Resources Performance Evaluation

Syllabus
CE 9195

1. Introduction
   1. Welcome to the Core Surgery Clerkship at OSU-COM. This clerkship is offered at the designated "core" hospitals in the OSU-COM system:
      1. Tulsa Regional Medical Center (TRMC)
      2. St. Anthony's Hospital in Oklahoma City
   2. It is the basic surgical experience upon which you may, if you desire, build your future surgical training either while in school or during your post-graduate years. This syllabus provides you with basic and essential information for your use while planning for and working on the core surgery service. It is not meant to be your only source of information.
   3. This clerkship is conducted under the supervision of the Chairperson of the Department of Surgery and the Associate Dean for Clinical Education. The Chairperson, or his/her designee, will assign the immediate supervisor(s) for each student or group of students. Student activities will be coordinated to combine didactic and practical instruction to optimize educational opportunities. The goal for the clerkship is to prepare the student to work effectively, as a primary care provider, within a multidisciplinary medical team caring for the surgical patient. The curriculum will emphasize the importance of evaluation of potential surgical patients, the appropriate referral to a surgical specialist, and effective communication with both the patient and the specialist. If you have any questions regarding the conduct, objectives or content of the clerkship, please contact your course coordinator, Fred J. Crapse, D.O. or the Department Chairman, Douglas C. Foster, D.O., FACOS.
2. Learning Resources
   1. Required Texts: You will be assigned reading from the required textbook.
      1. Essentials of General Surgery, 4th Edition, by Peter F. Lawrence, M.D., Publisher: Lipincott, Williams and Wilkins.
   2. Additional Texts: Encouraged reading and reference textbook Sabistons Textbook of Surgery.
      1. Available in the College bookstore.
      2. There are several other excellent surgical texts available. If you have questions about any one of them, please contact a department faculty member for advice.
3. Mission Statement
   The mission of the Department of Surgery is to:
   1. Provide the highest quality of surgical and non-surgical care to patients whom we serve without regard to ethnic, religious or financial status, matching our resources to the patient's needs.
   2. Provide the care if we have the resources but never compromise patient safety for ego or money.
   3. Arrange for appropriate care if the patient's needs are not met within our department's skill set:
      1. Remember that compassion and technical expertise are equally important.
      2. Priority for recruitment will be to expand our skill set within the accepted scope of surgical practice.
   4. Provide the highest quality surgical education to students at all levels of training.
   5. Foster the "physician as lifelong student" philosophy.
      1. Educate ourselves each day to prepare us to teach others.
      2. Encourage an attitude of curiosity amongst those whom we teach.
      3. Tailor instruction to the learner's level of sophistication.
         1. Undergraduate: "How do I fit in the system?"
         2. Intern: "Where are my interests?"
         3. Resident: "Prepare me to serve my patients."
         4. Community surgeons: "Keep me current to meet the challenges of today and the future."
   6. Contribute to the advancement of osteopathic medicine and medicine as a whole.
      1. Participate in research to enlarge the body of scientific knowledge.
      2. Strive to advance the "state of the art" each day.
4. Department Faculty
   

1. Robert Baker, D.O. Clinical Assistant Professor Ophthalmology Fred J. Crapse, D.O., FACOS Assistant Professor of Surgery Course Coordinator Douglas C. Foster, D.O., FACOS Interim Chair and Assistant Professor of Surgery

   Brian Diener, D.O. Assistant Professor of Surgery Michael Thomas, M.D. Assistant Professor of Surgery Michael H. Whitworth, D.O, FACOS Assistant Professor of Surgery Program Director in General Surgery Tulsa Regional Medical Center

   1. Clerkship Objectives
      1. The primary objective of the core rotation in surgery is to introduce the osteopathic medical student to the world of general surgery and several of its subspecialties.
      2. By the completion of the core rotation, the student should have an appreciation of the similarities and differences between surgery and other medical specialties.
      3. The core rotation is intended to give the student the fundamental skills on which to build during later, more advanced elective rotations.
      4. The core rotation will place more emphasis on cognitive skills than on procedural and technical skills.
      5. The student will develop an understanding of the role of the primary care physician in the care of the patient with a surgical problem.
   2. Roles and Responsibilities
      1. Primary Responsibility: The student's primary responsibility is to acquire the essential knowledge to make him/her an effective member of the surgical team.
         1. Gathering data on the patient
            1. The surgical history and physical exam.
            2. Essential laboratory and ancillary testing.
            3. Accessing important medical intelligence related to this patient.
            4. Formulating your own differential.
         2. Communicating
            1. Presenting pertinent information to intern, resident attending, or the group.
            2. Comparing your differential to that of more experienced team members.
         3. Monitoring
            1. Observing the clinical course of your assigned patient.
               1. Daily rounds.
               2. Frequent un-scheduled visits.
               3. Chart and information system review.
            2. Be prepared to discuss and defend your assessment.
         4. Participating
            1. Be available to help with or watch procedures or surgeries.
               1. Remember, it is more important that you "learn" than "do" at this stage of your development.
               2. Students are required to attend all procedures, rounds and conferences.
            2. Be present and prompt for lectures, rounds, etc.
            3. Be an enthusiastic, active learner.
            4. Read the appropriate literature and discuss it with your colleagues.
         5. Synthesizing
            1. Begin to develop the ability to synthesize multiple data points into a coherent explanation for the patient's signs and symptoms.
      2. Attendance: ONE HUNDRED PERCENT ATTENDANCE is expected from all clinical clerks. Permission to be absent must be obtained from the rotation director, and/or the department chairperson and/or the facility director of medical education (DME) prior to any planned absence. Absences for reasonable cause, as determined by the chairperson and DME, will be approved.
         1. Absence due to short-term illness, accident, or personal matters (e.g., intern interviews) is expected to be made up by the student. Arrangements for reasonable make up should be made with and approved by the rotation director and the facility DME. It is the student's responsibility to immediately notify the appropriate persons when absence becomes unavoidable.
         2. Longer leaves of absence must be addressed with and approved by the Office of Clinical Education and the Dean of the College. Requests must be made in writing following College procedures.
      3. Rotation Evaluations:
         1. The student is expected to provide the College with a completed facility/rotation evaluation form to help improve the quality of the educational experience of their classmates in the future.
         2. The rotation will not be considered complete until the evaluation form has been submitted.
   3. Evaluations
      While you are on the Surgery Core Rotation you will be evaluated by several methods:
      1. Surgeons and Surgery Residents: You will work with a number of surgeons and surgery residents. These experiences will form the basis for completing an evaluation form regarding your basic fund of knowledge, clinical competence, technical ability and interpersonal relationships.
      2. Advisory Evaluations: You will have advisory evaluations periodically by one of the attending surgeons which will include:
         1. Didactic strengths
         2. Didactic weaknesses
         3. Clinical strengths
         4. Clinical weaknesses
         5. Areas for improvement
      3. Written Final Exam: You will have a 50-question written final exam that will cover all aspects of general and vascular surgery. An overall (written exam and evaluations) grade of 75% will be necessary to successfully complete the rotation. Questions will be taken from the following general areas:
         1. Trauma
         2. Abdominal Wall, Including Hernia
         3. Esophagus, Stomach, and Duodenum
         4. Small Intestine and Appendix
         5. Colon, Rectum and Anus
         6. Biliary Tract, Pancreas, and Liver
         7. Breast and Spleen
         8. Surgical Endocrinology
      4. Final Grade: Your final grade will be assigned based on your performance on the written exam (20%) and supervisor evaluations (80%). The grade will be determined by the Chairperson of the department in consultation with attending level surgeons.
   4. Orientation to the Service
      1. Schedule
         1. The typical workday begins at 6:00 a.m. and lasts until the student is excused by the attending supervisor, but may vary at the supervising physician's discretion.
         2. The student will have at least two days off in every 14-day period (every other weekend).
         3. Students will recieve one day mandatory holiday for Thanksgiving and two days of mandatory holiday for Christmas (may be scheduled to coordinate with hospital schedule).
      2. Attire
         1. Students may wear scrubs while in the hospital but should NEVER LEAVE THE BUILDING IN SCRUBS.
         2. Remember to remove hair covers, masks and shoe covers before leaving the operating room area.
         3. Always wear a lab coat or other appropriate cover gown when leaving the operating room area.
         4. Remember, you are a professional and should always dress appropriately when in the hospital.
      3. Supervision
         1. You will be assigned to an attending surgeons service who with a surgical resident will monitor your performance and progress.
         2. You must have direct supervision whenever you are performing any procedure.
         3. Remember that you represent the attending surgeon in all of your contacts with patients, family, and friends.
         4. Never represent yourself as a licensed physician.
      4. Reading
         1. It is essential that you read aggressively every day to allow you to master the material. Remember that habits you develop now will be with you forever in your career.
   5. Subject Areas
      1. Trauma
      2. Abdominal Wall, Including Hernia
      3. Esophagus, Stomach, and Duodenum
      4. Small Intestine and Appendix
      5. Colon, Rectum and Anus
      6. Biliary Tract, Pancreas, and Liver
      7. Breast and Spleen
      8. Surgical Endocrinology
   6. Additional Information
      1. The OSU-COM Department of Surgery updates and edits this Surgery Syllabus annually in order to familiarize students beginning their clerkship course in Surgery. As clinical clerkship related policies and procedures change, an attempt will be made to notify students participating in the program. If you have questions pertaining to this syllabus please contact the Chairman of the OSU-COM Department of Surgery.
      2. The College is not responsible for any misrepresentation of its requirements or provisions resulting from editorial or printing errors in the preparation of this syllabus or official changes in College policy approved after the printing of these guidelines.