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Electives - General Surgery

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ACE - A. I. in Pediatric Surgery

Elective Number: 3016

Rotation Supervisors: Dr. Eugene McGahren

Coordinator: Heather Trainium

Duration: 4 weeks

Available: Rotations 3-7

A pager is required and will be supplied by the department.

Report to: Pediatric Surgery Chief Resident

Time to Report: As designated by the Peds Surgery Chief

Place to Report: As designated by the Peds Surgery Chief

Typical day: 6:00 am - 6:00 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 Pediatric Surgery elective is considered an "acting internship" on the service. The role of the “ACE” student is distinct from the role of a third-year clerkship student. The ACE student is expected to approach the rotation as a preparation for her/his role as an intern. As such, it is anticipated that the ACE student will cover 2-3 patients as their primary patients. But, the ACE student should also be familiar with the entire service so as to understand and assist with service management issues. In addition, the ACE student can help in the mentoring process for the clerkship students. The students are expected to assist with the workup of new patients who present in the clinic, Emergency Department, from consults, and from pre and post-operative presentations. In the clinic, they will be initial providers for many patients. They are expected to assist in the operating room, particularly with the patients they have initially evaluated. An ACE student would be expected to be able to first assist in appropriate cases where there are not other residents who have priority. They are expected to assist with post-operative management of the patients on the service. The students will share night call one night per week with the overnight Resident covering this service. There is no weekend call, but the ACE student is expected to participate in weekend rounds and activities with the caveat that one day in every seven, on average, must be an off day. This day is typically a weekend day. The student will be expected to participate in the Division's conferences and to provide one prepared topical presentation to the team during the rotation. The rotation supervisors will closely observe the student. Final evaluation will be completed by the Rotation Supervisor. Appropriate input for this evaluation will be provided from all residents and attendings that the student has worked with during the elective.


Goal: The goal of this elective is to introduce and involve the student in the evaluation and management of the wide variety of anomalies and illnesses in children encountered by Pediatric Surgeons. This is done in the spirit of helping the student start to develop a sense of independence in the care of patients as they progress toward her/his residency.

Learning Objectives:
1. Recognize and evaluate newborn infants with signs & symptoms of bowel obstruction, such as intestinal atresias and Hirschsprung's Disease.
2. Evaluate children presenting with acute and chronic abdominal pain.
3. Know the principles of fluid management in childre with surgical conditions; particularly calculating daily fluid requirements, hourly maintenance IV fluid rates, and appropriate IV fluid components.
4. Become familiar with the evaluation and resuscitation of pediatric trauma victims and know the principles involved in coordination of the in-hospital care of these patients.
5. Understand principles of nutritional management of pediatric surgical patients; e.g. be able to calculate daily calorie needs and understand how that determines formula management for babies or TPN management for children in general.
6. Recognize the importance of involving family members in decision-making and management of Pediatric surgical patients and the cost effective pre & postoperative care of these children.
7. Recognize and understand engagement of supporting services such as Child Life, Social Work, Child Protective Services, Occupational Therapy, and Physical Therapy.
8. Recognize and understand the importance of interaction amongst a variety of medical and other surgical specialists in the care of pediatric surgical patients.
9. Participate in outpatient clinic activities, exposing the student to acute patient presentations requiring evaluation and management, short term follow-up of patients both operative and non-operative, and long-term functional evaluation of patients after treatment for various surgical conditions.
10. Understand and participate in operating room time-out.
11. Become familiar with and participate in the process of obtaining operative consent.

Suggested Learning Resources:
Texts:

Pediatric Surgery, 2-Volume Set: Expert Consult
Feb 28, 2012
by Arnold G. Coran MD and N. Scott Adzick MD


Ashcraft's Pediatric Surgery: Expert Consult - Online + Print, 6e (Expert Consult Title: Online + Print)
Mar 10, 2014
by George W. Holcomb III MD and Jerry D Murphy


Operative Pediatric Surgery
Mar 18, 2014
by Moritz Ziegler and Richard G. Azizkhan

Fundamentals of Pediatric Surgery: Second Edition
Oct 2, 2016
by Peter Mattei and Peter F. Nichol


Websites:

American Pediatric Surgical Association
IPEG (International Pediatric Endosurgery Group)

Journal:

Journal of Pediatric Surgery
Pediatric Surgery International

 

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