Modular curriculum for undergraduate medical students

Department: Surgery

Program: Undergraduate medical education

Module title: Surgery I

Module code/ number: SURG 3011 (ECTS 14)

Duration: 11 weeks in Year III

Number of students:

Prerequisite modules: Completion of clinical methods and communication skills module.

Learning outcomes: By the end of this module, student will be able to:

• Take relevant history, do important physical examination & reach to relevant clinical diagnosis of common surgical problems.
• List differential diagnosis of common surgical diseases.
• Suggest relevant investigation of common surgical problems.
• Should be able to communicate effectively with patients, relatives and Colleagues including in other disciplines and senior faculty.
• Should effectively work in collaboration with health care team.
• Should be able to contribute to effectiveness of the health care organization and serve in administration and leadership role.
• Should be advocate of the wellbeing of individuals, communities and the general populous.
• Should be willing to take part in Continuous Professional Development to maintain high level of Clinical knowledge and Competence, and critically evaluate information and its sources to apply it appropriately to practice decision.
• Should demonstrate commitment to patents and professionalism through Sound ethical practice; make the care of patients their priority; treat them with politeness, dignity and respect.

Assessment criteria

Progressive Assessment [40%]

• Punctuality will be graded out of 5 (lateness on any session will be punished by deduction of 1 point for each session – a maximum of 5 points)
  • Mark “ L” on the attendance sheet per rounds/ bedsides

 

• Appearance will be graded out of 5 (lack of cleanliness, dressing and hair styles deemed inappropriate will be punished by deduction of 1 point for each incident -a maximum of 5 points]
• Mark “ P” for poor appearance per round / bed side

 

• Attitudewill be graded out of 5 [lack of preparation, dedication on Teaching Rounds, Bedsides, and /or lack of respect will be punished by deduction of 1 point for each incident- a maximum of 5 points]
  • Mark “ A” on the attendance sheet per rounds/ bedsides

Preceptorship will be graded out of 15 [sub-components specified on the guideline]

Mid Attachment Exam will be graded out of 5

Pre-Seminar tests will be graded out of 5

Written examination – 20%

Oral, practical examination, OSCE -40%

NB: A student absent for three sessions will not sit for exam.

• Mark “ X” on the attendance sheet per rounds/ bedsides

Module calendar:

Module will be offered for 11 weeks during year III. Students will rotate in the various wards and units during the 11 weeks of attachment. Lectures will be given 5 days per week with weekly seminars.

Time Table

	Week I	Week II-X	Week XI
Monday	orientation grouping, briefing in BLH and other hospitals Pt. clerking	Lectures Bedside/round 1hr OR	Written exam
Tuesday	Lecture [8- 9 am]1hr Teaching rounds 1hr Bedside teaching 1hr Patient clerking	Lectures Bedside/round OR Seminars 2hrs	Revision round
Wednesday	Pt. clerking reading and contact with preceptors	Lectures pt. clerking studying	Revision round
Thursday	Lecture 8- 9 am Teaching rounds Bedside teaching Patient clerking	Lectures Round/Bedside OR	Practical exam
Friday	Lecture 8- 9 am Teaching rounds Bedside teaching Patient clerking	Lectures Bedside/round OR Seminars	Practical exam

Pt. clerking

 

Lectures Bedside/round 1hr

ORWritten examTuesdayLecture [8- 9 am]1hr

Teaching rounds 1hr

Bedside teaching 1hr

Patient clerking

Lectures

Bedside/round

OR

Seminars 2hrsRevision roundWednesdayPt. clerking reading and contact with preceptorsLectures pt. clerking studyingRevision roundThursdayLecture 8- 9 am

Teaching rounds

Bedside teaching

Patient clerkingLectures Round/Bedside

ORPractical examFridayLecture 8- 9 am

Teaching rounds

Bedside teaching

Patient clerkingLectures Bedside/round

OR SeminarsPractical exam

 

1. There will be one week of Skills Lab basic surgical Skill training in the weeks 2-10

Rationale for preceptorship:

Although learning in a preceptorship takes place in a less structured atmosphere than the classroom, the educational experience can be as rewarding and enriching as a classroom or clinical teaching sessions [bedside, rounds, etc]. The preceptorship gives both the student and the teacher a platform to know each other well and deal with clinical, academic and/or social issues concerning the student.

1. Preceptorship, in this context, is not meant to replace the day to day routine teaching – learning activity. It is put in place to supplement it.

The stakeholders of preceptorship:

1. Undergraduate medical students coming to the department of surgery, especially clinical Year I students
2. The specialist MDs in the department
3. The Department of Surgery

The responsibilities of the preceptor:

1. The preceptor should orient students on the facility and activities of the department and what is expected of them.
2. The preceptor holds regular session with students during their attachmentin the department of surgery.
3. The preceptor can reschedule the time and place of the preceptorship if need arises.
4. The timing of the preceptorshipfalls within the discretion of the preceptor as long as it is within working hours and does not interfere with the routine teaching- learning activities of the students.
5. The preceptor, through guidance and teaching,should help students perfect their skills in history taking, physical examination, effective communication, clinical record keeping and reporting in surgery.
6. The preceptor, through guidance and teaching, helps students in problem assessment and developing solutions.
7. The preceptor should give feedback to students in time [e.g. case report, assignments, questions…etc]
8. The preceptor submits the evaluation grades of students to the department within 2 days of the completion of the attachment.
9. The preceptor identifies students who may need special attention and communicatesthe situation with the undergraduate committee.

Responsibilities of the student

1. The student should be present on time for the scheduled sessions.
2. The representative of the students should in advance inform the preceptor if there is a need to reschedule the sessions.
3. A student should get the preceptor’s permission for absence from the preceptorship unless the absence is forced [e.g. serious illness].
4. The student should be prepared for the scheduled session.
5. The student should not practice plagiarism in any of the assignments, case reports, etc.
6. The student should submit assignments, case reports, etc on time.
7. The student should seek feedback and be receptive to coaching, feedback and evaluation.
8. The student should respect and interact courteously with the preceptor.
9. The student should follow the dressing code of the school.

 

Reading materials:

1. Bailey & Love’s short practice of surgery
2. Schwartz textbook of surgery
3. Sabiston’s, textbook of surgery
4. SRB’s manual of Surgery

Post graduate seminar and tutorial topics

Thoracic Surgery

• Physiology of respiration and lung function and its assessment
• Diagnostic work up of Thoracic Surgery patients
• Anatomy of trachea bronchus and lungs
• Spontaneous pneumothorax pulmonary cysts, bullae & blebs
• Micro flora of the respiratory tract
• Pulmonary suppuration empyema, lung abscess, bronchiectasis
• Pathology of lung tumors
• Lung cancer and carcinoids
• Pathology of lung TB
• Lung Tb clinical Features and Surgical management
• Pathology of mediastinal tumors
• Management of mediastinal tumors
• Pathology of esophageal disease
• Carcinoma of the esophagus and achalasia
• Anatomy of thoracic wall, diaphragm, mediastinal structures and the heart
• Management of chest injuries

Neurosurgery  

• Brain and Peripheral Nerve Anatomy
• Neurologic Assessment
• Management of head injuries
• Ventricle Anatomy and CSF Physiology
• Hydrocephalus
• Spinal Cord Anatomy
• Management of spinal cord injuries
• Embryology of Neural tissue and neural Tube Defect
• CNS tumors & management
• Degenerative diseases of the cervical & lumbar spine

Abdominal Surgery

• Physiology of gastric motility and digestion
• PUD management, emphasis on Surgery
• Pathology of gastric cancer
• Gastric cancer management
• Anatomy of stomach and duodenum
• Vagotomy and drainage procedures techniques and complication
• Clinical pathology and physiology of the liver and biliary tract
• Gallbladder disease management and cholecystectomy techniques and complications
• Anatomy of biliary tract, duodenum and pancreas
• Pancreatic Cancer management (curative and palliative options)
• Anatomy of the liver, spleen, bowel and retroperitoneal major vessels
• Abdominal trauma management
• Microbiology of the GI tract
• Abdominal sepsis and peritonitis management
• Pathology of Colorectal cancer
• colorectal cancer management
• Anatomy of the anorectum and pelvic floor
• Management of hemorrhoids, perianal fistulas, anal fissure, and rectal prolapse
• Anatomy of the abdominal wall and inguinal region
• Groin and abdominal wall hernias operative Management
• Physiology of absorption and motility of Intestine
• Intestinal obstruction management in adults

Endocrine Surgery

• Physiology of thyroid gland
• Management of hyperthyroidism
• Anatomy of thyroid & parathyroid gland
• Management of thyroid Ca
• Anatomy & physiology of Breast
• Breast Ca management
• Anatomy & physiology of adrenals
• Cushing syndrome and pheochromocytoma

Pediatrics Surgery

• Fluid and electrolyte physiology in children
• Fluid & electrolyte management of pediatric surgical patient
• Pathology of childhood abdominal tumors
• Approach to abdominal masses in children
• Embryologic basis of GI malformation and malrotation
• Logical approach to acute abdomen in a child
• Embryology of GUT malformations
• Management of undescended testis and acute scrotum in a child
• Physiologic disturbances in surgical causes of respiratory distress
• Management Surgical causes of neonatal respiratory distress
• Embryology of Abdominal wall defect
• Management of Abdominal wall defect

Plastics and reconstructive Surgery

• Wound healing
• Burn management
• Anatomy of Blood supply of skin & Muscle
• Principles of skin graft & flaps
• Common Skin tumors (Sq cell ca. Basal cell ca. malignant melanoma)
• Embryology of the head & neck
• Cleft lip & Palate
• Surgical anatomy of the head & neck
• Head & neck tumors (Parotid tumor)
• The role of skin in thermoregulation and lymphedema
• Surgical anatomy of the hand
• Management of Acute Hand injury
• Management of Vascular Anomalies
• Pressure sore

 

Basic principles of surgery

• Preoperative care emergency & elective with Condition including DM,HTN
• Organization of Operation theater, prevention of infection, sterilization, Disinfection
• Equipment, instrument& suture Materials
• General principle of management of trauma
• Physiologic response to trauma
• Cancer Biology & Management Principles
• Review of surgical infection
• Antibiotic Use in Surgery: Prophylactic &Therapeutic
• Septic shock
• General Principle of Anesthesia
• Shock: General Principle & Classification
• Hypovolemic Shock Causes, pathophysiology&
• Blood Transfusion & Plasma Substitute & Their Complication
• Management
• Coagulation Disorder & Management
• Postoperative Complications
• Multiple Organ Failure
• Management of Wound
• Fluid & Electrolyte in Children
• Nutritional Assessment & Management of Surgical Pts
• Physiology of Wound Healing
• Fluid & Electrolyte Disturbance in Surgical Pt