Orientation Presentation-Student Version

Surgery Clerkship
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Dr. Juliet Holder

Haynes
Assistant Professor of Surgery
Clerkship Director
WELCOME!
Associate Clerkship Director: Dr. Stephanie Gordy
UME Clerkship Coordinator: Ashlie Contos
Surgery Education Office, Jewish Suite 404D
On This Rotation
Youll have lots of fun
Clinical encounters unlike any other
More like a marathon than a sprint but itll be

Click
worth it!! Pace to edit title style
yourself
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Dont expect to edit
to learn howsubtitle style
to operate it takes us
5 years!
Website
https://www.bcm.edu/departments/surgery/students/core-clerkship
Medical Education Training
Core Surgery Clerkship
Medical Student Programs (Sub-Internships and Electives)
https://bcm.blackboard.com/
Clerkship Goals & Objectives
Clerkship Overview Document
Passport / Evaluation Forms
Important Schedules
Rotation Schedule/ Resident Rotation Schedule
Didactic Schedule (lecture/small groups)
Trauma Shift Schedule
Breast Clinic Schedule
Chairmans Rounds Schedule
BSLMC Group Scrub Training
School Wide Policies
Harassment/Mistreatment Policy
Harassment includes but is not limited to:
Slurs
Jokes
Verbal, graphic, or physical conduct related to an individual's race, color, sex,
religion, national origin, age, physical or mental disability, or marital or veteran
status.
Sexual Harassment
Baylor College of Medicine does not discriminate based on sex and will not
tolerate discrimination which includes sexual harassment, sexual violence, dating
violence, domestic violence and stalking. Incidents of sexual harassment, sexual
violence, dating violence, domestic violence and stalking are taken seriously.
A student who experiences sexual harassment, sexual violence, dating violence,
domestic violence and/or stalking may contact the Baylor Title IX Coordinator for
assistance.
Blood Borne Pathogen and Infectious Disease

Policy
Baylor College of Medicine students (Students) are expected to
provide the appropriate level of care to all patients while
following standard precautions to prevent the spread of
infectious diseases due to exposure to human blood or bodily
fluid.

In the event of an exposure, students should immediately inform
their supervisor and should notify the BCM Occupational Health
Program (OHP) at (713) 798-7880. Students will be provided
with all OHP and associated
Click to edithospitals and clinics
subtitle style contact
information during orientation.
Duty Hours Policy
Duty hours, including all in-house call activities, must be limited

to an average of 80 hours per week over a four-week period.
Duty periods may be scheduled to a maximum of 24 hours of
continuous duty in the hospital. An additional four hours may
be spent to ensure appropriate, effective and safe transition of
care. Minimum time off between scheduled duties is 10 hours.
Students must also receive a minimum of either 24 hours off
per seven-day work period, or four days off per 28-day work
period.
Duty Hours Policy
Link to BCM Student Handbook

Duty Hours Policy
faculty and residents are aware the

policy, but
YOU MUST LET US KNOW

IF YOU ARE IN VIOLATION OF
THE
ClickDUTY HOURS
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Duty Hours Policy
No defined hours to clock in/out

Goal
Identify the diseases where surgical intervention is indicated, understand

principles of perioperative management of a surgical patient

Objectives
Conduct a focused history and physical exam.
Develop a relevant problem list and differential diagnosis using

patients history findings.
Formulate appropriate care plans, including diagnostic tests and

interventions.
Demonstrate understanding of the perioperative preparation of

patients and routine postop care pathways.

Demonstrate familiarity with the anatomy/pathophysiology of and
establish treatment of the surgical diseases and procedures.
Deliver organized and concise written notes and oral presentations.

Practice self-directed learning to improve the care of surgical
patients.
Demonstrate skills to communicate with team and patients
Perform basic clinical skills

Clerkship Expectations
Attend all mandatory lectures and teaching sessions

Complete assignments on time
Complete Mid-point Feedback/Direct Observation
Submit Passport
Pass Shelf, CPX, Oral Exam
Adhere to Professionalism Standards
Follow dress code
Be on time Click to edit subtitle style
Adhere to attendance policy
Check email regularly
Rotation Structure
One (1) Month General Surgery
Ben Taub Hospital
Michael E. DeBakey Veterans Hospital
Baylor St. Lukes Medical Center
Texas Childrens Hospital
Two 2-Week Rotations

Cardiothoracic/Thoracic
Transplant
Vascular

ICU
Note the weekend between Month 1 and

Month 2 are not considered days off
Surgery Education Contacts
General Surgery Site Directors Surgery Subspecialty Site Directors
Ben Taub Hospital Congenital Heart

Dr. Stephanie Gordy Dr. Carlos Mery
VAMC CT-VAMC
Dr. Konstantinos Makris Dr. Lorraine Cornwell
BSLMC Thoracic-BSLMC
Dr. George Van Buren Dr. Bryan Burt
TCH Transplant-BSLMC

Dr. Bindi Naik Mathuria Dr. Abbas Rana
Vascular-BSLMC
Dr. Charles West
Click to edit subtitle

Vascular-VAMC style
Dr. Neal Barshes
Vascular-BTH
Dr. Ramyar Gilani
Surgical Diseases
Acute Abdomen
Biliary Disease
Breast Disease
Hernia
Soft Tissue
Surgical Critical Care
Surgical Click
Diseasesto edit title style
in Children
Thoracic
Trauma Click to edit subtitle style
Vascular Disease
Surgical Diseases
What do I need to know

about common surgical
diseases?
Surgical Diseases
What do I need to know about common surgical

diseases?

Manual of Surgical Objectives
Disease Specific Learning Objectives
For each presenting symptom, condition, or disease state, the
student is expected to know:
Anatomy
Pathophysiology
Common associated symptoms
Positive physical findings
Differential Diagnosis
Treatment
Medical/Surgical alternatives

When treated medically, indications for surgical intervention
Risk factor assessment
Pre and Post operative management
Adjuvant therapies indications and outcome
Prognosis
Discharge
Timing
Patient education
Follow-up
Resumption of activities
What are my responsibilities?
Students Level of Responsibility:
Perform an appropriately focused history and physical

exam, interpret labs, and diagnostic tests and develop a
prioritized list, assessment, and plan
Assist the team with patient care, collect data
Perform supervised procedures
Keys to Success
Helpful students are:
Well read
Proactive (but dont touch drains)
Helpful to residents
Work well with other students
Engaged in the OR

Maintain positive communication with patients and nurses
Ask questions in a respectful manner
Report exam Click
findingsto
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that you subtitle style
actually observed
Report any new/relevant finding
Always remember you are in a hospital setting!
Keys to Success
qBe available
qKnow your patients well
qHelp the team

qPut your patients first
Students MUST be supervised
while performing procedures on
patients!!

Hospitals
Ben Taub
Lots of resident autonomy
Opportunities for procedures
Large census
BSLMC
Private patients
Complexity
More hands on
TCH
Wide variety of General Surgery
You choose cases and attendings
VAMC
Veteran population
Wide variety of cases
Service Activities

OR Rounds
A day on the typical Surgery service revolves around the following:

Clinic Call/Shifts
OR Rounds
Patient
Care
Call/Shifts
Clinic
Service Activities - Rounds
Follow a number of patients during your entire time on the
service.
Morning (working) Rounds

Rounds begin early; be on time.
Evening Rounds
Gather days data to help rounds proceed smoothly.
Each student will be expected to present a patient at one of

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the services daily to edit subtitle style
rounds.
Briefly present a patient that is not new to the service.
After each rounding session, the attending or chief resident (who
rounded with the student) is to provide feedback to ensure the
student improves throughout the clerkship.
Service Activities
Rounds Etiquette
You should know all pertinent details (hpi, pmh, reasons for
hospitalization, surgery)
Present/write notes in a SOAP format
Pay attention when colleagues are presenting you should know all

patients on the service
Know as much as the intern
80-hour work restriction
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Report any violations to edit subtitle style
Service Activities Clinic Etiquette
Arrive on time and be professionally dressed.
When seeing new patients, perform a complete history and

physical.
When seeing returning patients, perform a focused history

and physical.
Present patients to upper level/attending.

You must get approval prior to leaving.
Students needing EPIC access at Baylor Clinic

instructions are posted on Blackboard in the orientation folder.
Service Activities - OR Etiquette
Read beforehand
Know:
Anatomy
Indications
Complications
Meet patient in the holding area
Arrive early for procedure opportunities

Introduce yourself to the OR staff
Get your own gown and gloves
First scrub of the day should take 5 minutes
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Ask questions at the to edit
appropriate subtitle
time style
Be ready with the scissors
Be aware of the Mayo Stand
Service Activities - Observing in the OR
While observing, be sure to know:

Diagnosis, Decision (& why)
Drainage
Why, Type (Suction,), Size, Position, How?
Closure - Layers Sutured

Muscle, Decision (& why), Skin
Suturing
How? (Simple, Subcuticular), and ask the resident to show you how its done.
Material (proline, Vicryl, silk)
When? (ask when to use different types, and size?)
And why?
Dressing
Betadine, Dressing, Plaster
Service Activities
Minimizing HIV/Hep C Exposure
Scrubbing on these cases is completely optional.
Use forceps and needle drivers to handle needles/blades
Protect needles when tying knots when possible.

Inform staff when you are passing off sharps.
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Recap syringes with oneto edit
hand subtitle
versus style
two hands.
Report any needle sticks immediately to OR personnel.

Service Activities
Ben Taub Trauma Shift/ Breast Clinic Visit
Students on their subspecialty sub-rotation will take a scheduled weekend trauma
shift at Ben Taub. This excludes student who are assigned to BTH for their general surgery sub-rotation.
The schedule is posted on Blackboard and will shifts are:
Sub-Specialty Friday Night (6pm-6am) Saturday (6am-6pm) Saturday Night (6pm-6am)
BTH Sunday Night (6pm-6am) Monday Night (6pm-6am) Thursday Night (6pm-6am)
Please note that the Clerkship Coordinator should be contacted if you wish to discuss shift changes.

Reminders and contact information will be emailed each Thursday.
To expose students to breast disease and breast patients, students on their general
surgery sub-rotation, will be assigned to visit Dr. Elizabeth Bonefas at her clinic (either
her private practice or at Baylor Clinic) or Dr. Eric Silberfein at HHS Smith Clinic.
The schedule is posted on Blackboard. Dr. Bonefas sees students on Mondays and
Tuesdays and Dr. Silberfein on Wednesdays.
Dr. Bonefas asks that you contact her beforehand to ensure that she
will be in the office.
Service Activities - Shifts
No call on General Surgery
Students who would like to take observe at Ben Taub

may contact:
Dr. Stephanie Gordy, S. Rob Todd
Chief Resident Trauma Service

Security for call rooms

Notes and H&Ps
Students cannot write notes and H&Ps of record, must

be signed by a resident.
Should practice writing Op notes and admission orders.
Students are required to complete independent H&P

write-ups to include the assessment and plan of a
patient.
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Ashley will discuss to edit
the details of this subtitle
later. style
SOAP Notes
Subjective
Overnight events, any N/V/F/C, pain control, bowel function, oral intake
tolerance
Objective
Vitals, Physical Exam (include wound appearance), drain output and
appearance, urine output, labs, imaging
Assessment
EX., POD #3 s/p sigmoid colectomy. Stable. Post-op ileus. Hypokalemia
Plan
Await return of bowel function
Replete K+
Brief OP Notes
Pre-op Diagnosis Fluid

Post-op Diagnosis Specimens
Procedure Drains
Surgeon Complications
Assistant Condition
AnesthesiaClick to edit title style
Estimated Blood
Loss/Urine Output
Admission/Transfer Orders
A Admitting Physician, Floor, Service
D Diagnosis
C Condition
V Vitals Frequency
A Allergies
A Activity
N Click to edit title style
Nursing Instructions
D Diet
I Click
IV fluid to edit subtitle style
and rate
M Medications
L Labs
Laparotomy Sponges

Raytec Sponges
Sponge stick
Electrocautery
Yankauer suction

Pool tip suctionClick to edit subtitle style
Ligasure
Scrub Technique Videos
Scrub technique
Gown and Gloving

Technique
Instrument Handling
You will have an orientation on scrub technique
at your respective hospitals.
Recommended Study Resources
Current Surgical Diagnosis and Treatment
Doherty/Way
Essentials of General Surgery
Peter Lawrence
NMS Surgery Casebook
Bruce Jarrell
Surgical Recall
Click
Lorne Blackbourne
to
Sabiston Textbook of Surgery
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Pestana Review Notes
Access Surgery
via TMC library
Discourse LLC
Virtual surgical patient cases
uworld question bank
What should I study?

When should I study?
You will be busy, and then have some downtime
Finding time and energy to study may be limited
Good to have something in your pocket to pull out and

study
Copy a chapter at a time to keep in your pocket and read
while waiting
ADMINISTRATIVE
INFORMATION

Attendance
When you need to be absent, email:
Ashlie Contos
Attending
Cc Dr. Holder-Haynes
Cc Chief resident (NOT an Intern)
Can miss a total of 5 days over the eight-week rotation for acceptable
reasons
Issues with attendance will be sent to PACE (Professionalism Appraisal and
Competency Evaluation) Committee
Attendance
Your team mates cover in your absence
May ask for a doctors note
May be asked to make up time
We do not give time off to study for the Shelf must inform
if accommodations needed BEFORE THE START OF THE
ROTATION
Excused Absences
Medical illness experienced by the student (physician note
required if three or more days of illness experienced)
Personal crisis (e.g., death or illness of immediate family
member)
Child birth (maternity and paternity policy of the College
takes precedence)
Presentation at professional meetings (up to two days with
attendance up to department's discretion)
Residency Interviews
BCM Holidays
New Years Day

MLK Day
Easter
Memorial Day
Independence Day
Labor Day
Thanksgiving Day
Christmas Break
Didactic Sessions
Lectures and Small Groups are typically held every Wednesday from 8 am
10 am at main Baylor campus
To prepare for lecture complete required portion of Access Surgery
modules
Take short quiz beforehand, complete cases
Small Groups will be student lead with an assigned facilitator for guidance
Cases (located on blackboard) are to be reviewed and ready to discuss before
each session
Lecturer/Small Group Facilitator must sign next to topic on passport
Ben Taub General Surgery Teaching Rounds
Dr. Scott will hold teaching rounds every Monday from 1-2 pm
TSICU Rounds every Monday from 2-3 pm
Held for BTGH students and residents in the BTGH trauma SICU
Calendar invite will be sent by the General Surgery Residency Coordinator
Didactic Sessions
Grand Rounds held every Wednesday from 7-8 am. Mandatory
Ben Taub General Surgery Teaching Rounds

Dr. Scott will hold teaching rounds every Monday from 1-2 pm
TSICU Rounds every Monday from 2-3 pm

Held for students and residents in the trauma SICU
Calendar invite will be sent by the General Surgery Residency Coordinator

St. Lukes Teaching Conference with Dr. Holder-Haynes
St. Lukes General Surgery students Fridays 77:45 am

Weekly M&M conference at each hospital - TBA
Didactic - Lecture/Small Group Topics
Acute Abdomen Hernia

Aortic Aneurysms GI Bleeding
Biliary Disease Melanoma/Sarcoma
Breast Disease Pancreas
Carotid Disease/PAD Pediatric Surgery
CT Surgery Perioperative Care

Colorectal Disease Sepsis/Shock
DVT/PE Trauma
Endocrine Plastic Surgery & Wound
Foregut Surgery Healing
Chairmans Rounds
Occurs each Wednesday 1-2 pm.
Location alternates between BTH and

BSLMC.
Attendance is mandatory for students

on general surgery sub-rotation.
Click to edit
Schedule title style
& Instructions
Blackboard
are on
.
(Calendar invite will be sent)
Click toEach
editstudent
subtitle style
at both locations should
prepare to present thorough history
on an interesting patient.
Skills Lab
Bi-monthly skills lab are held for General Surgery sub-rotation students.
Take this opportunity to practice surgical skills such as:
Basic laparoscopic
Open skills
Central line insertion
Trauma scenario
Held on the following Wednesdays from 10:30 11:30 am for the general
surgery sub-rotation students; attendance is required (a calendar invite will be sent).

Suture kits may be borrowed from Ashlie Contos.
Passport
Didactic Teaching Sessions
Mid-point Feedback Session
Observed/Unobserved H&P
Patient Contact
Clinical Skills
Case Logs
Completed passport and evaluation forms must be
submitted to Click
receiveto edit subtitle
a grade. style
Take pictures/have copies
of your passport.
Losing passport is not an excuse. Grade will be held

if not submitted at end of clership.
Passport: Mid-Point Feedback
Mid-Point Feedback Session
Evaluation forms are included in your passport. Your attending
must complete the form after providing feedback.
Helpful if a senior resident can be in attendance
Identify person who will provide feedback and inform office by

next Thursday.
All students must have at least one evaluation completed &
uploaded to Blackboard by Wednesday of the 4th week
Mid-point feedbackClick
is to occur once on general surgery sub-rotation
to edit subtitle style
and once on subspecialty sub-rotation.
*Failure to comply will result in the student receiving a dropped

letter grade and or an incomplete for the course.
Passport: Observed/Unobserved H&P
Observed H&P
Focused exam
Evaluation forms are included in your passport. Your attending
must complete the form while observing you and you are required
to upload at least one evaluation form to blackboard by
Wednesday of week 4.
This is to occur once on general surgery sub-rotation and once on
subspecialty sub-rotation.
Written H&P Click to edit title

A brief write-up of a patient assessment and plan
style
Click
All students must have to edit
at least subtitle
one observed H&P style
evaluation
completed & uploaded to Blackboard by Wednesday of the 4th week
detailed due dates are located in your passport.
*Failure to comply will result in the student receiving a dropped

letter grade and or an incomplete for the course.
Passport: Observed/Unobserved H&P
Only a PORTION of the history and

physical must be observed

*Failure to comply will result in the student receiving a

dropped letter grade and or an incomplete for the course.
Passport
Patient Contact participate in the care of patients with:

Acute abdomen
Biliary disease
Breast cancer/disease [Access Surgery option]
Comorbidity is acceptable
Hernia
Soft tissue infections
Surgical critical care
Trauma
Vascular disease
Surgical disease of chest
Click
Admission/Transfer Orderto edit subtitle style
Brief Operative Notes

Passport
Clinical Skills
Suturing a wound
Wound care dressing
Foley Catheter insertion
NGT/OGT insertion [optional]
Presentation of a patient
Case Logs
Procedure
Hospital
I.e. BTH, TCH, VAMC, BSLMC
Service
I.e. Red, Gold, CT, Vas
Quality of Faculty Interaction
Marginal
Good
Excellent
Grading
50% is clinical performance
30% - Average of evaluations from General Surgery Attending and

Residents
o 2 attendings
o 2 residents (one must be a senior)
10% - Two week ICU Rotation (Average of Attending and Resident/fellow)
10% - Average of evaluations from Subspecialty Attending and Residents
o 2 attendings
o
2 residents (one must be a senior)
20% - CPX Exam

30% - National Board Exam

*STUDENTS WHO DO NOT PASS AN EXAM ON THE FIRST ATTEMPT WILL BE REQUIRED TO
RE-TEST. IF THE EXAM IS SUCCESSFULLY PASSED ON THE SECOND ATTEMPT A PASS WILL
BE THE HIGHEST GRADE AWARDED. {THIS ALSO APPLIES IF YOU MISS AN EXAM}
Grading
You can fail the rotation for professionalism issues, e.g.

Unexcused absences
Disruptive behavior
Disrespectful behavior towards houses staff/admin staff
Failing to complete assignments on time
Can also fail if:
Evaluation scores <= 2SD below mean
Failing to pass BCM required exams after 2 attempts
Failing both Shelf and CPX
Evaluations
E*Value (Who Did You Work With?)
Must be completed by the last day of the sub-rotation.
Recommend asking for evaluations from 2 attendings, 1 chief resident, and

1 resident per service. (General Surgery and Subspecialty)
Evaluators have 2 weeks to complete evaluations

Office will actively contact for completed evaluations.
If no response, grades will be calculated without them.

Issues will be reported to Vice Chair of Education and Department Chairman.
Mid-Term Rotation Feedback and Overall Course Survey (E*Value)

Sent out through E*Value during week 4 and 8
These surveys are to be taken seriously
Not completing them in a timely manner is not an option
We will not consider any evaluations received 4 weeks after the end
of the clerkship.
Oral Exam
You will be examined on two clinical scenarios which should last 15-30
minutes each.
A facilitator will be assigned and information will be sent to you at week 4 or
5.
It will be your responsibility to contact the faculty to schedule a time for your
exam.
We suggest scheduling your exam during week 6 and 7.
It is fair game to be asked any additional questions that are appropriate for
a student at your level.

ASE Cases will help you prepare for the exam.
Links to the cases are in posted on Blackboard.
Grading is Honors/Pass/Fail
Extra point on the Shelf grade for honors performance.
Those who fail mayClick
to
remediate edit subtitle style
*Dr. Holder-Haynes will give a preparation review at the mid-point of the

clerkship.
Oral Exam Topics
The following topics are those in which you may be tested on
however, this is not a comprehensive list:
Breast Disease Limb Ischemia

Biliary Disease Pediatric obstruction
Colon Disease Peptic Ulcer Disease
DVT/PE Small Bowel Disease
GI Bleeding Click to edit title style
Trauma/Shock

CPX Exam
Given on the last Monday of the Clerkship
You will get one case either

Upper or lower abdominal pain
Each case with standardized patient includes:

History
Physical exam
Communication

Verbalize what you are doing and why
You will have 15 minutes for the SP encounter and 30 minutes for the post
encounter.
If you dont pass the exam, you must retake the entire exam.
If you successfully pass after retesting, the highest grade achievable is
a Pass.
Passing score 70%
Differential What does not What supports the What studies and
diagnosis support the diagnosis? results would
diagnosis? support your
diagnosis?
1. 1. 1. 1.
2. 2. 2.
3. 3. 3.
2. 1. 1. 1.
2. Click to2.edit title2.style

3. 3. 3.
3. 1. 1. 1.
2. 2. 2.
3. 3. 3.
Differential What does not What supports the What studies and
diagnosis support the diagnosis? results would
diagnosis? support your
diagnosis?
1. Acute MI 1. Radiates to back 1. Diaphoresis 1. EKG ST
2. segment elevation
2. Prior history of 2. + stress test
3. chest pain
3. Resolution with 3. Echo with wall
NTG abnormalities
2. Pulmonary 1. Responds to 1. Diaphoresis 1. CT PE protocol
embolus oxygen with embolus
2. Click to edit title style
2. Shortness of
breath
2. V/Q scan with
mismatch
3. 3. Recent knee 3. Angiogram with
surgery filling defect
3. Pneumothorax 1. No trauma 1. Shortness of 1. CXR with
breath dropped lung
2. 2. Decreased 2. CT scan with
breath sounds dropped lung
3. 3. Hypoxia 3. CT placement
with rush of air
NBME Shelf Exam
Given on last day of the Clerkship
110 questions 2 hours 45 minutes
We cant possible teach you everything that will appear on the Shelf.
You are ultimately responsible for knowing testable material.

You must pass this exam to pass the rotation.
The passing score is equal to the NBME 5th percentile.
If you do not pass the exam you be required to retest; If you fail
twice, you must repeat the clerkship.
If you successfully pass after your retest, the highest grade achievable
is a Pass.
CLOSING
REMARKS
You Said.We Did
You Said: We Did:
More organization. Try to condense lecture material and simulations The clerkship now conducts all of its education didactic session on
all in one day. Wednesdays.
Consolidation of all passport/midpoint feedback forms/supervised

The passport now houses all evaluation forms and required
H&P forms/any and all forms required to be documented in one
documented material into one booklet.
booklet would be very helpful.
Might be better to set clear expectations for assignments such as The orientation was revamped to address expectations of all
access surgery, chairman's rounds, and other accessory coursework. educational activities.
The number of email communications should be reduced.

We received multiple emails and sources of information containing Only one email is sent a week - "weekly announcements" email.
More skills lab would be helpful.

carious portions of scheduled clerkship events.
We have scheduled 3 skills lab per month for students that are on
their general surgery sub-rotation.
The clerkship now has created a chart on blackboard as well as our

One centralized area on blackboard would be helpful to include all
scheduling information for the clerkship.
BCM surgery website that provides the students with a weekly
snapshot of activities that are scheduled for the clerkship.
Only Ben Taub students get Trauma exposure Added Trauma Shift
Provided Manual of Surgical Objectives

Not sure what we should study
Access Surgery Modules
More faculty interaction needed Developed Small Group Curriculum
Student Mentor Program

Need more access to faculty mentors early in med school
Pre-Clinical Student Shadowing Program
REMEMBER
You MUST submit evaluation forms and a completed
Passport (including observation cards) to receive your
grade.
You MUST perform at least one Observed H&P before a

FACULTY member before Wednesday of the 4th
week. Will receive Incomplete if not completed.
You MUST have at least one Mid-Point Feedback
session with a FACULTY member and senior
resident before the Wednesday of the 4th week. Will
receive Incomplete if not completed.
Complete AccessSurgery Modules points deducted!

ADVICE
Invest time needed to learn your
patients
Keep small snacks nearby
OR can be cold wear an extra

layer Click to edit title style
Interns/nurses are your friends
Pull up images in OR for case
ADVICE
Clinic is the best place for faculty
contact and getting H&Ps
TCH: open structure, choose your

own cases
SLEH Thoracic: Fill out the Turtle

SLEH Transplant: Patient cards
SLEH: M&M protocol
ADVICE
Clinic great opportunity for

attending contact time
Ben Taub: resident run, lots of

procedures, involvement
VA : no wi-fi access
Ortho, Ophtho, ENT, Plastics,
Urology not Click
part oftothis
edit subtitle style
rotation.
DO NOT call attendings on their

cell
ADVICE
Before starting on a new service, contact

prior students to learn logistics/pts on
service
Click
Take frequent pics ofto edit
your title
passport style
DISCLAIMER
Clinical course of a surgical patient can

change abruptly. We will update you of
any changes. Check your email/calendar
daily

Cc Ashlie if you email me:
holderha@bcm.edu
Ashlie.contos@bcm.edu
THANK YOU
We want you to have fun.
We really appreciate you!

Where do I go today?
Refer to the contact info you

received with your
orientation schedule.
Contact the Intern/Resident

or your service
Click to edit
Even iftitle
you knowstyle
where you
are going, contact them.
QUESTIONS?
Turn in the following before leaving:
Pre-Test
Clerkship Guidelines Signature Page
Any applicable site credentialing documents


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Surgery Clerkship

Click to edit title style

Dr. Juliet Holder

Youll have lots of fun

Clinical encounters unlike any other

More like a marathon than a sprint but itll be

Blood Borne Pathogen and Infectious Disease

Click to edit title style

Duty hours, including all in-house call activities, must be limited

Link to BCM Student Handbook

faculty and residents are aware the

YOU MUST LET US KNOW

No defined hours to clock in/out

Identify the diseases where surgical intervention is indicated, understand

Click to edit title style

Develop a relevant problem list and differential diagnosis using

Formulate appropriate care plans, including diagnostic tests and

Demonstrate understanding of the perioperative preparation of

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Deliver organized and concise written notes and oral presentations.

Demonstrate skills to communicate with team and patients

Perform basic clinical skills

Attend all mandatory lectures and teaching sessions

Two 2-Week Rotations

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Note the weekend between Month 1 and

Ben Taub Hospital Congenital Heart

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What do I need to know

What do I need to know about common surgical

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Students Level of Responsibility:

Perform an appropriately focused history and physical

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qKnow your patients well

qHelp the team

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A day on the typical Surgery service revolves around the following:

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Morning (working) Rounds

Each student will be expected to present a patient at one of

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When seeing new patients, perform a complete history and

When seeing returning patients, perform a focused history

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Students needing EPIC access at Baylor Clinic

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While observing, be sure to know:

Closure - Layers Sutured

Scrubbing on these cases is completely optional.

Use forceps and needle drivers to handle needles/blades

Protect needles when tying knots when possible.

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Report any needle sticks immediately to OR personnel.

The schedule is posted on Blackboard and will shifts are:

Sub-Specialty Friday Night (6pm-6am) Saturday (6am-6pm) Saturday Night (6pm-6am)

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No call on General Surgery

Students who would like to take observe at Ben Taub

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