Four-Week Electives for the Clinical Continuum - Department of Surgery

Tulane students interested in applying for special surgical clerkships at other schools (extramurals) should note our medical school's requirements for extramural clerkships stated on pages v., vi. and vii. of the Tulane senior's version of this brochure and the additional requirements of the Tulane School of Medicine, Department of Surgery, which specifies:

1. Only students who have had an excellent performance in their scholastic studies to date will be given approval for such special clerkships.
2. Extramural clerkships must be shown to provide exposure in special interest areas, which might not otherwise be available at Tulane University School of Medicine.
3. With regard to the Medical School requirement that the clerkship must be served in an institution which is an integral part of a medical school teaching program, it must be emphasized that preceptorships will not be approved.
4. Credit will be given for one month of clerkship.
5. The Chairman of the Department of Surgery, or his designated representative, reserve the prerogative to communicate personally with the designated Program Director and to solicit a grade for the student's work.

Pediatric Cardiothoracic Surgery
(Course Code: MDSR CT TMC)

Clinical clerkship with emphasis on operative experience and post-operative management of patients with congenital cardiac defects

1 month rotation on the Pediatric Cardiothoracic Surgery service. Time will be Divided between the Cardiothoracic Surgical Research Lab (10-20%) and the clinical service (70-80%).

Clinical (4 days/week):

1. Morning multi-disciplinary rounds in the Pediatric ICU with members of Pediatric Cardiology, Pediatric Cardiac Surgery, and Pediatric Intensive Care.
2. Four days a week spent in the ICU and operating room. Time will be divided between demonstrations of anatomy by direct observation and review of diagnostic studies such as echocardiography and cardiac catheterization. Explanation of treatment of congenital cardiac disease.
3. Attend weekly Department of Surgery grand rounds.
4. Attend weekly interdisciplinary cardiac catheterization conference
5. Pre and post-operative evaluation of patients

1. Participate in large animal experimentation including surgical preparation, data gathering, and data analysis.
2. Critical literature and statistical analysis.
3. Introduction to writing animal protocols and grants.

Objectives: Participation on the pediatric cardiac surgery service will serve as a model to demonstrate the interaction between anatomy, physiology, and pharmacology in the care of patients with congenital heart lesions. The elective will also integrate basic science research with clinical education at an introductory level.

Understand the anatomy & physiology of common congenital cardiac defects. Participate in the surgical repair and understand the unique aspects of post-operative care.

Outline:

1. A.M. Rounds With Attending
2. Operating Room-Scrub For Cases
3. P.M. Attending Rounds
4. Cardiac Cath Conference Weekly
5. Optional participation in clinical & laboratory research

Time Offered: throughout the year
Method of Evaluating Student Performance: Daily interaction; 8 minute presentation on topic on students choice. Presentation can discuss any aspect of the clinical or research aspects of the rotation.
How is this course evaluated by the Course Director: 1. knowledge of anatomy & physiology at end of course; 2. participation in pt. care during course
How is this course evaluated by students: standard course evaluation
Prerequisite: 4th year elective

Plastic Surgery Clerkship: Tulane Medical Center and the Medical Center of Louisiana
(Course Code:  MDSR PLS C/T)

Students will serve for 1 month under the direction of the resident in Plastic Surgery and the attending staffs of Plastic Surgery. Ward rounds will be made with the resident daily and with the visiting staff. The student will scrub on as many patients as possible. The student will also attend Plastic Surgery Clinics and participate in the Plastic Surgery teaching conferences.

Quota: 1 student
Duration: 1 month

Breast Surgery Clerkship: Tulane Medical Center
(Course Code:  MDSR ONC TMC)

The breast surgery externship is designed to provide additional experience in the management of breast cancer patients with emphasis on surgery, and the multi-disciplinary approach in treating these patients. Special instruction directed towards the diagnosis and treatment of all modalities is provided.

Faculty: Mary Jo Wright, M.D.

Quota: 1 student
Duration: 1 month

Surgery Research Fellowship - Tulane Medical Center
(Course Code: MDSR SRF TMC)

By special arrangement with the faculty of that area, the student may integrate into one of several ongoing laboratory (benchwork) research projects. The student will carry out, under direct supervision, experiments, collate and interpret subsequent data, and submit an abbreviated report summarizing these research efforts.

Objectives:

1. To gain insight to the surgical perspectives on experimental design.
2. To develop technical skills relative to the selected experimental methodology.
3. To learn fundamentals in data interpretation.

General Surgery Clerkship: Tulane Medical Center, Lakeside, or Elmwood
(Course Code:  MDSR SUB TMC; MDSR SUB UH, MD SUB MCL)

Two students at TMC, one at Lakeside; one at Elmwood

NOTE: Tulane students may take this course for Core or Selective credit.

Students will serve as acting interns on the General Surgery service. As such, they will become an intergral part of the Surgery housestaff members assigned to the Tulane Medical Center. Students are expected to conduct daily ward rounds, participate in surgical procedures, perform patient workups, and attend the Surgery Conferences. Students will follow the daily routine of surgical houseofficers.

Objectives:

1. Develop skills in diagnosis and management of surgical disease states;
2. Improve procedural skills (surgical techniques).

Honors General Surgery Clerkship - Tulane Medical School
(Course Code:  MDSR ADV TMS)

The students will be exposed to the responsibilities of an academic General Surgeon, as they pertain to teaching, research, and service.  The students will in part be responsible for the instruction of the principles of Surgery given to third year medical students at the beginning of the General Surgery Clerkship.  Each student will, under the direct supervision of one of the faculty in the Department of Surgery, conduct a clinical or benchwork research project -- the results of which will be presented to the Chairman of the rotation.  Finally, the students will be instructed in basic surgical skills and techniques, both open and laparoscopic, under the direct supervision of the General Surgery faculty. These skills will be refined in anesthetized pigs.

Objectives: Sharpen the skills of senior medical students committed to a career in General Surgery.

Director: Michael Weaver, M.D.
Faculty: James Korndorffer, M.D.
Quota: Minimum of 4 students, maximum of 10 students.
Time Offered: FIRST BLOCK ONLY, JULY.
Duration: 1 month
Prerequisite:

1. A grade of "Pass" or higher during the third year clerkship.
2. Committed to pursuing a career in General Surgery.
3. Direct approval must be obtained from Dr. Michael Weaver & Dr. James Korndorffer.

1. Surgical skills will be evaluated in the animal laboratory.
2. Manuscript will be graded by the Chairman of the Department of Surgery.

Pediatric Surgical Clerkship:  Tulane Medical Center
(Course Code: MDSR PED TMC)

Students will be expected to be an active member of the surgical team.  A variety of interesting and complicated cases will be seen during any one clerkship period. The students are urged to act with the house staff in the preoperative evaluation, the operative and postoperative care of the Pediatric patient. They will be expected to scrub in on all operations.

Faculty: Dr. Rodney Steiner

Quota: 1 student
Duration: 1 month

Surgical Critical Care: Tulane Medical Center
(Course Code:  MDSR ICU TMC)

This one month rotation will be situated in the Tulane Medical Center Surgical Intensive Care Unit. It is designed to give the student a broad experience in Surgical Critical Care. The student will be an integral part of the Surgical ICU team and will participate in ICU rounds, educational sessions, conferences, and procedures.

Objectives: To acquaint the student with Surgical Critical Care with emphasis on such topics as shock, invasive monitoring, ventilator management, nutrition, surgical infectious diseases, and pharmacology.
Director: Mel Gitlin, M.D. (Anesthesia)
Quota: 2 students
Duration: 1 month
Method of Evaluation: Students will be evaluated as to their performance on rounds, during small group discussions and their presentations.  All of the ICU attendings will have input into the evaluation.  The evaluation will be written and utilize the same form as the junior general surgery clerkship.

Every 6 months, the Course Director will review the comments solicited from the participating students and ICU faculty.  At the completion of each rotation, the student will meet with Course Director at which time the student's evaluation of the course will be solicited.  Additionally, each student will be asked to complete a written evaluation of the course.

Prerequisite: Successful completion of Junior General Surgery clerkship.

Senior Surgery Selective:  Centreville, Mississippi
(Course Code:  MDSR GEN CEN)

The student will be on a one-on-one basis with Dr. Richard Field throughout his stay in which he will make rounds twice a day and operate daily.  He will serve as first assistant the majority of the time and second assistant the remainder.  He will work in the outpatient clinic with Dr. Field in the afternoon and will attend the Journal Club on Friday mornings and the monthly staff meeting of the hospital.

Quota:   l student
Duration: 1 month
Time Offered: Blocks 02, 04, 06, 08, and 10

Note:  This course is also offered for Community Medicine Core Credit (Course Code:  MDCM CMQ CEN) in alternate blocks: 01, 03, 05, 07, 09.  If an opening is available, this course may be taken as a Surgery Selective using the code MDSR GEN CEN.

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