The purpose of undergraduate surgical education is to prepare the medical student for residency and the practice of medicine. Because there is greater emphasis on primary care in medical school today, the time allotted to the study of surgery has diminished greatly in recent years. More than ever the third year surgical curriculum must address the diagnosis and treatment of the most common surgical diseases. Students spend much of the fourth year of medical school in a variety of elective and selective clerkships which do not focus on general surgery or surgical specialties. Because many students will never focus on surgery after the third year surgical clerkship, the content of the surgical curriculum becomes critical. Senior medical students will take one inpatient and one outpatient selective rotation for academic requirements and these rotations may not be in a surgical discipline. The surgical curriculum must emphasize fundamental surgical concepts for students who seek nonsurgical residencies. Students who do not pursue surgical careers must have a fundamental understanding of the goals, risks and limitations of surgical care, in order to provide surgical options to an informed patient.
For those students interested in surgery, the third year clerkship will provide:
- broad exposure to surgery and surgical subspecialties,
- intellectual stimulation in a dynamic, evolving field
- dedicated surgical role models
The goals of the third year surgical curriculum should be divided into seven categories:
- sound knowledge of basic surgical principles,
- proficiency in simple surgical skills,
- ability to care for surgical patient in the inpatient and ambulatory setting,
- interpersonal relationships and communication skills,
- understanding of high-quality cost-effective health care, analysis of risk-benefit ratios to patient outcome, utilization of health care resources to provide surgical care to patients, understanding the surgeon’s role in patient management,
- evaluation of the curriculum by students and residents/faculty.
The student must have a sound knowledge of surgical anatomy, the pathophysiology of surgical illness, and diagnosis and treatment of the common surgical diseases. The student should demonstrate ability to care for patients in the ICU, on the ward and in the clinic. The student should develop a systematic approach for diagnostic evaluation and therapeutic intervention for surgical problems. The student should master a focused history and physical examination on the surgical patient. The student should master simple surgical skills before the end of the clerkship. The student should refine professional behavior and develop strong interpersonal relationships with patients, their families and members of the surgical team. The student should develop a clear sense of the delivery of high quality, cost-effective surgical care. Evaluation of the curriculum by the students, residents and faculty is critical to ensure improvement in the content of the surgical clerkship so that students learn surgical concepts that are relevant to the daily practice of medicine. Remember that surgery is not just an operation.