Education: Third Year Surgical Clerkship
Welcome to the third year surgical clerkship at Indiana University School of Medicine and the Department of Surgery. Indiana University is unique as relates to being the single medical school for the State of Indiana and the second largest medical school in the United States. This has many benefits but carries challenges that continue to push our curriculum to new innovations in education.
The surgical block at Indiana University is composed of 16 weeks of curriculum that involves general surgery, subspecialty surgery, anesthesia, and obstetrics and gynecology. The block is divided into 3 sessions that are 5.3 weeks in length and involve individual sessions which include either general surgery, subspecialty surgery/anesthesia or obstetrics and gynecology. Each student will rotate on each of these specialties.
While on the general surgery session, students have the opportunity to choose 1 of the 9 different rotations available at facilities that include University Hospital, Veterans Hospital, Wishard Hospital, Methodist Hospital, Riley Hospital for Children and St. Vincent’s Hospital. The curriculum is enhanced by the following elements:
- Small Group Problem Solving Conferences that occur 2 times per week with faculty moderators
- Skills Workshops on a weekly basis involving the student in nutrition education, intravenous catheter placement, suturing, ostomy care, Gastrostomy tube education, chest tube placement, and central venous catheter placement.
- Chairman’s Conference on a weekly basis under the direction of Dr. Keith Lillemoe. Students are responsible to present cases with treatment options and this is discussed with the chairman.
- Small Group Competency Sessions that occur on a weekly basis involving the topics of communication, ethics and professionalism as they relate to surgery.
- The use of PDA logging to track procedural skills and patient encounters that the student has been involved with during the clerkship.
- Faculty review of history and physical exam write-ups.
- Emergency Room call and Breast Clinic rotation for all students.
- Mid-rotation feedback cards
- E*Value as an electronic database and evaluation system. With E*Value, the student has the ability to log and follow work hours, complete evaluations, do personal journal entries, review calendar of events and download any curricular materials that are required for the clerkship.
During the surgical subspecialty session, a student will spend approximately 4 weeks on 1 of 9 subspecialty rotations. The student has the opportunity to choose the rotation for which they feel they have the highest interest. In addition, the final 1.3 weeks will be spent on the anesthesia service to complete the 5.3 weeks session. During this session, the curriculum is enhanced with the following elements:
- Rotating educational conferences involving all subspecialties.
- TEAM teaching which involves a student ATLS session taught by Indiana University trauma surgeons.
- Anesthesia simulator sessions in the simulation lab.
- The use of PDA logging to track basic clinical skills and patient encounters that the student has been involved with during the clerkship.
- E*Value as an electronic database and evaluation system. With E*Value, the student has the ability to log and follow work hours, complete evaluations, review calendar of events and download any curricular materials that are required for the clerkship.
Although there are no specific guidelines in regard to work hours and 3 rd year medical students, the Department of Surgery honors the current ACGME guidelines as relates to duty hours. Student E*Value logging data is reviewed on a weekly basis by the surgical clerkship coordinator to determine work hour violations and to adjust student exposure to remain sensitive to work hour limitations. In addition, the current use of PDA logging has allowed the department to shift students to needed areas of exposure when deficiencies are noted.
We continue to be excited about the opportunities that Indiana University School of Medicine and the Department of Surgery offer the medical student in regards to surgical education. The department has recently been awarded a Sim Man and we are in the process of incorporating this virtual reality tool into the student curriculum while on the surgery clerkship. The future is bright and we would be happy to discuss educational opportunities with any individuals interested.
