GENERAL SURGERY SELECTIVE
SUR 827
Course Title, Department, & Number: SUR 827
Course credit or length: 4 Weeks
Course director and contact information:
David Denning, MD
Course Coordinator and contact information:
Lisa Clagg-Blizzard, 304.691.1281; Clagg@marshall.edu
Course location: Cabell Huntington Hospital
Description and Goals of Course:
The surgical sub-internship (Sub-I) is a focused month designed to have students directly participate in the
care of surgical patients; that is, initial evaluation, formulation of differential diagnoses, establishment of
treatment plans and eventual daily care of the patient. It is important to emphasize that the student should
function at the PGY-1 level with close supervision from the resident and attending surgical team. Students will
actively participate on rounds, daily care tasks, procedures, and conferences.
The Sub-I is a chance for the soon-to-be resident to gain and/or polish the clinical skills critical for entering
residency. The student should actively participate in procedures, clinical decision-making, and patient
interaction. Call responsibility will be addressed by the attending surgeon and Chief Resident. This month is a
chance to establish a preliminary comfort level in taking care of patients and is designed to simulate what it
may be like as a PGY-1, with appropriate supervision. Although the patient population is primarily of a
surgical nature, students will obtain a broad clinical exposure which will provide a solid experience for
entrance into any type of residency program.
INSTITUTIONAL GOALS AND OBJECTIVES MET OR ADDRESSED
Patient Care:
During this rotation, students will:
1. Develop skills to complete an initial assessment of the patient and his/her problems (e.g., to distinguish
the patient who needs intervention now from the "sick" patient with less acute needs).
2. Manage the short-term needs of the acutely sick patient.
3. Formulate a diagnosis and a plan of treatment
4. Directly participate in the care of surgical patients; that is, initial evaluation, formulation of differential
diagnoses, the establishment of treatment plans and eventual daily care of the patient.
5. Demonstrate basic knowledge of and initial management of patients with clinical presentation of
surgical diseases of the GI tract, breast, abdominal wall, vascular system, endocrine systems,
trauma/critical care etc., their evaluation and management.
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Medical Knowledge:
The student will:
1. Understand the approach to the preoperative and postoperative management of the surgical patient.
2. Have an increased understanding of the pathophysiology of surgical disease.
3. Have an increased understanding of ambulatory surgical care.
4. Have a basic knowledge of various drug overdose syndromes and associated anecdotal treatments.
5. Have a basic knowledge of the pathophysiology, assessment and management of respiratory failure
(including interpretation of EKG’s and the use of mechanical ventilation).
6. Have a basic knowledge of the pathophysiology and management of shock and multiple organ failure
syndrome (including the use and interpretation of invasive hemodynamic monitoring).
7. Be familiar with the nutritional support.
8. Be familiar with the common general surgical procedures such as
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
Acute care of surgery
Appendectomy
Gall bladder
Hemorrhoidectomy
Hernia repair
Peptic ulcers
Skin liaisons
Soft tissue tumors
Small bowel resection
Trauma/Critical Care
Vascular surgery
9. Have a basic knowledge of how to order and interpret appropriate ancillary studies such as lab tests,
and how to apply the results of arterial blood gas analysis.
10. Be familiar with the management of end of live issues.
Practice Based Learning and Improvement:
The student will
1.
Complete assigned reading.
2.
Identify knowledge gaps and seek out methods to correct.
3.
Review medical literature specific to assigned patients.
4.
Utilize online resources for reading assignments.
5.
Identify indications for central venous access and invasive hemodynamic monitoring.
Interpersonal and Communication skills:
The student will be able to
1.
Demonstrate basic ability obtain patient history.
2.
3.
4.
5.
Discuss warning signs of complications.
Participate and learn effective communication with the family members.
Communicate patient information with other members of the health care team.
Develop interpersonal and communication skills.
Professionalism:
The student will demonstrate
1.
Ability to obtain informed consent.
2.
Ability to maintain patient confidentiality.
3.
Use professional judgment in caring for patients.
4.
Function as a member of a surgical care team.
5.
Be reliable and dependable for patient care.
6.
Dress appropriately
System Based Practice:
The student will demonstrate the ability to:
1. Work effectively in various health care delivery settings and systems relevant to their clinical specialty.
2. Coordinate patient care within the health care system relevant to their clinical specialty.
3. Incorporate considerations of cost awareness and risk-benefit analysis in patient and/or populationbased care as appropriate.
4. Advocate for quality patient care and optimal patient care systems.
5. Work in inter-professional teams to enhance patient safety and improve patient care quality.
6. Participate in the identification of system errors as part of performance improvement activities and
contribute to the development and implementation of potential systems solutions.
ASSESSMENT METHODS
Mid Point Evaluation
In accordance with LCME standard ED-30, the Course Director will evaluate student performance at mid-point
to review the student’s professional, clinical and academic performance up to that point. The formative
evaluation must be reviewed with the student and the student will have an opportunity to discuss with the
Course Director. The form must be signed by the student and returned to the Course Director. The Course
Director shall then forward a copy of the form to the Office of Academic Affairs. The form will NOT however
be included in the student’s official academic record.
Preceptor Evaluation- 75%
Grading
A= 90-100% B= 80-89%
C= 70-79%
F= below 70%
The preceptors’ evaluation will be based upon, but are not limited to, the following factors:

Attendance and participation in tutorials

Conference attendance
•
Maturity and Professionalism
•
Oral Case Presentation/Patient Workup
•
Participation in call
•
The demonstration of basic knowledge of critically ill patient care.

Successful completion of Institutional and Course Goals and Objectives
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On-Line Final Examination- 25%
A final on-line exam will be given at the end of the rotation. Study material and readings will be assigned at
the beginning of the rotation and students are encouraged to read the material early in the course. Students
must score at least 75% to pass the on-line exam. Passage of the examination is a requirement for passage of
the course – irrespective of the student’s performance on other components of this course. Students may
retest one (1) time only and must retake the examination within two weeks. A successful retake will result in
the student’s score being the average score of the two attempts. An unsuccessful second attempt will result
in failure of the course, irrespective of other academic or clinical performance.
Students who are unable to retest within the required two week period must submit a written request to the
Course Director to be granted permission to delay the retake. The Course Director will decide if the request is
acceptable and notify the student of whether the request is granted. The Course Director’s decision may be
appealed to the Department Chair whose decision is final.
Evaluation of Course and Faculty Requirement
Completion of evaluations of Course and Faculty members by students is a required component of this course.
Students will be issued an “Incomplete” until the course and faculty evaluations have been submitted.
DRESS CODE
1.
2.
Students must wear appropriate attire when caring for patients, attending lectures, exams,
conferences and case presentations.
Appropriate attire includes:
 Clean shirt with ties (for males)
 Clean, white laboratory or clinic coat
 Clean, pressed trousers or skirts
 Identification name badge
 Polished shoes
 Identification name badge
3.
The following items of dress are NOT ACCEPTABLE:
 Jeans
 Shorts or Capri’s
 Sandals, flip-flops, sneakers, tennis shoes, jogging shoes, Birkenstock, earth, open toe
 Low cut blouses or sweaters, midriff tops
 Skirts above the knee
4.
Scrubs suits belong in the OR. They are not to be worn on the wards, except when emergency
situations arise too quickly to permit changing clothes, or when returning to the OR immediately. On
such occasions a clean laboratory coat must be worn over the suit. Shoe covers, hats & mask are
NOT to be worn outside of the OR at any time.
Scrub suits or portion of scrub suits are NOT to be worn outside the hospital for any reason.
Hair is to be neatly cut & combed.
Beards and mustaches are to be neatly trimmed.
Students are to attend to their dress and personal hygiene at all times, including after a night on-call.
Smoking: Cabell Huntington, St. Mary’s and the HVAMC are smoke free facilities. Smoking is only
permitted in designated areas.
5.
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8.
9.
MUJCESOM Policies: All medical students taking this course will comply with School of Medicine policies given
at http://musom.marshall.edu/students/policies.
Individual policies can be found at the following websites:
Student Infectious Material Exposure:
http://musom.marshall.edu/ups/postexposure.asp
MS-IV Attendance:
https://musom.marshall.edu/students/documents/policies/Yr4attendence.pdf
Academic Dishonesty Policy:
https://musom.marshall.edu/students/documents/policies/Standards-of-Professionalism-and-Honor-Code.pdf
Academic Standards Policy:
https://musom.marshall.edu/students/documents/Policies/ASC-FINAL-POLICY.pdf
Policy for Students with Disabilities:
https://musom.marshall.edu/students/documents/Guidelines.pdf
University Computing Services’ Acceptable Use Policy:
http://www.marshall.edu/ucs/CS/accptuse.asp
Affirmative Action Policy:
pp. 16-17
http://www.marshall.edu/catalog/Graduate/S2008/gr_sp08.pdf
Inclement Weather Policy:
https://musom.marshall.edu/students/documents/policies/MUSOM-Inclement-Weather-Policy.pdf
Notification of delays and cancellations of classes are posted on the Medical Education Home Page when
Marshall University Main Campus is not in session
https://musom.marshall.edu/weather
Required Reading:
To be assigned by Course Director
Suggested Textbook: American Colleges of Surgeons ACS Surgical Text (Copy in SUR library)
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