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Surgery Clerkship – Fourth Year (MS4)

SURG 545 (Alpha) – Electives in Surgery

Advanced clinical experience in:

SURG 545-B | Urology
Objectives:

This block of instruction is designed to give the student an added exposure to the field of urology. This will be an experience on a broader and more involved plane than the student was exposed to in his/her third year yet will still be given with the premise that the student is seeking either knowledge in this field to perform more effectively as a ‘generalist’, or as an introduction to a potential career in urology

Program Coordinator: D. Gary, Lattimer, MD

SURG 545-C | Opthalmology
Objectives:

This block of instruction is designed to give the student an added exposure to the field of ophthalmology. This will be an experience on a broader and more involved plane than the student was exposed to in his/her third year yet will still be given with the premise that the student is seeking knowledge in this field in order to perform more effectively as a “generalist” and is not necessarily interested in ophthalmology as a career.

Program Coordinator: Greg Kokame, MD

SURG 545-D | Otolaryngology
This block of instruction is designed to give the student an added exposure to the field of otolaryngology. This will be an experience on a broader and more involved plane than the student was exposed to in his/her third year yet will still be given with the premise that the student is seeking knowledge in this field in order to perform more effectively as a “generalist” and is not necessarily interested in otolaryngology as a career. The elective would also be suitable for students who are contemplating going into the field of otolaryngology and would give them an opportunity to interact and get counseling from the preceptor(s) on how to achieve those objectives.

Program Coordinator: Daniel Alam, MD

SURG 545-E | Plastic Surgery
Objectives:

The students should accomplish the following at the end of their rotation:

1. Know how to suture wounds in a professional manner independently.

2. Know how to place simple and more complex stitches: simple interrupted skin sutures, interrupted intradermal sutures and running intradermal sutures.

3. Know the indications for use of different suture materials.

4. Understand how to perform suturing in a most efficient manner.

5. Know how to handle tissues during surgery and minor surgical procedures with least trauma.

6. Know how to obtain hemostasis with least damage to surrounding tissues.

7. Know the no-touch techniques when inserting foreign devices into patients.

8. Know how to perform procedures as an outpatient under local anesthesia.

9. Know the indications for intravenous sedation and how to perform procedures under light sedation.

10. Know how to diagnose common skin tumors such as BCC, Squamous cell carcinoma and Melanoma.

11. Know the classification of Melanomas.

12. Know how to diagnose and treat hand’s nerve and tendon injuries.

13. Know how to diagnose and treat various facial fractures.

14. Know the principles of breast reconstruction after mastectomy.

15. Know the principles and indications of various aesthetic surgical procedures.

16. Know how to manage minor burns and wounds as an outpatient.

17. Learn the techniques of microsurgery under a microscope if interested.

Program Coordinator: F. Don Parsa, M.D.

SURG 545-F | Neurosurgery
Program Objectives:

This block of instruction is designed to give the student an added exposure to the field of neurosurgery. This will be an experience on a broader and more involved plane than the student was exposed to in his/her third year yet will still be given with the premise that the student is seeking knowledge in this field in order to perform more effectively as a “generalist” and is not necessarily interested in neurosurgery as a career.

Program Coordinator: William Obana, MD

Surg 545-G | Orthopedics
Objectives:

This block of instruction is designed to give the student an added exposure to the field of orthopedics. This will be an experience on a broader and more involved plane than the student was exposed to in his/her third year yet will still be given with the premise that the student is seeking knowledge in this field in order to perform more effectively as a “generalist” and is not necessarily interested in orthopedics as a career.

Program Coordinator: Kyle Mitsunaga, MD

Surg 545 H | Anesthesia
Objective:

The student will be able to recognize and describe basic aspects of general and regional anesthesia. He/she shall be able to demonstrate basic skills such as bag-mask controlled respiration, insertion of airways, application of monitoring aids, and will be able to calculate various drugs and fluid dosages.

Program Coordinator: Jason Isa, MD

SURG 545 I | SICU
Objectives:

This clerkship will consist of a four-week experience as a member of the Surgical Intensive Care Service, providing cardiopulmonary care and life support to pre- and post-operative patients. Under supervision, the student will learn hemodynamic monitoring, pulmonary pathophysiology and ventilator management, renal dysfunction, nutritional support, and treatment of all types of shock: septic, hemorrhagic, neurogenic, and myocardial shock. The goal of this rotation is to transform a fourth-year medical student into a functional resident able to handle life-threatening situations.

Program Coordinator: David Inouye

SURG 545 J | General Surgery Sub-I
Objectives:

This clerkship consists of a 4-week experience on a busy Surgical Service in one of the participating hospitals. The major objective is to provide the student with additional experience in the surgical disciplines concomitant with graded responsibility (commensurate with the level of competency) beyond that of his/her third-year experience.

Program Coordinator: Susan Steinemann, MD

SURG 545 K | Pediatric Surgery Sub-I
Objectives:

This clerkship consists of a 4-week experience on a busy Surgical Service in one of the participating hospitals. The major objective is to provide the student with additional experience in the surgical disciplines concomitant with the graded responsibility (commensurate with the level of competency) beyond that of his/her third-year experience.

Program Coordinator: Walton Shim, MD

SURG 545 M | Diagnostic Radiology
Objectives:

1. To gain practical experience and basic knowledge in the multiple facets of diagnostic radiology to include:

a. Relationship of radiological changes to pathology and clinical findings.
b. Selection of the most cost-efficient diagnostic modality for radiological examinations.
c. Familiarization with special equipment in diagnostic radiology.
d. Familiarization with special procedures in diagnostic radiology including all fluoroscopic and angiographic procedures, nuclear medicine, ultrasound, CT and MRI scanning.

2. To review current as well as selected teaching cases in the various disciplines of diagnostic radiology.
Program Coordinator: Joan Kendall, MD

SURG 545 | N Radiation Oncology
Objectives:

To provide practical experience in clinical evaluation, diagnostic work-up, treatment, and follow-up techniques in patients with cancer.

Program Coordinator: Joh L. Lederer

SURG 545 P | Extramular Activity (Away)
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SURG 545 Q | Cardiovascular Sub-I
Objectives:

This block of instruction is designed to give the student an added exposure to the field of cardiovascular surgery. This will be an experience on a broader and more involved plane than the student was exposed to in his/her third year yet will still be given with the premise that the student is seeking knowledge in this field in order to perform more effectively as a “generalist” and is not necessarily interested in cardiovascular surgery as a career.

Program Coordinator: Elna Masuda

SURG 545 R | Surgical Research
Objectives:

1. To familiarize the student with the design and execution of clinical research studies, including study design, data collection/chart review, database setup, and statistical analysis.

2. To provide the student with an opportunity to produce and present research at the national level.

Program Coordinator: Chad Cryer, MD

SURG 545 T |Preceptorship in Asia
Objectives:

To expose students to the practice of surgery or its subspecialties in Asia and to compare this to practice in the US and specifically in Hawaii.

Program Coordinator: Chad Cryer, MD

SURG 545 X | Transplant
Objectives:

By the end of this rotation, students will be expected to be able to:
• List indications for transplantation of the solid organs (kidney, liver, pancreas, heart).
• List contraindications to solid organ transplant.
• List contraindications to organ donation.
• Describe the national system for organ sharing (UNOS).
• Outline the process of transplant evaluation and identifying appropriate candidates.
• Describe anatomy pertinent to the transplantation of solid organs.
• Name commonly used transplant immunosuppressive medications and their mechanisms of action and side effects.
• List common complications after solid organ transplant, both short term, and long term.

Program Coordinators: Alan Cheung, MD and Linda Wong, MD

SURG 545 Y | Ultrasound
Objectives: Objectives

By the end of this 2-week rotation, the student will be:
• Familiar with basic ultrasound (US) physics
• Familiar with the nomenclature used in image acquisition and interpretation
• Be knowledgeable with the appropriate applications for patients in the ED setting
• Be able to perform the following basic US imaging studies:
• FAST exam (and extended-FAST)
• Hepatobiliary
• Renal
• Limited echocardiography
• Pelvic/obstetric
• Aorta
• IVC volume assessment
• Procedural
• Be aware of the limitations of US and when formal radiology ultrasound study is advised

Program Coordinator: Gregory Suares, MD

SURG 545 Z | Laparoscopic
Obejectives:

1. To understand the general principles of laparoscopic surgery prior to entering general
surgery residency including the following: equipment selection, the effect of
pneumoperitoneum on cardiopulmonary physiology, systemic carbon dioxide absorption,
venous gas embolism, and risks of intraabdominal organ injury.

2. To develop and become proficient in laparoscopic technical skills in a laboratory setting.
Attainment of this skill level would facilitate successful completion of tasks outlined in
the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES)
laparoscopic certification program, Fundamentals of Laparoscopic Skills (FLS).

Program Coordinators: Cedric Lorenzo, MD; Dean Mikami, MD; and Kenric Murayama, MD

Visiting Students
JABSOM invites and accepts visiting students for elective rotations during the senior academic year only from LCME (or AOA) accredited U.S. and Canadian medical schools on a space available basis. For more information, please visit this page

For more information, please view our curriculum guide found under student resources.

Contact:

Nicole Stenstrom
Surgery Clerkship Coordinator
Department of Surgery Clerkship
Phone: 808-586-8236
Fax: 808-586-3022
Email: surgclrk@hawaii.edu

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