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Surgery Rotation Objectives

The surgical curriculum of the Family Medicine Residency Program is designed to provide residents with knowledge of surgical illnesses and facility with basic surgical skills.  This portion of the curriculum is divided into an inpatient and outpatient component in order to facilitate the residents' surgical education and broaden their surgical experience.

Goals for Inpatient Surgical Rotation

Residents in Family Medicine must be competent in the recognition of surgical diseases and in their management or referral as appropriate.  The resident should be trained in basic surgical principles and in those surgical techniques a family physician may be called upon to perform.  The residents’ education should include training at surgical assisting, as well as pre and post-operative management so that he/she can be fully involved in the comprehensive management of his/her own patients.

Objectives

  1. The resident must be able to obtain an appropriate History and Physical exam on all surgical patients.
  2. The resident should be able to demonstrate a thorough knowledge of the anatomy involved in a presenting surgical problem with special emphasis on the abdomen.
  3. The resident must be able to formulate surgical diagnoses and perform appropriate medical evaluation for pre-operative surgical patients.  Such an evaluation should include an assessment of the patient’s risks for metabolic and cardiopulmonary complications as a result of anticipated surgery.
  4. The resident should understand the medical management of surgical diseases where surgery is postponed or not elected.
  5. The resident should be able to perform a pre-operative assessment of the psychosocial impact the surgery will have on a patient and his/her family and be able to provide supportive management and guidance.
  6. The resident should learn those intra-operative skills necessary to first assist in surgical procedures.
  7. The resident should be aware of common pre/post-operative and long-term complications of surgical management.  Among those post-operative complications the resident should be competent to manage are the following:
    • Wound infection or dehiscence
    • Urinary retention or oliguria
    • Ileus
    • Hemorrhage
    • Pulmonary embolism
    • Respiratory Insufficiency
    • Thrombotic Venous Disease
    • Decubiti
    • Atelectasis
    • Fluid and Electrolyte/Metabolic Imbalance
    • Nutritional Deficiency
  8. The resident should be able to anticipate the surgical patient's length and degree of disability, design a post-operative rehabilitation program, and participate in comprehensive discharge planning.  The resident should understand and communicate to his/her patients their prognosis and requirements for ongoing care.
  9. The resident should recognize the cost of procedures and associated care and be aware of second opinion policies.
  10. The resident should be able to list the indications and contraindications for the following in surgical patients:
    • IV fluids
    • Analgesia
    • Special Diets/Hyperalimentation
    • Antibiotics
    • Respiratory Therapy
    • Wound Care
    • Debridement
    • Laxatives/Antiemetics