ࡱ> '` :zbjbj{P{P 4::]$RRRRRRRfRRRR<RfzhSSSSSTTT!######$hJ~GRTTTTTGRRSS4UUUT RSRSoUT!UUnyRR}SS RT z ~\J0z{ȆT|Ȇ@}ȆR}TTUTTTTTGGUdTTTzTTTTfff*J/d#fffJ/fffRRRRRR Residency Level: PGY 1 Surgical Rotation: General Surgery (GS I, II, III, IV, NF) Length of Rotation: 32 Weeks - (Eight 4-Week Rotations) Goals and Objectives Patient care: Evaluation and preparation of the pre-operative general surgical patient Management skills required to independently evaluate the surgical patient, develop your own plan for the patient and communication of the plan to the appropriate level of supervision Take ownership in care of the patient Post-operative care of the surgical patient Mechanisms and criteria for minimally invasive surgery of the abdomen Fluid and electrolyte management including indications for parenteral and enteral nutrition Understanding and utilization of diagnostic techniques including routine films, contrast studies, ultrasound, CT scan, MRI and endoscopic procedures Clear and timely documentation of daily progress notes Develop a strong work ethic Develop appropriate safe hand offs Develop the ability to care for surgical emergencies in the role as the surgical resident on call Technical skill: Become proficient in correct basic surgical technique such that incision, suturing, knot-tying and dissection Evaluation of the acute abdomen Assist at major abdominal and minimally invasive surgical procedures After a period of learning and appropriate supervision, perform procedures for venous access, chest tube placement, etc. After a period of learning and appropriate supervision, learn to perform minor surgical procedures (i.e. excisional biopsies, lipoma removal), hernia repair, appendectomy, cholecystectomy and bowel resections Medical knowledge: Demonstrate evidence of continued increase in general surgery core knowledge from basic surgical texts, additional readings and the SCORE curriculum as noted below Obtain a broad knowledge base of general surgery and other surgical specialties Study and prepare for the ABSITE Anatomy and physiology of the GI tract, liver, biliary tract and pancreas Fluid and electrolyte management including management of parenteral and enteral nutrition Practice-based learning and improvement: Participate actively in M and M conferences, daily chief conferences and journal clubs Understand and when possible participate in SCOAP projects Learn to critically read the literature Master the IT resources available to you to develop a commitment to lifelong learning and education You are encouraged to pursue a clinical research project in an area that interests you Interpersonal and communication skills: Develop the appropriate skills to provide efficient, concise, patient presentations Master text paging, emailing, etc. Develop strong doctor patient relationships using counseling and education of patients and their families Learn to master EPIC to provide proper documentation in the electronic medical record Learn to properly consult other specialty services in a professional manner Professionalism: Respect every patient regardless of social or other circumstances Log cases appropriately Log your duty hours using My Evaluations appropriately and in a timely fashion Complete all required clinical and residency documents in a timely fashion Demonstrate sensitivity to age, gender and culture of patients and other members of the health care delivery team Learn to be punctual Always exemplify professional attire, appropriate grooming and hygiene Demonstrate honesty, integrity and leadership skills Systems-based practice: Demonstrate effective communication with referring physicians throughout the Swedish health care system Keep patients safety foremost while discharging patients in a timely fashion Demonstrate time management and organizational skills while adhering to work hour regulations Gain an understanding of the importance of discharge planning and the writing of timely discharge orders to the overall throughput of patients in our system CATEGORY 1: ABDOMEN " GENERALDiseases/Conditions BROAD " Acute abdominal pain " Intra-abdominal abscess " Rectus sheath hematoma FOCUSED " Chronic abdominal pain " Carcinomatosis " Pseudomyxoma peritoneii " Spontaneous bacterial peritonitis " Desmoid tumors " Chylous ascites " Retroperitoneal fibrosisOperations/Procedures ESSENTIAL " COMMON " Insertion peritoneal dialysis catheter " Laparoscopic exploratory laparotomy " Open exploratory laparotomy ESSENTIAL " UNCOMMON " Open drainage abdominal abscess  SCORE CURRICULUM - CATEGORY 2: ABDOMEN " HERNIADiseases/Conditions BROAD " Inguinal hernia " Femoral hernia " Ventral hernia " Miscellaneous hernias Operations/Procedures ESSENTIAL " COMMON " Open repair of inguinal and femoral hernia " Laparoscopic repair of inguinal and femoral hernia " Open repair of ventral hernia " Laparoscopic repair of ventral hernia ESSENTIAL " UNCOMMON " Repair miscellaneous hernias SCORE CURRICULUM - CATEGORY 3: ABDOMEN " BILIARYDiseases/Conditions BROAD " Jaundice " Cholangitis " Acute cholecystitis " Chronic cholecystitis " Choledocholithiasis " Biliary pancreatitis " Acalculous cholecystitis and biliary dyskinesia FOCUSED " Gallbladder cancer " Cancer of the bile ducts " Choledochal cystOperations/Procedures ESSENTIAL " COMMON " Open cholecystectomy with or without cholangiography " Laparoscopic cholecystectomy with or with out cholangiography ESSENTIAL " UNCOMMON " Cholecystostomy  SCORE CURRICULUM - CATEGORY 4: ABDOMEN " LIVERDiseases/Conditions BROAD " Liver mass " evaluation " Hepatic abscess FOCUSED " Hepatic adenoma " Focal nodular hyperplasia " Hemangioma " Hepatocellular carcinoma " Cholangiocarcinoma " Metastatic tumors " Miscellaneous hepatic neoplasmsOperations/Procedures ESSENTIAL " COMMON " Open liver biopsy " Laparoscopic liver biopsy ESSENTIAL " UNCOMMON " Drainage liver abscess  SCORE CURRICULUM - CATEGORY 5: ABDOMEN " PANCREASDiseases/Conditions BROAD " Pancreatic abscess and infected necrosis " Pancreatic pseudocyst FOCUSED " Autoimmune pancreatitis " Chronic pancreatitis, including hereditary pancreatitis " Pancreatic insufficiency " Ductal adenocarcinoma " Acinar cell carcinoma " Cystic neoplasms " Intraductal papillary mucinous neoplasms SCORE CURRICULUM - CATEGORY 6: ABDOMEN " SPLEENDiseases/Conditions BROAD " Postsplenectomy sepsis FOCUSED " Hemolytic anemias " Idiopathic thrombocytopenic purpura " Secondary hypersplenism and splenomegaly " Neoplasms of spleen " Splenic cysts SCORE CURRICULUM - CATEGORY 7: ALIMENTARY TRACT "ESOPHAGUSDiseases/Conditions BROAD " Gastroesophageal reflux and Barrett s esophagus " Hiatal hernia " Dysphagia FOCUSED " Achalasia " Zenker s diverticulum " Epiphrenic diverticulum " Foreign bodiesOperations/Procedures ESSENTIAL " COMMON " Laparoscopic antireflux proced9@ADEIJMNQfhrw  < B M   % & : ; ĸ|thh5h hq05hq0hq05h6<hf2h}Mhhq0 h5 hX5 h45hg_hX5h4+h45CJaJh45CJaJhX5CJaJhx55CJaJhHm5CJaJh4+hXCJaJh4+hX5CJaJ+R  K < s   &  & F 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$7$8$H$Ifgd )) **J*L*\***&+R+r+t+ $Ifgd $7$8$H$Ifgd @kd$$Ifl,"" t644 la t+v+x+++,$,,,,S@kd$$Ifl,"" t644 la $7$8$H$Ifgd  LgdXSkd$$Ifl0,"LL t644 la ,,,-L-n---X X XXX LgdXSkd$$Ifl0,"LL t644 la $Ifgd $7$8$H$Ifgd ure  SCORE CURRICULUM - CATEGORY 8: ALIMENTARY TRACT " STOMACHDiseases/Conditions BROAD " Upper gastrointestinal bleeding " Gastric carcinoma " Duodenal ulcer " Gastric ulcer " Peptic ulcer disease with bleeding " Peptic ulcer disease with perforation " Peptic ulcer disease with obstructionOperations/Procedures ESSENTIAL " COMMON " Percutaneous endoscopic gastrostomy " Open gastrostomy  SCORE CURRICULUM - CATEGORY 9: ALIMENTARY TRACT " SMALL INTESTINEDiseases/Conditions BROAD " Small bowel obstruction and ileus " Emergent management of Crohn s disease of small intestine " Acute mesenteric ischemia: arterial, venous, and nonocclusive " Meckel s diverticulum " Radiation enteritisOperations/Procedures ESSENTIAL " COMMON " Open small bowel resection " Open adhesiolysis " Laparoscopic adhesiolysis " Ileostomy " Ileostomy closure " Open feeding jejunostomy " Laparoscopic feeding jejunostomy SCORE CURRICULUM - CATEGORY 10: ALIMENTARY TRACT " LARGE INTESTINEDiseases/Conditions BROAD " Lower gastrointestinal bleeding " Large bowel obstruction " Acute appendicitis " Diverticulitis " Diverticular bleeding " Diverticular fistulae " Colonic polyps " Colonic cancer " Volvulus " Ischemic colitis " Antibiotic-induced colitisOperations/Procedures ESSENTIAL " COMMON " Open appendectomy " Laparoscopic appendectomy " Open partial colectomy " Laparoscopic partial colectomy " Colostomy " Colostomy closure  SCORE CURRICULUM - CATEGORY 11: ALIMENTARY TRACT " ANORECTALDiseases/Conditions BROAD " Hemorrhoids " Anal fisXXXXX$YFYfYYZPZ|ZZZ[[ $Ifgd $7$8$H$Ifgd @kd$$Ifl,"" t644 la|ZZZZ[[:[>[|[~[[[[[[n]p]]]]]]___<_@________aaaaabcc c@cDccccccccdrrrrrrr s4s8sFsttttttuu*uhjhX5\ hjhXUhg_hX5\ hBhXhXhg_hX5 hX5CJ hg_hXhg_hX6]H[[[[[[[\t\\S@kd$$Ifl,"" t644 la $7$8$H$Ifgd  LgdXSkd$$Ifl0,"LL t644 la \\]D]p]]]]$^\^t^^^____ LgdXSkd$$Ifl0,"LL t644 la $7$8$H$Ifgd ____`P`z````a@aTazaaab.bfbbb $7$8$H$Ifgd @kd $$Ifl,"" t644 labbccc ccccJ@kd $$Ifl,"" t644 la LgdXSkd $$Ifl0,"LL t644 la $Ifgd $7$8$H$Ifgd ccc rLrlrrrrrr sFssstJttt $Ifgd $7$8$H$Ifgd sure " Anorectal abscess and fistulae " Rectal cancer " Anal cancer FOCUSED " Pelvic floor dysfunction " Rectal prolapseOperations/Procedures ESSENTIAL " COMMON " Banding for internal hemorrhoids " Hemorrhoidectomy " Subcutaneous lateral internal sphincterotomy " Drainage anorectal abscess " Anal fistulotomy/seton placement  SCORE CURRICULUM - CATEGORY 15: SKIN AND SOFT TISSUEDiseases/Conditions BROAD " Pilonidal cyst and sinus " Nevi " Melanoma " Squamous cell carcinoma " Basal cell carcinoma " Evaluation of soft tissue masses " Epidermal cyst " Apocrine tumor " Eccrine tumor " Sebaceous tumor " Merkel cell tumor " Dermatofibrosarcoma " Hidradenitis " Cellulitis " Necrotizing fasciitis " Paronychia " Felon " Wound infection FOCUSED " Decubitus ulcerOperations/Procedures ESSENTIAL " COMMON " Excisional and incisional biopsy of skin/soft tissue lesions " Incision, drainage, debridement for soft tissue infections " Pilonidal cystectomy ESSENTIAL " UNCOMMON " Wide local excision melanoma " Sentinel lymph node biopsy for melanoma  tttuu,gkd $$Ifl#H$ t0H$644 la $7$8$H$Ifgd  LgdXSkd $$Ifl0,"LL t644 lau*u6uluzuuuu8vZv|vvvvw2wLw|wwwwwww*xPxxxHy $7$8$H$Ifgd *u6uwwwwww*x>xBxPx0y2ytyvyxyyyy2z6z8z:zh h hX5CJhjhX5\ hBhXhX hjhXhjhX6]Hyvyxyyy2z4z6z:zmd pgdzkde $$Ifl0#L t0H$644 la $Ifgd $7$8$H$Ifgd 21h:pX/ =!"#$% z$$If!vh5"#v":Vl t065"$$If!vh5L5L#vL:Vl t065Lz$$If!vh5"#v":Vl t065"$$If!vh5L5L#vL:Vl t065Lz$$If!vh5H$#vH$:Vl t0H$65H$$$If!vh5L5#vL#v:Vl t0H$65L5z$$If!vh5"#v":Vl t065"$$If!vh5L5L#vL:Vl t065Lz$$If!vh5"#v":Vl t065"$$If!vh5L5L#vL:Vl t065Lz$$If!vh5"#v":Vl t065"$$If!vh5L5L#vL:Vl t065Lz$$If!vh5"#v":Vl t065"$$If!vh5L5L#vL:Vl t065Lz$$If!vh5"#v":Vl t065"$$If!vh5L5L#vL:Vl t065Lz$$If!vh5"#v":Vl t065"$$If!vh5L5L#vL:Vl t065Lz$$If!vh5"#v":Vl 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