Inpatient Acting Internship in Surgery

Catalog description

COURSE A (Elective Surgery) LOCATION: Academic Medical Center at Ochsner LSU Health Shreveport and Monroe Medical Center at Ochsner LSU Health Shreveport (elective surgery) NUMBER OF STUDENTS PER 4 WEEK BLOCK: 2 SELECTIVE AVAILABLE DURING BLOCKS: All COURSE CODE: SISRAA Primary Goals The student will: 1. Obtain a more advanced understanding of surgical disease processes, work-up, and treatment. 2. Obtain more advanced experience in assessment and diagnosis of surgical disease processes 3. Obtain experience in graduated responsibility as an acting intern on an inpatient service. Specific Objectives The student will: 1. Obtain experience in taking a history and performing a problem-focused physical examination on the wards and in clinics. 2. Formulate a differential diagnosis in clinic and on the wards, adding emphasis to assessment and plan. 3. Obtain experience in the performance of basic surgical skills in the operating room and clinics. 4. Obtain experience in surgical decision making with attending supervision in and out of the operating room. 5. Practice interpersonal and communication skills during interactions with patients, families, and health care teams. COURSE B (Surgical Oncology) LOCATION OF ELECTIVE: Academic Medical Center at Ochsner LSU Health Shreveport MAXIMUM NUMBER OF STUDENTS: 2 ELECTIVE OFFERED DURING BLOCKS: All Blocks Course Code: SISRAB GOALS Learn to perform a thorough Oncology exam Develop an understanding of the preoperative evaluation of Oncology patients, including preoperative staging of tumors, evaluation of co-morbidity, determination of the role of surgery and preoperative optimization for surgery. Develop an understanding of the likely outcome of surgical oncology treatments OBJECTIVES The student will scrub in on operative cases and examine, work-up and preoperatively prepare patients for surgery and other treatments. The student will postoperatively manage the care of patients that includes the care of the sequelae and complications .of surgical interventions SPECIFIC DUTIES OF SENIOR STUDENTS • Written work-ups of patients assigned to senior student • Present work-up patients to senior resident/staff • Participating in surgery cases (scrubbing in) on patients he/she worked up • Participating in/performing certain procedures on patients on service (e.g. placing and removing chest tubes, central lines, arterial lines, some suturing (under supervision) • Participating as a “junior intern” in daily service rounds including SICU and including the writing or progress notes and orders (under supervision) (co-signed by resident or staff) and perform daily post-op exams, dressing change. • Participate in weekend ward rounds on at least one day of each weekend while on service • Participate in Oncology Clinic and outpatient evaluation of patients Course C (Trauma, Acute Care Surgery & Surgical Critical Care) LOCATION OF ELECTIVE: Academic Medical Center at Ochsner LSU Health Shreveport MAXIMUM NUMBER OF STUDENTS: 4 ELECTIVE OFFERED DURING BLOCKS: All COURSE CODE: SISRAC GOALS • To become familiar with the initial evaluation of the trauma patient in the emergency room, as well as the principals of resuscitation and stabilization. • To become familiar with general principals of both operative and non-operative management of the trauma patient. • To become familiar with principles of surgical critical care. • To provide additional experience for senior students considering the pursuit of a surgical career. • To learn how to manage mechanical ventilators, the use of hemodynamic monitoring and optimization in various forms of shock including septic and hemorrhagic shock. • To gain facility with overall evaluation and management of all systems and function of critically ill patients including nutrition, fluid maintenance, and electrolyte balance. • To understand the principles of the physiological response to stress and its application to the support of the critically ill. OBJECTIVES The student will participate as an active intern in the pre-operative, intraoperative, and post-operative care of the patients of the trauma service under the supervision of the house staff and trauma staff. • Student will make rounds on surgical critical care service daily • Student will participate with intern in consultations, orders, and other chart review • Student will act independently in critical assessment and plan initiatives • Student will participate in line placement and other invasive procedures • Student will document daily activities, learning events, and self-directed learn activities in a diary for review by Dr. Samra • Student will meet with Dr. Samra before beginning the course, again at the halfway point, and again at the end for clarification and feedback SPECIFIC DUTIES OF SENIOR STUDENTS • The senior student will be the acting intern assigned to specific patients on the trauma service, de- pendent upon his/her desires and abilities with supervision of the house staff and trauma staff. She/he will be responsible for the new work-up, pre-operative, post-operative care of these patients. • The student will take call with the intern on the trauma team, and is expected to participate in all trauma surgery taking place on his call nights. • The student is expected to take call on any day that the intern is on call, even when it falls on a weekend. If the weekend has no call for the intern, the senior student may elect to take Sunday off. • This one month rotation will be located in the University Health Hospital Surgical Intensive Care Unit or Burn Unit. The student will be an integral part of the Surgical ICU Team. She/he will be assigned responsibility for knowing all aspects of the patients assigned to them. Student will be supervised by the house staff and the staff of the division of trauma and critical care. Students will be expected to identify the patient’s problems, present these problems clearly and comprehensively and to devise a plan for addressing the problems. Also the student will participate in the procedures done in the critical care unit including the placement of central lines, Swan Ganz catheters, bronchoscopy, burn wound change, etc. The student’s hours will be exactly those of the SICU or Burn Unit residents. Course D (Vascular Surgery) LOCATION OF ELECTIVE: Academic Medical Center at Ochsner LSU Health Shreveport MAXIMUM NUMBER OF STUDENTS: 2 ELECTIVE OFFERED DURING BLOCKS: All Course Code: SISRAD GOALS • To understand the etiology, epidemiology, and treatment of atherosclerotic vascular disease. Develop a working knowledge of cardiovascular risk assessment. • To learn the elements of and to perform a complete vascular history and physical examination. • To learn basic hemodynamics, ultrasound physics and noninvasive vascular laboratory investigations • To understand the appropriate indications for surgical in patients with Vascular disease and the appropriate treatment options • To understand basic vascular surgical techniques: exposure of blood vessels, suturing of blood vessels, wound approximation. • To understand endovascular surgery: diagnostic arteriography of the entire aorta, cerebrovascular, mesenteric, renal, and lower extremity circulation. OBJECTIVES Student will participate in open and endovascular procedures Student will be assigned patients in the clinic and hospital. Student will spend a week in the vascular lab. LOCATION OF ELECTIVE: Academic Medical Center at Ochsner LSU Health Shreveport MAXIMUM NUMBER OF STUDENTS: 2 ELECTIVE OFFERED DURING BLOCKS: All Course Code: SISRAE This rotation is recommended for students interested in cardiothoracic and general surgery. Students not going into surgery will be allowed on the rotation at the discretion of the course director and student rotation coordinator. GOALS • To understand the etiology, epidemiology, and treatment of cardiovascular and thoracic diseases. Develop a working knowledge of cardiovascular risk assessment. • To learn the elements of and to perform a complete cardiothoracic and vascular history and physical examination. • To be able to describe the basic hemodynamics and management of postoperative cardiac surgery patients. • To understand the appropriate indications for surgery in patients with cardiothoracic and vascular diseases and the appropriate treatment options. • To understand basic cardiothoracic and vascular surgical techniques: thoracotomy, median sternotomy, thoracoscopic surgery, exposure of blood vessels, suturing of blood vessels, vein harvesting, wound approximation. • To be able to describe the basics of cardiopulmonary bypass. OBJECTIVES Student will participate in open and thoracoscopic procedures. Student will be assigned patients in the clinic and hospital. Course F (Pediatric Surgery) LOCATION OF ELECTIVE: Academic Medical Center at Ochsner LSU Health Shreveport ; St. Mary Medical Center, Willis-Knighton South MAXIMUM NUMBER OF STUDENTS: 1 ELECTIVE OFFERED DURING BLOCKS: All Course Code: SISRAF This rotation is limited to students interested in pediatric surgery or general surgery. GOALS • To understand the etiology, epidemiology, and treatment of pediatric surgical diseases. • To learn the elements of and to perform a complete pediatric history and physical examination. • To understand the anatomy relevant to common surgical diseases and surgical approaches: ie. inguinal hernia anatomy and abdominal wall anatomy. • To understand developmental anatomy that is relevant to common pediatric surgical problems • To understand the appropriate indications for surgery in pediatric patients and the appropriate treatment options. • To understand basics of common surgical techniques: laparotomy, laparoscopy, inguinal hernia repair, thoracotomy, wound closure • To learn basic care of postoperative pediatric surgery patients. OBJECTIVES Student will participate in open and minimally-invasive procedures. Student will be assigned patients in the clinic and hospital. ROTATION SYLLABUS • Responsibilities of the students will be that of an acting intern, functioning as integral part of the resident team. • Participate in all surgical cases. • Participate in pediatric surgery clinic throughout the week (specific schedule will be determined by the number and complement of students and residents on the service). • Take call in accordance with other acting internship rotations (1 week per month). • Active participation in small round table didactic discussions on basic pediatric surgical problems with our team.