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Electives - General Surgery


ACE - A. I. in General Surgery - Green Service

Elective Number: (Oasis E76p) 3022

Rotation Supervisor: Dr. Victor Zaydfudim

Rotation Attendings: Todd Bauer, Reid Adams & Victor Zaydfudim

Rotation Coodinator: Heather Trainium

Duration: Maximum 8 weeks, Minimum 4 weeks

Available: All Rotations

Report to: Chief Resident

Time to Report: 7:00 am

Place to Report: Ward designated by Chief Resident (contact by pager one week prior to elective)

Typical day: 6:00 am - 9:00 pm

Attendance: A student may not take time off during an ACE.

Attendance at elective activities is mandatory.

  • Anyone who is ill or has a personal or family emergency must contact Student Affairs and the Attending on Service.
  • Students are allowed to take off up to 1 day per week to interview between November 1 and February 1.
    • Specific days missed must be approved by the Attending on Service.

Number of students per rotation:

Course Description: The Green surgery service is primarily responsible for the care of patients with non-transplant related hepato-biliary-pancreatic disease (HPB). Drs. Adams, Bauer and Zaydfudim are the primary HPB attendings. Drs. Bauer also has an interest in soft tissue sarcoma. Residents assigned to this service will include a PGY-5 (Chief), a PGY-3, and a PGY-1 resident. The administrative duties of the service overall will be the responsibility of the Chief resident, which includes care & oversight of the patients. The Chief resident will distribute cases and responsibilities for the other members of the team. The PGY-1 residents will participate in providing care for all patients on the service as delegated by the Chief resident.

Learning Objectives:

1. Describe the presentation, diagnosis, and management of patients with hepatic, pancreatic, and biliary lesions.
2. Develop a plan of care for all in-house surgical patients with whom they come in contact. This includes data collection, ordering and interpreting appropriate diagnostic tests, and working to provide a patient centered plan consistent with the resident’s level of training
3. Evaluate and develop a plan for patients seen in consultation in the emergency room or inpatient service
4. Recognize significant changes in patient status
5. Be able to develop appropriate diagnostic and treatment algorithms for common surgical emergencies
6. Present a problem based summary of all admissions and consults to the attending /chief resident and to discuss complications occurring in patients for whom they had the primary responsibility.
7. Discuss the pathophysiology and associated medical problems of liver disease, diseases of the pancreas and diseases of the biliary tree.
8. Develop an understanding of the importance of the multidisciplinary approach to patients with gastrointestinal malignancies. A critical part of this experience is participation in the GI Tumor Board on Thursdays, 6:45-8:15 am, 6th Floor West Complex, Cancer Center Conference Room.
9. Describe the work-up, staging, multidiscliplinary management of and indications and contraindications for surgical treatment of soft tissue sarcoma and cancers of the hepatobiliary system and pancreas.

Student Role:

1. Attend clinic for the preoperative and postoperative care and evaluation of patients. Dress professionally for clinic.
2. Be involved in the care of inpatients on the Green Surgery service. You are expected to be involved in the ongoing care of any patient in whom you were involved in the admission or operative care. You should round on these patients. You should see every patient daily, examine them (including wounds), review appropriate laboratory and study data results, report the status of each patient and their studies on rounds, and write a daily progress note in the chart. You should manage dressings and wound care under the guidance of the residents on service.
3. Being involved in the operative care of patients on the service. You should be completely prepared for every OR case prior to scrubbing in. This means that you have reviewed the patient's history and know the results of all laboratory, radiology and pathology studies. In addition are expected to read about the patient's disease process, the treatment options, and the details of the proposed surgery, including relevant anatomy and the surgical techniques involved. We do not expect that you will become a surgeon during the rotation. We do expect you to develop an understanding of the rationale for, and the implications of, the interventions that we perform.
4. Prepare a presentation on a topic of your choice. The residents and faculty can provide guidance on a topic and will arrange a time for presentation.
5. Plan ahead. The residents on service can guide you as to the anticipated schedule. This will allow you to dress appropriately/professionally and will allow ample time to read ahead about patients and disease processes prior to the date of elective surgery.


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