Clinical Practice 6th Year (clerkship)
A.Y. 2023/2024
Learning objectives
The clerkship scheduled in the 6th year conclude the practical training started in the 5th year. Students are trained to more advanced surgical and medical skills through attendance in the ward (medical and surgical) and in the operating room and consolidate technical and soft knowledge and skills developed during frontal lectures.
Expected learning outcomes
Students are expected to achieve the following requirements: - knowing how to perform a complete physical examination and knowing how to identify the pathological pictures - 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 - For each presenting problem Identify the most appropriate tests to formulate a correct diagnosis and plan the appropriate treatment - Principles of electrosurgery - Minimally invasive surgical techniques (laparoscopy) - Central venous cannulation - Urinary catheter insertion - Nasogastric tube insertion - General anesthesia and orotracheal intubation - The ultrasound of the abdomen - Laparoscopic simulator For each presenting problem: - Identify the most appropriate tests to formulate a correct diagnosis - Plan the appropriate treatment.
Lesson period: First semester
Assessment methods: Giudizio di approvazione
Assessment result: superato/non superato
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.
Internal medicine
Course syllabus
Comprehensive Training on clinical judgment in the evaluation of patients with complex presenting problem and complex diseases, prescription and interpretation of appropriate use of clinical, laboratory, tests and exams findings
Internal medicine:
Clinical approach to admitted patients: execution of a complete physical examination and recognition of pathological pictures, discussion of possible differential diagnoses and related exams prescription, setting of a therapeutic scheme. Multidisciplinary meeting attendance.
Internal medicine:
Clinical approach to admitted patients: execution of a complete physical examination and recognition of pathological pictures, discussion of possible differential diagnoses and related exams prescription, setting of a therapeutic scheme. Multidisciplinary meeting attendance.
Teaching methods
Clerkship attendance and sufficient exposure to practice (i.e. simulation lab, formal patients examination at bedside, training of basic medical-surgical techniques etc.) will be registered, as clinical teaching will be based also on direct participation of the students to different aspects of the hospital life.
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
· ACSM's Guidelines for Exercise Testing and Prescription. 2018, 10th ed
· Up to Date-Evidence based clinical decision support resources
· UP To Date - Evidence Based Clinical Decision Support resource
· ACSM's Guidelines for Exercise Testing and Prescription. 2018, 10th ed
· Up to Date-Evidence based clinical decision support resources
General surgery
Course syllabus
Surgery
Clinical approach to surgical patient:
Operating Room Attendance: Surgical hand scrub, management of sterility during surgery. Assist to surgical incision and principles of hemostasis, wound suture, peripheral venous cannulation.
Physical examination of operated patients: physical examination of the surgical patients, wound care, management of drainage
Clinical approach to surgical patient:
Operating Room Attendance: Surgical hand scrub, management of sterility during surgery. Assist to surgical incision and principles of hemostasis, wound suture, peripheral venous cannulation.
Physical examination of operated patients: physical examination of the surgical patients, wound care, management of drainage
Teaching methods
Clerkship attendance and sufficient exposure to practice (i.e. simulation lab, formal patients examination at bedside, training of basic medical-surgical techniques etc.) will be registered, as clinical teaching will be based also on direct participation of the students to different aspects of the hospital life.
Teaching Resources
Significant material and all slides used during frontal lessons and seminars are uploaded in the Ariel platform for student access.
· Sabiston Textbook of Surgery. The Biological Basis of Modern Surgical Practice. 20th Edition Elsevier 2017
· Sabiston Textbook of Surgery. The Biological Basis of Modern Surgical Practice. 20th Edition Elsevier 2017
General surgery
MED/18 - GENERAL SURGERY - University credits: 1
Clerkship (professional training): 25 hours
Professor:
Sposito Carlo Ferruccio Alvise
Internal medicine
MED/09 - INTERNAL MEDICINE - University credits: 1
Clerkship (professional training): 25 hours
Professor:
Aversano Maria Gloria
Professor(s)