Anesthesia 251 Clinical Clerkship in Anesthesiology University of the Philippines College of Medicine – Philippine General Hospital Department of Anesthesiology

Anesthesia 251 Course Coordinators Resident Monitors Preceptor Dr. Patricia Lorna O. Cruz Dr. Sheila Espina-Bertoso Resident Monitors Dr. Fernando Serra III Dr. Lala Datiles Preceptor Dr. Michelangelo Alvarez Bioethics Dr. Fides Flores

Anesthesia 251 Clerks are required to be either in the official school uniform or in the official clerks’ scrub suit at all times, with name plate or ID. Inside the operating room complex, clerks are required to be in their scrub suits with cap, masks, and OR footwear

Anesthesia 251 At the end of the course, the student should be able to:  Prepare patients for surgery and anesthesia; Assist in the administration of general and regional anesthesia; Discuss perioperative fluid therapy; Discuss the peculiarities and special considerations in the anesthetic management of the different surgical specialties; Discuss Acute Pain management; and Discuss a bioethical issue in the practice of Anesthesiology.

Anesthesia 251 Clerks are to submit a standardized 5” x 8” index card with a recent 1” x 1” picture. Index cards should be submitted to the resident monitor by the first Friday of the rotation.

Anesthesia 251 Name Nickname Premed Course/College Contact numbers Email Person to contact in case of emergency Organizations Talents/Skills Specialty preference 1x1 pic

Attendance Clerks are required to sign in at the attendance logbook located at the corner table beside the Anesthesia Residents’ Lounge. The attendance will be closed at 6:30 am everyday and 6:00 pm for the duty group. A grace period of 15 minutes will be observed, after which the clerk will be considered absent.

Attendance For purposes of daily attendance and duty, clerks will have to prepare a second 5” x 8” index card on which you will write down the date, time, rotation, name of resident in charge and other remarks. Index cards will be signed by the resident in charge or the team captain; and will be submitted at the end of the rotation.

Attendance Name LU VI Block date time rotation RIC with Signature other remarks

Attendance Clerks are expected to be in their posts from 6:30 am to 4:00 pm everyday (Monday to Friday) except during lectures If a lecture is scheduled during this time, clerks may proceed to the conference room after informing the resident in charge at your post. Once the lecture is over, clerks are expected to return to posts and stay until 4:00 pm or until the end of the case, whichever is earlier.

Attendance Excused from posts Pharma Lectures Tues 3-5 College Activities Kindly inform your Resident Monitor re: changes in Pharma Lec schedules and College Activities

Attendance Duties will be scheduled with two clerks going on duty everyday from 6:00 pm to 6:00 am. Each clerk should have gone on duty at least 3 times during the whole rotation. The duty team should report to the team captain by 6:00 pm.

Attendance The liaison officer should pass a copy of the block’s schedule of duties to the resident monitor by the second day of the rotation. The resident monitor should be informed of any changes in the duty groups at least a day ahead.

Attendance Clerks are not expected to be at their posts or go on duty during cancellation of classes due to typhoons or other emergencies. However, clerks are expected to report for duty on weekends, national, and school holidays. Post duty clerks should proceed to their day post and are off by 12noon

Attendance An absence is considered excused if the resident monitor is informed ahead of time and a formal letter of excuse addressed to the chair of the department is submitted. An accompanying certification from the UP Health Service is expected for absences due to illness.

Attendance Unexcused absences will mean make up duties, computed as the number of hours missed multiplied by two. Make-up duties will be only on weekends. Clerks should consult with their resident monitor regarding scheduling of make-up duties.

Attendance IMPORTANT! Attendance is 10% of the total rotation grade. Absences totaling 30% of the total rotation time will result in a grade of 4.0 or a repeat rotation.

Academics Lectures take precedence over all rotation activities. Lectures will be scheduled on the first week of the rotation, depending on the availability of the consultant-lecturer. Clerks should report and stay at their post until the liaison officer confirms the lecture.

Academics Students should report to the conference room on time. Attendance will be taken by the liaison officer and should be countersigned by the lecturer. This will be submitted at the Anesthesia office immediately after the lecture (Ma’am Erna). Or to your Resident Monitor.

Preceptorials Preceptorials are to be conducted as a block. This will comprise 10% of your grade. The block will be assigned a consultant-preceptor whom the liaison officer should contact on the first day of the rotation, to confirm their preceptorial meeting with him/her.

Preceptorials If the consultant will not be available anytime during the entire rotation, the liaison officer should inform the resident monitor so that another consultant may be assigned.

Conferences Clerks are required to attend the weekly Wednesday conference at 2:00 pm at ERC 205, and Friday Lectures at 6:30am at the Conference Room Attendance shall be taken by the liaison officer and submitted to the resident monitor right after the conference.

Wet clinics Clerks are to report to their elective posts at 6:30 am up to 4:00 pm during weekday, where they are the responsibility of that post’s resident-in-charge (RIC). A properly filled out preoperative anesthetic evaluation form scheduled for surgery that day is expected of each clerk.

Wet clinics Clerks are required to have at least 10 properly filled up preoperative anesthetic evaluation forms signed by their residents Clerks need not write notes in the charts of the patients.

Wet clinics Clerks are not allowed to perform a procedure without first conducting a pre-operative evaluation on the patient. Clerks are also expected to assist the RIC during the entire case and to complete the intraoperative monitoring of the patient.

Wet clinics Clerks are to submit 2 case discussions of 2 elective cases to which they were co-decked with focus on implications of comorbidities and surgery requirements on anesthetic management

Wet clinics During the first day of rotation, clerks shall have an observer status, hence will not be expected to perform procedures. However, RICs may allow clerks to perform certain procedures as they may see fit. When assigned to a pay case, maximize this opportunity to learn from the consultant.

Duties During duties, clerks are to stay at the LCB to assist with the emergency cases. Each clerk will be co-decked with a resident and be expected to assist your RIC during the entire case. Clerks are required to stay at the vicinity of the LCB / Anesthesia Residents’ Lounge for the duration of the duty. Clerks caught out of post will be sanctioned with an unexcused absence.

Duties Mon Tues Wed Thur Fri Sat Sun W1 OFF W2

Duties Clerks are to submit 1 case discussion on anesthetic management of 1 ER case

Examinations A total of three short quizzes (20 pts each) will be given throughout the two-week rotation (Friday – Monday – Friday), covering the reading assignments. On the 3rd quiz, there will be additional items taken from the lectures of the consultants The sum of the scores from the three quizzes will comprise 30% of the final grade.

Examinations Clerks who missed quizzes or exams because of an excused absence will be required to take a make-up exam, to be scheduled with the resident monitor. A missed quiz or exam due to an unexcused absence will mean a grade of zero for that exam.

Examinations An Organized Systematic Clinical Evaluation (OSCE) on the conduct of anesthesia via endotracheal intubation will be conducted on the second week of the rotation, to be given by a consultant or resident monitor/senior resident.

Examinations Clerks are responsible for scheduling their OSCE with the consultant or resident monitor/senior resident. OSCE may be done during elective hours or evening duty.

Requirements The following should be submitted in a long brown envelope to the resident monitor at the end of the rotation: index card for identification Index card for attendance pre-anesthetic evaluation forms (at least 10) – countersigned by RIC procedure forms (at least 6 intubations and 3 spinals – with corresponding intraoperative records countersigned by the RIC, stapled to the procedure form)

Requirements 2 Elective Case Discussions 1 ER Case Discussion 1 completed OSCE grading sheet one-page reaction paper (typewritten on short bond paper) on one of the cases presented during the Wednesday conference. This will be worth an additional 2% on the final grade a duly accomplished preceptorial evaluation form, countersigned by the consultant (to be submitted in the liaison officer’s envelope)

Grading Grading will be according to a pre-determined scale, to be standardized by the Clinical Clerks’ Committee. Should a grade of incomplete or failed be given to a clerk, deliberations will be conducted by the department’s Learning Unit 6 Committee. Results of this deliberation will be final.

Grading Breakdown of grades shall be as follows: 90% Quizzes 30% Procedures 10% Case Discussions 10% Attendance 10% Attitude 10% OSCE 10% Preceptorials 10% Comprehensive exam 10% (to be taken at the end of clerkship year) 90%

Reading Requirement Introduction to Anesthesia by David Longnecker and Frank Murphy, 9th edition

Anesthesia 251 Clinical Clerkship in Anesthesiology University of the Philippines College of Medicine – Philippine General Hospital Department of Anesthesiology