting surgical problems?
Yes No