Within this site you will find an orientation packet. You will find everything that a student receives at the beginning of their rotation. This includes the following: A description of the General Surgery clerkship; how the grades are broken down; the goals and objectives; information regarding each hospital at which students do their General Surgery month; all subspecialty clerkships which are offered; evaluation forms used to grade each student's performance; conferences with required attendance, and other useful information.

Day 1 and Day 2: Principles of Surgery Lecture Series

Day one and two of your rotation consist of distributing an orientation packet, an introduction to the Surgical Clerkship, and a lecture series from 8:00 AM to 5:30 PM each day. The lecture series topics include: Hypovolemic/Cardiogenic Shock; Surgical Infection; Assessment of Liver Function; Nutrition; Acute Abdomen; Transplant; CNS Injury and Neurogenic Shock; Wound Healing; Coronary Artery Disease; Trauma Assessment and Management; Breast, Colon & Lung Cancer; Fluid and Electrolytes, Abdominal Wall Hernias; Neonatal Physiology; Pathophysiology of Peripheral Vascular Disease; a Knot Tying and Suturing class and an OR orientation.

TULANE DEPARTMENT OF SURGERY

Operting Room Orientation

The OR is located on the 3 rd floor of Tulane Medical Center . You are part of a surgical team whose main objective is to provide quality patient care in a safe environment for staff and patients. Certain tasks seem mundane but each of us has a significant role and responsibility to meet this purpose. Since OR's vary, you are responsible for following the policies/procedures of the hospital to which you are assigned.

SURGERY CLERKSHIP  

COURSE DIRECTOR: Mary Jo Wright, M.D.; (586-3909 Room 8527); Pager 489-3510; Mwright2@tulane.edu

INTERIM COURSE DIRECTOR: Stephenie Long, MD (988-3311 Room 8530); srlong@tulane.edu

PROGRAM COORDINATOR: Patricia Kirsch (586-3909 Room 8502); Fax 988-1882; Pduboue@tulane.edu

SUGGESTED READING MATERIAL: Sabiston Textbook of Surgery, 16 th edition, (Townsend, ed.)

The Surgical Review; An Integrated Basic and Clinical Science Study Guide (Kreisel, Krupnick, Kaiser editors)

Surgery; Scientific Principles and Practice, 2 nd edition ( Greenfield , ed. - In chief)

Principles of Surgery, 6 th edition (Schwartz, ed. – in chief)

DESCRIPTION: All students are to assemble for the Principles of Surgery portion of the clerkship (described above). This series of lectures is designed to provide you with:

1.  A surgical perspective relative to fundamental topics in medicine

2.  Basic technical skills in knot-tying & suturing

A written examination (consisting solely of questions taken from the lecture material) will be administered upon completion of this lecture series at 8:30 AM of your third day on surgery.

Upon completion of the General Surgery and the Subspecialty Services, a National Board of Clinical Sciences Examination will be administered. Your clinical duties will end at 7:00 p.m. on the Wednesday immediately prior to Friday's final examination.

FINAL GRADE:

Clinical Evaluations: General Surgery 30%*

Inpatient Services 25%*

Examinations: National Board Surgery Examination 25%*

Oral Examination (General Surgery) 10%

Principles of Surgery Lecture Series 5%

Case Summaries 5%

TOTAL 100%

GRADING POLICY: To receive a grade of “pass”, a student must achieve minimal acceptable standards on both the National Board Examination (equivalent to a score in the 5 th percentile), and on each of the clinical evaluations. These requirements are marked with an asterisk above.

Should a student fail only the National Board Examination (and receive passing grades on each clinical rotation), a letter grade of “C” (Condition) and a numerical grade of 65 will be assigned. Given those circumstances, the student will be asked to undertake a period of intense review of the precepts in General Surgery. Upon completion of the remainder of their academic year, a second National Board Examination will be offered. Should he/she fail this examination, that student will be required to repeat the entire General Surgery clerkship prior to beginning his/her final year of medical school.

A student who receives a failing grade on any of the faculty evaluation forms will be notified immediately, and the General Surgery Medical Student Curriculum Committee will review their clerkship performance. Unless evidence is presented to the contrary, the student will receive a grade of “F”, and be asked to repeat, and pass elements of the entire General Surgery clerkship prior to beginning his/her final year.

A distinctly superior performance by a medical student on this clerkship will be properly accorded a letter grade of “ High Pass ” or “Honors”. A candidate for either grade must first have 1) established – in most if not all areas objective clerkship assessment listed above - numerical grades that consistently signify a quality performance -- and 2) a student must receive within the mean average of their group on the national board exam to quality for a “ High Pass ” or “Honors”.

Upon completion of the clerkship, the records of qualified candidates will be presented to the Department of Surgery Medical Student Curriculum Committee. At that time, pertinent additional factors - not limited to, but including the comments supplied by faculty evaluators on your evaluation forms, comments relating to individual performance on the oral examinations, reflections on a student's noncognitive skills, the degree of responsibility assumed by the student while rotating on the various services, etc., will be taken into consideration by the committee.

A singular performance will be reflected in awarding a grade of “Honors” by the committee, while that deemed to be outstanding but failing short of honors level work will be signified by a grade of “High Pass”. Short of mathematical error, all numerical and letter grades are final.

In the student letter to the Dean's Office, the course director will at minimum, summarize the written comments received by the student on the rotation assessment forms. A statement as to the students' performance on the National Board of Clinical Sciences Examination will be included in each letter.

STUDENT ASSESSMENT:

Evaluation Forms: Each faculty will receive an evaluation form, designed to assess your progress in mastering the fundamentals in surgery. In addition, the house officers with whom you worked will submit an evaluation that will contain their consensus of your progress.

Oral Examination: About eight days before the end of the General Surgery block of this clerkship, you will be assigned a staff member in the Department of Surgery who is responsible for administering your oral examination. This list will be made available in Patricia Kirsch's office (586-3909, room 8502).

It is your responsibility to contact the office of the assigned staff member to mutually set aside ½ hour, during the final week of the rotation, for this examination. The date and time of the exam are the choice of the examiner. You are to bring with you the patient log you were asked to maintain; you will be questioned primarily on your knowledge regarding the disease processes of the patients for whom you cared. After the examination is finished, the patient log will be attached to the oral examination form.

Any student who fails the oral examination will be asked to retake the test until a minimally acceptable performance is achieved.

CONFERENCES:

Entire Rotation: {unless rotating at Huey P. Long, Ochsner, or Touro}

1. Grand Rounds: Room 7062 in the Medical School every Thursday at 5:00. Students on Neurosurgery, Orthopaedics, ENT, and Urology should attend only if they have nothing scheduled during this time.

2. Junior Surgery Presentations: Every Friday from 11:00-12:00 room 6001. Each student must check the attached schedule to find out which Friday they are scheduled to present. Every Wednesday at 3:30 Dr. Hewitt will meet with the students (in his office, room 8513) scheduled for that Friday to discuss what is expected. All students are required to attend.

3. Noon Case Summary Conference: Room 8563 (Surgery Library) every Wednesday at 12:00 p.m. All students are invited to discuss their case scenarios. A light lunch will be provided. All students are required to attend.

General Surgery Month: {unless rotating at Huey P. Long, Ochsner, or Touro}

1. Case Presentations Conference: Charity, TMC, and University students are required to participate in the Case Presentations Conference, held on Wednesday's at 4:00 p.m. in the Plastic Surgery Conference Room (room 8207). Dr. Raafat will explain the format of this conference to you during the first session.

Subspecialty Services Month:

Inpatient Conferences: Students are required to attend every conference except Urology, which is optional.

Cardiothoracic; Monday 3:00 p.m.; Surgery Library (room 8563)

Neurosurgery; Friday 8:00 a.m.; Tidewater Building (rm 1621)

Lap Skills Lab; Friday 10:00 a.m.; Medical School (room 8720)

Orthopaedics; Wednesday 7:15 a.m.; Medical School (room 2115)

Lap Skills Lab; Wednesday 11:00 a.m.; Medical School (room 8720)

Otolaryngology; Thursday 3:00 p.m.; Medial School (room 2040)

Lap Skills Lab; Thursday 11:00 a.m.; Medical School (room 8720)

Pediatric; Surgery Tuesday 12:00 p.m.; Surgery Library (room 8563)

Urology (all optional); 4th Wednesday 5:30 p.m.; Urology Library (room 3515)

2nd Wednesday; 6:00 p.m.; Urology Library (room 3515)

1st & 2nd Tuesday; 6:00 p.m.; Children's Hospital

Every Wednesday; 7:00 a.m.; Urology Library (room 3515)

WEDNESDAY JUNIOR SURGERY STUDENT NOON CONFERENCE

PURPOSE: The purpose of the Wednesday conference is to provide an opportunity to improve clinical problem solving, library research, oral presentation, and writing skills. This exercise will be done in the small group seminar format. A series of case studies have been prepared. There will be a faculty facilitator at each conference. One or more students will be chosen at each conference to present and defend the case summary each has prepared for the conference. All case summaries must be given to Patricia (room 8502, pduboue@tulane.edu , or faxed to 988-1882) before the conference begins. Case summaries submitted after the start of the conference will not be accepted. Scores for the entire series will be averaged at the close of the clerkship.

BASIC INSTRUCTIONS:

1.  During the course orientation, each student will receive the case histories on which each conference will be based.

2.  You should review the case histories and prepare a one page written summary of your analysis of the problem posed by the case, your understanding of the pathophysiology, and your plan for management of the case. Neatness, grammer and spelling count toward your grade. Typewritten reports are preferred. If we can't read it - we can't grade it properly (e.g. font of typewritten reports is too small or penmanship is poor). Please make sure you limit your summary to one page, including references. Failure to do so will result in deducted points.

3. At the end of the summary, remaining within the one page limit, you should list three references you used to prepare your summary. Only one of these may be a standard textbook and one must be a journal article written during the past 10 years.

4.  Grades for each summary will be based on the following:

•  Organization - 25%

•  Content - 50%

•  Clarity, Grammar & Style - 15%

•  References - 10%

5.  There will be an emphasis on complete care plans which focus on the best interest of the patient. Cost effectiveness will also be stressed.

GRADE: Your grade will be derived from five case summaries. Those students who submit more than five summaries will benefit by having the five highest grades selected for their composite grade. The composite grade will count as 5% of your clerkship grade.

JUNIOR SURGERY PRESENTATIONS

11:00 – 12:00 Friday (room 6001)

Six Friday Dates within the rotation

Four students on each of the six Friday's are chosen to present. If you are presenting, you will meet as follows:

· Every Wednesday at 3:30 Dr. Hewitt will meet with the students scheduled for that Friday to discuss what is expected. (room 8513)

On Thursday, Patricia Kirsch will contact you by beeper to give you your patient's name, hospital and room number and diagnosis.

On that Friday, you will present that patient to your peers.

GENERAL SURGERY  

DESCRIPTION: The General Surgery rotation is primarily an inpatient-based experience designed to familiarize the student with acute and elective surgical decision making processes (see Goals & Objectives ). However, much of the postoperative management is now performed in the outpatient setting and students will as well be expected to participate in this phase of care as well.

A team of surgery house officers and at least one attending surgeon-preceptor will staff each General Surgery service, on which medical students will rotate. These personnel will provide ample opportunities for “on the job” experience relative to the discipline of medicine in general and surgery in particular. Com prepared with the knowledge of surgical procedure, anatomy and patient history. You will be asked to assist with positioning, prepping and possibly draping. If not, once gowned and gloved, stand on the sterile field side of the room.

During the course of the General Surgery rotation, you are to keep a concise log of all patients for whom you were given primary responsibility. Specific data to be recorded are: primary diagnosis, whether management occurred on an inpatient or outpatient basis, operation (if any), and complications.

HOSPITAL SITES: Charity, University, Tulane, Ochsner, Touro and Huey P. Long

Charity Hospital : Four students will be assigned as follows.

Clinic: Thursday at 8:30 AM on MCLNO's 10 th Floor Center

In-house call will occur on Tulane Trauma days (every other day). You are to maintain the same on-call hours as your house officer. The Call Room is on the 16 th Floor of Charity Hospital, room 1613. In-house call will occur every fourth night on Tulane trauma days. Two students take call each trauma day.

· Since many services do not require in-house call, Charity Emergency Room Call will be assigned to all General Surgery rotations from 7 p.m. – 7 a.m., once a month. Please contact Patricia to schedule your night.

Huey P. Long: It is expected that the students who select this rotation will be provided with considerable “hands on” experience in the care of surgery patients, under the supervision of the attending faculty (Dr. Lee) and the general surgery house officers. You will assume considerable responsibility in the care of patients assigned to you, have the opportunity for active participation in daily rounds, perform of admission history and physical examinations, and, to the extent of your abilities, operative and preoperative management.

There will be no in-house call. Call is taken from the housing facilities (located next to the hospital) provided during your stay. A parking area is available next to the housing quarters. Meals can be purchased in the cafeteria at a reduced rate ($ 1.50/meal maximum). Your contact person in Pineville is Irma White (318-473-1425).

DIRECTIONS:

Ochsner Hospital : Each student will be assigned for a one week period of time to each of three or four surgery services. The attending who oversees the student surgery program at Ochsner is Dr. Richardson. Your contact person is Rhonda Crews (842-4620).

1.  Dr. G. Fuhrman: Residency Program Director

This is a general surgery and surgical oncology service, with an emphasis on diseases of the breast, pancreas and melanoma. A PGY-V and a PGY-II resident staff this service.

2.  Dr. J. Bolton: Associate Medical Director of the Ochsner Clinic

This is a general surgery and surgical oncology service, with an emphasis on disease of the esophagus, liver, and endocrine system. A PGY-V and a PGY-I resident staff this service.

3.  Dr. J. Bowen: Chairman- Department of Surgery

This is a general and vascular surgery service with an emphasis on diseases of the biliary tract and cerebrovascular system. A PGY-V and a PGY-I resident staff this service.

4.  Dr. D. Beck: Chairman - Department of Colon & Rectal Surgery

This is a service with an emphasis on colorectal carcinoma and inflammatory bowel disease. A colorectal fellow, a PGY-IV and a PGY-I resident staff this service.

During each of your rotations, you will be given ample opportunity to work with your surgery team in the inpatient and outpatient environments. You are expected to become an integral part of the service to which you are assigned. All student rounds must be completed prior to making rounds with the residents. This will necessitate early arrival at the hospital so that all patients can be evaluated prior to making rounds with the residents and staff. There will be no in-house call , but you should remain with your team until the clinical and educational responsibilities have been completed for the day.

A mandatory student conference schedule will be issued to each student prior to the beginning of the rotation. The conduct of this conference will be explained to you at the beginning of the rotation. Medical students are expected to prepare for each of these sessions. In addition, each medical student will be responsible for a weekly case presentation. The student should be well prepared to discuss the details of the assigned case and be knowledgeable regarding the pathophysiology of the patient's disease process. Attendance at the Saturday morning conferences ( 7:00-10:00 a.m. ) in Conference Room A & B will be required of each student. Finally, the daily lectures that were held during the 1995-1996 year will be re-instituted. The schedule for lectures will be provided to the students prior to the beginning of the rotation. These lectures will be mandatory and students must attend and be on time for the assigned lecture. The noon conference write-ups are to be faxed to Patricia (988-1882) to be graded. They must be received by 12:00 on Wednesday.

Each student will have an exit interview with Dr. Fuhrman prior to the end of the rotation. The purpose of this is to discuss the student's evaluation during this rotation, and to allow the student the opportunity to discuss the quality of their educational experience at Ochsner.

You must see Rhonda Crews in the office of Graduate Medical Education as soon as you arrive at Ochsner. The address is 1516 Jefferson Hwy , room 634. Her phone numbr is 842-3260.

Before beginning this rotation, each student must obtain an immunization form signed by a representative of the Office of Student Affairs. Please order your immunization form one week prior to starting your rotation at Ochsner. Bring this form with you when you check in with the Office of Graduate Medical Education Rhonda will register each student for insurance purposes and to issue parking passes.

Touro Infirmary: Students who select this rotation will be assigned to each of the two general surgery teaching services, Surgery I and Surgery II. Several surgeons have volunteered to be on the teaching services; it is their responsibility to work with the residents in order to provide the students with additional instruction regarding the precepts of surgery and monitoring your progress in assimilating its fundamentals.

During your rotation, you are expected to become an integral part of the service to which you are assigned. This includes maintaining inpatient ward responsibilities, experiencing the operating room environment, participating in outpatient clinics, and attending conferences. A case presentation conference will be held each Friday at 3:00 p.m.

Each student will have no in-house call . Your contact person is Claudia Ruello, in the Medical Education Office (897-8853).

Parking is provided for medical students at the Bultman Parking Lot , located at the corner of Louisiana Avenue and Prytania Street . Please be advised:

1.  Enter on Louisiana Avenue only

2.  Place the temporary parking permit in your windshield

3.  If you choose to park in the Delachaise lot, you will be responsible to pay the normal parking rates.

Tulane Medical Center : At least two students will be assigned to a service and will assist in the care of those patients under the care of Dr. Jaffe and under the care of Drs. Scott, Corsetti, Townsend and McKinnon. Your duties are to include, but are not limited to:

1.  Provide daily inpatient care for the patients to whom you are assigned.

2.  Perform histories and physical examinations.

3.  Participate in the operations being performed on your patients.

4.  Work with attending physicians in their outpatient clinics (5 th floor of the hospital)

5.  Attend relevant conferences.

University: Two students are assigned to this service. Your duties are to include, but are not limited to:

1.  Provide daily inpatient care for the patients to whom you are assigned.

2.  Perform histories and physical examinations.

3.  Participate in the operations being performed on your patients.

4.  Work with residents and attendings in the outpatient clinics

5.  Attend relevant conferences.

Clinics:

Surgical Oncology: 1:00 PM on MCLNO's 10 th Floor East

General Surgery: 8:00 AM on MCLNO's 10 th Floor Center

GENERAL SURGERY GOALS & OBJECTIVES

I. COGNITIVE GOALS

A.  Develop an appreciation of the unique potential of surgical therapy in the correction of seriously deranged physiological status.

1.  Define physiologic and biochemical derangement's amenable to anatomic correction.

2.  Define the limits beyond which life-threatening derangement's are no longer responsive to non-invasive methods.

B. Become familiar with diseases amenable to surgical correction or amelioration.

1.  Define surgical diseases and methods of diagnosis.

2.  Outline techniques and procedures used in surgical treatment.

3.  Differentiate common surgical and non-surgical diseases by using history and physical findings.

4.  Select appropriate laboratory and x-ray studies for establishing diagnosis.

C.  Comprehend the effect of trauma, shock, sepsis, and surgical intervention.

1.  Enumerate the common disorders of metabolism and physiology associated with trauma.

2.  Contrast above disorders in varying types of injury.

3.  Outline methods of resuscitation for correction to hypovolmia, and maintenance of cardiopulmonary function.

D.  Correlate disordered physiology observed pre-operatively and pre and postoperative physical findings with pathology seen at the time of operation.

1.  Outline the anatomic and physiologic consequences of surgical intervention.

2.  Discuss the range of therapeutic choices for specific disease entities.

3.  Extrapolate above generalities to the specific case.

II. AFFECTIVE GOALS

A.  Perform as a member of a surgical team in an environment, which requires prompt decisions and responses.

1.  Responds to the rapid adjustments demanded by surgical illness.

2.  Accepts responsibility for night and emergency work.

3. Maintain student orientation rather than developing lifestyle of surgical milieu.

B.  Understand the emotional effects of surgical intervention.

1.  Define and accept risks of surgical intervention.

2.  Maintain stable and empathetic manner toward the patient faced with the need for surgical intervention.

3.  Anticipate and allay the fears, guilt, and depression associated with trauma and operation.

4.  Value the dignity of the patient.

5.  Outline appropriate alterations in the approach to the patient and family depending on multifactorial situations.

C.  Comprehend the effects of surgery on social and economic status and family.

1.  Outline costs if hospitalization, common laboratory procedures, and operations.

2.  Outline costs of rehabilitation time.

3.  Plan patient work-up and care to minimize hospitalization time and costs.

III. SKILLS

A.  Master common manual techniques and procedures used for diagnosis and therapy.

1.  Demonstrate proper use of aseptic technique and wound dressing.

2.  Suture simple lacerations under local anesthesia.

3.  Demonstrate poise in the operating room.

4.  Function as 2 nd assistant in the operating room.

GENERAL SURGERY/INPATIENT ROTATION EVALUATION FORM

Name ______________ Rotation Dates ____________

Department ______________ Evaluator ___________________

Uses of the evaluation: This evaluation becomes a part of this student's permanent record. It will be used: 1) by the Department of Surgery whenever it bears on problems or awards concerning this student; 2) as a significant part of any letter of recommendation for this student that may arise from the Dean's Office or from the Department of Surgery.

PROFESSIONALISM 

Rating Scale: 1 2 (Lowest Score) -- 3 4 5 6 7 8 -- 9 10 (Higest Score)

UA (Unable to Evaluate)

•  Altruism: 1 2 3 4 5

Student demonstrates arrogance and pretentiousness towards patients and/or colleagues. Student demonstrates greed for personal fame/power.

•  Altruism: 6 7 8 9 10 UA

Student always puts the best interest of the patient as the highest priority.

•  Accountability: 1 2 3 4 5

Student demonstrates impaired judgment and incompetence. Student refuses to accept patient's responsibility for his/her actions .

•  Accountability: 6 7 8 9 10 UA

Student is accountable for fulfilling the contract of the physician to the patient and the patient's family.

•  Commitment to Excellence: 1 2 3 4 5

Student is content to do the minimum, is uncommitted to academic responsibilities.

•  Commitment to Excellence: 6 7 8 9 10 UA

Student demonstrates commitment to life-long learning and self improvement.

•  Acceptance of Professional Responsibility: 1 2 3 4 5

Student is not to be found when on call, putting personal needs ahead of professional responsibility. Student does not attend conferences and/or unprepared if present.

•  Acceptance of Professional Responsibility: 6 7 8 9 10 UA

Student demonstrates willingness to serve the needs of patients despite inconvenience, or reasonable personal risk. Student is available when on call. Student attends conferences, is well prepared and punctual, and contributes to patient care discussions.

•  Integrity and Honor: 1 2 3 4 5

Student has misrepresented achievement through fraud and/or laziness.

•  Integrity and Honor: 6 7 8 9 10 UA

Student is fair, truthful, consistently meets commitments, recognizes and avoids conflicts of interest.

•  Respect for Others: 1 2 3 4 5

Student has demonstrated abuse of power of toward patients, colleagues or faculty. Student has demonstrated bias or discrimination against others. Student has breached patient confidentiality.

•  Respect for Others: 6 7 8 9 10 UA

Student demonstrates the hightes standards respect for patients, families, colleagues, residents, faculty, nurses, and other members of the health care team.

(Over)

COGNITIVE SKILLS 

COMMENTS: Please comment upon this student's unique strengths and/or weaknesses. Neither superior/unsatisfactory marks will be accepted unless justified in sufficient detail.

_______________________________ _________________________

Student's Name Department

_______________________________ __________________________

Numerical Grade Signature

When submitting your overall score to include your assessment of the student's professionalism, please keep in mind that the numerical s core is as follows: Honors - 90-100; High Pass - 87-89; Pass - 80-86; Condition - 65-79; Fail - <65. Detailed comments for students given superior or unsatisfactory grades must be submitted so as to justify these marks.

SUBSPECIALTY ROTATIONS

DESCRIPTION: Each student will spend an equivalent amount of time (two weeks) on each of two subspecialty services. The surgical subspecialty services that offer two week rotations include: Cardiothoracic Surgery, Neurosurgery, Orthopaedic Surgery, Otolaryngology, Pediatric Surgery, Transplant, Urology, and Vascular Surgery. These specialties have their own educational guidelines and objectives. You will be informed of these early in each rotation by the faculty in charge of student education and you will be expected to follow these guidelines.

Patient care responsibilities, in-house call schedule, attendance at specialty conferences, and the like will vary considerably form specialty to specialty. However, the common goal of each specialty is to teach the fundamental concepts of patient care within that particular field.

STUDENT CONFERENCES: A series of instructional conferences are offered to students on the subspecialty rotations. All students, regardless of which service they are assigned, are required to attend each conference except Urology, which is optional. Attendance at these conferences virtually supersedes all other responsibilities.

STUDENT ASSESSMENT: The faculty member in charge of each of the specialty rotations will receive an evaluation form that is designed to assess your performance. In addition, the residents with whom you worked will submit a single evaluation form summarizing their consensus of your performance on the rotation.

CONTACT PEOPLE: Cardiothoracic, Dr. Pigott; TBA; 988-3311

Neurosurgery, Dr. Richardson; Patricia 588-5565

Otolaryngology, Dr. Amedee; Sharon 588-5454

Orthopaedics, Dr. Edmunds; Lorelei 588-3515

Pediatric Surgery, Dr. Steiner; Heide 586-3994

Plastic Surgery, Dr. Newsome/Jansen; Linda 988-4584

Transplant, Dr. Slakey; Maria 588-2317

Urology, Dr. Thomas; Margeaux 584-2794

Vascular, Surgery Dr. Akers/Dr. Hewitt; Debra 587-7520

The times of these conferences are as follows:

Cardiothoracic, Monday 3:00 p.m., Surgery Library (8563)

Pediatric Surgery, Tuesday 12:00 p.m., Surgery Library (room 8563)

Orthopaedics, Wednesday 7:15 a.m., Medical School (room 2115)

Lap Skills Lab, Wednesday 11:00 a.m., Medical School (room 8720)

Otolaryngology, Thursday 3:00 p.m., Medical School (room 2040)

Lap Skills Lab, Wednesday 11:00 a.m., Medical School (room 8720)

Neurosurgery, Friday 8:00 a.m., Tidewater Building (room 1621)

Lap Skills Lab, Friday 10:00 a.m., Medical School (room 8720)

Urology (all optional), 4 th Wednesday of the month 5:30 p.m., Urology Library (room 3515)

2nd Wednesday of the month, 6:00 p.m., Urology Library (room 3515)

1st & 2nd Tuesday of the month, 6:00 p.m., Children's Hospital.

3rd Wednesday of the month, 6:00 p.m., (room 6001)

* only students on Urology -- every Wednesday 7:00 a.m., Urology Library (room 3515)

SUB-SPECIALTY: CARDIOTHORACIC SURGERY

COURSE DIRECTOR: John D. Pigott, M.D.; Professor of Surgery Cardiothoracic/Transplant

Serafin Y. DeLeon, M.D.; Professor of Surgery- Pediatric Cardiothoracic

CONTACT PERSON: TBA, 988-3311, Room 8530

PRIMARY RESPONSIBILITIES:

1. Operating room and rounds with Dr. Pigott

SECONDARY RESPONSIBILITIES:

Tuesday TMC Surgery Clinic (Dr. DeLeon) 5th Floor TMC 1:00-3:00

Friday TMC Surgery Clinic (Dr. Pigott) 5th Floor TMC 1:00-3:00

SUB-SPECIALTY: NEUROSURGERY

COURSE DIRECTOR: Donald Richardson, M.D.; Professor & Chairman of Neurosurgery; Suite 1621 Tidewater Building; 1440 Canal Street; New Orleans , LA 70112

CONTACT PERSON: Patricia, 588-5565, TW Room 1621

COURSE OBJECTIVES:

1. Basic understanding, the management and operative techniques used in care of the neurosurgical patient.

2. Student will gain experience in direct care of the neurosurgical patient and in decision making that is unique to the field.

DIDACTIC MATERIAL: Neurosurgery an introductory text ($10.00 refundable deposit)

OUTPATIENT CLINICAL RESPONSIBILITIES:

Monday: 6:15 a.m.- Neurosurgery Rounds

7:00 a.m. - OR MCLNO

7:30 a.m. - OR TMC

Tuesday: 6:15 a.m. - Neurosurgery Rounds

7:00 a.m. - OR MCLNO

7:30 a.m. - OR TMC

Wednesday: 6:15 a.m. - Neurosurgery Rounds

7:00 a.m. - OR MCLNO

7:30 a.m. - OR TMC

12:00 noon - VAMC Clinic

Thursday: 6:15 a.m. - Neurosurgery Rounds

7:30 a.m. - OR TMC

12:00 noon - Charity Clinic

Friday: 6:15 a.m. - Neurosurgery Rounds

8:00 a.m. - Junior student case presentation (TW room 1621)

12:00 noon - Neurosurgery Conference (TW room 1621)

1:15 p.m. - Neuropathology Conference

Saturday: 7:00 a.m. - Neurosurgery Rounds

Sunday: 8:00 a.m. - Neurosurgery Rounds

CONFERENCES:

The 2nd Saturday of each month is M&M Confenence

(January, April, July, & October - Held at Ochsner Hospital )

(February, May, August, & November - Held at LSU Medical School )

(March, June, September, & December - Held at Tulane Medical School )

NOTE: · Goal is to get good exposure at TMC, MCLNO & VAMC. Students are encouraged to scrub on any interesting neurosurgical case they desire.

SECTION REQUIREMENTS

SUB-SPECIALTY: ORTHOPAEDIC SURGERY

COURSE DIRECTOR: J. Ollie Edmunds, MD; Professor of Orthopaedic Surgery; Director of Orthopaedic Medical Student Education; Suite 1500 Tidewater Building; 1440 Canal Street; New Orleans , LA 70112; oedmunds@msn.com; 558-0103 x10, FAX 558-0106

CONTACT PERSONS: Michon Shinn, 584-3516, TMS 2068; Lorelei Miller, 558-0103 x10, Tidewater Suite 1500

COURSE OBJECTIVES:

1. To introduce the junior student to the concepts, principles, and terms of orthopaedics by reading and clinical work.

2. To prepare the junior student for the orthopaedic portion of the National Board examination in surgery.

3. To introduce the future young physician to common everyday musculoskeletal problems useful in clinical practice no matter what area of medicine is later chosen.

4. To enhance the student's diagnostic and physical examination skills with respect to the extremities, spine, and musculoskeletal system.

5. To enhance the student's ability to read and interpret x-rays of the skeletal system.

REQUIRED READING : Textbook of Disorders and Injuries of the Musculoskeletal System; Robert B. Salter (3 rd Edition); Williams & Wilkins, Baltimore , Maryland , 1999

**Refer to the Orthopaedic Surgery Course Description and course outline and study guide for required reading

CLINICAL RESPONSIBILITIES:

**Refer to the “Orthopaedic Surgery Course Description” for more details

All junior students directly assigned to orthopaedics will be assigned to MCLNO ( Charity Hospital ), under the supervision of the chief residents at Charity and faculty supervisor Ollie Edmunds, MD.

One of the chief residents will assign students to a team and a junior resident in his first year of orthopaedics (PGY2). Students should spend most of their day and evening with that junior resident. When he works up a patient, goes to surgery, or goes to the ER, they should accompany him, learn from him, get his beeper number, and know where he is at all times night and day. Students are expected to work up patients, scrub in surgery, assist in fracture reductions and casting, see patients in the Charity clinic, attend conferences, and do the required reading.

Students are expected to be on call when their resident is on call at Charity. Every night which is a Tulane admitting night at Charity two of the junior students should also be on call. This way with every other night a Tulane admitting night, each junior student should have at least one, and hopefully two, on-call nights during a two-week rotation.

RESIDENT PAGER NUMBERS:

ACADEMIC RESPONSIBILITIES:

All students will be given a written outline of academic and clinic responsibilities. Textbook reading is required. Final grades are assigned by faculty member, Ollie Edmunds, MD, on the basis of a written final exam and written reports to him by both junior and senior residents at Charity.

ADDITIONAL RESPONSIBILITIES:

**Refer to the Outline “Orthopaedic Surgery Course Description” for more details

* = Required

† = Optional

Upon completion of the orthopaedic rotation, it is the student's responsibility to contact Heidi Clayton (558-0103 x10), Tidewater Suite 1500 , to set up an Exit Interview with faculty student supervisor, Dr. Ollie Edmunds.

SUB-SPECIALTY: OTOLARYNGOLOGY

COURSE DIRECTOR: Ronald Amedee, M.D.; Professor & Chairman of Otolaryngology

CONTACT PERSON: Sharon Barousse (588-5454, room 2030)

Contact the Friday before the rotation begins.

They will give you the resident's pager number. It is your duty to contact her/him on Friday to arrange for a meeting time/place.  

OBJECTIVES:  

During your two-week rotation in Otolaryngology/Head and Neck Surgery you will be exposed to the full array of medical and surgical conditions seen and treated in clinic and in the operating room. Even though up to 70% of our surgical procedures are performed on an outpatient basis, extensive head and neck resections requires lengthy stay in the ICU and surgical ward.

RESPONSIBILITIES DURING CLINIC:

· You are expected to learn to perform a thorough head and neck exam.

· To examine patients and discuss their care under resident's supervision.

RESPONSIBILITIES DURING ICU/SURGICAL WARD:

· You are expected to follow in-patients, write notes, and present patient to attending and/or chief residents during morning rounds.

OUTPATIENT CLINICAL RESPONSIBILITIES:

Monday, Clinic (MCLNO East 219), 8:30 a.m. - 5:00 p.m.

Tuesday, MCLNO Surgery (room 17-18 west side), 6:45 a.m. - till

Wednesday, Clinic (MCLNO East 219), 8:30 a.m. – 5:00 p.m.

Thursday, MCLNO Surgery, 6:45 a.m.

Friday, every other Friday clinic, 8:30 a.m. – 5:00 p.m.; Every other Friday surgery 6:45 a.m.

ADDITIONAL RESPONSIBILITIES:

· You are expected to attend the weekly Thursday Conference at 3:00 p.m. (room 2040).

· Suggest that each student attempt to spend some time in the ER when Otolaryngology is on call for facial trauma.

· You are expected to take in-house call on facial trauma nights, which are currently every 6 th night.

OTOLARYNGOLOGY CONFERENCE SCHEDULE

JANUARY – JUNE 2002  

JANUARY  (3:00-4:00)

3rd - Lippincott

10th - TBA

17th - "Sensorineural Hearing Loss"; Ronald G. Amedee, MD

24th - Vaughn

31st - "End of Life Care"; Marc Kahn, MD

JANUARY  (4:00-5:00)

3rd - Case Conference

10th -

17th - Pre-op/M&M

24th - Combined Eye/ENT Pre-op/M&M; Case Conference

31st - Pre-op/M&M

JANUARY  (5:00-6:00)

3rd - Pre-op/M&M

10th - Kim

17th - Khoury

24th - Pre-op/M&M

31st - Schaffer

FEBRUARY  (3:00-4:00)

7th - "Malignant Melanoma"; Andrew Nemecheck, MD

14th - Gamma Knife @ Touro; John Walsh, MD

21st - "Speaking for Excellence - Part II"; op/M&M; Sponsored by Bayer Pharmaceuticals

28th - CONFERENCE CANCELLED -IN-SERVICE EXAM

FEBRUARY  (4:00-5:00)

7th - Pre-op/M&M

14th - Gamma Knife (cont.)

21st - Speaking for Excellence (cont.)

28th - CONFERENCE CANCELLED -IN-SERVICE EXAM

FEBRUARY  (5:00-6:00)

7th - Lacey

14th - Pre-op/M&M

21st - Preop/M&M

28th - CONFERENCE CANCELLED -IN-SERVICE EXAM

MARCH  (3:00-4:00)

7th - TBA

14th - "Endoscopic Approach to the Skull Base"; Daniel Nuss, MD

21st - "Rehabilitation of the Laryngectomy Patient"; Hope McGougin

28th - Pre-op/M&M

MARCH  (4:00-5:00)

7th -

14th - Pre-op/M&M

21st - Pre-op/M&M

28th - Case Conference

MARCH  (5:00-6:00)

7th - O'Mara

14th - Rodriguez

21st - Sharma

28th - Schneider

APRIL  (3:00-4:00)

4th - "Lymphoma: Diagnosis and Classification"; Charles Krause, MD

11th - Smullen

18th- "Introduction to Radiation Oncology"; Lucien Nedzi, MD

25th - Schaffer

APRIL  (4:00-5:00)

4th - Pre-op/M&M

11th - Case Conference

18th- Pre-op/M&M

25th - Case Conference

APRIL  (5:00-6:00)

4th - Lippincott

11th - Pre-op/M&M

18th- Khoury

25th - Pre-op/M&M

MAY (3:00-4:00)

2nd - "Surgical Orbital Anatomy"; Kyle Acosta, MD

9th - Schneider

16th- COSM (MAY 12-14)

23th - Lacey

30th - "Pediatric Pulmonary Update"; Robert Beckerman, MD

MAY (4:00-5:00)

2nd - Pre-op/M&M

9th - Case Conference

16th- COSM (MAY 12-14)

23th - Combined Eye/ENT; Case Conference

30th - Pre-op/M&M

MAY (5:00-6:00)

2nd - Gonzales

9th - Pre-op/M&M

16th- COSM (MAY 12-14)

23th - Pre-op/M&M

30th - Sharma

JUNE (3:00-4:00)

6th - Gonzales

13th - "Management of Lower Airway Lesions"; Kevin Kovitz, MD

JUNE (4:00-5:00)

6th - Case Conference

13th - Pre-op/M&M

JUNE (5:00-6:00)

6th - Pre-op/M&M

13th - Rodriguez

SUB-SPECIALTY: PEDIATRIC SURGERY

COURSE DIRECTOR: Rodney Steiner, M.D.; Associate Professor of Clinical Surgery; Clinical Associate Professor of Pediatrics

CONTACT PERSONS: Heide Dyer, 586-3994, Room 8557

PRIMARY RESPONSIBILITIES:

Monday, MCLNO Clinic, 10 Center MCLNO 1:00-4:00

Tuesday, TMC Pediatric Surgery, Clinic 5th Floor TMC 9:00-12:00

Friday, TMC Pediatric Surgery Clinic, 5th Floor TMC 9:00-12:00

CONFERENCES:

Tuesday, Pediatric Surgery Student Conference, Surgery Library (room 8563) 12:00-1:00

Tuesday, Pediatric Tumor Conference, Pediatric Library (4th fl TMC) 4:00-5:00

3rd Wednesday of each month, Ochsner Pediatric Surgery Conference, Monroe Hall 7:00-8:00 am  

Wednesday, Department of Surgery M&M, Medical School (room 5150) 4:00-5:00

Thursday, Department of Surgery Grand Rounds, Medical School (room 7062) 4:00-5:00

SUB-SPECIALTY: PLASTIC SURGERY

COURSE DIRECTOR: David A. Jansen , MD; Associate Professor of Surgery; Chief, Section of Plastic and Reconstructive Surgery

R. Edward Newsome , MD; Associate Professor of Surgery

CONTACT PERSON: Linda Hill, 988-4584, Room 8207

PRIMARY RESPONSIBILITIES:

Monday, 7:15 a.m., TMC O.R. 3rd floor (Dr. Newsome/Dr. Jansen)

Wednesday, 9:00 a.m., TMC Clinic 5th floor (Dr. Newsome)

First Wednesday of the month, 9:00 a.m. Craniofacial Clinic, 5th floor (Dr. Jansen)

First Thursday of the month, 9:00 a.m., Multidisciplinary Skin Cancer Clinic (Dr. Newsome)

Wednesday, 1:00 p.m., TMC Clinic 5th floor (Dr. Jansen)

Thursday, 1:00 p.m., TMC Clinic 5th floor (Dr. Newsome)

Friday, 7:15 a.m., TMC O.R. 3rd floor (Dr. Newsome)

SECONDARY RESPONSIBILITIES:

Rounds with Dr. Newsome and Dr. Jansen

DIDACTIC MATERIAL: See Dr . Newsome

SUB-SPECIALTY: TRANSPLANT (ABDOMINAL)

COURSE DIRECTOR: Douglas Slakey, M.D., MPH, Assistant Professor of Surgery, Director of Multi-Organ Transplant Center

Sunil Geevarghese, M.D.

Sander Florman , MD, Assistant Professor of Surgery

CONTACT PERSONS: Maria , 588-2317, Room Tidewater 1615

COURSE OBJECTIVES:

1.  Basic understanding of abdominal transplant patient management and operative techniques.

2.  Student will gain experience in direct care of abdominal transplant patients and in decision making that is unique to the field.

DIDACTIC MATERIAL: Check with Dr. Slakey

PRIMARY RESPONSIBILITIES:

Monday 6:45 a.m. - Abdominal Transplant Rounds

Monday 7:15 a.m. - TMC OR

Monday 9:00 a.m. - TMC Clinic (5th floor TMC)

Tuesday 6:45 a.m. - Abdominal Transplant Rounds

Tuesday 7:15 a.m. - TMC OR

Wednesday 6:45 a.m. - Abdominal Transplant Rounds

Wednesday 7:15 a.m. - TMC OR

Wednesday10:00 a.m. - TMC Clinic (5th floor TMC)

Thursday 6:45 a.m. - Abdominal Transplant Rounds

Thursday 7:15 a.m. - TMC OR

Thursday 9:00 a.m. - TMC Clinic (5th floor TMC)

Friday 6:45 a.m. - Abdominal Transplant Rounds

Friday 7:15 a.m. - TMC OR

CONFERENCES:

Friday 1:00 p.m. - Selection Committee (Tidewater 16th Floor)

NOTE: Goal is to get exposure at TMC with clinical and surgical care. Students are encouraged to scrub in on any case.

SUB-SPECIALTY: VASCULAR SURGERY

COURSE DIRECTOR: Donald Akers, M.D., Associate Professor of Surgery

Robert Hewitt, M.D., Professor & interim Chairman of Surgery

CONTACT PERSON: Debra Felix (587-7520, room 8530)

COURSE OBJECTIVES:

1.  Become familiar with patients who have peripheral vascular disease. Specifically to understand the diagnosis and treatment of aneurysmal disease, aorta iliac occlusive disease, peripheral occlusive disease, and carotid disease.

2. Learn concepts in the management of venous insufficiency and the concepts of treatment of DVT and pulmonary embolism.

3.  Become familiar with the use of the vascular laboratory and the diagnosis and treatment of peripheral vascular disease.

DIDACTIC MATERIALS:

1. Seymor Schartz - Principles of Surgery (5th edition)

2. Textbook of Surgery - Sabiston (13th edition, volume 1)

3. Pertinent articles will be reprinted for the students to discuss

OUTPATIENT CLINICAL RESPONSIBILTIES: (TMC)

Monday, 9:00-12:00, Vascular Laboratory - Dr. Hewitt; (5th floor behind Surgery Clinic); check with Vascular Laboratory

Monday, 1:00 p.m. 5th floor Surgery Clinic - Dr. Akers

Tuesday, 7:30 a.m. Operating Room - Dr. Akers

Tuesday, 9:00 a.m. Vascular Clinic - Dr. Hewitt

Wednesday, 7:30 a.m. Operating Room - Dr. Hewitt

Wednesday, 9:00 a.m. Vascular Clinic - Dr. Akers

Thursday, 7:30 a.m. Operating Room - Dr. Akers

Thursday, 1:00 p.m. Vascular Clinic - Dr. Hewitt

Friday, 7:30 a.m. Operating Room - Dr. Akers & Dr. Hewitt

SUB-SPECIALTY: UROLOGY

COURSE DIRECTOR: Raju Thomas, M.D., F.A.C.S., M.H.A., Professor & Chairman of Urology

CONTACT PERSONS: Margeaux , 584-2794, Room 3508

COURSE OBJECTIVES:

1. Familiarize students with complete urologic examination.

2. Give an overview of urologic subspecialties.

3.  Familiarize students with means to diagnose more common adult and pediatric urologic problems.

DIDACTIC MATERIAL: Smith's General Urology (copies are available in the library) and in urology department room 3508

PRIMARY RESPONSIBILITIES: (the schedule below is subject to change)

Monday, Surgery (TMC/CHNO), TMC Clinic (3rd floor)

Tuesday, TMC Clinic (3 rd floor)/VANO Surgery, TMC Clinic (3rd floor)

Wednesday, Lithotripsy/Surgery (TMC), TMC Clinic (3rd floor)

Thursday, Surgery (TMC/VANO), TMC Clinic (3rd floor)

Friday, Surgery (TMC/CHNO), TMC Clinic (3rd floor)

CONFERENCES:

1.  Death & Complications Conference: 4 th Wednesday of the month, 5:30 p.m. Urology Library (room 3515)

2.  Journal Club: 2 nd Wednesday of the month, 6:00 p.m. , Urology Library (room 3515)

3.  Pediatric Conference: 1 st & 2 nd Tuesday of the month, 6:00 p.m. , Children's Hospital.

4.  Pyelogram Conference: 3 rd Wednesday of the month, 6:00 p.m. , (room 6001)

5.  The faculty member “on call” will administer a brief didactic lecture during your rotation.

6.  Walk rounds: every Friday, 4:30 p.m. at TMC.

7.  Pre-op conference: every Wednesday, 7:00 a.m. , Urology Library (room 3515)

ADDITIONAL RESPONSIBILITIES:

There are far more clinical experiences available, in a variety of other nearby hospitals than are listed above. You will meet one of the Urology senior level house officers and, together, come up with a schedule that is mutually acceptable.

RESIDENT PAGER NUMBERS:

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