PRINCIPLES OF SURGERY LECTURE SCHEDULE (Block 3) Rotation OCTOBER 26 DECEMBER 18, 2009 October 26, 2009 ROOM 6001

1 ORIENTATION Kirsch 8-8:30 AM SURGICAL INFECTION Nichols 8:30-9:00 AM PRINCIPLES OF ANESTHESIA Fox 9-9:30 AM BREAST CANCER Jones 9:30-10 AM BREAK 10-10:15 AM WOUND HEALING Wright 10:15-10:45 AM How to be a Surgery Student Rennie 10:45-11:15 AM HERNIA Bellows 11:15-11:45 AM Lunch 11:45-1 PM Endocrine Kandil 1-1:45 PM NUTRITION Kelly Sparks 1:45-2:15 PM Acute Abdomen Jaffe 2:15-2:45 PM BREAK 2:45-3:00 PM PULMONARY FUNCTION & FAILURE & LUNG CA Weaver 3:00-3:30 PM PERIPHERAL VASCULAR DISEASE McGinness 3:30-4:00 PM UPPER & LOWER GI Brown 4-4:45 PM

Lecture Test Wednesday, October 28, 2009 Room 5150 at 8:00 AM

LABS October 27, 2009 (Tuesday) TEAM 7:00-10:00 AM CS COTs version of ATLS for medical students, called TEAM (Trauma Evaluation and Management), consist of pre and post test, lecture and 3 rotation stations. The pre and post test are for research only and consist of 10 20 questions. The presentation changes. Group 1 William Acker Anh-Van Mai Daniel Petroni Catherine Firestein Garland Mcquinn Seeyuen Lee Jean Wheeler Group 2 Benjamin Leach David Casey Sylvia Szentpetery Kieran Stober Daniella Miller Elizabeth Leimbach Gregory Weiner Group 3 Joshua Denson Brian Halbert Akilah Jefferson Christine Cao Joshua Orabone Patrick Richard Clayton Smith Group 4 Alexandra Sleed Margaret Jones Marco Fossati-Bellani Nichole Guillory Brian Talleur Melissa Adrouny Richard Brucker Anne Sammarco Group 5 Megan Stock Ryan Leblanc Christiana Roussis Whitni Milton Ann Katz Andrew Prouse Dorothy Contiguglia

Stations: Suturing & Knot tying w/ residents OR orientation w/ Nancy Iovino Foley cath insertion & Central Line Placement w/ residents Lap Skills & Endoscopy w/Cheri Touchard You, the student, will be required to achieve the preset proficiency level for knot tying and suturing. Beyond the orientation/training day, you need to check into the skills lab on your own time to practice. This is accomplished by contacting the SIM Center Coordinator, Candice Flood at 988-9150 or [email protected] to schedule a one hour practice session. Drop-ins will not be accommodated. The time spent will be monitored and Candice Flood will keep the attendance sheet. However, please keep a record also. You must achieve the preset proficiency level for knot tying and suturing by the end of your General Surgery Clerkship. Your grade for knot-tying and suturing is worth 5% of your final grade. If you have achieved proficiency, you will contact Candice Flood to arrange to be tested. If you test as proficient, you will earn a 100%. We are aware some may not have the requisite skill to achieve proficiency therefore, for every 1 hour that you practice, you will earn 10 points; therefore if you practice 10 hours, you earn 100%.
Suturing/ Knot Tying 1 2 LUNCH 3 4 5 Foley Cath/ OR orientation 2 3 LUNCH 4 5 1 Central line Placement 3 4 LUNCH 5 1 2 Lap Skills/ Endoscopy 4 5 LUNCH 1 2 3

10:00-11:00 11:00-12:00 12:00-1:00 1:00-2:00 2:00-3:00 3:00-4:00

OR Orientation: 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 ORs vary, you are responsible for following policies/procedures of the hospital to which you are assigned. Your Responsibilities: Come 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. Please wear clean Tulane green scrubs. All above training will be done on the 3 rd Floor of the Simulation Center at the Murphy building.
2

Test Wednesday from 8:00 9:00 AM in room 5150. Meet your team following the test, but confirm logistics the day before.

OCTOBER 28-NOVEMBER 22, 2009 NAME TRAUMA ACKER, William ENT/CT-TOURO ADROUNY, Melissa HPLH BRUCKER, Richard PLASTICS/BREAST SURGERY CAO, Christine ELECTIVE SERVICE CASEY, David CONTIGUGLIA, Dorothy OCHSNER VASCULAR/UROLOGY DENSON, Joshua BREAST/HAND SURG FIRESTEIN, Catherine FOSSATI-BELLANI, OLOL Marco HPLH GUILLORY, Nichole ORTHO/CT-TOURO HALBERT, Brian OCHSNER JEFFERSON, Akilah OLOL JONES, Margaret CT-TOURO/ENT KATZ, Ann ORTHO/VASCULAR LEACH, Benjamin ACUTE CARE LEBLANC, Ryan ORTHO/NEUROSURGERY LEE, Seeyuen ELECTIVE SERVICE LEIMBACH, Elizabeth CT/PEDIATRICS MAI, Anh-Van TXP MCQUINN, Garland LAKESIDE MILLER, Daniella ENT/PLASTICS MILTON, Whitni PEDS ENT ORABONE, Joshua PEDIATRICS/ENT PETRONI, Daniel ENT/ORTHO PROUSE, Andrew OCHSNER RICHARD, Patrick OCHSNER ROUSSIS, Christiana OLOL SAMMARCO, Anne UROLOGY/PEDIATRICS SLEDD, Alexandra CT-TOURO/NEUROSURGERY SMITH, Clayton OCHSNER STOBER, Kieran PLASTICS/ORTHO STOCK, Megan ACUTE CARE SZENTPETERY, Sylvia HAND SURGERY/ORTHO TALLEUR, Brian NEUROSURGERY/PLASTICS WEINER, Gregory TRAUMA WHEELER, Jean HOLIDAY: November 26-29, 2009 (Thurs Sunday)

NOVEMBER 23-DECEMBER 16, 2009 VASCULAR/ORTHO HPLH UROLOGY/ENT OLOL ORTHO/CT-TOURO PEDIATRICS/NEUROSURGERY TXP LAKESIDE PEDIATRICS/ENT PLASTICS/BREAST SURG OLOL PLASTICS/CT HAND SURG/NEUROSURGERY ACUTE CARE ELECTIVE SERVICE ENT/VASCULAR OCHSNER NEUROSURGERY/UROLOGY OCHSNER VASCULAR/PEDIATRICS CT-TOURO/PEDIATRICS OCHSNER OCHSNER ELECTIVE SERVICE TRAUMA ORTHO/PEDIATRICS ENT/PLASTICS ORTHO/CT-TOURO HPLH ACUTE CARE CT/ORTHO OCHSNER UROLOGY/PLASTICS OLOL TRAUMA BREAST/ORTHO

HOSPITAL TRAUMA TMC/ACUTE CARE TMC/ELECTIVE SERVICE OLOL (Drs.Schwartzberg/ Froelich) OLOL (Dr. Hausman) OLOL (Dr. Hirsch) HPLH TRANSPLANT LAKESIDE OCHSNER

Department of Surgery OCTOBER 28-DECEMBER 18, 2009 October 28 November 22, 2009 November 23 December 16, 2009 Brian Acker Gregory Weiner Jean Wheeler Andrew Prouse Ryan LeBlanc Clayton Smith Sylvia Szentpetery Ann Katz David Casey Ben Leach Elizabeth Leimbach Daniel Petroni Margaret Jones Brian Talleur Anne Sammarco Marco Fossati-Bellani Richard Brucker Nichole Guillory Garland McQuinn Daniella Miller Akilah Jefferson Patrick Richard Dorothy Contiguglia Kieran Stober Christiana Roussis Name David Yu, MD Ravi Tandon, MD Kashaf Sherafgan, MD Rafael Sierra, MD Rafael Sierra, MD Georgia Wahl, MD Dr. Glen Schwartzberg Dr. Mark Hausmann Dr. Hirsch Catherine Baucom, MD David Yu, MD Marie Unruh, MD Christine Cao Brian Halbert Alexandra Sledd Melissa Adrouny Joshua Denson Catherine Firestein Megan Stock Seeyuen Lee Whitni Milton Anh-Van Mai Josh Orabone Pager 213-1605 (Oct) 550-0385 (Nov & Dec) 423-4727 (Oct) 599-2211 (Nov & Dec) 599-2211 (Oct) 213-0239 (Nov & Dec)

CHIEF RESIDENTS: TRAUMA (Duchesne) TMC/ACUTE CARE (McGinness) TMC/ELECTIVE SERVICE (Bellows) OLOL/Baton Rouge Clinic OLOL/The Surgeons Group of Baton Rouge OLOL/Surgical Assocaites (not BRG) TMC/HEPATOBILIARY (Florman) LAKESIDE (Dr. Brown)

[email protected]
[email protected] [email protected] 584-8753 (Oct) 213-1605 (Nov & Dec) 538-2526

SUBSPECIALTY SERVICES (October 28 November 22, 2009)

1ST 2 WEEKS Breast Surgery 10/28-11/8/09 1ST 2 WEEKS CT/Touro 10/28-11/8/09 1ST 2 WEEKS ENT 10/28-11/8/09 1ST 2 WEEKS Hand Surgery 10/28-11/8/09 1ST 2 WEEKS N/S 10/28-11/8/09 1ST 2 WEEKS Ortho 10/28-11/8/09 1ST 2 WEEKS Peds 10/28-11/8/09 1ST 2 WEEKS Plastics 10/28-11/8/09 1ST 2 WEEKS Urology 10/28-11/8/09 1ST 2 WEEKS Vascular 10/28-11/8/09

Catherine Firestein
2nd 2 WEEKS Breast Surgery 11/9-22/09

Ann Katz Clayton Smith

2nd 2 WEEKS CT/Touro 11/9-22/09

Andrew Prouse Melissa Adrouny

2nd 2 WEEKS ENT 11/9-22/09

Brian Talleur
2nd 2 WEEKS Hand Surgery 11/9-22/09

Gregory Weiner
2nd 2 WEEKS N/S 11/9-22/09

Ben Leach Brian Halbert

2nd 2 WEEKS Ortho 11/9-22/09

Daniel Petroni
2nd 2 WEEKS Peds 11/9-22/09

Christine Cao
2nd 2 WEEKS Plastics 11/9-22/09

Alexandra Sledd
2nd 2 WEEKS Urology 11/9-22/09

Joshua Denson
2nd 2 WEEKS Vascular 11/9-22/09

Christine Cao

Brian Halbert Melissa Adrouny

Daniel Petroni Ann Katz

Catherine Firestein

Clayton Smith

Brian Talleur Andrew Prouse

Alexandra Sledd

Gregory Weiner

Joshua Denson

Ben Leach

SUBSPECIALTY SERVICES (November 23 December 16, 2009)

1ST 2 WEEKS Breast Surgery 11/23-12/6/09 1ST 2 WEEKS CT/Touro 11/23-12/6/09 1ST 2 WEEKS ENT 11/23-12/6/09 1ST 2 WEEKS Hand Surgery 11/23-12/6/09 1ST 2 WEEKS N/S 11/23-12/6/09 1ST 2 WEEKS Ortho 11/23-12/6/09 1ST 2 WEEKS Peds 11/23-12/6/09 1ST 2 WEEKS Plastics 11/23-12/6/09 1ST 2 WEEKS Urology 11/23-12/6/09 1ST 2 WEEKS Vascular 11/23-12/6/09

Jean Wheeler

Daniella Miller

Ryan LeBlanc

Margaret Jones
2nd 2 WEEKS Hand Surgery 12/7-16/09

Elizabeth Leimbach
2nd 2 WEEKS N/S 12/7-16/09

David Casey Anne Sammarco

2nd 2 WEEKS Ortho 12/7-16/09

Marco FossatiBellani
2nd 2 WEEKS Peds 12/7-16/09

Nichole Guillory
2nd 2 WEEKS Plastics 12/7-16/09

Richard Brucker Sylvia Szentpetery

2nd 2 WEEKS Urology 12/7-16/09

Garland McQuinn Brian Acker

2nd 2 WEEKS Vascular 12/7-16/09

2nd 2 WEEKS Breast Surgery 12/7-16/09

2nd 2 WEEKS CT/Touro 12/7-16/09

2nd 2 WEEKS ENT 12/7-16/09

Nichole Guillory

Richard Margaret Brian Acker Garland McQuinn Sylvia Elizabeth Brucker Jones Jean Wheeler Daniella Miller Szentpetery Leimbach Marco FossatiBellani CHIEF RESIDENT(S) FOR TULANE SURGERY SERVICES/ALL OTHERS CONTACT NAME ON INDIVIDUAL SUBSPECIALTY SHEETS: Name Beeper Touro CT Thomas Chaly, MD 538-2527 (Oct) Marco Hidalgo, MD 547-9031 (Nov & Dec) Pediatrics Plastic Surgery Vascular Breast Surgery Marquinn Duke, MD Mary Jo Wright, MD Marquinn Duke, MD Marie Unruh, MD 538-2621 (Oct-Dec) 213-0681 (Oct-Dec) 538-2621 (Oct-Dec) 538-2526 (Oct Dec) 7

Anne Sammarco David Casey

Ryan LeBlanc

2009/2010 Medical Student Rotation Schedule

Students
10/28-11/8/09

Block 3
11/9-22/09 11/23-12/6/09 12/7-16/09

Akilah Jefferson Patrick Richard Dorothy Contiguglia Kieran Stober Christiana Roussis Megan Stock Anh-Van Mai Seeyuen Lee Whitni Milton
Joshua Orabone

3
2 1 4 5 Plastics CT Ortho ENT Peds

3
2 1 4 5 Plastics CT Ortho ENT Peds

3
2 1 4 5 Ortho Peds NeuroS Plastics ENT

3
2 1 4 5 Ortho Peds NeuroS Plastics ENT

Plastics
Ortho Peds CT ENT 3 4 5 2 1

Plastics
Ortho Peds CT ENT 3 4 5 2 1

CT
Peds

CT
Peds

NeuroS
Ortho Plastics 3 4 5 2 1

NeuroS
Ortho Plastics 3 4 5 2 1

Specialty CRS - Dr. David Beck General Surgery 1 - Dr. William Richardson General Surgery-2 - Dr. John Bolton General Surgery-3 - Dr. Ralph Corsetti General Surgery-4 - Dr. Townsend/Bowen General Surgery-5- Dr. W. Charles Conway, II, MD General Surgery-6 Dr. Wooldridge Neurosurgery - Dr. Roger Smith Pediatric Surgery - Dr. Vincent Adolph Urology Drs. Lester Prats and Richard Vanlangendonck Vascular Surgery - Dr. Britt Tonnesson Cardiothoracic Surgery - Dr. Michael Bates Plastic Surgery - Dr. Christopher Babycos Orthopedics - Dr. Mark Meyer ENT - Dr. Ronald Amedee

10

SURGERY CLERKSHIP COURSE DIRECTOR: Michael Weaver, M.D. (988-7520 Room 8530) Pager 480-1715 [email protected] Patricia Kirsch (988-3909 Room 8558) Fax 988-1882 [email protected] Essentials of General Surgery (Third Edition) by Peter F. Lawrence Sabiston Textbook of Surgery, 16th edition, (ed.) (Basic Science) Current Surgical Therapy 8th ed (Cameron, ed-in chief) Charpters on Pneumothorax, hemothorax, carotid enderectomy, and section on operative and Post-operative care. Surgery: A compentency-Based Companion by Barry D. Mann (available in the bookstore.)

PROGRAM COORDINATOR:

REQUIRED READING: SUGGESTED READING MATERIAL: Pre-

NOTE: It is not expected for you to read the entire book for any of the suggested reading. It takes the residents about one year to finish one book. You should read the sections in the books that are pertinent to the patients you are seeing and the operations which you are attending. When you have time, if you have not covered hernia, gallbladder, bowel obstruction, acute abdomen, colon and breast cancer. (and any other topics you all can think of), read those chapters as well. I have The Virtual Patient Self-directed Study Guide in Surgery (2007) Copyright from the University of Texas Southwestern Medical Center at Dallas for each of you to use as a study guide. I will loan the CD out to the students on their General Surgery month only and they must be returned to my office on the last day of your general surgery service for the next group. Your grades will not be posted until this CD is returned to me or you pay $35.00 for the CD. DESCRIPTION: All students are to assemble for the Principles of Surgery portion of the clerkship. 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 (the following Wed from 8-9 AM in room 5150). Upon completion of General Surgery and the Inpatient 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 Fridays final examination (December 18, 2009 in room 6001 8:00 AM). No additional time will be granted from clinical duties for study preparation. FINAL GRADE: Student Evaluations: Examinations: General Surgery Inpatient Services National Board Surgery Examination Oral Examination (General Surgery) Knot Tying & Suturing Principles of Surgery Examination Case Summaries TOTAL
11

30%* 20%* 25%* 10% 5% 5% 5% 100%

GRADING POLICY: To receive a grade of pass, a student must achieve acceptable standards on both the National Board Examination (equivalent to a score in the 5th percentile), and on each of the student 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) will be assigned. Given those circumstances, the student will be asked to undertake a period of intense reviewing 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 January of the graduating year. 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 January of the graduating year. You will have a mid block evaluation 2 weeks into your General Surgery clerkship by your resident and faculty. If you do not receive this mid block evaluation, please discuss this with your resident. A distinctly superior performance by a medical student on this clerkship will be properly accorded a letter grade of High Pass or Honors by the Department of Surgery Medical Student Curriculum Committee. A candidate for High Pass must have established the following: In most, if not all areas, numerical grades that consistently signify a quality performance. A candidate for Honors must have established the above criteria and in addition, must receive at the national mean average or higher on the national board exam which is a 71.6. Upon completion of the clerkship, the records of qualified candidates (numerical grade of 86.50 and above) 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 students 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. Short of mathematical error, all numerical and letter grades are final. Also, there will be no exceptions made to students grading 86.49 and below. Only students with an 86.50 and above will be presented to the Curriculum Committee. In the student letter to the Deans 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 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 Kirschs office (988-3909, room 8558), and sent out to you by e-mail. It is your responsibility to contact the office of the assigned staff member to mutually set aside 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. After 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 and the grades will be averaged for a final grade.

12

Some links that you may find helpful are listed below: Students with disabilities: http://erc.tulane.edu/disability/ Academic dishonesty link: http://www.som.tulane.edu/student/honorcode/new.htm SOM Phase I & II Objectives: http://tulane.edu/som/ome/upload/Tulane_SOM_Learning_Objectives_Phase_1_-_2.pdf

13

WEDNESDAY EDUCATION CONFERENCES: Entire Rotation: DRESS APPROPRIATELY for conferences, SCRUBS ARE NOT APPROPRIATE! IF YOU QUESTION WHAT IS APPROPRIATE, ASK YOU RESIDENT 1. M & M: 7:00 AM-8:00 AM in room 6001 This conference will be attended by surgical faculty, residents and medical students. This educational conference is designed to teach the pathophysiology and decision-making process regarding complex and interesting surgical cases and surgical cases that result in a complication. 2. Department of Surgery Grand Rounds: 8:00 AM-9:00 AM in room 6001 Presentations at this conference will be by department faculty, invited lecturers and surgical residents as assigned by the chairman. These presentations should last 30-40 minutes, with a period of questions and answers if one lecture is to be given. On certain dates, two case presentations may be given, each lasting approximately 20 minutes. This format will be used primarily for resident presentations. You will receive by e-mail prior to the Grand Rounds to inform you of the topic. 3. Bullpen: 9:15 AM-10:15 AM in Room 5150 See page 20 & 21.

Date

Morbidity & Mortality 7 AM

Grand Rounds 8 AM
Burns & Plastic Surgery Portal Hypertension - Dr. Mary Killackey

Bullpen 9:15-10:15 Room 5160

28Oct M&M CORE CURRICULUM GRAND ROUNDS 4-Nov M&M CORE CURRICULUM GRAND ROUNDS

Neurosurgery & GU TBA - Dr. Clifton McGinness

Christiana Roussis Brian Acker Ryan LeBlanc David Casey Kieran Stober

11Nov M&M CORE CURRICULUM GRAND ROUNDS

Key Words/Didactic Session Geriatric Surgery - Dr. Ronnie Rosenthal Yale University

Daniella Miller Garland McQuinn Elizabeth Leimbach Jean Wheeler

18Nov M&M CORE CURRICULUM GRAND ROUNDS

Statistics & Pharmacology Alton Ochsner Lecture - Dr. Julie Freischlag Johns Hopkins Hospital

Dorothy Contiguglia Sylvia Szentpetery Patrick Richard Gregory Weiner

25Nov M&M CORE CURRICULUM GRAND ROUNDS

CANCELLED - THANKSGIVING CANCELLED - THANKSGIVING CANCELLED - THANKSGIVING

Clayton Smith Ben Leach Megan Stock Andrew Prouse

2-Dec M&M
14

CORE CURRICULUM Grand Rounds

Pediatric Surgery Robotic Urologic Oncology-Dr. B. Lee

Ann Katz Daniel Petroni Seeyuen Lee

9-Dec

M&M Core Curriculum Grand Rounds

Anesthesia & Orthopedics TBA-Ron Stein & April Zarifian

Joshua Denson Catherine Firestein Whitni Milton Josh Orabone

16Dec

M&M Core Curriculum Grand Rounds

Key Words/Didactic Session Update on Surgical Infections-Dr. Nichols

15

4. Nov 4 Nov 11 Nov 18 Nov 25 Dec 2 Dec 9

Specialty and Sub-Specialty lectures/conferences: 10:30 AM-12:30 (Schedule below) Room 5150 10:30-11:30 AM Pediatrics Dr. Steiner 11:30 12:30 PM Case Summary: Large & Small Bowel Dr. Jaffe 10:30-11:30 AM Neurosurgery Dr. Manish Singh 11:30 12:30 PM Case Summary: Adrenal Incidentloma Dr. Kandil 10:30-11:30 AM GI Dr. Brown 11:30 12:30 PM Case Summary: Lung Cancer Dr. Weaver 10:30-11:30 AM Otolaryngology Dr. Luke Thompson 11:30 12:30 PM Case Summary: Reflux Esophagitis Dr. Korndorffer 10:30-11:30 AM Orthopaedic Surgery Dr. Ollie Edmunds 11:30 12:30 PM Case Summary: Thyroid Mass Dr. Jaffe 10:30-11:30 AM Case Summary: Liver, Pancreas & Gallbladder Dr. Paramesh 11:30 12:30 PM Urology Dr. Thomas Case Summary Conference: All students are invited to discuss their case scenarios.

16

CASE SUMMARY GRADE FORM

Organization Content Clarity, grammar & style References Bonus Points

25% 50% 15% 10%

Grade Grade Grade Grade

Total Grade

17

JUNIOR SURGERY STUDENT CASE SUMMARY CONFERENCE PURPOSE: The purpose of the case summary 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 8558, [email protected], or faxed to 988-1882) before the conference begins. Case summaries submitted after the start of the conference will not be accepted. In addition to getting these case summaries to Patricia before the case summary begins, Dr. Jaffe likes the students to hand him their case summary upon the start of the session. 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 counts. Typewritten reports are preferred. If we cant read it - we cant 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. Do not use Surgical Recall. This is NOT a surgical reference. For Dr. Jaffes case summary(s), see Dr. Jaffes specific case history(s) for his specific instructions. 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 and compassionate care plans which focus on the best interest of the patient. Cost effective case will also be stressed. GRADE: Your grade will be derived from all six case summaries. The composite grade will count as 5% of your clerkship grade.

18

November 4, 2009

Lung Cancer
72 y/o WF w/ recent onset of shortness of breath. CXR revealed RLL pneumonia. W/U included bronchoscopy which revealed an endobronchial lesion in the bronchus intermedius. Biopsy was taken. 1) 2) 3) 4) 5) What is likely diagnosis? What other history would be pertinent? What further W/U is needed? What surgical intervention is needed or not needed? What complications and outcomes would be expected if surgery is performed?

19

November 11, 2009

Adrenal Incidentloma
42 year old previously healthy man is evaluated for right hypochondriac pain. W/U included abdominal US. There was no evidence of cholecystitis, however, a 4 cm mass in the right adrenal gland was found. Issues: a.) What is the differential diagnosis of this mass. b.) What tests would you want to order to narrow your differential diagnosis? c.) Would you biopsy the lesion if you were to decide to follow this lesion? d.) Assuming all tests come back negative, at what size would you operate on an incidentaloma? e) Assuming the patient has an aldosteronoma, how will you differentiate hyperplasia from an adenoma? Do you need to do selective venous sampling?

20

November 18, 2009

Large and Small Bowel A 65 year old previously healthy man is admitted to the hospital with a 24-hour history of obstipation, nausea, vomiting, and abdominal distention. He has never had a prior abdominal operation. 1. 2. 3. 4. 5. 6. 7. What is the differential diagnosis (not the cause) from most common to least common? What physical findings can be used to establish a diagnosis (include at least 6)? Flat and upright abdominal x-rays reveal dilated small bowel with air fluid levels. How does that influence the diagnosis? Aside from plain films, what imaging studies are necessary to establish a diagnosis? The patients abdomen is nontender and he has a normal white blood cell count. What are the indications for operation and how quickly should he go to the OR? At operation, an ileocolic intussusception is identified. What are the options for treatment, and what would you do? What would you look for in the pathology report and how would that influence your operative care?

Dr. Jaffe expects you, the student, to read, utilize, and accurately cite at least three references from the literature (not the internet) dealing with 3 different aspects of the topic, at least one and preferrably two, from surgical journals. He wants you to know how to look up journal articles and how to document their citations accurately, something you will have to do as part of your education, residency and career.
ADDITIONALLY, DR. JAFFE WOULD LIKE YOU TO HAND YOUR CASE SUMMARY INTO HIM AT THE TIME OF THE LECTURE. YOUR CASE SUMMARY WILL NOT BE GRADED IF NOT HANDED INTO DR. JAFFE AT THE TIME OF THE CASE SUMMARY (EXCEPT FOR OLOL STUDENTS WHO CONTINUE TO E-MAIL TO ME)

21

November 25, 2009 Reflux Esophagitis

1. What are the typical symptoms of GERD? Atypical Symptoms? 2. What workup is needed to evaluate for GERD? 3. Assuming the diagnosis is uncomplicated GERD, what are the appropriate management options? What would you tell your patient about those options? 4. What operative interventions are performed for GERD? Why is one selected over the other? 5. What are the success rates for operative intervention? 6. If Barrett's esophagitis is documented on workup, how does it alter your management?

22

December 2, 2009
Thyroid Mass A 32-year-old man is seen with a 1.5-cm firm nodule in the left lobe of the thyroid gland. The remaining gland is normal to examination. His only relevant past history is that he received radiation therapy for Hodgkins disease involving the mediastinum. 1. What is the differential diagnosis? 2. How can you reach a definitive diagnosis in an efficient and cost-effective manner? 3. Which thyroid function studies would be useful? 4. Which radiologic studies would be needed prior to planning therapy? 5. If the diagnosis was follicular carcinoma, what are the options for operative therapy, and what would you do? 6. What postoperative complications are specific to this procedure? 7. What specialized follow up would be in order? Dr. Jaffe expects you, the student, to read, utilize, and accurately cite at least three references from the literature (not the internet) dealing with 3 different aspects of the topic, at least one and preferrably two, from surgical journals. He want you to know how to look up journal articles and how to document their citations accurately, something you will have to do as part of your education, residency and career.
ADDITIONALLY, DR. JAFFE WOULD LIKE YOU TO HAND YOUR CASE SUMMARY INTO HIM AT THE TIME OF THE LECTURE. YOUR CASE SUMMARY WILL NOT BE GRADED IF NOT HANDED INTO DR. JAFFE AT THE TIME OF THE CASE SUMMARY (EXCEPT FOR OLOL STUDENTS WHO WILL CONTINUE TO E-MAIL TO ME)

23

December 9, 2009
Liver, Pancreas & Gallbladder 54 yo man with history of hepatitis C found to have a 3cm mass in the right lobe of the liver. Questions: What is the differential diagnosis for this mass? What would be the appropriate evaluation for this patient? What are the treatment options? What is the surgical anatomy of the liver?

24

SURGICAL BULLPEN
Background: The Surgery Bullpen is an exercise for students to hone their case presentation skills as well as learn pathophysiology and management of surgical diseases. The contemporary Bullpen is based upon a tradition begun by Dr. Alton Ochsner nearly seventy years ago. Senior Tulane students were assigned an unknown patient and were expected to determine the diagnosis and differential, treatment plan and the pathophysiology following a brief history and physical examination without the patient chart or other information. The exercise was modified and extended to the third year clerkship in a way similar to the present Bullpen. The Tulane Surgical Bullpen gained national notoriety and was described in an article in Time Magazine nearly fifty years ago. The Rules: Four students are assigned to present at Surgical Bullpen each Wednesday at 9:15 am in Room 5150. Each presentation is approximately fifteen minutes. Students are assigned patients by Dr. Jaffe and the student coordinator, Ms. Patricia Kirsch, on the preceding morning, and she will contact you with the name and bed of the patient. (If you have not heard from her by 10:00 am or so on Tuesday, check with her.) The patients will be from Tulane University Hospital and University. You should review the patients chart, do a history and physical examination where appropriate and review pertinent laboratory and radiographic studies. Sometimes the patients are too ill or incapacitated to give a history or to even be examined. Use your own judgment, but remain sensitive to the patients situation, comfort and dignity. Frequently, all of your information must come directly from the chart and not from the patient. If so, simply make that clear in your presentation. Presentations should be made just as if you were in the hospital. Decorum requires you to wear your white coat and for men to either wear ties or scrub suits and women accordingly. Make your presentations concise and precise. If possible bring radiographs, arteriograms or other imaging studies which add value to the presentation. University no longer permits the students to check out films. You receive the film on a CD rom. If you would like to present the film, please have a lap top and the projector will be made available in Room 5150 for your presentation. Do not prepare Power Point , overheads, hand outs, or movies, but you are free to use your notes and to draw anatomy, procedures and other diagrams on the black board when indicated. You may prepare by textbook reading and review of articles. Since patients are currently discharged very soon after uncomplicated operations, occasions do arise when the patient has been discharged prior to your visit to them. If that occurs, you will simply present from the chart but indicate this during your presentation.

25

JUNIOR SURGERY PRESENTATIONS 9:15-10:15 AM Wednesday (room 5150)

November 4
Christiana Roussis Brian Acker Ryan LeBlanc David Casey

November 11
Kieran Stober Daniella Miller Garland McQuinn Elizabeth Leimbach

November 18
Jean Wheeler Dorothy Contiguglia Sylvia Szentpetery Patrick Richard

November 25
Gregory Weiner Clayton Smith Ben Leach Megan Stock

December 2
Andrew Prouse Ann Katz Daniel Petroni Seeyuen Lee

December 9
Joshua Denson Catherine Firestein Whitni Milton Josh Orabone

If your name does not appear on this sheet, you will not be presenting. Please do not use this conference for your lunch time. No food or drinks are allowed while this Bullpen is taking place. Thank you.
26

1GENERAL 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, to the extent that much of the preoperative and postoperative management is now carried out in the outpatient setting, students will as well be expected to participate in this phase of care. 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. In accordance with the ACGME requirements, you may not be in the hospital more than 80 hours per week and you are required to have at least one day off each week. During the course of the General Surgery rotation, you are to keep a concise log of all patients for whom you were given primarily responsibility. Specific data to be recorded are: primary diagnosis, whether management occurred on an inpatient or outpatient basis, operation (if any), and complications. Additionally, you will have a mandatory presentation weekly. This presentation will be a 15 minute oral presentation, backed-up by a 1 page paper, given to the faculty or resident of your service while you are on your general surgery month. Your chief resident will discuss what, where and when in regards to this weekly presentation. If your resident does not, please let me know. Again this should be weekly while you are on your general month. IN-HOUSE CALL: All students will be expected and required to take 1 in-house call on your services team AND one in-house call on the Trauma service at University. You are to maintain the same on-call hours as your house officer When taking your in-house call, please have your houseofficer sign off and date your procedure log indicating that you have completed this.

Please note that in keeping with the ACGME 80-hour work week, when you do take In- house overnight call, you may only work an additional 6 hours after that call ends. If you rotate at OLOL; please take your overnight University call the week before you go or the first week you return.
HOSPITAL SITES: University Trauma (Dr. Duchesne/Leslie Schwartzmann 988-5111) - In-house call will be expected on those days on which the Tulane Faculty has primary call (approximately every 4 th night). You are to maintain the same on-call hours as your house officer. The Call Rooms are located on the 1st floor next to the resident nourishment room. Please note that in keeping with the ACGME 80-hour work week, when you do take In-house overnight call, you may only work an additional 6 hours after that call ends; but note, you will be expected to make rounds after in-house call nights to sign patients off to the next service. The notes on your patients will be expected to be complete by 6:30 AM. Please contact your resident the evening before; as they might not be able to return your call the minute you are ready to begin that service. Tulane IDs are not compatible with the access control system at University. Tulane students who are assigned to MCL/University need to go to the medical staff office. The medical staff office will make arrangements for you to be issued a MCL/University affiliate badge which will grant you access to the approved areas. The medical staff office is Room 313 in the Butterworth Building at 1541 Tulane Ave. For questions, send mail to:[email protected].

27

Ochsner Hospital: Each student will be assigned to one of several surgical services for two to four week rotations. Check in with Ms. Helen Roussel (842-3907) Room 8112 on the 8th floor of General Surgery and Dr. Corsetti or his resident to set up the rotation schedule, after going to see Nicole Magee in Graduate Medical Education (Brent House 6 th floor, Room 634). Her phone number is 842-3267. There will be a cash $20 refundable deposit for your ID/Access card. Make sure that Ms. Roussel has your beeper #. General Surgery Services: 1. Dr. William Richardson This is a General Surgery, Laparoscopic, and Bariatric Surgery service, with an emphasis on diseases of the biliary system and upper abdomen. A PGY-V, IV, III and a PGY-II resident will staff this service. 2. Dr. J. Bolton, Chairman of the Department of Surgery of the Ochsner Clinic/Dr. Ralph Corsetti, Residency Program Director: This is a General Surgery and Surgical Oncology service, with an emphasis on Diseases of the esophagus, liver, endocrine system, breast, pancreas and melanoma. A PGY-V, IV, III, II and a PGY-I resident will staff this service. 3. Dr. Ralph Corsetti 4. Dr. Bowen and Townsend: This is a General Surgical Service with an emphasis on Gastrointestinal, Vascular Surgery, Critical Care and the Endocrine system. A PGY-V and PGY-I resident will staff this service. 5. Dr. W. Charles Conway, II: This is a General Surgery/Surgical Oncology. ([email protected])

6. Dr. Wooldridge: This is a Bariatric/Laparoscopic/General; [email protected]

Subspecialty Services: 1. Dr. D. Beck, Chairman/David Margolin, MD - Department of Colon & Rectal Surgery This is a service that places an emphasis on colorectal carcinoma and inflammatory bowel disease. A colorectal fellow, a PGY-V and a PGY-III resident will staff this service. [email protected]; [email protected]. Main campus 4th fl Clinical Atrium 842-4060. 2. Dr. Britt Tonnesson: [email protected] , 846-2926, Main Campus, 8th fl. Clinic Tower. & Dr. Charles Sterbergh, [email protected], 842-4919, Main Campus. This service places an emphasis on vascular surgery. A vascular fellow, PGY I and III will staff this service. 3. ENT: Ronald Amedee, MD, [email protected] , 842-4080, Main Campus, 4th Clinic Tower

4. Urology: Drs. Lester Prats, [email protected], and Richard Vanlangendonck, rvanlangendonck.ochsner.org, 8425263, Main Campus, 4th Clinic Atrium 5. Neurosurgery: Roger Smith, MD, [email protected] , 842-4033, Main Campus, 7th fl, Clinic Tower

6. CT: Michael Bates, MD, [email protected] and phone number is 842 - 3966, Main Campus, 8th floor, Clinic Tower, Department of Surgery 7. Pediatric Surgery: Vincent Adolph, MD, [email protected], 842-3907 and his office is on the 8th floor, Main Campus, Clinic Tower, Department of Surgery 8. Plastics Surgery: Christopher Babycos, MD, [email protected] , 842-3950, Lisolette Tansey Breast Center and the 8th floor, Main Campus 9. 10. Ortho: Mark Meyer, MD, [email protected] ; Main Campus, 5th fl. Clinic Atrium 842-3910 Transplant: Dr. George Loss - [email protected] and Dr. Ian Carmody - [email protected]

28

EXPECTATIONS: The expectations for students on their general surgery rotation are to see patients in clinic, scrub in the operating room, and follow patients in the hospital. Students will be directed in these activities by the residents and staff on their services. Students are expected to read on surgical problems they are involved with or are likely to encounter. In addition, students are to go to all lectures for general surgery residents. There is no call but students will stay through the end of the work day and be involved with rounds on Saturday. Students will not come in to work on Sundays. Students will be relieved of any work at Ochsner to go to anything required at Tulane. 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 inhouse call, but you should remain with your team until the clinical and educational responsibilities have been completed for the day. In order to be sure that students have the opportunity to monitor surgical patients progress, rounds will be required to be made every day, including Saturdays. Students will be given Sunday off to comply with the 24-hour off rule. Students are required to attend all resident conferences. Dr. Corsetti will try to complete an exit interview prior to the end of the rotation. The purpose of this is to discuss the students evaluation of their performance during this rotation, and to allow the student the opportunity to discuss the quality of their educational experience at Ochsner. Dr. Corsetti may, depending on the demands on his time, not be able to complete an exit interview with each student individually (this will continue to be monitored). Before beginning this rotation, each student must check in with the Office of Graduate Medical Education (1516 Jefferson Highway, room 634, 842-3267) at 8:30 a.m. on the 1st day of the rotation. Nicole Magee will register each student for insurance purposes and to issue ID/Access cards. You must see Nicole as soon as you arrive at Ochsner. Her phone number is 842-3267 (room 634).

29

Tulane Medical Center/Lakeside: TMC Acute Care: Drs. McGinnis (301-0270 [email protected]) and Brown (583-6459 [email protected]) TMC Elective Service: Dr. Charles (Chip) Bellows)/Stephanie Reed at 988-2307 Lakeside General: Drs. Brown (583-6459 [email protected]) and Jones (988-2305 [email protected]) Transplant: Dr. Sandy Florman is the Director of Abdominal Transplant (988-7867 [email protected]) but you will additionally work with Drs. Mary Killackey and Anil Paramesh (988-0783). The students assigned to this service will assist in the care of those patients under the care of the General Surgery Service. House officers will provide resident coverage for this service. Your duties are to include, but are not limited to:

1. 2. 3. 4. 5. 6.

Provide daily inpatient care for the patients to whom you are assigned. Perform histories and physical examinations. Participate in the operations being performed on your patients. Work with attending physicians in their outpatient clinics (3rd floor of professional office building) Attend all Wednesday morning Educational conferences. Be available for home call up to every third night and every other weekend.

EXPECTATION: The expectations for students on their general surgery rotation are to see patients in clinic, scrub in the operating room, and follow patients in the hospital. Students will be directed in these activities by the residents and staff on their services. Students are expected to read on surgical problems they are involved with or are likely to encounter. In addition, students are to go to all lectures for general surgery residents. There is no call but students will stay through the end of the work day and be involved with rounds on Saturday. If rotating on TMC Hepatobiliary, your notes will NOT be included in the patients chart. Therefore it will be mandatory that you write 3 H & Ps and 6 progress notes, give to the faculty you are working with and those will be graded and placed in your file. Additionally, there is no in-house call for students on this TMC Hepatobiliary Service. There are clinics and other conferences that you will be expected to attend as are the residents. Dr. Flormans office has a bibliography of core reading materials for you. All of this above information is included in the student/resident handbook which once revised will be give to you. For now students should look to the senior resident on the service for direction. Expectations:

Make rounds with the resident on the service every AM. Examine the patients, review the labs, come to decisions, and make recommendations consistent with resident and staff. Naturally, implementations of recommendations depend on resident and staff. Do complete history and physicals on new patients admitted to the service and turn them in to the attending for review. See consults to the service and do history and physicals, review labs, make recommendations consistent with resident and staff recommendations. Make rounds with staff daily and present patients to staff in a manner consistent with working rounds. Much teaching will be done on these rounds. Therefore, students are expected to have read about the diseases present in their patients. Students are expected to attend surgery on all of their patients. There must be a good reason to be absent from the surgical procedure on their patients. Students are expected to attend clinics at Lakeside and do complete histories and physicals on the new consults and referrals and discuss diagnoses and recommendations with the staff attending.
30

Students are expected to take call at night for emergency admits and emergency surgery. Students are expected to learn basic surgical procedures well enough to assist in surgery. Students are encouraged to attend surgical procedures done on patients other than their own if it does not conflict with primary responsibilities. Students are encouraged to make week-end rounds on their hospitalized patients.

31

OLOL
We have 3 different rotations based out of Our Lady of the Lake in Baton Rouge; listed below in red. Each rotation will rotate at different hospital sites and each site has its own packet of paperwork (as depicted below). Please see Betty Burton in Dr. Kranes office, or if not available, then Patricia in room 8558 of the medical school when the schedule comes out to complete these packets. The earlier the packets are completed and returned, the more assurance you will have that your experience on the rotation will run smoothly. Rotation Name Dr. Schwartzberg/Froelich Dr. Hausmann Dr. Hirsch/Gordon OLOL Yes Yes Yes BR General/HIPAA Compliant Yes/Yes No/No Yes/Yes Lake Surgery Center Yes No Yes Womens Yes Yes Yes

Dr. Glen Schwartzberg, James Froelich, & Dr. Bonner) Baton Rouge Clinic. [email protected]; [email protected]. Office #: (225) 769-4044; cell #: (225) 247-8354 (Contact BR Clinic Administrator Mr. Ed Silvey at 225-9301 to assure that your HIPAA training at Tulane is sufficient.) The Surgeons Group of Baton Rouge Dr. Mark Hausmann, MD, FACS General Surgery, Bariatric Surgery Karl LeBlanc, MD [email protected] John Whitaker, MD [email protected] Keith Rhynes, MD [email protected] Kenny Kleinpeter, MD [email protected] Brent Allain, MD [email protected] 7777 Hennessy Blvd., Suite 612 Baton Rouge, LA 70808 Office #: (225) 769-5656; CELL: (225) 229-9094 FAX #: (225)766-6996 e-mail: [email protected] Dr. Alec Hirsch General Surgery, Surgical Associates. [email protected]; office #: (225) 769-6400 Contacts:
Housing, ID badges, computer access, etc: Leigh Salvant Graduate Medical Education Our Lady of the Lake Regional Medical Center Phone 225-765-7730 Fax 225-765-3497 [email protected]

Baton Rouge General Medical Center (BRG) Connie Rome, GME Manager; [email protected] Sandra Wiley, Senior Coordinator; [email protected] (225) 387-7736 or (225) 387-7707 Fax (225) 387-7872 Floyd J. Roberts, Jr., M.D., FACP, FCCP, Chief Medical Officer, Medical Director of Graduate Medical Education & DIO of Baton Rouge General Medical Center (225) 387-7121.

Jayne B. Bacot, RN @ Lake Surgical @ 225-765-3133. John Clifford, MD, FACS, Medical Director Graduate Medical Education and DIO of OLOLRMC @ 225-765-1955.
32

Huey P. Long: The students who select this rotation will be provided with considerable hands on experience in the care of surgery patients, under the supervision of attending faculty, Drs. Lee, Muchmore, Wigle and Dr. Rayburn, and the general surgery house officers. You will assume considerable responsibility in the care of patients assigned to you, the opportunity for active participation in daily rounds, performance of admission history and physical examinations, and, to the extent of your abilities, operative and preoperative management will be provided. As occurs at the other institutions that afford the students experience in General Surgery, weekly case summary conference sessions will be held. There will be no in-house call. Call can be 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 Sandy Corley (318-473-1425).
FY: 2009-2010

TO: CC: FROM: RE:

TUHSC Student & Residency Coordinators; HPLMC Chief of Services Switchboard; Housekeeping; Maintenance; Dietary; Human Resources Medical Staff Office Medical Student Orientation

Welcome to Huey P. Long Medical Center. The following information has been prepared to acquaint you with our facility in order to make your stay as pleasant and comfortable as possible. CHECK IN AT SWITCHBOARD UPON ARRIVAL: Switchboard personnel will assign dormitory room. Room assignments are made on first-come first-served basis. (No preferential assignment is possible due to limited room availability.) There is a $5.00 deposit fee (payable in exact cash only) for your front door & room keys. Deposit fee will be returned to you when keys are returned at time of departure. (Nonrefundable if key lost or broken.) PLEASE notify the operator ASAP if you have lost your keys. Room key will open Storage Room (extra linen, etc.) Front door key will open Laundry room. Please page staff, the chief resident and/or resident on call as applicable to let them know you have arrived. Please report to Medical Staff Office personnel and bring your Tulane ID badge and drivers license. You will need to obtain and wear LSUHSC-HPLMC Identification badge . Please report to Human Resources (Annex Bldg. at the corner of Hospital Boulevard & Main St.) ASAP or upon arrival. All students are to complete a Personnel Data Form in case of an emergency. RULES AND REGULATIONS: You should leave all rooms including kitchen & living room in a clean & tidy condition daily. (General housekeeping services for the building provided.) You are not allowed to have overnight guests in your room. Institutional facilities are not available for one's spouse, children, or significant other. Motel accommodations are available and within a reasonable distance to the hospital, but the institution will not defray the cost of such accommodations. No pets allowed. Smoke Free Environment. MISCELLANEOUS INFORMATION: 33

One free meal daily will be provided at each serving time for the students. Additional meals available at $3.00 each. Breakfast hours: 6-8 a.m.; lunch 11:30 a.m. -1 p.m.; dinner 4:15 - 5:30 p.m. (See attached dietary policy & procedure) Students are provided disposable scrubs only. (You are responsible for bringing & laundering your own scrub suits.) Medical Staff Office has a Medical Library, librarian & computers available for your use and is available after hours if needed. Key may be signed out from switchboard. (Librarian ph # 318-473-1425 from 8a-4:30p)

DORMITORY: First Floor Lobby/Foyer Phone # (318) 473-6348 Living Room/Lounge area - Television with cable, wireless internet, sofa, chairs, desk, etc. Complete kitchen - Refrigerator, stove, microwave, etc. Please put label (your name/date) on items placed in refrigerator. Restroom 2 Washer/Dryers - located in back of building. (You are responsible for your own laundry & laundry supplies.) Second Floor: Bathroom in each bedroom (except 201, 206, 207 next to rooms); towels, washcloths & soap available (May bring own bathroom linen as desired.) Linen/blankets are provided - single beds (May bring own bed linen as desired.) All rooms have (1 or 2) single bed, chest of drawer, desk, chair, lamp & clothes hamper. Outside balcony Room 201 (left): 1 single bed (318) 473-6333 Reserved for Anesthesia student Room 202 (left): 2 single beds (318) 473-6354 Room 203 (left): 2 single beds (318) 473-6313 Room 204 (right): 2 single beds (318) 473-6254 Room 205 (right): 2 single beds (318) 473-6301 Room 206 (right): 1 single bed (318) 473-6240 Reserved for Anesthesia student Room 207 (left): 1 single bed (318) 473-1439 CONTACT INFORMATION: To insure proper delivery, mail should be addressed: Student Name C/o Medical Staff Office Huey P. Long Medical Center Physical Address: 352 Hospital Blvd., Pineville, LA 71360 Mailing Address: P. O. Box 5352, Pineville, LA 71361-5352 Hospital phone # (318) 448-0811 Medical Staff Office Ph. # (318) 473-1437 or 1426 Medical Staff Office Fax# (318) 473-1435 MAINTENANCE ISSUES: If you become aware of any maintenance/housekeeping concerns, please notify designated hospital staff immediately. Medical Staff Office - Sandy Corley, Adm. Asst. (Ext. # 1426) during normal business hours (Monday Friday 7a.m.4:30p.m.) Switchboard Operator on duty after 4:30 p.m. (Operator to forward all emergent concerns to Maintenance Dept. with carbon copy to MSO; Non-emergent concerns to MSO for scheduling.) Information issued to student: 1.) Medical Student Orientation/Welcome letter (Medical Staff Office) 2.) Acknowledgment of Self Study Orientation for Medical Staff & Residents (Human Resources) 3.) Personal Data Form 4.) Information Security Training for LSUHSC HPLMC Non-computer Users 5.) Hospital ID & Emergency Response Codes to be worn at all times Enjoy your stay. Sandy Corley 34

Adm. Asst. 4 Medical Staff Office/Credentialing Ph # 318-473-1426 [email protected]

Revised: 08/21/09

35

PERSONAL DATA FOR FILE IN PERSONNEL FOLDER

(PLEASE PRINT OR TYPE)

NAME: __________________________________ SSN: ______________________________

DATE OF BIRTH: ___________ SEX: _____ RACE: _____MARITAL STATUS: _______ ADDRESS: __________________________________________________________________ __________________________________________________________________ MAILING ADDRESS (IF DIFFERENT THAN ABOVE) ____________________________ ____________________________ PHONE NUMBER: ________________________________ PERSON TO NOTIFY IN CASE OF EMERGENCY: NAME: __________________________________ RELATIONSHIP: __________________ ADDRESS: ___________________________________________________________________ PHONE NUMBER: _________________________________ I have received a key to my room and a key to the outside door of the doctors quarters. I agree to abide by the Medical Staff Bylaws, Rules & Regulations, and policies & procedures of the hospital.

___________________________________ SIGNATURE DATE

DIRECTIONS:

http://maps.google.com/maps?hl=en&tab=wl

36

Department of Surgery Hutchinson Building, 8th Floor SL 22 (504) 988-3909 (504) 988-1882 fax 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, to the extent that much of the preoperative and postoperative management is now carried out in the outpatient setting, students will as well be expected to participate in this phase of care. 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. During the course of the General Surgery rotation, you are to keep a concise log of all patients for whom you were given primarily 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: University, Ochsner, TMC, OLOL and Lakeside.

GOALS Patient Care: 1. Insert Nasogastric tube. 2. Insert Foley Catheter. 3. Be able to perform as a second assistant in the operating room. 4. Be able to function as a first assistant for minor or bedside procedures. 5. Demonstrate sterile technique. 6. Demonstrate patient prep in operating room. 7. Perform wound or incision closure. 8. Describe the steps and indications for central line insertion. Medical Knowledge: 1. Perform a complete history and physical exam. 2. Write appropriate patient admission orders for a variety of surgical conditions including but not limited to: trauma, GI bleeding, vascular conditions, and acute abdomen. 3. Write appropriate post-operative orders for both out-patient and emergency surgery patients. 4. Assess and discuss management of post-operative fever. 5. Explain and interpret chest x-rays. 6. Discuss patient CT scans. 7. Discuss diagnosis and management of: a. Acute appendicitis b. Acute Cholecystitis c. Pulmonary Embolus d. Hernias e. Lower and Upper GI bleeding f. Colon cancer g. Pancreatic masses h. Liver disease including: i. Cirrhosis ii. Common liver tumors iii. Transplant indications i. Peripheral vascular disease
37

8. 9. 10. 11. 12. 13.

14. 15.

j. Carotid artery stenosis k. Deep vein thrombosis l. Gastritis m. Entero-cutaenous fistula. n. Complete and partial small and large bowel obstructions. Interpret arterial blood gases. Understand and verbalize indications for mechanical ventilation. Discuss the differences and uses for various forms of mechanical ventilation. Appraise patient for post-operative complications: infections, anastomotic leak, hernia, bleeding, DVT, heart attack, hyperglycemia. Discuss management and give examples of post-operative pain control. Recognize symptoms, causes, and treatments of common electrolyte derangements in surgical patients: a. Hyponatremia / Hypernatremia b. Hypokalemia / Hyperkalemia c. Hypocalemia d. Hypomagnesemia Demonstrate and discuss management of anemia. Calculate daily caloric needs of different types of patients. Calculate and write TPN orders for a variety of patient conditions.

Practice Based Learning and Improvement: 1. Evaluate patient care through personal assessment and feedback from residents and staff. 2. Develop personal process of acquiring and appraising scientific knowledge. Interpersonal and Communication Skills: 1. Discuss patient condition and assessment with resident team. 2. Present patient to staff during rounds in clear concise manner, including exam, assessment of condition, and plan of patient care. 3. Document steps in patient care. 4. Participate in development of patient care plan. Professionalism: 1. Perform patient care in an ethical manner. 2. Attend conferences, clinics, and rounds on time. 3. Display commitment to patient care and educational process. 4. Respect patient culture, privacy, and disease process. System Based Practice: 1. Define cost-effective patient care. 2. Understand the basic costs and risk-benefit of common lab tests, radiology exams, and operative interventions.

38

POST-OPERATIVE ORDERS 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. Location of admission (recovery room, one day surgery, ICU, etc.) Status post (surgical procedure) Admitting physician Condition Vital signs (per recovery room protocol, then on ward, ICU, etc.) Diet Activity (up with assistance, bathroon privileges, etc.) Allergies Intravenous fluids Medications Nursing care orders (dressing care, wound care, assistant with ambulation, etc.) Care of drains, lines Intake and output; record patient weight daily Special nursing care orders Monitoring device instructions Miscellaneous (anything else necessary for good patient care, such as notifying the physician if the patient is unable to void post-operatively, etc.) Laboratory tests Roentgenographic studies EKG

39

SURGERY THIRD YEAR MEDICAL STUDENT MID-BLOCK EVALUATION TWO WEEKS INTO YOUR GENERAL SURGERY SERVICE, I WILL SEND OUT ELECTRONICALLY YOUR MID BLOCK EVALUATION. BUT IT IS APPROPRIATE, AT THE APPROPRIATE DOWN TIME, TO ASK YOUR RESIDENT TO COMPLETE THIS EVALUATION, REVIEW WITH YOU AND RETURN TO MY OFFICE FOR YOUR FILE. PLEASE IF YOU DO NOT GET YOUR MIDBLOCK EVALUATION INTO YOUR THIRD WEEK OF YOUR GENERAL MONTH, CONTACT PATRICIA KIRSCH IMMEDIATELY AND DR. WEAVER WILL CONTACT YOUR TEAM AND REVIEW YOUR MID BLOCK PERFORMANCE WITH YOU. THANK YOU. Date of Evaluation: , 2009 Student Name: Surgery Service: Faculty evaluation summary: _____________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ Resident evaluation summary: _____________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ Surgery (common procedure log) review: ____________________________________ _____________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ Professionalism: ________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ Student Response: _______________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ Faculty signature: _______________________________________________________ Student signature: _______________________________________________________ Program Directors Response: _____________________________________________ ______________________________________________________________________ Program Directors Signature: _____________________________________________ FAX: Patricia Kirsch at 504-988-1882 Evaluator: Dr. Block: /09 /09

40

GENERAL SURGERY/INPATIENT ROTATION EVALUATION FORM Name Department ______________ ______________ Rotation Dates ____________ Evaluator ___________________

Uses of the evaluation: This evaluation becomes a part of this students 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 Deans Office or from the Department of Surgery. PROFESSIONALISM Rating Scale: 1 2 Lowest Score 3 4 5 6 7 8 9 10 UA Highest Score Unable to Evaluate UA

1. Altruism: 1 2 3 4 5 6 7 8 9 10 Student demonstrates arrogance and pretentiousness Student always puts the best interest of the towards patients and/or colleagues. Student patient as the highest priority. demonstrates greed for personal fame/power. 2. Accountability: 1 2 3 4 Student demonstrates impaired judgment and incompetence. Student refuses to accept responsibility for his/her actions. 3. Commitment to 1 2 3 Excellence: Student is content to do the minimum, is uncommitted to academic responsibilities. 4 5

6 7 8 9 10 UA Student is accountable for fulfilling the contract of the physician to the patient and the patients family. 6 7 8 9 10 UA

Student demonstrates commitment to life-long learning and self improvement. 5 6 7 8 9 10 UA

4. Acceptance of 1 2 3 4 Professional Responsibility: Student is not to be found when on call, putting personal needs ahead of professional responsibility. Student does not attend conferences and/or is unprepared if present.

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. 5 6 7 8 9 10 UA

5. Integrity and 1 2 3 Honor: Student has misrepresented achievement through fraud and/or laziness.

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

41

6. Respect for1 2 3 4 5 6 Others: Student has demonstrated abuse of power patients, colleagues or faculty. Student has demonstrated bias or discrimination others. Student has breached patient care team. confidentiality.

10

UA

Student demonstrates the highest standards of toward respect for patients, families, colleagues, residents, faculty, nurses, and other members of the health against

Superior Fund of knowledge Clinical acumen Histories & physicals Presentations Technical Skills Appearance & Demeanor Patient records & Documentation

Satisfactory

Unsatisfactory

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

_______________________________ Students Name _______________________________ Numerical Grade

_________________________ Department __________________________ Signature

When submitting your overall score to include your assessment of the students professionalism, please keep in mind that the numerical score 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.

42

TABLE OF CONTENTS FOR ORAL EXAM You will be questioned on 1 topic from each of the 3 categories below (therefore 3 total questions). All test questions can be found in the Sabiston & Schwartz textbook. ACUTE 1. Surgical Infections 2. Cholecystitis 3. Nutrition 4. Appendicitis 5. Diverticulitis GENERAL 1. Peripheral Vascular Disease (Fem Pop) 2.Inguinal Hernia 3. Upper Gastrointestinal Bleeding 4. Reflux Esophagitis 5. Portal Hypertension ONCOLOGY 1. Breast Cancer 2. Thyroid 3. Colon Cancer 4. Lung Cancer 5. Melanoma

43

GRADE SHEET Student Name _____________________________ Examiner Name____________________________ Date______________________________________ ACUTE----Question #_______ Pathogenesis________________ Anatomy___________________ Diagnosis___________________ Management_________________ GENERAL-Question # ______ Pathogenesis_________________ Anatomy____________________ Diagnosis____________________ Management__________________ ONCOLOGY-Question#______ Pathogenesis___________________ Anatomy______________________ Diagnosis______________________ Management____________________ TOTAL SCORE (Maximum 300)___________ EXAM SCORE (Maximum 100)____________ Signature_______________________________

44

The table below are the cases and numbers we expect you to see while on your eight week rotation. You will be completing this on the e-value website. Log into: https://www.e-value.net/ Go to User Menu then PxDx then add new. If on same patient, you saw multiple procedures, you can add multiple listings. After entering all procedures for that one patient, click next and save record and repeat for next patient. COMMON PROCEDURES Student:____________________________ Attending: _______________________ AY2009-2010 Block 1 *MARK LOCATION* H&P OR IC Hosp Post-op SOA U Course P Acute Abdomens 2 2 2 2 Trauma Patients 2 Critical Care ICU/Patients 2 Biliary Tract Disease 2 2 2 2 Laparoscopic Procedures 2 2 2 2 Surgical Oncology 2 2 2 2 G.I. Operations 2 2 2 2 Breast Exam 2 Chest X-Ray (2) KUB interpretation (2) H & P (2) Wound Care 5 Simple Suture Technique 1 Sterile Technique 1 PVD Exam 1 E-mail me when you do both of these calls w/ the resident or faculty you did call with. In-House call completed on _________________ Service on _____________ (date). In-House call completed on the Trauma Service on _____________ (date).

*H&P, O.R., ICU, In-patient, Out-patient, post-op

45

SUBSPECIALTY SERVICES DESCRIPTION: Each student will spend an equivalent amount of time on each of the two inpatient services: Cardiothoracic Surgery, Breast Surgery, Neurosurgery, Orthopaedic Surgery, Otolaryngology, Plastic Surgery, Pediatric Surgery, Hand Surgery, and Urology 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 that these experiences will all have merit in regards to learning about some of the fundamental concepts of patient care within the particular specialty field. 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. CONTACT PEOPLE: Breast Surgery Touro Cardiothoracic Hand Surgery Neurosurgery Otolaryngology Orthopaedics Pediatric Surgery Plastic Surgery Urology Vascular Dr. Stephen Jones Leslie 988-5111 Dr. Nick Moutoukas Carita 616-8562 Dr's Jared Gilmore and Eugene Kukuy Dr. Stokes Kelly Todd 412-1650 Dr. Melgar Janice Lucas 988-5565 Dr. Friedlander Mary Olivio 988-5453 Dr. Ollie Edmunds Michon 988-2178 Dr. Steiner Heide 988-3994 Dr. Newsome Debra 988-5500 Plastic Surgery Fellow (varies, check w/ Debra) Dr. Thomas Demi 988-2794 Dr. Luke Fifer 213-1721 Dr. Weaver Lynn 988-5049

46

SPECIALTY: COURSE DIRECTOR: CONTACT PERSON:

BREAST SURGERY Dr. Stephen Jones Cell 250-0052; [email protected] Leslie Schwartzman; [email protected] 988-5111

Welcome to Surgical Oncology. I am looking forward to working with you. Hopefully, you will find this to be an educational and pleasant experience. Below is the schedule for the week: You should contact the Tulane resident on service at Lakeside and /or contact Dr. Jones on his cell phone. Monday: Tuesday: Thursday: 7:00am Surgery unless informed otherwise Tulane/Lakeside Clinic 1:00 p.m. to 4:00 p.m. Tulane/Lakeside Clinic 8:00 a.m. to Noon

Academic Interests: lymphedema, breast conservation therapy, disparities in breast cancer care, and high risk breast cancer populations. Research Interests: clinical studies in breast cancer care, womens health and surgical education.

47

SPECIALTY:

TOURO CARDIOTHORACIC SURGERY Drs. Nick Moutoukas, Jared Gilmore and Eugene Kukuy 616-8563 Carita 616-8562 897-7164

COURSE DIRECTOR: CONTACT PERSON: OFFICE #:

All students, please check in at the Medical Education Office, 2nd floor, Suite B 200. You must sign a confidentiality form and we will make a copy of your Tulane picture ID for security purposes. PRIMARY RESPONSIBILITIES: 1. Clinic Tuesday 9:00 AM noon. 2. Operating room (times will vary) 7:30 AM-4:00 PM 3. Rounds EXPECTATIONS: 1) 2) 3) 4) Round on the patients daily; Attend surgery clinic weekly; Scrub in on patients assigned unless student has a previous commitment, i.e, conferences Prepare talk on cardiothoracic surgery; about 10 minutes with handouts

CONFERENCES: Wednesday noon Cardiology Conference. READING MATERIAL: Will be distributed at time of rotation.

48

DEPARTMENT OF NEUROSURGERY SPECIALTY: COURSE DIRECTOR: NEUROSURGERY John W. Walsh, MD Program Director of Neurosurgery 1440 Canal St. Suite 1621, Tidewater Building New Orleans, LA 70112 Chief Resident: Jorge Alvernia, MD Pager: 538-0859 Janice Lucas; [email protected] Department of Neurosurgery 1440 Canal St. SL-47 Suite 1621 New Orleans, LA 70112 504.988.5565 504.988.5793 fax 1. Basic understanding of Neurosurgical patient management and operative techniques. 2. Student will gain experience in direct care of neurosurgical patient and in decision making that is unique to the field. OUTPATIENT CLINICAL RESPONSIBILITIES: 6:15 AM 7:00 AM 7:30 AM 6:15AM 7:00 AM 7:30 AM 6:15 AM 7:00 AM 7:30 AM 6:15 AM 7:30 AM 12:00 PM 1:00 PM 3:00 PM SATURDAY SUNDAY 7:00 AM 8:00 AM Neurosurgery Rounds OR MCLNO OR TMC Neurosurgery Rounds OR MCLNO OR TMC Neurosurgery Rounds OR MCLNO OR TMC Neurosurgery Rounds OR TMC In-service Neuroscience Lecture w/ Dr. Ware Neurosurgery Conference (possible Junior student Case Presentation (RM1621) Neurosurgery Rounds Neurosurgery Rounds

CONTACT PERSON:

COURSE OBJECTIVE:

MONDAY

TUESDAY

WEDNESDAY

THURSDAY

FRIDAY

*NO* CONFERENCES: The 2nd Saturday of each month in M&M Conference

49

SECTION REQUIREMENTS
SPECIALTY: COURSE DIRECTOR: ORTHOPAEDIC SURGERY Raoul Rodriguez, MD Professor of Orthopaedic Surgery Director of Orthopaedic Medical Student Education 1430 Tulane Ave., SL-32 New Orleans, LA 70112 988-2178 ; FAX: 988-3600 CONTACT PERSONS: Michon Shinn 988-2178 FAX: 988-3517 Resident: David Ferachi, MD Beeper: 595-9455 [email protected]

Always meet Dr. Ferachi in the Orthopaedic Library, Room 2115 (across from service elevator) 2nd floor of the med school on the first day of your rotation at 5:30 AM.
COURSE OBJECTIVES: 1. 2. 3. 4. 5. EXPECTATIONS: To introduce the junior student to the concepts, principles, and terms of orthopaedics by reading and clinical work. To prepare the junior student for the orthopaedic portion of the National Board examination in surgery. To introduce the future young physician to common everyday musculoskeletal problems useful in clinical practice no matter what area of medicine is later chosen. To enhance the students diagnostic and physical examination skills with respect to the extremities, spine, and musculoskeletal system. To enhance the students ability to read and interpret x-rays of the skeletal system.

1. At the completion of the rotation the student should be able to read x-rays of the long bones and spine. 2. At the completion of the rotation the student should be able to recognize fractures of the long bones and spine. 3. The student should be able to perform an orthopaedic exam of the extremities and spine.

REQUIRED READING:

Textbook of Disorders and Injuries of the Musculoskeletal System Robert B. Salter (3rd Edition) Williams & Wilkins, Baltimore, Maryland **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 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 and write notes on them, scrub in surgery, assist in fracture reductions and casting, see patients in clinic, attend conferences, and do the required reading.
50

2008-2009 ORTHOPAEDIC SURGERY RESIDENT PAGER NUMBERS: RESIDENT PGY 5 Michael Cox PGY 4 David Ferachi Otis Drew Juan Serrato BEEPER NUMBER 596-1309 595-9455 477-9333 596-7596 528-4501 544-2908 576-1097 477-5477 550-9424 663-5531 538-0674

Kyle Caswell Wade Van Sice Cary Sanders Sergey Dzugan PGY 2 Wesley Clark Carol Meyer Felipe Ramirez ACADEMIC RESPONSIBILITIES:

PGY 3

All students will be given a written outline of academic and clinic responsibilities. Textbook reading is required. Final grades are assigned by faculty member, Raoul Rodriguez, MD, on the basis of a written final exam and written reports to him by both junior and senior residents. ADDITIONAL RESPONSIBILITIES: **Refer to the Outline Orthopaedic Surgery Course Description for more details RESPONSIBILITY * Basic Science * Grand Rounds REQUIRED * M & M Conference/Research Journal Club * = Required = Optional PLACE TMS Room 2115 TMS Room 6001 TMS, Room 2115 TBA DATE/TIME 1:00-2:00 pm (Thursdays) 3:00-5:00 PM (Thursdays) 2:00-3:00 PM (Thursdays) 4th Thursday of the month

51

SPECIALTY: COURSE DIRECTOR: CONTACT PERSON:

OTOLARYNGOLOGY Paul Friendlander, M.D. Interium Chairman of Otolaryngology Mary Olivio (988-5453, room 2030) Contact the Friday before the rotation begins. They will give you the residents 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 residents 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: All rotations are centered at TUH&C where daily clinics and surgeries are performed from 7am until 5pm daily, Monday through Friday. ADDITIONAL RESPONSIBILITIES: You are expected to attend the weekly Thursday Conference at 3:00 p.m. Visit the departments website for the current conference schedule. (http://www.som.tulane.edu/departments/otolaryng/ under applicant info) Suggest that each student attempt to spend some time in the ER when Otolaryngology is on call for facial trauma.

52

SPECIALTY: COURSE DIRECTOR:

PEDIATRIC SURGERY Rodney Steiner, M.D. Associate Professor of Clinical Surgery Clinical Associate Professor of Pediatrics Heide Dyer, 988-5500, Room 8207

CONTACT PERSONS:

The Pediatric Surgery rotation for third year medical students is based at Childrens Hospital at Henry Clay and Tchoupitoulas. There are three attending physicians and three surgical residents. Drs Hill, Valerie and Steiner share responsibilities for clinical and teaching duties. Third year students are encouraged to work with all of us depending on our schedules. We have clinics on Tuesday and Thursday at Childrens from 1pm to 4. Students should come and may wear scrubs to clinic. Students can see the patient first and then present their findings to the attending. Tumor board is Wednesday at 4pm at Childrens. Students should write brief notes on the patients they follow which will be reviewed and signed by the surgical residents. There is no in house call but students can provide contact information in the event that there is a good after hours case. The Pediatric Surgery section of an up to date Surgical textbook is adequate reading. The Tulane library often has a Pediatric Surgery textbook to check out. There is a library at Childrens on the third floor with good materials. Students on the rotation should learn all there is to know about the patients they follow and the patients on the service. There is no better motivation to learning than patient interaction followed by some investigation. When you finish this rotation one should be able to recognize some of the more common pediatric surgical conditions. We dont expect you to be experts! It takes ten years of post graduate training to be a pediatric surgeon. Enjoy! PRIMARY RESPONSIBILITIES: Monday Tuesday Wednesday 8:00 a.m. 2nd & 4th Wednesday Thursday Friday Tulane Clinic (Downtown) Childrens Hospital Clinic 1:30p-3:30p 1:00p-4:00p TMC O.R. Cases (Downtown) 7:30 a.m. Childrens Hospital Clinic 1:00p-4:00p TMC O.R. Cases (Downtown) Childrens Hospital O.R. Cases 7:30 a.m.

53

54

2009-2010 Tulane Plastic Surgery Medical Student Clerkship

Course Director: Ernest S. Chiu, MD Associate Professor of Surgery Director of Research Division of Plastic and Reconstructive Surgery Ms. Debra Felix 504-988-5500 Room 8207

Contact Person:

Welcome to the Tulane Plastic Surgery Rotation! This should be a fun and educational experience for all students. GOALS and OBJECTIVES Medical student will gain exposure to the field of plastic and reconstructive surgery. They will actively participate in patient care in the O.R., hospital, and clinics. Topics that will be discussed include: 1. Wound Care 2. Sutures 3. Flaps and Grafts 4. Benign and malignant skin lesions 5. Burns 6. Implants and biomaterials 7. Reconstructive Surgery 8. Aesthetic Surgery 9. Pediatric Plastic Surgery ORIENTATION On the Friday BEFORE beginning the plastic surgery elective, Call Ms. Debra Felix ([email protected]) or Heide Dyer ([email protected]) for rotation information (504-988-5500). The student should obtain the contact information for the Tulane Downtown plastic surgery resident about the upcoming weeks activity. A Red Plastic Surgery Study Guide is available in the office. OR SCHEDULE: Ask Debra or Heide to e-mail OR schedule. This is generally compiled and sent by Heide weekly on the Thursday or Friday before the week of the OR schedule. The plastic surgery resident will assign cases so that the student has an opportunity to read prior to coming to the OR. DAILY MORNING ROUNDS: Contact plastic surgery resident for the mornings schedule. PLASTIC SURGERY WALK ROUNDS WITH FACULTY: Weekly on Wednesdays starting at 1pm from the Plastic Surgery Office. CLINIC SCHEDULE (Downtown Clinics Only): Newsome Tuesdays Wednesdays Thursdays Tuesdays Thursdays Mondays 9:00a-1:00p 9:00a-1:00p 9:00a-12:00p 2:00-4:00p 2:00-4:00p 6th Floor Surgery Clinic 6th Floor Surgery Clinic 6th Floor Surgery Clinic 6th Floor Surgery Clinic 6th Floor Surgery Clinic

Chiu Chaffin

9:00a-12:00pm 6th Floor Surgery Clinic 55

READING MATERIAL: Grabb and Smiths Plastic Surgery selected chapters CONFERENCES Wednesday 2pm Location: Thursdays 5:30 pm Location: Breast Multidisciplinary Conference Tulane Cancer Center Grand Rounds/Hand Conference)/M&M (Varies based on the week) 1st and 2nd Thursday of the Month: East Jefferson Hospital, 4200 Houma Blvd, Metairie, LA). Weekly room assignment vary and are included in weekly Plastic Surgery Conference E-Mail Announcements. 3rd Thursday of the Month: LSUHSC Allied Health Bldg, 1900 Gravier Street, Room 6A15, New Orleans, LA Friday 7-8am Friday 8-9am Location: Core Curriculum Case Presentations LSUHSC Allied Health Bldg, 1900 Gravier Street, Room 6A15, New Orleans, LA

Journal Club and Visiting Professor Events: Journal club is held on the 4th Thursday evening of every month. Visiting Professor events are held throughout the year. Students are invited to attend. For more information, please contact the Tulane Downtown plastic surgery resident. In-House Call: There is no in-house call; however, the student should give his/her contact number to the Tulane plastics surgery resident in case there is an emergency.

56

SPECIALTY: COURSE DIRECTOR: CONTACT PERSONS:

HAND SURGERY Harold M. Stokes, MD Cell 832-260-6673 4228 Houma Suite Suite 600 A Kelly Todd 504-412-1650 Fax: 412-1660

COURSE OBJECTIVES: The objective of this course is to expose the students to common problems in the hand, surgery, traumatic neurological congenital arthritic and neoplastic conditions. EXPECTATIONS: The Hand Surgery Rotation is designed to familiarize the student with a subspecialty of combined orthopedic and plastic surgery disciplines. Common disorders of the hand will be presented through clinical and surgical observations. The student will demonstrate proficiency through hand specialized histories and physicals and will assist with office surgical procedures. DIDACTIC MATERIAL: Biweekly hand conference related to the above. Students need to be familiar with Hepatobiliarys Operative Text Book of Hand and Regional Anatomy.

PRIMARY RESPONSIBILITIES: The primary responsibility is to assist Dr. Stokes and to be available for emergency situations. Dr. Stokes is out of the office the 4 th Thursday of each month; please use this time to study if nothing further is indicated. Students starting on a Monday, meet Dr. Stokes in Rm. 12 in EJs Operating room (3 rd floor) at 7:30 AM. PLEASE COMPLETE THE ATTACHED FORM AND FAX TO DAVID POTTER, AT EJS MEDICAL AFFAIRS OFFICE at 504-454-5656: EAST JEFFERSON GENERAL HOSPITAL MEDICAL SCHOOL STUDENT REGISTRATION FORM Name: _________________________________________________ Address: _______________________________________________ School Affiliation: _______________________________________ Specialty Training: _______________________________________ Term of Rotation at EJGH: _______________________________ Phone Number: __________________________________________ Beeper/Cell Number: _____________________________________ Birthdate: _______________________________________________ Social Security # _________________________________________

57

I have read and agree to comply with the rules and regulations stipulated in the Medical School Student Practice Guidelines policy. Medical School Student Date

EJGH Sponsoring Physician

Date

EJGH Medical Director

Date

58

SPECIALTY: COURSE DIRECTOR: CONTACT PERSON:

TMC Vascular/CT Dr. Michael Weaver [email protected] Lynn at 988-5049

59

SPECIALTY: COURSE DIRECTOR: CONTACT PERSONS:

UROLOGY Raju Thomas, M.D., F.A.C.S., M.H.A., Professor & Chairman of Urology Cell: (504)583-8732 Demi Robert, 988-2794, Room 3508. Please report to Demi at the beginning of your rotation to receive your didactic material. If you cannot get in touch with Demi, contact the URO-4 resident, Dr. Mathew Raynor at beeper 538-2487.

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. 4. Introduce students to Urologic technology (various endoscopes, lasers, and robotic surgery.) DIDACTIC MATERIAL: Chapter from Campbells Urology textbook available in urology department room 3508

PRIMARY RESPONSIBILITIES: (the schedule below is subject to change) The primary responsibilities are: the students are responsible for both the patient care responsibilities, as well as the didactic related educational experience. The students are encouraged to participate actively in the urology clinic and in endoscopic, laparoscopic, and robotic surgical procedures, so as to have a well-rounded experience which includes the continuum of urologic care. There is no fixed schedule but the residents are assigned to clinics and to the surgical suite based on the appropriateness of the learning experience. Guidelines for the Med Students rotating thru Urology. 1. The assigned student/s should contact the Chief resident the night before the rotation to let them know where they are scheduled to meet. 2. The Med Student/s are expected to make patient rounds, with notes in the charts (along with the residents) prior to surgery start each day. 3. They are expected to get experience in the Out-patient Urology clinics. 4. They are to get a copy of the urology hand-out, preferably prior, but at the least on the day they start their rotation. 5. They have to attend didactics by Dr Moparty. 6. They have to take a multiple choice exam on the last day of their rotation. 7. Evening rounds on post-op and in-patients are expected every day, with notes. 8. Grades are assigned based on performance at every stage of their rotation. The suggested schedule: Mornings TMC-Lakeside Clinic-Suite 510 Monday Dr. Hellstroms Clinic Tuesday Dr. Hellstroms Clinic Wednesday Dr. Hellstroms Clinic Thursday Dr. Thomass Clinic Friday Open Afternoons (Andrology & Erectile Dysfunction) Dr. Thomas ((Endo-Oncology)

The above clinic schedule give medical students an introduction to outpatient urologic care where they have access to the routine diagnostic and therapeutics, but also pre-operative evaluation, as well as post operative management.

60

Surgical schedule is available for medical students almost every day of the week at Lakeside Hospital and the students can avail themselves of the opportunity to maximize that experience between the outpatient and surgical setting. The students are expected to be up to date on inpatients at all times and should participate actively in rounds and in the patient care decision making process. All orders and any changes in patient management have to be cleared by the Chief Resident, Fellow, or the attending. Expectations: It is anticipated that by the time the medical student finishes this rotation, they will be comfortable with urologic physical examinations, common investigative procedures, common endoscopic, laparoscopic and robotic procedures and hopefully stimulate several to pursue urology as a career option. Research opportunities: The urology department offers ample opportunity for basic laboratory, as well as clinical studies and students are always welcome to participate in these studies. Those interested can contact the program director or faculty. CONFERENCES: (Please check with the Demi Robert or Chief Resident for updated conference schedule.) The normal conferences for a given week are as follows: 1. Death & Complications Conference: 4th Wednesday of the month, 6:00 p.m. Urology Library (room 3515) 2. Journal Club: 2nd Wednesday of the month, 6:00 p.m. Location to be announced prior to each meeting. This is in combination with the LSU/Ochnser Urology program 3. Pediatric Conference: 1st & 2nd Tuesday of the month, 6:00 p.m., Childrens Hospital. 4. Pyelogram Conference: 3rd Wednesday of the month, 6:00 p.m., location varies. This is in combination with the LSU/Ochnser Urology program 5. Didactics will be administered by Dr. Moparty, cell 504-421-9827. (The faculty member on call will administer a brief didactic lecture during your rotation.) ADDITIONAL RESPONSIBILITIES: Check with the chief resident on your service for questions while on the Urology Services

2009-2010 Resident Listing

Resident Name Fifer, Luke Richardson, Brian Bowen, Ashley Oommen, Mathew Patel, Kush Caire, Arthur PGY-Yr PGY-5; URO-4 PGY-4; URO-3 PGY-3; URO-2 PGY-3; URO-2 PGY-2; URO-1 PGY-2; URO-1 Pager 213-1721 544-9364 538-2487 213-0174 550-9335 213-0089

61

The O.R. is located on the 3rd floor of Tulane Medical Center. There are five main areas that you will be involved in: GOR which has 14 rooms, SDS Dept./Pre-admit (where patients go pre-operatively and post-operative), LLI/Cysto Dept., Recovery Room and SICU. The GOR is open from 6:45 a.m. 11:30 p.m. Monday through Friday with emergent cases done after 11:00 p.m. and on weekends. Surgery starts at 7:15a.m. Monday Friday and 7:45a.m. on Wednesday s. 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 ORs vary, you are responsible for following policies/procedures of the hospital to which you are assigned. Your Responsibilities Come 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. Scrubs: Tulane Medical Center Scrub Suit Policy and Procedure Policy: Tulane Medical Center will provide scrub suits for personnel while they are working in the following areas: Bone Marrow Transplant, all areas of the Operating Room (Anesthesia, Post Anesthesia Care Unit), Outpatient Surgery, Endoscopy and Radiology Special Procedures. Scrub Suits are not to be worn outside the Hospital/Clinic Medical School complex. They are also not to be worn as uniforms within departments outside of invasive areas. Procedure: Scrub suits are available in jade green and are stamped Property of Tulane Hospital. Unauthorized removal from the facility is a violation of hospital policy. An automated scrub suit dispensing system will be used in the Operating Room. The system is activated by an identification card. To receive an activated card, all authorized Tulane employees, physicians and residents must complete an application form and submit it to the Operating Room management staff. Once form is completed, data will be input to the ScrubEx system, and employee badge activated. All users must submit application with a personal identification number (PIN) to use in the event that the badge is unavailable. Because medical students have a university-issued badge, access to the system will be via the PIN. All forms for medical school students will be coordinated through the Student Coordinators. If you are at Ochsner or OLOL, you will not use Tulane scrubs. Attending faculty and staff will have a credit of two scrub suits. Medical students will have a credit of one scrub suit. Once this limit has been reached, in order to receive additional scrub suits, previously issued scrubs must be returned to the unit. Visiting physicians and vendors will be issued scrubs by the Operating Room front desk personnel. Contact people for the Scrub Ex machine are: Lynetra McCord @ 988-9090 and [email protected] Melissa Guidry @ [email protected] Shannon Labore @ [email protected] Forms should be sent to: Linda Levesque
62

[email protected] 988-2469 Mike Calcagno [email protected] FAX: 988-7653

63