COURSE: Emergency Surgery/Trauma Service

COURSE DIRECTOR: John Cone, M.D.
PHONE: 501-686-6184
DURATION: 4 weeks

Course Goals & Objectives:

  1. Learn the initial management and resuscitation strategies for treating patients in shock, especially hypovolemic shock.
  2. Learn the basic techniques for evaluating injured patients.
  3. Learn the differential diagnosis and diagnostic algorithm for patients with common, non-traumatic surgical emergencies such as peritonititis.
  4. Learn the principles of post-operative care of surgical patients.

Specific Duties:

  1. To provide care for assigned patients admitted to the trauma service under the supervision of surgical residents and attending surgeons.
  2. To participate in daily rounds on all patients admitted to the Emergency Surgery / Trauma Service.
  3. Scrub on operations on injured patients or those requiring emergency procedures.
  4. Participate in the initial evaluation of urgent surgical consults from the emergency room and the non-surgical wards.
  5. Participate in the various conferences of the surgery department with particular emphasis on the trauma conference.

 

COURSE: Colorectal Surgery

COURSE DIRECTOR: Jonathan Laryea, M.D.
PHONE: 501-686-6262
DURATION: 4 weeks

Course Goals & Objectives:

  1. Integration of basic knowledge regarding the anatomy and physiology of the gastrointestinal tract into the management of patients with colorectal and gastrointestinal diseases.
  2. Develop a differential diagnosis and diagnostic algorithm for patients with common colorectal and gastrointestinal diseases.
  3. Understand the basic anatomic and physiologic principles underlying surgical and endoscopic procedures relevant to colorectal surgery.
  4. Technical skills to be learned on this elective include:
    1. History & physical examination skills of patients with diseases of the gastrointestinal tract.
    2. Preoperative evaluation strategies for patietns with colorectal or gastrointestinal diseases.
    3. Flexible sigmoidoscopy, proctoscopy, anoscopy, esophagogastroduodenoscopy, and colonoscopy.
    4. Observing major abdominal procedures involving the gastrointestinal tract.
    5. Post-operative care of patients undergoing major abdominal operations.

Specific Duties:

  1. To participate in daily rounds on all patients admitted to the endoscopy & colorectal surgery service.
  2. Attend relevant surgical conferences, including surgery grand rounds.
  3. Scrub on and assist in operations on patients with diseases of the gastrointestinal tract.
  4. Read assigned material.
  5. Assist the residents on the service in clinic, surgical suites, and endoscopic suites.

 

COURSE: Total Care of the Burn Patient

COURSE DIRECTOR: Pam Howard, M.D.
PHONE: 501-364-1649

Course Goal & Objectives:

  1. Proper technique of burn dressing.
  2. Management of burn wound, including:
    1. debridement with and without anesthesia,
    2. cautery excision of full thickness burns,
    3. heterografting principles suing frozen pigskin and cadaver skin.
  3. Proper resuscitation methods for severe burns and monitoring techniques.
  4. Develop understanding of the pathophysiological changes which accompany burning.
  5. Review of the energy requirements of the burned child.
  6. Homografting, use of dermatones, mesher, and application of skin grafts.
  7. Introduction to Intensive Care as it related to the thermally injured patient.

Specific Duties:

The student will work one on one with resident assigned to the Burn Center. Daily rounds including attending the burn dressing changes.

 

COURSE: Surgical Oncology/Breast Service

COURSE DIRECTOR: Suzanne Klimberg, M.D. and *
PHONE: 501-686-5604
DURATION: 4 Weeks

* Drs. Kent Westbrook, Ronda Henry-Tillman, & Anne Mancino

Course Goal & Objectives:

Technical Skills:

  1. History and physical examination of patients with breast disease, endocrine tumors, and melanoma.
  2. Preoperative evaluation of patients.
  3. Work-up and presentation of patients in clinic.
  4. Interpretation of abnormalities of mammogram, breast ultrasound, and MRI.
  5. Basic surgical principles while observing and assisting in surgical procedures.
  6. Techniques of insertion of central venous catheters.

General Objectives:

  1. Integration of basic knowledge of anatomy, pathology and physiology of the breast, endocrine organs, and skin into the management of patients with disease.
  2. Develop understanding of the multidisciplinary aspects involved in the care of oncology patients.
  3. Recognition of risk factors and genetic influences on cancer incidence and the implications for patients and their families.

Specific Duties:

  1. Daily rounds with resident and/or staff on service.
  2. Work-up of patients in Women’s Oncology Clinic and Melanoma Clinic and presentation to staff.
  3. Observe/assist on surgical cases as scheduled.
  4. Read appropriate assigned material.
  5. Attend conferences including weekly Breast Conference, Melanoma Conference, Tumor Board, Surgical Grand Rounds, M&M and Journal Club.
  6. For interested students, develop a case presentation/clinical research project for presentation and/or publication.

 

COURSE: Pediatric Surgery

COURSE DIRECTOR: Sam Smith, M.D.
PHONE: 501-364-2943
DURATION: 4 Weeks

Course Goal & Objectives:

Technical Skills:

  1. Basic surgical procedures including suture closure of simple lacerations, incision and drainage of superficial abscesses, difficult vascular access, chest tube placement, etc.
  2. Basic wound care.
  3. Basis ostomy care.
  4. Manual reduction of an incarcerated inguinal hernia.

General Objectives:

  1. Familiarity with the surgical emergencies of infancy and their presentation.
  2. Diagnosis and management of the more common surgically correctable, congenital anomalies:
    1. diaphragmatic hernia,
    2. esophageal atresia,
    3. duodenal atresia,
    4. jejunal/ileal atresia,
    5. malrotation,
    6. meconium ileus,
    7. Hirchsprung disease,
    8. imperforate anus, and
    9. anterior abdominal wall defects.
  3. Diagnosis and management of the common surgical condition of childhood:
    1. acute appendicitis,
    2. hypertrophic pyloric stenosis,
    3. intussusception,
    4. umbilical hernia, and
    5. inguinal hernia.
  4. Diagnosis and management of the acute surgical abdomen.
  5. Diagnosis and management of the major solid tumors of childhood.
  6. Evaluation and management of the child with multiple injuries.
  7. Basic pre- and postoperative care including fluid and electrolyte management, surgical antibiotics, nutritional care and respiratory care.
  8. Basic principles of surgical follow-up.

Specific Duties:

  1. Daily ward rounds with student, residents and staff.
  2. Participation in preoperative and postoperative care.
  3. Participation in appropriate operative procedures.
  4. Participation in weekly general clinic.
  5. Participation and attendance at appropriate pediatric and surgical conferences.
  6. Appropriate reading.

 

COURSE: Vascular Surgery

COURSE DIRECTOR: Mohammed Moursi, M.D. and John Eidt, M.D.
PHONE: 501-686-6176
DURATION: 4 weeks

Course Goal:

This rotation is designed to expose the fourth year medical student to the field of vascular surgery in a more detailed fashion and to add to the knowledge obtained during the third year. The student will be able to understand the basic and clinical science of pre-op, operative, and post-op vascular disease processes including aneurysm disease, carotid disease, and peripheral vascular disease.

Course Objectives:

  1. Proper history and physical examination of vascular surgical patients.
  2. Understanding of vascular lab studies.
  3. Pre-op evaluation of patients with vascular disease.
  4. Management of vascular patients in post-op SICU setting.
  5. Integration of basic science into surgical management of patients with vascular disease.
  6. Basic surgical skills of wound care.
  7. Basic vascular radiology skills and anteriography interpretation.
  8. Principles of hemodynamics including hemodynamic profile and how to select appropriate therapy based upon this data.
  9. Pulmonary physiology applied to respiratory failure and care of patients on mechanical ventilation post-operatively.

Specific Duties:

  1. Daily rounds with staff and residents on vascular patients.
  2. Closely follow post-op vascular patients and report to vascular fellow or staff.
  3. Attend weekly vascular clinic.
  4. Scrub and assist on selected vascular cases.
  5. Read selected literature and peripheral literature appropriate to vascular surgery and SICU care.
  6. Attendance at appropriate weekly conferences such as Grand Rounds, M&M, etc.
  7. Assist with various procedures in the SICU.
  8. One-on-one conference with Dr. Moursi or Dr. Eidt 1-2 hours per week.

 

COURSE: Private Surgery

COURSE DIRECTOR: J. Michael Stair, M.D. and Hugh Burnett, M.D.
PHONE: 501-686-6647
DURATION: 4 weeks

Course Goal & Objectives:

Technical Skills:

  1. Surgical history and physical
  2. Preoperative evaluation of patients
  3. Participating in major surgical procedures
  4. Performing some minor surgical procedures under direction
  5. Follow-up review and care in physician’s office, individual option

General Objectives:

  1. Integration of basic knowledge into care of surgical patients
  2. Role of general surgeon in a general community hospital
  3. Activities of a surgeon in his office practice, individual option

Specific Duties:

  1. Each student will be assigned to one or more surgeons and focus on the following tasks or duties:
    1. Perform and dictate for the chart a pertinent history and physical
    2. Outline a set of admission orders, call the attending physician, and place orders in the chart when confirmed by the physician.
    3. Will consult texts and current literature relevant to each surgical procedure planned and be prepared to discuss this with the surgeon.
    4. Will spend mornings in the operating room observing and/or assisting in surgical procedures as arranged the previous evening.
    5. Will ascertain rounding time and make daily rounds with staff.
  2. Student will attend conferences as scheduled.
  3. Assisting in the Emergency Room can be arranged individually.
  4. Will be expected to scrub on 10-20 cases per week with his preceptor or other surgeons.

Students may be assigned as follows: Pulaski Surgery – 1; Surgical Clinic of Central Arkansas – 2.

Addresses:

Pulaski Surgery
3401 Spring Hill Drive, Suite 400
North Little Rock, AR 72217

Surgical Clinic of Central Arkansas
9500 Kanis Road, Suite 501
Little Rock, AR 72205

 

COURSE: Pediatric Cardiothoracic Surgery

COURSE DIRECTOR: R.D.B. Jaquiss, M.D.
PHONE: 501-364-5858
DURATION: 4 weeks

Course Goals & Objectives:

The student will develop:

General:

  1. Familiarity with the specialty of pediatric cardiothoracic surgery – obtain a general understanding of the fundamental physiologic principles which guide surgical decision making.
  2. Familiarity with the context in which the specialty is practiced – a multidisciplinary, team approach to care.

Specific:

  1. Familiarity with specific concepts of left-to-right and right-to-left shunts in the cardiovascular system.
  2. Familiarity with concepts of pressure-loading and volume-loading of the cardiovascular system.
  3. Familiarity with the concept of early repair of congenital heart disease as opposed to initial palliation and delayed repair.
  4. Familiarity with the history and development of pediatric cardiovascular surgery.

Technical:

  1. An understanding of basic surgical techniques – asepsis, delicate tissue handling, and wound healing to be demonstrated by the student primarily during wound closure.
  2. an understanding of the proper use of thoracostomy drains and invasive homodynamic monitoring.

Specific Duties:

The student will demonstrate synthesis of the concepts listed above by evaluating a patient preoperatively, participating in the surgical management and post-operative care of the patient, and delivering a 45-minute lecture which comprehensively describes the current state of knowledge about the condition for which the patient is treated. The lecture will include a succinct case presentation followed by a thorough summary of the relevant literature.

  1. Scrub in to the operating room on selected patients.
  2. Attend weekly student/faculty tutorial sessions..
  3. Opportunity for in-depth research on selected oncological problems with possibility of publication.

 

COURSE: Plastic & Reconstructive Surgery

COURSE DIRECTOR: James Yuen, M.D.
PHONE: 501-686-5736
DURATION: 4 weeks

Course Goals & Objectives:

Technical Skills:

  1. Wound management.
  2. Basic and advanced suture techniques with various types of wound repair.
  3. Application of skin grafts.
  4. Scar revision.
  5. Tissue expansion.
  6. Myocutaneous flaps
  7. Microsurgery.
  8. Assist in surgery.

Other Principles:

  1. Principles of wound healing.
  2. Management of straightforward and difficult wounds.
  3. Exposure to all aspects* of aesthetic and reconstructive plastic surgery.
  4. Congenital anomalies and craniofacial surgery*.

*Dr. Kris Shewmake (Private Practice)

Specific Duties:

The students will participate in all aspect of the plastic surgical evaluation and treatment. He/she will learn the nuances of dealing with aesthetic and reconstructive plastic surgical patient from preoperative evaluation to intraoperative techniques to postoperative management. The experience will be at all three hospital associated with the University of Arkansas for Medical Sciences campus as well as some exposure to the private group of clinical faculty. Students will be asked to assist in obtaining the preoperative history and physical on the reconstructive patients along with the general surgery resident. Students will be expected to participate in the operating room as either first or second assistant and will be allowed to assist in closing wounds. Postoperative ward work will be expected. Appropriate reference material will be provided.

Patient load:

Student can expect to participate in from 10 to 15 procedures per week and in the evaluation of approximately 15 to 40 patients per week as seen in the clinic.

Basic Textbooks:

Basic required reading will be from one of the recognized plastic surgery textbooks and from a provided syllabus.

 

COURSE: Surgical Research

COURSE DIRECTOR: John Cone, M.D.
PHONE: 501-686-6184
DURATION: Minimum 8 weeks

Course Goals & Objectives:

  1. Properly design an experiment to test a chosen hypothesis.
  2. Write a research proposal as a model for research grant proposals.
  3. Read the relevant medical literature critically to spot flaws in design or conclusion.
  4. Basic statistical methods of use in medical research and the application of small computers to these methods.
  5. Write a scientific paper in the formal of Medical Journals.

Specific Duties:

  1. Participate in an approved research project with a member of the surgical faculty. This may be a small individual project or a clearly defined segment of a larger, ongoing project.
  2. Participate in weekly surgical research conferences.
  3. Write an initial proposal outlining the scope of the planned research.
  4. ubmit a written report and a verbal presentation summarizing the work completed.

This rotation must be taken for a minimum of eight weeks. Credit will be on week by week basis (8 hours for 8 weeks, etc.) as along as you are taking this longitudinal full time and not combining it with another longitudinal. If you are combining it with another elective, credit will be variable according to effort: see Dr. Wheeler for details.