The Year 4 Surgical Rotation in the Department of Surgery is the final required surgical rotation in the School of Medicine at UTMB. The Senior Clerkship will be an Acting Internship, which means that students will, as closely as possible, have the same responsibilities as interns on the service. The specific goals and objectives for the Senior Surgical Rotation are detailed below.

GOALS OF THE SENIOR SURGICAL ROTATION:
1. Increase knowledge of care of surgical patients.
2. Improve ability to assess possible surgical problems/emergencies.
3. Improve ability to determine when a surgical consultation is needed.
4. Improve ability to communicate with surgeons.

EXPECTATIONS OF THE SENIOR SURGICAL CLERKSHIP STUDENTS:
1. Assume primary responsibility for a set of inpatients. Duties will include writing orders, developing management and diagnostic plans based upon monitoring of the patient's status and presenting these plans to upper level residents or faculty, and performing such procedures that are appropriate for the intern level of training.
2. Perform primary assessment and evaluation of outpatients in the clinic and other settings followed by presentation of patients. Including diagnosis and a plan of management to upper-level resident or faculty.
3. Take call on the same basis, with the same frequency, and with the same responsibilities as interns.
4. Function as a member of the surgical team with the same hours of responsibility as the house officers, including weekends. This excludes student holidays.
5. Attend the same conferences as the house officers on the team to which they are assigned.

EDUCATION:
Attendance at departmental/divisional grand rounds, morbidity and mortality and other conferences is expected just as it would be for surgical house officers on your service. Attendance at junior medical student lectures is not required but may be attended with the understanding that clinical responsibilities take precedence. Appropriate reading is strongly recommended. An excellent way to reinforce one's own knowledge is to teach others.

EVALUATION:
Senior Surgical Clerkship Students will be graded on Honors, High Pass, Pass or Fail scale. One must receive a passing grade on their clinical evaluation to successfully complete the Senior Surgical Clerkship. To receive a grade of "Honors" or "High Pass" individuals, in addition to receiving an appropriate clinical evaluation score, must submit a scholarly paper that is acceptable to the grading faculty. The details of the grading guideline are described in the table below.

	Clinical Evaluations*	Paper**
Honors††	10 - 12	Required
High Pass	07 - 09	Required
Pass	04 - 06	Optional
Fail†	03 or below	Optional

*An assessment of clinical performance by house officers and faculty based on clinical skills, knowledge and teaching performance; grading scale 1 to 12 [01 - 03 = below required performance (requires supporting documentation from faculty/residents justifying the grade), 04 - 06 = met minimal requirements, 07 - 09 = exceeded expectations, 10 - 12 = outstanding (requires supporting documentation from faculty/residents justifying the grade)]; pass = min. ave. score of 04.
**Each senior student has the option of submitting a paper. The paper will not lower a clinical evaluation grade but may raise a student's overall grade for the clerkship. Also, "Passing" the senior surgical clerkship is not automatic by submitting the paper, nor is receiving and overall grade of "High Pass" or "Honors." Those who choose to do a paper will need to discuss their interests for possible topics with Dr. Gugliuzza or Dr. Chung who will ultimately assigned the paper's topic.
††Honors are usually awarded to 15-20% of the senior class.
† Failing the clinical evaluation regardless of the grade received for a submitted paper means failure of the month long clerkship requiring that the student to repeat the senior surgical clerkship.

FEEDBACK:
Senior Surgical Clerkship Students are expected to participate in the evaluation of junior medical students. In addition, Senior Surgical Clerkship Students will be asked to assess the teaching performance of the house officers and faculty with whom they work with. There will be a mandatory debriefing session with Ms. Stephanie Aleman at the end of the month for all Fourth Year Surgical Students.

Problems or questions? Contact Dr. Higgins (x77350) mihiggin@utmb.edu, Dr. Gugliuzza (x26559) kgugliuz@utmb.edu, Dr. Chung (x22307) dhchung@utmb.edu or Dr. Kimbrough (x21201)