Year 3 Surgery Posting Sylabbus 2008

3rd year Surgical posting (New integrated curriculum)

Undergraduate Year 3 Curriculumfor

Surgical Posting

Department of Surgery

Faculty of Medicine

Universiti Kebangsaan MalaysiaCONTENTS

1.Directory of Staff2.Introduction 3.Prerequisites 4.Objectives 5.Setting 6.Contents7.Student Assessment8.Resource Materials9.Teaching-Learning Methodology

10. Appendix 1Timetable of General Surgical Units

Appendix 2Timetable for 3rd Year Undergraduate Teaching

Appendix 3Procedures & LogbookDIRECTORY OF TEACHING STAFFHead of Department:A/P Razman Jarmin

Module head

:Mr Ainul Syahrilfazli JaafarNoLecturerSpecialtyPager/Ext.Email address

1Prof Rohaizak MuhammadB&[email protected]

2AP Naqiyah IbrahimB&[email protected]

3Miss Saladina JaszleB&E

4Mr Abdul Rahman ShakeerUGI/MIS

5Prof Jasmi Ali YaakubUGI/[email protected]

6AP Lukman RashidUGI/[email protected]

7AP Razman [email protected]

8Mr Hairol [email protected]

9AP Ismail [email protected]

10Mr Imtiaz [email protected]

11AP Hanafiah HarunarashidVascular

12Mr Mohd Azim [email protected]

13AP Zulkifli [email protected]

14Mr Nazri [email protected]

15Mr Lee Boon [email protected]

16Mr Badrulhisham [email protected]

17Prof [email protected]

18Miss Dayang AnitaPaeds

19Mr Azizi Abu [email protected]

20Mr Toh Charng Jeng Neuro

21Mr [email protected]

22Mr Ainul Syahrilfazli [email protected]

23Mr Zamrin [email protected]

24Mr [email protected]

25Mr Shahrul Akmal [email protected]

26Dr Goh Eng HongPlastic Surgery

YEAR 3OBJECTIVES (standardized for all)

At the end of Year 3, students should be able to:

1.clerk cases in a comprehensive and holistic manner

2.perform basic investigations and procedures.

3.communicate effectively as an individual, a leader and a team member of the healthcare profession.

4.demonstrate a sense of responsibility in self development and life long learning

5.discuss the health services provided by the district health officers, health clinics and hospitals.

6.formulate a research proposal, conduct a survey, diagnose the main health problems in the community and conduct health promotion activities

SURGERY MODULE (FF3124) 2INTRODUCTION

The surgical posting in the 3rd year of Universiti Kebangsaan Malaysia medical school is an 8-week posting with emphasis on professional and personal development (PPD) and self directed learning (SDL).

The Department of Surgery is made up of general surgery and related surgical subspecialties such as neurosurgery, urology, and paediatric and cardiothoracic surgery. General surgery is further subdivided into the Breast and Endocrine Unit, Colorectal Unit, Hepatobiliary Unit, Upper Gastrointestinal / Minimally Invasive Surgery (MIS) Unit and Vascular Unit.Each unit is headed by a consultant (usually a Professor / Assoc. Professor / Senior lecturer) under whom there is a clinical specialist (lecturer), registrars and medical officers who are usually Master of Surgery (MS) postgraduate students as well as housemen.

Students are distributed among lecturers in all the units whereby the main aim is exposure to general surgery with a secondary aim of exposure to the subspecialties. They will spend 7 weeks in general surgery and 1 week in the surgical subspecialties.3PREREQUISITES

1.Good understanding of basic biomedical sciences

2.Basic clinical skills (history taking and physical examination)

3.Basic PPD skills4MODULE OBJECTIVES

At the end of the 8-week posting, students should have the knowledge, skills and right attitude to be able to:

1.take a history and perform a physical examination on the surgical patient competently and present the cases confidently.

2.discuss the provisional as well as differential diagnoses.

3.a)request for relevant investigations,

b)justify these investigations, and,

c)interpret the results of basic investigations (eg lab tests)4.a)outline the management plan for surgical patients, and b)identify the various factors which can potentially influence clinical decision making.5.perform simple, invasive clinical procedures (such as phlebotomy, intravenous access, asepsis and sterility, wound care etc.) 6.a)demonstrate familiarity with the surgical ward environment, outpatient setting and operating theatres,and

b) comply with ward rules and regulations.

7.discuss the principles of surgical practice, ethics and medico-legal issues in the management of surgical patients.8.apply basic medical sciences (especially clinical anatomy, physiology, pathology and pharmacology) to clinical situations of the surgical patient.

9.demonstrate appropriate skills indealing with uncertainty, deathand dying.

10.communicate effectively in day-to-day professional interactions with patients, relatives and fellow healthcare professionals.

11.contribute as a team member and appreciate the multidisciplinary approach in patient care.

12.demonstrate a sense of responsibility in their personal and professional conduct 5SETTING

Department of Surgery, 8th floor Hospital UKM

Lectures and Tutorials are given on a weekly basis in the department by both lecturers and trainee lecturers. There are also weekly housemen CME, surgical update presentations every fortnight as well as monthly postgraduate revision course and histopathological meetings. The students are encouraged to attend these meetings.

There are also a surgical skills lab where basic suturing and knotting can be thought are taught and a room where students get to practise clinical examination using mannikins.

Surgical Wards (2 hours per day)There are 2 dedicated general surgical wards on the 5th floor with a total number of 56 beds. There are also the high dependency and intensive care wards. The setting for bedside teaching will be in the wards on a daily basis from morning and afternoon ward rounds. Students are expected to tag along with the housemen on days where their respective teams are on call and present the cases the following day.

Outpatient Clinics (2 hours per week)Located on the ground floor, these clinics tend to be quite busy, therefore teaching is usually conducted at the very end of the clinic session although the students do sit in and observe the doctor-patient relationship and can learn about the common outpatient surgical conditions. Students are expected to clerk in new cases and present them to the lecturers and trainee lecturers. Students are expected to attend at least 2 outpatient sessions with their respective teams and 2 sessions each with the other 3 teams.

Operating Theatres (2 hours per session)There are elective, emergency, day care and minor OT surgery operating theatres. The operating theatres can accommodate a much smaller number of students at any one time (3-4) so as to reduce infection rate in surgical patients. Students are expected to at least attend 2 sessions of each operating theatre during their 8-week posting. Scrubbing and donning operating gowns will be taught during the practical workshop.Accident & Emergency Department (A & E) (1 hours per session)Students are expected to at least attend 2 sessions with the medical officers at the A&E Department to experience first-hand emergency situations involving surgical patients as well as exposing them to emergency medicine. Toilet and suturing, as well as wound care, are abundant in this department.

Radiology Department (1 hour per week)A series of tutorials on imaging investigations are provided for by our radiology colleague in the radiology department.

Endoscopy Unit (2 hours per session)Students are expected to attend at least 2 sessions during their posting. Both upper and lower endoscopy as well as ERCPs should be seen to appreciate these procedures.

6CONTENTSTopics to be covered include:In DetailIn PrincipleAware of

Trauma

ABC of trauma

Chest injury

Head injury

Blunt abdominal trauma

Burns

Endocrine

Goitre

Differentiated thyroid Ca

Thyrotoxicosis

Thyroglossal cyst

Adrenal tumours

Breast

Breast Ca - infiltratingBreast fibroadenoma

Breast abscess

Upper GI

Upper GI bleeding

Oesophageal Ca

Achalasia

Reflux oesophagitis

Peptic ulcer disease

Gastric Ca

Hepatobiliary

Hepatoma

Metastatic liver disease

Liver cirrhosis

Portal hypertension

Liver abscess

Obstructive jaundice

Ascending cholangitis

Gallstone disease

Pancreatitis

Ca head of pancreas

Colorectal

Lower GI bleeding

Acute intestinal obstruction

Colorectal Ca

Diverticular disease

Acute appendicitis

Anorectal abscess

Haemorrhoids

Stomas

Hernia

Inguinal

Femoral

Incisional

Paraumbilical

Complications

Vascular

Peripheral vascular disease

Venous insufficiency

Deep venous thrombosis

Pulmonary embolism

Abdominal aortic aneurysm

Urology

Genitourinary calculi

Renal Ca

Bladder Ca

Benign prostatic hyperplasia

Testicular torsion

Testicular Ca

Hydrocoele

Urinary tract infection

Plastic Surgery

Skin ulcers

Oral ulcers

Salivary gland tumours

Skin tumours

Cutaneous abscesses

Cutaneous lesions Endocrine

Complications of thyroid surgery

Hyper/hypothyroidism

Hyperparathyroidism

Undifferentiated thyroid Ca

Breast

Breast Ca in-situ

Phyllodes tumour

Pagets disease

Duct ectasia

Fibroadenosis

Mastitis

Upper GI

Barretts oesophagus

Oesophageal corrosive injuriesGastric lymphoma

Pancreatic pseudocyst

Pancreatic abscess

Colorectal

Familial adenomatous polyposis

Colonic polyps

Sigmoid volvulusInflammatory bowel disease

Angiodysplasia

Anal fissure

Fistula in ano

Anal carcinoma

GI tuberculosis

Urology

Prostate Ca

Paediatric Surgery

Inguinoscrotal swelling in childhood

Billous vomiting in newbornsIntestinal obstruction in children

Pyloric stenosis

Endocrine

Carcinoid tumour

Insulinoma

Adrenocortical Ca

Thymoma

Mediastinal mass

Thyroiditis

Branchial cyst and fistula

Upper GI

Hiatus hernia

Hepatobiliary

Hepatic encephalopathy

Benign liver tumours

Hepatolithiasis

Colorectal

Rectal prolapse

Anal sphincter injuryChronic constipation

Radiation proctitis

Ischaemic colitis

Paediatric Surgery

Hydrocephalus

Recurrent abdominal pain in childhood

Surgical causes of respiratory distress in newbornsCommon abdominal tumours in children

7STUDENT ASSESSMENT

Prerequisites

Log book is completed, signed and submitted

2 case write-ups are completed, signed and corrected

Attendance throughout the whole posting has been satisfactory (at least 80%)Students who fail to fulfill the above criteria will be barred from the examination and considered to have failed the surgical posting.A.Continuous assessment (refer to appendix for assessment form)

i) Long Case Presentations (10%)

students are required to obtain the clinical competency form and present a supervised long case to their respective supervisors and marks will be given according to the indices shown on the form

ii) Case Write-ups (10%)

2 case write ups

iii) Mentor assessment and logbook (10%)

Completed logbooks are given a maximum score of 10. B.Theory

End-of-semester Theory Examination

The end-of-semester theory examination is in the form of MCQ (OBAs and EMQs) and Key feature questions (KFQ)C.Clinical

End-of-semester Clinical Examination (OSCE)Students are rotated through a series of examination stations which test their history taking, examination skills and interpretative skills where simulated and real patients, slides and instruments are used.

Breakdown of marks:

Continuous Assessment

30%

End-of-semester Theory Examination

35%

End-of-semester Clinical Examination

35%8RESOURCE MATERIALS

Please include edition (should be the latest)Recommended Textbooks:1.Principles and Practice of Surgery

OJ Garden, AW Bradbury, and JLR Forsythe

Churchill Livingstone2.Lecture Notes on General Surgery

Harold Ellis and Roy Calne

Blackwell Science

3. Essential Surgery

Burkitt & Quick

Churchill Livingstone

4. Symptoms & Signs of Surgical Disease

Norman & Browse5. Bailey & Loves Short Textbook of Surgery

Mann, Russell & Williams

Online Materials :1.Surgical Tutor (www.surgical-tutor.org.uk)

2.emedicine (www.emedicine.com)3.MDConsult (via HUKM library website)

4.E-learning website( www.medicine.ukm.my/e.learning )

9TEACHING-LEARNING METHODOLOGY

A. Weekly lectures 9 topics (1 and hours 1 hours each session)

1.Lecture 1 (Week 1 Day 1)

History & physical examination in the surgical patient (video presentation)Lecturers in-charge Mr Imtiaz / Mr Hairol

Specific Learning Objectives

The lecture should enable the students to:

1.observed how to take a history from the surgical patient

2.

observed how to examine the surgical patient with emphasis on the abdomen,

breast,neck and lower limbs.

2.Lecture 2 (Week 1)

Perioperative Management

Lecturers in charge Mr Shaker / Mr Azim

Specific Learning ObjectivesThe lecture should enable the students to:

1. explain the principle of obtaining consent

2. discuss the principle of bowel preparation

3. discuss the principle of DVT prophylaxis

4. discuss the principle of prophylactic antibiotics

5. list the post-operative complications in general

6. list the different types of post-operative analgesia

7. outline the principles of stoma care

8. discuss the management of intravenous fluids


Common Neurosurgical Conditions/Head Injury

Lecturers in charge Mr Azizi / Mr Toh/ Mr Sanmugarajah / Mr Syahril


1. outline the management of traumatic head injury

2. relate the pathophysiology of hydrocephalus3. discuss the principle of management of neurosurgical infections4. principles of intracranial tumours5. relate the pathophysiology of spinal cord compression4.Lecture 4 (Week 3)

Common Urological Conditions

Lecturers in charge Mr Zulkifli / Mr Nazri / Mr Lee Boon Cheok/ Mr Badrul



1. explain the causes of renal, ureteric, bladder and urethra injury

2. identify the signs and symptoms of each component of genitourinary trauma

3. describe the methods of investigation in patients suspected to have genitourinary trauma

4. outline the management of genitourinary trauma

5. Lecture 5 (Week 4)

Common Plastic Surgical Conditions/Burns

Lecturers in charge Visiting Consultant/ Mr Goh Eng HongSpecific Learning ObjectivesThe lecture should enable the students to:

1. outline the management of burn injury

2. describe the common skin tumours and its management

3. outline the management of salivary gland tumour

4. describe the principle of skin cover


Nutrition in Surgery (with dietitian)

Lectures in charge AP Lukman / Miss Birinder


1. explain and perform nutritional assessment

2. relate the history taking and physical examination of nutritional assessment in the surgical patient

3. explain the basic nutritional requirements

4. explain the nutritional requirements in abnormal condition

5. explain the indication for nutritional support

6. describe the methods and routes of nutritional support

7. explain the complications of nutritional support

8. relate the role of monitoring in nutritional support


Trauma Chest and Abdomen

Lectures in charge Mr Zamrin / Mr Ramzi / Mr Shahrul


1. explain the pathophysiology of traumatic pneumothorax, haemothorax, lung contusion, flail chest and cardiac tamponade

2. define the common injuries in chest trauma

3. identify the signs and symptoms of pneumothorax, haemothorax, lung contusion, flail chest and cardiac tamponade

4. describe the chest X-rays for the features above

5. outline the basic resuscitation and immediate management of these traumas


Common Surgical ProceduresLectures in charge AP Razman / AP Naqiyah


1. correlate the history taking and physical examination in a patient with breast lump by listing the differential diagnoses accordingly.

2. explain the meaning of triple assessment in approaching the patient with a breast lump.3. explain the difference between fine needle aspiration and tru cut biopsy for pathological diagnosis in the patient with a breast lump.4. explain the difference between the need for mammogram and ultrasound of the breast in assessing the patient with a breast lump.


Common Paediatric Surgical ConditionsLecturers in-charge Prof Thambidoorai / Miss Marjmin



1. explain the signs and symptoms, diagnosis and treatment of inguinal scrotal swelling and umbilical hernia

2. explain the principle and management of acute abdominal pain such as acute appendicitis and intussuception

3. explain the basic principle of pyloric stenosis

4. explain the clinical presentation of neonatal intestinal obstruction particularly Hirschprungs disease and malrotation

5. explain the examination of anorectal anomalies

6. explain the importance of early diagnosis of biliary atresia and jaundice

7. relate the diaphragmatic hernia to respiratory distress

B. Self-directed learning sessions / Elearning (2.5 hours each session)

Total contact hours = 2.5 X 8 = 20 hoursOnline self-directed learning (SDL) and student led seminar with group presentations.

TopicSpecific Learning Objectives

Approach to the patient with a breast lump At the end of the session, the student should be able to

The session should enable students to:

1. obtain proper history of breast diseases.

2. explain breast examination.

3. list the differential diagnoses (such as fibroadenoma, carcinoma etc).

4. list the relevant investigations (such as ultrasound/mammogram, FNAC, biopsy).

5. list the management options (such as excision, conservative treatment, mastectomy etc).

Approach to the patient with a neck lump The session should enable students to:

1. obtain proper history of neck lump;

2. explain neck examination;

3. list the differential diagnoses (such as cervical lymph node enlargement, goiter, branchial cyst etc).

4. list the relevant investigations (such as ultrasound/CT scan; FNAC or biopsy).

5. list different management options (such as conservative treatment, thyroidectomy or excision of lump including chemotherapy in lymphoma and antituberculous therapy in tuberculosis).

Approach to the patient with acute abdomen The session should enable students to:

1. obtain proper history on acute abdomen;

2. explain abdominal examination;

3. list the differential diagnoses (such as appendicitis, perforated viscus, acute pancreatitis, acute cholecystitis, ischaemic bowel, etc).

4. list the relevant investigations (such as FBC, serum amylase, ultrasound/CT abdomen, diagnostic laparoscopy, etc).

5. list treatment options in acute abdomen (ie conservative treatment or surgery).

Approach to the patient with abdominal mass The session should enable students to:

1. obtain relevant history pertaining to abdominal mass


3. list the differential diagnoses (such as causes of hepatosplenomegaly, gastrointestinal malignancy, abdominal aortic aneurysm, etc).

4. list the relevant investigations (such as ultrasound/CT scan of the abdomen; endoscopic examination with biopsy).

5. list the management options of either surgical excision or non-surgical.

Approach to the patient with gastrointestinal bleeding The session should enable students to:

1. obtain relevant history of gastro-intestinal bleeding;


3. list the differential diagnoses (such as bleeding peptic ulcer, gastric malignancy, oesophageal varices, etc).

4. list the relevant investigations (including FBC, coagulation profile, upper gastrointestinal endoscopy, etc).

5. list the management options - conservative versus surgical.

Approach to the patient with jaundice The session should enable students to:

1. obtain the relevant history of the jaundiced patient;


3. list the differential diagnoses (such as haemolytic disorder [prehepatic], acute hepatitis [hepatic], choledocholithiasis, Ca head of pancreas [posthepatic]).

4. list the relevant investigations (such as LFTs, ultrasound of the hepatobiliary system, ERCP).

5. list the management depending on cause ie conservative versus surgical.

Approach to the patient with intestinal obstruction The session should enable students to:

1. obtain the relevant history of intestinal obstruction;


3. list the differential diagnoses for small and large bowel obstruction; functional versus mechanical causes. (Common causes: adhesions, hernia or gastrointestinal malignancy).

4. list the relevant investigations (including blood investigations, radiological investigations).

5. list the management options, depending on cause; conservative versus surgical.

Approach to the patient with limb ischaemia The session should enable students to:

1. obtain the relevant history of limb ischaemia;

2. explain vascular examination;

3. list the differential diagnoses (such as acute or chronic limb ischaemia secondary to peripheral vascular disease, embolism or trauma).

4. list the relevant investigations (including Doppler ultrasound, angiogram etc).

5. list the management options (such as conservative, embolectomy, bypass, amputation, etc).

6. explain the role of prevention and modification of risk factors.

C.Practical skill workshops (1/2 day sessions)

These sessions cover:

- principles and practice of asepsis/sterility and wound management - examination techniques on mannequin (breast, PR, catheterization, RT insertion)

- intravenous access and basic suturing

Students are expected to attend 3 sessions on sterility, wound management and examination technique. They will have a hands-on experience and will be supervised

Total contact hours = 3 hoursD. Clinical conference & meetings (see Appendix 2)

Total contact hours = 8 X 5 = 40 hours (CPC and housemen CME)E. Bedside teaching minimum 2 hours per week

Total contact hours = 2 X 8 = 16 hoursStudents are divided into groups of 7-8 students under 2 lecturers. There are a minimum of 2 sessions per week whereby students are trained in the basic clinical skills from clerking, physical examination and patient management. Students are expected to clerk these cases and discuss them in small groups before the session. Each session lasts at least 1 hour. Students are required to participate and will be assessed based on their participation and attendance in these sessions. During these sessions, the emphasis is on critical thinking and communication skills.

F.Ward rounds, ward work and operating theatre

Students are expected to attend ward rounds at 2pm according to their respective teams. They are expected to know about the patient and to present the cases during ward rounds. Students are expected to tag along with the house officers for procedures and ward work. The students are also expected to attend operating sessions according to the schedule given.

At the end of the posting, students should be able to:

1.take the history and perform physical examination of the surgical patient

2.take the history and examine the surgical patient

3.formulate the provisional and differential diagnoses

4.discuss the management plan

5.perform routine simple procedures (such as venepuncture, urinary cathetherization and wound dressing)6.demonstrate familiarity with the common procedures performed in the surgical ward (such as chest drain insertion)

7.appreciate common surgical operative proceduresContact Hours per Posting

Hours per postingSurgical rounds (2 hours per day)

80 hours

Clinics (2 hours per week)

16 hours

Operating theatre (2 x 2 hours per session)

4 hours

Accident and Emergency (1.5 x 2 hours per session)

3 hours

Radiology (1x7 hours per week)

7 hours

Endoscopy (2 x 2 hours per session)

4 hours

E-learning (2.5 x 8 hours per session)

20 hours

Lectures (1.5 x 9 hours per session)

13.5 hours

Bedside Teaching (2x 8 hours per week)

16 hours

Practical Skill Workshops

3 hours

CME and Meetings (5 hours per week)

40 hours

Total

206.5 hours

9Appendix 1TIMETABLE FOR THE GENERAL SURGICAL UNITS

Attached Appendix 2Timetable for 3rd Year Undergraduate Teaching (per academic year)Teaching Groups:1. Prof Rohaizak/Mr Nazri/Mr Shaker2. Prof Jasmi/Mr Yahya/Mr Ramzi3. Prof Thambidoorai/Mr Zamrin/Miss Marjmin

4. Mr Ismail/ Mr Badrul/Mr Shahrul5. Mr Razman/Mr Azim/Mr Shan6. Mr Zamrin/Mr Lukman /Mr Teoh7. Mr Azizi/Miss Naqiyah/8. Mr Zulkifli/Mr Imtiaz/Mr Hairol

Students are also divided into 5 clinical attachment groups for ward rounds, clinics, OT & endoscopy exposure.A. Breast & Endocrine

B. Upper Gastrointestinal & Minimally Invasive Surgery

C. Hepatobiliary

D. Colorectal

E. Vascular

Year 3 Timetable

WEEK12345678

GROUP

1SubspecialtyWR ( HPB )

D/C OT

Minor OT

ScopeWR ( HPB )

HPB

- clinic wed

- OT

WR ( HPB )

ENB

- clinic thurs

- OTWR ( HPB )

ENB

- clinic fri

- OTWR ( HPB )

CR

- clinic tue

- OTWR ( HPB )

MIS

- clinic mon

- OTWR ( HPB )

Vasc- clinic wed

- OT

2WR ( HPB )

Vasc

- clinic wed

- OT

SubspecialtyWR ( HPB )

D/C OT

Minor OT

ScopeWR ( HPB )

HPB

- clinic wed

- OT

WR ( HPB )

ENB

- clinic thurs

- OTWR ( HPB )

ENB

- clinic fri

- OTWR ( HPB )

CR

- clinic tue

- OTWR ( HPB )

MIS

- clinic mon

- OT

3WR ( ENB )

MIS

- clinic mon

- OT

WR ( ENB )

Vasc

- clinic wed

- OTSubspecialtyWR ( ENB )

D/C OT

Minor OT

Scope

WR ( ENB )

HPB

- clinic wed

- OT

WR ( ENB )

ENB

- clinic thurs

- OTWR ( ENB )

ENB

- clinic fri

- OTWR ( ENB )

CR

- clinic tue

- OT

4WR ( ENB )

CR

- clinic tue

- OTWR ( ENB )

MIS

- clinic mon

- OTWR ( ENB )

Vasc

- clinic wed

- OTSubspecialtyWR ( ENB )

D/C OT

Minor OT

ScopeWR ( ENB )

HPB

- clinic wed

- OT

WR ( ENB )

ENB

- clinic thurs

- OTWR ( ENB )

ENB

- clinic fri

- OT

5WR ( CR )

ENB

- clinic fri

- OTWR ( CR )

CR

- clinic tue

- OT

WR ( CR )

MIS

- clinic mon

- OTWR ( CR )

Vasc

- clinic wed

- OTSubspecialtyWR ( CR )

D/C OT

Minor OT

ScopeWR ( CR )

HPB

- clinic wed

- OT

WR ( CR )

ENB

- clinic thurs

- OT

6WR ( CR )

ENB

- clinic thurs

- OT

WR ( CR )

ENB

- clinic fri

- OTWR ( CR )

CR

- clinic tue

- OT

WR ( CR )

MIS

- clinic mon

- OTWR ( CR )

Vasc

- clinic wed

- OTSubspecialtyWR ( CR )

D/C OT

Minor OT

ScopeWR ( CR )

HPB

- clinic wed

- OT

7WR ( MIS )

HPB

- clinic wed

- OT

WR ( MIS )

ENB

- clinic thurs

- OT

WR ( MIS )

ENB

- clinic fri

- OTWR ( MIS )

CR

- clinic tue

- OT

WR ( MIS )

MIS

- clinic mon

- OTWR ( MIS )

Vasc

- clinic wed

- OTSubspecialtyWR ( MIS )

D/C OT

Minor OT

Scope

8WR (Vasc )

D/C OT

Minor OT

ScopeWR (Vasc )

HPB

- clinic wed

- OT

WR (Vasc )

ENB

- clinic thurs

- OT

WR (Vasc )

ENB

- clinic fri

- OTWR (Vasc )

CR

- clinic tue

- OT

WR (Vasc )

MIS

- clinic mon

- OTWR (Vasc )

Vasc

- clinic wed

- OTSubspecialty

ALL

GROUPSLecture 1

Lecture 2

A&E

Radiology

HCME

Sur Updates

PGRC

Lecture 3

A&E

Radiology

HCME

Sur Updates

PGRC

Lecture 4

A&E

Radiology

HCME

Sur Updates

PGRC

Lecture 5

A&E

Radiology

HCME

Sur Updates

PGRC

Lecture 6

A&E

Radiology

HCME

Sur Updates

PGRC

Lecture 7

A&E

Radiology

HCME

Sur Updates

PGRC

Lecture 8

A&E

Radiology

HCME

Sur Updates

PGRC

Lecture 9

A&E

Radiology

HCME

Sur Updates

PGRC

Notes :

Lecture 1 - Monday 9am - 11am

Lecture 2 - 9 - Wed 9am - 10 am

WR - ward round

HPB - Hepatobiliary

ENB - Endocrine and Breast

CR - Colorectal

MIS - Minimally invasive and general

Vasc - Vascular

Scope - Endoscopic suite (scope and ERCP)

Sur Updates - Surgical updates mon 8 am

HCME - Houseman CME (wed 12 pm)

Subspecialty - follow the timetable subspecialty

Surgical Subspecialty Programme a.Duration of Posting

1 week posting.Lecturers :Urology

:Mr Zulkifli Zainuddin

Mr Mohd Nazri Jamaan

Mr Lee Boon Cheok

Mr Badrulhisham Bahadzor

Neurosurgery

:Mr Azizi Abu Bakar

Mr Toh Charng Jeng

Mr Shanmugarajah

Mr Ainul Syahrilfazli Jaafar

Paediatric Surgery:Prof Thambidoorai

Ms Marjmin Osman

Plastic & Burns:Visiting Consultant

Dr Goh Eng Hong

b.No. of students per week

8-9 students per week

c.Weekly Timetable

TimeMondayTuesdayWednesdayThursdayFriday

amClinic (Paediatric Surgery)Ward & Burns Unit (Plastics)OT (Urology & Plastic Surgery)OT(Paediatric Surgery)OT (Neurosurgery)

pmWard (Paediatric Surgery)Ward (Urology)OT (Urology)Ward (Neurosurgery)CME

d.Teaching-Learning Methodology

Clinic

i. Bedside Teaching

ii. Case Discussion

iii. Radiograph DiscussionWard

i. Clerk cases

ii. Ward rounds

iii. Observe procedures

iv. Assisting doctors in ward

OTi. Clerk cases day before surgery (for Urology & Neurosurgery)

ii. Present cases before operation begins

iii. Topic discussions during surgery

E-learning

i. Core knowledge according to syllabus

e.Assessment

ii. MEQs

iii. OSCEs

f.Syllabus

Urology

Urinary calculus

Bladder outflow obstruction & prostate cancer

Haematuria & Genitourinary tumours (Renal, Urothelial tract, Testes)

Trauma

Neurosurgery

Traumatic head injury

Hydrocephalus

Spinal cord compression

Common intracranial tumours

Neurosurgical infections

Paediatric Surgery

Gastrointestinal obstruction in newbornsCommon tumours in paediatric surgery

Inguinal scrotal anomalies

Plastic & Burns

Burns injury & management

Common skin tumours

Salivary gland tumours

Principle of skin cover

g.Notes

Should there be a public holiday, the group of students affected will join in the other group scheduled for the following week.

Appendix 3Procedures & LogbookProcedures students are expected to observe and have performed at least once by the end of their posting:Phlebotomy

Insertion of peripheral venous cannula

Nasogastric tube insertion

Urethral cathetherization

Wound dressings

Procedures students are expected to observe by the end of their posting:Per rectal examination

Thoracic & abdominal paracentesis

Intercostal drain insertion

Incision & drainage of abscess

Excision biopsies of lumps

Proctoscopy and banding of haemorrhoids

Appendicectomy

Fine needle aspiration cytology (FNAC)

Tru-cut biopsy

Endoscopic procedures

Toilet & sutureUNIVERSITI KEBANGSAAN MALAYSIA

SURGICAL CASE REPORT

STUDENT NAME:

MATRIC NO:

YEAR / GROUP :

SUPERVISOR:

ASSESSMENT OF SURGICAL CASE REPORT:

Core Clinical Component

History /10Discussion/ 5

Examination/10References/ 5

Investigation/10Preventive and community health/5

Diagnosis/Differential Diagnoses/10Referral letter/10

Management and progress of patient/10Prescription/5

Professionalism

Communication issues/10Reflective writing

- lifelong learning

- professional judgment/5

/5

Ethical issues/10

Critical thinking/10

MARKS FOR CORE CLINICAL COMPONENT

MARKS FOR PROFESSIONALISM COMPONENT TOTAL SCORE =

/1200

Jabatan Surgeri

Gambar

Fakulti Perubatan

Universiti Kebangsaan Malaysia

PENILAIAN POSTING SURGERI TAHUN 3

Nama:No. Matrik:

Sesi:Tarikh mula posting:Tarikh akhir posting:KEHADIRANMemuaskan (lebih dari 80%)

Tidak memuaskan (kurang dari 80%)

Ulasan (jika berkenaan)

Supervisor:

A. Case Write Up:

Case write up 1 (80)

Case write up 2 (80)

Average mark

Converted mark (10%)

B. Supervisor Assessment:

Log Book (40)

Presentation Skills (20)

Diagnostic Ability (10)

Participation in group discussion (10)

Clinical knowledge (20)

Total score (100)

Converted mark (10%)

C. Long Case Assessment:Mark (20)

Converted score (10%)

Total Score:

Part A (10%)

Part B (10%)

Part C (10%)

Total score

THEORYMCQ AND KFQ

35%

CLINICAL

OSCE

35%Comments from mentor:

Signature:

/ 80

/ 40

Documents

Year 3 Surgery Posting Sylabbus 2008