General Surgery

Goals and Objectives

General Objectives

  • The following EPAs pertain to clinical rotations during the first year of training
  • Foundation EPA #3: “Assessing patients and integrating clinical information in the evaluation of disease processes”

The following conditions must be met:

  • Direct observation and/or case review by supervisor and can consist of direct observation of history; direct observation of communication with patients; case discussion or chart review
  • Collect at least 10 observations of achievement
  • At least 2 of each type of observation listed above
  • At least 2 each for medicine, surgery, oncology, and pediatrics
    • For the PGY1 AP resident completing EPAs during their General Surgery rotation, ensure you select “surgery” for this EPA.
  • At least 1 assessment from a staff supervisor in each setting
  • Core EPA #18A: “Participating in direct patient care activities that highlight clinicopathological correlation”
    • Part A: Clinical setting
      • Direct observation and/or case discussion by supervisor, this may include clinicians, pathologists, or senior trainees (TTP residents, fellows) in clinical or pathology disciplines
    • Setting: cancer clinic; colposcopy clinic; endoscopy clinic; dermatology clinic; genetics counselling; other
    • Collect 3 observations of achievement
    • At least 2 different clinical settings

The PGY1 Anatomical Pathology  resident is expected to:

  • Be assigned to the colorectal team, breast team or hepatobiliary team in order to completely fulfill the specific objectives of the rotation.
  • Cover the pager of the acute care surgery team when on call or if not engaged in activities with the other teams.
  • Understand the medical problems related to underlying diseases that he/she will be required to diagnose.
  • Enhance communication and collaboration between the pathologists and their clinical colleagues.
  • Respect  the  CanMEDS  roles  as  set  by  the  Department  of  General  Surgery  and Anatomical Pathology

Specific Objectives

Medical Expert

  • Demonstrate the ability to perform a focused history and physical exam pertinent to the patient’s presenting illness.
  • Present cases in a clear, concise, integrated, and problem-based manner.
  • Demonstrate the appropriate diagnosis and management of patients with: appendicitis, small bowel obstruction, cholecystitis, acute abdomen/free air, diverticulitis, pancreatitis, lower GI bleed, perianal abscess, breast  cancer,  esophageal  cancer, gastric cancer, colon cancer, rectal cancer, liver cancer, and pancreatic cancer.
  • Develop an appreciation for the role of pathology and imaging in aiding in the diagnosis of various pathologies.
  • Attend the colorectal and/or breast clinic. Through clinical practice with staff and/or senior resident surgeons:
  • Develop an understanding of guidelines and indications for screening for GI and breast malignancies.
  • Develop an understanding of risk factors and prognostic factors for GI and breast malignancies.
  • Spend sufficient time in operating room
  • Participate in surgical procedures.
  • Learn the basis of the surgical techniques: indications, benefits and complications.
  • Identify the surgical margins on the fresh specimens.
  • Learn the rules of tissue fixation.
  • Participate in the frozen sections when indicated.
  • Further to this, the resident should develop an understanding of the multidisciplinary approach to cancer care, including surgery, radiology, pathology, chemotherapy, and radiotherapy.

Communicator

  • To understand the importance for a clinician of a clear and concise pathology report.
  • Establish therapeutic relationships with patients/families.
  • Obtain and synthesize relevant history from patients/families/communities.
  • Listen effectively.
  • Discuss appropriate information with patients/families and the health care team.

Collaborator

  • To understand the importance of a pathologist’s report in the management of patients.
  • To understand the questions that a pathology report may generate and the importance of being able to communicate physician to physician for clarification.
  • To understand the role of the pathology report along the continuum of patient investigations (eg breast ultrasound, mammography, biopsy, resection).

Manager

  • To gain an understanding of the various laboratory requisitions that a physician must be familiar with in order to appropriately access laboratory medicine services.
  • To understand the various transport media which practitioners routinely have in their offices.
  • To understand the role of specimen collection and processing in the context of quality control and quality assurance (eg. importance of proper and immediate labeling of specimen when collected).
  • To gain an understanding of the handling and disposal of hazardous materials within a surgery clinic.

Health Advocate

  • To identify the important determinants of health affecting patients.
  • To understand the role of the physician as a health advocate, including their role to provide population screening and preventative health.

Scholar

  • To implement a strategy for critically appraising sources of medical information.
  • To facilitate the learning of patients, staff and medical learners regarding the role of a laboratory medicine professional and available educational resources.
  • To understand the value of laboratory medicine education for practitioners in regards to ancillary tests. (eg guidelines for fasting bloodwork, consider flow cytometry if lymphocytosis)
  • To understand the guidelines regarding the frequency of screening tests containing a laboratory medicine component (eg. stool for fecal occult blood, pap tests, serum lipids).
  • To view the clinical presentation of disease entities.
  • To understand obstacles that physicians may face in obtaining sample material.
  • To learn the management of various disease entities including both surgical modalities.

 

Updated April, 2022

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