Goals and Objectives: SFGH Trauma Draft 6/1/2007 v2
PGY 1
Medical knowledge base skills
1. Principle of Advanced Trauma Life Support/tertiary survey 2. Write orders 3. Pathophysiology of surgical diseases 4. Basics of fluid and electrolyte management 5. Nutrition/TPN (Total Parenteral Nutrition and enteral Nutrition) 6. Inguinal anatomy 7. Understand the basic principles of inflammatory response of SIRS
Technical skills
1. Incision of a cutaneous mass 2. Inguinal hernia repair 3. Placement of a foley 4. Placement of an IV
PGY 2
Medical knowledge base skills
1. Resuscitation principles including patients with head injury, and coma 2. Principles of surgical infection 3. Perianal diseases 4. The principles of ICU care 5. Understanding pathophysiology of burns 6. Participate in a 912 7. Principles of ATLS 8. Management of breast diseases
Technical skills
1. Laparoscopic cholecystectomy 2. Laparoscopic appendectomy 3. Open abdomen correctly 4. Simple vascular anastomosis 5. Incision and drainage of abscess 6. Placement of a chest tube 7. Arterial line placement 8. Central line placement 9. Lumpectomy and axillary node dissection 10. Perform renal vascular access 11. Split thickness skin grafts 12. Burn excision 13. Fiberoptic bronchoscopy 14. Chest CT 15. Upper endoscopy and lower endoscopy
PGY 3
Medical knowledge base skills
1. Principles of Advanced Trauma Life Support 2. Thyroid and parathyroid diseases 3. Principle of colorectal surgery 4. Management of traumatic brain injury 5. Management of ARDS 6. Renal replacement therapy/CVVH 7. Management of spontaneous pneumothorax 8. Principles of surgical consultation 9. Management of gastric perforation and duodenum perforation 10. Melanoma management 11. Renal access surgery
Technical skills
1. Laparoscopic appendectomy 2. Performance of bowel anastomosis 3. Performance of vascular anastomosis, 4. Perform a diagnostic peritoneal fast exam 5. Rigid sigmoidoscopy
PGY 4 & 5
Medical knowledge base skills
1. Understanding the principle of damage control 2. Work-up of vascular trauma 3. Team lead trauma resuscitations 4. Thyroid and parathyroid disease management 5. Management of Gastric cancer 6. Management of esophageal disease including esophageal cancer and esophageal reflux disease 7. Management of perforated peptic ulcer diseases 8. Splenectomy, both open and laparoscopic 9. Management of pancreatic injuries preoperatively 10. Management of pancreatic cancer 11. Management of thoracic tumors 12. Management of peripheral vascular disease 13. Management of rectal tumors 14. Perform weekly talks to educate the junior residents at Morbidity and Mortality conference 15. develop skills as a surgical educator (PGY-5) 16. PGY4 Everyday management of surgical inpatients 17. PGY5 Consultant to the senior residents for difficult case management 18. Surgical management of extremity and retroperitoneal sarcomas 19. Recognition and management of abdominal aortic aneurysms 20. Evaluating and determining if an operative procedure is indicated 21. Discuss cases at medical surgical conferences 22. Develop treatment plan for patients and present at Tumor Board 23. ICU consultation and ED consultation 24. Devise appropriate antibiotic choice 25. Understand the principles of endocrine surgery 26. Management of necrotizing fasiciitis
Technical skills
1. Recognize and devise treatment for rectal injuries 2. Visceral rotation maneuver both right and left side 3. Management of neck trauma 4. Thoracotomy for Trauma and Cancer 5. Perform a median Sternotomy 6. Operative Exposure of axillary and Subclavian artery and vein injuries 7. Femoral artery and vein access 8. Management of the superficial femoral artery injury at the adductor canal 9. Management of portal venous injuries 10. Perform the Pringle Maneuver 11. Management of difficult open abdomen 12. Management of extremity sarcomas 13. Management of retroperitoneal sarcomas 14. Management of Ruptured Abdominal Aortic Aneurysms 15. Management of Peripheral Vascular Disease
PRACTICE BASED LEARNING
1. Attend all weekly Surgical M&M/teaching conferences and participate in analysis of treatment outcomes by review of cases at morbidity and mortality conference. 2. Attend GI Tumor Board conferences. 3. Present a patient seen in clinic or on the service and critically analyze relevant literature at one teaching conference. 4. Maintain a personal patient log
INTERPERSONAL AND COMMUNICATION SKILLS
1. Communication
a. Communicate appropriately and effectively with all those involved in the patient’s care b. Inform senior residents and attendings of all changes in patient status in a timely manner c. Counsel and educate patients and families – assist with education before discharge. d. Document the patient’s care with timely completion of admission history and physical examination, entry of progress notes, and discharge summaries. 2. Interpersonal skills a. Interact on a daily basis with nurse practitioners, ICU and floor nurses, pharmacists, nurse coordinators. b. Mentor the third and fourth year medical students on the service. c. Respect the chain of command regarding senior residents and attendings. d. Obtain informed consent of patients. e. Request post mortem exams of patients.
PROFESSIONALISM
1. Respect patient confidentiality.
2. Learn the principles of informed patient decision making.
3. Be punctual.
4. Complete medical records, dictations, discharge summaries in a timely fashion.
5. Maintain attendance at Grand Rounds and Basic Science conference.
SYSTEM BASED PRACTICE
1. Understand the cost implications of medical decision making.
2. Partner with health care management to facilitate efficient utilization of hospital resources.
3. Demonstrate consistency in working with healthcare management team in discharge planning.