SURGICAL ONCOLOGY: Goals and Objectives
The objective of the service is to educate the residents about the pathophysiology, diagnosis and treatment of solid tumors. The resident is expected to have a clear working knowledge of the role of surgery in the treatment and palliation of malignant disease.
1. The PGY-5 is expected to run the clinical service; The chief will maintain 24 hour/day beeper availability; i.e. after hospital hours he/she will be available by beeper for service/administrative responsibilities, questions or patient care issues.
2. Care of surgical consults referred to the service. This is both in terms of initial evaluation (either the PGY-5 or the PGY-2/3) and subsequent planning of care.
3. The resident is responsible for team attendance to weekly Morbidity and Mortality, Grand Rounds, Treatment Planning, Tumor Board and Breast conference. In addition, the resident is responsible for submitting and presenting interesting cases for the treatment planning conference and Tumor board.
4. Operating room. The chief resident will operate with an attending on the Oncology service Monday, Wednesday and Friday. The chief is responsible for assigning OR coverage every day of the week.
5. Weekly clinic attendance. The resident will attend general surgical oncology clinic on Tuesday and breast cancer clinic on Thursday. The resident will see and evaluate each new patient. They are expected to examine the patient, review relevant clinical materials, formulate a treatment plan and present the case to the attending.
6. Education. The chief resident should achieve competence in evaluating the patient with cancer, formulating differential diagnoses and developing a diagnostic approach. The resident should be knowledgeable about the surgical management of solid tumor malignancies. Emphasis will be weighted toward patients with GI, soft tissue, breast and cutaneous malignancies. The resident will be evaluated on their competence in the operating room in terms of operative preparedness, treatment plan, procedural skill and operative judgment is a primary goal. In addition, evaluation, diagnosis, clinical management of patients with general surgical diseases will be a significant part of their experience.
7. The chief resident in charge of the Surgical Oncology team will act as the University Hospital Administrative Chief. Responsibilities include:
a. Compilation of the weekly list of patients for M&M.
b. Resident attendance to all teaching conferences
c. Call schedule formulation and related issues
d. Visiting professor case presentations
e. Departmental administrative issues
1. The daily care of all inpatients admitted to the Surgical Oncology service. The resident should know all information regarding clinical course, management and plan on each patient.
2. Care of surgical consults referred to the service. This is both in terms of initial evaluation (either the PGY-5 or the PGY-2) and subsequent planning of care.
3. Education. Learn clinical evaluation, diagnostic approach and treatment options for the cancer patient. Develop procedural skill and operative decision making. In addition, evaluation, diagnosis, clinical management of patients with general surgical diagnoses will be a significant part of the PGY-2 experience.
4. Weekly clinic attendance for PGY3.
5. Attendance to Morbidity and Mortality, Grand Rounds, all resident didactic lectures and all Surgical Oncology conferences.
6. Operating room. All cases should be covered by a member of the resident team
1. The daily care of all inpatients admitted to the Surgical Oncology service. The resident should know all information regarding clinical course, management and plan on each patient. In addition, the PGY-1 should be familiar with all aspects of care regarding consults.
2. Education. Goals for the PGY-1 include pre and postoperative care of the surgical patient. These include but are not limited to appropriate skills in medical management, understanding and decision making regarding the preoperative care of the variety of general surgical and oncologic diseases, performance of minor bedside procedures (see below) as well as those performed in the operating room. In addition, the PGY-1 will actively participate in the departmental didactics, conferences and journal club. Presence at all conferences is mandatory.
Evaluation meetings will take place with the PGY-5 and 2 at the mid and end point of the rotation. PGY-1 will meet with an attending for review at the end of their rotation. Clinical evaluations are based on observations in the areas of the core competencies (patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism and systems-based practice. For more information regarding core competencies refer to the following web site: http://www.acgme.org/outcome/comp/compFull.asp. Attending evaluations will be based on achievement of objectives as outlined above and will be based on input from the following:
1. Attending-resident interaction during rounds, the operating room, consultation assessment, daily rounds and other clinical responsibilities.
2. Presentation at M&M, Tumor Board and Treatment planning conference
3. Performance in the operating room in terms of pre-operative planning, dexterity, intraoperative judgment and ability to act autonomously.
4. Nursing and patient evaluations
5. Medical student interaction and evaluation. The ability of residents to teach medical students is of primary importance and is a major objective of the rotation.
Foley catheter insertion
Arterial blood gas
Skin tumor excisions
Feeding tube placements
Gastrostomy tube placement
Sentinel lymph node biopsies
All major abdominal surgery
Complex Breast cancer cases
Radical soft tissue tumor resections
Lymphadenectomy for melanoma
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