LUMEN - Surgery

Surgery

During each general surgical and subspecialty assignment, the student will be required to work-up patients and discuss findings with the resident and/or attending. The format for this exercise will include:

Case History:

Taking a history and physical.
Establishing a probable diagnosis and differential diagnosis.
Plan for laboratory and x-ray testing if appropriate, to confirm diagnosis.
Treatment plan including appropriate orders.
Plan for patient education regarding their illness.

This format will be adhered to with each work-up so that maximum teaching and dialogue may occur between faculty and student in a uniform manner at all three institutions. After completion of the patient evaluation, it will be initialed by the faculty member or senior resident and orders countersigned. It can then be entered in the hospital chart and the remainder of the format included in the progress notes. A minimum of three formal workups should be done each week during the Surgery Clerkship.

The student will be expected to choose one H&P to write up and present to the attending for that case. The student should also write a brief monograph about one aspect of the disease process for that patient. It will be the student's responsibility to make an appointment with the attending for this. The attending will then fill out an evaluation form. The student should turn their H&P and evaluation form to the clerkship director or the education office in the surgery department.

Progress Notes:

Progress Notes, when entered in the chart, should follow a standardized format (see Appendix II). Student notes will be countersigned by housestaff or faculty.

The Surgical Team:

Each student will be assigned to two general surgical services. His/her interaction with each member of the hospital team will determine the quality and ease of learning while "on the floors."
The student, although recognized by faculty and housestaff as an integral and important member of the surgical team, is perceived by the public somewhat differently. Because of this, it is of the utmost importance that any exchange between patient and student, or student and family, be done with discretion and good sense. If any difficulty should arise it should be brought to the immediate attention of the senior resident or the attending.
The senior resident will be responsible for the assignment of duties on a day-to-day basis; these include assignment of patient evaluations and various floor duties. He/she will be responsible for the teaching of fundamental skills, fostering of an open dialogue between housestaff and students and assuring that the acquisition of knowledge is the foremost consideration in having students on any clinical service. The student should seek advice from the senior resident regarding problems on the clinical service.

Return to top

Previous Page