MED6008

Surgery (city/rural) and anaesthetics

Mr J Dawson, Professor D Scott and Professor C Goodchild

5-week 'student intern' rotation and 9-week teaching blocks combined with medicine in a rural hospital, a private city hospital and the specialty wards and clinics of a major city teaching hospital.

Objectives On completion of this subject, students will have a sound understanding of how to formulate a problem list from analysis of the findings from a comprehensive history and examination and the skills required for problem analysis in relation to surgical disease: pathogenesis and pathology of surgical illness to enable appropriate practice as a junior doctor; requirements and responsibilities of formulating a total patient management plan; the range and presentation of surgical problems occurring in a rural community; differences that exist in mortality and morbidity patterns in the rural setting and particular aspects of rural culture; advantages and disadvantages of both specialty and general practice in rural areas including personal, professional and family issues involved; the spectrum of surgical disease seen in the private sector and specific aspects of management in this setting; aspects of a specific range of surgical specialties covered in outpatient clinics and surgical seminars and warranting reinforcement in the final year program to enable practice in relation to these at the level of a junior doctor. Competence will be gained in technical and minor surgical skills at the level required by a junior doctor. Students will also have a sound understanding of principles underlying basic anaesthesia and post operative pain relief. Competence in practical aspects associated with provision of a normal anaesthetic in relation to basic surgical procedures.

Synopsis The major city teaching hospital rotation consists of a continuous attachment to a surgical unit with admission and clerking of patients and involvement in technical aspects of their management; bedside clinical tutorials and surgical seminars; involvement in all unit activities including regular presentation of patient problems to junior and senior medical staff. In the private and rural hospital setting and the specialty clinic and unit attachment in the major city teaching hospital, involvement in outpatient clinics and ward-based activities with supervised clinical work including practise of procedural skills; formal and informal case presentations emphasising clinical diagnosis and problem solving skills as well as technical and patient management skills; attachment to an emergency service operating outside normal working hours in a rural setting. All teaching environments will provide formal teaching in theoretical and practical anaesthesia including two full days of practical skills training in an operating theatre.

Assessment Continuous assessment (satisfactory faculty requirement)

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