Surgery Clerkship

Surgery is a six-week clerkship during which students are introduced to the care of surgical patients with an emphasis on establishing a diagnosis, learning the pathophysiology of surgical diseases, participating in the treatment of surgical patients, and supporting patients before, during, and after surgery.

Course Learning Objectives:

Medical Knowledge (MK)

• (SUR1) Apply knowledge of the pathophysiology, epidemiology, and natural history of diseases in a surgical context. (MK3)
• (SUR2) Describe how altered structure and function (pathology and pathophysiology) of the body and organ systems affect surgical care, surgical outcomes and operative risk. (MK4)
• (SUR3) Describe the scientific principles underlying diagnostic methods, including laboratory and radiologic testing, and treatment approaches (pharmacologic and non-pharmacologic) that may be applied to major diseases and conditions in a surgical context. (MK5)
• (SUR4) Explain how preventive measures, health behaviors and social determinants affect disease, injury and health in surgical patients. (MK7)
• (SUR5) Demonstrate knowledge of the scientific method in establishing causation of health and disease, the utility of diagnostic modalities, and the efficacy of therapies in surgical patients. (MK8)

Patient Care (PC)

• (SUR6) Obtain essential, accurate, and age-appropriate information about surgical patients through history-taking and physical examination and the use of laboratory data, imaging, and other tests during the preoperative, intraoperative, and postoperative periods. (PC1)

• (SUR7) Obtain essential intraoperative and postoperative patient information through hemodynamic monitoring with arterial lines, central lines, transesophageal echocardiogram, etc. (PC 1)

• (SUR8) Synthesize relevant patient data to formulate an accurate diagnosis for patients during the multiple phases of surgical care. (PC2)

• (SUR9) Evaluate a patient with a presumed surgical diagnosis and develop an appropriate evaluation and management plan utilizing patient information and preferences, evidence-based medicine and clinical judgment. (PC3)

• (SUR10) Manage patients during the preoperative, intraoperative, and postoperative phases of care including recognition of common postoperative complications (ex. AKI, respiratory failure, infection, DVT, anemia, malnutrition, nausea/emesis, shock, and wound complications), assessment and management of volume status, management of blood pressure, and management of perioperative pain. (PC3)

• (SUR11) Call a consult for surgical patients with a presumed medical diagnosis (ex. infectious, cardiac, renal disease, etc.) and follow up on patient progress and outcomes. (PC4)

• (SUR12) Counsel, educate, and partner with patients and families to address acute and chronic ;surgical conditions. (PC5)

• (SUR 13) Perform routine procedures for surgical patients. (PC7)

  • Perform a preoperative risk assessment including the cardiac, pulmonary, nutritional status of a surgical patient.

  • Obtain informed consent.

  • Discuss anesthetic options and management with surgical patients including general anesthesia, conscious sedation, regional block, spinal anesthesia, and airway management (ex. intubation, tracheostomy).

  • Demonstrate appropriate sterile technique.

  • Evaluate and dress a surgical wound including assessment of healing status and infection.

  • Discuss appropriate narcotic dosing and multimodal pain management options.

Communication Skills (CS)

• (SUR14) Communicate effectively with the patient, patient's family, colleagues and other health care professionals through the use of active listening and appropriate verbal, nonverbal and written skills. (CS1)
• (SUR15) Present patient information to the surgical team and consulting teams in a fluid, concise manner. (CS1)
• (SUR16) Foster therapeutic and ethically sound relationships with surgical patients through respect, empathy and support of emotions. (CS2)
• (SUR17) Demonstrate sensitivity, honesty, and compassion in difficult conversations, including those about death, end of life, surgical complications, bad news, disclosure of errors, and other sensitive topics. (CS3)

Professionalism (PR)

• (SUR18) Demonstrate honesty, integrity, respect, and compassion in all interactions with patients, peers, faculty, staff, and other health care professionals in all settings including about medical ability and in documentation. (PR1)
• (SUR19) Demonstrate ethical, patient-centered decision-making and respect for the confidentiality of patient information in all settings (i.e., clinical, academic, electronic or web-based.) (PR2)
• (SUR20) Demonstrate sensitivity and responsiveness to the personhood of the patient considerate of culture, race, ethnicity, spirituality, gender, sexual orientation, age, physical characteristics, medical condition, disabilities, socioeconomic status, family-context and other aspects of personal and health beliefs, practices and decisions. (PR3)
• (SUR21) Demonstrate accountability for academic, patient care and professional responsibilities (PR4)
• (SUR22) Demonstrate responsiveness to patient needs that supersedes self-interest. (PR5)

Personal and Professional Development (PD)

• (SUR23) Acknowledge personal limitations and mistakes openly and honestly, seek and respond to feedback in a positive way, and demonstrate flexibility and maturity in adjusting one's behavior. (PD1)
• (SUR24) Demonstrate strategies for analyzing, identifying and improving personal deficiencies in knowledge and skills by setting learning and improvement goals. (PD2)

Practice-based and Lifelong Learning (PL)

• (SUR25)& Demonstrate the ability to retrieve, critically appraise, and integrate current, evidence-based biomedical information into the care of a surgical patient. (PL3)
• (SUR26) Apply principles of medical informatics, patient safety and quality improvement to enhance patient care. (PL4)

Systems-based Learning (SL)

• (SUR27) Describe health disparities and health care disparities and how they affect surgical patients. (SL4)

Interprofessional Collaboration (IP)

• (SUR28) Define the roles and responsibilities of various health professionals in the healthcare team. (IP1)
• (SUR29) Work with other health professionals in the operating room and during postoperative care of surgical patients to establish and maintain a climate of mutual respect, dignity, comprehensive, ethical integrity, and trust. (IP2)
• (SUR30) Communicate effectively and respectfully with other health professionals in a responsive and responsible manner while caring for surgical patients. (IP3)
• (SUR31) Collaborate with other health professionals and health care teams to discuss physical therapy and occupational therapy discharge recommendations, discuss medication dosing, and discuss discharge planning. (IP4)

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