Course Director

M. Michael Eisenberg, M.D.

Associate Director

Nitsana Spigland, M.D.

Course Coordinator

Ingrid H. Brown

Course Goals

During this clerkship students will learn about "surgical" illnesses; irrespective of the area of medicine chosen for a career, they will be able to diagnose and plan for the care of patients who require surgery.

Course Objectives

The specific behavioral and surgical skills that a student should have mastered by the end of the Surgical clerkship include:

• Performance of a complete history and physical examination on patients hospitalized for surgical illnesses
• The writing of a complete admission note as well as daily progress notes
• The ability to interact as a professional with the patient, family, and members of the surgical team
• The ability to function as a member of the surgical team
• A gain in overall knowledge of surgical illnesses and important steps in the decision process for treating these conditions
• An understanding of the physiology of an acutely injured patient, whether this injury derives from trauma, burns, infection, or surgery itself
• Learning the basic principles governing wound care, suturing, and management of tissue infections - for example: the decision making involved in determining when an infection needs drainage vs. when antibiotics alone will suffice
• Learning how to assess an acute abdomen
• Learning about nutritional support and its role in treating severely ill patients
• Learning about the different surgical subspecialties, and the day-to-day practices of the staff surgeons in both academic and private practice settings
• Becoming familiar with some of the procedures which are important to critical care:
  1. Central lines
  2. Intubations
  3. Chest tubes

Course Description

The third year clerkship in Surgery consists of an eight-week cycle at New York Presbyterian Hospital, New York Hospital Queens or Lincoln Hospital. In addition to eight weeks of General Surgery, there is a mandatory four-week rotation in Surgical Subspecialties. You may chose one, two, or three subspecialties areas which you may pursue during this four-week period, but one week must be Anesthesia. The surgical subspecialties may be taken, all or in part, at any of the affiliated hospital groups, or at New York Presbyterian Hospital. Arrangements must be made at least 60 days in advance of beginning the clerkship with Ms. Ingrid Brown, 746-5684. Thus there are four eight-week rotations in General Surgery, and eight four-week rotations in Specialties during the course of an academic year.

Student Responsibilities

In the Surgical clerkship, student's responsibilities include:

1. Devoted participation in surgical team activities
2. History and physical examination notes on assigned patients
3. On call availability, to be determined by team leaders
4. Assigned presentations at conferences on surgical problems, including case outlines and appropriate literature reviews
5. Active prepared participation in the operating room
6. Conscientious attendance at course conferences and core lectures

Didactic Sessions

There are currently 14 core surgical lectures and approximately twice as many specialty lectures. In addition, students in the Surgical clerkship attend weekly meetings with their assigned preceptor, as well as attending teaching rounds, grand rounds, and a weekly meeting with the department chairman.

Grading, Evaluation and Examinations

Grades in Surgery are determined from a variety of sources, which include: evaluations from attendings and senior residents based upon performance on the wards, in the OR, and at teaching conferences. A portion of your grade will also come from written and oral exams, so you need to study the basics of surgery, preferably from a text and in preparation for the lectures. The weight given to each of these activities as a percentage of your grade is 50% for the service experience and 25% each for the written and oral exams. Grading for the eight week General Surgery experience will be on a Pass, High-Pass, Honors basis with the team evaluation making up half the grade and the oral and written exams each making up one quarter. A Pass-Fail system will be used for the Specialty experiences.