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M3 Surgery Clerkship
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POLICY UPDATE:
PICU Admission 2016

Surgical Educational Programs

SHADOWING:
   M1 & M2 Trauma
   All Other Shadowing

M3 SURGERY CLERKSHIP:
   Contact Info
   Overview
   Program Components
   Goals & Objectives
   Educational Resources
   e-Curriculum
   Lecture Schedule (8.21)
   M3—Call Instructions
   Honors Advice

M4 SURGERY ELECTIVES

RESIDENCY PROGRAMS:
   General Surgery
   Oral & Maxillofacial
   Plastic & Reconstructive
   Urology

FELLOWSHIPS:
  Advanced GI MIS
  Burn
  Cardiothoracic
  Critical Care
  Surgical Oncology
  Transplant Surgery
  Vascular Surgery

ADDITIONAL LINKS:
   Simulation Center
   CME Office
   All About RVA

RESOURCES:
   Surgery Library Guide
   Surgery Intranet (GSW)

Program Components

I. CEI SESSIONS/DIDACTIC SEMINARS:

The schedule is posted on the VCU SoM eCurriculum Portal.  Cancellations and re-scheduling are expected due to the nature of this field.  If made aware, the Clerkship Coordinator Office informs students of changes/cancellations via text, paging and/or email, time permitting.

NOTE: If a scheduled lecturer isn’t in attendance for his/her lecture, contact the Clerkship Coordinator Office and/or text-page Dr Aquilina 0r Dr. Kale.

  • Didactic Lectures: The lectures are held weekly on Tuesdays and Thursdays starting at 3:00 PM or 4:00PM in the MIS Center, located in the Gateway Basement (attached to the main hospital). It is required that the student review lectures online (VCU SoM eCurriculum Portal) prior to the scheduled lecture or prepare using WISE-MD or outside reading. The objective is to promote interactive case discussions.

    For each Didactic Lecture students will be divided up by the Clerkship Coordinator to answer a three question evaluation on their assigned lecture. The day of the lecture each student will receive an email from Survey Monkey that will have a link for them to complete the “M3 Surgery Clerkship Lecture Evaluation.” Please complete the evaluation within 24 hours of the lecture. Please let the Clerkship Coordinator know if you have any questions.

  • CEI Seminars: Topics include H&Ps, Foley Insertion, Abdominal Imaging, NG Tube Insertion, Suture and Knot Tying Workshop, and Patient Perspective on Surgery and Surgical Complications. For H&P seminars, student is assigned to different instructors based on his/her GS month. An H&P can be on various types of surgical patients (e.g., Pre- Post-op, Clinic, etc.). One H&P will be completed during your General Surgery month and one H&P will be during one of your sub-sub-specialty rotations (2 H&P’s total while on Surgery).

INSTRUCTORS:

Dr. James Bittner: CEI group includes MCV Bariatric & Gastrointestinal students. Student is required to email Dr. Bittner a completed H&P. Dr. Bittner reviews and discusses with student during clinic or after Tuesday morning conference.

Dr. Charles Bagwell: CEI group includes MCV Pediatric students. Student is required to email Dr. Bagwell a completed H&P and ask when it is best to review and discuss.

Dr. Jeannie Savas: CEI group includes VA GS students.  Student is required to bring an H&P to Dr. Savas’s session.  Dr. Savas to give student input at that session.

Dr. Brian Kaplan: CEI group includes MCV Surgical Oncology students. No prior H&P is needed. Student is required to attend H&P session with Dr. Kaplan. Please contact Dr. Kaplan as to when the session will be held during your time on service.

Dr. Alan Rossi: CEI group includes MCV Acute Care Surgical Services students. Student is required to bring an H&P to the session. Session will be set up by students at a mutually convenient time. Dr. Rossi is to give student input at that session.  

Dr. Amit Sharma: CEI group includes Transplant students. Student is required to email Dr. Sharma a completed H&P and ask when it is best to review and discuss.

Drs. Gretchen Aquilina or Santosh Kale: CEI group includes sub-specialty students. Email a completed H&P to Clerkship Coordinator for review. Drs. Aquilina or Kale will make comments and you will be able to pick up from the Clerkship Coordinator.

II. CONFERENCES:

  • M & M starts at 7:30 am and Grand Rounds is not every week but randomly throughout the year. Basic Science at 6:30 am and it is optional for students to attend.

III. PHLEBOTOMY EXPERIENCE:

Student is required to take an onsite Phlebotomy Course in the Blood Lab at the VA Hospital.  The Blood Lab is located in Area 1B.  Student receives an automatic email regarding training and sign-on during the first week of his/her rotation.  The Phlebotomy Schedule is included in the GS Clerkship Orientation packet.  Student MUST pass both test courses and print out the certificate to present to the Lab prior to his/her “hands-on” training.  If student finds that there is a conflict with the time and date that he/she has been scheduled, contact the Clerkship Coordinator first.  The Lab Manager can be reached at 804/675-5000, ext. 4477

V. CALL RESPONSIBILITIES:

  • Trauma/Acute Care General Surgery Call

Students not on the Trauma/Acute Care General Surgery (AGS) Service take 12-hour call shifts beginning at 7:00 PM on Friday and ending at 7:00 PM on Sunday. One student is assigned to Trauma/Critical Care Service as Trauma Night Float (TNF) Sunday to Thursday nights. There is no call on Orientation Monday. On-call student must sign on to the Virtual Pager (9102) – other students sign on to the trauma call list.

On the FRIDAY to SUNDAY call nights, one student will be assigned to the GENERAL SURGERY (POG – pager 9993) (CTV – pager 9994) (consult) team. The consult team can also be found by referring to the resident call schedule.

The other students will be on the trauma team.  

  • Call Schedules

Call Schedules are distributed at orientation. Copies of all call schedules should be posted in the Trauma Bay and in the STICU Resident Room.

  • Medical Student Duty Hours

Medical students share the same work hour restrictions as Surgery Residents (PGY 2 and above).

1. On duty no more than 80 hours/week (averaged over 4 weeks)
2. No more than 30 consecutive hours on duty
3. 1 day out of 7 free from all clinical responsibilities

*Students are not expected to attend Thursday afternoon didactics while on night float.

NOTE: Students are not “off” between the 2 and 4-week rotations.  Students are expected to come in and round.  The 2 and 4-week rotations do not end at 5:00 PM on Friday.  The rotation officially ends at 5:00 PM on Friday of the last week of the rotation.  Communicate with your team’s Chief Resident about rounding on the weekends.

VI. VIRTUAL PAGER:

Virtual Pager coverage for MCVH Trauma/GS Call

  1. From any hospital computer, open web browser and go to http://paging.mcvh-vcu.edu.
  2. Select “Personal Profile” from menu on right side of the screen.
  3. At the “Login Box”, enter Pager ID (9102) in ‘User ID’ field.
  4. Enter 19102 in ‘Password’ field.
  5. Click “Sign In” button.  This takes student to “Personal Profile” page.
  6. At “Personal Profile” page, click “Exception” tab.
  7. Select “Coverage”, then “Continue” button.
  8. The “Exception Box” pops up:
    • Make sure Exception Type is “Coverage”.
    • Enter covering pager’s ID.
    • Enter Start Date and Time.
    • Enter End Date and Time.
    • Make sure that the Time Zone field is correct (e.g., Eastern).
    • Click “Save” button.

To schedule additional coverage changes, repeat steps 7 and 8

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VII. CONTACTS FOR GENERAL SERVICES:

Check in with Service Coordinator at the beginning of each 2 or 4 week rotation.

General Service
Acute Care Surgical Services (MCV) Jennifer Quinney, Divisional Coordinator, West 15, East Wing, phone 827-1207
Bariatric & Gastrointestinal Surgery (MCV) Rachel Wilson, Division Manager, ACC 6th Floor, phone 628-3626
General Surgery (VA) Barbara Strange, VA Room 2F-103, phone 675-5000 ext 5404, Cassandra McMillan, VA Room 2K-129 phone 675-5249 or Contact the Chief Resident for service (see locations below)
Pediatric Surgery (MCV) Rochelle Murtaza, Divisional Coordinator, Sanger Hall, Room 8-013, phone 628-0040
Surgical Oncology (MCV) Ann Whitaker, Divisional Coordinator, West 7, West Wing, phone 828-9322                                                          
Transplant Surgery (MCV) Natasha Williams, Transplant Coordinator, West 9, South Wing, Room 9-307 phone 828-8048 or Joyce Williams, phone 828-2461
Sub-specialty Service
Cardiothoracic Surgery (MCV) Kimberly Lettmann, Divisionall Coordinator, West 7, South Wing, phone 828-4620
Cardiothoracic Surgery (VA) Gregory Labenz, Med Support Asst., Room: 2F-176
phone 675-5403
Antoinette Chase, Admin Officer, Room: 2F-176
phone 675-5403
or Contact the Chief Resident for service (locations below)
Neurosurgery (MCV) Sharon Mann, Educational Coordinator, Sanger Hall, phone 838-2437
Neurosurgery (VA) Sharon Mann, Educational Coordinator, Sanger Hall, phone 838-2437
Sub-specialty Service, cont.
Ophthalmology Brenda Ayala, Scheduling Coordinator, Nelson 4, Suite 439,
phone 828-5208
Orthopedic Surgery (MCV) Amber Cox, West 9, North Wing, phone 827-1204
Otolaryngology (MCV) JoAnn Hendren, West 12, South Wing, phone 828-3966
Plastic Surgery Rhonda Atkinson, Residency Coordinator, West 16, North Wing, Phone 828-3039
Urology (MCV) Agnieszka Fandrejewska, Residency Coordinator, West 7, East Wing, phone 628-1559
Vascular Surgery (MCV) Lita Tucker, Educational Coordinator , West 16, East Wing,
phone 828-3211
Vascular Surgery (VA) Barbara Strange, VA Room 2F-103, phone 675-5000 ext5404, Cassandra McMillan, VA Room 2K-129, phone 675-5249 or Contact the Chief Resident for service (see locations below)
VAMC Campus Resident Rooms
General Surgery Residents Room 2E-171 (ext. 2126, 2326, 2471) or Section 2A-180 (ext. 4098)
Cardiothoracic Residents Room 2F-171 (ext. 5403)
Neurosurgery Residents Room 2E-161 (ext. 4087)
Urology Residents Room 2F-181 (ext. 5409) or Room 1T158
Orthopedic Residents Room 1K-153 (ext. 4143)

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VIII. STUDENT LIAISON:

The Liaison outlines service expectations and discusses learning objectives, as well as what the student can expect to gain from the rotation.

General Surgery Clerkship Directors Dr. Gretchen Aquilina
Dr. Santosh Kale
827-0045
828-3033
General Surgery MCVH Dr. James Bittner 827-0045
Surgical Oncology Dr. Brian Kaplan 828-3250
Acute Care Surgical Services Dr. Alan Rossi 827-1207
General Surgery VAMC Dr. Jeannie Savas 675-5112

IX. PASSPORT REPORT ENTRIES:

Throughout the GS Clerkship rotation, required core clinical skills and Passport System-required items must be listed in the Practical Learning Experiences Section of the SoM Passport System. Items must be completed by the last day of the rotation. If the Student Passport is not completed by the end of the 8 week rotation, he/she receives an incomplete grade until it is completed.

Core Clinical Skills: The Clerkship Coordinator inputs necessary clinical skill information such as NG tube placement, Foley insertion and suturing. You must complete the rest of the core clinical skills and input them yourself.

X. COMPUTER CODES at VA:

A student assigned to the VA for his/her 2 or 4-week rotation needs to attend Computer Training for the VA. If his/her VA computer codes are still active from a prior rotation, he/she does not have to attend the training session. Computer training starts promptly at 1:00 PM at the VA in Room 2L-151 on Orientation Monday.

XI. PARKING:

  • MCV Campus: Students are issued a parking pass through the VCU Parking Office for N-Deck ONLY while rotating on his/her GS month (e.g., Surgical Oncology, Acute Care, Pediatric, Transplant, MCV/VA GS). Students will only be issued a parking pass through VCU if they have purchased a VCU parking pass for that semester/year. Parking passes are issued on Orientation Day. When rotating on sub-specialty month, the Parking Office may issue student a parking pass to another parking facility if there are available spaces.

    • DO NOT PARK ON N-DECK IF NOT ROTATING ON GS — VEHICLE MAY BE TOWED.

  • VA Campus: Students are issued a parking pass through the VA Police Department located on the Main Floor of the hospital while rotating on his/her her GS month.  Parking passes are issued on Orientation Day.  When rotating on sub-specialty month, the Police Department may issue student a parking pass if there are available spaces.

XII. STUDENT LOCKERS

  • MCV Campus: Lockers are located in the Sunshine Hallway on Main 5.  Student must bring own lock to put on locker and should remove lock no later than 5:00 PM on the last Friday of GS rotation.

  • VA Campus: Lockers and uniform machine are located in the OR Surgery Locker Room and available to all students/staff.  Student must bring own lock to put on locker and should remove lock no later than 5:00 PM on the last Friday of GS rotation.

XIII. AWAY INSTITUTIONS (AIs):

A 3rd year medical student should be covering all cases however; this is strictly determined by each division. A 4th year medical student from an outside institution should be given a chance to go to the Operating Room (OR) and is given the same priority as a 3rd year student. An AIs primary responsibility is floor (intern) work. AIs should cover cases if 3rd year students are unavailable due to exams, lectures or other reasons.

XIV. TRAUMA & ACUTE CARE GENERAL SURGERY:

  1. There are three or four students at a time on Trauma and AGS.  During each week, one student is assigned as TNF and one to AGS, leaving the remaining students on Daytime Trauma.

  2. The Trauma and AGS students function under the same group of Attendings, but each team has a different team of Residents.

  3. The Daytime Trauma student rotates with the Trauma Team and the AGS student with the AGS Team.

  4. AGS cases should be covered by AGS student, and Trauma cases by Trauma student.

  5. All day time students (Trauma and AGS) attend clinic and all Trauma/AGS conferences, unless otherwise directed to go to the OR.

  6. Please make an effort to ensure every case is covered.  This requires attention to daily operations of the service as cases may sometimes go “out of sequence.”

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XV. RESOURCES for SUCCESS:

  • Be Present:

— Access the OR Schedule using Discern Explorer

  • Outside Reading:

It is impossible to over-emphasize the importance of regular, attentive reading.  The ultimate responsibility to learn a great deal of material rests with the student.  The recommended textbook for the 8-week GS Clerkship rotation is “NMS CASEBOOK” by Bruce E. Jarrell.

  • WISE-MD:

WISE-MD is a system of online case modules and an invaluable resource for learning outside of the OR.  It can be accessed from any computer with Internet access. 

    To login to WISE-MD:

    1. Go to med-u.org.
    2. Click on WISE-MD.
    3. Click on login to cases.
    4. Click on first time users.
    5. Create an account with VCU.edu email address.
    6. Click on the link in his/her email to confirm registration.
    7. Select course (WISE-MD) to proceed.

WISE-MD can be used to supplement reading and preparation for certain lectures. Please refer to the lecture schedule for specific lectures which can be supplemented by WISE-MD. For technical issues with WISE-MD, please contact Katherine Tucker of the Curriculum Innovation Resource Center via email at kjtucker@vcu.edu. Students receive 1 hour of protected time as part of the Thursday after afternoon lecture series in order to prepare for the cases (study hall).  This block of time can be dedicated to independent study or WISE-MD. Suggested cases include Burn, Bowel Obstruction, Lung Cancer and Skin Cancer.

  • Learn what it means to be a surgeon.  This is accomplished by becoming a part of the Surgery Team, observing surgical faculty and residents, and being actively involved in all aspects of pre-operative, operative and post-operative patient care.

  • Learn how to think as a surgeon.  Student should be intellectually engaged in clinical decision-making in regard to the patients for whom he/she has primary responsibility. Student should pay close attention on rounds and in the OR, as well as in all conferences that he/she attends as part of the Surgery Team. Ask questions!!!

XVI. GRADING & EVALUATION:

  • At the end of each clinical rotation, Faculty, Fellows, Residents and Nurse Practitioners (NPs) from that service meet and complete a single composite evaluation for each student.  The Clerkship Committee then meets to determine grades.  The Committee reviews T-scores, written comments and Shelf Exam scores, as well as research project write-ups.  Student must pass each major grading component in order to pass the Department of Surgery Clerkship.  Grading is computed as follows:

Grading is computed as follows:

General Surgery 4-week block 30%
NBME Shelf Exam 30%
Sub-speciality 2 week blocks 30% (15% for each block)
Completion of 4 WISE-MD Cases 10%
Professionalism, attendance, H&P completion and EbM write-up Pass or Fail
  • The M3 GS Clerkship has the following criteria for Honors and High Pass:

    1. Honors—Must get at least a raw score of 80 on the Shelf Exam with excellent evaluations.
    2. High Pass—Must get at least a raw score of 70 on the Shelf Exam.

  • Professionalism concerns, including poor attendance at conferences, turning in projects late, and failing to complete an Exception Form and notifying the Clerkship Coordinator of absences may be grounds for lowering a student’s overall grade.

  • A Mid-point Evaluation Form should be obtained by the student, preferably during his/her GS month.  The form is available on the VCU SoM eCurriculum Portal under FORMS, and should be discussed with a faculty member or Chief Resident. Students are required to turn in evaluations to the Clerkship Coordinator at time of exam (or prior).

  • Grades are reviewed by the Clerkship Committee and are rarely changed.  If the student feels he/she has a legitimate concern regarding their final grade, a request must be submitted in writing to the Clerkship Coordinator with a legitimate reason. Dr. Anand decides whether the request is worthy of a formal appeal. There is a process for appeals.  Please follow it!

XVII. SHELF EXAM:

Refer to—

http://www.nbme.org/pdf/SubjectExams/SE_ContentOutlineandSampleItems.pdf

 in order to review sample questions and formats in preparation for the Department of Surgery Shelf Exam.

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  last updated: 07/15/2015

 

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