Goals:

The goal of this rotation is exposure to surgical procedures, post-operative care, trauma and outpatient surgical follow up. The more you put into this rotation, the more benefit you will take from the rotation. 

 

Rotation Overview:

• Rotation Location

  • The rotation will primarily be based out of the Hackley campus, but you may be required to evaluate patients at the Mercy campus as well.

  • Residents and medical students will be following the on call general surgeon, which changes weekly. The list of surgeons for the month will be available to you at the beginning of the rotation. Each week night, the general surgeon covering the surgical service changes.

  • Weekend nights of Friday-Sunday from 6p-6a, there will be one surgeon on call which the night resident will follow.

• Sign Out

  • Sign out from the day shift takes place before the start of you shift. Please communicate with the day resident to determine where this takes place.

• Rounding​ Expectations

  • Expect to start the rotation at 6am at the Hackley campus on the first day. Generally, you meet on the 4th floor.

  • Rounds usually start between 7-8am. 

  • Some surgeons can be contacted via DocHalo and some via pager.

  • Each day you are expected to round on the patients on the list and write a note prior to rounding with the attending physician. 

  • The senior resident will divide the list. 

  • It would be of benefit to follow the same patients daily, however, this is not always possible.

• Operating Room Expectations

  • If your patient is scheduled for surgery, you are expected to be in the case with the surgeon. Generally, only one resident or student in the OR at a time, but this may vary depending on the case. Discuss with the attending.  

  • If there are cases you are interested in observing/assisting, discuss this with the residents and the attending.

• Trauma Resident Expectations

  • ​​One resident will carry the trauma pager and is expected to respond to all trauma pages.  

  • Given the limited space in the trauma bay, there should only be on resident along with the attending in the trauma bay.  

  • After the patient is stabilized, a consult or admission note needs to be completed and sent to your attending physician.  

  • If you have questions, go to the senior resident first prior to asking the attending. This may include putting in orders if the patient requires admission or speaking to consultants. 

  • This also doubles as a acute surgical care service so you are expected to see the new consultations in the emergency room or transfers from outside hospitals.  These may include appendicitis, cholecystitis, bowel obstruction, etc. A page will be sent out to the surgical pager when the transfers arrive to the hospital. 

  • Write a history and physical. If you have not placed inpatient orders or have questions, I recommend discussing this with either you senior resident or attending. If it is a ER consult, discuss the case with the attending prior to putting inpatient admission orders unless they specifically state that the patient does require admission.  

• Clinic Expectations

  • ​General surgery clinic is expected of all residents other than emergency room residents. 

  • This can either be done at the Muskegon Surgical Associates located at the Mercy campus or with Dr. Zwemer located at the Hackley campus. The schedule at each office varies.  

  • Each resident is expected to schedule the days of clinic by contacting the surgical office or discussing it with the on-call surgeon.

  • After speaking with each program director, they recommend either 1 full day or 2 half days of surgical clinic. 

• Off-Service Resident Responsibilities 

  • It is understood that all family medicine, ob/gyn and OMM residents will have their own designated clinic days, which will count to your total number of shifts for the month.

  • All residents are required to go to the program specific didactics and SCS when scheduled and will be excused from the rotation during that time. 

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Scheduling Expectations

• Daily, at least 1 resident needs to be on service from 6a-6p.

• There will be rounders, who will help with the patient list in the morning and will be allowed to leave after rounding.  

• If there are several admission or surgeries taking place during the day, you may be required to stay.

• The night shift if from 6p-6a which is generally covered by one resident.  

• The number of residents during the day shift is largely dependent on the number of patients on the list, surgical cases and outpatient clinic days.  

• The number of residents per month varies.  

• All residents on the service are expected to work 20 shifts over the 4 week block with 2 weekends. They will also be required to work nights.  

• The clinic days count towards your total number of shifts.

• A resident needs to be in house 24 hours a day for the 4 week block.  

• There is no home call on this rotation. 

• Resident sleep rooms are located in the basement. 

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Required Reading Topics

1. ATLS: Primary, secondary and tertiary survey

   1. Head and Neck Trauma

   2. Thoracic Trauma

   3. Abdominal Trauma

   4. Extremity Trauma

   5. Trauma in pregnancy

2. Acute Abdomen: exam, differential, imaging, treatment

3. Biliary Disease

4. Diverticular disease

5. Post-op patient: Management and complications

6. Wound Care

7. Cancer screening

8. Skin