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The primary goal of the clerkship is to introduce the clerks to principles of caring for the surgical patient.
This goal is accomplished by allowing the student to participate in the care of patients in the various stages of evaluation and treatment by surgeons in several specialties. These stages include the preoperative area, inpatient and outpatient clinics, operative procedures, recovery and follow-up. The student will have the opportunity to observe the surgeon as part of the multidisciplinary team involved in caring for the patient.
The goal of the clerk should be to function as an integral part of the surgical team and to take on increasing responsibility for patient care as experience and skills allow.
Director, Office of Surgical Education
Dr. Steven Lopushinsky – steven.lopushinsky@ahs.ca pager # 06233
Director:
Dr. Jeremy LaMothe - jeremy.lamothe2@ucalgary.ca
Evaluation Coordinator:
Dr. Hyea Min Yoon - HyeaMin.Yoon@ahs.ca
Education Coordinator:
Jerilee Paredes (interim), Gail Wright-Wilson – surgical.clerkship@ahs.ca
Program Coordinator:
Shauna Bonnett – surgery1@ucalgary.ca
The Surgery Clerkship rotation will provide the medical clerk with an excellent learning opportunity to gain the knowledge and skills required to prepare for a residency program and clinical practice. The medical clerk will gain knowledge on various patient conditions and co-morbidities, diagnosis, investigations, treatments and follow-up evaluations as the patient presents for a surgical procedure. The medical clerk’s critical analysis will be advanced to include treatment of the patient in a holistic, comprehensive and collaborative way that involves all members of the health care team.
There are eight (8) blocks of Surgery Clerkship per graduating class at the University of Calgary, Cumming School of Medicine. Each Block consists of a six (6) week surgical clerkship rotation.
The six week surgical rotation will consist of a 3 week rotation in General Surgery which focuses on the adult population. The following 3 weeks will be divided between a 3 week selective in Orthopedic Surgery, or 2 week selective in Plastic Surgery, Orthopedic Surgery or Urology Surgery and a 1 week selective in ENT Surgery, Neuro Surgery, Thoracic Surgery, Trauma Surgery, Urology Surgery or Vascular Surgery (adult or pediatric population).
For Medical Clerks who are enrolled in the University of Calgary Longitudinal Integrated Clerkship (UCLIC) / Rural Medicine program, their Surgery Rotation will consist of 2 weeks in General Surgery (adult population) and a 2 week selective in Orthopedic Surgery, Plastic Surgery or Urology Surgery or two 1 week selectives in ENT Surgery, Neurosurgery, Thoracic Surgery, Trauma Surgery, Urology Surgery or Vascular Surgery (adult or pediatric population).
The Top 10 University of Calgary Objectives are sent to all preceptors and surgical residents for every block of medical clerks. The link is: http://www.ucalgary.ca/mdprogram/about-us/big-10-graduation-educational-objectives
The Surgery Clerkship Objectives are also sent to all preceptors and surgical residents for every block of medical clerks. The link is:
http://www.ucalgary.ca/mdprogram/files/mdprogram/surgical-clerkship-core-document2017_1.pdf
The 2 (UCLIC) or 3 week rotations in General Surgery will be divided into a 2 week subspecialty in surgery (depending upon site) and 1 week on the Acute Care Emergent Surgical Services Team (ACESS). The UCLICs are not assigned a week on the ACESS Team but may be involved with the team during rounds each morning while on their 2 week general surgery rotation.
Medical Clerks are assigned to the following sites within Calgary for their general surgery rotation that focuses on the adult population: Foothills Medical Centre (FMC), Peter Lougheed Centre (PLC), Rockyview General Hospital (RGH), and the South Health Campus (SHC). Subspecialties in surgery at each site include:
Each hospital site has an ACESS service which covers all emergency consults during the day and night. The ACESS Team will follow all consults in the Emergency Department, through to the Operating Room and then manage their post-operative care needs on the surgical unit and arranges for follow-up post discharge from the health care facility. The ACESS Team will round on inpatients every day and the medical clerk will be exposed to the management and follow-up care needs of these post-operative patients. The medical clerk will receive the most comprehensive experience in pre and post-operative care management for an optimal surgical learning experience.
On-Call Requirements: There are on-call requirements scheduled by the Education Coordinator during the general surgery rotation. Any missed call shifts will need to be rescheduled. The call consists of two (2) week day evening (1700 – 2300), a Friday overnight (1700 – 0800) a Sunday day (0800 – 2300) and a Saturday overnight (0800 – 0800, scheduled only if one of their selectives do not have call requirements). All call shifts are entered into the Regional On-Call Application (ROCA) system with AHS.
All clerks in the Surgical Clerkship rotation are assigned a weekday evening call shift (1700 – 2300) in Trauma Surgery at the FMC during their selective rotation and not during the general surgery rotation. The UCLICs are not assigned a Trauma call shift unless requested to have one. Clerks who are at a different site will need to arrive at the FMC in time for their call shift.
A Clerkship Booklet has been created by the Education Coordinator and given to each medical clerk. It contains the resources and information needed for a successful surgical clerkship. Information on lockers and call rooms at all the sites plus some additional medical information (Blood Gas Analysis, ECG Interpretation, Safe Surgery Checklist, Massive Transfusion Protocol, Pain Management, Fluids & Electrolytes, Hypotension, Fever, Intracranial Pressure and PONV) is included as a reference in the booklet.
The medical clerk can select their preference for a 2 or 3 week rotation in Orthopedic Surgery, a 2 week rotation in Plastic Surgery or a 2 week rotation in Urology Surgery. The assignment in each subspecialty is based on availability. The Office of Surgical Education attempts to accommodate each medical clerk’s request for a specific subspecialty selective. Each hospital site (FMC, PLC, RGH, SHC & ACH) can facilitate rotations for medical clerks in these three subspecialties in surgery.
Orthopedic Surgery
A two (2) or three (3) week rotation in Orthopedic Surgery will be assigned to medical clerks at a specific hospital site. The focus is on the adult or pediatric population (depending upon site). The medical clerks are assigned a preceptor team of 2 or 3 surgeons plus Orthopedic Residents that are assigned to that site. The following hospital sites and subspecialties are:
There is on-call requirements for the Orthopedic Surgery rotation and are scheduled in conjunction with the medical clerk’s preceptor / resident team. Any missed call shifts will need to be rescheduled.
Two Orthopedic Surgery (Ortho Trauma & Pediatric Ortho) seminars are presented by a surgeon to the clerks during the surgical rotation.
Plastic Surgery
A two (2) week rotation in Plastic Surgery will be assigned to medical clerks at a specific hospital site. The FMC & ACH Plastic Surgeons have a team approach to clerk clinical practice. Therefore, a preceptor will not be assigned to each clerk. The medical clerk will work alongside the whole surgical team plus Plastic Surgery Residents. At the other sites of PLC, RGH & SHC, Medical clerks will be assigned a surgeon as preceptor and Plastic Surgery Residents that are assigned to that site. The Plastic Surgery Residency Program in Calgary is highly regarded within Canada. The following hospital sites and subspecialties in Plastic Surgery are:
The medical clerk is exposed to a variety of aspects of Plastic Surgery and clinics during their rotation.
There is on-call requirements for the Plastic Surgery rotation and are scheduled in conjunction with the medical clerk’s preceptor / resident team. Any missed call shifts will need to be rescheduled.
There are many resources in Plastic Surgery available to the medical clerk in OSLER. Two Plastic Surgery Seminars (Hand and Facial Injuries & Wound Healing and Skin Cancer) are presented by a surgeon to the clerks during the surgical rotation.
Urology Surgery
A two (2) week rotation in Urology Surgery will be assigned to medical clerks at either the RGH or ACH site. The medical clerk must specifically request to be at the ACH site for a rotation. The medical clerk will be assigned a preceptor team or 1, 2 or 3 Urology Surgeons depending upon hospital site and their preference. The medical clerk will work with their preceptor / fellow team. The medical clerk is exposed to a variety of aspects of Urology Surgery and clinics during their rotation.
There is on-call requirements for the Urology Surgery rotation and are scheduled in conjunction with the medical clerk’s preceptor team. Any missed call shifts will need to be rescheduled.
There is a Urology Surgery Seminar presented by a Urologist to the clerks during the surgical rotation.
Otolaryngology (ENT) Surgery
A one (1) week rotation in Otolaryngology Surgery will be assigned to medical clerks based on their preferences selected. The Otolaryngology department operates at each site within Calgary. The medical clerk will be exposed to a variety of aspects of Otolaryngology Surgery and clinics during their rotation.
There are no on-call requirements for this rotation. There is an Otolaryngology (ENT) Surgery Seminar presented by a Surgeon or Resident during the surgical rotation.
Neurosurgery
A one (1) week rotation in Neurosurgery will be assigned to medical clerks based on their preferences selected (#1) and availability. The Division of Neurosurgery is based at the FMC and has a highly regarded Residency Program. The surgeons in Neurosurgery have a team approach to clerk clinical practice. The clerk will not be assigned a specific preceptor but will work with the whole team of surgeons and residents.
The medical clerk will be exposed to various aspects of neurosurgery and clinics during this rotation.
There is on-call requirements for the Neurosurgery rotation and are scheduled in conjunction with the lead surgeon / resident team. Any missed call shifts will need to be rescheduled.
There are two Neurosurgery Seminars presented by a neurosurgeon during the surgical rotation.
Thoracic Surgery
A one (1) week rotation in Thoracic Surgery at the FMC will be assigned to a medical clerk based on the preferences selected. The medical clerk will be exposed to a variety of aspects of Thoracic Surgery and clinics during their rotation. There are no on-call requirements for this rotation. There are numerous resources available on Thoracic Medicine available to clerks in OSLER.
Trauma Surgery
A one (1) week rotation in Trauma Surgery at the FMC will be assigned to a medical clerk based on the preferences selected. The medical clerk will be exposed to a variety of aspects of Trauma Surgery and Advanced Trauma Life Support (ATLS) principles during their rotation https://www.facs.org/quality-programs/trauma/atls. The FMC in Calgary is a Level 1, Tertiary Care Trauma Centre with designated Trauma bays in the Emergency Department and an Interventional Trauma Operating Room (ITOR) at the McCaig Tower. The ITOR is fully equipped with Diagnostic Imaging services. Calgary is also serviced by the Shock, Trauma, Air Rescue Service (STARs) which has ground and air ambulance services throughout Alberta, south-western Saskatchewan and south-eastern British Columbia (stars.ca). The McCaig Tower at the FMC campus has a helicopter landing area on the roof to facilitate transport of the critically injured patient to the Trauma Bay in ER, ICU and / or Operating Room. A Trauma workbook is provided to every clerk in the surgical clerkship rotation.
A specialized group of General Surgeons, within Calgary, have advanced training in Trauma Surgery and coordinate day and night coverage for this service.
There is an on-call requirement in the Trauma Rotation and are assigned by the Education Coordinator in the Office of Surgical Education. Any missed call shifts will need to be rescheduled.
There is a Trauma Surgery Seminar presented by a Trauma Surgeon during the surgical rotation.
Note: All clerks in the surgical rotation are assigned a Trauma call shift during one of their Selectives (not General Surgery) by the Education Coordinator. UCLICs are not assigned a Trauma call shift unless requested.
Vascular Surgery
A one (1) week rotation in Vascular Surgery will be assigned at the PLC to a medical clerk based on the preference selected. The Vascular Surgeons at the PLC have a team approach to clerk clinical practice. Therefore, the clerk will not be assigned a specific preceptor but will work with the whole surgeon / resident team.
The medical clerk is exposed to various aspects of Vascular Surgery (included in Trauma cases at the FMC) and clinics during their rotation.
There are no on-call requirements for Vascular Surgery.
Two Vascular Surgery Seminars that encompasses all aspects of Vascular Surgery are presented by a Vascular Surgeon to the clerks in the surgical rotation. There are numerous references available to the clerks in OSLER.
Urology Surgery
A one (1) week rotation in Urology Surgery will be assigned at either the RGH or ACH site to a medical clerk based on the preference selected. The medical clerk will be assigned a preceptor team or 1, 2 or 3 Urology Surgeons depending upon hospital site. The medical clerk will work with their preceptor / fellow team. There are no Urology Surgery Residents in Calgary.
The medical clerk is exposed to a variety of aspects of Urology Surgery and clinics during their rotation.
There is on-call requirements for the Urology Surgery rotation and are scheduled in conjunction with the medical clerk’s preceptor team. Any missed call shifts will need to be rescheduled.
There is a Urology Surgery Seminar presented by a Urologist to the clerks during the surgical rotation.
Seminar Sessions
Seminar sessions are held every Tuesday afternoon at the Health Sciences Centre (HSC). A Seminar Schedule is provided containing information about each topic and presenter, dates, times and room allocation. The seminars will commence at 1200 – 1700 every Tuesday afternoon and there will be a total of three (3) different topics with a short break between each session. The topics are presented by a Surgeon (unless otherwise stated) and include:
The Office of Surgical Education is in the process of creating an updated seminar for Upper GI Surgery and Thoracic Surgery.
All of the seminar sessions are mandatory with a sign in sheet available. The medical clerks are encouraged to fill out an evaluation for the sessions so that revisions can be done if indicated. An evaluation is provided at the sessions.
Clerkship Electives: The University of Calgary third year medical students (clerks) have time allotted from January – mid April each year to schedule electives. The Medical Student must contact the Education Coordinator to schedule a two (2) to four (4) week elective of their choice within the Department of Surgery. The number of medical clerks accepted is dependent upon the subspecialty. Elective experiences are offered to clerks at all sites (FMC, PLC< RGH, SHC & ACH) within Calgary and for a variety of surgical subspecialties. The subspecialties are:
Orthopedic Surgery and Neurosurgery electives are coordinated by the individual departments.
Elective medical clerks will participate in all aspects of pre and post-operative care management for patients with a wide range of co-morbidities. They are a welcomed part of the collaborative health care team.
Information regarding an elective is sent to each medical clerk approximately one (1) month prior to the start of their elective (where to meet, preceptor & resident contact information).
There are on-call requirements during electives and these shifts are scheduled in conjunction with the preceptor / resident team.
The University of Calgary Elective Objectives link: http://www.ucalgary.ca/mdprogram/files/mdprogram/mdcn-514-clerkship-electives.pdf
Pre-Clerkship Electives: The University of Calgary second (2nd) year medical students (pre-clerks) have the opportunity to schedule an elective of their choice in July of that year. The 2nd year medical student needs to contact the Education Coordinator with the Department of Surgery if seeking to schedule an elective in Surgery. A confirmation email will be sent to the student once an elective is confirmed.
Information regarding the elective is sent to each medical student approximately one (1) month prior to the start of their elective (where to meet, preceptor’s contact information & resident information).
Shadow Experiences: The University of Calgary first year medical students are able to request a shadow experience with a preceptor in conjunction with a course or in an area of their own interest. The medical student will arrange with a preceptor and gain his / her consent for the dates mutually agreed upon. The Office of Surgical Education does not schedule a Shadow Experience.
Visiting Electives:
A National on-line system went live in February 2015 for Canadian Medical Students in their clerkship year to apply for electives at accredited schools across Canada. The portal is with the Association of Faculties of Medicine in Canada. AFMC Portal: https://www.afmcstudentportal.ca/
Medical clerks across Canada can enter the documents required by other schools (immunization records, police check, payment) so the medical school hosting the elective can download the documents needed. Visiting electives are scheduled for electives starting mid-April to mid-December each year. There is also the first 2 weeks in January where visiting electives are allowed. All other times are closed and only accessed to University of Calgary medical students. Medical students are off for two weeks between Christmas and New Year’s.
Surgical visiting electives are scheduled at all sites within Calgary (FMC, PLC, RGH, SHC, & ACH) and are subject to availability. These sub-specialities in Surgery are available for visiting electives in Calgary:
Visiting electives in Orthopedic and Neuro Surgery are scheduled by those departments. Urology Surgery electives are not available at this time. Canadian Medical Clerks contact the Education Coordinator directly to inquire / schedule an elective in Calgary. Once an elective is confirmed, the clerk will enter it into the portal system. The cost per elective in Calgary is $100.00. This is non-refundable so it is imperative that the medical clerk has confirmation of an elective before it is entered in the portal system. The portal system will generate a request to confirm an elective to the Education Coordinator. Once the elective is confirmed in the portal system, the clerk has 1 week to “accept” the elective via the portal. Another acceptance form is sent by the portal system to the Education Coordinator confirming acceptance of an elective by each clerk for each elective.
An email from the University of Calgary Electives Department is sent to each confirmed visiting elective clerk outlining documents that need to be completed (Confidential Agreements) and sent to the Calgary Medical Office at cal.medicaleducationoffice@ahs.ca . Information regarding access to the electronic patient record and transcription services are provided by this office as well.
Upon arrival in Calgary for an elective, visiting medical clerks are given an AHS ID card and proxy card that will be programmed to access areas of the hospital. The Office of Surgical Education provides a loaner pager for use during their elective and must be returned at the end of each elective. A cost of $250 will be the responsibility of the visiting clerk for unreturned pagers.
There are on-call requirements for a visiting elective which are scheduled in conjunction with the preceptor / resident team. All call shifts are entered into the AHS Regional On-Call Application (ROCA) system.
For Internationally trained medical clerks, there is an agreement through accreditation with other medical schools – Liaison Committee on Medical Education (LCME – USA accredited medical schools) and the International Federation of Medical Student Association Exchange Program (IFMSA) and AFMC. The portal will only accept a few international applications for an elective per year. The elective must be for a minimum of 4 weeks. This acceptance is not determined by the medical school who has agreed to schedule the international clerk for an elective.
For inquiries into visiting electives, please contact the Education Coordinator via email: dory.glaser@ahs.ca
Visiting Shadow Experiences:
A Canadian Medical Student can arrange with a preceptor for a shadow experience. The Alberta Health Services website has information and documents needed for a shadow experience:
Completed documents are forwarded to Ashley Ulmer (ashley.ulmer@ahs.ca) with the Department of Surgery for final approval by the Calgary Zone Surgery Director.
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