Final Year Surgical Teaching
In final year of medical school teaching, clinical teaching in surgery would base on the foundation from Curriculum of fourth year. The aim is to provide medical students with enhanced exposure to common surgical problems, develop basic clinical skills appropriate for final year curriculum and to broaden their horizon about surgery and its subspecialties so that they can evaluate surgery as a future career.
Upon completion of the surgical rotation, following general objectives of clinical surgical teaching should be met by the student:
-
Student is able to take meaningful clinical history and perform clinical examination leading to diagnosis making.
-
Demonstrate and strengthen professional attitude and values towards colleagues and patients
-
Identify the common surgical problems and construct appropriate diagnostic and brief management plan
-
Identify the common surgical emergencies and acquire surgical consultation
-
Learn to apply the principles of resuscitation to a patient with shock
Final Year Clinical Teaching would primarily comprise patient side teaching at C3 (Bloom’s Taxonomy) and above cognitive level, P1-3 Psychomotor skill level and A1-2 affective level. The teaching should be in form of didactic, bedside and case-based learning with eventual transformation to problem based learning (PBL).
The Department of General Surgery, Orthopedics, Radiology, Anesthesia, Cardiothoracic Surgery, Pediatric Surgery, Neurosurgery and Urology Faculty members have been designated the lecture schedule designed to introduce basics of surgery. Basics of clinical judgement and approaches to various common presentations of surgical problems would be introduced. The students are subdivided into batches and rotate for 12 weeks in Shalamar Teaching Hospital (See Appendix). The teaching would be done in Didactic sessions and bedside teaching with equal focus. The teaching modules for clinical teaching have been developed (See Below). Online Modules are also available at the website to complement the didactic and bedside teaching.
ATLS Symposium would be conducted on a selected day for the final year students. A Clinical Skill Competition would also be arranged. All students would be required to write down 20 histories and clinical examinations for various disorders. An online Surgical Quiz of the Week would be administered based on problem based learning.
The students would be exposed to Case Presentations, Journal Club in the Surgical Units on alternate days.
Following Online Modules would be developed which would be problem based and scenario-based learning modules for the overall surgical teaching to cover the core topics. These modules would be made available through a virtual learning environment.
-
Upper GI Bleed
-
Lower GI Bleed
-
Postoperative Respiratory Distress
-
Management of Acute Revealed or Concealed Hemorrhage
-
Postoperative Fever
-
Pain Management
-
Acute intestinal Obstruction
-
Acute Abdomen- Peritonitis
-
Dealing with Head Injury
-
ABC of the Trauma patient
-
Obstructive Jaundice- Painful
-
Obstructive Jaundice- Painless
-
Dysphagia
-
Painful Defecation
-
Bleeding per Rectum
-
Gastric Outlet Obstruction
-
Carcinoma Breast Stage 1
-
Carcinoma Breast Stage 2
-
Carcinoma Breast Stage 3
-
Carcinoma Breast Stage 4
-
Carcinoma in Situ Breast
-
Colorectal Cancer
-
Ulcerative Colitis
-
Crohn’s Disease
-
Pain Epigastrium
-
Pain Right Hypochondrium
-
Pain Right Ileac Fossa
-
Pain Periumblical region
-
Pain Hypogastric Region
-
Pain left Iliac Fossa
-
Pain Flank
-
Inguinoscrotal Swelling
-
Abdominal Mass
-
Blunt Abdominal Trauma
-
Chest Trauma
General Surgery Rotation:
12 weeks rotation would be split into two surgical units (6 weeks each). Final Year students would be taught in 4 sessions to encompass various dimensions of clinical teaching.
Here is the teaching roster for the final year students in Unit 1 & 2.
Following Core Topics need to be essentially covered in six weeks of general surgical rotation by Surgical Unit 1:
-
Examination of Swelling, Differential Diagnosis, Understanding Clinical Reasoning, Diagnosis Making and Management
-
Examination of Ulcer, Differential Diagnosis, Understanding Clinical Reasoning, Diagnosis Making and Management
-
Examination of Neck Swellings, Differential Diagnosis, Understanding Clinical Reasoning, Diagnosis Making and Management
-
Examination of Thyroid, Differential Diagnosis, Understanding Clinical Reasoning, Diagnosis Making and Management
-
Examination of Peripheral Neurovascular System, Differential Diagnosis, Understanding Clinical Reasoning, Diagnosis Making and Management
-
Examination of varicose veins & DVT, Differential Diagnosis, Understanding Clinical Reasoning, Diagnosis Making and Management
-
Examination of abdominal exam, Differential Diagnosis, Understanding Clinical Reasoning, Diagnosis Making and Management
-
Examination of Breast, Differential Diagnosis, Understanding Clinical Reasoning, Diagnosis Making and Management
-
Examination of Inguinoscrotal Area, Differential Diagnosis, Understanding Clinical Reasoning, Diagnosis Making and Management
-
Examination of Perianal Area, Differential Diagnosis, Understanding Clinical Reasoning, Diagnosis Making and Management
Following Core Topics need to be essentially covered and form the learning objectives in six weeks of general surgical rotation by Surgical Unit 2:
-
Examination of Neck Swellings, Differential Diagnosis, Understanding Clinical Reasoning, Diagnosis Making and Management
-
Examination of parotid & Submandibular Swellings, Differential Diagnosis, Understanding Clinical Reasoning, Diagnosis Making and Management
-
Examination of Abdominal Swellings and Masses, Differential Diagnosis, Understanding Clinical Reasoning, Diagnosis Making and Management
-
Examination of Inguinoscrotal Swellings, Differential Diagnosis, Understanding Clinical Reasoning, Diagnosis Making and Management
-
Examination of Peripheral Neurovascular System, Differential Diagnosis, Understanding Clinical Reasoning, Diagnosis Making and Management
-
Examination of Diabetic Foot, Differential Diagnosis, Understanding Clinical Reasoning, Diagnosis Making and Management
-
Examination of abdominal exam, Differential Diagnosis, Understanding Clinical Reasoning, Diagnosis Making and Management
-
Examination of Breast, Differential Diagnosis, Understanding Clinical Reasoning, Diagnosis Making and Management
-
Examination of Acute Abdomen, Differential Diagnosis, Understanding Clinical Reasoning, Diagnosis Making and Management
-
Examination of Perianal Area, Differential Diagnosis, Understanding Clinical Reasoning, Diagnosis Making and Management
During the theater days, peri-operative care, Sterilization, CSSD, and Instrumentation would be covered apart from the operative clinical teaching.
In Skill Lab various psychomotor surgical skills would be practiced in a simulated environment.
The detail of the student Batch rotating in clinical wards is attached here in Appendix III. At the end of each rotation both at Shalamar Teaching Hospital, an assessment of clinical skills would be conducted in the Department of Surgery. The material provided in this website would be part of the clinical assessment.
The detail of lectures to be delivered has been attached in this manual at the end. (Appendix IV).
During this year the students are tested for delivered lectures with MCQ based assessment papers (Cognitive Domain) conducted throughout the year and the results are shared with Department of Medical Education and Student Affairs through the software.
For the Online Modules (involving History Taking, Clinical Examination and Communication Skills), an OSPE is conducted (10 Stations) which would assess the Clinical Skills of the students through Cognitive, Psychomotor and Affective Domain. The OSPE has 30% Cognitive, 50% Psychomotor and 20% Affective domain. 10% would be reserved for attendance.
Surgical Unit heads are responsible for ensuring the overall coordination and conduction of assessments during Year 5.
Mode of Teaching: Lectures (Cognitive Domain)
Online Modules, Didactics & Bedside Teaching (Psychomotor & Affective Domain)
Final Year Lecture List (Surgery & Allied)
Final Year Ward Rotation Plan (Surgery & Allied)
Final Year Clinical Flow Chart (Surgery & Allied)
Final Year Academic Planner 2023-24