Clinical Practice 5th Year
A.Y. 2023/2024
Learning objectives
The clinical practice course is organized along 3 semesters (1st and 2nd sem 5° year and 1st sem 6° year) and integrates several disciplines to provide the students with conceptual tools to properly manage major clinical presenting problems. The 5° year module integrates Internal medicine and General surgery with Pharmachology, Clinical Pathology, Urology, Plastic surgery, Starting from a presenting problem (e.g. Jaundice, weight disorders, syncope, chest pain ) the differential diagnosis and the therapeutic aspects are addressed. By integrating the different disciplines students are trained to identify the most appropriate clinical and diagnostic tests to formulate a correct diagnosis and start planning the appropriate treatment. The neurobiological basis of pain and the mechanisms of chronification and palliative care are specifically addressed. Specific topics relative to Plastic, Thoracic surgery and Urology are addressed.
Expected learning outcomes
At the end of the 5th year module fo the course students are expected to - Report the basics of clinical judgment in the evaluation of patients starting from their presenting problems - Manage complex differential diagnoses by the appropriate use of clinical, laboratory, tests and exams findings - manage the basics of a proper patient's treatment - know the basics of palliative care and pain management - know the guidelines and basic principles to correctly address prognostic perspective of patients suffering cancers and how to deal with the main complications of chemotherapies
Lesson period: year
Single course
This course cannot be attended as a single course. Please check our list of single courses to find the ones available for enrolment.
Course syllabus and organization
Single session
Responsible
Prerequisites for admission
To attend the Clinical Practice course, students must have already passed all the exams of the first and second year (Fundamentals of Basic Sciences, Cells, Molecules and Genes 1 and 2, Human Body, Functions and Mechanisms of Diseases).
Assessment methods and Criteria
The exam will be organized at the end of the 1st semester of the 6th year, when the course will be completed, and will cover all the topics of Clinical Practice 5th year and Clinical Practice 6th year courses. Students' fulfillment of competencies will be assessed by 2 written tests and an oral session. It is mandatory to pass both the written test to be admitted to the oral examination.
WRITTEN EXAMINATION
1) Written test of General Surgery
A written test using multiple choices Q&A questionnaire. 40 questions, each question has 4 answers, and each answer can be true or false. The questionnaire will be prepared on the slides presented at the frontal lessons (uploaded in the University website for student access) and on the official Textbook. The written test will be considered valid when at least 75% of responses will be answered correctly.
2) Written test of the following disciplines:
Plastic Surgery; Thoracic Surgery; Urology; Clinical Pathology; General psychology; Pharmacology; MED-EF/01
10 questions with 4 answers for each discipline, with only one correct answer. To pass this test students must answer correctly to 6/10 questions in each module.
3) Oral examination of Internal Medicine and General Surgery
ORAL EXAMINATION
For each exam session, the oral examinations of Internal Medicine and General Surgery are scheduled in two separate dates.
An oral discussion with the Course Director and/or Collaborators focused on clinical cases, multi-disciplinary analysis, risk-benefit of various therapeutic alternatives and clinical/research speculations on surgical patients presenting with clinical conditions described in the synchronous and asynchronous learning material as well as in the suggested Textbook. Contents of the asynchronous activities (e.g. Surgery Blog) will be valued, as part of the general assessment of student's participation and acquired knowledge.
The final mark is the weighted average of the two marks obtained in the oral examinations of Internal Medicine and General Surgery.
Written tests and Oral examinations can be taken in different exam sessions. Once passed, the written tests and the oral examinations remain valid. For general information about Exams required skills see also the section "Expected Outcome" below.
BIOSTATISTICS ASSESSMENT
Student assessment is based on the evaluation of a presentation of the work conducted during the practical activities. Students are required to present a draft research protocol for a clinical trial or an observational study. The presentation will be made in the presence of selected components of the exam commission and other students. The presentations will be prepared by small groups of students (maximum 3) and will be divided equally among the group members.
Attendance is required to be allowed to take the exam. Unexcused absence is tolerated up to 34% of the course activities. University policy regarding excused illness is followed.
Registration to the exam through SIFA is mandatory.
WRITTEN EXAMINATION
1) Written test of General Surgery
A written test using multiple choices Q&A questionnaire. 40 questions, each question has 4 answers, and each answer can be true or false. The questionnaire will be prepared on the slides presented at the frontal lessons (uploaded in the University website for student access) and on the official Textbook. The written test will be considered valid when at least 75% of responses will be answered correctly.
2) Written test of the following disciplines:
Plastic Surgery; Thoracic Surgery; Urology; Clinical Pathology; General psychology; Pharmacology; MED-EF/01
10 questions with 4 answers for each discipline, with only one correct answer. To pass this test students must answer correctly to 6/10 questions in each module.
3) Oral examination of Internal Medicine and General Surgery
ORAL EXAMINATION
For each exam session, the oral examinations of Internal Medicine and General Surgery are scheduled in two separate dates.
An oral discussion with the Course Director and/or Collaborators focused on clinical cases, multi-disciplinary analysis, risk-benefit of various therapeutic alternatives and clinical/research speculations on surgical patients presenting with clinical conditions described in the synchronous and asynchronous learning material as well as in the suggested Textbook. Contents of the asynchronous activities (e.g. Surgery Blog) will be valued, as part of the general assessment of student's participation and acquired knowledge.
The final mark is the weighted average of the two marks obtained in the oral examinations of Internal Medicine and General Surgery.
Written tests and Oral examinations can be taken in different exam sessions. Once passed, the written tests and the oral examinations remain valid. For general information about Exams required skills see also the section "Expected Outcome" below.
BIOSTATISTICS ASSESSMENT
Student assessment is based on the evaluation of a presentation of the work conducted during the practical activities. Students are required to present a draft research protocol for a clinical trial or an observational study. The presentation will be made in the presence of selected components of the exam commission and other students. The presentations will be prepared by small groups of students (maximum 3) and will be divided equally among the group members.
Attendance is required to be allowed to take the exam. Unexcused absence is tolerated up to 34% of the course activities. University policy regarding excused illness is followed.
Registration to the exam through SIFA is mandatory.
Pharmacology
Course syllabus
TOPIC 1 - The neurobiological bases of pain and the mechanisms of chronification: a matter of neural plasticity
The nociceptive pathway and its modifications during chronification
The descending modulatory pathways as drug targets
TOPIC 2- Focus on opioids
Clinical pharmacology of opioids
Opioids in chronic non-cancer pain: friend or foe?
TOPIC 3 - Pharmacology of nociceptive pain (blended. Asyncronous)
Pathological basis of nociceptive pain
Rational use of drugs for nociceptive pain
TOPIC 4 - Pharmacology of neuropathic pain: the art of combination
Pathological basis of neuropathic pain
Combinatorial therapy for neuropathic pain
TOPIC 5 Cancer pain: not just palliation
The mechanisms of cancer pain and the drugs: beyond the WHO's ladder
Breakthrough cancer pain: the drugs
TOPIC 6 New drugs for pain treatment (blended. Asyncronous)
The nociceptive pathway and its modifications during chronification
The descending modulatory pathways as drug targets
TOPIC 2- Focus on opioids
Clinical pharmacology of opioids
Opioids in chronic non-cancer pain: friend or foe?
TOPIC 3 - Pharmacology of nociceptive pain (blended. Asyncronous)
Pathological basis of nociceptive pain
Rational use of drugs for nociceptive pain
TOPIC 4 - Pharmacology of neuropathic pain: the art of combination
Pathological basis of neuropathic pain
Combinatorial therapy for neuropathic pain
TOPIC 5 Cancer pain: not just palliation
The mechanisms of cancer pain and the drugs: beyond the WHO's ladder
Breakthrough cancer pain: the drugs
TOPIC 6 New drugs for pain treatment (blended. Asyncronous)
Teaching methods
FOR ALL MODULES: Interactive lectures, Clinical cases, Seminars, Discussion on clinical cases, Case studies
Synchronous learning: video conferences, interactive webinars, chat-based online discussions and lectures
Asynchronous learning: audio-video based (pre-recoreded, multimedia platforms); text-based (e-mail, electronic documents, discussion boards, blogs); mixed (virtual libraries, social networks).
Synchronous learning: video conferences, interactive webinars, chat-based online discussions and lectures
Asynchronous learning: audio-video based (pre-recoreded, multimedia platforms); text-based (e-mail, electronic documents, discussion boards, blogs); mixed (virtual libraries, social networks).
Teaching Resources
MATERIALE DI RIFERIMENTO
Wall and Melzack's textbook of pain 6th edition 2013 Elsevier Saunders
Essential pain pharmacology. The prescriber's guide H. Smith and M. Pappagallo 2012 Cambridge University pain
Wall and Melzack's textbook of pain 6th edition 2013 Elsevier Saunders
Essential pain pharmacology. The prescriber's guide H. Smith and M. Pappagallo 2012 Cambridge University pain
Clinical pathology
Course syllabus
TOPIC 1 - Analysis of fluids/biologial samples other than blood: focus on liquor
TOPIC 2 - Analysis of fluids/biological samples other than blood: focus on semen
TOPIC 3 - Analysis of fluids/biological samples other than blood: focus on urine
TOPIC 4 - Analysis of fluids/biological samples other than blood: focus on synovial fluid and pleural fluids
TOPIC 5 - Analysis of fluids/biological samples other than blood: focus on salivary
TOPIC 6 - Biomarkers of bone remodeling
TOPIC 7- Examples of new biomarkers: focus on Irisin and metabolism
TOPIC 8 - Examples of new biomarkers: focus on glycated albumin and glycemic control
TOPIC 9 - Epicardial adipose tissue and cardiovascular risk
TOPIC 10 - New biomarkers of sepsis: focus on presepsin
TOPIC 11 - New biomarkers of cardiac remodeling: focus on ST2/IL33
TOPIC 12 - Cell-free DNA
TOPIC 2 - Analysis of fluids/biological samples other than blood: focus on semen
TOPIC 3 - Analysis of fluids/biological samples other than blood: focus on urine
TOPIC 4 - Analysis of fluids/biological samples other than blood: focus on synovial fluid and pleural fluids
TOPIC 5 - Analysis of fluids/biological samples other than blood: focus on salivary
TOPIC 6 - Biomarkers of bone remodeling
TOPIC 7- Examples of new biomarkers: focus on Irisin and metabolism
TOPIC 8 - Examples of new biomarkers: focus on glycated albumin and glycemic control
TOPIC 9 - Epicardial adipose tissue and cardiovascular risk
TOPIC 10 - New biomarkers of sepsis: focus on presepsin
TOPIC 11 - New biomarkers of cardiac remodeling: focus on ST2/IL33
TOPIC 12 - Cell-free DNA
Teaching methods
FOR ALL MODULES: Interactive lectures, Clinical cases, Seminars, Discussion on clinical cases, Case studies
Synchronous learning: video conferences, interactive webinars, chat-based online discussions and lectures
Asynchronous learning: audio-video based (pre-recoreded, multimedia platforms); text-based (e-mail, electronic documents, discussion boards, blogs); mixed (virtual libraries, social networks)
Synchronous learning: video conferences, interactive webinars, chat-based online discussions and lectures
Asynchronous learning: audio-video based (pre-recoreded, multimedia platforms); text-based (e-mail, electronic documents, discussion boards, blogs); mixed (virtual libraries, social networks)
Teaching Resources
Coleman-Tsongalis, Molecular Pathology, Elsevier 2018
Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics, 8th Edition
Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics, 8th Edition
Internal medicine
Course syllabus
TOPIC 1. Less is more
TOPIC 2. Diagnostic tools arterial blood gas measurement
· ECG
· echocardiography
TOPIC 3. Clinical reasoning Diagnosis decision making overview
· Fever of unknown origin FUO
TOPIC 4. Dyspnea: consider differential diagnosis focusing on:
· Pulmonary infections—pneumonia
· Chronic obstructive pulmonary disease
· Heart failure
· Pulmonary hypertension
TOPIC 5. Chest pain: Consider differential diagnosis focusing on:
Cardiovascular causes of chest pain, Precordial chest pain, Coronary hearth disease (Atherosclerotic CAD, ischemic hearth disease)
TOPIC 6. Irregular heart rhythm (Montano, 4h)
· Atrial fibrillation
· Sudden Cardiac Death
TOPIC 7. Transient loss of consciousness (TLOC) (Costantino/Solbiati, 4h)
· Syncope
TOPIC 8. Approach to the adult with anemia: Consider differential diagnosis focusing on:
· Decrease RBC production, Increases destruction of circulating RBC, Blood loss, Systemic disorders
TOPIC 9. Coagulation Disorders:
· Emergency assessment of hemostasis Disorders
· Thrombocytopenia Diagnosis and treatment
· How to use: Old and new anticoagulants
· The management of complex clinical cases
TOPIC 10. Jaundice
· Identify the two main categories of the patients with jaundice (i.e. obstructive and non-obstructive jaundice)
TOPIC 11. Altered hepatic function/edema/ascites
· Identify the main categories of patients with liver disease (Acute and chronic hepatitis, advanced chronic liver disease)
· Consider differential diagnosis focusing on cardiovascular causes of edema (heart failure), renal causes, edema in cirrhosis, hypoalbuminemia
TOPIC 12. Weight disorders - overweight and obesity, Metabolic syndrome and diabetes
· Focus on the metabolic syndrome (increased blood pressure, a high blood sugar level, excess body fat around the waist and abnormal cholesterol level, clinical presentation and management
TOPIC 13. Uncommon abdominal pain: Relationship with rare diseases
TOPIC 14. Immune system disease
· Serological test of autoimmunity
· Pericarditis
· Vasculitis and polymyalgia rheumatic
· Medical condition and pregnancy
TOPIC 15. Geriatric medicine
TOPIC 16. Principles of Human genetics: Clinical cases
TOPIC 17. Value-based Health care
TOPIC 18. Palliative Medicine
TOPIC 2. Diagnostic tools arterial blood gas measurement
· ECG
· echocardiography
TOPIC 3. Clinical reasoning Diagnosis decision making overview
· Fever of unknown origin FUO
TOPIC 4. Dyspnea: consider differential diagnosis focusing on:
· Pulmonary infections—pneumonia
· Chronic obstructive pulmonary disease
· Heart failure
· Pulmonary hypertension
TOPIC 5. Chest pain: Consider differential diagnosis focusing on:
Cardiovascular causes of chest pain, Precordial chest pain, Coronary hearth disease (Atherosclerotic CAD, ischemic hearth disease)
TOPIC 6. Irregular heart rhythm (Montano, 4h)
· Atrial fibrillation
· Sudden Cardiac Death
TOPIC 7. Transient loss of consciousness (TLOC) (Costantino/Solbiati, 4h)
· Syncope
TOPIC 8. Approach to the adult with anemia: Consider differential diagnosis focusing on:
· Decrease RBC production, Increases destruction of circulating RBC, Blood loss, Systemic disorders
TOPIC 9. Coagulation Disorders:
· Emergency assessment of hemostasis Disorders
· Thrombocytopenia Diagnosis and treatment
· How to use: Old and new anticoagulants
· The management of complex clinical cases
TOPIC 10. Jaundice
· Identify the two main categories of the patients with jaundice (i.e. obstructive and non-obstructive jaundice)
TOPIC 11. Altered hepatic function/edema/ascites
· Identify the main categories of patients with liver disease (Acute and chronic hepatitis, advanced chronic liver disease)
· Consider differential diagnosis focusing on cardiovascular causes of edema (heart failure), renal causes, edema in cirrhosis, hypoalbuminemia
TOPIC 12. Weight disorders - overweight and obesity, Metabolic syndrome and diabetes
· Focus on the metabolic syndrome (increased blood pressure, a high blood sugar level, excess body fat around the waist and abnormal cholesterol level, clinical presentation and management
TOPIC 13. Uncommon abdominal pain: Relationship with rare diseases
TOPIC 14. Immune system disease
· Serological test of autoimmunity
· Pericarditis
· Vasculitis and polymyalgia rheumatic
· Medical condition and pregnancy
TOPIC 15. Geriatric medicine
TOPIC 16. Principles of Human genetics: Clinical cases
TOPIC 17. Value-based Health care
TOPIC 18. Palliative Medicine
Teaching methods
FOR ALL MODULES: Interactive lectures, Clinical cases, Seminars, Discussion on clinical cases, Case studies
Synchronous learning: video conferences, interactive webinars, chat-based online discussions and lectures
Asynchronous learning: audio-video based (pre-recoreded, multimedia platforms); text-based (e-mail, electronic documents, discussion boards, blogs); mixed (virtual libraries, social networks)
Synchronous learning: video conferences, interactive webinars, chat-based online discussions and lectures
Asynchronous learning: audio-video based (pre-recoreded, multimedia platforms); text-based (e-mail, electronic documents, discussion boards, blogs); mixed (virtual libraries, social networks)
Teaching Resources
Harrison's Principles of Internal Medicine, 20th Edition, McGraw Hill, 2018 (also available as ebook in the digital library of the University of Milano http://www.sba.unimi.it/)
UP To Date - Evidence Based Clinical Decision Support resource
UP To Date - Evidence Based Clinical Decision Support resource
General surgery
Course syllabus
TOPIC 1 - GENERAL PRINCIPLES OF SURGICAL SCIENCE AND STRUCTURE OF THE COURSE
Learning goals:
· Historic perspective: the long road to science
· Ethics, Professionalism and Principles of Surgery
· Pre-operative and Operative Principles
· Operating Room and available technology: staplers, adhesives, probes
TOPIC 2 - ANESTHESIA AND MANAGEMENT OF PAIN
Learning goals:
· Principles of Anesthesiology, fluid management, conscious sedation
· Treatment of acute and post-operative pain
· Anatomic pathways of pain, somatic and visceral pain
· Treatment of chronic pain
TOPIC 3 - SHOCK AND PRINCIPLES OF RESUSCITATION
Learning goals:
· Bleeding and Transfusion
· Fluids types, Lactate, Acidosis,
· Oxygen delivery and Coagulopathy
· Principles of resuscitation
TOPIC 4 - THE SURGICAL PATIENT- 1
Learning goals:
· Metabolism in the surgical patient, nutrition assessment and support
· Coagulation monitoring and management
· Venous Thromboembolism and Pulmonary Embolism
· The concept of safety in surgical procedures
TOPIC 5 - THE SURGICAL PATIENT- 2
Learning goals:
· Surgical complications of the wound: wound healing, dehiscence, wound infection
· G.I bleeding, anastomotic leak, and intestinal fistulas
· Surgical infections and antibiotics use
TOPIC 6 - SURGERY FOR FUNCTIONAL DISEASES - ABDOMINAL WALL
Learning goals:
· Abdominal wall and Umbilicus
· Inguinal hernia and femoral hernia
· Anterior abdominal wall hernias, repair, prosthetic materials
· Incisional hernias, parastomal hernias
TOPIC 7 - SURGERY FOR ACUTE INFLAMMATION
Learning goals:
· Acute abdomen, Peritonitis, Cholecistitis, Appendicitis
· Management of ascites
· Retroperitoneum: Abscesses, Hematomas, Fibrosis
TOPIC 8 - FROM HUMAN HANDS TO ROBOTS IN SURGERY
Learning goals:
· Minimally invasive surgery and simulation training
· Augmented reality and surgical planning
· Image-guided and endoscopic procedures
· Surgery and internet
TOPIC 9 - SURGERY FOR FUNCTIONAL DISEASES - ESOPHAGUS
Learning goals:
· Achalasia and Management of Esophageal motility disorders
· Gastroesophageal Reflux Disease
· Diverticular disorders
· Benign and Acquired disorders: perforation, caustics, foreign body
TOPIC 10 - SURGERY FOR FUNCTIONAL DISEASES - ANAL CANAL
Learning goals:
· Hemorrhoids
· Anal fissures and fistulas
· Inflammatory and sexually transmitted diseases
· Pelvic floor disorders: incontinence
TOPIC 11 - SURGICAL ONCOLOGY - GENERAL
Learning goals:
· General principles: recap of cancer biology and immunology
· Role of surgical and non-pharmacologic treatments in cancer care
· Surgical margins and Lymph-nodal dissection
· Surgery for cure and Surgery for palliation
TOPIC 12 - SURGICAL ONCOLOGY - BREAST
Learning goals:
· Diagnosis and planning of surgical treatment
· Mastectomy vs. Breast-preserving approach
· Lymph nodes in breast cancer: sentinel lymph node
· Locally advanced, Inflammatory cancer, Paget, Aged patients
TOPIC 13 - SURGICAL ONCOLOGY - UPPER G.I.- 1
Learning goals:
· Diagnosis and workup
· Endoscopic/US diagnosis and principles of endoscopic resections in upper G.I.
· Surgery in early-stage, superficial and locally advanced esophageal cancers
· Cardias: cancer of the gastro-esophageal junction
TOPIC 14 - SURGICAL ONCOLOGY - UPPER G.I.- 2
Learning goals:
· Gastric cancers: diagnosis, classification and treatment planning
· Gastrectomies and post-gastrectomy syndromes
· Lymph nodes and gastric cancer
· Gastric Lymphoma, GIST and NET of the stomach
TOPIC 15 - SURGICAL ONCOLOGY - HEPATO-BILIO-PANCREATIC - 1
Learning goals:
· Anatomical surgery and surgical anatomy of the liver
· Benign liver lesions: Cysts, Abscesses, Hemangioma, Hyperplasia, Adenoma
· Assessment of liver function, portal hypertension and liver insufficiency
· Primary liver cancer; guidelines for surgical and non-surgical treatment
TOPIC 16 - SURGICAL ONCOLOGY - HEPATO-BILIO-PANCREATIC - 2
Learning goals:
· Liver Metastases: role of surgery, assessment of resectability
· Partial liver resections and role of native vs. induced regeneration
· Cancer of the biliary system: curative vs. palliative procedures
· Other primary malignant neoplasms: Hepatoblastoma, Vasculary tumors
TOPIC 17 - SURGICAL ONCOLOGY - HEPATO-BILIO-PANCREATIC - 3
Learning goals:
· Exocrine pancreas: acute and chronic pancreatitis
· Cystic Neoplasia of the pancreas, mucinous cysts, IPMN
· Cancer of exocrine pancreas: surgery of tumors of the head, body and tail
· Endoscopic perspective on palliation and pre-operative treatments
TOPIC 18 - SURGICAL ONCOLOGY - LOWER G.I.1
Learning goals:
· Diagnosis and treatment management of colo-rectal cancer
· Hereditary Cancer Syndromes and Sporadic Colo-rectal Cancer
· Colonoscopy, Stomas
· Anatomical surgery and surgical anatomy of the colo-rectal cancer according to most practiced colectomies
TOPIC 19 - SURGICAL ONCOLOGY - LOWER G.I.- 2
Learning goals:
· Diagnosis and treatment management of colo-rectal cancer
· Technology-assisted colectomies and modern surgical management: "have laparoscopic and robotic instruments replaced human hands"?
TOPIC 20 - SURGICAL COMPLICATIONS: MANAGEMENT AND CASE DISCUSSION; SURGERY OF THE SPLEEN
Learning goals:
· Emergency operations in immunocompromized, aged, fragile patients
· Case discussion on acute and late complications of abdominal operations
· Anatomy and functions of the spleen
· Surgical and non-surgical treatments for the spleen
Learning goals:
· Historic perspective: the long road to science
· Ethics, Professionalism and Principles of Surgery
· Pre-operative and Operative Principles
· Operating Room and available technology: staplers, adhesives, probes
TOPIC 2 - ANESTHESIA AND MANAGEMENT OF PAIN
Learning goals:
· Principles of Anesthesiology, fluid management, conscious sedation
· Treatment of acute and post-operative pain
· Anatomic pathways of pain, somatic and visceral pain
· Treatment of chronic pain
TOPIC 3 - SHOCK AND PRINCIPLES OF RESUSCITATION
Learning goals:
· Bleeding and Transfusion
· Fluids types, Lactate, Acidosis,
· Oxygen delivery and Coagulopathy
· Principles of resuscitation
TOPIC 4 - THE SURGICAL PATIENT- 1
Learning goals:
· Metabolism in the surgical patient, nutrition assessment and support
· Coagulation monitoring and management
· Venous Thromboembolism and Pulmonary Embolism
· The concept of safety in surgical procedures
TOPIC 5 - THE SURGICAL PATIENT- 2
Learning goals:
· Surgical complications of the wound: wound healing, dehiscence, wound infection
· G.I bleeding, anastomotic leak, and intestinal fistulas
· Surgical infections and antibiotics use
TOPIC 6 - SURGERY FOR FUNCTIONAL DISEASES - ABDOMINAL WALL
Learning goals:
· Abdominal wall and Umbilicus
· Inguinal hernia and femoral hernia
· Anterior abdominal wall hernias, repair, prosthetic materials
· Incisional hernias, parastomal hernias
TOPIC 7 - SURGERY FOR ACUTE INFLAMMATION
Learning goals:
· Acute abdomen, Peritonitis, Cholecistitis, Appendicitis
· Management of ascites
· Retroperitoneum: Abscesses, Hematomas, Fibrosis
TOPIC 8 - FROM HUMAN HANDS TO ROBOTS IN SURGERY
Learning goals:
· Minimally invasive surgery and simulation training
· Augmented reality and surgical planning
· Image-guided and endoscopic procedures
· Surgery and internet
TOPIC 9 - SURGERY FOR FUNCTIONAL DISEASES - ESOPHAGUS
Learning goals:
· Achalasia and Management of Esophageal motility disorders
· Gastroesophageal Reflux Disease
· Diverticular disorders
· Benign and Acquired disorders: perforation, caustics, foreign body
TOPIC 10 - SURGERY FOR FUNCTIONAL DISEASES - ANAL CANAL
Learning goals:
· Hemorrhoids
· Anal fissures and fistulas
· Inflammatory and sexually transmitted diseases
· Pelvic floor disorders: incontinence
TOPIC 11 - SURGICAL ONCOLOGY - GENERAL
Learning goals:
· General principles: recap of cancer biology and immunology
· Role of surgical and non-pharmacologic treatments in cancer care
· Surgical margins and Lymph-nodal dissection
· Surgery for cure and Surgery for palliation
TOPIC 12 - SURGICAL ONCOLOGY - BREAST
Learning goals:
· Diagnosis and planning of surgical treatment
· Mastectomy vs. Breast-preserving approach
· Lymph nodes in breast cancer: sentinel lymph node
· Locally advanced, Inflammatory cancer, Paget, Aged patients
TOPIC 13 - SURGICAL ONCOLOGY - UPPER G.I.- 1
Learning goals:
· Diagnosis and workup
· Endoscopic/US diagnosis and principles of endoscopic resections in upper G.I.
· Surgery in early-stage, superficial and locally advanced esophageal cancers
· Cardias: cancer of the gastro-esophageal junction
TOPIC 14 - SURGICAL ONCOLOGY - UPPER G.I.- 2
Learning goals:
· Gastric cancers: diagnosis, classification and treatment planning
· Gastrectomies and post-gastrectomy syndromes
· Lymph nodes and gastric cancer
· Gastric Lymphoma, GIST and NET of the stomach
TOPIC 15 - SURGICAL ONCOLOGY - HEPATO-BILIO-PANCREATIC - 1
Learning goals:
· Anatomical surgery and surgical anatomy of the liver
· Benign liver lesions: Cysts, Abscesses, Hemangioma, Hyperplasia, Adenoma
· Assessment of liver function, portal hypertension and liver insufficiency
· Primary liver cancer; guidelines for surgical and non-surgical treatment
TOPIC 16 - SURGICAL ONCOLOGY - HEPATO-BILIO-PANCREATIC - 2
Learning goals:
· Liver Metastases: role of surgery, assessment of resectability
· Partial liver resections and role of native vs. induced regeneration
· Cancer of the biliary system: curative vs. palliative procedures
· Other primary malignant neoplasms: Hepatoblastoma, Vasculary tumors
TOPIC 17 - SURGICAL ONCOLOGY - HEPATO-BILIO-PANCREATIC - 3
Learning goals:
· Exocrine pancreas: acute and chronic pancreatitis
· Cystic Neoplasia of the pancreas, mucinous cysts, IPMN
· Cancer of exocrine pancreas: surgery of tumors of the head, body and tail
· Endoscopic perspective on palliation and pre-operative treatments
TOPIC 18 - SURGICAL ONCOLOGY - LOWER G.I.1
Learning goals:
· Diagnosis and treatment management of colo-rectal cancer
· Hereditary Cancer Syndromes and Sporadic Colo-rectal Cancer
· Colonoscopy, Stomas
· Anatomical surgery and surgical anatomy of the colo-rectal cancer according to most practiced colectomies
TOPIC 19 - SURGICAL ONCOLOGY - LOWER G.I.- 2
Learning goals:
· Diagnosis and treatment management of colo-rectal cancer
· Technology-assisted colectomies and modern surgical management: "have laparoscopic and robotic instruments replaced human hands"?
TOPIC 20 - SURGICAL COMPLICATIONS: MANAGEMENT AND CASE DISCUSSION; SURGERY OF THE SPLEEN
Learning goals:
· Emergency operations in immunocompromized, aged, fragile patients
· Case discussion on acute and late complications of abdominal operations
· Anatomy and functions of the spleen
· Surgical and non-surgical treatments for the spleen
Teaching methods
FOR ALL MODULES: Interactive lectures, Clinical cases, Seminars, Discussion on clinical cases, Case studies
Synchronous learning: video conferences, interactive webinars, chat-based online discussions and lectures
Asynchronous learning: audio-video based (pre-recoreded, multimedia platforms); text-based (e-mail, electronic documents, discussion boards, blogs); mixed (virtual libraries, social networks)
GENERAL SURGERY MODULE:
Synchronous learning: Formal lessons delivered by the Course Director, Faculty and Invited Experts will be delivered as formal lectures, seminars, video sessions, video tutorial and clinical case discussions focused on the topics summarized below in the detailed program.
Asynchronous learning: During a 3 months period to the students will be assigned the study of a clinical case chosen from the many presented in class, giving them the elements to individually investigate the many aspects connected to the surgical and non-surgical management of the patient. Students will be able to interact with the teachers during the preparation of the case to better orient themselves and focus on the problems to be evaluated from an operational point of view. We will proceed as follows:
· Students registered for each course (5th or 6th year) will be gathered into Working Groups which will be asked to produce structured reports on the presented cases.
· In particular, each Group will be asked to produce a specific presentation in accordance with a predetermined format, structured around the main components of clinical judgment and multidisciplinary decision-making in surgery (see below). Each Group will have to produce one report for every assigned topic of the analysis format.
· Collective and individual contributions to the report will be valued as part of the general assessment of student's participation and acquired knowledge over time, with particular reference to independent, structured contributions and insights
Clinical cases in Working Groups:
Topics for Clinical case analysis will be Assigned and students will investigate:
- Epidemiology, incidence, global and regional impact
of the presented disease condition
-Causes and mechanisms of the presented disease
related to concomitant patient condition
-Therapeutic alternatives according to disease presentation
and possible treatment combinations
-Surgical intervention (techniques and technology)
-Complications, pre/post operatory management
(morbidity and mortality discussion)
-Expected outcomes (literature search)
-Cost-Benefit analysis (general and individual)
-Ethics determinants of the intervention
etc
Synchronous learning: video conferences, interactive webinars, chat-based online discussions and lectures
Asynchronous learning: audio-video based (pre-recoreded, multimedia platforms); text-based (e-mail, electronic documents, discussion boards, blogs); mixed (virtual libraries, social networks)
GENERAL SURGERY MODULE:
Synchronous learning: Formal lessons delivered by the Course Director, Faculty and Invited Experts will be delivered as formal lectures, seminars, video sessions, video tutorial and clinical case discussions focused on the topics summarized below in the detailed program.
Asynchronous learning: During a 3 months period to the students will be assigned the study of a clinical case chosen from the many presented in class, giving them the elements to individually investigate the many aspects connected to the surgical and non-surgical management of the patient. Students will be able to interact with the teachers during the preparation of the case to better orient themselves and focus on the problems to be evaluated from an operational point of view. We will proceed as follows:
· Students registered for each course (5th or 6th year) will be gathered into Working Groups which will be asked to produce structured reports on the presented cases.
· In particular, each Group will be asked to produce a specific presentation in accordance with a predetermined format, structured around the main components of clinical judgment and multidisciplinary decision-making in surgery (see below). Each Group will have to produce one report for every assigned topic of the analysis format.
· Collective and individual contributions to the report will be valued as part of the general assessment of student's participation and acquired knowledge over time, with particular reference to independent, structured contributions and insights
Clinical cases in Working Groups:
Topics for Clinical case analysis will be Assigned and students will investigate:
- Epidemiology, incidence, global and regional impact
of the presented disease condition
-Causes and mechanisms of the presented disease
related to concomitant patient condition
-Therapeutic alternatives according to disease presentation
and possible treatment combinations
-Surgical intervention (techniques and technology)
-Complications, pre/post operatory management
(morbidity and mortality discussion)
-Expected outcomes (literature search)
-Cost-Benefit analysis (general and individual)
-Ethics determinants of the intervention
etc
Teaching Resources
Sabiston's Textbook of Surgery.- The Biological Basis of Modern Surgical Practice. 20th Edition Elsevier 2017
Additional material is provided by the slide-presentation used during frontal lessons and seminars, uploaded in the Ariel platform of the University for student access.
Additional material is provided by the slide-presentation used during frontal lessons and seminars, uploaded in the Ariel platform of the University for student access.
Plastic surgery
Course syllabus
TOPIC 1 - Burns
TOPIC 2 - Wound management
TOPIC 3 - Fat grafting
TOPIC 4 - Breast reconstruction
TOPIC 2 - Wound management
TOPIC 3 - Fat grafting
TOPIC 4 - Breast reconstruction
Teaching methods
FOR ALL MODULES: Interactive lectures, Clinical cases, Seminars, Discussion on clinical cases, Case studies
Synchronous learning: video conferences, interactive webinars, chat-based online discussions and lectures
Asynchronous learning: audio-video based (pre-recoreded, multimedia platforms); text-based (e-mail, electronic documents, discussion boards, blogs); mixed (virtual libraries, social networks)
Synchronous learning: video conferences, interactive webinars, chat-based online discussions and lectures
Asynchronous learning: audio-video based (pre-recoreded, multimedia platforms); text-based (e-mail, electronic documents, discussion boards, blogs); mixed (virtual libraries, social networks)
Teaching Resources
Grabb and Smith's Plastic Surgery, Wolters Kluwer
Thoracic surgery
Course syllabus
TOPIC 1 - Lung cancer: epidemiology, aetiology and clinical approach.
TOPIC 2 - Malignant pleural mesothelioma.
TOPIC 3 - Other thoracic malignancies (mediastinum, chest wall and diaphragm).
TOPIC 4 - "robotic approach in thoracic surgery"
TOPIC 5 - Interventional pneumology in the diagnosis, staging and treatment of lung cancer.
TOPIC 6 - Personalized medicine in lung cancer: genetic and immunological treatment.
TOPIC 2 - Malignant pleural mesothelioma.
TOPIC 3 - Other thoracic malignancies (mediastinum, chest wall and diaphragm).
TOPIC 4 - "robotic approach in thoracic surgery"
TOPIC 5 - Interventional pneumology in the diagnosis, staging and treatment of lung cancer.
TOPIC 6 - Personalized medicine in lung cancer: genetic and immunological treatment.
Teaching methods
FOR ALL MODULES: Interactive lectures, Clinical cases, Seminars, Discussion on clinical cases, Case studies
Synchronous learning: video conferences, interactive webinars, chat-based online discussions and lectures
Asynchronous learning: audio-video based (pre-recoreded, multimedia platforms); text-based (e-mail, electronic documents, discussion boards, blogs); mixed (virtual libraries, social networks)
Synchronous learning: video conferences, interactive webinars, chat-based online discussions and lectures
Asynchronous learning: audio-video based (pre-recoreded, multimedia platforms); text-based (e-mail, electronic documents, discussion boards, blogs); mixed (virtual libraries, social networks)
Teaching Resources
Shields' General Thoracic Surgery by Joseph LoCicero III MD 8th Edition, Wolters Kluwer
Urology
Course syllabus
TOPIC 1 - Syndromes in urology: acute retention of urine, haematuria, obstructive renal failure, incontinence
TOPIC 2 - Urolithiasis
TOPIC 3 - Urothelial & kidney cancer
TOPIC 4 - Testicular & prostate cancer
TOPIC 2 - Urolithiasis
TOPIC 3 - Urothelial & kidney cancer
TOPIC 4 - Testicular & prostate cancer
Teaching methods
FOR ALL MODULES: Interactive lectures, Clinical cases, Seminars, Discussion on clinical cases, Case studies
Synchronous learning: video conferences, interactive webinars, chat-based online discussions and lectures
Asynchronous learning: audio-video based (pre-recoreded, multimedia platforms); text-based (e-mail, electronic documents, discussion boards, blogs); mixed (virtual libraries, social networks)
Synchronous learning: video conferences, interactive webinars, chat-based online discussions and lectures
Asynchronous learning: audio-video based (pre-recoreded, multimedia platforms); text-based (e-mail, electronic documents, discussion boards, blogs); mixed (virtual libraries, social networks)
Teaching Resources
Smith & Tanagho's GENERAL UROLOGY, Jack W. McAninch & Tom F. Lue, 18th or 19th Edition
Clinical pathology
MED/05 - CLINICAL PATHOLOGY - University credits: 2
Lessons: 16 hours
: 8 hours
: 8 hours
Professor:
Dozio Elena
General surgery
MED/18 - GENERAL SURGERY - University credits: 5
Lessons: 40 hours
: 20 hours
: 20 hours
Professors:
Mazzaferro Vincenzo Maria, Sposito Carlo Ferruccio Alvise
Internal medicine
MED/09 - INTERNAL MEDICINE - University credits: 7
Lessons: 56 hours
: 28 hours
: 28 hours
Professors:
Brucato Antonio Luca, Caraceni Augusto Tommaso Giovanni, Montano Nicola, Motta Irene, Solbiati Monica, Tobaldini Eleonora
Pharmacology
BIO/14 - PHARMACOLOGY - University credits: 1
Lessons: 12 hours
Professor:
Fornasari Diego Maria Michele
Plastic surgery
MED/19 - PLASTIC SURGERY - University credits: 1
Lessons: 8 hours
: 4 hours
: 4 hours
Professor:
Klinger Marco Ettore Attilio
Thoracic surgery
MED/21 - THORACIC SURGERY - University credits: 1
Lessons: 8 hours
: 4 hours
: 4 hours
Professor:
Casiraghi Monica
Urology
MED/24 - UROLOGY - University credits: 1
Lessons: 8 hours
: 4 hours
: 4 hours
Professors:
Albo Giancarlo, Montanari Emanuele
Educational website(s)
Professor(s)
Reception:
to be agreed via email
European Institute of Oncology, Milan