Medical Students

SURGERY 300 - Junior Surgery Clerkship

Surgery 300 is one of the required clerkships for the Doctor of Medicine degree at LSUHSC-Shreveport. Requirements for this course are successful completion of the first and second year curricula of the LSUHSC-Shreveport Medical Education Program. In addition, the student must have taken and passed the United States Medical Licensing Examination (USMLE) Step 1.

Course Objectives: The Surgery 300 course is intended to provide students with the broad base of knowledge and understanding of surgical science that every primary care physician should possess. The student will begin to utilize the basic science knowledge and more fully develop the basic clinical training acquired in the first two years of medical school.

While development of a basic understanding of the pathophysiology of surgical disease is the principle objective of this clerkship for the student, further goals include demonstration of steady improvement in required clinical skills: 1) history-taking and physical examination, 2) developing problem lists, differential diagnoses and treatment plans, 3) establishing skills in team work and communication with patients and their families and other health care providers.

By the completion of the rotation, the student should possess an understanding of common surgical diseases, insight into the diagnosis and treatment of these diseases, and an enhanced awareness of the importance of a surgeon's behavior and professionalism.

Course Description
Surgery 300 is a 6-week course consisting of one 3 -week rotation on a general surgery service, one 3-week rotation on a surgical specialty service (trauma/critical care, cardiothoracic, vascular, plastics and reconstruction, pediatric surgery, surgical oncology). All rotations are done in Shreveport at University Health-Shreveport and Overton-Brooks VA Medical Center.

The student will be assigned patients to follow on the inpatient services as well as in the clinics. While part of the surgical team, the student will not have major responsibility for ward duties, but will be expected to understand common ward procedures and participate in daily patient care activities. The student is expected to know his/her assigned patient's history, present findings and diagnostic work-up, and to follow the patient to the operating room and scrub on their operative procedure. For those assigned patients who remain inpatients after their surgical procedure, the student is expected to write daily progress notes in the chart. This allows the student to observe and participate in the patient's treatment in a continuum - initial presentation to diagnosis to operation to recovery.

Didactic instruction as well as "hands-on" training will be given on the wards, in the operating room and in the clinic setting. Students will also be required to attend and participate in:

  • Didactic sessions including three lectures per week on a broad range of common surgical topics given by surgery faculty members
  • Suture laboratory conducted by a surgical faculty member providing instruction in knot-tying, various suture techniques and instrument handling   
  • Formal weekly multidisciplinary conferences such as the residents' focus group and Morbidity & Mortality Conference, Students' Surgery Conference, and Bullpen*    

NOTE: All lectures and conferences are mandatory for all students regardless of their service assignment.

Service Rotations
During the 6-week course, students will rotate on two of the following surgical services: 

  • Elective Surgery - On this service, students will participate in the care of general, endocrine and colon & rectal surgery patients. Vascular access procedures are also done on this service. Students will participate in a wide variety of general surgery cases. This service also includes the burn surgery service.    
  • Overton-Brooks VAMC - This service is an overall "general" surgery experience for the student, and includes thoracic surgery and peripheral vascular surgery as well.
  • Surgical Oncology - Students will be exposed to breast, sarcoma and melanoma surgery as well as GI cancer surgery cases. The service has an outpatient clinic with an outpatient surgery schedule.
  • Trauma/Surgical Critical Care/Acute Care - Students will participate in triage, initial stabilization and resuscitation, intra-operative treatment as well as intensive care and ward management of patients.
  • Cardiothoracic Surgery - Students will see and participate in the surgery and care of a variety of patients with cardiac, thoracic and esophageal surgical problems. Critical care management of postoperative patients is also a large component of the service.
  • Vascular Surgery - Students will participate in the care of patients with vascular disease.

Recommended Texts:

Essentials of General Surgery, Third Edition 
Peter Lawrence, MD, Editor Williams and Wilkins, 2000

Essentials of Surgical Specialties
Peter Lawrence, MD, Editor Williams and Wilkins, 2000

Cope's Early Diagnosis of the Acute Abdomen, 20th edition
Revised by William Silen, MD  Oxford University Press, 2000

  Senior Electives & Selectives

Surgery 400 courses are electives and Surgery 500 courses are selectives offered in the final year of training for the Doctor of Medicine degree at LSUHSC-Shreveport. All electives and selectives are graded in a Pass/Fail manner and all must be passed satisfactorily to successfully complete medical training. Satisfactory completion of all required 300 level clerkship courses plus a passing score on the USMLE Part I exam are pre-requisites for taking any 400 level electives or 500 level selectives.

Prior to entry into the final year of medical school training, it is advisable that the student select an advisor. Students may choose any of the MD faculty members of LSUHSC-Shreveport from a list of faculty who agree to be advisors. This list is maintained in the Registrar's office. Most commonly, students select a faculty member in the field in which they have greatest interest or intend to enter. Together with the advisor, students should plan and select the electives and the selective fields for the student's senior year of study.

Course Objectives and Description
Surgery 400 and 500 courses are designed to advance and broaden the student's knowledge and understanding of surgical science and its practice. In these courses, the student is given an advanced level of ward, clinic and operating room patient-care responsibilities than that experienced in the Surgery 300 rotation. The student also functions as an educator for the underclassmen assigned to their service. By this design, these courses are intended to serve as a bridge to facilitate the transition from the student role to that of the competent PGY 1 resident and to broaden the student's knowledge and understanding of surgical science and its practice.

Selectives (500 level courses) are 4-week courses required for all senior students. The Department of Surgery offers choices in the two clinic selective areas.

Inpatient Acting Internship Selective -
University Health Shreveport
This selective may be taken on the following surgery services:

  • Community Surgery
  • Outpatient Surgery
  • Elective Surgery (IAI)
    • Elective Surgery
    • Surgical Oncology
    • Critical Care/ Acute Care
    • Vascular Surgery

Senior students participate on these surgical services in the role of "acting interns", functioning at a level of responsibility greater than that of the Surgery 300 student. They will be assigned duties and responsibilities in the special care units, wards, and operating rooms at the level of those of the PGYI resident on the service.

Community - based Selective in Surgery - 
Students select or are assigned to either Willis Knighton- North or Christus Highland private practice surgery groups located in the Shreveport area. On this selective, students are able to observe and experience the practice of surgery as practiced in the private sector. All private surgeons participating as faculty in this selective possess gratis faculty status in the LSUHSC-Shreveport Department of Surgery. At present, two local private surgery groups participate and only one student is assigned to each group per 4-week rotation. Students will be expected to scrub on surgical cases as second or even first assistant and participate in patient care in the hospital and physicians' offices.

For additional information regarding participating community surgeons, refer to Ms. Debra Thornhill, Coordinator of Student Medical Education in the Department of Surgery.

Surgery electives (400 level courses) are 2- or 4-week courses and may be taken on a variety of different surgery services at LSUHSC-Shreveport, its affiliated hospitals or approved "away" facilities. On electives at LSUHSC-Shreveport and affiliate hospitals, students function as acting interns and their duties have been described previously under the category of inpatient acing internship selective. Although not required to attend the number of mandatory didactic sessions that Surgery 300 students must, they are expected to use their unstructured time for independent study, clinical research projects and development of their own skills and fund of knowledge about the field of surgery.

The LSUHSC-Shreveport Department of Surgery offers a number of elective choices. These include: 

  • General Surgery
  • Plastics and Reconstructive Surgery
  • Surgical Critical Care
  • Surgical Oncology
  • Trauma Surgery
  • Vascular Surgery

It should be noted that, with the approval of the course director, students may elect to choose any of the in-patient selective courses described previously as an elective.

Electives at "away" locations for LSU students
Away electives are conducted at off-campus locations and are not administered by LSUHSC-Shreveport School of Medicine. This includes all electives taken with a physician who is not listed in the LSUHSC-Shreveport Fourth Year Manual. To take an Away Surgery Elective, students must obtain the approval of the Department of Surgery, from the fourth year course director the Chairman or their advisor (if a member of the Surgery Department). They must complete the Away Elective Registration form (available in the Registrar's office) and have one of the above Surgery Department faculty approve and sign the form. It is then submitted to the Registrar's office. Direct communication with the Surgery Department at the selected "away" site is highly suggested to clarify any requirements the department might have for the student. Students who wish to take a surgery elective outside the United States must have the approval of the Department Chairman.

Electives at LSUHSC-Shreveport and affiliated hospital for non-LSU students
Only Louisiana residents from an LCME-accredited institution will be considered for a visiting student rotation. The student must provide verification through their Registrar to the LSUHSC - Shreveport Registrar's Office that they have satisfactorily completed the prerequisite course work necessary for senior surgery electives and are in good standing at their medical school. They must also send the elective request form from their institution with appropriate faculty approval.

For additional information regarding Electives and Selectives offered by the LSUHSC-Shreveport, please consult the Fourth Year Manual for the appropriate academic year. These are available in the Registrar's office.

For specific information regarding electives and selectives in the Department of Surgery, LSUHSC-Shreveport, or affiliated hospitals, contact Ms. Debra Thornhill or Jane M. Eggerstedt MD, Third and Fourth Year Student Course Director at 318.675.6126.