Division Specific Objectives
The following are considered “must see” for all students, within each sub-rotation on
the surgical clerkship.
UROLOGY
1) Perform a prostate examination
 Yes / No
 Number of cases: 1 / 2-5 / >5
 Degree of supervision: always supervised / gradually given independence
/ never supervised
2) Involvement in patient assessment / management referred for lower urinary
tract symptoms
 Yes / No
 Number of cases: 1 / 2-5 / >5
3) Involvement in patient assessment /management referred for a urologic
malignancy (kidney/prostate/bladder)
 Yes / No
 Number of cases: 1 / 2-5 / >5
4) Involvement in patient assessment /management referred for hematuria
 Yes / No
 Number of cases: 1 / 2-5 / >5
5) Observe a cystoscopy procedure
 Yes / No
 Number of cases: 1 / 2-5 / >5
 Were you given the opportunity to practice this technical skill: yes / no
NEUROSURGERY
1) Involvement in patient assessment /management for chronic subdural
hematoma
 Yes / No
 Number of cases: 1 / 2-5 / >5
2) Involvement in patient assessment /management for aneurismal subarachnoid
hemorrhage
 Yes / No
 Number of cases: 1 / 2-5 / >5
3) Involvement in patient assessment /management for primary brain tumor
 Yes / No
 Number of cases: 1 / 2-5 / >5
4) Involvement in patient assessment /management for lumbar disc herniation and
/or stenosis (claudication)
 Yes / No
 Number of cases: 1 / 2-5 / >5
5) Involvement in patient assessment /management for traumatic brain injury
(acute subdural, epidural, DAE)
 Yes / No
 Number of cases: 1 / 2-5 / >5
GENERAL SURGERY
1) Observe at least one laparotomy or laparoscopy
 Yes / No
 Number of cases: 1 / 2-5 / >5
2) Involvement in patient assessment /management of at least one acute abdomen
or abdominal trauma
 Yes / No
 Number of cases: 1 / 2-5 / >5
3) Involvement in patient assessment /management of one groin hernia
 Yes / No
 Number of cases: 1 / 2-5 / >5
4) Examine one breast lump
 Yes / No
 Number of cases: 1 / 2-5 / >5
 Degree of supervision: always supervised / gradually given independence
/ never supervised
5) Involvement in management of one patient in the first 3-5 days following
laparotomy and laparoscopy (must see both)
 Yes / No
 Number of cases: 1 / 2-5 / >5
6) Involvement in patient assessment /management with appendicitis
 Yes / No
 Number of cases: 1 / 2-5 / >5
ORTHOPAEDICS
1) Observe or assist in the closed reduction of a fracture or dislocation.
 Yes / No
 Number of cases: 1 / 2-5 / >5
 Degree of supervision: always supervised / gradually given independence
/ never supervised
2) Observe or assist in the surgical management of a fracture.
 Yes / No
 Number of cases: 1 / 2-5 / >5
 Long bone / joint (intra-articular) / I saw both during the rotation
3) Observe or assist in a joint replacement operation of the upper or lower
extremity.
 Yes / No
 Number of cases: 1 / 2-5 / >5
4) Evaluate (history, physical examination) at least one patient with arthritis of a
major joint, and or back.
 Yes / No
 Number of cases: 1 / 2-5 / >5
 Degree of supervision: always supervised / gradually given independence
/ never supervised
5) Observe or participate in the casting of at least one upper extremity and one
lower extremity injury.
 Yes / No
 Number of cases: 1 / 2-5 / >5
 Degree of supervision: always supervised / gradually given independence
/ never supervised
THORACIC SURGERY
Ambulatory/ Outpatient
1. Clinic assessment of at least one patient with a pulmonary nodule or mass
2. Assess at least 1 patient on first post-operative visit
3. Clinic assessment of at least one patient with dysphagia, or GERD
4. Interpret chest x-ray or CT chest for pneumothorax, pleural effusion or lung mass
Inpatient
1. Observe at least one Thoracotomy or Thoracoscopy with lung resection
2. Observe at least one Bronchoscopy Mediastinoscopy and/or EBUS (endobronchial U.S.)
3. Observe at least one procedure on the esophagus ( endoscopy, resection,
fundoplication, myotomy)
4. Assess one patient with a pleural space problem ( eg pneumothorax,
hemothorax, empyema or pleural effusion
5. Assist or perform chest tube insertion
6. Assess and trouble shoot chest tube drainage systems eg for air leak
7. Follow at least one patient following pulmonary resection from day of surgery to
discharge from hospital
CARDIAC SURGERY
1) observe at least one Aortic Valve replacement procedure.
 Yes / No
 Number of cases: 2-5
 Degree of supervision: always supervised
2) observe at least one Coronary Artery bypass grafting procedure.
 Yes / No
 Number of cases: 2-5
 Degree of supervision: always supervised
3) involvement in patient assessment and management of a postoperative patient
with atrial fibrillation.
 Yes / No
 Number of cases: >1
 Degree of supervision: gradually given independence
4) involvement in the assessment of a patient undergoing coronary artery bypass
grafting with silent ischemia.
 Yes/ No
5) involvement in the assessment of a patient with symptoms of aortic valve disease.
 Yes /No
 Number of cases: >1
 Degree of supervision: gradually given independence
6) Subcuticular closure of one leg wound incision.
 Yes /No
 Number of cases: >1
 Degree of supervision: gradually given independence
7) Transthoracic implantation of one chest tube during coronary bypass surgery.
 Yes / No
 Number of cases: >1
 Degree of supervision: always supervised / gradually given independence
PLASTIC SURGERY
Following a rotation in Plastic Surgery, the student will be able to:
1. Describe the phases of wound healing, and
a. will have examined one wound at a minimum
Yes / No
Number of cases: 1 / 2-5 / >5
Degree of supervision: always supervised / gradually given independence
/ never supervised
b. be able to describe at least two types of wound dressings
Yes / No
Number of cases: 1 / 2-5 / >5
Degree of supervision: always supervised / gradually given independence
/ never supervised
2. Describe the plastic surgery “reconstructive ladder”, and
a. will have attended one reconstructive procedure at a minimum
Yes / No
Number of cases: 1 / 2-5 / >5
b. be able to described at least one reconstructive technique used in Plastic
Surgery
Yes / No
3. Performed a basic hand examination
Yes / No
Number of cases: 1 / 2-5 / >5
Degree of supervision: always supervised / gradually given
independence / never supervised
4. Performed a wound closure with simple interrupted sutures in a least one wound
(ie. under supervision)
Yes / No
Number of cases: 1 / 2-5 / >5
Degree of supervision: always supervised / gradually given
independence / never supervised
5. Can describe the clinical features of three common skin cancers: basal cell
carcinoma, squamous cell carcinoma and malignant melanoma.
Yes / No
VASCULAR SURGERY
1) Learn types of aortic aneurysms, understand risk of rupture, thresholds for
therapy, modes of therapy and complications.
Yes / No
2) Develop an understanding of Peripheral Arterial Disease (PAD); presentations,
natural history, diagnostic modalities, therapeutic options including risk factor
modification, angiographic intervention and operative approaches.
Yes/No
3) Develop an understanding of the diagnosis and therapy for venous disease,
including DVT, Varicose veins, and venous ulcer.
Yes / No
4) Learn the causes of stroke and the different therapies available. Understand the
role of intervention in the both the symptomatic and asymptomatic states.
Yes/ No
5) Develop an approach to the swollen leg, investigation, differential diagnosis and
management.
Yes / No