General Surgery

Director(s): Erik Alexander, Mark Fairweather
Prerequisites: HMS Principal Clinical Experience (Core Clinical Clerkships) or equivalent
Offered: Full time every month. Closed to Int'l student Jul- Dec
Location: BWH - Brigham and Women's Hospital (23)
Open to Exclerks: Yes (may be restricted for international students)
Description: This course will give students an in-depth experience in clinical management of patients with surgical problems, on one of the six General Surgery services at Brigham and Women’s Hospital: Surgical Oncology/Breast (Moore), Surgical Oncology/Endocrine (Chiefs), Colorectal (Zinner), GI/Minimally Invasive (Cutler), Vascular (Mannick), or Emergency General Surgery/Trauma (Cushing). Students will be contacted by the clerkship coordinator (Charity Stafford) as soon as they are confirmed for the rotation, and asked to rank the services of their choice. Students will serve as clerks on a busy general surgical service, and are expected to perform close to the level of an intern. The course will provide students the opportunity to gain experience in preoperative, intraoperative and postoperative patient management, including evaluating patients, deciding on a diagnostic and management strategy, and providing care under housestaff and faculty supervision. There will be ample opportunity to attend and participate in didactic conferences. The student will do up to 4 overnight/weekend shifts during the rotation, after discussion with the preceptor. This course assumes experience in the Core Surgery sequence at HMS or its equivalent. The elective student functions under the supervision of senior and junior residents, assisting in management of patients in clinic and on the floor, and participating actively in procedures in the operating room. Evaluation of performance and progress is based on evaluation by staff and residents. Areas of evaluation will include: organization and reporting of clinical data for patients assigned to the student, ability to interpret information to develop differential diagnoses and plans of management, professionalism in carrying out assigned tasks and interacting with the team and other care providers, efforts to contribute to the environment of learning by presentations to the team, and progress in technical areas. Feedback will be provided to students by their assigned preceptor in the middle and end of the rotation, in addition to a final debriefing session with Dr. Fairweather.
Incorporation of Basic Science Content and Evidence-Based Medicine:
Basic science, especially anatomy and physiology, is discussed daily on rounds and in conferences. Evidence based medicine is central to care, its use or absence being discussed at weekly M&M conferences and in various multidisciplinary conferences.
Grade Criteria:
Honors with Distinction: The student demonstrates above peer-level skills in data gathering and reporting, and interpretation and development of plans of management for patients in whose care they are engaged. The student demonstrates above peer-level abilities to identify the key issues in management, and initiative in seeking out information from the literature that will inform those decisions. An above-peer level of professionalism will be observed by team members and attending staff in the student's carrying out of assigned tasks and interactions with the team and other care providers. Consistent efforts will be observed in the student’s contributions to the environment of leaning by presentations to the team and progress in technical areas. Technical progress and participation in the operating room will be at or above peer-level.

Honors: The student performs above peer-level for some of the skills above, and at peer-level for others. Presentations and management plans are accurate but lack clarity and depth of understanding. Professionalism is appropriate but not exemplary. Technical skills show some progress but not to the above-peer level.

Satisfactory: The student is punctual and reliable in carrying out assigned tasks and recognized responsibilities within the team. The student has a fund of knowledge, information-gathering skills, ability to integrate information, and professional attitude at the level of an HMS third year student, according to standards set in the HMS Core Surgery Course.

Unsatisfactory: The student repeatedly fails to be punctual and is not generally engaged in completion of assigned tasks. The student fails to demonstrate a fund of knowledge, information-gathering skills, ability to integrate information, and professional attitude at the level of an HMS third year student, according to standards set in the HMS Core Surgery Course.