1. Assigned readings. IV. EVALUATION Final evaluation will be based upon clinical performance. Completion of an addiction medicine rotation in the CBY/PGY1 trainee requires performance at the level of reporter or greater. V. ROTATION EVALUATION At the completion of the rotation, residents will complete an end of rotation evaluation. The evaluation will include their assessment of: Educational experience Caseload diversity and volume Strengths and weaknesses of the rotation CBY/PGY 1 ROTATION IN GENERAL SURGERY Residents will be expected to demonstrate competence in the six ACGME general competencies as outlined below. Evaluations will be used to assess their progress in attaining these goals and also to promote continuous learning. Patient Care Goals: Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health. Residents are expected to: Perform an appropriate evaluation, including history, physical exam and laboratory studies when needed. Demonstrate the basic skills necessary for the care of surgical patients. Manage patients with acute or chronic conditions undergoing diagnostic workups and medical or surgical management. Provide safe, efficient, and compassionate care to patients. Objectives: Demonstrate detail-oriented systems based management of surgical patients. Perform initial assessment of surgical patients pre and postoperatively. Evaluate and interpret abdominal pain. Evaluate and interpret oliguria and renal failure. Evaluate massive bleeding and transfusion. Evaluate and interpret shock, including hypovolemic, cardiogenic, neurogenic and septic shock.
Medical Knowledge Goal: Residents must demonstrate knowledge of established and evolving biomedical and clinical sciences and the application of this knowledge to patient care. Apply relevant scientific knowledge and reasoning to the care of the surgical patient. Understand the pathophysiology of patients requiring surgery or possible interventions. Understand the principles and the endpoints of resuscitation in surgical patients. Objectives: Explain the principles of volume status assessment in trauma patients. Describe the pathophysiologic states that patients have who require or may require surgery. Identify the priorities in acute resuscitation and define the end points of resuscitation. Compare and contrast the use of crystalloid (hyper and isotonic) and colloid fluids in trauma resuscitation. List transfusion criteria for blood and blood products with an emphasis on the application in acute trauma. List and justify the considerations for urgent (non-emergent) surgery. Discuss and defend the management principles for cardiovascular, pulmonary and renal failure in the ICU and OR. Define the management principles of sepsis and sepsis syndromes in the ICU and OR. State the principles and methods of routine prophylaxis for: DVT. Gastritis / stress ulceration. Delirium tremens. Formulate and justify a management plan for septic shock. Define the nutritional goals and techniques for ICU patients. State the rational for advanced ventilatory management and define the use of APRV, noninvasive positive pressure ventilation and prone positioning Interpersonal Skills and Communication Goals: Residents must demonstrate interpersonal and communication skills that result in effective information exchange and team-building with patients, patients’ families, and professional associates. Objectives: Discuss with patients and family members the advantages and disadvantages of the different surgical vs. non-surgical options. Establish and sustain a therapeutic and ethically sound relationship with patients and families, addressing patient and family concerns and anxieties.