Clinical and academic staff from the Discipline of Surgery

The course timetable is available in the Course Handbook. As students undertake their placements at different hospitals and in different clinics, timetables will vary. Students are advised to consult the Course Handbook for details regarding the weekly tutorial program, end of rotation assessments and discuss with their allocated team what their particular timetable and activities are. This information should be obtained from interns and/or registrars on the allocated team.

Learning Outcomes
The SHU clinical attachments provide first hand experiences in how surgical patients are managed. From this experience, students are expected to expand their knowledge base, develop clinical competence and learn and model appropriate professional attributes.



Aim
Students are required to demonstrate effective cognitive, psycho-motor, behavioural and affective skills in assessing and managing patients with surgical presentations.



Outcomes
Students are required to develop clinical skills in the following areas;

1. History taking
2. Physical examination
3. Developing a management plan
4. Case presentation


Regarding physical examination, students are expected to be able to undertake an examination of the following body regions and systems.

- Head and neck
- Breast and axilla
- Skin and subcutaneous lesions
- Abdomen
- Groin, scrotum, perineum
- Neurovascular assessment of limbs including hands


Key Learning Outcomes
The student should be able to,

Take a history – enquire about clinical symptoms and signs; assess for co-morbidities and risk factors; demonstrate patient-centred communication skills; adopt an orderly, comprehensive and focussed approach
Perform a physical examination – obtain consent; adopt an orderly and systematic approach; appropriately and correctly elicit symptoms and signs; ensure patient safety, dignity and comfort; perform hand hygiene and take universal precautions
Weigh up available information to provide a likely condition or diagnosis
Identify the spectrum of presentation for a given condition or diagnosis
Justify a list of differential diagnosis
Refer to an appropriate evidence-base and understanding of theoretical knowledge to explain clinical reasoning
Explain associated anatomy and pathophysiological processes and how this links to clinical presentation
Identify and quantify aetiological, predisposing and risk factors
Select and explain reason for relevant investigations as it relates to diagnosis and management
Interpret results of investigations and explain how this relates to the diagnosis
Describe key principles of an appropriate management plan including treatment options
Anticipate and describe expected desired and adverse outcomes of management, referencing prognostic factors of outcome
Present clinical information in a structured, orderly and concise manner
Discuss clinical problems in a coherent and sensible manner – provide rational explanation for opinions and decisions
Discuss certainties and uncertainties of assessment and management
Document patient assessment and management in a contemporaneous, coherent, concise, structured and ordered format
Identify and access appropriate resources to gain knowledge and understanding of clinical presentation
Reflect on cognitive, behavioural and affective performance – self-identify what was done well and why, what should be done differently and how


Core Surgical Topics
Students are advised to review the Surgical Syllabus.pdf document for the SHU Course. This outlines core topics in which students are to demonstrate a coherent understanding of related information and concepts, which can then be applied to surgical practice.

Not applicable

* Essential Surgery. Burkitt HG, Quick CRG, Reed JB. Fourth Ed. Churchill Livingstone. 2007
* Clinical Problems in Medicine and Surgery. Devitt PG, Mitchell J, Hamilton-Craig C., Elsevier. Edinburgh. 2011. www.fleshandbones.com
* Textbook of Surgery. Tjandra JJ, Clunie GJA, Kaye AH, Smith JA. Blackwell Publishing. 2006

http://www.emedici.com: this site contains the online case studies. To gain access to the eMedici cases go to www.emedici.com. Please register there to gain access to your cases. Details of many of the problems, topics and diseases with which the graduating student is expected to have a clear understanding with respect to their recognition and principles of management can be found in the eMedici modules.

Learning Opportunities
As a guide, students should aim to have significant interactions with at least five new patients per week throughout their 9-week clinical placement. This can be achieved by the following activities;


- seeing in-patients
- participating on ward rounds
- observing on consults
- attending outpatient clinics
- attending pre-admission clinics
- attending peri-operative high-risk clinics
- attending anaesthetic high-risk clinics
- participating on on-call to see acute patients
- attending operating lists


Patient interactions and participation in unit activities should be recorded in the logbook that forms part of the assessment ward reports.



Other learning opportunities include;

- multi-disciplinary meetings
- unit and, or hospital-based tutorials
- online resources within CANVAS


It is important that during the 9-week attachment students take the initiative to seek exposure to a broad range of surgical problems. Even when students have rotations to two units, it is unlikely that the full spectrum of surgery will be seen within the confines of the allocated units. It is therefore appropriate that students seek learning opportunities offered by other surgical clinics at the hospital to which they are attached. For example, attendance at a Breast or ENT clinic will provide a valuable learning opportunity for students who might not otherwise see patients with such presentations during their nine-week attachment. A request to the Consultant or Registrar running a particular out-patient clinic will generally be met with a positive response.



The RAH, TQEH, LMH & MPH deliver weekly hospital-based tutorial programs aligned to the course syllabus. These are typically face-to-face, small group, interactive sessions over 60 to 90 minutes. Students will be forwarded information on the program.



For students at Rural Surgical Units, a weekly virtual tutorial program will be delivered via Zoom. The 60 to 90-minute session will be facilitated from Whyalla Hospital and will include students from all rural sites. Students will be forwarded information on the program.

Workload for the individual students will vary from week to week but students can assume that on average they will work a 45 hour week which will include clinic sessions, lectures (both delivered and online), seminars, tutorials and private study but does not include after hours call.

See Learning & Teaching Modes above

It is an MBBS entry requirement to obtain a police checks as set out in letters of offer to prospective students. Other requirements will be advised at the start of the course.

Assessment requirements

Assessment Task	Assessment type	Percentage	Hurdle?
Mid-term logbook & ward report	Summative	20%	No
End-term logbook & ward report	Summative	20%	No
Case study write-up	Summative	20%	No
MCQ examination	Summative	40%	No

It is the student's responsibility to ensure completed logbooks with ward reports and case study write up are submitted via MyUni by the due dates. Marks will not be credited if assessments are not submitted by the due date.


To pass this course and the Fourth Year MBBS Examination Annual Examination Part 2 course, students must obtain:

•    a satisfactory result in each of the components of the summative assessment in semesters 1 and 2; and
•    a satisfactory performance in the examinations overall

If an overall borderline grade is achieved in the examinations, a student may be offered an opportunity to sit a Replacement/Additional Assessment examination.

Academic Progression Requirements
Progression from one year to the next in the MBBS is dependent on the student successfully completing a compulsory annual examination course in which a full year’s learning is assessed.

To successfully complete the MEDIC ST 4000AHO and MEDIC ST 4000BHO Fourth Year MBBS Exam Part 1 and Part 2 courses, the student must pass the end of year examinations and have successfully completed all year level component courses (24 units).

IF a student fails the compulsory examination course no passing grade will be received for any core medical studies courses.

IF a student has not completed all required MEDIC ST units of the year they must successfully complete an appropriate remedial course of the same or greater value as specified in Term 4 of the same academic year.

It is compulsory for students to attend clinical placements and their specific activities in line with the principles and guidelines outlined in the Medical Student Clinical Hours document.

Exemptions to mandatory clinical placement attendance requirements may be granted by the Program Coordinator in consultation with the relevant course coordinator and year level advisor if there are exceptional medical, compassionate or extenuating circumstances as defined by the Modified Arrangements for Coursework Assessment Policy.

In addition, the University has developed a Scope of Practice document which outlines appropriate activities for Year 4 students. Students should be familiar with this document, and adhere to its guidelines. The document can be found in MyUni and here.

Assessment Task	Task Type	Due	Weighting	Learning Outcome
Mid-term logbook and ward report	Summative	Med Term	20%	1,2,13,14,15,16
End-term logbook and ward report summative	Summative	End of Term	20%	1,2,13,14,15,16
Case Study Write Up	Summative	End of Term	20%	3,4,5,6,7,8,9,10,11,12,13,17,18
MCQ examination	Summative	End of Term	40%	3,4,8,9,10,11,12

Electronically via MyUni.

MEDIC ST 4016BHO

Grades for your performance in this course will be awarded in accordance with the following Grades for your performance in this course will be awarded in accordance with the following scheme: GS4

GS4

Grade	Description
NGP	Non-Graded Pass
S	Satisfactory
U	Unsatisfactory
F	Fail

In addition, students will receive a banded result upon completion of their attachment.

Five bands are available to determine the assessment in fourth year of MBBS.  The Bands available for determining student performance are:
A  Above expected competency for Year 4
B  Clearly at expected competency for Year 4
C  Just reaches expected competency for Year 4
D  Below expected competency for Year 4
E  Far below expected competency for Year 4        

Any submission details will be outlined at the beginning of the attachment.

The MBBS Program has a regular program of evaluation.  In addition, student representatives are appointed to MBBS committees and are encouraged to report on issues of importance to students.

Students may access the University Health Practice, 61+ 08 83135050
http://www.adelaide.edu.au/student/health/
The MBBS Program website has details on Student Well-being resources which can be accessed.

Please read the MBBS Program Code of Conduct