Introduction

MCS 604- Senior clerkship in surgery is a progression of the five courses in the department offered in Year 4 and Year 5 to consolidate the principles of management in surgical conditions and diseases

Course Goals

MCS 604- Senior Clerkship in Surgery is geared to:

1. To acquaint students with knowledge and skills to adequately diagnose, manage and prevent surgical diseases
   
   
2. To enable the students acquire surgical skills necessary to allow them perform specific interventions required of a graduate of the MBChB program 

Description

Senior rotation in General Surgery and related specialties. 

The course is taught as a seven week clinical rotation with the following sessions

1. Didactic block lectures for the whole class running throughout the academic year. In the Academic Year 2021/2022, beginning September 2022, we will blend physical and online lectures with the longitudinal lectures offered from November 2022 to May 2023

2. Moderated academic sessions- didactic with designated topics and case scenarios. The case scenarios will be offered to the Class both as online sessions for the whole class and during group sessions during the clinical rotations.  

3. Clinical rotation in the surgical wards, elective and emergency surgery theatres

4. Attendance of the surgical outpatient clinic

5. Teaching sessions in grand rounds, tumour boards and mortality review meetings

6. Completion of the log book during the rotation

7. Weekly assignment of write ups 

Required Readings

1.       Williams, Norman and Bulstrode, Christopher (2013). Bailey and Love’s Short Practice of Surgery. CRC Press.

2.       Brunicardi, F; Anderson, Dana, et-al (2010). Schwartz’s Principles of Surgery Self-assessment and Board Review. McGraw Hill-Professional.

3.       Lumley, J (1997). Bailey’s Physical Signs: Demonstration of Physical Signs in Clinical Surgery. CRC Press.

4.       Garden, James; Bradley, Andrew, et-al (2012). Principles and Practice of Surgery. Churchill Livingstone.

5.       Wilmore, Douglas (2001). ACS Surgery: Principles and Practice of Surgery. WebMD Reference.

6.       Tjandra, Joe; Clunie, Gordon, et-al (2006). Textbook of Surgery. Wiley-Blackwell.

7.       Cameron, John and Cameron, Arthur (2013). Current Surgical Therapy. Saunders.

8.       Velasco, Jones, et-al (2011). Rush University Medical Centre Review of Surgery. Saunders.

Assignments and Projects

During the online sessions and during the clinical rotations, students shall be assigned specific tasks to present at moderated sessions. These tasks shall count for part of their assessment during the rotation. The tasks shall include- 

Assessment Methods

In conformity with the examination guidelines of Maseno University for the MBChB program, the end of year examination shall count for 60% of the final mark, with the consolidated CAT mark accounting for 40% of the final mark. The CAT mark shall comprise the end of rotation written CAT paper accounting for 40%, end of rotation clinical assessment accounting for 40% and all other assessments during the rotation accounting for 20%. The assessment during the rotation shall include marks assigned for attendance of didactic sessions and clinical rotation, assignments and quizzes assigned during the rotation

Course Schedule

SKILLS TO BE ACQUIRED 

At the end of the course the student is able to:

·         Take a full medical history

·         Perform a complete physical examination of the patient.

·         Record a summary with provisional diagnosis (impression)

·         Propose relevant tests (biochemical and radiological) that may be important to confirm diagnosis and be able to interpret the results obtained

·         Perform and record routine clinical procedures

·         Participate in the management of common surgical problems, propose treatment and management plans

·         Outline immediate surgical and non-surgical measures in cases of emergencies and infections

·         Outline the definitive care and management of patients with surgical conditions

·         Prepare and present an academic discussion based on case summaries and reports in the teaching hospital

COURSE CONTENT

The course will be delivered by

Lectures- online as per the attached schedule

Weekly online moderated sessions

Group discussions and moderated case scenarios

Clinical Rotation in the Wards

The schedule of the clinical rotation will be as follows:

WHAT IS EXPECTED OF THE STUDENTS

IN THE SPECIALIST CLINICS

1. To present themselves to the Consultants in the clinic at the start of the clinic 

2. Clerk, present and manage patients designated to them by the consultant, in groups of 2-3 students per patient.

3. Be conversant with the common conditions/diseases attended to at the specialist clinic.

IN THE WARDS

1. Clerk and present a minimum of ten patients each or as a group (during tutorials).

2. Be conversant with the conditions/ diseases of the patients in the unit.

3. Every week be able to read on topics assigned to them and discuss with the consultants during the Friday session.

IN THEATRE

1. To have clerked the patients scheduled for elective surgery

2. To attend and assist in elective surgical procedures.

In addition, each student has a Log book to be duly filled during the rotation and signed only by the consultants or medical officers rotating in the unit or casualty departments.

IN PRESENTATIONS AND GRAND ROUNDS

1. To prepare case reports and PowerPoint presentations for the Case presentations and the surgical grand rounds

2. To adequately research around the topics assigned

3. To present the ideal and current differential diagnosis and treatment modalities for surgical conditions

AT LECTURES AND TUTORIALS

1.       Attend at the least 80% of the lectures offered

2.       Complete all assignments and submit timely

3.       Attend and actively participate in all moderated sessions, case scenarios and quiz offered during the rotation

ASSESSMENT

1. The students will be assessed on their history taking and clinical examination skills weekly and a form duly filled by one of the consultants.

2. At the end of their rotation the students shall undergo a Continuous Assessment Test (CAT). The CAT shall be in the form of a written part (40 MCQs) and a clinical part (consisting of a seven station OSCEs assessment).

3. The assessments undertaken during the period of the rotation shall count for forty percent of the final end of year exam marks.

WHAT IS EXPECTED OF THE CONSULTANTS

1. To allow the students access to patients in the units (clinics, wards and theatre).

2. To allocate patients for clerkship in the specialist clinics.

3. To undertake tutorials during the clerkship period.

3. To continuously assess the students and duly fill the assessment forms. Upon assessment the forms are retained by the assessor and passed on to faculty members.

4. To present themselves for end of rotation and final year assessment of the students during the clinical assessment.

LECTURE SCHEDULE