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Dress and act as a professional at all times. At no time should a student wear jeans. Scrubs are only for the operating room, not elsewhere.
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If you are going to miss any time from the clerkship for any reason (medical appointment, religious holiday, death in the family, interviews, etc.) you MUST inform your site director prior to your absence.
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Each student will be "on call" no more often than every fourth night. You do NOT get a day off the day after you are on call. There is NO CALL the night before the written exam or the oral exam. At each hospital, someone likely will be on call the first night. BE PREPARED!!!!
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When a student is not on call, he/she will be allowed to go home when evening rounds are completed or at 7:00 P.M. if evening rounds are not completed, whichever is earlier. No scut should be assigned to any student for performance after evening rounds.
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On the first day of the clerkship, the site director or preceptor will assign 2 or 3 patients to each student to follow. The student is responsible to present these patients to the surgical team on rounds each morning and to write daily progress notes about the patient. A surgical resident must countersign these daily progress notes.
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Students will follow all patients admitted to the hospital during their time on call. Once a patient is assigned to a student, that student will be responsible for knowing about that patient’s care, including morning presentation to the chief resident, writing the daily progress note (which requires a resident counter-signature), daytime scut, going to the operating room with that patient, and post-operative follow-up. Clearly, a student will also be responsible, but to a lesser degree, for other patients on the service. The practice of allowing the student who was on call to scrub on all cases the next day is counter-productive to the student’s education. Instead, each student should scrub on cases he/she has worked up either in clinic, the emergency room, or the hospital. If a student scrubs on a case that he/she has not worked up previously, that patient then becomes assigned to that student.
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During the day, the student’s primary responsibility is to his/her surgical team with the only exceptions being mandatory student conferences and dire emergencies.
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The students will be required to present various surgical topics to the teams. These will be short, 10-15 minute presentations and will occur once per week. Topics will be assigned based on the diagnoses and surgical procedures of the patients being followed by the student.
Each student will be required to prepare three complete history and physical examinations and to turn them in to the site surgery office. These will be reviewed by an attending surgeon and returned to the student with written comments and a grade. Please see the "Complete History and Physical" for further information. Failure to complete this requirement will result in a grade of incomplete for the rotation. If an H & P is turned in late, the grade will be lowered by one letter grade for each day it is late.
Each student will be required to complete an in-depth review of a basic surgical problem. This review will be based on an operative case on which the student has scrubbed. It will include:
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a complete history and physical examination,
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hospital course (including major details of the operation),
follow-up after hospital discharge (if possible),
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a review of the physiology and pathophysiology of the diseased organ,
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various treatments (both operative and non-operative) available for this particular condition, and the outcomes for these treatments (including possible complications).
There should be at least three appropriate references from the current literature (peer reviewed) and at least two references from standard textbooks. This review is to be turned in the last Monday of the clerkship. Failure to complete this requirement will result in a grade of incomplete for the rotation. If this review is turned in late, the grade will be lowered by one letter grade for each day it is late.
Each student will keep a log of operations he/she has scrubbed on and seen. (See attached log sheets.) Be sure to keep a coy for yourself. A copy of this case log must be submitted to your preceptor at the end of your clerkship and a copy must be presented to the exam proctor for admission to the written examination. Failure to complete this requirement will result in a grade of incomplete for the rotation. Each student should scrub on at least one operative case per day, if possible.
Unless he/she is in the operating room, a student should go to the emergency room with a resident to examine all emergency room admissions to his/her service.. The student should accompany this resident when new patients are evaluated.
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When on call, students should be paired with the consult resident and not an intern. That way, they can see and evaluate new patients.
