The University of Southampton
Courses

MEDI6117 Surgery

Module Overview

This module provides the students with the opportunity to develop the knowledge, skills and attitudes which are necessary to practice in Surgery as a newly qualified doctor. This module builds on earlier Surgical attachments and the Acute Care and Ethics & Law modules. This module focuses on the knowledge and understanding, practitioner and professional skills required of a newly qualified doctor in Surgery, and the assessments within this module will focus on these areas. The BM programmes are however highly contextualised and integrated programmes in which the application of knowledge and understanding, clinical skills and professional practice applicable to medicine are learned through a range of modules none of which are stand alone modules and therefore this module should be recognised by teachers and students alike as part of the whole year and programme. The Surgery Module in BM Year FIVE is studied along with 5 other clinical teaching modules in Primary Care, Medicine, a student selected unit, an assistantship module, an elective module; a 6 month long Personal and Professional Development (PPD) module; and an Assessment and ILS module. The emphasis of the assessments for each of the modules aligns with the focus of learning for that module, however the integrated nature of the course means that there will undoubtedly be overlap and aspects of the assessment in each module will draw upon learning from modules studied in earlier years as well as modules studied in that year. In addition, the Year 5 assessment & ILS module has been purposely designed to assess learning outcomes covered in any of modules within the programme. The module will normally take the format of an 8 week placement in one or more partner trusts. The timing will vary for different student groups and the teaching staff will vary for different practices and student groups. As is the nature of clinical placements, the exact learning experiences of each student will be variable however all students will receive the same broad opportunities sufficient to achieve the learning outcomes of the module and it is expected that students will take responsibility for making the most of the opportunities provided and being pro-active in securing experiences in areas in which they feel they are weak and/or they have had least learning experiences.

Aims and Objectives

Module Aims

The aims of this module are to: • Further develop skills of history taking and physical examination with special reference to surgical patients • Relate clinical disorders to the patient and his/her family • Understand these disorders in the context of basic sciences and mechanisms of disease • Develop skills in diagnostic decision making, alongside a more in-depth understanding of the management of patients in elective and non-elective (emergency) surgical settings. • Understand the role of healthcare professionals in end of life care. Within either your Medicine OR your Surgery Module you are also expected to attend : • a session on intravenous procedures • 2 pharmacist-led rounds/clinical teaching sessions In addition you are expected to complete two self-assessment drug folders which can be found in the pharmacy prescribing handbook

Learning Outcomes

Learning Outcomes

Having successfully completed this module you will be able to:

  • Describe common surgical disorders [1.1a, 1.1b]
  • Communicate effectively in the following ways: a. With the patients and their families [2.3] b. With professional colleagues [2.3] c. Written clinical record suitable for inclusion in case notes [2.7a, 2.7c] d. Formal oral case presentations to your colleagues and senior medical staff [2.2e, 2.3h]
  • Describe how you would relate clinical disorders to patients and family [1.2a, 1.2b, 1.2c, 1.2d, 1.2e, 1.2f, 1.3c, 1.3d, 2.2h, 2.3h]
  • Understand the patient pathway in a surgical and operating theatre setting [2.2g, 3.3c]
  • Demonstrate an appreciation of basic safety principles - for patients and staff - in the operating theatre [3.4a, 3.4d]
  • Contribute to the care of patients and their families at the end of life including management of symptoms and safe and effective Teamworking [2.2j]
  • Demonstrate understanding of the roles of different team members within the inter-professional setting [3.3a, 3.3b, 3.3c]
  • Develop good relationships with all members of the surgical team (medical and non-medical) [2.3a, 3.1d, 3.3c]
  • Develop an enquiring basis to learning and take responsibility for your own learning and your continuing professional development [3.2b]
  • Maintain appropriate attire and demeanour [3.4a, 3.4d, 3.4h]
  • Demonstrate understanding of basic sciences and pathology underlying common disorders relating to surgical patients [1.1a, 1.1b, 1.2d, 1.2f, 1.3d, 1.4e, 1.4g]
  • Apply scientific method and approaches to medical research [1.5a,c]
  • Take a history of the presenting complaint, relevant past surgical history, medication history, associated disease particularly those relevant to anaesthesia, and the social history, particularly family and home circumstances which may influence postoperative management [2.1a, 2.2b, 2.2a]
  • Examine normal and abnormal systems with particular reference to surgical disease [2.1c]
  • Understand the process of developing and refining a differential diagnosis in a surgical context [2.2a, 2.2b]
  • Understand the management (incorporating the investigation and treatment) of commonly presenting surgical disorders, in both elective and acute settings [1.1c, 1.1d, 1.1g, 2.2c, 2.2d, 2.2e,2.2g, 2.4a, 2.5b, 2.5d]
  • Synthesise and communicate a differential diagnosis and proposed plan of management [2.2b, 2.2e, 2.3a]

Syllabus

Students are attached to one or more named consultant surgeons and their extended teams, and will gain exposure to general and specialist (breast and endocrine/urological/vascular) surgery. Experience in the clinical team includes emergency work. There will be opportunities to revise clinical skills teaching, and ample opportunities for completing the practical procedures competency sign offs that are necessary to pass the Assessment and ILS module. Students’ surgery learning modules will be located in one of the many clinical centres affiliated to the University of Southampton Faculty of Medicine (see separate list). Details of these attachments and a course handbook will be available during module induction and on blackboard. Students are required to have seen and documented their attendance at: • 3 x upper GI theatre cases • 3 x lower GI theatre cases • 2 x other cases (urology, vascular, breast, cardiothoracic and neurosurgical) • 2 x anaesthetics (from induction of anaesthesia to recovery) • 2 x upper GI clinics * • 2 x lower GI clinics * • 3 x other clinics* (eg vascular, urology, breast,,cardiothoracic and neurosurgical clinics) • 2 x Case conferences/multi-disciplinary meetings • 2 x observed informed consent • * clinics should include urgent cancer referrals Common Procedures You will have the opportunity to observe common operations and interventions. This will give you an understanding of surgical disease management and enable a smooth transition to becoming a newly qualified doctor Although attendance at every procedure will not be possible, the procedures that you will be expected to understand are: Upper GI • Laparoscopic cholecystectomy • OGD • ERCP Lower GI • Flexible sigmoidoscopy and colonoscopy • Bowel resection for cancer • Haemorrhoidal procedures • Interventions for perianal sepsis Urology • Transurethral resection of prostate and bladder tumour • Nephrectomy Vascular • Abdominal aortic aneurysm repair • Carotid endarterectomy • Limb revascularisation (fem-pop/fem-distal) • Interventional radiological procedure (stenting) Breast • Wide local excision • Mastectomy • Axillary clearance • Reconstructive surgery General • Abdominal and groin hernias • Minor surgery for skin lesions Emergency • Appendicectomy (laparoscopic) • Laparotomy • Abscess surgery This list is not exhaustive but will be achievable during your surgical attachment.

Learning and Teaching

Teaching and learning methods

The module will be taught through a range of learning and teaching strategies which may include: • Outpatient clinics, inpatient operating (elective and emergency), day case surgery and endoscopy • Tutorials • Patient and ward-based learning • Guided self-study • Satisfactory completion of the Learning Logbook • 3 Assessments of Clinical Competence (ACCs) Doctors work in shift patterns and rotas throughout much of their working lives and to prepare you for such working once you graduate, throughout your programme you will be expected to undertake placements in the evenings, at nights and at weekends. This will not be an onerous requirement and will be negotiated well in advance so that students with carers’ requirements will be able to ensure appropriate arrangements are in place for cover Within this module there may be some core/compulsory activities that will take place in the evenings, nights or weekends therefore students will commitments that will be affected by these should be pro-active in securing details of these activities well in advance of the start of the module. In addition, many non core learning opportunities will be available during these times and students are encouraged to take advantage of them Although students are NOT required to complete or pass 3 formative ACCs to complete this module, those who can evidence satisfactory marks in 3 ACCs will be able to use these for successful completion of the ACCs assessment component of the “Finals Assessment” module in final year. Students who complete all of their ACC assessment components in the Finals Assessment module through ACCs within other modules will be exempt from the ACC final examination (see Finals Assessment Module for further details). The Learning Logbook The purpose of this Learning Logbook is to record your activities during your surgical attachment. It should act as both a record of your clinical experience and a means of reflecting on your learning. You are expected to clerk and present a minimum of 30 cases during your final year surgical attachment. This must include both elective and emergency inpatients and could also include outpatients. At least 3 of these patients should be followed through the hospital journey. You will find space within your Learning Logbook to record your clinical experience during each of these interactions on a case-by-case basis. You should briefly summarise the cases/clinical conditions seen within each section, and reflect on the learning points that each has afforded (for example any ethical, diagnostic, management, or communication challenge experienced). These should be used to inform your further learning, and the Learning Logbook and its contents should then be discussed with your consultant at the end of your attachment as part of the assessment of your performance

TypeHours
Seminar16
Work based learning300
Revision10
Tutorial16
Supervised time in studio/workshop20
Preparation for scheduled sessions13
Total study time375

Resources & Reading list

Garden OJ, Bradbury AW, Forsythe JLR, Parks RW (2012). Principles and Practice of Surgery. 

Ellis H, Calne R, Watson C. (2016). Lecture notes on General Surgery. 

Cuschieri A, Steele RJC, Moossa AR (2001). Essential surgical practice: basic surgical training. 

Burnand KG, Black J, Corbett, SA, Thomas WEG (2015). Browse's Introduction to the Symptoms & Signs of Surgical Disease.. 

Assessment

Summative

MethodPercentage contribution
End of Placement Evaluation 100%

Referral

MethodPercentage contribution
Individual Activity’ 100%

Repeat Information

Repeat type: Internal

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