St.

Joseph Mercy Oakland

Department of Surgery
Medical Student Curriculum

Welcome to the General Surgery rotation. The purpose of this rotation is to provide you
with a solid introduction into the diverse field of General Surgery. The service is
designed to steadily increase your exposure and level of responsibility as the rotation
progresses and you have demonstrated mastery of core level skills.
This document will provide you with a general orientation to the rotation. You will find
information on how you will be assigned and evaluated, academic programs you must
attend, learning objectives and service requirements. Become familiar with this
document; it tells you everything you need to know to get started and to finish
successfully.
The Department of Surgery sincerely hopes that your experiences will be positive. If at
anytime you feel that things are not going as expected, please contact Dr. Amy
Braddock, Associate Program Director, or Dr. Dorfman, Director of Medical Students.
They will address any concerns you have.

Goals Based on Core Competencies

1. Patient Care
Effectively performs history and physical
Provides care for patient in immediate post-operative period
Writes appropriate progress notes in chart
Recognizes common postoperative complications
Develops basic surgical technical skills (sterile technique, drains, suturing, I & D)
Management of pain can discuss options for
2. Medical Knowledge
Demonstrates an understanding of surgical problems - pathophysiology
Develops an appropriate differential diagnosis
Interprets basic diagnostic studies (EKG, labs, X-rays)
Demonstrates that he/she has done independent reading regarding current
patients
3. Professionalism
Adheres to institutional code of conduct at all times in terms of demeanor,
behavior, and attire
Demonstrates respect and discretion in patient care
Demonstrates a good work ethic
Develops an awareness of ones limitations
Shows self-directed learning skills
Demonstrates the basic principles of ethics
Manages time appropriately, including punctuality
4. Interpersonal and Communication Skills
Conveys information accurately
Listens attentively to patients and staff
Develops effective communication patterns
Demonstrates ability to handle criticism
Appreciates and is able to discuss sensitive issues (death, substance abuse)
Demonstrates sensitivity to emotional and social background of patients
5. Practiced-Based Learning and Improvement
Demonstrates ability to access, analyze, and use scientific literature
Describes principles of evidence-based practice
Uses electronic medical record
6. Systems-Based Practice
Uses medical record appropriately
Complies with JCAHO and HIPAA standards
Understands risk management
Shows collegiality with all associates
Applies information effectively to enhance care

Learning Objectives
A. For each condition or disease listed under B the student should know:
1. Anatomy
2. Pathophysiology
3. Presenting symptoms
4. Positive physical findings
5. Differential diagnosis
6. Treatments alternatives, indications, preoperative evaluation
7. Prognosis
8. Discharge when appropriate, follow-up care
B. Common Surgical Entities:
1. Acute abdomen
2. Biliary disease
3. Cancer breast, colon, lung
4. Thyroid and parathyroid disease
5. Diverticular disease
6. Fluids and electrolytes
7. Gastrointestinal bleed
8. Intestinal obstruction
9. Cirrhosis and portal hypertension
10. Obstructive jaundice
11. Pancreatitis
12. Neck mass
13. Appendicitis
14. Inflammatory bowel disease
15. Hernias
16. Shock
17. Trauma
18. Skin cancer
19. Vascular disease carotid, abdominal aortic aneurysm
20. Peptic ulcer disease
Be able to recognize and treat the following post-operative complications (under
supervision)
1. Fever
8. Pneumonia/atelectasis
2. Urinary retention
9. Hematoma/seroma
3. Ileus
10. Urinary tract infection
4. Constipation
5. Renal failure

Student Responsibilities and Expectations

Students are required to give one lecture during their rotation

-Topic will be assigned by the chief resident and given at afternoon conference
-Should be no more than 30 minutes
-Required to use PowerPoint
Students must attend staff clinic on Monday and Thursday afternoons
-Exceptions post-call or in an assigned surgical case
Students will be on overnight call when supervising resident is on call
-Responsibilities on call include:
-Assess patients
-Write H&Ps and consults
-Perform bedside procedures under supervision
-Scrub cases
-Leave when dismissed by supervising resident
Students are expected to round with assigned team daily unless in the OR
-Weekend and holiday schedules will be made by chief resident
-Cases are assigned by chief resident
Students are expected to wear appropriate professional attire while in hospital or clinic
including short white coat. Scrubs are not to be worn outside of the hospital
Students will attend all educational activities that the residents are expected to attend.
Lectures that are scheduled specifically for students are mandatory even
if it means leaving a case
Students are expected to read the assigned textbook, as stipulated by their school. If
one is not assigned, the Lawrence textbook is recommended. Surgical Recall is
also a good reference
Student evaluations will be completed by the chief residents and associate program
director. All students will take an oral exam at the end of the rotation with the
associate program director. The exam will focus on the work-up and treatment of
common surgical processes
If a student is unable to attend work, the chief resident must be notified
immediately.
Students will spend 2-4 weeks on each service which will include general surgery and
subspecialties such as vascular, cardiovascular, trauma and colorectal