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Electives - General Surgery
ACE - A. I. in Pediatric Surgery
Elective Number: 3016 (lottery)
Rotation Supervisors: Dr. Eugene McGahren
Coordinator: Heather Trainium
Duration: 4 weeks
Available: Rotations 3, 4, 5 & 6
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.
Number of students per rotation: 1
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. However, by the mid-point of the rotation, it is expected that the ACE student will become familiar enough with the entire service so as to understand and assist with service management issues and be able to present patients on daily ward rounds as necessary in the manner of an intern. In addition, the ACE student can help in the mentoring process for the third year clerkship students. The ACE student is 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 assist in a variety of operative cases and to be able to first assist in appropriate cases where there are no other residents who have priority. Roles that the student may assume in an operative case may include, but not be limited to, making an incision, helping with appropriate exposure, assist in dissection, tie appropriate ligatures, run the camera/scope in minimally invasive cases, help with soft tissue or skin closure, activate stapling devices, activate and use bag retrieval devices for MIS cases, placing a drain or a chest tube, drain abscesses. Â They are expected to assist with post-operative management of the patients on the service. The student will share one night call 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 that can be arranged ahead of time by communication with the Chief Resident or attending covering the service call. 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. This presentation is not graded, but is an opportunity for the student to perform a literature search, and PowerPoint presentation to the team on a particular topic of interest to the student related to Pediatric Surgery.Â The rotation supervisor will closely observe the student. Feedback will be provided halfway through and at the end of the rotation. We ask that the student provide 3 H&Ps and 3 progress notes for review and feedback from a faculty member or Chief Resident. Final evaluation will be completed by the Rotation Supervisor. However, appropriate input for this evaluation will be provided from all residents and attendings that the student has worked with during the ACE.
1. Recognize and evaluate newborn infants with signs & symptoms of bowel obstruction, such as intestinal atresia, Hirschsprung's Disease, meconium ileus, etc.; develop a differential diagnosis for the presentation; define appropriate lab and imaging studies based on the patient presentation; determine the appropriate intervention or referral
Suggested Learning Resources:
Ashcraft's Pediatric Surgery: Expert Consult - Online + Print, 6e (Expert Consult Title: Online + Print)
Fundamentals of Pediatric Surgery: Second Edition
American Pediatric Surgical Association
Journal of Pediatric Surgery
(Rotations director can provide access to these sites if needed)