Residency Level:PGY 3

Surgical Rotation:Transplant Surgery

Length of Rotation:Two Months

Goals and Objectives

Patient care:

  • Pre-operative evaluation and post-operative management of the transplant patient
  • Management skills required to independently evaluate the transplant surgical patient, develop your own plan for the patient and communication of the plan to the appropriate level of supervision
  • Take ownership in care of the patient
  • Post-operative care of the transplant surgical patient
  • Fluid and electrolyte management of the transplant patient including indications for parenteral and enteral nutrition and management of electrolyte imbalances
  • Management of acute and chronic renal failure
  • Understanding and utilization of diagnostic techniques including routine films, contrast studies, ultrasound, CT scan, MRI and endoscopic procedures
  • Clear and timely documentation of daily progress notes
  • Develop a strong work ethic
  • Develop appropriate safe hand offs
  • Develop the ability to care for transplant surgical emergencies in the role as the surgical resident on call

Technical skill:

  • Assist liver transplants and other major hepatic surgical procedures
  • After a period of learning and appropriate supervision, perform procedures for kidney and pancreatic transplant procedures including graft preparation and ureteral anastomoses
  • Assist at organ procurement procedures

Medical knowledge:

  • Principles of immunology and pharmaco-kinetics of immunosuppression
  • Principles of organ donation and transplantation
  • Demonstrate evidence of continued increase in transplant surgery core knowledge from basic surgical texts, additional readings and the SCORE curriculum as noted below
  • Obtain a broad knowledge base of transplant surgery and other surgical specialties
  • Study and prepare for the ABSITE
  • Anatomy and physiology of the GI tract, liver, biliary tract and pancreas
  • Fluid and electrolyte management including management of parenteral and enteral nutrition

Practice-based learning and improvement:

  • Participate actively in M and M conferences, daily chief conferences and journal clubs
  • Learn to critically read the literature
  • Master the IT resources available to you to develop a commitment to lifelong learning and education

Interpersonal and communication skills:

  • Develop the appropriate skills to provide efficient, concise, patient presentations
  • Master text paging, emailing, etc.
  • Develop strong doctor patient relationships using counseling and education of patients and their families
  • Learn to master EPIC to provide proper documentation in the electronic medical record
  • Learn to properly consult other specialty services in a professional manner

Professionalism:

  • Understanding of the ethical, legal, and financial aspects of organ transplantation
  • Respect every patient regardless of social or other circumstances
  • Log cases appropriately
  • Log your duty hours using My Evaluations appropriately and in a timely fashion
  • Complete all required clinical and residency documents in a timely fashion
  • Demonstrate sensitivity to age, gender and culture of patients and other members of the health care delivery team
  • Learn to be punctual
  • Always exemplify professional attire, appropriate grooming and hygiene
  • Demonstrate honesty, integrity and leadership skills

Systems-based practice:

  • Demonstrate the effective communication with referring physicians throughout the Swedish health care system
  • Keep patients’ safety foremost while discharging patients in a timely fashion
  • Demonstrate time management and organizational skills while adhering to work hour regulations
  • Gain an understanding of the importance of discharge planning and the writing of timely discharge orders to the overall throughput of patients in our system

SCORE CURRICULUM - CATEGORY 21: TRANSPLANTATION
Diseases/Conditions
FOCUSED
• Immunosuppression / Operations/Procedures
COMPLEX
• Donor nephrectomy
• Donor hepatectomy
• Kidney transplant
• Kidney-pancreas transplant
• En bloc abdominal organ retrieval
• Liver transplant
• Pancreas transplant