Surgery Clerkship

Overview:

The six-week surgery clerkship at Iowa Methodist Medical Center is composed of two 3-week blocks. Exposure to abdominal surgery cases of varying complexity is assured during one of the three-week blocks.  While the student is assigned to IMMC's Surgical Oncology or Colorectal Surgery service. The other three-week block is typically spent on one of the specialty surgery teams; either Pediatrics/Plastics or Vascular Surgery. 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 participate daily in the post-operative care of these patients. Students will also be assigned one night of call each week for the first 4 weeks of the clerkship.

Students will participate in weekly core lectures and will attend residency program teaching conferences (Morbidity & Mortality Conference and Surgery Grand Rounds) on Thursday mornings. There will also be extensive reading assignments from the required textbooks Essentials of General Surgery, 5th edition, 2012 and Essentials of Surgical Specialties, 3rd edition, 2007, both by Peter F. Lawrence (ed.)

A knot-tying and suturing skills lab will be conducted at the start of the clerkship in the OR Simulation Lab in the Education and Research Center. A subsequent knot-tying and suturing competition will be conducted near the end of the clerkship.

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 Peter 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:

  1. Peter F. Lawrence (ed.): Essentials of General Surgery. Baltimore: Williams & Wilkins, 5th Edition, 2012.
  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, 13th Edition, 2009.
  2. Seymour I. Schwartz (ed.): Principles of Surgery. McGraw-Hill Book Company, 9th Edition, 2009.
  3. David C. Sabiston, Jr. (ed.): Textbook of Surgery: Biological Basis of Modern Surgical Practice. Philadelphia: W.B. Saunders Company, 19th Edition, 2012.
  4. Lazar J. Greenfield (ed.): Surgery: Scientific Principles and Practice. Lippcott-Raven, 5th Edition, 2010.
  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 2014. Web MD Professional Publishing.
  • Health Sciences Library: Students have 24-hour access 7 days per week to the IMMC Health Sciences library. A UnityPoint - Des Moines picture ID badge will be needed for after-hours entry. Internet and photocopying is available. Students may call the Health Sciences librarians for assistance at 515-241-6490.

Conferences:

Students will participate in weekly core lectures with faculty and should consult the conference schedule for times and locations.  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 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 will 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 also will review the proper surgical treatment of the patient. A thorough search of the relevant medical literature will 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 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 in PxDx 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.

    Students must complete both the on-line collegiate course evaluation and teaching evaluations for assigned residents and faculty at the end of the clerkship . 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.

    Contact Information:

    If you have questions about the Des Moines Surgery Clerkship, you may contact:

    Des Moines Surgery Clerkship Director: Peter Tonui, MD at 515-241-4455 or Peter.Tonui@unitypoint.org.

    Des Moines Area Medical Education Consortium Secretary: Wendi Kruger at 515-241-4455 or Wendi.Kruger@unitypoint.org

    Des Moines Area Medical Education Consortium Medical Director: Steve Craig, MD at 515-241-4455 or Steven.Craig@unitypoint.org

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