School of Medicine
University of Patras
>University of Patras
HQA
Undergraduate Courses

Surgery (Clinical Training I)

Semester 9th & 10th ()

Hours Teaching 0 hours, Laboratory 0 hours, Tutorial 0 hours , Clinical Training 35 hours (per week)

Teachers

Description

The clinical training of students in Surgery is taking place both in the 5th and 6th year and lasts 8 weeks in the 5th year (including the clinical training in anesthesiology - intensive monitoring and Orthopaedics) and 6 weeks in the 6th year.

The main objective of the clinical training of students of the 5th year, is at the end of the training to feel that they are able to undertake the access and identification procedure of the surgical problem of a patient.

The practical application of achieving this goal which will also be the culmination of undergraduate surgical education of the student, will be in the responsibility of an assistant that the student will take during the clinical training in the 6th year.

Achieving this goal is a bidirectional concept and it is based on the effort of both the trainer and the trainee.
The instructor is academically obliged to help the student in order to be able to handle scientifically well and responsibly the problem of the patient. This procedure is performed on one hand with lessons- discussions in small groups referred to the most common surgical problems (diagnostic approach, differential diagnosis and therapeutic approach are taught) and on the other hand by applying the above to clinical practice, namely to the patients hospitalized in the clinic, with various surgical problems.

The process of this interactive educational effort, in order to achieve the above objective, is based on a specific training program, which has theoretical and practical parts.

Α. Theoretical part

Courses focused on the clinical problems of hospitalized patients in the Surgery Clinic:

  1. Upper – lower digestive system bleeding
  2. Fluids - electrolytes
  3. Ileum
  4. Colon cancer
  5. Liver- biliary – pancreatic cancer
  6. Investigation of thyroid nodule
  7. Surgical treatment of the clinically severe obesity
  8. Jaundice
  9. Acute surgical abdomen
  10. Breast lumps investigation
  11. Hypovolaemic shock
  12. Embolism – limbs thrombosis
  13. Acute pancreatitis
  14. Surgical treatment of type II diabetes and metabolic syndrome
  15. Solid organ transplantations
  16. Acute thorax

Β. Practical part, that aims to:

  1. Physical examination, proper learning and execution.
  2. The collection of reliable information and data from patients with skillful efficient and effective manner.
  3. The writing of a form of a medical history with diagnostic plan, choice of laboratory tests and choice of therapeutic methods

Reading Material

​Clinical training curriculum for the students of the 5th year.

The clinical training is mandatory and in accordance with the decision of the Department, only two justified absences are allowed.

  • Students’ arrival time is 8:00 p.m. From 8:00 p.m. to 8:30 p.m. they watch both of the departments of their clinic. Students of the 6th year and the interns are collecting blood samples; scheduling examinations on patients and preparing the medical history of the patient for the morning round.
  • 9.00-10.30: Watch and participate in the clinical visit in both of the departments of the clinic with the department head, the interns and the students of the 6th year. In this clinical visit the students of the 5th year will be taught physical examination in specific surgical diseases and the preoperative preparation and postoperative monitoring.
  • 11-13.00: The students with the students of the 6th year and with the interns participate in medical history taking and in the clinical examination of new patients.
  • 13.00-14.00: Lesson.
  • Then, the students watch in both of the departments of the clinic the interns and the students of the 6th year preparing patients to be operated the following day.

At the end of the course only the students on call stay in the clinic. Student participation in the call of the clinic is considered to be mandatory. Specifically there are 2 students of the 5th year in the general call and 2 of them in the internal call, according to a program drawn up at the beginning of the two months period. The call is mandatory and students on duty must remain in the hospital until 11p.m. in the general call and by 9 in the internal call.

The students’ presence is mandatory in the advanced courses of the clinic that are taking place once a month, in the Auditorium of the Hospital.
 
Educational objectives in clinical training of the students of the 5th year in Orthopaedics.

The student must be able to:

  1. Recognize the clinical presentation of emergency orthopaedic cases and managed them appropriate.
  2. Apply casts, dressings and splints and to know their usage and complications.
  3. Recognize the clinical signs of orthopaedic soft tissues, joints and bone infections. He/she must be able to start immediate therapy and order the appropriate laboratory and imagine tests. 
  4. Interpret and understood the radiological signs of fractures and degenerative diseases in orthopaedics. 
  5. Perform a thorough clinical examination and comprehensive history taking for orthopaedic diseases in the past. To explain the problem to the patient and his or her relatives. To cooperate with the rest medical and nursery stuff of the clinic.
  6. Attend basic surgical procedures in the OR and discuss the approach and management with the consultants.
  7. Actively participate in the on call rota at the A & E Department under the supervision of specialist registrars and consultants.
  8. Participate in the regular outpatient office of the clinic where he/she will be able to examine the patients, interpret the x-rays and to follow up the patients who have been operated.

Εducational objectives of the clinical training in Intensive Care of the students of the 5th year

During the practice in the Intensive Care Unit the students will acquire basic knowledge in the following subjects:

  1. Support of the airway in critically ill patients and practice in advanced cardiopulmonary resuscitation.
  2. Forms of oxygen- therapies.
  3. Assessment of priorities for therapeutic interventions in patients with multiple problems.
  4. Monitoring (namely continuous monitoring and recording of vital functions): respiratory, circulatory, CNS, renal function etc.
  5. Assessment of critically ill patients and treatment planning per system:
    • Respiratory
    • Cardio - circulatory
    • CNS (Traumatic brain injury treatment, Glasgow Comma Scale(GCS), ICP monitoring , Αnalgesia, Sedation)
    • kidney (and acid-base balance disorders)
    • Liver, biochemical disorders
    • Infection, Sepsis, Antibiotic treatment
    • Gastrointestinal (includes diet and gastroprotection)
  6. Systems of assessment of critically ill patients (scoring systems, such as  APACHE-ΙΙ, SOFA, SAPS, TISS etc)
  7. Triage and criteria for introduction to the ICU.
  8. Ventilation mechanism (invasive and noninvasive)
    • Indications – Contra-indications
    • Methods
    • Respirators
      Weaning
  9. Metabolic and electrolyte disorders
  10. Αddressing the multiple trauma patient in the ICU with or without concomitant traumatic brain injury
  11. Systemic inflammatory response and sepsis
  12. Disinfection, prevention and treatment of infection
  13. Patient with brain death in the ICU – organ donors and recipient
  14. Τechnological issues: Respirators, Electrical safety, Ultrasounds etc.

Exercise evaluation

At the end of the clinical training the students of the 5th year are graded by the trainers.