Surgery Rotation Director: Dr. Gregory Harding

Surgery Rotation
Director: Dr. Gregory Harding
Program Coordinator: Karen Holmes
Email: [email protected]
Office: 204-787-3154
Web page:
http://www.umanitoba.ca/faculties/medicine/units/surgery/undergraduate_education/index.html
A. Overview
Welcome to the Surgery rotation. Surgery consists of a group of specialties, with a common
interest in applying invasive techniques in treatment of disease. Surgery has a wide scope,
managing problems in all age groups, with a range of acute emergency to elective procedures,
inpatient and outpatient procedures, and minimally invasive to highly invasive operations. Despite
the scope of surgery as a discipline, the practice of individual specialties, services or surgeons may
be highly focused or specialized. The Department of Surgery has many sites within the Winnipeg
region and the Province of Manitoba, and follows a distributed-education model.
The major objective in the Surgery rotation is for the student to acquire the basic knowledge,
clinical skills, technical skills and attitudes for management of the surgical patient, which will
become the basis for providing care to patients in a competent fashion, in any field of medicine
that the student pursues.
1. Structure
The Surgery Clerkship consists of:
 The new curriculum at the University of Manitoba has paired the Surgery and Anesthesia
programs creating a 12 week rotation. The main objective on the Surgery and Anesthesia
rotation is for the student to acquire the basic knowledge, clinical and technical skills and
attitude for management of the surgical patient. This will become the basis for providing
care to patients in a competent fashion in any field of medicine that the student pursues.
2. Rotation Assignment
 Students will receive an email from the Undergraduate Coordinator with their scheduled
rotations, usually in May or June before clerkship.
 After the initial assignment of surgical rotations, rotation changes will only be made under
exceptional circumstances.
3. General Surgery Rotations (3-week)
 Gold Service, Health Science Centre
 Green Service, Health Science Centre
 Orange Service, Health Science Centre
 “A” Service, St. Boniface General Hospital
 “B” Service, St. Boniface General Hospital
 Acute Care Surgery Service, St. Boniface Hospital
 Pediatric General Surgery, Children’s Hospital
 Acute Care Surgery Service, Grace Hospital
4. Surgical Specialty Rotation (3-week)
 Neurosurgery, Health Sciences Centre
 Plastic Surgery
o Adult, Health Sciences Centre
o Adult, St. Boniface General Hospital
 Urology
o Adult, Health Sciences Centre
o Adult, St. Boniface General Hospital
o Pediatric, Children’s' Hospital
5. Musculoskeletal (MSK) Rotation:
Orthopedic Surgery
 Adult Trauma, Health Sciences Centre
 Spine, Health Sciences Centre
 Pediatric, Children’s' Hospital
 Arthoplasty, Concordia Hospital
 Sports, Pan-Am Clinic
4. Orientation for the Surgical Clerkship
 The orientation session is held on first day of the Surgery/Anesthesia Block
 The orientation takes place at Health Sciences Centre for all surgical clerks
 In addition, each service will orientate the students at the beginning of their respective
service rotation.
5. On Call
 On general surgery, students take call at HSC with the Gold Surgery service and at SBGH
with the ACSS service.
 On selectives, whether in the Surgery rotation or the Med-Surg Selective rotation, the
requirement to take call depends on the rotation. Some rotations have no call
requirements and others have home call or in-hospital call. However, if the selective has
a call requirement, then the student is required to take call, whether the selective is
done during the Surgery rotation or during the Med-Surg block.
 Students assigned to take call on Wednesday night (i.e. before Thursday teaching), are
freed from call requirements as of 22:00 to allow for sleep. Attendance at Thursday
teaching is mandatory for students based in Winnipeg, and therefore, there is no postcall on Thursday morning.
 Students assigned to take call on Thursday are freed from call responsibilities for the
duration of Thursday teaching.
 The student will not be on call the night before and day of any examination.
 The student will not be on call on the night before a change of rotation.
 The Surgery Education Office has developed on call schedule templates to avoid
scheduling students and to minimize conflicts regarding call schedules. For the most
part, these call templates distribute call fairly within and among clerkship groups.
6. Recommended Textbooks
 Essentials of General Surgery, Peter F. Lawrence.
 Essentials of Surgical Specialties, Peter F. Lawrence.
 Cecil's Essentials of Medicine. Many chapters are directly relevant to surgery.
7. Weekly Seminars
 Didactic teaching during the surgery clerkship is held on Thursdays at HSC, starting at
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0800. Exceptions might be necessary, if a holiday falls on Thursday.
The seminars are interactive sessions with active participation by the students.
After teaching, students are required to report back to their rotations.
Students should read the objectives, recommended reading and case scenarios on the
Department of Surgery Undergraduate webpage.
Attendance is taken and absences require a valid excuse. Unexcused absences are
remediated with submission of a summary of each topic missed.
8. Student Evaluation
Students will be evaluated at the end of each rotation, and will also have a mid-rotation evaluation
during the 6-week rotation in surgery (General Surgery and the Sub Specialty rotations). There will
be an evaluation after the MSK rotation is completed. The evaluation form is completed by the
service chief or designate in consultation with the surgical preceptor, attending surgeons, surgical
residents, and nursing staff. Upon completion of the surgical clerkship the student will write the
National Board Part II examinations in surgery.
For successful completion of the surgical clerkship, the student is required to pass the clinical
evaluations for all rotations, the written examination, and successfully complete or remediate
essential clinical presentations. Failure to satisfactorily complete the clerkship will require
remedial work as prescribed by Faculty guidelines.
9. Clerkship Feedback
At the end of the each part of the rotation the student is requested to complete an evaluation of
the rotation and of the surgical staff on OPAL.
10. Clerk Responsibilities
The responsibility of the clinical clerk will include:
 Performing a complete history, physical examination, differential diagnosis as well as
suggested investigations and management on assigned patients under the guidance and
supervision of the resident and attending surgeon or preceptor.
 The student must learn to integrate and apply the clinical, laboratory and other
investigational data to patient problems. To accomplish this, students must understand
the pathophysiology the disease entity and the application of basic sciences to surgery.
The student is expected to read about the clinical conditions of patients under his or
her care.
 Write orders which must be countersigned by a qualified physician.
 Write daily progress notes.
 Attend his or her own cases in the operating room and other selected cases, the latter
dependent upon his or her own interest.
 Attend the outpatient sessions of the assigned service.
 Participate in the daily and weekly service rounds, seminars and conferences. This may
include clinical presentations, involvement in decision making process, literature
investigations and management of assigned cases. The clerk will become an integral
member of the team of clinical clerk, resident(s) and fellow(s) on the clinical service.
 All Winnipeg-based clerks must attend the Thursday clerkship teaching, when on the
Surgery block.
Last revised: September 25, 2014