Surgery

Rotation Goals and Objectives

  1. General Description
    1. Family Physicians commonly care for adult patients with surgical disorders. Family Physicians practices vary considerably in the extent are provided. This portion of the curriculum is designed to provide residents with the skills and expertise expected of family physicians with active practices involving the care of patients with surgical disorders.
    2. Residents will work with a team of surgeons. The resident will be supervised at all times by a faculty surgeon or a senior surgical resident rotation at our hospital. With the support of the senior resident and faculty physician, the resident will be responsible for the comprehensive care of all patients assigned to them. Daily didactic material and formal didactic material will be presented to the resident from the attending physician and senior resident during hospital rounds at varying times depending on the attending surgeon's availability and operating room demands.  Teaching rounds are routinely at 7:30 am daily. The resident may present topics at these morning report sessions. M & Ms are every Friday morning at 8:00 am and include not only general surgery, but also vascular surgery, anesthesia, orthopedics, ENT, and urology
    3. Residents are expected to follow their patients in the Family Medicine Center during these rotations.
    4. Level: PGY1 
    5. Location: VAMC
    6. Duration: One 4 week rotation, done once or twice during the PG1 year 
    7. Surgery is a full-time rotation.
    8. One-half day per week will be spent in the family medicine center during the PG 1 rotations. 
    9. Work hour form submission is required at the completion of these rotations.
    10. Evaluation of Rotation
      1. The evaluation of the resident will be done by the attending physicians and senior resident at the end of the rotation.
      2. The resident will fill out a rotation evaluation for at the end of the rotation.
      3. The knowledge, skills, and competencies acquired during this rotation will be evaluated by a Family Medicine attending as the resident provides outpatient care at the family medicine residency clinic.
      4. The resident's performance on the American Board of Family Medicine In-Training examination will also be used to assess knowledge in this area.
  2. Patient Care skills to be mastered
    1. Performance of complete history taking for surgical or trauma patients
    2. Performance of complete physical examination for surgical or trauma patients
    3. The evaluation and treatment of common surgical problems
    4. The coordination of comprehensive care for surgical patients
    5. Recognition of the role of the family and other psychosocial factors in the care of surgical patients.
    6. Develop an understanding of what consultative services are useful to a surgical patient
    7. Develop an understanding of the multidisciplinary services that are useful to surgical patients
    8. The arrangement of discharge and follow up care for patients who have been hospitalized.
    9. The principles of aseptic technique, tissue handling and surgical assisting
  3. Medical Knowledge skills to be mastered
    1. An increasing knowledge base to care for the breadth of patients cared for by surgical specialists.
      1. Specific medical topics should be reviewed and learned on a daily basis based on the diagnoses and disorders of patients currently admitted to the resident's service.
      2. A list of 7 American Family Physician journal articles relating to surgical issues is on our website.  These are intended to augment teaching a family physician skills needed to address surgical issues.
  4. Practice-Based Learning and Improvement
    1. This competency is addressed longitudinally throughout the rotation.
      1. Scientific evidence will be reviewed by the resident and attending physician in the context of their patients.
      2. The practical implementation of evidence-based medicine will be discussed as medical decision making is reviewed.
      3. Medical evidence will be reviewed and presented during the daily morning report sessions.
      4. Information technology will be utilized by the resident as directed by the attending physician.
      5. Information technology will be utilized as the hospital implements its electronic health record.
      6. The resident will also be evaluated on the steps they took during the rotation to improve their shortcomings.
  5. Interpersonal and Communication Skills
    1. This competency is addressed longitudinally throughout the rotation.
      1. The resident will observe and be observed, taught and evaluated in the performance of obtaining patient histories, documenting histories, writing prescriptions, educating patients about treatment plans and prognosis, teaching medical students and other learners, and interactions with patients, families, office staff and physicians.
  6. Professionalism
    1. This competency is addressed longitudinally throughout the rotation.
      1. The attending physician will observe and assess the resident's sense of personal responsibility including attendance, promptness, motivation, completion of duties, and appropriate dress.
      2. Ethical and legal practice skills will be taught
      3. Respect for cultural, age, and gender differences will be taught, observed and evaluated.
      4. The resident is expected to treat patients, families, and colleagues with respect, understanding, sympathy and honesty
  7. Systems Based Practice
    1. This competency is addressed longitudinally throughout the rotation.
      1. The resident will learn to become aware of available resources and the cost-effectiveness of testing and therapeutic options
      2. The resident will gain an increased understanding of the role of the patient, physician, support staff, and insurer in the health care environment
      3. The resident will gain an increasing understanding in the role of the hospital in the health care environment.
      4. Through the coordination of care for the hospitalized patients, the resident will become aware of the breadth of available resources in our community as well as to the limitations of the resources in our community. In this regard, the resident will be expected to work very closely with social workers and hospital case coordinators to assist in providing the best care available to our patients.

Revision: June 4, 2019 by Leslie Greenberg MD