SURG 7500

Surgery Externship

Contact

Leah Vierzba
Course Coordinator
vierz009@umn.edu

Campus: 
Curriculum focus: 
Clinical level: 
Requirement: 
MS year: 
Hands-on: 
Terms offered: 
Credits: 
Prerequisites: 

N/A

    Details

    Catalog Description: In addition to competence in the course objectives, it is expected that the students will attend clinical departmental conferences, laboratory exercises, team discussions and group seminars. Recommended textbooks for the rotation: Way: Current Surgical Diagnosis and Treatment, 11th edition, 1996, Sabiston and Lyerly; Essentials of Surgery, 2nd edition, 1994. A handbook of core topics, readings, and oral exam questions is provided at the beginning of each period.

    Sites: Students will be assigned to one of the following clinical sites:

    • DU - Essentia Health - St. Mary's Medical Center - 407 E 3rd St., Duluth, MN
    • FU - UMMC-Fairview East Bank, 500 Harvard St SE, Minneapolis, MN
    • HC - HCMC - 701 Park Avenue South, Minneapolis, MN
    • HYB - Primary site attachment with Hennepin Healthcare 
    • MC - Minneapolis Children's - 2525 Chicago Ave S, Minneapolis, MN
    • MT - Methodist-Park Nicollet - 6500 Excelsior Blvd., St. Louis Park, MN
    • NM - North Memorial Medical Center - 3300 Oakdale Ave N, Robbinsdale, MN
    • RH - Regions - 640 Jackson St., Minneapolis, MN
    • SC - St. Paul Children's - 345 Smith Ave N, St. Paul, MN 55102
    • VA - VAMC - 1 Veterans Drive, Minneapolis, MN

    For additional information about sites please see this document: SURG 7500 Sites - Description, Location and Contact Information.

    Required session attendance:

    Typical weekly schedule/Delivery Mode: Varies by site/services; mix of clinic and OR opportunities

    Direct patient care: Yes

    Consent Requirement: Open to student scheduling

    Course Objectives: This course provides the medical students an opportunity to learn various responsibilities of a PGY-1 Surgery resident. At the completion of the rotation it is expected that the student will have achieved competence in the following subject areas:

    Gastrointestinal Bleeding

    • Identify patient with acute gastrointestinal bleed
    • List common causes of GI bleeds
    • Justify selection of standard diagnostic and therapeutic studies
    • Describe signs and symptoms of hemodynamic instability
    • Describe various operations and treatment strategies used to control GI bleeds
    • Describe what blood products to transfuse and when
    • Write orders for GI consult
    • Order endoscopies, labs, radiographic imaging
    • Interpret results from the above workup
    • Bowel Obstruction
    • Identify patients with complete and partial bowel obstructions
    • List common causes of bowel obstruction
    • Understand usual diagnostic labs and studies
    • Describe management and treatment options to deal with bowel obstruction
    • Evaluate patient with suspected bowel obstruction
    • Complete a thorough abdominal and rectal exam
    • Order labs, radiographic studies and management regime
    • Interpret evaluation results and physical findings
    • Demonstrate proper insertion of Nasogastric tube (NGT) (must be performed with Resident)

    Post-Op Management, Complications

    • List common post-operative management points
    • Justify selection of post-operative labs, diagnostic studies and radiographic studies
    • Describe possible post-operative complications and their signs and symptoms
    • Specifically describe evaluation of low urine-output, hypoxia and confusion in the post-operative patient
    • Describe common doses, uses and modalities of narcotic and non-narcotic pain management
    • Write standard post-operative orders including labs, diagnostic tests, radiographic tests and nursing orders
    • Write appropriate "call House Officer for…" parameters
    • Write and discuss appropriate "prn" orders
    • Write for pain management medication (must be performed with Resident)
    • Order and interpret appropriate labs, radiographic imaging, studies for evaluation of low urine output, hypoxia and confusion in post-operative patients

    Colorectal Cancer

    • Identify risks of colorectal cancer
    • Justify standard diagnostic evaluations
    • Describe signs and symptoms of colorectal cancer
    • Describe various operations and treatment strategies for colorectal cancer
    • Perform digital rectal exam
    • Order laboratory and radiographic studies appropriate to your patient
    • Observe colonoscopy, proctoscopy and sigmoidoscopy

    Acute Abdominal Pain

    • Identify patient with acute abdominal pain
    • List common causes of abdominal pain
    • Differentiate potentially life threatening abdominal pain from other types of abdominal pain
    • Describe standard evaluation labs and studies for acute abdominal pain based on presumed diagnosis
    • Recognize a 'surgical abdomen' based on presentation, history and physical exam
    • Describe appropriate algorithm for abdominal pain evaluation and work-up
    • Perform thorough abdominal exam including rectal exam
    • Verbalize differential diagnosis
    • Order appropriate laboratory and radiographic studies
    • Interpret study results
    • Verbalize rationale for narrowing differential diagnoses
    • Perform serial abdominal exams including documentation of exam findings (must be performed with Resident)

    Pancreatobiliary Disease

    • Identify patient with pancreas, liver and biliary disease
    • List common types of biliary, hepatic and pancreatic disorders
    • Describe signs and symptoms of biliary, hepatic and pancreatic dysfunction
    • Justify selection of standard diagnostic and therapeutic studies
    • Describe various operative and treatment strategies to deal with diseases of the biliary system, liver and pancreas
    • Perform thorough abdominal exam and verbalize pertinent findings
    • Order appropriate labs, radiographic and invasive studies
    • Verbalize interpretation of study results
    • Observe ERCP and evaluate cholangiogram results

    Hernia

    • Identify patient with hernia (e.g., inguinal, umbilical, incisional, ventral, hiatal)
    • List common causes and types of hernia
    • Describe signs, symptoms and complications of hernias
    • Describe both surgical and non-surgical treatment modalities for hernias
    • Perform physical exam for hernia based on location.
    • Order appropriate studies and pre-operative evaluation for hernia diagnosis and repair
    • Evaluate post-operative hernia patient
    • Observe or perform reduction of hernia (must be performed with Resident)

    Breast Disease

    • Identify patient with breast disease
    • List common causes of breast pain, discharge, abnormal mammography and mass
    • Describe signs, symptoms and risk factors for breast disease
    • Justify selection of standard diagnostic studies
    • Describe various operative and treatment strategies for different breast diseases including sentinel lymph node biopsy
    • Perform thorough breast exam
    • Order appropriate labs and radiographic studies
    • Verbalize interpretation of results
    • Order appropriate drain and wound care for inpatients and for discharge
    • Observe breast biopsy or operation including sentinel lymph node biopsy

    Trauma, Burns & Shock

    • Identify patient with burns that require medical attention
    • Identify patient with signs and symptoms of shock
    • List common causes of shock
    • Describe various types and pathophysiology of burns and shock
    • Justify common laboratory and radiographic studies for burn or shock evaluation
    • Describe standard operations and treatments for various types of burn
    • Describe various operations and treatment for various types of shock
    • Perform estimation of burned body surface area
    • Calculate burn resuscitation requirements
    • Order appropriate labs, radiographic and invasive studies
    • Interpret appropriate laboratory and diagnostic studies
    • Perform fluid resuscitation of burn patient or patient in shock (must be performed with a Resident)
    • Interpret pulmonary artery catheter data
    • Observe or perform central venous catheter placement

    Fluid / Electrolytes / Nutrition

    • Identify patient with fluid, electrolyte or nutritional abnormality
    • Describe common causes of fluid, electrolyte or nutritional imbalances
    • Describe various treatments for fluid, electrolyte or nutritional problems
    • Order appropriate laboratory evaluations for fluid, electrolyte or nutritional abnormality
    • Interpret laboratory findings
    • Order fluid, electrolyte and nutritional replacements specific to patient
    • Interpret follow-up laboratory findings after intervention

    Endocrine Diseases

    • Identify patient with endocrine disease
    • Describe common causes and types of endocrine disorder
    • Justify standard diagnostic, laboratory and radiographic studies to work-up endocrine problem
    • Understand complications associated with endocrine diseases with operative therapy
    • Describe life-saving therapies
    • Describe other operative and treatments available for endocrine disease
    • Order appropriate laboratory and radiographic studies
    • Interpret results from above studies
    • Evaluate post-operative thyroid or parathyroid patient for complications (must be performed with Resident)
    • Verbalize treatment for post-operative complications of neck surgery
    • Verbalize treatment for post-operative complications of endocrine organ surgical manipulation

    Vascular Disease

    • Recognize signs and symptoms of atherosclerotic disease (carotid, aortic, and peripheral vascular) and aneurysmal disease.
    • Differentiate between underlying vascular disease and other etiologies with similar presentations
    • Describe standard evaluation steps and studies (including specific physical exam maneuvers)
    • Describe various operations and treatment strategies used to treat patients with vascular disease
    • Order appropriate labs and diagnostic studies
    • Interpret results from above studies
    • Demonstrate ABI (Ankle Brachial Index) exam

    Pediatric Surgery

    • Identify child with surgical issue
    • Justify labs and studies based on surgical problem
    • Identify difference between gastroschisis and omphalacele
    • List signs and symptoms of emergency surgical conditions
    • Perform thorough abdominal exam on a child
    • Observe repair of one congenital anomaly
    • Observe an inguinal hernia repair

    Graded Components: 

    • Clinical performance assessment
    • NBME Shelf Exam
    • OSATS Exam
    • Attendance at lectures and Grand Rounds Conferences, skills labs, and assignment completion
    • Professionalism

    Grading Scale: H/E/S/N

    More

    Allow repetition of course: Repetition not allowed

    Limited to Student Type: No

    Course equivalency: INMD 7204 (RPAP), INMD 7213 (MetroPAP), INMD 7311 (VALUE), INMD 7411 (EPAC), INMD 7351 (HeLIX), INMD 7111 (REACH)

    Related curricular experience:

    Secure Exam:

    Course evaluation: MedHub