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For Medical Students

The Department of Surgery Education offers third and fourth-year medical students the opportunity to rotate on surgical units at Iowa Methodist Medical Center. For information on eligibility and availability, please call (515) 241-4078 or email paula.rasmussen@unitypoint.org.

Third-Year Surgery Clerkship (University of Iowa)

Overview

During the six-week surgery clerkship at Iowa Methodist Medical Center, students will be assigned to work 3 weeks on one of the General Surgery teams and 3 weeks on one of the specialty surgery teams (either the Pediatric Surgery team or the Vascular Surgery team).

Students will be supervised and taught by teaching faculty and residents of the Des Moines Surgery Residency Program. Students will follow 3-5 patients and will assist in the OR and then participate daily in the post-operative care of these patients. Students will also be assigned one night of call each week.

Students will participate in weekly core lectures and will attend residency program teaching conferences on Wednesday afternoons and Thursday mornings. There will also be extensive reading assignments from the required textbooks Essentials of General Surgery, 4th edition, 2005 and Essentials of Surgical Specialties, 3rd edition, 2007, both by Peter F. Lawrence (ed.)

A suturing session for students will be conducted at the start of the clerkship, where students will be instructed on proper suturing and wound care. This session will be held in the Surgical Skills Lab. Hands-on practice will be provided under supervision of senior surgery residents and faculty.

Orientation

Orientation will be provided the first day of the clerkship in the Des Moines Area Medical Education Consortium office on the campus of Iowa Methodist Medical Center at 1415 Woodland, Suite 130. Consortium staff and Dr. Tonui (clerkship director) will jointly conduct the orientation session. Formal instruction on access and use of the hospital's electronic medical record system will be provided. Students will also be provided a folder containing important information including rotation-specific goals and objectives, conference schedules, reading assignments, maps, contact information, evaluation forms, and grading policy information.

Resources

Required reading will be assigned from two textbooks:
1. Peter F. Lawrence (ed.): Essentials of General Surgery. Baltimore: Williams & Wilkins, 4th Edition, 2005.
2. Peter F. Lawrence (ed.): Essentials of Surgical Specialties. Baltimore: Williams & Wilkins, 3rd Edition, 2007.

Additional reference textbooks that students may access during the clerkship include the following:
1. Gerald M. Doherty: Current Surgical Diagnosis and Treatment. United States: McGraw-Hill Companies, 12th Edition, 2006.
2. Seymour I. Schwartz (ed.): Principles of Surgery. McGraw-Hill Book Company, 8th Edition, 2005.
3. David C. Sabiston, Jr. (ed.): Textbook of Surgery: Biological Basis of Modern Surgical Practice. Philadelphia: W.B. Saunders Company, 16th Edition, 2007.
4. Lazar J. Greenfield (ed.): Surgery: Scientific Principles and Practice. Lippincott-Raven, 4th Edition, 2005.
5. JJ Hoballah (ed.): Vascular Surgery: Springer-Verlag, 2008.
6. Edwin Deitch (ed.): Tools of the Trade and Rules of the Road - A Surgical Guide. Lippincott-Raven, 1997.
7. Wiley W. Souba (ed): ACS Surgery: Principles and Practice 2007. Web MD Professional Publishing.

Conferences

Students will participate in weekly core lectures with faculty and should consult the conference schedule to see when and where these lectures will be held. These lectures will address core topics in surgery. Students are expected to read the appropriate chapter from the required Essentials of General Surgery textbook and come prepared to discuss assigned cases with faculty.

Students are encouraged but not required to attend the weekly Surgery Resident Conferences conducted in the Paradise Conference Room on Tuesday evenings from 5:00 to 7:00 p.m. Students must attend the weekly Surgery Department Morbidity and Mortality conferences and Grand Rounds conferences that are conducted in Thompson Auditorium on Thursday mornings from 7:00 to 9:00 a.m.

Scholarship Requirements

Students are required to complete a case presentation during the clerkship. Students should review an interesting patient that they have seen and cared for during the clerkship. They are expected to lead a discussion of the proper diagnostic workup and differential diagnosis of the patient with the other students. They should then review the proper surgical treatment of the patient. A thorough search of the relevant medical literature should be completed and information from at least two peer-reviewed journal articles must be referenced during the presentation.

These case presentations will be delivered to the course director. These "Director's Conferences" will be conducted twice during the the 6-week clerkship and students should consult the conference schedule to see when their case presentation is scheduled.

Grading Policy

Students completing the surgery clerkship in Des Moines will be evaluated, tested and graded in the same way as students in Iowa City. The final clerkship grade is determined based on the following required elements: the final written exam, clinical evaluations from residents, clinical evaluations from faculty members, the clinical and note-writing portions of the clinical skills assessment (Surgery PBA), the case presentation, and the Clinical Log form that each student must complete.

The final written exam is the national surgery shelf examination prepared for M3 clerkship students by the NBME. Exam items are intended to reflect the learning objectives which are found at the beginning of each chapter of Essentials of Surgery and Essentials of Surgical Specialties. Students will have two additional opportunities to take the surgery written exam if they do not pass on the first attempt, but students who fail the first attempt will not be candidates for either Honors or Near Honors.

An additional 25 points are available as extra credit for completion of both the on-line collegiate course evaluation and teaching evaluations for assigned residents and faculty. Students must complete at least one resident and one faculty evaluation from each 3 week segment.

The top 10-15% of students will receive Honors in Surgery. These students usually have both outstanding clinical evaluations and a strong exam performance. An additional group of students may be given the designation "Near Honors" such that no more than 30% over the course of the academic year receive a higher grade than "Pass," in keeping with collegiate policy.

Fourth-Year General Surgery Service Elective

Overview

During the course of the General Surgery Service rotation, the medical student is allowed to function as a senior level medical student under the direction of the house officers and faculty.

On the General Surgery Service the student is expected to participate in the preoperative evaluation including diagnostic workup of patients with a myriad of general and vascular surgical diseases. The student will be exposed to invasive and non-invasive diagnostic maneuvers for many general surgical diseases including oncologic, GI and endocrine diseases and will participate in the management of the intra-operative and post-operative care of these patients.

The student is responsible for assisting the surgical team and will be allowed to have actual participation in operations. The student will have the opportunity to demonstrate manual dexterity skills, overall comprehensive knowledge of disease states, and pathophysiologic alterations caused by surgery and surgical diseases. The student may assist in the management of the post-operative care of patients and write daily progress notes as well as appropriate physician orders which are to be countersigned by a resident and/or faculty physician.

The medical student will participate actively in the ambulatory setting following-up with patients who have been operated on as well as seeing new patients referred to the surgical service for evaluations. The student will have exposure to evaluation of not only abdominal and thoracic CT scans and ultrasounds, but also invasive angiography, and participation in patient care during these procedures.

Overall, the student will be exposed to a wide variety of general surgical, vascular and traumatically induced disease states.

Resources

Provided a copy of the general surgery basic textbook selected by the Surgery Residents to use for didactic conference.

Health Sciences Library: You have 24 hour access 7 days per week to the IMMC Health. You will need your picture ID for after-hour entry. You may call the Health Science librarians for assistance at 515-241-6490

Conferences 

  • Trauma Video Reviews (Tuesday at 4 pm, Hill Auditorium)
  • Didactic Conference (Tuesday at 5 pm, Paradise Conference Room) 
  • Mortality and Morbidity Conference (Thursday 7:00 am, Thompson Auditorium) 
  • Surgery Grand Rounds Conference (Thursday 8:00 am, Thompson Auditorium) 
  • Surgical Teaching Rounds (TBA basis)

Evaluations & Final Grading

  • Faculty may request the student to do a case presentation.
  • Faculty and Surgery Residents fill out evaluations.
  • Program Director reviews and compiles all of the evaluations and returns the evaluations to medical school.

Fourth-Year Surgical Critical Care Elective

Overview

During the course of the Surgical Critical Care Service rotation, the medical student is allowed to function as a senior level medical student under the direction of the house officers and faculty. Specifically on the Surgical Intensive Care Unit, the student will participate in the management of critically ill patients from both surgical illnesses as well as trauma.

During the course of this clerkship he/she will become facile in the management of ventilator support; both initiating patients on ventilator support as well as monitoring their progress while on the ventilator. The student will become facile in the parameters for extubation and will participate in determining points of extubation.

Also, during this clerkship the student will participate in providing central venous access for invasive hemodynamic monitoring and will become facile with the use of pulmonary artery wedge pressure measurements as well as cardiodynamic indices in the management of critically ill patients. The student will demonstrate facility in both manual capabilities as well as abilities to participate in the management of the patients.

The student will be exposed to pharmacological issues and will acquire knowledge of drug-to-drug interactions.

Resources

Sabiston Textbook of Surgery: Expert Consult: Online 1th ed.
(Textbook or articles will be provided)

Health Sciences Library: You have 24 hour access 7 days per week to the IMMC Health Sciences Library. You will need your picture ID for after-hour entry. You may call the Health Science librarians for assistance at 515-241-6490.

Conferences

  • Trauma Video Reviews (Tuesday at 4 pm, Hill Auditorium)
  • Didactic Conference (Tuesday at 5 pm, Paradise Conference Room)
  • Multidisciplinary Trauma Rounds (Monday and Thursday at 11 am - ICU)
  • Mortality and Morbidity Conference (Thursday 7:00 am, Thompson Auditorium)
  • Surgery Grand Rounds Conference (Thursday 8:00 am, Thompson Auditorium)

Evaluations & Final Grading

  • Faculty may request the student to do a case presentation.
  • Faculty and Residents fill out evaluations.
  • Program Director compiles all of the evaluations and submits the completed evaluations to medical school.