OVERVIEW Welcome to Plastic Surgery. We hope your time on our service will be instructional and enjoyable.

Transcription

1 OVERVIEW Welcme t Plastic Surgery. We hpe yur time n ur service will be instructinal and enjyable. INTRODUCTION Lcatin(s): Health Sciences Centre St. Bniface General Hspital Preceptrs: Attending Surgens Health Sciences Staff: Dr. Edward Buchel (Sectin Head, Plastic Surgery) Recnstructive Micrsurgery, Csmetics Dr. Thmas Hayakawa Recnstructive Micrsurgery, Hand Surgery Dr. Leif Sigurdsn General Plastic Surgery, Micrsurgery, Hand Surgery, Cranifacial, Pediatrics Dr. Lnny Rss - Pediatric Plastic Surgery, Cranifacial Dr. Sarvesh Lgsetty Burn Surgen, General Surgery Trauma Dr. Jyti McGregr Pediatric Plastic Surgery St. Bniface Staff: Dr. Avi Islur (Prgram Directr Plastic Surgery) General Plastic Surgery, Hand & Micrsurgery Dr. Kenneth Murray General Plastic Surgery Dr. Balbir Singh General Plastic Surgery Dr. Kenneth Dlynchuk General Plastic Surgery Cntact Persn: Cherie Marynwski, Prgram Administratr Phne: (204) cmarynwski@hsc.mb.ca LEARNING OBJECTIVES (CanMEDS) Medical Expert As Medical Experts, physicians integrate all f the CanMEDS Rles, applying medical knwledge, clinical skills and prfessinal attitudes in their prvisin f patient-centered care. Cncept f Plastic Surgery and its breadth Basic suturing and wund clsure skills (including understanding f different suture techniques and materials) Knwledge f basic wund care and dressings. In particular, the wrk-up and treatment ptins fr diabetic ft ulcers, venus stasis ulcers, pressure sres and burns, laceratins Ability t identify and examine cmmn Plastic Surgery prblems, with emphasis n:

2 examinatin f the hand and upper extremity; acute flexr and extensr tendn injuries, carpal tunnel syndrme, cubital tunnel syndrme, acute nerve injuries, finger tip and nail bed injuries, finger fractures. burns - acute management cranifacial trauma (zygma, mandible, LeFrt), including examinatin and initial emergency management cmmn skin tumurs and skin lesins breast recnstructin (TRAM flap, latissimus drsi, tissue expanders, implants) skin grafts This will be achieved by regular attendance and participatin as a member f the Plastic Surgery Team. We hpe that all clinical clerks will feel as an integral part f the team and participate actively with their suggestins in patient care. If at any time yu have any questins r cncerns, please feel free t apprach any staff member r resident. Cmmunicatr Physicians effectively facilitate the dctr-patient relatinship and the dynamic exchanges that ccur befre, during, and after the medical encunter. As Cmmunicatrs, students will facilitate the dctr-patient relatinship: Establish rapprt, trust and a therapeutic relatinship with patients and families. Listen effectively. Elicit relevant infrmatin and perspectives f patients, families, and the health care team. Cnvey relevant infrmatin and explanatins t patients, families and the health care team. Cnvey effective ral and written infrmatin abut a medical encunter. Maintain clear, accurate, apprpriate, and timely recrds f clinical encunters and perative prcedures Address challenging cmmunicatin issues effectively Obtaining infrmed cnsent Delivering bad news Disclsing adverse events Discussing end-f-life care Discussing rgan dnatin Addressing anger, cnfusin and misunderstanding Cllabratr Physicians effectively wrk within a healthcare team t achieve ptimal patient care. As Cllabratrs, students will wrk effectively within the surgical team t achieve ptimal patient care Leader Understand the team apprach t health care Participate effectively in an interprfessinal and interdisciplinary health care team. Recgnize and respect the diversity f rles, respnsibilities, and cmpetences f ther health prfessinals in the management f the surgical patient. Wrk with thers t assess, plan, prvide, and integrate care f the surgical patient.

3 Physicians engage with thers t cntribute t a visin f a high-quality health care system and take respnsibility fr the delivery f excellent patient care thrugh their activities as clinicians, administratrs, schlars, r teachers. As Leaders, students will participate in the activities f the surgical service, making decisins, allcating resurces, and cntributing t the effectiveness f the health care team: Emply infrmatin technlgy apprpriately fr patient care. Allcate finite health care resurces apprpriately Health Advcate Physicians respnsibly use their expertise and influence t advance the health and well-being f individual patients, cmmunities and ppulatins. As Health Advcates, students will respnsibly use their expertise and influence t advance the health and well-being f individual patients, cmmunities and ppulatins. Cncern fr the best interest f patients Identifying health needs f individual patients Prmte and participate in patient safety Schlar Physicians demnstrate a lifelng cmmitment t reflective learning, as well as the creatin, disseminatin, applicatin and translatin f medical knwledge. As Schlars, students will demnstrate a lifelng cmmitment t learning Ability fr cntinuing self-learning Learning the principles f surgery and the applicatin f basic sciences t surgical treatment. Demnstrate apprpriate presentatin skills, including frmal and infrmal presentatins. Critically evaluate medical infrmatin and its surces and apply this apprpriately t clinical decisins. Critically appraise the evidence in rder t address a clinical questin. Integrate critical appraisal cnclusins int clinical care. Prfessinal As Prfessinals, physicians are cmmitted t the health and well-being f individuals and sciety thrugh ethical practice, prfessin-led regulatin, and high persnal standards f behaviur. As Prfessinals, students are cmmitted t health and well-being f individuals thrugh ethical practice, prfessin-led regulatin and high persnal standards f behavir: Exhibit prfessinal behavirs in practice, including hnesty, integrity, cmmitment, cmpassin, respect and altruism. Demnstrate a cmmitment t delivering the highest quality care. Recgnize and respnd apprpriately t ethical issues encuntered in practice. Recgnize and respect patient cnfidentiality, privacy and autnmy. Participatin in peer review

4 Manage cnflicts f interest Maintain apprpriate relatins with patients. Demnstrate awareness f industry influence n medical training and practice Recgnitin f persnal and clinical limitatins INFORMATION These are lcatins, readings, evaluatins, call respnsibilities, etc. Required Reading Lawrence Essentials f General Surgery, 3rd Ed. Chapters f particular relevance t this rtatin include: Chapter 7 - Wunds & Wund Healing Chapter 8 - Surgical Infectins Chapter 10 - Burns Chapter 26 - Surgical Prcedures, Techniques & Skills Lawrence Essentials Of Surgical Specialties, 2nd ed. Chapters f particular relevance t this rtatin include: Chapter 4 - Plastic Surgery: Diseases f the Skin and Sft Tissue, Face and Hand Suggested Reading The Red Bk Dwnlad r read nline -- Click n "Medical Prfessinals" Click n "Publicatins" Click n "Plastic and Recnstructive Surgery Essentials Fr Students" Hand, 4th r 5th Ed, Little Brwn & C. Green s Operative Hand Surgery, 3rd Ed, Vl. 1&2, Churchill Livingstn Wund Care & Dressings Vascular Skin Ulcers f Limbs; Tam et al. Cardilgy Clinics 9(3):555, Aug Occlusive Wund Dressings. Why, When, Which? A Review, Falanga; Archives f Dermatlgy 124: , June 1988 Burns Burn Shck Resuscitatin; Warden et al., Wrld J. Surg. 16:16-23, 1992 Burn Depth: A Review; Hemibach, et al. Wrld J. Surg. 16:10-15, 1992 Facial Fractures Rwe & Williams Maxillfacial Injuries, Vl. 1&2, 1985, Churchill Livingstn Cmmn Skin Tumurs Clinics in Plastic Surgery Benign Skin Tumurs 14(2), April 1987 Clinics in Plastic Surgery Dermatlgy fr Plastic Surgens 20(1), January 1993 Lever s Histpathlgy f the Skin, Lippinctt-Raven Breast Recnstructin

5 Skin Grafts Teaching Unit The Plastic Surgery ward at HSC is lcated n GH5. The Plastic Surgery ward at SBGH is lcated n 7AWest. Call Respnsibilities Students are expected t be n call 1-in-5 and cver the emergency rm during thse days. This usually des nt preclude participating in clinics, the OR s, etc., as bth can usually be managed simultaneusly. Students are als expected t pick ne weekend day during their rtatin t cver a 24 hur call perid. If the student has n preference, a weekend day will be assigned t her/him. Students shuld feel free t see patients in the emergency n ther (nn-call) days, as this may represent sme f the best learning and hands-n pprtunities. If a clinical clerk admits a patient she/he shuld make every effrt t fllw this patient thrugh their inpatient stay, pssible perative interventin, pst-perative perid t discharge in rder t maximize the learning value f inpatient plastic surgical care. Residents and staff will supprt and attempt t facilitate this as much as pssible. Hme call WARD ACTIVITIES These are examples f schedules, expectatins, rtatin details, etc. All the details belw are subject t change. Expectatins Prir t starting rtatin, please btain a schedule as this is invaluable in planning yur weeks and knwing where t be at what times. Please page the Plastic Surgery Resident n call prir t starting rtatin t find ut where t meet. Please cntact the apprpriate chief resident and intrduce yurself t Dr. T.E.J. Hayakawa & Dr. L.L. Rss at HSC Dr. A. Islur at SBGH Please liase with the senir resident n the service each mrning at runds fr yur daily instructins. Yur perfrmance, during yur plastic surgery rtatin, will be assessed accrding t the Final Departmental Evaluatin. In additin, yur attendance and punctuality fr runds, clinics and the ORs will be factred int yur evaluatin. Ward Runds Please refer t the schedule fr daily times. Clinical clerks are expected t participate in mrning runds and chse 2-5 patients n the ward wh they will fllw and be respnsible fr. This includes participating in the patient care

6 plan, writing daily prgram ntes, checking labratry values, mnitring prgress, checking and adjusting medicatins, etc. It is nt necessary t see patients prir t mrning runds, as they will be reviewed every mrning with the team. Clinics Clinical Clerks are expected t attend a minimum f 2 clinics a week. Operating Rm We hpe that students will take advantage f a number f OR experiences, including pediatric, minr prcedures, csmetic/private facilities and main OR. Clerks are expected t attend at least ne OR day per week. OR experiences and the emergency prvide the ideal frum fr hands-n teaching and allw the students t develp surgical skills and judgment. They are t attend the perating rms and a minimum f tw clinics/week (assigned t them by the Senir Resident). Weekly Teaching Schedule September June Mnday Ward Runds, H5 (#73775) OR, General Centre (Dr. Hayakawa - #73524) OR, General Centre (Dr. Buchel - #73524) OR, Children s Centre Wks 1 & 3 (Dr. Rss - #72240) OR, Children s Centre Wks 2 & 4 (Dr. Rss - #72240) Children s Lcals, MS3 (Open Wk 1 & 3 - #71292) Clinical Teaching Sessin, Rms. PX236/238, Psychealth Theatre (# ) Seminar Sessin, Rms. PX236/238 Psychealth Theatre (# ) Case Presentatins, Psychealth Theatre (#) fllwed by Jurnal Club (last Mnday f the mnth place t be determined by assigned staffman schedule can be btained frm GC413 Tuesday Ward Runds, H5 (#73775) OR, General Centre (Dr. Buchel - #73524) OR, General Centre (Dr. Hayakawa - #73524

7 Children s OPD Clinic, Unit 3 (Dr. Rss - #72667) Children s OPD Clinic, Unit 3 (Dr. Rss - #72667) Wednesday Ward Runds, H5 (#73775) Pht Runds, Rm. Z3052 St. Bniface General Hspital, Surgical Library # (First 2 weeks f the mnth) McCarthy Club, Rm. GC413 (Last 2 Wks Of The Mnth) Adult Out-Patient Clinic, GD1 (Dr. Hayakawa - #73793) Surgical Grand Runds (when requested by prgram directr) Head & Neck Clinic, Unit 1, Cancercare (Dr. Buchel - #72180) OR, General Centre (Dr. Ziesmann - #73524) OR, General Centre (Dr. Lgsetty - #73524) OR, Children s Centre (Dr. Rss - #72240) Adult Out-Patient Clinic, GD1 (Dr Buchel - #73793) Onclgy/Head & Neck Clinic, Unit I, Cancercare (Dr. Hayakawa - #72180) (Anatmy Sessin nce per mnth) try t schedule same week as Prblem Hand Runds Thursday Ward Runds, H5 (#73775) Adult OPD Clinic Yellw Desk (GD1) (Dr. Rss #73793) Western Surgery Centre (Dr. Buchel - # ) Pan Am OR (Dr. Hayakawa - # ) Adult OPD Clinic RR4 (Dr. Sigurdsn) Nasendscpic Clinic, Unit 2 alternating weeks with Children s Starscanner Clinic (Dr. Rss - #72672) Adult Out-Patient Clinc, GD1 (Dr. Lgsetty - #73793)

8 Ward Runds, CK3 (#74785) Cleft Palate Clinic, Unit 2 alternating weeks with Cranifacial Clinic (Dr. Rss - #72672) Friday Wards Runds, H5 (#73775) Pht Runds, Rm. GC413 (Last 2-3 weeks f the mnth) 0730 end McCarthy Club, Rm. Z St. B. Surgical Library # (First 2 weeks f the mnth) The Maples Surgical Centre (Dr. Buchel/Dr. Rss ) alternating weeks with OR, General Centre (Dr. Buchel/Dr. Rss - #73524 Sample Schedule Mn Tues Wed Thurs Fri 6:00-8:00 Ward runds Ward runds Ward runds Ward runds Ward runds 6:45-7:45- Hand Runds AM Clinic/OR* Clinic/OR* Clinic/OR* Academic Clinic/OR* PM Clinic/OR* Clinic/OR* Clinic/OR* Day Clinic/OR* 16:00-18:00 Teaching Runds