Download student principles of surgery lecture schedule

PRINCIPLES OF SURGERY LECTURE SCHEDULE
(AY 2015-2016 Block 4)
Rotation October 26, 2015 to December 18, 2015
Monday, October 26, 2015
ROOM 6065
Surgery Orientation
Meade/Reed
Surgical Infections
Nichols
Break
Biliary Pathology
DuCoin
7:30-8:30 AM
Procedures Consult
Volo
Adrenal Incidentloma
Kandil
Lunch
8:30-9:15 AM
9:15-9:30 AM
9:30-10:30 AM
Wound Healing
Jansen
Hemorrhagic Shock/TEAM
8:00 -10:00 AM
Dr. Meade
CS COT’s version of ATLS for medical students, called
TEAM (Trauma Evaluation and Management), consist of
lecture and 3 rotation stations.
Break
10:00-10:15 AM
10:15-11:00 AM
11:00 -11:30 AM
OR Orientation
Morrill, RN
10:45 AM -11:30 AM
11:30 AM- 1:15 PM
Suturing/Knot Tying/Foley Cath
1:15-4:15 PM
NG Tube and IV/Lap Skills Endoscopy
SIM Center (Murphy Bldg)
DuCoin/Hamner/Ochoa/Honor Surgery Students
Tuesday, October 27, 2015
Room 6065
7:30 AM-8:00 AM
Lunch
Neonatal Physiology
Dr. Steiner
10:30 -10:45 AM
12:00-1:00 PM
Practical Information for
Medical Students
Pointer/Ochoa
1:00-1:30 PM
Nutrition
Cohen
Breast CA
Jones
Fluids and Electrolytes
Slakey
1:30-2:00 PM
2:00-2:30 PM
2:30-3:00 PM
11:30 AM – 12:00 Noon
OR Orientation: You are part of a surgical team whose main objective is to provide quality patient care in a safe
environment for staff and patients. Certain tasks seem mundane but each of us has a significant role and responsibility
to meet this purpose. Since OR’s vary, you are responsible for following policies/procedures of the hospital to which
you are assigned.
Your Responsibilities: Come prepared with the knowledge of surgical procedure, anatomy and patient
history. You will be asked to assist with positioning, prepping and possibly draping. If not, once gowned and
gloved, stand on the sterile field side of the room. Please wear clean Tulane green scrubs in the Operating
Suites at Tulane. Scrub User and Pin # can be found on the biographic data sheet in E*value (scroll down to
bottom of page) Also see page 41 for additional information. The Sim Center now has a YouTube Channel and all the
Surgery Clerkship videos are published there and accessible by anyone. http://www.youtube.com/user/TulaneSimCenter
Pre-surgery Lecture Test, Wednesday, October 28, 2015 from 7:00 – 8:00 AM in room 6065. Meet your
team following the test, but confirm logistics the day before.OLOL and Baton Rouge LEAD students will take
their test at those sites; therefore you will arrive at those sites on Wednesday, October 28, 2015.
1
LABS – Monday October 26, 2015 (SIM Center)
GROUP 2
GROUP 3
Bateman, Marjorie “Betsy”
Breskin, Lydia
Cicero, Kara
Edward, Justin
Dasgupta, Aditi
DeCesare, Laura (LEAD)
Feigenbaum, Sheri
Fleischer, Brian
Green, Erik
Hatfield, Sam
Haemer, Zoe
Jones, Steven
Kissee, Ryan
Mathai, Abraham (LEAD) Kobashigawa, Erin
Murphy, Caroline (LEAD) McLellan, David
Nelson, Whitney
O’Leary, Ryan
Patel, Neil
Rodebeck, Elsie
Spitzer, John
Summers, Whitney
Thomas, Alexander
Waterfield, Kristen
Wlodarczyk, Jordan
Yu, Brian
GROUP 1
Group 4
Cooney, Sean
Dortonne, Isabelle
Grunau, Zachary
Kavanaugh, Michael
Konfirst, Christopher (LEAD)
Newsome, David
Schindelar, Lili
Turnock, Adam
Stations:
ALL BELOW TRAINING WILL BE DONE ON THE 3RD FLOOR OF THE SIMULATION CENTER AT THE MURPHY BUILDING .
Suturing & Knot Tying w/Honor’s Surgery Students in the CLASSROOM.
You will be required to achieve the preset proficiency level for knot-tying and suturing by the end of your General
Surgery clerkship; this grade is worth 5% of your final grade. Beyond the orientation/training day, you may use the skills
lab to practice on your own time by making an appointment with the Sim Center staff ([email protected] or 988-
9150). You will also need to make an appointment to take the test once you feel you are ready. ALL
TESTING AND PRACTICE HOURS MUST BE COMPLETED BY 5PM ON THE LAST MONDAY
OF THE BLOCK (December 14, 2015). The time spent will be monitored as well as an attendance sheet
will be kept. If you have achieved proficiency, you will contact the Sim Center to arrange to be tested. If you
test as proficient, you will earn a 100%. (See Key Suturing and Knot tying elements in the handout portion of
the website). A passing grade for suturing is 16/20 or better, and a passing grade for knot tying is 7/10 or
better. If you failed either part, you need to practice as stated in the below chart, and then retest. This
is a pass/fail module so if you passed both portions you will receive 100%.








Surgery Clerkship Suture Testing
Initial practice 1-2 hours (optional, but highly recommended)
Test
If fail, must practice 2 hours
Test 2
If fail, must practice 3 hours
Test 3
If fail, must practice 4 hours
Test 4 – at this point you will have 10 hours for credit, even if you fail again
Foley cath, NG Tube and IV insertion w/Drs. Ducoin, Hamner and Ochoa in the PATIENT EXAM ROOM; Lap Skills
w/Cheri Touchard in the LAPAROSCOPIC LAB
Time
Suture/Knot Tying
Foley/ NG/ IV
Lap Skills
OR Orientation Video
1:15 -2:00
2:00 - 2:45
2:45 - 3:30
3:30 - 4:15
Group 1
Group 4
Group 3
Group 2
Group 2
Group 1
Group 4
Group 3
Group 3
Group 2
Group 1
Group 4
Group 4
Group 3
Group 2
Group 1
Lap Skills: You may be asked to observe or assist in laparoscopic cases during your clerkship. The skills you will practice
in the lab help you better understand the technology and techniques of laparoscopy.
Foley Cath, NG Tube and IV Insertion: While also a required procedure for students to perform, Foley catheters, NG tube
and IV insertion are regularly used in operating rooms and represent another way in which students can be involved in patient
care, as well as being very helpful to the residents and staff.
2
NAME
Bateman, Marjorie “Betsy”
Breskin, Lydia A.
Cicero, Kara I.
Cooney, Sean J.
Dasgupta, Aditi
Dortonne, Isabelle S.
Edward, Justin A.
Feigenbaum, Sheri B.
Fleischer, Brian P.
Green, Erik A.
Grunau, Zachary S.
Haemer, Zoe E.
Hatfield, Samuel A.
Jones, Steven D.
Kavanaugh, Michael C.
Kissee, Ryan S.
Kobashigawa, Erin A.
McLellan, David M.
Nelson, Whitney B.
Newsome, David B.
O'Leary, Ryan W.
Patel, Neil K.
Rodebeck, Elsie M.
Schindelar, Lili
Spitzer, John L.
Summers, Whitney M.
Thomas, Alexander S.
Turnock, Adam R.
Waterfield, Kristen
Wlodarczyk, Jordan R.
Yu, Brian P.
DeCesare, Laura
Konfirst, Christopher
Mathai, Abraham
Murphy, Caroline
October 28, 2015 to November 22, 2015
November 23, 2015 to December 16, 2015
Hepatobiliary (TMC)
GS/Trauma (UMCNO)
OLOL 2
General Surgery/Thibodaux
Breast/Peds Surgery (Lakeside)
Acute Care (TMC)
GS/Lakeview Regional (Covington)
OLOL 1
GS/Lakeview Regional (Covington)
CT/Vascular (TMC)
GS/Oncologic (West Jeff)
GS III/Thoracic (Ochsner)
Breast/Peds Surgery (Lakeside)
GS/Trauma (UMCNO)
Elective (TMC)
Peds/Transplant (Ochsner)
Elective (TMC)
Hepatobiliary (TMC)
GS/Oncologic (West Jeff)
General Surgery (VA)
Colorectal Surgery (East Jeff)
Hepatobiliary (TMC)
GS/Trauma (UMCNO)
Transplant/GS III (Ochsner)
Acute Care (TMC)
Thoracic/GS II (Ochsner)
Acute Care (TMC)
General Surgery/Thibodaux
Pediatric Surgery (Childrens)
Colorectal Surgery (East Jeff)
Pediatric Surgery (Childrens)
BR General
BR General
BR General
BR General
GS/Lakeview Regional (Covington)
Elective (TMC)
Hepatobiliary (TMC)
CT/Vascular (TMC)
Colorectal Surgery (East Jeff)
General Surgery/Thibodaux
GS/Trauma (UMCNO)
Acute Care (TMC)
General Surgery (VA)
GS/Oncologic (West Jeff)
GS II/Pediatric (Ochsner)
GS/Trauma (UMCNO)
Thoracic/GSII (Ochsner)
GS/Oncologic (West Jeff)
OLOL 1
Acute Care (TMC)
GS/Lakeview Regional (Covington)
GS III/Thoracic (Ochsner)
Breast/Peds Surgery (Lakeside)
OLOL 2
GS/Trauma (UMCNO)
Breast/Peds Surgery (Lakeside)
General Surgery/Thibodaux
Elective (TMC)
Transplant/GS III (Ochsner)
Hepatobiliary (TMC)
Pediatric Surgery (Childrens)
Colorectal Surgery (East Jeff)
Acute Care (TMC)
Elective (TMC)
Hepatobiliary (TMC)
BR General
BR General
BR General
BR General
3
HOSPITAL
October 28, 2015 to November
22, 2015
TMC/Acute Care
Dortonne, Isabelle
Spitzer, John
Thomas, Alexander
Breast/Peds Surgery (Lakeside)
Dasgupta, Aditi
Hatfield, Samuel
Colorectal Surgery
O'Leary, Ryan
(East Jefferson)
Wlodarczyk, Jordan
General Surgery/ Oncologic
Grunau, Zachary
(West Jefferson)
Nelson, Whitney
General Surgery
Cooney, Sean
(Thibodaux Regional Med Center) Turnock, Adam
TMC Hepatobiliary
Bateman, Betsy
Transplant
McLellan, David
Patel, Neil
Pediatric Surgery Children’s
Waterfield, Kristen
Yu, Brian
GS/Trauma /UMC
Breskin, Lydia
Jones, Steven
Rodebeck, Elsie
TMC/CT Vascular
Green, Erik
TMC/Elective
Kavanaugh, Michael
Kobashigawa, Erin
TMC/ General Surgery VA
Ochsner:
Transplant/GS III
Thoracic/GS II
GS III/Thoracic
Pediatric Surgery/Transplant
Newsome, David
Lakeview Regional Medical
Center (Covington)
Edward, Justin
Fleischer, Brian
Feigenbaum, Sheri
Cicero, Kara
DeCesare, Laura
Konfirst, Christopher
Mathai, Abraham
Murphy, Caroline
OLOL 1
OLOL 2
BR General (Lead)
BR General (Lead)
BR General (Lead)
BR General (Lead)
Schindelar, Lili
Summers, Whitney
Haemer, Zoe
Kissee, Ryan
November 23, 2015 to December 16, 2015
Feigenbaum, Sheri
Kissee, Ryan
Waterfield, Kristen
Nelson, Whitney
Patel, Neil
Dasgupta, Aditi
Turnock, Adam
Green, Erik
Jones, Steven
Dortonne, Isabelle
Rodebeck, Elsie
Cicero, Kara
Summers, Whitney
Yu, Brian
Thomas, Alexander
Edward, Justin
Haemer, Zoe
O'Leary, Ryan
Cooney, Sean
Breskin, Lydia
Schindelar, Lili
Wlodarczyk, Jordan
Fleischer, Brian
Ochsner:
Transplant/GS III
GS II/Pediatric
Thoracic/GS II
GS III/Thoracic
Spitzer, John
Grunau, Zachary
Hatfield, Samuel
McLellan, David
Bateman, Marjorie “Betsy”
Kobashigawa, Erin
Kavanaugh, Michael
Newsome, David
DeCesare, Laura
Konfirst, Christopher
Mathai, Abraham
Murphy, Caroline
Students will be expected to attend clinic 1 day a week with a faculty member of your team; the residents will make
those assignments!
4
CONTACT INFORMATION
CHIEF RESIDENTS:
ACUTE CARE/TMC (Brown/Meade/Schroll)
Name
Jennifer Turney, MD (Oct)
Matt Zelhart, MD (Nov-Dec)
Pager
504.268-1406
504.268-1408
BREAST SURGERY/LAKESIDE (Dr. Jones)
Melanie Jeansonne, Clinic RN
Amy Scheller, MD (Oct-Nov)
Morgan Martin, MD (Dec)
504.988-8169 Office
504.268-0109
504.268-3820
CT/Vascular (TMC) (Sam)
Monica Llado Farrulla, MD (Oct-Nov) 504.268-3811
Robert Reily, MD (Dec)
504.268-3818
COLORECTAL SURGERY (EJ)
Matt Zelhart, MD (Oct)
Kira Long, MD (Nov-Dec)
(Griffin/Normand)
504.268-1408
504.538-2635
Elective/TMC (DuCoin/Kandil/Korndorffer/Slakey) Samantha Zeringue, MD (Oct)
Jennifer Turney, MD (Nov-Dec)
504.213-0239
504.268-1406
GS Oncologic (West Jeff) (Minnard)
Peter Lundberg, MD
504.268-1405
General Surgery/Thibodaux Regional
Dr. Landry
HEPATOBILIARY (TMC)
Ashlie White, MD
504.268-3109
CHILDREN’S PEDIATRIC SURGERY (Yu)
Jiselle Heaney, MD
504.268-3104
TRAUMA/UNIVERSITY (Meade/Moore/Scholl)
Adam Hauch, MD
504.268-1404
General Surgery (VA) (Korndorffer/Griffin)
Kira Long, MD (Oct)
Samantha Zeringue, MD (Nov-Dec)
504.538-2635
504.213-0239
Office:
985.446-1763
Ochsner Department of Surgery
Reporting Information: Upon arrival, ALL surgery students
must first report to Melissa Johnson, at 8:30 AM located at Ochsner Academic Center, UGME receptionist, 1514
Jefferson Highway. Please bring $10.00 CASH, as a refundable deposit for your temporary Ochsner ID badges. After
your rotation, you need to bring back your ID badge. Please print pages 4 and 5 of the Scrub Class Documents and
bring with you to your scrub class. You must have these documents in order to attend scrub class (An email from
Stacey Porter will be sent prior to start of your rotation).
GS II
Drs. Bolton and Conway
Transplant
Drs. Richardson and
Wooldridge
Drs. Ahmed, Bohorquez,
Bruce, Carmody, Cohen,
Reichman, and Seals
Thoracic
Pediatric
Surgery
Dr. Pettiford
Drs. Adolph, Roybal and
Steiner
GS III
Upper GI/Oncologic/General Surgery
Laparoscopic and Bariatric Surgery
Transplant Surgery
Thoracic Surgery/Esophageal and Lung
Pediatric Surgery
The first two week surgeons will do the two week mid-block evaluation and the 2nd two week surgeons will do the final evaluation on
each student. Ochsner Office Contact: Melissa Johnson, Clerkship Program Coordinator, 1514 Jefferson Highway, New
Orleans, LA 70121 Office: 504.842-0558; Fax: 504.842-4805 [email protected]
5
OLOL 1/Baton Rouge Clinic Dr. Glen Schwartzberg
[email protected]
OLOL 2 /The Surgeons Group of Baton Rouge Dr. Kenny Kleinpeter Cell: (225)6156198; (225) 413-7048. [email protected]
Baton Rouge Campus
Clerkship Director: Dr. David Depp [email protected]
Roberta Cartaginese. LEAD Senior Program Coordinator
Tulane University School of Medicine – Baton Rouge Campus
3600 Florida Blvd., Baton Rouge, LA 70806 225-387-7732 office; 225-252-4186 cell
Baton Rouge Campus Community Preceptors:
Dr. Dhaval Adhvaryu
Dr. Everett Bonner
Dr. Peter Bostick
Dr. Stephen Gordon
Dr. Alec Hirsch
Dr. Michael Puyau
Dr. Jon Schellack
Thibodaux Regional Medical Center, Thibodaux Surgical Specialists
604 North Acadia Road, Suite 207
Thibodaux, LA 70301
Office: 985.446-1763, Nadine Hebert, Office Manager
William B. Bisland, Jr., M.D. (General/Laparoscopic/Bariatric Surgery)
Mark F. Hebert, M.D. (General Surgery) [email protected] Cell: 985.859-0190
Barry G. Landry, M.D. (General Surgery) [email protected] Cell: 985.209.3652
Brian J. Marino, M.D. (General Surgery)
Lakeview Regional Medical Center
Lakeview Regional Medical Group
Stephen O. Harkness, MD, FACS
101 Judge Tanner Blvd., Suite 402
Covington, LA 70433
985-789-0468 Office; 985-892-8975 Fax [email protected] Cell:
985-789-0468
6
SURGERY CLERKSHIP
COURSE DIRECTOR:
PROGRAM COORDINATOR:
Peter C. Meade, M.D. (988-2305 Room 8524)
[email protected]
Stephanie Reed (988-3909 Room 8549)
Fax 988-1882 [email protected]
Thanksgiving holiday info: students work Nov 23-25 (clinic responsibilities end at 5:00
PM on Wednesday, November 25) and have off Nov 26-29. There will be NO approved
CHIT for the Wednesday November 25th or Monday, November 30, 2015 - no excuses!
REQUIRED READING:
SUGGESTED READING MATERIAL:
Essentials of General Surgery (Fifth Edition) by Peter F. Lawrence
Sabiston Textbook of Surgery, 19th edition, (ed.) (Basic Science)
Current Surgical Therapy 8th ed (Cameron, ed-in chief) Chapters on
Pneumothorax, hemothorax, carotid enderectomy, and section on Preoperative and Post-operative care.
Surgery: A compentency-Based Companion by Barry D. Mann
(available in the bookstore.)
Cope’s Early Diagnosis of the Acute Abdomen, Twenty Second
Edition, William Silen
NOTE: It is not expected for you to read the entire book for any of the suggested reading. It takes the residents about
one year to finish one book. You should read the sections in the books that are pertinent to the patients you are seeing
and the operations which you are attending. When you have time, if you have not covered hernia, gallbladder, bowel
obstruction, acute abdomen, colon and breast cancer, (and any other topics you all can think of), read those chapters as
well.
“The Virtual Patient” Self-directed Study Guide in Surgery (2007) Copyright from the University of Texas Southwestern
Medical Center at Dallas can be used as a study guide. Link: http://tmedweb.tulane.edu/portal/studentguide/item/surgery
Some links that you may find helpful are listed below:
Students with disabilities: http://erc.tulane.edu/disability/
Academic dishonesty link: http://www.som.tulane.edu/student/honorcode/new.htm
SOM Phase I & II Objectives:
http://tulane.edu/som/ome/upload/Tulane_SOM_Learning_Objectives_Phase_1_-_21.pdf
RESOURCES:
Several new learning resources have been added to the educational armamentarium of the
clerkship. They include:
1. Procedures Consult – The web based learning process provides considerable information, editorial, videos of
specific operational procedures. Weekly assignments are made and students are expected to complete them and
take the brief examination. Completion of the assignments will be monitored. (Instructions for login attached at
end of document; use your Tulane email address and the password is hello1. Please login in prior to the start of
rotation and notify Stephanie Reed if unable to login in order to address issues of problems before the
assignments are due.
Assignments
Assigned Date
Due by/on
T3s#29-1
10/28/15
11/04/15
T3s#29-2
10/28/15
11/11/15
T3s#29-3
10/28/15
11/18/15
T3s#29-4
10/28/15
11/25/15
T3s#29-5
10/28/15
12/02/15
T3s#29-6
10/28/15
12/09/15
T3s#29-7
10/28/15
12/16/15
7
In addition to the assignments, students are encouraged to review the material in Procedures Consult which is
relevant to their patients.
2. Resident Lectures – On each service, the residents have been assigned lectures to present to the students on their
service. The same topics will be presented each week on all services. The lectures and topics are all among the
27 topics listed below. The following topics are to be covered:
Week 1 (11/02/15)
Femoral Artery Occlusions
Week 2 (11/09/15)
Hemorrhoids Fistula-in-Ano
Week 3 (11/16/15)
Inguinal Hernia
Week 4 (11/23/15)
Obstructive Jaundice
Week 5 (11/30/15)
Appendicitis
Week 6 (12/07/15)
Melanoma
Week 7 (12/14/15)
Carotid Disease
Grand Rounds – Grand Round lectures will be recorded using Mediasite. The recording is available on the Surgery minisection on TMedWeb, link http://tmedweb.tulane.edu/portal/t3t4 - At TMedWeb website: choose a Clerkship Article
to View; Select the Surgery tab; Click Grand Rounds Recording.
OBJECTIVES OF THE ROTATION: Surgery is a discipline that provides care to patients in the outpatient areas,
hospital ward, and operating room. The clerkship is designed to teach students the role of surgical care in the overall
management of patients. Specifically, the students are expected to learn the work-up and evaluation of surgical patients.
The indications and contraindications for expected results, risks and complications of specific operations. While the
operating room is one site of leaning, it is NOT the only site. Students are expected to be able to scrub on a number of
operations, but involvement in a large number of operations is NOT the goal of the rotation. Ideally, students will be
able to follow patients from presentation, work-up, treatment including operations and post-treatment/postoperative care.
It is this continuum that is the major goal of the clerkship.
Twenty-seven diseases have been selected as targets for your education. They are listed below:
ACUTE
Surgical Infections
Acute Pancreatitis
Hemorrhagic Shock
Cholecystitis
Nutrition
Abdominal Trauma
Appendicitis
Diverticulitis
Thoracic Trauma
GENERAL
Peripheral Vascular Disease
Peptic Ulcer Disease
Inguinal Hernia
Carotid Disease
Upper Gastrointestinal Bleeding
Postoperative Complications
Reflux Esophagitis
Fistula-in-Ano
Portal Hypertension
ONCOLOGY
Breast Cancer
Adrenal Mass
Thyroid Nodule
Obstructive Jaundice
Colon Cancer
Splenectomy for Disease
Intestinal Obstruction
Lung Cancer
Melanoma
The Department of Surgery expects you to study these diseases on the rounds, in the operating room if possible, in the
classroom, and at home using textbooks. The oral examination will focus on these 27 topics.
DESCRIPTION:
All students are to assemble for the Principles of Surgery portion of the clerkship. This series of
lectures is designed to provide you with:
1. A surgical perspective relative to fundamental topics in Medicine
2. Basic technical skills in knot-tying & suturing
A written examination (consisting solely of questions taken from the lecture material and lab day) will be administered
upon completion of this lecture series (Wednesday, October 28, 2015 from 7:00-8:00 AM in room 6065). An oral
examination will be administered to each student shortly before the NBME examination. Upon completion of General
Surgery Services, a National Board of Clinical Sciences Examination will be administered. Your clinical duties will
end at 7:00 p.m. on the Wednesday, December 16, 2015 immediately prior to Friday’s final examination, Friday,
December 18, 2015, Room 7062 (1430 Tulane Avenue); report at7:30 AM, testing begins promptly at 8:00 AM.
No additional time will be granted from clinical duties for study preparation.
8
Grading for the Surgical Clerkship
The overall grade for the clerkship is based on the following formula:
1st 4 weeks General Surgery Student Evaluations
2nd 4 weeks General Surgery Student Evaluations
25%*
25%*
National Board Medical Examination (NBME)
25%*
Oral Examination (General Surgery)
Knot Tying & Suturing
Principles of Surgery Lecture Examination
Case Summaries (6)
TOTAL
10%
5%
5%
5%
100%
You are eligible for Honors in Surgery if you achieve an overall average of at least 92 and shelf score (NBME) of at
least 75th percentile.
You are eligible for a High Pass in Surgery if you achieve an overall average of at least 89 and shelf score (NBME) of a
least 50th percentile.
You are eligible for a Pass in Surgery if you achieve at least an overall average of 80% and a shelf score (NBME) of at
least 5th percentile.
You are eligible for a C/F in Surgery if you achieve an overall average of at least 80% and a shelf score (NBME) of less
than 5th percentile. This is corrected to a C/P once you successfully pass the NBME surgery retest examination.
You are eligible for a Fail in Surgery if you do not achieve an overall average of 80% or you fail either the oral
examination or the shelf examination twice or if there is evidence of non-professional behavior or you miss any days
without an Approved CHIT.
You are eligible for an Incomplete in Surgery if you miss four or more days from the clerkship for any reason. You can
only receive a passing grade in Surgery (based on the criteria above) once you have made up the missed time or
responsibility.
A student who receives a failing grade on any of the faculty evaluation forms will be notified immediately, and the
General Surgery Medical Student Curriculum Committee will review their clerkship performance. Unless evidence is
presented to the contrary, the student will receive a grade of “F”, and be asked to repeat, and pass elements of the entire
General Surgery clerkship within 6 months, but not later than January of the graduating year. You will have a mid block
evaluation 2 weeks into your General Surgery clerkship by your resident and faculty. If you do not receive this mid
block evaluation, please discuss this with your resident.
Honors – 92 -100; High Pass – 89-91; Pass 80-88; Condition 65-79; Fail <65
Absences on Friday Educational day will require a 3 page written paper on the topic covered for that day that was
missed.
In the student letter to the Dean’s Office, the course director will at minimum, summarize the written comments received
by the student on the rotation assessment forms. A statement as to the students’ performance on the National Board
Clinical Sciences Examination may be included in each letter.
STUDENT ASSESSMENT:
Evaluation Forms:
Each faculty and highest level resident will receive an evaluation form, designed to assess your
progress in mastering the fundamentals in surgery, and will contain their consensus of your progress.
9
Oral Examination:
You will be assigned a faculty member in the Department of Surgery who is responsible for
administering your oral examination (see table for your assignment on page 10-11) (page 37-38). Oral exams are to be
scheduled beginning on Monday, December 7, 2015 (DO NOT WAIT UNTILTHE 7th TO SCHEDULE) and must be
completed by Wednesday, December 16, 2015 (with the exception of the OLOL on the rotation for the period of
November 23, 2015 to December 16, 2015 must be completed after the shelf exam on Friday, December 18, 2015).
It is your responsibility to contact the office of the assigned staff member to mutually set aside ½ hour, during the final
week of the rotation, for this examination. The date and time of the exam are the choice of the examiner.
Any student who fails the oral examination will be asked to retake the test until a minimally acceptable
performance is achieved (<70) and the grades will be averaged for a final grade.
Student
Faculty
Contact
Bateman, “Betsy”
12/11/15 1:30 PM
Dr. Bernard Jaffe
[email protected]
Dr. Cliff McGinnis
Lauren Dickerson 988-2307
[email protected]
Nakisha Farria 988-5111 [email protected]
Maria Reynaud 988-7867 [email protected]
Maria Reynaud 988-7867 [email protected]
[email protected]
Breskin, Lydia A.
Cicero, Kara I.
Cooney, Sean J.
Dasgupta, Aditi
Dortonne, Isabelle S.
12/11/15 2:00 PM
Edward, Justin A.
Feigenbaum, Sheri B.
Fleischer, Brian P.
Green, Erik A.
Trauma Faculty
Transplant Faculty
Transplant Faculty
Dr. Bernard Jaffe
Transplant Faculty
Dr. Korndorffer
Plastic Faculty
Dr. Douglas Slakey
Dr. James Brown
Grunau, Zachary S.
Dr. Emad Kandil
Haemer, Zoe E.
Hatfield, Samuel A.
Jones, Steven D.
Kavanaugh, Michael C.
12/18/15 1:00 PM
Transplant Faculty
Dr. Chris DuCoin
Dr. Bernard Jaffe
Dr. Steven Jones
Kissee, Ryan S.
Kobashigawa, Erin A.
12/11/15 1:00 PM
McLellan, David M.
Nelson, Whitney B.
Newsome, David B.
12/18/15 1:30 PM
Maria Reynaud 988-7867 [email protected]
Mel’isa Morel 988-2306 [email protected]
Debra Felix Office 504.988-5500
[email protected]
Joynetta Bell 988-2317 [email protected]
[email protected] or Lauren Dickerson 9882307 [email protected]
Lauren Dickerson 988-2307
[email protected]
Maria Reynaud 988-7867 [email protected]
Joynetta Bell 988-2317 [email protected]
[email protected]
Dr. Bernard Jaffe
Melanie Jeansonne, Clinic RN
504.988-8169 or 504.988-8100
[email protected] or
[email protected]; or Lauren Dickerson
988-2307 [email protected]
[email protected]
Trauma Faculty
Dr. Ducoin
Dr. Bernard Jaffe
Nakisha Farria 988-5111 [email protected]
Joynetta Bell 988-2317 [email protected]
[email protected]
10
Dr. James Brown
O'Leary, Ryan W.
Dr. Emad Kandil
Patel, Neil K.
Rodebeck, Elsie M.
12/11/15 2:30 PM
Dr. Bernard Jaffe
Dr. James Brown
Schindelar, Lili
Spitzer, John L.
Summers, Whitney M.
Thomas, Alexander S.
Transplant Faculty
Trauma Faculty
Dr. Korndorffer
Dr. Steven Jones
Turnock, Adam R.
Plastic Faculty
Waterfield, Kristen
Dr. Cliff McGinnis
Wlodarczyk, Jordan R.
Yu, Brian P.
Trauma Faculty
11
[email protected] or Lauren Dickerson 9882307 [email protected]
Lauren Dickerson 988-2307
[email protected]
[email protected]
[email protected] or Lauren Dickerson 9882307 [email protected]
Maria Reynaud 988-7867 [email protected]
Nakisha Farria 988-5111 [email protected]
Mel’isa Morel 988-2306 [email protected]
Melanie Jeansonne, Clinic RN
504.988-8169 or 504.988-8100
[email protected] or
[email protected]; or Lauren Dickerson
988-2307 [email protected]
Debra Felix Office 504.988-5500
[email protected]
Lauren Dickerson 988-2307
[email protected]
Nakisha Farria 988-5111 [email protected]
FRIDAY EDUCATION CONFERENCES:
Entire Rotation: DRESS APPROPRIATELY for conferences, SCRUBS ARE NOT APPROPRIATE! IF YOU
QUESTION WHAT IS APPROPRIATE, ASK YOUR RESIDENT.
1. M & M: 7:00 AM-8:00 AM in room 6065. This conference will be attended by surgical faculty, residents and
medical students. This educational conference is designed to teach the pathophysiology and decisionmaking process regarding complex and interesting surgical cases and surgical cases that result in a
complication.
2. Department of Surgery Grand Rounds: 8:00 AM-9:00 AM in room 6065 Presentations at this conference will be by
department faculty, invited lecturers and surgical residents as assigned by the chairman. These presentations
should last 30-40 minutes, with a period of questions and answers if one lecture is to be given. On certain
dates, two case presentations may be given, each lasting approximately 20 minutes. This format will be used
primarily for resident presentations. You will receive by e-mail prior to the Grand Rounds to inform you of
the topic.
3. Bullpen (See page 13-14): 8:00 AM/9:00 AM-10:30 AM (time changes as noted) in Room 6001
4. Case Summary & Subspecialty Lectures (see pages 15-22): 9:30/10:30 AM to 12:30 PM (time changes as noted) in
Room 6001
12
Date
M&M
7 AM
Room
6065
Grand
Rounds
8 AM
Room 6065
Bullpen
Students Presenting
Room 6001
8:30 AM w/Jaffe
Dasgupta, Aditi
Kavanaugh, Michael
McLellan, David
10/30/15
(surgery
resident
interview)
11/06/15
11/13/15
(surgery
resident
interview)
No grand
rounds
11/20/15
None
None
Wednesday
11/25/15
9:00 AM w/Jaffe
Dortonne, Isabelle
Kobashigawa, Erin
Newsome, David
Thomas, Alexander
10:00AM w/Slakey
Bateman, “Betsy”
Breskin, Lydia
Hatfield, Samuel
Jones, Steven
Rodebeck, Elsie
10:00 AM w/Meade
Green, Erik
Patel, Neil
Spitzer, John
Yu, Brian
8:30 AM w/Jaffe
Fleischer, Brian
Haemer, Zoe
Kissee, Ryan
Summers, Whitney
Waterfield, Kristen
10:00 AM w/Slakey
Cicero, Kara
Conney, Sean
Nelson, Whitney
O’Leary, Ryan
Wlodarczyk, Jordan
Case Summary and SubSpecialty
lectures/conferences
Room 6001
Faculty
9:45 AM Lecture:
Acute Abdomen
10:30 AM Case Summary:
“Colon CA”
11:30 AM Lecture:
“Neurosurgery
10:30 AM Case Summary
“Intestinal
Obstruction”
Dr. Jaffe
9:00 AM Lecture:
“ Neonatal Obstruction”
11:30 AM Case Summary:
“ Lung CA”
Dr. Heaney
9:00 AM Case Summary:
“Thyroid”
11:30 AM Lecture:
“Otolaryngology”
Dr. Kandil
10:30 AM Case Summary:
“Pancreatitis”
11:30 AM Lecture:
“Urology”
9:00 AM Case Summary:
Reflux Esophagitis”
11:30 AM-12:30 PM
“Shelf Prep
Lecture:
OB/GYN
Dr. Jaffe
Dr. Frank Berry
Dr. Brown
Dr. Weaver
ENT Chief Resident
Dr. Jaffe
Dr. Thomas
Dr. Korndorffer
Honors Surgery
Dr. Shamsnia
12/04/15
09:00 AM w/Paramesh 10:30 AM: Shelf Prep
Honors Surgery
Edward, Justin
Feigenbaum, Sheri
11:30 AM Lecture:
Dr. O’Brien
Grunau, Zachary
“Orthopaedic Surgery”
Schindelar, Lili
(stretcher to be provided)
Turnock, Adam
Case Summary Conference: All students are invited to discuss their case scenarios.
(surgery
resident
interview)
12/11/15
13
SURGICAL BULLPEN
Background: The Surgery Bullpen is an exercise for students to hone their case presentation skills
as well as learn pathophysiology and management of surgical diseases. The contemporary Bullpen
is based upon a tradition begun by Dr. Alton Ochsner nearly seventy years ago. Senior Tulane
students were assigned an unknown patient and were expected to determine the diagnosis and
differential, treatment plan and the pathophysiology following a brief history and physical
examination without the patient chart or other information. The exercise was modified and extended
to the third year clerkship in a way similar to the present Bullpen. The Tulane Surgical Bullpen
gained national notoriety and was described in an article in Time Magazine nearly fifty years ago.
The Rules: Four to Five students are assigned to present at Surgical Bullpen each Friday at 9:00
am in Room 6001. Each presentation is approximately fifteen minutes. Students are assigned
patients by Dr. Jaffe and the student coordinator, Ms. Stephanie Reed, on the preceding Monday
afternoon, and she will contact you with the name and bed of the patient. The patients will be from
Tulane University Hospital and University. You should review the patient’s chart, do a history and
physical examination where appropriate and review pertinent laboratory and radiographic studies.
Sometimes the patients are too ill or incapacitated to give a history or to even be examined. Use
your own judgment, but remain sensitive to the patient’s situation, comfort and dignity. Frequently,
all of your information must come directly from the chart and not from the patient. If so, simply make
that clear in your presentation.
Presentations should be made just as if you were in the hospital. Decorum requires you to wear
your white coat and for men to either wear ties or scrub suits and women accordingly. Make your
presentations concise and precise. If possible bring radiographs, arteriograms or other imaging
studies which add value to the presentation. University no longer permits the students to check out
films. You receive the film on a CD rom. If it is of value to present the film, a lap top will be
made available in Room 6001 for your presentation. Do not prepare Power Point, overheads,
hand outs, or movies, but you are free to use your notes and to draw anatomy, procedures and other
diagrams on the black board when indicated. You may prepare by textbook reading and review of
articles. Since patients are currently discharged very soon after uncomplicated operations,
occasions do arise when the patient has been discharged prior to your visit to them. If that occurs,
you will simply present from the chart but indicate this during your presentation.
Please do not use this conference for your lunch time. No food or drinks are allowed while this
Bullpen is taking place. Thank you.
14
CASE SUMMARY GRADE FORM

Organization
25%
Grade

Content
50%
Grade

Clarity, grammar & style
15%
Grade

References
10%
Grade

“Bonus Points”
Total Grade
15
JUNIOR SURGERY STUDENT CASE SUMMARY CONFERENCE
PURPOSE:
The purpose of the case summary conference is to provide an opportunity to improve clinical problem
solving, library research, oral presentation, and writing skills. This exercise will be done in the small group seminar
format. A series of case studies have been prepared. There will be a faculty facilitator at each conference. One or more
students will be chosen at each conference to present and defend the case summary each has prepared for the conference.
All case summaries must be given to clerkship coordinator/student worker (room 8549, email [email protected] , or
faxed to 988-1882) before the conference begins. Case summaries submitted after the start of the conference will not be
accepted for a grade.
BASIC INSTRUCTIONS:
1. During the course orientation, each student will receive the case histories on which each conference will be based.
2. You should review the case histories and prepare a one page written summary of your analysis of the problem posed
by the case, your understanding of the pathophysiology, and your plan for management of the case. Neatness counts.
Typewritten reports are preferred. If we can’t read it - we can’t grade it properly. (e.g. font of typewritten reports is
too small or penmanship is poor) Please make sure you limit your summary to one page, including references.
Failure to do so will result in deducted points.
3. You are expected to read, utilize, and accurately cite at least three references from the literature (not the
internet or a textbook) dealing with 3 different aspects of the topic, at least one and preferably two, from
surgical journals. You should know how to look up journal articles and how to document their citations
accurately, something you will have to do as part of your education, residency and career. Do not quote
statements from the articles in the text of your paper. That process dilutes your learning how to utilize
information and write it for others to read. In addition, avoid initials or other language shortcuts to learn to
make the document readable.
4. Grades for each summary will be based on the following:
 Organization
25%
 Content
50%
 Clarity, Grammar & Style
15%
 References
10%
5. There will be an emphasis on complete and compassionate care plans which focus on the best interest of the patient.
Cost effective case will also be stressed.
6. Dr. Jaffe expects you, the student, to read, utilize, and accurately cite at least three references from the
literature (not the internet or a textbook) dealing with 3 different aspects of the topic, at least one and
preferably two, from surgical journals. He wants you to know how to look up journal articles and how to
document their citations accurately, something you will have to do as part of your education, residency and
career. In addition, Dr. Jaffe does not want you to quote statements from the articles in the text of your
paper. That process dilutes your learning how to utilize information and write it for others to read. In
addition, he requests that you avoid initials or other language shortcuts to learn to make the document
readable.
A. Medscape and textbooks are not articles and are inappropriate as references
B. Please deal with this specific patient, now the world of patients in general. 26 year olds don’t realistically get
bleeding diverticulosis, for example and there are lots of others
C. Please be more specific about details. Saying you would work-up a patient or remove the mass is not
relevant. This is your chance to learn the hard facts and specifics
D. Doi is not appropriate. All we care is that you read the article, the whole articles, not the abstract
16
GRADE:
Your grade will be derived from all six case summaries. The composite grade will count as 5% of your
clerkship grade.
17
Dr. Bernard Jaffe
PANCREATITIS
A 45 year old obese female with a history of multiple episodes of identical right upper quadrant pain is admitted with
epigastric pain and tenderness. Her lipase is 750 and her amylase is 3,200.
a.)
What is the likely diagnosis?
b.)
What are some other possible causes of her disease?
c.)
How should you determine if she has a common duct stone? Does it change the treatment if there is one?
d.)
What are Ranson’s criteria at 48 hours for severe disease?
e.)
What are the common complications of this disease and what should you do to try to prevent them?
f.)
What are the indications (if any) for antibiotics?
g.)
What are the indications for cholecystectomy, and when should it be performed?
h.)
If she develops a pseudocyst, what options are there for drainage? Which would you choose and why? When
should it be performed?
18
Dr. Bernard Jaffe
Colon CA
A 26-year old woman twice notices bright red blood on her stool. She goes to her doctor’s office and is totally
asymptomatic and comfortable.
1. What is the differential diagnosis in descending order of frequency?
2. How should she be worked-up?
3. If a flexible sigmoidoscopy reveals a 4cm irregular sessile mass 11cm from the anal verge, how should the
patient be evaluated?
4. What are the expected routes of local spread and of metastasis and how can these routes best be assessed
preoperatively?
5. What specific operation should be performed and what are the goals of the procedure?
6. At operation, invasion of the vagina and trigone of the bladder are noted. How should these areas be dealt
with?
7. If her CEA level rises from 2.0 immediately postoperatively to 87 three years later, what should be done?
19
Dr. James Korndorffer
Reflux Esophagitis
1. What are the typical symptoms of GERD? Atypical Symptoms?
2. What workup is needed to evaluate for GERD?
3. Assuming the diagnosis is uncomplicated GERD, what are the appropriate management options? What would you tell
your patient about those options?
4. What operative interventions are performed for GERD? Why is one selected over the other?
5. What are the success rates for operative intervention?
7. If Barrett's esophagitis is documented on workup, how does it alter your management?
20
Dr. James Brown
INTESTINAL OBSTRUCTION
SMALL BOWEL OBSTRUCTION (SBO)
A 53 y/o female presents to the ER with the acute onset of abdominal pain, nausea, vomiting, and moderate
abdominal distention for the last 18 hours. The ER doctor has ordered some studies, suspects a SBO and
consults you for further diagnosis and therapy.
1. List 5 other diagnoses (pertinent and common) you would consider besides the SBO.
2. List three of the most important questions you would ask about the present illness and why.
3. IF patient has SBO (complete-simple), list three most common physical findings that would be
compatible with your diagnosis.
4. Why are the CBC and BMP important in this patient?
5. Name the three most common causes of SBO.
6. List the only two radiographic studies you need and why----in their order of complexity and expense.
7. Assuming adhesions are the etiology, outline a plan of treatment for:
A. Partial SBO
B. Complete simple SBO
C. Complete gangrenous SBO
SUGGESTIONS FOR CASE SUMMARY ON INTESTINAL OBSTRUCTION
1. Always precede your answers with the question typed appropriately.
2. Clarity, grammar and style do make a difference in the grade. Avoid errors due to carelessness.
3. Please read the questions carefully. (Hint: Know the difference between a physical finding and a
symptom.)
21
Dr. Emad Kandil
Thyroid Mass
A 32-year-old man is seen with a 1.5-cm firm nodule in the left lobe of the thyroid gland. The remaining gland is normal
to examination. His only relevant past history is that he received radiation therapy for Hodgkin’s disease involving the
mediastinum.
1. What is the differential diagnosis?
2. How can you reach a definitive diagnosis in an efficient and cost-effective manner?
3. Which thyroid function studies would be useful?
4. Which radiologic studies would be needed prior to planning therapy?
5. If the diagnosis was follicular carcinoma, what are the options for operative therapy, and what would you do?
6. What postoperative complications are specific to this procedure?
7. What specialized follow up would be in order?
22
Dr. Michael Weaver
Lung Cancer
72 y/o Caucasian female complained of recent onset of shortness of breath. Chest X-ray revealed right lower lobe
pneumonia. Her work-up included bronchoscopy which revealed an endobronchial lesion in the middle lobe bronchus.
Biopsy was taken.
1)
What is the differential diagnosis? What is most likely?
2)
What other historical information would be pertinent?
3)
What physical findings would support the diagnosis?
4)
What further work-up is needed?
5)
What surgical intervention is needed?
6)
What would preclude surgical intervention? Surgical resection?
7)
What would be the expected outcome?
8)
What complications might occur if surgery is performed?
23
GENERAL SURGERY
DESCRIPTION:
The General Surgery rotation is primarily an inpatient-based experience designed to familiarize
the student with acute and elective surgical decision making processes (see Goals & Objectives) However, to the extent
that much of the preoperative and postoperative management is now carried out in the outpatient setting, students will as
well be expected to participate in this phase of care.
A team of surgery house officers and at least one attending surgeon-preceptor will staff each General Surgery service, on
which medical students will rotate. These personnel will provide ample opportunities for “on the job” experience
relative to the discipline of Medicine in general and surgery in particular.
You will have a mandatory presentation weekly. This presentation will be a 15 minute oral presentation, backed-up by a
1 page paper, given to the faculty or resident of your service while you are on your general surgery month. Your chief
resident will discuss what, where and when in regards to this weekly presentation. If your resident does not, please let
me know. Again this should be weekly while you are on your general month.
Surgery is a 7-day/week rotation and the responsibility includes being present on both Saturdays and Sundays.
Students are entitled to one free weekend/month, which means you are expected to be present on both days of all other
weekends. Please divide up the free weekends among your colleagues, so there are no weekends with none of the
students on the service. You are not permitted to work more than 80 hours/week, and we expect the hours will be much
shorter than that.
For the Breast Surgery Service at Lakeside, if there are no inpatients and no attending rounds on the weekend, students
should report to the Acute Care Surgery Service at Tulane University Hospital for the weekend learning clinical
experience.
On call is a critical component of medical care. Accordingly, it is expected that students will spend at least two evenings
on call until 11:00 PM during each of the 4-week blocks of the clerkship. Students who are interested may also spend
one or two evenings working with the Trauma Service at University Hospital, which is a great experience.
Outpatient care represents an increasing share of all patient care. Accordingly, we expect that students will spend time in
the outpatient clinic with their attending and residents whenever the clinic is ongoing (assuming it is consistent with their
in-patient responsibilities).
The attendings have received a copy of this directive also, so there should be no conflict about this meaning. They have
specifically been notified about this policy and we hope, they will make it easy for you to comply.
HOSPITAL SITES:
UMCNO Trauma (Drs. Meade/Moore/Schroll: Office: Nakisha Farria – 988-5111) - In-house call will be expected on
those days on which the Tulane Faculty has primary call (approximately every 4th night). You are to maintain the same
on-call hours as your house officer. Please note that in keeping with the ACGME 80-hour work week, when you do take
In-house overnight call, you may only work an additional 6 hours after that call ends; but note, you will be expected to
make rounds after in-house call nights to sign patients off to the next service.
The notes on your patients will be expected to be complete by 6:30 AM.
Please contact your resident the evening before; as they might not be able to return your call the minute you are ready to
begin that service.
Tulane ID’s are not compatible with the access control system at UMCNO. Tulane students who are assigned to
UMCNO need to go to the medical staff office. The medical staff office will make arrangements for you to be issued an
affiliate badge which will grant you access to the approved areas.
24
You are scheduled for a medical student rotation at Ochsner Medical Center, New Orleans. Each
student will be assigned to one of the several surgical services for a four week rotation. Please read important
information below (students will receive an email from Stacey Porter prior to the start of the rotation):
Ochsner Hospital:
Students on Surgery Rotations: You must watch the video on "Orientation to the OR" prior to
attending scrub class. Please print pages 4 and 5 of the Scrub Class Documents and bring with you
to your scrub class. You must have these documents in order to attend scrub class.
Reporting Information: Upon arrival, ALL surgery students must first report to Melissa Johnson, at
8:30 AM located at Ochsner Academic Center, UGME receptionist, 1514 Jefferson Hwy. Please
bring $10.00 CASH, as a refundable deposit for your temporary Ochsner ID badges.
EMR Access: You will receive an individual email from us with the training instructions for access to
Epic. Training must be completed by all students prior to access being granted.
Parking: All students are required to park in the Coolidge parking lot in Section B, located behind
the pediatrics and breast center buildings, across the street from the hospital. You may take the
shuttle to the south side of campus
EXPECTATIONS: The expectations for students on their general surgery rotation are to see patients in clinic, scrub in
the operating room, and follow patients in the hospital. Students will be directed in these activities by the residents and
staff on their services. Students are expected to read on surgical problems they are involved with or are likely to
encounter. In addition, students are to go to all lectures for general surgery residents. There is no call but students will
stay through the end of the work day and be involved with rounds on Saturday. Students will not come in to work on
Sundays. Students will be relieved of any work at Ochsner to go to anything required at Tulane.
During each of your rotations, you will be given ample opportunity to work with your surgery team in the inpatient and
outpatient environments. You are expected to become an integral part of the service to which you are assigned. All
student rounds must be completed prior to making rounds with the residents. This will necessitate early arrival at the
hospital so that all patients can be evaluated prior to making rounds with the residents and staff. There will be no inhouse call, but you should remain with your team until the clinical and educational responsibilities have been completed
for the day. In order to be sure that students have the opportunity to monitor surgical patients’ progress, rounds will be
required to be made every day, including Saturdays. Students will be given Sunday off to comply with the 24-hour off
rule.
Students are REQUIRED to attend all Friday educational conferences (see page13).
Dr. Corsetti will complete an exit interview prior to the end of the rotation. The purpose of this is to discuss the student’s
evaluation of their performance during this rotation, and to allow the student the opportunity to discuss the quality of
their educational experience at Ochsner. Dr. Corsetti may, depending on the demands on his time, not be able to
complete an exit interview with each student individually (this will continue to be monitored).
25
Tulane Medical Center/Lakeside/Childrens:
TMC Acute Care:
Dr. James Brown (583-6459 [email protected]); Dr. Peter Meade (988-5111
[email protected]) and Dr. Rebecca Schroll (988-5111 [email protected]; Dr. McGinness
[email protected] and Dr. Christopher DuCoin [email protected]
TMC CT Vascular:
Dr. Sam 988-2093 [email protected]
TMC Elective:
Kandil/Korndorffer/Slakey/DuCoin
Dr. Kandil 988-7520 [email protected]); Dr. Korndorffer 988-7123 [email protected];
Dr. Slakey 988-2317 [email protected]; Dr. DuCoin [email protected]
Lakeside General:
Transplant:
Dr. Stephen Jones (988-2305 [email protected])
Melanie Jeansonne, Clinic Nurse, 988-8169 or 988-8100; [email protected]
Dr. Joe Buell is the Interim Director of Abdominal Transplant (988-7867
[email protected] ) but you will additionally work with Drs. Mary Killackey, Anil
Paramesh , (988-0783).
TRANSPLANT SURGERY CURRICULUM—
Meet the 2nd and 4th Thursday of each month from 7:45-8:30 (before clinic) in the clinic side of
the hospital- Rm # TBD. The curriculum will be based on the modules set forth by the
American Society of Transplant Surgeons.
Students rotating on TMC Hepatobiliary, meeting with all the residents and students at the beginning of the rotation to
discuss expectations. Student notes will NOT be included in the patient’s chart. Therefore it will be mandatory that you
write 3 H & P’s and 6 progress notes, give to the faculty you are working with and those will be graded and placed in
your file. Students pick up new patients and present them on rounds. They also have to continue to present their patients
daily while they are inpatient, which is used as their H&P and progress notes used for evaluation. Additionally, there is
no in-house call for students on this TMC Hepatobiliary Service. There are clinics and other conferences that you will be
expected to attend as are the residents. Transplant office has a bibliography of core reading materials for you. Students
should look to the senior resident on the service for direction.
26
Childrens Pediatric Surgery: Dr. David Yu ([email protected])
The students assigned to this service will assist in the care of those patients under the care of the General Surgery
Service. House officers will provide resident coverage for this service. Your duties are to include, but are not limited to:
1.
2.
3.
4.
5.
6.
Provide daily inpatient care for the patients to whom you are assigned.
Perform histories and physical examinations.
Participate in the operations being performed on your patients.
Work with attending physicians in their outpatient clinics (3rd floor of professional office building)
Attend all Friday morning Educational conferences.
Be available for home call up to every third night and every other weekend.
EXPECTATION: The expectations for students on their general surgery rotation are to see patients in clinic, scrub
in the operating room, and follow patients in the hospital. Students will be directed in these activities by the
residents and staff on their services. Students are expected to read on surgical problems they are involved with or are
likely to encounter. In addition, students are to go to all lectures for general surgery residents. There is no call but
students will stay through the end of the work day and be involved with rounds on Saturday.
Expectations: Make rounds with the resident on the service every AM. Examine the patients, review the labs,
come to decisions, and make recommendations consistent with resident and staff. Naturally, implementations
of recommendations depend on resident and staff.
Do complete history and physicals on new patients admitted to the service and turn them in to the attending for
review.
See consults to the service and do history and physicals, review labs, make recommendations consistent with
resident and staff recommendations.
Make rounds with staff daily and present patients to staff in a manner consistent with working rounds. Much
teaching will be done on these rounds. Therefore, students are expected to have read about the diseases present
in their patients.
Students are expected to attend surgery on all of their patients. There must be a good reason to be absent from
the surgical procedure on their patients.
Students are expected to attend clinics at Lakeside and do complete histories and physicals on the new
consults and referrals and discuss diagnoses and recommendations with the staff attending.
Students are expected to take call at night for emergency admits and emergency surgery.
Students are expected to learn basic surgical procedures well enough to assist in surgery.
Students are encouraged to attend surgical procedures done on patients other than their own if it does not
conflict with primary responsibilities.
Students are encouraged to make week-end rounds on their hospitalized patients.
27
TMC General Surgery/Colorectal at VA
Drs. James Korndorffer and Jeffrey Griffin
Students must enroll in the VA Talent Management System (MSE-TMS)
1.
2.
3.
4.
Contact Ms. Paulette Hammond at the VA to explain that you are a medical student who will be rotating to the VA and that
you need for her to contact the fingerprinting office to authorize them to process you for the surgery service line (504-4123700 Extension 7572 and [email protected]. Ms. Paulette Hammond is the point of contact for the PM&R
division, which is under the surgery service line at the VA. She will interface with the fingerprinting office so that they will
expect your phone call for scheduling the fingerprinting session.
Please print the signature packet, which is the Word file, and complete. Again, these are mainly signature pages
acknowledging review of policies.
Go to this link and complete the training:
https://www.tms.va.gov/plateau/user/SelfRegistrationUserSelection.do. This should not be time consuming.
Once done, you can print a completion certificate.
Please print the VAfingerprints file and complete. Then, call the fingerprinting office at the number listed on top of the
page (504-558-1408) to schedule your fingerprinting. This process must be completed quite early, as it is a limiting factor.
Once you schedule a time to get fingerprinted, the time required from you will be minimal. The fingerprinting office is
located on the first floor of 1555 Poydras Street, behind the credit union in the lobby. Enter the credit union, inform them
that you are going to be new to the VA, and that you need fingerprinting completed.
Colorectal Surgery/East Jefferson: Drs. Jeffrey F. Griffin; Mayfield; Filinsky; McCarthy
Ms. Toni Marques, Office Manager
4224 Houma Blvd, Suite 540, Metairie, LA 70006
504.456-5108
[email protected] [email protected]
Students must complete the East Jefferson General Hospital medical
student registration form prior to the start of the rotation. Please contact
Stephanie Reed, surgery student coordinator for this information if not
received.
General Surgery/Oncologic
West Jefferson/Ochsner WB:
Dr. Emery Minnard; Deanna Miller, RN
Crescent Surgical Group
1111 Medical Center Blvd.
Marrero, LA 70072
504.349-6556 [email protected]
The medical students report on their first day to West Jefferson Medical
Center at 8:00 AM, located at 1101 Medical Center Blvd. Marrero, LA
70072. You will check-in at the GME/Medical Staff Office on the 1st
floor to the office of Jana Burst, Graduate Medical Education
Coordinator (504.349-1897) to get your hospital badges, orientation
binder, and access codes.
28
OLOL
We have 2 different rotations based out of Our Lady of the Lake in Baton Rouge; listed below in red. Each rotation will
rotate at different hospital sites and each site has its own packet of paperwork (as depicted below). Please see Janice
Lucas in Dr. Krane’s office, when the schedule comes out to complete these packets. The earlier the packets are
completed and returned, the more assurance you will have that your experience on the rotation will run smoothly.
Rotation Name
OLOL BR General/HIPAA Compliant
Lake Surgery Center Women’s
Yes
Yes/Yes
Yes
Yes
Dr. Schwartzberg/Froelich
(OLOL 1)
Yes
No/No
No
Yes
Dr. Kenny Kleinpeter
(OLOL 2)
Dr. Glen Schwartzberg, James Froelich and Dr. Bonner)-Baton Rouge Clinic (Julia):
[email protected]; [email protected]. Office: (225) 769-4044; cell: (225) 247-8354
Contact BR Clinic Administrator Mr. Ed Silvey (225) 246-9301 to assure that your HIPAA training at Tulane
is sufficient). PA: Denise Roblet; Office Manager: Dawn Landry (225) 246-4572
The Surgeons Group of Baton Rouge
Dr. Mark Hausmann, MD, FACS – General Surgery, Bariatric Surgery
Karl LeBlanc, MD Keith Rhynes, MD Kenny Kleinpeter, MD Brent Allain, MD
7777 Hennessy Blvd., Suite 612
Baton Rouge, LA 70808
Office #: (225) 769-5656;
CELL: (225)413-7048 FAX #: (225)766-6996
Floyd J. Roberts, Jr., M.D., FACP, FCCP, Chief Medical Officer, Medical Director of Graduate Medical Education & DIO of
Baton Rouge General Medical Center (225) 387-7121. Jayne B. Bacot, RN @ Lake Surgical @ 225-765-3133.
John Clifford, MD, FACS, Medical Director Graduate Medical Education and DIO of OLOLRMC @ 225-765-1955.
Contacts:
Tiffany Rogers, GME Services Coordinator
Our Lady of the Lake Regional Medical Center
Division of Academic Affairs/Graduate Medical Education Department
7556Hennessy Boulevard, | Baton Rouge | LA 70808
225-765-7730 (office) [email protected]
Lisa Loustalot| GME Services Coordinator
Our Lady of the Lake Regional Medical Center
Division of Academic Affairs/Graduate Medical Education Department
7556Hennessy Boulevard, | Baton Rouge | LA 70808
225-765-8769 (office) [email protected]
Baton Rouge General Medical Center
(BRG)
Roberta Cartaginese, LEAD Senior Program Coordinator
Tulane University School of Medicine 225-387-773; 225-387-7872 (Fax) : [email protected] or
[email protected]
Connie Rome, GME Manager; [email protected]
Chelsea Lemelle, Medical Education Coordinator, Baton Rouge General Medical Center, Office of Medical Education
Office; 225.381-6194 Fax: 225.387-7872 [email protected]
29
Lakeview Regional Physician Group/Surgical Specialists:
101 Judge Tanner Blvd., Suite 402
Covington, Louisiana 70433 Office: 985.892-8959 Fax: 985.892-8975
Secretary: Allison Nettles [email protected]
Secretary: [email protected]
Stephen O. Harkness, MD, FACS [email protected] Cell: 985.789-0468
Lance J. Wehrly, MD
EmCare Acute Care Surgery
101 Judge Tanner Blvd., Suite 408
Covington, LA 70433 Office: 985 892-4374 Fax: 985.892-9066
Secretary: Beverly West [email protected]
Marco Hidalgo, MD [email protected]
Lauren Buck, MD [email protected]
30
Department of Surgery
Hutchinson Building, 8th Floor
SL 22
(504) 988-3909
(504) 988-1882 fax
DESCRIPTION:
The General Surgery rotation is primarily an inpatient-based experience designed to familiarize
the student with acute and elective surgical decision making processes (see Goals & Objectives) However, to the extent
that much of the preoperative and postoperative management is now carried out in the outpatient setting, students will as
well be expected to participate in this phase of care.
A team of surgery house officers and at least one attending surgeon-preceptor will staff each General Surgery service, on
which medical students will rotate. These personnel will provide ample opportunities for “on the job” experience
relative to the discipline of Medicine in general and surgery in particular.
During the course of the General Surgery rotation, you are to keep a concise log of all patients for whom you were given
primarily responsibility. Specific data to be recorded are: primary diagnosis, whether management occurred on an
inpatient or outpatient basis, operation (if any), and complications.
HOSPITAL SITES:
University, Ochsner Medical Center, Ochsner St. Anne General Hospital, Tulane Medical
Center, Tulane/Lakeside, East Jefferson General Hospital, West Jeff Medical Center, Our Lady of the Lake Regional
Medical Center (OLOL) and Thibodaux Regional Medical Center .
GOALS
Patient Care:
1. Insert Nasogastric tube.
2. Insert Foley Catheter.
3. Be able to perform as a second assistant in the operating room.
4. Be able to function as a first assistant for minor or bedside procedures.
5. Demonstrate sterile technique.
6. Demonstrate patient prep in operating room.
7. Perform wound or incision closure.
8. Describe the steps and indications for central line insertion.
Medical Knowledge:
1. Perform a complete history and physical exam.
2. Write appropriate patient admission orders for a variety of surgical conditions including but not limited to:
trauma, GI bleeding, vascular conditions, and acute abdomen.
3. Write appropriate post-operative orders for both out-patient and emergency surgery patients.
4. Assess and discuss management of post-operative fever.
5. Explain and interpret chest x-rays.
6. Discuss patient CT scans.
7. Discuss diagnosis and management of:
a. Surgical Infections
b. Acute Pancreatitis
c. Hemorrhagic Shock
d. Cholecystitis
e. Nutrition
f. Abdominal Trauma
g. Appendicitis
h. Diverticulitis
i. Thoracic Trauma
j. Peripheral Vascular Disease
k. Peptic Ulcer Disease
l. Inguinal Hernia
31
8.
9.
10.
11.
12.
13.
14.
15.
m. Carotid Disease
n. Upper Gastrointestinal Bleeding
o. Postoperative Complications
p. Reflux Esophagitis
q. Fistula-in-Ano
r. Portal Hypertension
s. Breast Cancer
t. Adrenal Mass
u. Thyroid Nodule
v. Obstructive Jaundice
w. Colon Cancer
x. Splenectomy for Disease
y. Intestinal Obstruction
z. Lung Cancer
aa. Melanoma
Interpret arterial blood gases.
Understand and verbalize indications for mechanical ventilation.
Discuss the differences and uses for various forms of mechanical ventilation.
Appraise patient for post-operative complications: infections, anastomotic leak, hernia, bleeding, DVT, heart
attack, hyperglycemia.
Discuss management and give examples of post-operative pain control.
Recognize symptoms, causes, and treatments of common electrolyte derangements in surgical patients:
a. Hyponatremia / Hypernatremia
b. Hypokalemia / Hyperkalemia
c. Hypocalemia
d. Hypomagnesemia
Demonstrate and discuss management of anemia.
Calculate daily caloric needs of different types of patients. Calculate and write TPN orders for a variety of
patient conditions.
Practice Based Learning and Improvement:
1. Evaluate patient care through personal assessment and feedback from residents and staff.
2. Develop personal process of acquiring and appraising scientific knowledge.
Interpersonal and Communication Skills:
1. Discuss patient condition and assessment with resident team.
2. Present patient to staff during rounds in clear concise manner, including exam, assessment of condition, and plan
of patient care.
3. Document steps in patient care.
4. Participate in development of patient care plan.
Professionalism:
1. Perform patient care in an ethical manner.
2. Attend conferences, clinics, and rounds on time.
3. Display commitment to patient care and educational process.
4. Respect patient culture, privacy, and disease process.
System Based Practice:
1. Define cost-effective patient care.
2. Understand the basic costs and risk-benefit of common lab tests, radiology exams, and operative interventions.
32
POST-OPERATIVE ORDERS
1.
Location of admission (recovery room, one day surgery, ICU, etc.)
2.
Status post (surgical procedure)
3.
Admitting physician
4.
Condition
5.
Vital signs (per recovery room protocol, then on ward, ICU, etc.)
6.
Diet
7.
Activity (up with assistance, bathroon privileges, etc.)
8.
Allergies
9.
Intravenous fluids
10.
Medications
11.
Nursing care orders (dressing care, wound care, assistant with ambulation, etc.)
12.
Care of drains, lines
13.
Intake and output; record patient weight daily
14.
Special nursing care orders
15.
Monitoring device instructions
16.
Miscellaneous (anything else necessary for good patient care, such as notifying the physician if the patient is
unable to void post-operatively, etc.)
17.
Laboratory tests
18.
Roentgenographic studies
19.
EKG
33
SURGERY THIRD YEAR MEDICAL STUDENT
MID-BLOCK EVALUATION
TWO WEEKS INTO EACH OF YOUR GENERAL SURGERY SERVICE, I WILL SEND OUT ELECTRONICALLY YOUR MID
BLOCKEVALUATION. BUT IT IS APPROPRIATE, AT THE APPROPRIATE DOWN TIME, TO ASK YOU’RE RESIDENT TO
COMPLETE THIS EVALUATION, REVIEW WITH YOU AND RETURN TO MY OFFICE FOR YOUR FILE.
PLEASE IF YOU DO NOT GET YOUR MIDBLOCK EVALUATION INTO YOUR THIRD WEEK OF YOUR GENERAL MONTH,
CONTACT STEPHANIE REED IMMEDIATELY AND DR. MEADE WILL CONTACT YOUR TEAM AND
REVIEW YOUR MID BLOCK PERFORMANCE WITH YOU.
Date of Evaluation: _______, 2013
Evaluator: Dr.
Student Name:
Block #___2013-2014
Surgery Service:
Faculty evaluation summary: _____________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Resident evaluation summary: _____________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Surgery (common procedure log) review: ____________________________________
_____________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Professionalism: ________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Student Response: _______________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Faculty signature: _______________________________________________________
Student signature: _______________________________________________________
Program Director’s Response: _____________________________________________
______________________________________________________________________
Program Director’s Signature: _____________________________________________
FAX: Stephanie Reed at 504-988-1882
34
Student Evaluation Form
Attachment 4
Instructions: Rate the student’s performance using the criteria listed below. Please provide written comments as well, as they
may be used to compute an overall grade.
Professionalism
No
Opportunity
to Observe
Frequently irresponsible,
unreliable, or late.
Appearance fails to
reflect a professional
image. Discourteous and
resists feedback.
Insufficiently motivated
to acquire knowledge.
Shows little improvement
over the clerkship.
Shows little initiative and
refuses leadership roles.
Unwilling to work as part
of a team.
0
1
2
Below average
attendance or
reliability. Appearance
does not typically
reflect a professional
image. Does not
readily acknowledge
mistakes/ tends to
resist suggestions for
improvement. Below
average initiative and
avoids leadership
roles. Below average
ability to work as a
team player.
3
4
Usually responsible and
can be counted on to
follow through on tasks.
Dresses appropriately for
the work environment.
Generally respectful of
the feelings of others.
Recognizes mistakes and
accepts responsibility for
actions. Exhibits initiative
at times and accepts
leadership role when
asked. Usually able to
handle stress and work as
part of a team.
5
6
Good attendance and
reliability. Sincere, honest,
represents self and others
accurately. Well-groomed
and dressed appropriately
for the work environment.
Acknowledges mistakes
and accepts responsibility
for actions. Sometimes
seeks leadership. Adapts
well to different situations.
Works effectively as part of
a team.
Always self-motivated,
punctual, and reliable.
Maintains professional
appearance. Honest,
trustworthy, and
courteous. Actively
seeks feedback and
works diligently to
correct deficiencies.
Eagerly assumes extra
responsibilities.
Excellent leader and
team player.
7
9
8
10
Patient Care
No
Opportunity
to Observe
History /physical exam are
incomplete with major
omissions noted. Does
not synthesize or use
knowledge in clinical
situations, and decisionmaking adversely affects
the patient. Does not
attend to patient comfort
or consistently contributes
to patient discomfort.
Displays minimal cultural
understanding and
sensitivity.
History/ physical
exam are sometimes
incomplete and fail
to note major
findings. Frequently
has difficulty
prioritizing clinical
management issues.
Demonstrates little
attention to patient
comfort and below
average cultural
understanding and
sensitivity.
History/physical exam
are usually complete,
accurate, and organized.
Represents average
knowledge base
pertinent to disease
process and patient
situation.
Demonstrates concern
for maintaining patient
comfort and displays
cultural understanding
and sensitivity.
History/physical exam
are thorough, clear, and
well-organized.
Represents above
average knowledge base
pertinent to disease
process and patient
situation. Demonstrates
high regard for patient
comfort and displays
above average cultural
understanding and
sensitivity.
0
1
3
5
7
2
4
6
8
Always performs a
complete, accurate,
and efficient
assessment.
Consistently
demonstrates a
solid grasp and
understanding of
complex issues as
they relate to
patient situations.
Demonstrates high
regard for patient
comfort and
displays a high level
of cultural
understanding and
sensitivity.
9
10
Medical Knowledge
No
Opportunity
to Observe
0
Reflects failure to
read even standard
textbooks.
Knowledge is
limited,
fragmented, or
poorly applied.
Needs significant
remediation.
1
2
Reflects cursory
review of standard
textbooks. Below
average
knowledge base
and application to
clinical problems.
3
4
Reflects review of standard
textbooks. Usually
demonstrates general
understanding of
pathophysiology, diagnosis,
and management. Can
generally integrate knowledge
to answer patient-driven
questions.
5
6
Interpersonal & Communication Skills
35
Reflects review of
standard textbooks
sometimes
supplemented by
current literature.
Above average
knowledge, well
applied.
Reflects in-depth review of
standard textbooks and
current literature. Able to
integrate basic knowledge
into the clinical situation.
Level of knowledge is far
superior to peers.
7
9
8
10
No
Opportunity
to Observe
0
Oral presentations
are consistently illprepared and
include major
omissions of
relevant data.
Rarely
communicates
effectively. Fails to
treat others with
respect. Focuses
on self at the
expense of others.
Poor rapport with
team and other
professional staff.
1
2
Oral presentations are
below average and do
not follow standard
format. Sometimes
communicates
effectively. Often fails
to treat others with
respect. Lacks focus
on the needs of others
and has difficulty
communicating
empathy. Occasional
difficulty with team
and professional staff.
Oral presentations are
thorough and efficient
but may contain
extraneous or irrelevant
information.
Communicates
effectively and usually
treats others with
respect. Focuses on the
needs of others but has
some difficulty
communicating
empathy. Good rapport
with team and other
professional staff.
3
5
4
6
Oral presentations
are accurate, wellorganized, and
concise.
Communicates
effectively even in
difficult or new
situations. Treats
others with respect.
Focuses on the needs
of others and
communicates
empathy. Very good
rapport with team
and other
professional staff.
7
8
Oral presentations are
consistently accurate, wellorganized, and concise.
Consistently communicates
effectively, even in difficult
or new situations.
Consistently treats others
with the utmost respect.
Consistently focuses on the
needs of others and
communicates empathy
effectively. Demonstrates
excellent rapport with team
and other professional staff.
Above average
intellectual curiosity.
Seeks new information
and strives to enhance
understanding and
development. Accepts
feedback willingly and
uses it to improve.
Exceptional intellectual
curiosity. Always seeking
more information and
asking insightful questions.
Analyzes medical literature
and incorporates it into
patient plan. Consistently
seeks and uses feedback to
improve.
9
10
9
10
Practice-Based Learning & Improvement
No
Opportunity
to Observe
0
Poor intellectual
curiosity. Does not
seek new information
and appears
uninterested in
learning. Consistently
resistant and
defensive to
feedback.
1
2
Below average
intellectual curiosity.
Rarely seeks new
information and
resists learning with
others. Generally
resistant or
defensive to
feedback.
3
4
Average intellectual
curiosity. Puts forth
effort to enhance
understanding and
development. Seeks
new information and
learns from others.
Responds well to
feedback.
5
6
7
8
Systems-Based Practice
No Opportunity
to Observe
Unable to formulate
cost-conscious
treatment plan. Fails to
demonstrate
understanding of the
psychosocial and
healthcare needs of
patients. Fails to
engage patient and
family in care plan.
Fails to coordinate
patient care with other
health care
professionals.
Does not typically
consider cost when
reviewing treatment
options. Below average
understanding of the
psychosocial and
healthcare needs of
patients. Generally does
not engage patient and
family in care plan and
does not usually
coordinate care with
other health care
professionals.
Considers costconscious treatment
options with assistance.
Average understanding
of the psychosocial and
healthcare needs of
patients. Engages
patient and family
when prompted, and is
generally able to
coordinate patient care
with other health care
professionals.
0
1
3
5
2
4
6
Usually considers cost
in planning. Above
average
understanding of the
psychosocial and
healthcare needs of
patients. Easily
answers patient and
family questions about
care and is able to
work with other
healthcare
professionals in
coordinating patient
care.
7
8
Consistently demonstrates
the ability to formulate a
treatment plan with
appreciation for cost.
Exceptional understanding
of the psychosocial and
healthcare needs of
patients. Volunteers
appropriate information to
patient and family.
Consistently and effectively
coordinates patient care
with other health care
professionals.
9
10
RIME – How would you rank this student using the RIME framework?
OBSERVER: Present, but contributes minimally to patient care.
REPORTER: Reliably, respectfully, and honestly gathers information from patients. Communicates with faculty. Gets the basic work done. Can
answer the “what” questions.
INTERPRETER: Shows selectivity, prioritization, and implies analysis. Actively involved in thinking through patient problems, and of acquiring
knowledge to offer a reasonable differential diagnosis. Can answer the “why” questions.
MANAGER: Clinical planning fulfills a promise of working with patients on diagnostic and therapeutic decisions and a promise of developing
expertise to do so. Consistently answers “how” to resolve problems. This is the level of a competent intern.
EDUCATOR: Personal planning and reflection fulfill a commitment to deeper expertise for self and colleagues and patients. Is committed to selfcorrection and self-improvement. This is resident level and few students will meet these criteria.
Observer
Reporter
Interpreter
Manager
Educator
1
2
3
4
5
6
7
8
9
10
36
Overall Performance/Competence: How would you rank this student compared to all students you have trained?
Bottom 10% of students I
have trained
1
2
Bottom 33% of students I
have trained
3
4
Middle 33% of students I
have trained
5
6
Top 33% of students I
have trained
7
8
Please enter an overall numerical grade (Question 9 of 10 – Mandatory)
Honors – 92 -100; High Pass – 89-91; Pass 80-88; Condition 65-79; Fail <65
37
Top 10% of students I
have trained
9
10
TABLE OF CONTENTS FOR ORAL EXAM
You will be questioned on 1 topic from each of the 3 categories below (therefore 3 total questions). All test questions can be
found in the Sabiston & Schwartz textbook.
ACUTE
1.
2.
3.
4.
5.
6.
7.
8.
9.
Surgical Infections
Acute Pancreatitis
Hemorrhagic Shock
Cholecystitis
Nutrition
Abdominal Trauma
Appendicitis
Diverticulitis
Thoracic Trauma
GENERAL
1.
2.
3.
4.
5.
6.
7.
8.
9.
Peripheral Vascular Disease (Fem Pop)
Peptic Ulcer Disease
Inguinal Hernia
Carotid Disease
Upper Gastrointestinal Bleeding
Postoperative Complications
Reflux Esophagitis
Fistula-in-Ano
Portal Hypertension
ONCOLOGY
1.
2.
3.
4.
5.
6.
7.
8.
9.
Breast Cancer
Adrenal Mass
Thyroid Nodule
Obstructive Jaundice
Colon Cancer
Splenectomy for Disease
Intestinal Obstruction
Lung Cancer
Melanoma
38
GRADE SHEET
Student Name _____________________________
Examiner Name____________________________
Date______________________________________
ACUTE----Question #_______
Pathogenesis________________
Anatomy___________________
Diagnosis___________________
Management_________________
GENERAL-Question # ______
Pathogenesis_________________
Anatomy____________________
Diagnosis____________________
Management__________________
ONCOLOGY-Question#______
Pathogenesis___________________
Anatomy______________________
Diagnosis______________________
Management____________________
TOTAL SCORE (Maximum 300)___________
EXAM SCORE (Maximum 100)____________
Signature_______________________________
39
The tables listed below are the cases we expect you to see while on your eight week rotation. You will be completing this on
the e-value website. Log into: https://www.e-value.net/ Go to “User Menu” – then “PxDx” – then “add new”. If on same
patient, you saw multiple procedures, you can add multiple listings. After entering all procedures for that one patient, click
“next” and “save record” and repeat for next patient. If unable to login to E*value, send email message to [email protected]
for your login and password. PRINT OUT YOUR PROCEDURE LOG AND BRING W/ YOU TO YOUR ORAL EXAM.
Level I= Student observed examination or management of patient with this disorder OR participated in discussion of patient with
this disorder
Level II= Student examined and presented patient with this disorder to an attending physician or resident
Level III=Student Observed procedure being done
Level IV= Student participated in clinical skill or procedure with Patient, Standardized Patient or Simulation Lab
Level V= Student Performed Clinical Skill or Procedure and was directly observed by attending physician, resident, or standardized
patient
Group Name / Procedure Name+/Clinical Skills/Exam
+/-
Breast exam (Level V)
Patient's H & P (Level IV)
Clinical Skills/Interpretation
+/-
CXR: interpret (Level II)
KUB:interpret (Level II)
Clinical Skills/Procedure
+/-
ABG/Arterial Line (Level V)
CCI (Level I, II, or III)
Central Line: placement (Level V)
Foley Cath: placement (Level V)
IV access/venipuncture (Level V)
Intubation/airway management (Level V)
NG tube placement (Level V)
PVD (Level V)
Sterile Technique (Level II)
Suture (simple) Technique (Level V)
Suture fascia (Level III)
Trauma (Level I, II, or III)
Wound Care (Level V)
Surgery
+/-
Acute Abdomen (H&P) (Level IV)
Acute Abdomen (OR) (Level III)
Acute Abdomen (Post) (Level IV)
Acute Abdomen (SOAP) (Level III)
Biliary Tract Disease (H&P) (Level IV)
Biliary Tract Disease (OR) (Level III)
Biliary Tract Disease (Post) (Level IV)
Biliary Tract Disease (SOAP) (Level III)
Cancer Patients (H&P) (Level IV)
Cancer Patients (OR) (Level III)
Cancer Patients (POST) (Level IV)
Cancer Patients (SOAP) (Level III)
Intestinal Operations (H&P) (Level IV)
Intestinal Operations (OR) (Level III)
40
Intestinal Operations (POST) (Level IV)
Intestinal Operations (SOAP) (Level III)
Laparoscopic Procedures (H&P) (Level IV)
Laparoscopic Procedures (OR) (Level III)
Laparoscopic Procedures (POST) (Level IV)
Laparoscopic Procedures (SOAP) (Level III)
Pre-op a patient (Level IV)
41
The O.R. is located on the 3rd floor of Tulane Medical Center. There are five main areas that you will be involved in:
GOR which has 14 rooms, SDS Dept./Pre-admit (where patients go pre-operatively and post-operative), LLI/Cysto
Dept., Recovery Room and SICU. The GOR is open from 6:45 a.m. – 11:30 p.m. Monday through Friday with emergent
cases done after 11:00 p.m. and on weekends. Surgeries start at 7:15a.m. Monday – Friday and 7:45a.m.
You are part of a surgical team whose main objective is to provide quality patient care in a safe environment for staff and
patients. Certain tasks seem mundane but each of us has a significant role and responsibility to meet this purpose. Since
OR’s vary, you are responsible for following policies/procedures of the hospital to which you are assigned.
Your Responsibilities
Come prepared with the knowledge of surgical procedure, anatomy and patient history. You will be asked to assist with
positioning, prepping and possibly draping. If not, once gowned and gloved, stand on the sterile field side of the room.
Scrubs: Tulane Medical Center Scrub Suit Policy and Procedure
Policy:
Tulane Medical Center will provide scrub suits for personnel while they are working in the following areas: Bone
Marrow Transplant, all areas of the Operating Room (Anesthesia, Post Anesthesia Care Unit), Outpatient Surgery,
Endoscopy and Radiology Special Procedures.
Scrub Suits are not to be worn outside the Hospital/Clinic – Medical School complex. They are also not to be worn as
uniforms within departments outside of invasive areas.
Procedure:
Scrub suits are available in jade green and are stamped “Property of Tulane Hospital”. Unauthorized removal from the
facility is a violation of hospital policy.
An automated scrub suit dispensing system will be used in the Operating Room. Women’s locker room Code 2719*;
Men’s locker Room Code 1932*. To access scrub user and pin #: Log in E*Value; Click on the edit button Update
Your User Information to retrieve assigned User and Pin numbers. Scrub Ex machine requires the zero with the user #.
If you have any questions, please contact student coordinator, Stephanie Reed.
Because medical students have a university-issued badge, access to the system will be via the PIN. All forms for
medical school students will be coordinated through the Student Coordinators. If you are at Ochsner or OLOL, you will
not use Tulane scrubs.
Attending faculty, staff and medical students will have a credit of two scrub suits. Once this limit has been reached, in
order to receive additional scrub suits, previously issued scrubs must be returned to the unit.
Visiting physicians and vendors will be issued scrubs by the Operating Room front desk personnel.
Contact for the Scrub Ex machine:
Kathleen "Kat" Ryan, C.S.T.Schedule Coordinator
Tulane Medical Center
1415 Tulane Avenue, New Orleans, LA 70112
504-988-5906, 504-912-2681 cell, 504-988-7653 fax
[email protected]
42
43
44