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Medical Education

Third Year Clerkship

Organization of Third Year Clerkship

Rotation Schedule - New Brunswick Campus

Students complete six weeks of general surgery / vascular surgery.

Rotations occur at one of three sites: Robert Wood Johnson University Hospital in New Brunswick, Jersey Shore Medical Center in Neptune, or The Medical Center at Princeton in Princeton.

The remaining two weeks consist of an elective chosen from a list of available opportunities. Students will receive exposure in orthopaedic surgery and urologic surgery via outpatient experiences distributed throughout the third year clerkship. Students may utilize the two-week elective to obtain additional exposure to orthopaedic or urologic surgery.

A list of index cases with which the student should have some clinical experience will be provided. Attendance at clinical rotations is mandatory. Unexcused absences may result in a grade of Fail or Conditional Pass (please see Final Clerkship Grades below).

Faculty Preceptors and Tutors

Students will be assigned to a faculty preceptor who will oversee the students' activities throughout the eight-week clerkship. For each specific rotation (e.g. general surgery, vascular surgery, elective) the student will be assigned a faculty tutor(s) who will be the student's guide for that portion of the clerkship. The preceptor will facilitate surgical education throughout the clerkship to assure an adequate breadth and depth of clinical experience. The tutor will be the student's primary contact for day-to-day clinical activities. The preceptor and tutor will guide the student in constructing a daily schedule and discuss the student's current cases. The faculty will assist in the choice and preparation of the student's required case presentation and provide frequent feedback to the student about his/her progress in meeting the goals of the clerkship.

Preceptor responsibilities include:

  • Coordinate student participation throughout the eight-week clerkship to assure a breadth of clinical exposure.
  • Oversee the student's patient care activities (review written H&P's, discuss patient management of the student's assigned patients, etc.)
  • Conduct weekly clinical sessions with the group of students, possibly as teaching rounds.
  • Individual student meetings to review clinical activity (patient contact log) and overall progress (provide feedback).

Students will participate in the resident services as appropriate and available, and at a level commensurate with their experience and abilities, assist in direct patient care. Students will participate in resident /service rounds as appropriate for the educational goals of the clerkship. Students are encouraged to see and participate in the surgical management of cases even when they are being managed by an attending other than their tutor or preceptor. When reasonable, they may also cross over to other teams or services. Participation in an index case should be arranged by contacting the appropriate resident on the team concerned and clearing it with the tutor.

The student should meet with their tutor and preceptor on the first or second day of each rotation to establish learning objectives, determine the weekly meeting times (group and individual), and establish outpatient and operating room commitments. During the weekly individual meetings, the preceptor will review and critique the student's written H & P, and discuss the student's activity log.

The preceptor will not have primary responsibility for grading the students, but will have input into the grading process (see Final Clerkship Grades below). Students are encouraged to elicit specific feedback about their performance from their tutor and preceptor.

Weekly Written History and Physical

Each week (except for Weeks 1 and 8), the student is required to complete at least one H&P, for a total of 6 per rotation. The H&P should be actually performed by the student, written up, and submitted to the preceptor. The format for the H&P is a focused history and physical examination, a differential diagnosis, a brief discussion of the pathophysiology of the case, and a treatment plan with a rationale for the treatments selected. The tutor or another faculty member may review the H&P. It remains the student's responsibility to present the previously reviewed H&P to their preceptor for inclusion in the evaluation packet.

Weekly Case-based Didactic Sessions

A case-based framework is used to present didactic information. The topics for presentation are derived from a national consensus on competencies that should be mastered by students during their Surgery Clerkship. The 4th Edition of the Manual of Surgical Objectives will be the basis for all didactic sessions, including the teaching cases. The emphasis of the didactic session is to be on discussing the clinical case(s). Each session is intended to address clinical reasoning that crosses traditional discipline lines and focuses on developing a differential diagnosis and treatment plan. Student participation is to be active discussion, not passive attention solely to lectures. The case-based sessions will be facilitated by faculty and will cover essential information that is assessed on the final examinations. There may be assigned readings that students are expected to complete prior to the case-based sessions. Student attendance and participation during the case-based discussions is required for successful completion of the clerkship.

Student Case Presentations

Each student will prepare and present two cases. The purpose of the student case presentations is to give students the opportunity to give a focused case presentation followed by a cogent discussion of the point of interest. The presentation and discussion time will be limited. Therefore, the student should plan to limit his/her presentation to permit an interactive format without compromising their presentation. The topic should be on some interesting aspect of a case in which the student participated. The content of the case presentations should contribute to the students' basic knowledge of surgical disease and patient management, while emphasizing the aspect of the case that was intriguing to the presenter.

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