Clinical Clerkship in Surgery

General Surgery A
General Surgery B
Trauma
TDC

Orthopaedic Surgery
Plastic Surgery
Adult Burns
Urology

Transplant
Pediatric Surgery
Thoracic Surgery
Vascular Surgery
Shrine Burns
Neurosurgery

Locations of Clinics

University Hospital Clinic Building (UHC)
Formerly ACC (Ambulatory Care Center)

General Surgery A & B Adult Burns Transplant Vascular Surgery Thoracic Surgery	6th Floor, North Hall
Plastic Surgery	6th Floor, Middle Hall
Orthopaedic Surgery	6th Floor, South Hall
Urology	5th Floor, North Hall
Neurosurgery	7th Floor, North Hall
Pediatric Surgery	Children's Hospital, 1st Floor Clinic
Shrine Burns	Shrine Hospital
TDC	TDCJ Hospital Access from 4th Floor, Old John Sealy

Charting Outpatient Surgical Clinics

For each clinic visit:

Patient's hospital chart

Outpatient clinic notes, including:

• Computer-generated patient specific form
• Outpatient clinic standard form
• Ambulatory care clinic outpatient record
• Breast clinic record
• Billing & diagnosis report form
• Central supply/pharmacy charge sheet

UTMB Problem Summary List
Should be at front of each chart
Update at each visit

Medication Record
Should be at front of chart
Update at each visit

Subjective

• Chief complaint
• History of present problem
• Current medications, prescription and OTC
• Allergies
• Pertinent past medical history

Objective

• Physical examination
• Pertinent to present problem, but not excluding areas suggested by past medical history

Analysis

• Differential diagnosis

Plan - include your impressions in your note and

• Propose a plan

1. Medications prescribed
2. Treatments prescribed
3. Diagnostic tests ordered
4. Description of any diagnostic or therapeutic procedures to be performed during clinic visit
5. Management plans (consultations, etc.)
6. Follow-up plans (return to clinic)

Narrative Notes - Concise but Complete
(Pertinent to Present Problem)

Brief (one page)

Presentation to houseofficer - all patients must be presented and seen by houseofficer.

Signature - Yours and houseofficer, also initial of houseofficer in your logbook.

Evaluation of Each Student Will Consider Each of the Following:

Professional condcut

Appearance

Confidence

Responsibility

• Punctuality
• Follow-through, don't drop the ball

Team Member

Attitude and Motivation

• Enthusiasm
• Willingness to accept responsibility
• Intellectual curiosity
• Active participant
• Seek out next opportunity
• Don't wait for it to come to you
• If you want to improve your clinical skills, ask the nurse

Rapport with Your Patients

Confidentiality

• Entrusted with private or secret matters - patient trust is paramount
• Imparted in secret, told in confidence

The Chart:

• Review only information pertinent to present problem
• Don't allow anyone except appropriate physicians to read the chart
• Don't copy any portion of the chart without permission
• Chain of accountability - ask the nurse about the proper handling of chart and all clinic paperwork

Patient Interview:

• Close the door
• Speak in low tones (the walls are thin, doors may be cracked)

Presentation of Patient Information:

In clinic setting, presentations are performed in the hall in the midst of a plethora of people, most not relevant to your patient

• Speak in low tones
• Do not allow others to eavesdrop
• Do not discuss patient information in any other setting (class, elevators, dining, shopping)

Don't Break the Trust

Don't Expose Your Patient

Clinical Skills

Requirements for evaluation of your clinical skills:

• Logbooks - separate logbook for each rotation
• Evaluation forms

1. Pre-clerkship survey
2. Survey after each rotation
3. Post-clerkship survey

Grades will be based on a review of all of these forms as well as your clinical performance.