Medical University of the Americas

Course Syllabus
SURGERY
Required Clerkship
Length: 12 Weeks
Administrative Contacts: Executive Dean: Dr. Gordon Green, MD, FRCP(C), FAAP
Assistant Dean of Clinical Medicine:
Lucille Collins, Ph.D., clinicalcoordinator@mua.edu
Clinical Coordinator:
Michelle Malahay, michelle.m@mua.edu
Evaluations:
Melissa Moore, melissaclinical@mua.edu
Clinical core course assignments:
Jo-Anne Noonan, j.noonan@mua.edu

Introduction:

This is a twelve week Core Rotation that provides the groundwork for patient centered learning by
employing a degree of exposure and understanding to a number of common disease entities and
procedures.

During the course of this training period students are also expected develop their understanding and
competency in the areas of patient care, medical knowledge, practice-based learning, professionalism,
interpersonal and communication skills, and system-based learning. They will be exposed to the
management of patients with the expectation of enhancing their understanding of disease diagnosis and
prevention.

Core Clerkship Objectives:

Competencies: Demonstration of understanding and competency in the following areas relating to

practice-based learning. Each student should be able to:
¾ Interact at an acceptable level with patients while conducting interviews,
examinations, and procedures.
¾ Demonstrate medical knowledge and the ability to correlate clinical
situations with the mechanisms of disease.
¾ Use scientific data in patient care, and display initiative in learning.
¾ Demonstrate professionalism with patients, staff, and attending, including
the ability to acknowledge errors and accept criticism.
¾ Communicate proficiently verbally, non-verbally, and in writing with
patients and their families.
¾ Utilize systems of care and outside resources in effective patient care and
management.
¾ Demonstrate the ability to apply principles of anatomy and pathology to the
practice of Surgery
¾ Understand the principles of the Mortality and Morbidity Conference
 MUA Core Rotation Syllabus – SURGERY

Core Clerkship Objectives (continued):

Competencies: ¾ Demonstrate proficiency with imaging interpretation and surgical decision

making
¾ Understand the preoperative visit, surgical risk assessment and the
postoperative visit from the patient and family and attending perspectives
¾ Become proficient with basic procedural techniques

Disease Entities: Familiarization with the most prevalent diseases, and with the essentials of
structured thinking that leads to the diagnosis and formulation of management
plans. Including, but not limited to:
• CARDIAC DISEASE
Coronary artery disease, valvular disease, end stage heart disease, pericardial
disease
• VASCULAR DISEASE
Aortic aneurysm, aorto-iliac artery stenosis, carotid artery stenosis, renal artery
stenosis, GI ischemia, peripheral arterial disease, peripheral venous disease
• ENDOCRINOLOGY AND METABOLISM
Adrenal disease, pituitary disease, thyroid disease, parathyroid disease
• GASTROENTEROLOGY AND HEPATOLOGY
The “acute abdomen,” acute pancreatitis, GERD, GI bleeding, peptic ulcer
disease, gallbladder disease, appendicitis, acute bowel obstruction, inflammatory
bowel disease, hernias, portal hypertension, surgery for obesity (bariatric)
• HEMATOLOGY
Splenomegaly, splenic rupture
• ONCOLOGY
Breast cancer, colon cancer, pancreatic cancer, lung cancer, prostate cancer, skin
cancer, esophageal cancer, pain management
• PULMONARY MEDICINE
Pneumothorax, pleural effusion, acute airway obstruction, pulmonary embolus,
aspiration, ARDS/VIP
• NEUROSURGERY
Subdural hematoma, subarachnoid hematoma, epidural hematoma, decreased level
of consciousness, herniated disk, acute neck injuries
• MUSCULOSKELETAL
Injuries of the hip, hand, knee, ankle, shoulder and clavicle
• SHOCK / TRAUMA
Multiple injury patient, shock (4 types), penetrating trauma, blunt trauma, burn
management, blood gas disorders, acid base disorders, hemodynamic disorder
monitoring, nutritional disorders
• SPECIAL MEDICAL PROBLEMS IN SURGICAL PATIENTS
Respiratory disease, diabetes, cardiac disease, endocrine disease,
hematological disease, renal disease, pregnancy, geriatric patients and
surgery, ethical dilemmas in surgery

Medical University of the Americas • 27 Jackson Road, Suite 302, Devens, MA 01434
Tel. 1.978.862.9500 Fax 1.978.862.9500

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 MUA Core Rotation Syllabus – SURGERY

Core Clerkship Objectives (continued):

Procedural Exposure to and/or supervised completion of the following procedures, including

Learning: but not limited to:
ƒ Preoperative risk assessment
ƒ Sterile Operating Room technique
ƒ Postoperative procedure note
ƒ Postoperative care plan
ƒ Establish an IV and draw venous blood
ƒ Paracentesis and thoracentesis
ƒ Insert and remove a nasogastric tube
ƒ Suture insertion and removal
ƒ Acute and chronic wound care
ƒ Removal of drains
ƒ Apply pulse oximeter and observe bedside spirometry (FEV1)
ƒ Measure the ankle/brachial systolic index
ƒ Observe a hand held portable echo machine in use (abdomen and chest)

Evaluation:

Prior to May 1, 2010: Students’ final grade is calculated based upon the following:

Preceptor Evaluation: A formal evaluation by the attending physician is to be completed at the end of the
Percentage of Final rotation, which will be based on performance observation and demonstration of
Score: 75% required competencies.
Final Exam:
Students are required to take the subject specific Core Clerkship Examination upon
Percentage of Final
rotation completion at an approved testing location.
Score: 25%

After May 1, 2010: Students’ final grade is calculated based upon the following:

Preceptor Evaluation: A formal evaluation by the attending physician is to be completed at the end of
Percentage of Final Score: the rotation, which will be based on performance observation and demonstration
65% of required competencies.
Final Exam:
Students are required to take the subject specific Core Clerkship Examination
Percentage of Final Score:
upon rotation completion at an approved testing location.
25%
Weekly online
Assignments: MUAcourses Completion of online assigned cases/assignments via MUA Learning
Percentage of Final Score: Management System: MUAcourses
10%

Note: The preceptor’s evaluation may include consideration of periodic quizzes, research
assignments, topic presentations, and other assignments, dependent upon the clinical site’s
organization and policies, and the structure of the clinical team that the student is assigned to.
Guiding principles will always be from recognized physician competencies (see below).

Medical University of the Americas • 27 Jackson Road, Suite 302, Devens, MA 01434
Tel. 1.978.862.9500 Fax 1.978.862.9500

Page 3 of 7
 MUA Core Rotation Syllabus – SURGERY

Competencies for Evaluation:

During the course of this training period students are expected to develop their understanding
and competency in the areas of patient care, medical knowledge, practice-based learning,
professionalism, interpersonal and communication skills, and system-based learning. Students’
proficiency in these competency areas are to be evaluated by the preceptor throughout the course
of the clerkship and reflected in their final evaluation.

Patient Care
Below
Exceeding Expectations Meeting Expectations
Expectations

Medical Logical, thorough, and efficient Elicits most pertinent patient Incomplete, illogical, superficial
histories information histories
Interviewing
Physical Complete and accurate physical Some omissions but usually complete Incomplete, inaccurate, cursory, non-
examinations and accurate directed, unreliable physical
Examination examination

Procedural Proficient at procedures and Proficient in most procedures and Lacks proficiency in basic procedures
minimizes patients’ discomfort attempts to minimize patients’
Skills discomfort

Patient Care Exceptionally conscientious in Actively participates in patient care Lacks initiative in patient care
patient care activities, sound activities activities
Skills judgment

Medical Knowledge
Below
Exceeding Expectations Meeting Expectations
Expectations

Knowledge Base Exceptional knowledge of basic and Solid fund of knowledge Limited knowledge of basic and
clinical sciences clinical sciences

Interest in Enthusiastic interest in learning Demonstrates interest in learning Minimal interest in learning
Learning
Correlation of Comprehensive understanding of Correlates knowledge with clinical Poorly correlates knowledge with
complex clinical situations and situations and mechanisms of clinical situations and
Knowledge mechanisms of disease disease mechanisms of disease

Data Use and “Manager” – uses information to “Interpreter” – attempts to interpret “Reporter” – reports data but
develop insightful plans for patient or apply information appropriate to makes no attempt to interpret or
Interpretation management level of training apply information

Medical University of the Americas • 27 Jackson Road, Suite 302, Devens, MA 01434
Tel. 1.978.862.9500 Fax 1.978.862.9500

Page 4 of 7
 MUA Core Rotation Syllabus – SURGERY

Practice-Based Learning and Improvement

Below
Exceeding Expectations Meeting Expectations
Expectations

Facilitation of Unusually proficient in facilitating Facilitates the learning of other Shows little interest in facilitating
the learning of other students and students and health care the learning of other students and
Learning health care professionals professionals health care professionals

Ability to use Effectively uses scientific studies Attempts to use scientific studies Fails to use information from
to manage information for patient to manage information for patient scientific studies to enhance
Scientific Data to care care patient care
Manage Care
Display of Initiative Self-motivated learner Usually demonstrates personal Lacks insight and personal
initiative initiative

Professionalism
Below
Exceeding Expectations Meeting Expectations
Expectations

Compassion, Integrity, Always demonstrates respect, Demonstrates respect, Lacks respect, compassion,
compassion, integrity and compassion, integrity and integrity and honesty
and Honesty honesty honesty

Reaction to Feedback Seeks and rapidly responds to Readily responds to feedback Resists or ignores feedback
feedback

Responsibility Teaches/role models responsible Displays responsible behavior Does not display responsible
behavior behavior

Patient and Staff Consistently considers the needs Considers the needs of patients, Does not consider the needs of
of patients, families and families and colleagues patients, families or colleagues
Consideration colleagues above his/her own

Acknowledgement of Willingly acknowledges errors Acknowledges errors Fails to acknowledge errors

Errors

Interpersonal and Communication Skills

Below
Exceeding Expectations Meeting Expectations
Expectations

Relationship with Establishes highly effective, Establishes effective, humanistic Does not establish adequate,
humanistic and therapeutic and therapeutic relationships effective, humanistic and
Patients and Families relationships with patients and with patients and families therapeutic relationships with
families patients and families

Listening, Verbal, and Demonstrates excellent listening, Shows adequate listening, Demonstrates inadequate
written and nonverbal written and nonverbal listening, written or nonverbal
Non-Verbal Skills communication skills communication skills communication skills

Verbal Skills w/ Demonstrates excellent verbal Has adequate verbal Has deficient verbal
communication skills with communication skills with communication skills with
Patients and Families patients and families patients and families patients and families

Interpersonal Skills w/ Always “interpersonally Relates well to patients and their Not “interpersonally engaged”
engaged” with patients and their families with patients and their families
Patients and Families families

Medical University of the Americas • 27 Jackson Road, Suite 302, Devens, MA 01434
Tel. 1.978.862.9500 Fax 1.978.862.9500

Page 5 of 7
 MUA Core Rotation Syllabus – SURGERY

Interpersonal and Communication Skills cont.

Presentation Skills Delivers well organized Delivers organized patient Delivers poorly organized patient
presentations, appropriately presentation, including most presentations. Has difficulty
tailored to the situation pertinent information with little distinguishing pertinent from
extraneous information extraneous information

Written Notes Writes exceptionally organized
notes, tailored to the situation,
Proficiency with assessments that are
consistently thoughtful and
reflect reading
Writes organized, accurate notes,
of appropriate length, with
assessments that are thoughtful
and reflect reading
Writes notes that have some
omissions or inappropriate
redundancies, showing little
application of clinical thinking or
reading

System-Based Learning
Below
Exceeding Expectations Meeting Expectations
Expectations

Outside Resource Effectively accesses/utilizes Attempts to access/utilize Unable to access/utilize outside

outside resources needed for outside resources needed for resources needed for effective
Utilization effective and efficient patient care effective and efficient patient and efficient patient care
care

Systems of Care Effectively uses systematic Attempts to use systematic Does not use systematic
approaches to reduce errors and approaches to reduce errors and approaches to reduce error and
Utilization improve patient care improve patient care improve health care

Systems of Care Enthusiastically assists in Supports development of Resists efforts to improve

developing health care systems’ activities, leading to health care systems of care
Development improvement systems’ improvement

Medical University of the Americas • 27 Jackson Road, Suite 302, Devens, MA 01434
Tel. 1.978.862.9500 Fax 1.978.862.9500

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 MUA Core Rotation Syllabus – SURGERY

Texts:

Required:

Schwartz’s Principles of Surgery, 9th Edition (Hardback)

• By: F. Charles Brunicardi (Editor), Dana K. Andersen, Timothy R. Billiar, David L. Dunn, John
G. Hunter, Jeffrey B. Matthews, Raphael B.Pollock
• Publisher: McGraw-Hill; 9th Edition (September 2009)
• ISBN-10: 007154769X ISBN-13: 978-0071547697

Recommended References:

Sabiston Textbook of Surgery, 18th Edition (Hardback)

• By: Courtney M. Townsend, Jr., R. Daniel Beauchamp, B. Mark Evers, Kenneth L. Mattox
• Publisher: W.B. Saunders Company; 18th Edition (November 2007)
• ISBN-10: 141605233X ISBN-13: 978-1416052333

Greenfield’s Surgery: Scientific Principles and Practice (Hardback)

• By: Michael W. Mulholland (Editor), Keith D. Lillimore (Editor), Gerald M. Doherty (Editor),
Ronald V. Maier (Editor), Gilbert R. Upchurch, Jr. (Editor)
• Publisher: Lippincott Williams & Wilkins; 4th Edition (December 2005)
• ISBN-10: 078175626X ISBN-13: 978-0781756266

ACS Surgery: Principles and Practices (Hardback)

• By: Wiley W. Souba, Mitchell P. Fink, Gregory J. Jurkovich, Larry P. Kaiser, William H. Pearce,
John H. Pemberton, Nathaniel J. Soper
• Publisher: WebMD Professional Publishing; Revised Edition (February 2005)
• ISBN-10: 097483274X ISBN-13: 978-0974832746

The Washington Manual of Surgery, 5th Edition (Paperback)

• By: Washington University School of Medicine Department of Surgery
• Publisher: Lippincott Williams & Wilkins; 5th Edition (December 2007)
• ISBN-10: 0781774470 ISBN-13: 978-0781774475

Medical University of the Americas • 27 Jackson Road, Suite 302, Devens, MA 01434
Tel. 1.978.862.9500 Fax 1.978.862.9500

Page 7 of 7