General Surgery Advanced Clinical Rotation (ACR)

4 units

Students in the General Surgery ACR are placed in one of the following eight services. Students may enroll in this ACR twice, with the second assignment on a different service than the first. On each Surgical service, participation will involve floor management, ER evaluation, operating room participation and outpatient clinic experience. Emphasis will be on correlating anatomy to function in normal and pathologic states and clinical management of surgical patients. Duties include rounding on inpatients; participating in service and department-wide education conferences; participating/assisting in operations; seeing and evaluating new, return, and postoperative patients in clinic; and taking call in the emergency room. This will be done under the guidance of attendings, fellows, and residents. Acute and Critical Care Surgery: The ACCS service provides experience with a broad range of general surgical problems. Typically, students encounter patients with acute traumatic injuries or burns and are exposed to many acute surgical problems such as acute abdominal emergencies, skin and soft tissue infections (including some amputations), acute appendicitis, and acute cholecystitis. Students will likely experience a combination of laparoscopic, robotic, and open operations. Students also gain experience with pre-operative evaluation and operative management of patients undergoing elective surgical procedures such as hernia repair and cholecystectomy. Colorectal Surgery: The Colorectal Surgery rotation covers all aspects of benign and malignant colorectal and anal disease. The operative procedures vary from simple anorectal procedures to large open abdominal, robotic and laparoscopic operations. Students will likely encounter both urgent/emergent and elective operations. Hepatobiliary and Pancreatic Surgery: The HPB service exposes students to a variety of surgical conditions of the pancreas, liver, stomach, and biliary tract. This includes benign and cancerous conditions. Students may also encounter surgeries for various types of sarcomas. They will encounter laparoscopic, robotic, and large open operations. Minimally Invasive Surgery: The MIS service exposes students to patients with a variety of surgical problems (including hernias, gallstone disease, gastrointestinal foregut problems, morbid obesity, and endocrine disorders). Students are exposed to basic and advanced minimally invasive surgery (laparoscopic and robotic operations) as well as complex open operations. Pediatric Surgery: Pediatric surgery is essentially general surgery on children. Students are exposed to a wide variety of conditions involving the gastrointestinal tract, genitourinary tract, lung, diaphragm, etc. The service handles a significant amount of penetrating and blunt trauma, burns, and other acute surgical emergencies such as appendicitis, intestinal obstruction, and perforated viscus. In addition, the student will be exposed to surgery on newborns for vascular access and intestinal and abdominal wall conditions. Students will be exposed to a variety of surgical approaches including open, laparoscopic, and thoracoscopic procedures. Surgical Oncology: The Surgical Oncology (formerly Endocrine/Oncology) service is primarily dedicated to the treatment of some of the most common cancers in adults (including breast, melanoma, and thyroid). Students will also obtain experience with many other surgeries for benign disease processes in breast and endocrine glands (thyroid, parathyroid, and adrenal). Students may also encounter surgery for sarcomas and a unique operation that involves heated intra-peritoneal chemotherapy for advanced cancers (HIPEC). They will likely encounter some laparoscopic procedures (adrenalectomy). Transplant Surgery: Abdominal Organ Transplantation exposes students to a blend of medical and surgical care of solid-organ transplant patients (kidney, pancreas, and liver). Organ procurements provide the ultimate exposure to human anatomy in a heart-beating, brain-dead donor. Students will likely experience other hepato-biliary procedures (liver resection, pancreatic resection, biliary tract surgery etc) for benign/malignant conditions and vascular access procedures (AV fistula formation), providing broad anatomical exposure. Most of these operations are performed with large, open incisions but students may encounter some laparoscopic procedures (cholecystectomy). Vascular Surgery: Vascular Surgery exposes the student to a broad range of surgical vascular pathology, from varicose veins and peripheral arterial disease to the most complex thoracoabdominal and abdominal aneurysms. They may also see some amputations. Students will likely encounter a mix of urgent/emergent and elective procedures. The students will be exposed to the use of endovascular technology, in addition to the use of standard open surgical techniques.