` McMaster GENERAL SURGERY, PLASTIC SURGERY Residents
ON THEIR TWO-BLOCK PEDIATRIC SURGERY ROTATION:
Welcome to the Pediatric Surgery service! The Pediatric Surgery rotation is an opportunity to become familiar
with the diagnosis, initial management, and perioperative care of surgical conditions in neonates, infants, and
children up to the age of 18 years. During this rotation, residents will be under the direct supervision of the
pediatric surgery fellows and staff, will take first call to assess emergency consultations, and will gain surgical
experience in the operating room. The focus is on gaining comfort with pediatric surgical problems, working
with a team, and communicating with families.
Summary of Assessment Requirements – collect in your Educational Portfolio
It is your responsibility to arrange an introductory orientation meeting with your Mentor within the first week
of the rotation. KEEP THIS FORM WITH YOU.
Your name: ………………………………………………… Dates of your rotation: ………………………………………………………….
Your faculty Mentor is: ………………………………………………………….
Orientation with Mentor?
DATE: ………………………
Signature: ………………………………..
………………………………………………………………………………………………………………………………………………………………….
Arrange a mid-rotation meeting with your Mentor after the first 2-3 weeks of the rotation. These
assessments should be completed and reviewed with your mentor.
2 Intraoperative skills assessments
Case logbook list
3 completed dictations (print out one each consult, discharge summary, and OR notes)
(These qualify as Field Notes for GS residents)
Review by Mentor:
DATE: ………………………
Signature: ………………………………..
Comments:
………………………………………………………………………………………………………………………………………………………………….
Arrange to meet with your Mentor to complete the Final In-Training Evaluation Report (ITER).
Bring these assessments to review with your Mentor at the End of rotation, WITH THIS FORM:
Keep the originals for your Educational Portfolio.
At least 4 intraoperative skills assessments.
Complete case logbook
Rounds presentation evaluation summary
TOPIC? …………………………………….
Evaluation by Nurse from the Ward or the Operating Room
Self-evaluation using the ITER form.
Final meeting with Mentor:
DATE: ………………………
Summary Comments: (to be added to ITER).
Signature: ………………………………..
FINAL ITER ENTERED INTO WEBEVAL: DATE: ……………………… Signature: ……………………………….
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` McMaster GENERAL SURGERY, PLASTIC SURGERY Residents
ON THEIR TWO-BLOCK PEDIATRIC SURGERY ROTATION:
Pediatric Surgery Rotation Specific Objectives for Surgical Residents
Medical Expert: Core knowledge
By the end of the rotation, the resident should have the necessary basic science and clinical knowledge to:
Examine, diagnose, recognize indications for surgery, and initially manage children with these emergency
surgical problems: ex. soft tissue infections, lymphadenitis, incarcerated hernia, ingested foreign body, acute
abdominal pain/appendicitis, acute scrotal pain, pyloric stenosis, intestinal obstruction (malrotation/volvulus,
intussusception), gastrointestinal bleeding, blunt abdominal trauma, and empyema. Recognize when
emergency cases may be safely managed by a general surgeon.
Evaluate and decide when it is appropriate for a general surgeon to operate on children with common benign
conditions: ex. hernia and hydrocele, lymphadenopathy, neck cysts and sinuses, ingrown toenails and when it is
more appropriate to refer electively to a pediatric surgeon: ex. undescended testis, gastroesophageal reflux,
chest wall deformities, and abdominal solid tumours.
Manage pre and postoperative care including: obtaining consent when appropriate, NPO orders,
fluids/electrolytes, intravenous nutrition, pain management, antibiotics, pediatric drug dosing, wound
assessment, tubes and drains, central venous lines.
Recognize the presenting symptoms and know the principles of resuscitation for newborns with congenital GI
abnormalities: ex. diaphragmatic hernia, esophageal atresia, abdominal wall defects, and bowel obstruction
(including Hirschsprung’s disease and imperforate anus).
Medical Expert: Psychomotor skills
During the surgical rotation, the surgical resident is expected to demonstrate aseptic technique, learn to
recognize surgical anatomy and pathology, and gain proficiency assisting and doing some pediatric surgery
procedures.
Expected operative competencies include performance of:
laparoscopic appendectomy
inguinal hernia and hydrocele repair
gastrostomy tube insertion
excision of minor skin lesions
central line insertion.
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` McMaster GENERAL SURGERY, PLASTIC SURGERY Residents
ON THEIR TWO-BLOCK PEDIATRIC SURGERY ROTATION:
Communicator: The surgical resident must be able to obtain a relevant history from children of all ages, involve
children in decision making as appropriate, share medical information with families, and recognize the ethical
implications of communicating with interpreters and substitute decision makers including social workers and
Children’s Aid.
The resident will convey pertinent clinical information succinctly to other physicians verbally, over the phone, in
written and dictated notes, and to the team during signover and the weekly case conference.
Collaborator: The resident will work closely in collaboration with other members of the surgical team including
medical, nursing, and paramedical health professionals.
Manager: The resident will assess patients efficiently, and manage the multiple clinical demands of the ward,
operating room, clinic and emergency department. The surgical resident will manage the ward patients
including supervising junior residents and students on the team, delegation and followup management tasks.
Health Advocate: The resident will identify public health aspects of surgical conditions that are amenable to
preventive efforts, and ways in which surgeons can have an impact on reducing surgical complications to
improve long-term outcomes.
Scholar: The resident will demonstrate a curiosity and initiative in identifying the best evidence-based
management of surgical conditions they see. During the rotation the resident will present a case-based topic at
Pediatric Surgery Rounds, and may have an opportunity to participate in a research project.
Professional: The resident will be punctual attending ward rounds, timely in completing dictated notes, and
considerate of other team members when leaving their duties. Requests for vacation and time-off will be
negotiated in a professional manner with the senior team members.
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