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Catalog 2016-2017
Louisiana State University Health Sciences Center
   
 
  Dec 18, 2017
 
 
    
Catalog 2016-2017

SELECT SISRA - Inpatient Acting Internship in Surgery


DIRECTOR FOURTH YEAR DEPARTMENT COURSES: F. Dean Griffen, M.D.
SELECTIVE CATEGORY: Inpatient Acting Internship (A. elective surgery, B. Vascular, C. surgical oncology, D. Critical care/acute care surgery)
SELECTIVE DIRECTORS: F. Dean Griffen, M.D. (elective surgery)
Chiranjiv Virk, M.D. (vascular)
Quyen Chu, M.D. (surgical oncology)
Navdeep Samra, M.D. (critical care/acute care surgery)
ADMINISTRATIVE CONTACT: Debbie Thornhill, 675.6126, Room 3-303

1 credit

COURSE A (Elective Surgery)

 

DIRECTOR: F. Dean Griffen, M.D.  at UH Shreveport

SELECTIVE DIRECTOR:   F. Dean Griffen, M.D., 675.5569, Room 3-203 and Jo Ann Alley at UH Monroe.

ADMINISTRATIVE CONTACT: Debbie Thornhill, 675.6102, Room 3-203

LOCATION:  UH Health  - Shreveport or  UH Health - Monroe

NUMBER OF STUDENTS PER 4 WEEK BLOCK:  3

SELECTIVE AVAILABLE DURING BLOCKS:    All

COURSE CODE: SISRAA

 

Primary Goals

The student will:

1.  Obtain a more advanced understanding of surgical disease processes and treatment.

2.  Obtain more advanced experience in assessment and diagnosis of surgical disease processes

3.  Obtain experience in graduated responsibility as an acting intern on an inpatient service.

 

Specific Objectives

The student will:

 1.  Obtain experience in taking a history and performing a problem-focused physical examination on the wards and in clinics.

2.  Formulate a differential diagnosis in clinic and on the wards, adding emphasis to assessment and plan.

3.  Obtain experience in the performance of basic surgical skills in the operating room and clinics.

4.  Obtain experience in surgical decision making with attending supervision in and out of the operating room.

5.  Practice interpersonal and communication skills during interactions with patients, families, and health care teams.

6. Formulate a case log on a Word document and submit to the appropriate selective director at the end of the rotation. The log must include at least 15 cases. No patient can be used for more than one case, but specific surgical diseases may be used for multiple cases as long as the learning points and references differ. Each cases logged must include a brief but informative review of the case, a list of what has been learned, and a review of at least one article. Case logs must include 250 words or more.

 

Resources for Learning

Participating faculty:  Surgical faculty

Texts: Lawrence, Essentials of General Surgery

Hands-on Experience: Wards, OR, and clinics

Directed Readings: According to cases seen

Self-Directed Learning: Case studies

 

 

Formative Evaluation

 At the beginning of the second week of the elective, the student will be prompted by the secretary, Mrs. Debbie Thornhill, to pick up a Formative Evaluation Form and expedite completion.  Once completed, it must be returned to Mrs. Thornhill for review. If additional feedback is desired or required, Dr. Griffen will accommodate.

 

Outcome and Evaluation Measures (Grades)

Students will receive a grade of pass (P) or fail (F). No student will receive a pass (P) without completing the log requirements.  At the end of the course, the course director will review the student’s log and performance. No student will receive a pass (P) without completing the log requirements. Performance will be judged on the basis of knowledge, skill, and professionalism. Professionalism will be measured in terms of punctual attendance, maturity, interpersonal and communication skills, approach to the patient, and interaction with faculty and other staff.

 

 

 

COURSE B (Surgical Oncology)

 

ELECTIVE DIRECTOR: Quyen Chu, M.D.                                                                               PHONE: 318.675.4628

ADMINISTRATIVE CONTACT: Debbie Thornhill: 675.6126, Room 3-303

DURATION OF ELECTIVE: 4 Weeks

LOCATION OF ELECTIVE: LSU Health Sciences Center                                   ADM. CONTACT: (318) 675-6126

MAXIMUM NUMBER OF STUDENTS:  2

ELECTIVE OFFERED DURING BLOCKS: All Blocks

Course Code:  SISRAB

 

All foreign medical students who wish to do a clerkship in Surgery here at LSUHSC-S must be interested in applying to and qualified for our residency training program as well, because we have very limited clerkship positions available. Please see criteria for foreign medical graduates to qualify for residency training here on our website: http://www.lsuhscshreveport.edu; then click on “LSU Residency and Fellowship Programs.” If you meet these specifications, please let us know that you have read the requirements and that you qualify, so we can continue the process of approving a clerkship for you.

 

 

GOALS

 Learn to perform a thorough Oncology exam

Develop an understanding of the preoperative evaluation of Oncology patients, including preoperative staging of tumors, evaluation of co-morbidity, determination of the role of surgery and preoperative optimization for surgery.

Develop an understanding of the likely outcome of surgical oncology treatments

 

 

OBJECTIVES

The student will scrub in on operative cases and examine, work-up and preoperatively prepare patients for surgery and other treatments.

The student will postoperatively manage the care of patients that includes the care of the sequelae and complications .of surgical interventions

 

 SPECIFIC DUTIES OF SENIOR STUDENTS

 

• Written work-ups of patients assigned to senior student

• Present work-up patients to senior resident/staff

• Participating in surgery cases (scrubbing in) on patients he/she worked up

• Participating in/performing certain procedures on patients on service (e.g. placing and removing chest tubes, central lines, arterial lines, some suturing (under supervision)

• Participating as a “junior intern” in daily service rounds including SICU and including the writing or progress notes

and orders (under supervision) (co-signed by resident or staff) and perform daily post-op exams, dressing change.

• Participate in weekend ward rounds on at least one day of each weekend while on service

• Participate in Oncology Clinic and outpatient evaluation of patients

 

READING ASSIGNMENTS

 

• Schwartz or Sabiston Text of Surgery: Principle and Practice of Oncology - Selected chapters on

Oncology, Breast Cancer and related topics

• Participation in Multidisciplinary Tumor Board and discussion on multimodality approach to the treatment of cancer, including expected treatment outcome.

 

 

FORMATIVE EVALUATION

 

At the beginning of the second week of the elective, the student will be prompted by the secretary, Mrs. Debbie Thornhill, to pick up a Formative Evaluation Form and expedite completion.  Once completed, it must be returned to Mrs. Thornhill for review. If additional feedback is desired or required, Dr. Griffen will accommodate.

 

 

OUTCOME AND EVALUATION MEASURES

 

At the end of the course, the course director will submit an evaluation of the student’s diary and performance. It will include references to knowledge, skill, and professionalism. Professionalism will be measured in terms of punctual attendance, maturity, approach to the patient, and interaction with faculty and other staff. The student’s diary will contain daily entries. Entries should include references to problem solving, decision making, clinical reasoning, and communicating. Although each entry will contain different elements, entries overall must contain the patients seen, the operations seen or scrubbed for, the articles read (relate each article to a clinical encounter that led to the review and list at least two new things learned or observed,) One of the final entries must include a comprehensive review of what has been learned with specific notes relating the learning process to preparation for internship. For example, the student should have spent time learning processes like: entering orders, scheduling cases, providing informed consent, medication doses and IV fluids for acute care issues, and answering consults.

 

 

 

Course C (Critical Care/Acute Care)

 

ELECTIVE DIRECTOR: Navdeep Samra , M.D.

ADMINISTRATIVE CONTACT: Debbie Thornhill 675.6126, Room 3-303

DURATION OF ELECTIVE: 4 Weeks

LOCATION OF ELECTIVE: LSU Health Sciences Center

MAXIMUM NUMBER OF STUDENTS:  2 

ELECTIVE OFFERED DURING BLOCKS:  All

Course Code:  SISRAC

 

All foreign medical students who wish to do a clerkship in Surgery here at LSUHSC-S must be interested in applying to and qualified for our residency training program as well, because we have very limited clerkship positions available. Please see criteria for foreign medical graduates to qualify for residency training here on our website: http://www.lsuhscshreveport.edu; then click on “LSU Residency and Fellowship Programs.” If you meet these specifications, please let us know that you have read the requirements and that you qualify, so we can continue the process of approving a clerkship for you.

 

 

GOALS

 

1.    To learn how to manage mechanical ventilators, the use of hemodynamic monitoring and optimization in various forms of shock including septic and hemorrhagic shock.

2.     To gain facility with overall evaluation and management of all systems and function of critically ill patients including nutrition, fluid maintenance, and electrolyte balance.

3.   To understand the principles of the physiological response to stress and its application to the support of the critically ill.

 

 

OBJECTIVES

 

Student will make rounds on surgical critical care service daily

Student will participate with intern in consultations, orders, and other chart reviews.

Student will act independently in critical assessment and plan initiatives.

Student will participate in line placement and other invasive procedures.

Student will document daily activities, learning events, and self-directed learn activities in a diary for review by Dr. Samra.

 Student will meet with Dr. Samra before beginning the course, again at the halfway point, and again at the end for clarification and feedback.

 

 

SPECIFIC DUTIES OF SENIOR STUDENTS

 

This one month rotation will be located in the LSU Hospital Surgical Intensive Care Unit or Burn Unit. The student will be an integral part of the Surgical ICU team. She/he will be assigned responsibility for knowing all aspects of the patients assigned to them. Student will be supervised by the house staff and the staff of the division of trauma and critical care. Students will be expected to identify the patients problems, present these problems clearly and comprehensively and to devise a plan for addressing the problems. Also the student will participate in the procedures done in the critical care unit including the placement of central lines, Swan Ganz catheters, bronchoscopy, burn wound change, etc. The student’s hours will be exactly those of the SICU or Burn Unit residents.

 

 

READING ASSIGNMENTS (strongly recommended)

1. Orientation material given to incoming students describing commonly used SICU protocols and calculations.

2. “The SICU Book” - Paul Marino, M.D. (Williams and Wilkins)

 

 

 

FORMATIVE EVALUATION

 

At the beginning of the second week of the elective, the student will be prompted by the secretary, Mrs. Debbie Thornhill, to pick up a Formative Evaluation Form and expedite completion.  Once completed, it must be returned to Mrs. Thornhill for review. If additional feedback is desired or required, Dr. Samra will accommodate.

 

 

OUTCOME AND EVALUATION MEASURES

 

At the end of the course, the course director will submit an evaluation of the student’s diary and performance. It will include references to knowledge, skill, and professionalism. Professionalism will be measured in terms of punctual attendance, maturity, approach to the patient, and interaction with faculty and other staff. The student’s diary will contain daily entries. Entries should include references to problem solving, decision making, clinical reasoning, and communicating. Although each entry will contain different elements, entries overall must contain the patients seen, the operations seen or scrubbed for, the articles read (relate each article to a clinical encounter that led to the review and list at least two new things learned or observed,) One of the final entries must include a comprehensive review of what has been learned with specific notes relating the learning process to preparation for internship. For example, the student should have spent time learning processes like: entering orders, scheduling cases, providing informed consent, medication doses and IV fluids for acute care issues, and answering consults.

 

 

Course D (Vascular Surgery)

 

ELECTIVE DIRECTOR:  Chiranjiv Virk, M.D.                                                                         PHONE: 318.675.6154

ADMINISTRATIVE CONTACT:  Debbie Thornhill, 675.6126, Room 3-303

DURATION OF ELECTIVE: 4 weeks

LOCATION OF ELECTIVE: University Health Hospital

MAXIMUM NUMBER OF STUDENTS:  2

ELECTIVE OFFERED DURING BLOCKS:  All

Course Code:  SISRAD

 

All foreign medical students who wish to do a clerkship in Surgery here at LSUHSC-S must be interested in applying to and qualified for our residency training program as well, because we have very limited clerkship positions available. Please see criteria for foreign medical graduates to qualify for residency training here on our website: http://www.lsuhscshreveport.edu; then click on “LSU Residency and Fellowship Programs.” If you meet these specifications, please let us know that you have read the requirements and that you qualify, so we can continue the process of approving a clerkship for you.

 

This rotation is recommended for students interested in cardiovascular and general surgery. Students not going into surgery will be allowed on the rotation at the discretion of the course director and student rotation coordinator.

 

 

GOALS

 

•     To understand the etiology, epidemiology, and treatment of atherosclerotic vascular disease. Develop a working knowledge of cardiovascular risk assessment.

•     To learn the elements of and to perform a complete vascular history and physical examination.

•     To learn basic hemodynamics, ultrasound physics and noninvasive vascular laboratory investigations

•     To understand the appropriate indications for surgical in patients with Vascular disease and the appropriate treatment options

•     To understand basic vascular surgical techniques: exposure of blood vessels, suturing of blood vessels, wound approximation.

•     To understand endovascular surgery: diagnostic arteriography of the entire aorta, cerebrovascular, mesenteric, renal, and lower extremity circulation.

 

 

OBJECTIVES

 

Student will participate in open and endovascular procedures

Student will be assigned patients in the clinic and hospital.

Student will spend a week in the vascular lab.

Student will document daily activities, learning events, and self-directed learn activities in a diary for review by attending.

 

 

ROTATION SYLLABUS

 

• Responsibilities of the students will be that of an acting intern, functioning as integral part of the resident team.

• Participate in all surgical and endovascular cases.

• Spend 1 week in the vascular lab gaining exposure to non-invasive test and diagnostic imaging

• Participate in vascular clinic weekly (each Tuesday)

• Participate in vascular conference weekly (mandatory attendance)

• Take call in accordance with other acting internship rotations (1 week per month)

• Active participation in small round table didactic discussions on basic vascular disease problems with our vascular team.

 

 

REFERENCE

 

Textbooks/Journals: Rutherford: Vascular Surgery 7th Edition

The Journal of Vascular Surgery (in the library + e-journal, monthly publication)

• Participate in vascular conference weekly (mandatory attendance)

• Take call in accordance with other acting internship rotations (1 week per month)

• Active participation in small round table didactic discussions on basic vascular disease problems with our vascular team.

 

 

FORMATIVE EVALUATION

 

At the beginning of the second week of the elective, the student will be prompted by the secretary, Mrs. Debbie Thornhill, to pick up a Formative Evaluation Form and expedite completion.  Once completed, it must be returned to Mrs. Thornhill for review. If additional feedback is desired or required, Dr. Griffen will accommodate.

 

 

OUTCOME AND EVALUATION MEASURES

 

At the end of the course, the course director will submit an evaluation of the student’s diary and performance. It will include references to knowledge, skill, and professionalism. Professionalism will be measured in terms of punctual attendance, maturity, approach to the patient, and interaction with faculty and other staff. The student’s diary will contain daily entries. Entries should include references to problem solving, decision making, clinical reasoning, and communicating. Although each entry will contain different elements, entries overall must contain the patients seen, the operations seen or scrubbed for, the articles read (relate each article to a clinical encounter that led to the review and list at least two new things learned or observed,) One of the final entries must include a comprehensive review of what has been learned with specific notes relating the learning process to preparation for internship. For example, the student should have spent time learning processes like: entering orders, scheduling cases, providing informed consent, medication doses and IV fluids for acute care issues, and answering consults.

All

Pass/Fail