SURU-4064 - Clinical Oral Surgery

SURU-4064 - Clinical Oral Surgery

Elective Title: Clinical Oral Surgery
Course Number: SURU-4064
Elective Type: clinical Duration/Weeks: 4 Max Enrollment: 1
Prerequisites: Successful completion of Year 2
Additional Requirements: N/A
Responsible Faculty Director: Dr. Hisham Marwan Periods Offered: 1-13 including holiday period 8 
Coordinator: Amy White Other Faculty: Dr. Jeffery Garcia; Dr. Camilo Mosquera
Location to Report on First Day:
6th Floor John Sealy, OMFS Rooms

1. To manage common Oral Surgery/ENT/Facial plastics problems that are encountered in an oral surgery practice 2. To identify patients that require prompt referral for effective management and cure (e.g., osteonecrosis of jaw, unerupted teeth, intracranial complications, cancer of mouth, Head&Neck Trauma).

At the completion of a two-week elective the student should be able to: 1. Obtain and evaluate the history of a patient with symptoms of disorders of the mouth, trachea, and face. 2. Perform a thorough examination of the above structures. 3. Evaluate and institute the appropriate treatment for the common causes of pain and discharge of the face, mouth, or neck. 4. Evaluate and institute the appropriate treatment for the common causes of dysphagia, pain or discomfort in the throat, lumps on the face and obstruction to the airway. 5. Evaluate and manage trauma of the head and neck regions (e.g., ingestion of foreign bodies, facial fractures, open and closed injuries to the jaw).

Description of course activities
Students will attend clinic daily as assigned M-F and TDC clinic where students participate in patient care. Students should read about clinical entities seen during each clinic day and about those discussed in conferences. There will also be teaching conferences for which attendance is required. Students may also be assigned to see hospital consultations with the consult resident. Students will also get the opportunity to scrub in on cases with residents and faculty where they will be tested on anatomy knowledge. Students will also help with any ongoing research projects and help write notes for the residents for practice.

Type of students who would benefit from the course
All types of students, especially those intending a career in oral surgery, ENT, or Facial Plastic surgery.

    Weekly Schedule
          Estimated Course Activities (Start-Time/Finish-Time):
Day of Week   AM   PM
Monday 7:00 5:00
Tuesday 7:00 5:00
Wednesday 7:00 5:00
Thursday 7:00 5:00
Friday 7:00 5:00

 Average number of patients seen per week: 40
 Call Schedule: Optional

Research / Other Course Activities
(estimated schedule)
Activity Hours per Week
Faculty Contact-Time
Self-Directed Study

Method of Student Evaluation
1.  Clinical Observation
  A. Where are students observed on this elective?
    Inpatient Service   Ambulatory   Surgery   Standardized patients
Patients simulators   Other
  B. Frequency - How often are students observed clinically?
  C. Format - What method(s) are used to document the student's clinical performance?
    Daily oral feedback   End of period oral feedback   Written feedback

2.  Oral Presentation
  A. Audience - To whom does the student present?
  B. Frequency / Duration of Presentation(s)?
    2 cases per week
  C. Format - What guidelines are set for the student's presentation?
    Normal progress note length
  D. Assessment - Who assesses the student's presentation performance?
    Self-assessment   Peer assessment   Faculty assessment
  E. Method of content selection
    Current cases  Student-selected topic   Assigned topic

3.  Written Assignment (H&P's, notes, papers, abstracts, etc.)
  A. Frequency of written assignment(s)?
    Daily per patient
  B. Format - What guidelines are set for the student's written work?
    Progress notes, resident will review how it is done on day 1
  C. Length of written assignment(s)?
    Abstract   Annotated bibliography   1 - 2 page paper   3+ page paper
  D. Are recent references required?   No    If yes, how are they selected?
    Normal progress note length
  E. Method of content selection - e.g. student-selected, relate to cases, etc.?
    student selected or related to cases
  F. Audience - Who assesses the student's written performance?
    Peer Assessment     Faculty Assessment     Other

4.  Examination
    Oral   Written multiple choice   Written essay / short answer   OSCE

5.  Extra Course Activities
  What expectations do you have for the student to demonstrate participation in the elective (e.g. small group activities, seminars, thoughtful questions, providing resources, journal club, resident lecture attendance)?
    We expect the students on this rotation to participate fully with all the activities of the department. This includes didactic sessions for the residents and departmental wide conferences like M&M and Grand Rounds.

6.  Additional Costs
  Please list any additional costs and/or purchases (books, materials, movies to watch, etc.) that are required for this course. Include an estimated total cost. If there are no additional costs, please enter "None".

7.  Other Modes of Evaluation
  Please explain below.

8.  If this course is an Acting Internship, please complete the following:
  A. Objectives for the AI should relate directly to the Entrustable Professional Activities (EPAs). Each AI should describe how the four key Year-4 EPAs that our school has identified as being Year-4 skills are assessed. The Year-4 objectives are:
1. Entering and discussing orders/prescriptions.
2. Give or receive patient handover to transition care responsibility.
3. Recognizing a patient requiring urgent or emergent care and initiating management.
4. Obtaining informed consent for tests and procedures.
Specify how the student will be given formative feedback on their clinical skills.

Year-4 students should demonstrate mastery of EPAs they developed in the clerkship year, including recommending and interpreting common diagnostic and screening tests, and performing general procedures of a physician. They should be able to demonstrate masterfully and independently skills they mastered in Years 2-3, including efficiently performing comprehensive admission-notes and succinct daily progress notes and perform accurate, concise, and hypothesis-driven clinical presentations, form clinical questions and retrieve evidence to advance patient care. They should be able to demonstrate basic understanding of and beginning mastery of collaborate as a member of the interprofessional team and identify system failures and contribute to a culture of safety improvement.

List advanced clinical skills that a student will be assured an opportunity to practice.

How specifically will this AI build on developing skills from the clerkship year to prepare students for internship?

What opportunities will typically be available to all students who take this AI (procedures, required presentations, etc.)? What opportunities may be available based on patient load/presentation or student initiative (ie. Writing a case report)?

An AI should have expectation of a minimum of 32 hours per week of clinical responsibilities. Duty hours should be capped at ACGME limits for an intern, thus up to 24 hours followed by 4 hours of activities related to patient safety, education, and handoff. Students cannot work more than 80 hours per week averaged over 4 weeks. They can only have 1 day off in a 7-day work week with 8 hours off between shifts.

Clinical responsibilities will vary depending on specialty, but how is the student functioning with work commensurate to a PGY1 with an appropriate level of training?

How is the student demonstrating drawing clinical conclusions and/or developing a management plan and documentation as an intern would do?

How and by whom will midpoint feedback be provided to the student? How will you remediate deficiencies identified at midpoint?

Acting Internship students often seek letters of recommendation following their experience. How many different Faculty will work directly with the student and have knowledge of the student's abilities to detail in a written evaluation? Describe the degree of supervision and interaction with faculty vs. residents or other providers and how feedback will be obtained if more direct work is with residents or other providers.