GCRMC Care of the Surgical Patient

General Surgery Eval

Faculty Chair:

Leandrita Ortega, MD

Contacts:

William Pollard, MD

James Dumont, MD

Required Experiences:

Gerald Champion Regional Medical Center

Optional Experience:

Weekly Schedule:

Sunday Monday Tuesday Wed Thursday Friday Saturday
Clinic Surgery Surgery Clinic Surgery
Clinic Surgery Didactics Clinic

Requirements:

AOA

Surgery

The program must provide at least twenty weeks of training in surgical disciplines, including at least four weeks of general surgery training during the OGME-1 year.

At a minimum this shall include:

  • Preoperative and post-operative care.
  • Training in the following sub-specialties, which may be ambulatory or inpatient.
  • Ophthalmology.
  • Orthopedics.
  • Urology.
  • ENT.

ACGME

Residents must have at least 100 hours (or one month) dedicated to the care of surgical patients, including hospitalized surgical patients. (Core)

This experience must include operating room experience.

Description of Rotation or Educational Experience

The General Surgery Rotation is a required block rotation. Two months focused on general surgery will be required during the residency. The resident will obtain the skills necessary to diagnose, treat, and refer disorders that are common in the family physicians office. It is expected that the resident spend time in the clinic setting, and the operating room. Hands-on educational opportunities must be provided.

Expectations:

Residents

Residents are expected to arrive to the General Surgery rotation on time and to dress and act in a professional manner. They are expected to contact the preceptor’s office prior to their first day on the rotation in order arrange the initial meeting time and location on day one of the rotation. It is expected that while at the preceptor’s office the residents will be respectful of the office space and personnel. The resident is responsible for maintaining a procedure log as well as completing assigned readings.

Faculty

Dr. Pollard, Dr. Dumont, and other physicians as arranged, will provide precepting during the focused General Surgery rotation. The faculty and preceptors are expected to allow the resident to participate in active patient care as well as procedures when appropriate. The preceptors should also provide time and allowance for explanation and teaching of general sugical conditions and their treatments.

Call

There is no specific call responsibility for this rotation.

Patient Care

Goal

Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of the surgical patient. Residents are expected to:

Competencies

  • Be able to perform a surgical assessment and develop an appropriate treatment plan. (Medical Knowledge, Patient Care)
  • Coordinate ambulatory, in-patient and institutional care across health care providers, institutions and agencies. (Systems-based Practice, Patient Care)

Objectives

  • Obtain and report developmentally, age and presentation/setting appropriate history
  • Perform and report developmentally, age and presentation/setting appropriate physical examination
  • Generate an appropriate surgical differential diagnosis
  • Make informed decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment
  • Develop and carry out patient management plans
  • Counsel and educate patients and their families in a clear, respectful and culturally conscious manner
  • In the appropriate setting, the resident should demonstrate the ability to independently perform or appropriately refer:
    1. Intra-operative skills
      1. Basic principles of asepsis and sterile technique
      2. Antibiotic prophylaxis
      3. Patient monitoring
      4. Fluid management
      5. Blood requirements
      6. Temperature control
      7. Preparation & draping
      8. Basic use of surgical instruments
        1. Incision/dissection
        2. Exposure/retraction
      9. Hemostasis
      10. Wound closure
      11. Drains
      12. Dressings
      13. Assist on major procedures
      14. Perform minor procedures
        1. Simple excision
        2. I&D
        3. Aspiration
        4. Foreign Body removal
        5. Minor burns
        6. Wound debridement
        7. Enucleation/excision thrombosed hemmorhoid
    2. Post-operative care
      1. Suture removal
      2. Drain removal
      3. Dressing change
      4. Wound care
      5. Patient mobilization
      6. Nutrition management
      7. Pain management
  • Collaborate with health care professionals, including those from other disciplines, to provide patient-focused care

Medical Knowledge

Goal

  1. Residents must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences, as well as the application of this knowledge to patient care. Residents are expected to:

Competencies

  • Be able to demonstrate surgical knowledge and assessment and develop an appropriate treatment plan. (Medical Knowledge, Patient Care)

Objectives

In the appropriate setting, the resident should demonstrate the ability to apply knowledge of:

  1. Basic principles of surgical diagnosis
    1. Basic surgical anatomy
    2. Wound physiology, care and healing processes
    3. Invasive versus noninvasive diagnostic tests
    4. Common surgical diagnoses
      1. Abscesses
      2. Anal fistula, fissure or perianal abscess
      3. Aortic aneurysm
      4. Appendicitis
      5. Arterial insufficiency
      6. Benign neoplasia
      7. Bowel obstruction
      8. Breast masses
      9. Colon cancer
      10. Cysts and hematomas
      11. Diverticular disease
      12. Esophageal varices
      13. Gallbladder disease
      14. Gastrointestinal hemorrhage
      15. Hemorrhoids
      16. Hernias
      17. Pancreatic disease
      18. Ruptured viscus
  2. Recognition of surgical emergencies
  3. Preoperative assessment
    1. Recognition of appropriate surgical candidates
    2. Surgical risk assessment
    3. Comorbid diseases
    4. Antibiotic prophylaxis
    5. Patient preparation (bowel, medication, schedule, etc.)
  4. Postoperative care
    1. Common complications
      1. Fever work-up and management
      2. Wound dehiscence
      3. Urinary retention
      4. Hemorrhage
      5. Pneumonia
      6. Atelectasis
      7. Fluid overload
      8. Transfusion reaction
      9. Thrombophlebitis
      10. Pulmonary embolism
      11. Oliguria
      12. Respiratory insufficiency
      13. Ileus
      14. Infection
      15. Shock
  5. Outpatient surgery
    1. Patient selection
    2. Conscious sedation
    3. Postoperative observation principles
    4. Follow-up care
  6. Office care of common conditions
    1. Lumps, bumps and abscesses
    2. Simple lacerations
    3. Superficial burns
    4. Common methods of anesthesia
  7. Recognition and care of surgical wounds
    1. Penetrating wounds
    2. Avulsion, crush or shear injury wounds
    3. Bite wounds

Practice- Based Learning and Improvement

Goal

Residents must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and life long learning. Residents are expected to develop skills and habits to be able to:

Competencies

  • Recognize his or her practice limitations and seek consultation with other health care providers when necessary to provide optimal care. (Professionalism, Practice-based Learning)

Objectives

  • Ask questions as an engaged, critical learner
  • Use information technology to manage information, access on-line medical information, and support their own education

Systems Based Practice

Goal

Residents must demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care. Residents are expected to:

Competencies

  • Work in interprofessional teams to enhance patient safety and improve patient care quality
  • Coordinate ambulatory, in-patient, and institutional care across health care providers, institutions and agencies. (Systems-based Practice, Patient Care)

Objectives

  • Practice cost-effective health care and resource allocation that does not compromise quality of care
  • Advocate for quality patient care and assist patients in dealing with system complexities to minimize discomfort or confusion

Professionalism

Goal

Residents must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. Residents are expected to:

Competencies

  • Recognize his or her practice limitations and seek consultation with other health care providers when necessary to provide optimal care. (Professionalism, Practice-based Learning)
  • Demonstrate respect for patient privacy and autonomy
  • Demonstrate the ability to communicate effectively with the surgeon supervisor/consultant about the patient’s symptoms, physical findings, test results and proposed plan of care. (Communication, Professionalism)

Objectives

  • Accept responsibility for patient care
  • Consistently perform in a punctual, reliable and collegial manner

Interpersonal and Communication Skills

Goal

Residents must demonstrate interpersonal and communication skills that result in the effective exchange of information and teaming with patients, their families, and professional associates. Residents are expected to:

Competencies

  • Demonstrate the ability to communicate effectively with the patient, as well as the patient’s family and caregivers, to ensure that the diagnosis and treatment plan are clearly understood. (Communication)
  • Demonstrate the ability to communicate effectively with the surgeon supervisor/consultant about the patient’s symptoms, physical findings, test results and proposed plan of care. (Communication, Professionalism)

Objectives

  • Make organized and effective oral presentations
  • Communicate with the patient, family and members of the healthcare team in a timely, developmentally and culturally appropriate manner
  • Obtain informed consent in an appropriate manner
  • Document patient care in appropriate record system and maintain essential components of the patient’s record of care

Teaching Methods

Residents will provide medical care to patients under the direct supervision of the attending physician. They will be supervised on all procedures performed in the hospital. The will participate in weekly conferences at the FMC. Residents will be assigned specific reading topics to be completed by the end of their month on the service.

Assessment Method (Residents)

Direct observation with a final global assessment based on a competency scale. All procedures will be recorded on New Innovations.

Assessment Method (Program Evaluation)

Residents will be provided with an evaluation of their experiences and given the opportunity to provide feedback of the rotation during their quarterly IEP assessments.

Level of Supervision

The resident is directly supervised by the attending physician during all procedures performed in the hospital. The attending will see all patients on the service each day and will document their involvement in the patient’s care. An Attending will be available the entire time the resident is on the rotation.

Educational Resources

Readings

Videos

Location 2450 S. Telshor Blvd. Phone 575-521-5378 E-mail john.andazola@lpnt.net
search previous next tag category expand menu location phone mail time cart zoom edit close