year 3 surgery posting sylabbus 2008
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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&E40541rohaizak@mail.hukm.ukm.my
2AP Naqiyah IbrahimB&E32871naqiyah.ibrahim@gmail.com
3Miss Saladina JaszleB&E
4Mr Abdul Rahman ShakeerUGI/MIS
5Prof Jasmi Ali YaakubUGI/MIS40496jasmi@mail.hukm.ukm.my
6AP Lukman RashidUGI/MIS40454drlukman@mail.hukm.ukm.my
7AP Razman JarminHPB40665razman@mail.hukm.ukm.my
8Mr Hairol OthmanHPB42663hairol@mail.hukm.ukm.my
9AP Ismail SagapColorectal32877drisagap@mail.hukm.ukm.my
10Mr Imtiaz HamidColorectal40667imtiazhamid@hotmail.com
11AP Hanafiah HarunarashidVascular
12Mr Mohd Azim IdrisVascular40459AJIMA98@streamyx.com
13AP Zulkifli ZainuddinUrology40503zul_uro@yahoo.com
14Mr Nazri JemaanUrology42662mnj2567@yahoo.com
15Mr Lee Boon CheokUrology44879lbc@hotmail.com
16Mr Badrulhisham BahadzurUrology40575badrul.com@gmail.com
17Prof ThambidooraiPaeds40668tdorai@gmail.com
18Miss Dayang AnitaPaeds
19Mr Azizi Abu BakarNeuro42660abazizi@gmail.com
20Mr Toh Charng Jeng Neuro
21Mr ShanmugarajahNeurosparamasvaran@yahoo.com
22Mr Ainul Syahrilfazli JaafarNeuro0133410644drainul@mail.hukm.ukm.my
23Mr Zamrin DimonCTS0196520383wanzam_2@yahoo.com
24Mr RamzishamCTS40448ramzisham@hotmail.com
25Mr Shahrul Akmal SaatCTS40630akmal@mail.hukm.ukm.my
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
3.Lecture 3 (Week 2)
Common Neurosurgical Conditions/Head Injury
Lecturers in charge Mr Azizi / Mr Toh/ Mr Sanmugarajah / Mr Syahril
Specific Learning ObjectivesThe lecture should enable the students to:
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
Specific Learning Objectives
The lecture should enable the students to:
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
6.Lecture 6 (Week 5)
Nutrition in Surgery (with dietitian)
Lectures in charge AP Lukman / Miss Birinder
Specific Learning ObjectivesThe lecture should enable the students to:
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
7.Lecture 7 (Week 6)
Trauma Chest and Abdomen
Lectures in charge Mr Zamrin / Mr Ramzi / Mr Shahrul
Specific Learning ObjectivesThe lecture should enable the students to:
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
8.Lecture 8 (Week 7)
Common Surgical ProceduresLectures in charge AP Razman / AP Naqiyah
Specific Learning ObjectivesThe lecture should enable the students to:
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.
9.Lecture 9 (Week 8)
Common Paediatric Surgical ConditionsLecturers in-charge Prof Thambidoorai / Miss Marjmin
Specific Learning Objectives
The lecture should enable the students to:
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
2. explain abdominal examination;
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;
2. explain abdominal examination;
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;
2. explain abdominal examination;
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;
2. explain abdominal examination;
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
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