1. Introduction to Surgery 2 (SURG 636)
M K ALAM MS FRCS
Professor of Surgery
AL MAAREFA COLLEGE

2. Aims
To prepare professional clinicians with sound knowledge, skills, understanding and appropriate attitudes ready to qualify in the graduating examination.
They should be ready to specialize and practice in the field of medical science of their choice.

3. Theoretical objectives
To provide a broad based knowledge of diseases in the field of general surgery
To provide basic knowledge of diseases in the field of surgical specialties

4. Clinical objectives Perform and demonstrate careful history taking.
Perform and demonstrate a comprehensive clinical examination.
Demonstrate appropriate skills to interpret clinical signs.
Record and produce full & summarized history & clinical examinations.
Demonstrate knowledge of the symptoms & signs of common surgical diseases.
Demonstrate skill to formulate a reasonable differential diagnoses.

5. Clinical objectives Justify investigations & interpret its findings.
Show the need for careful, accurate and speedy decision making.
Demonstrate getting involved with surgical emergencies & critically ill patients.
Demonstrate the skill to choose from the spectrum of surgical care ( operative vs non-operative).
Demonstrate self-learning & use of different resources of teaching aids
Demonstrate dedication, concern, confidentiality of information.
Demonstrate professional manners.

6. COURSE DESCRIPTION
Surgery 2 (SURG 636)
Six (6) weeks.

7. Course plan Week 1: Lectures Week 2: Hospital posting & Tutorial
Week 4: SUNDAY- Mid-Block examination & Hospital posting
Week 5: Hospital posting & Case presentation (Tutorial day)
Week 6: End Block examination

8. Teaching Format Lectures Hospital posting
Tutorials (Interactive sessions):
Case scenarios/ interpretation of lab. results/ imaging studies/ spot diagnosis/ common instruments

9. Principles of surgery General surgery Urology Thoracic surgery
Syllabus
Course will include topics from:
Principles of surgery
General surgery
Urology
Thoracic surgery
Neurosurgery
Plastic surgery
Pediatric surgery
Vascular surgery

10. Principles of Surgery
Anaesthesia and pain management
Sterilization, aseptic technique & operation room (Sutures, diathermy, drains, laparoscopic surgery)
Day surgery
Principles of transplantation surgery

11. General Surgery Upper GI hemorrhage. Lower GI hemorrhage
Small bowel obstruction
Large bowel obstruction and colostomies
Obstructive jaundice
Surgical management of morbid obesity in adults (Bariatric surgery)

12. Urology
General presentation, assessment and investigations of urinary tract diseases.
Diseases of upper urinary tract (kidney & ureter)
Diseases of lower urinary tract (bladder, prostate, urethra)
Diseases of external genitalia: Circumcision, Congenital abnormalities of the penis, undescended testis (cryptorchidism), Torsion of the testis, Epididymo-orchitis, hydrocele, Varicocoele.

13. Thoracic surgery Diseases of oesophagus
Mediastinum, and pleuro-pulmonary infections
Presentation and management of: Bronchogenic carcinoma, other lung tumours including metastatic carcinoma, mesothelioma.

14. Pediatric surgery
Common neonatal emergencies: Hirschsprung’s disease, Esophageal atresia, Imperforated anus, intestinal atresia,
Pediatric emergencies: Acute appendicitis, intussusception, Meckel’s diverticulum, Foreign bodies, perianal sepsis
Hernias, abdominal wall defects, undescended testis, childhood obesity

15. Vascular surgery 1. Arterial diseases
Venous diseases & lymphatic diseases

16. Plastic surgery
Management of burn
Skin and subcutaneous tumours

17. Neurosurgery Management of head injury
Intracranial tumours and infections

18. Teaching program: SURG 2 (636) Semester 161 Date 11-12-16 to 12-01-17
Day AM AM
Break
9.40 -
10 AM
Prayer PM
1-2 PM
2-3 PM
SUNDAY
Small bowel obstruction
Prof. AlSaigh
Upper GI bleeding
Introduction to
Surgery 2
Prof. Alam
Day Surgery
Prof Alam
Chronic Arterial disease
Dr. Qaisar
Venous & lymphatic diseases
MONDAY
Lower GI bleeding
Principles of transplantation surgery
Sterilization, aseptic technique and operation room
Acute limb ischemia
Hernias, abdominal wall defects, undescended testis, childhood obesity
Dr. S Mallick
TUESDAY
General presentation, assessment and investigations of urinary tract diseases
Dr. M Turki
Diseases of upper urinary tract (kidney & ureter)
Diseases of oesophagus
Dr. Waseem Hajjar
Diseases of mediastinum & pleuro-pulmonary infections
Management of head injury+ Raised ICP
Dr. Safdar
Intracranial tumors and infections
WEDNESDAY
Management of Burn
Dr. Shareef
Management of skin & subcutaneous tumours, skin grafts
Surgical management of morbid obesity in adults
Anaesthesia and pain management
Dr. Bilal
Common neonatal emergencies
Pediatric emergencies
THURSDAY
Diseases of lower urinary tract
Diseases of external genitalia
Obstructive jaundice
Introduction to minimally invasive surgery
Large Intestinal obstruction and colostomies
Dr. Alam
Bronchogenic carcinoma, other lung tumours, metastatic carcinoma and mesothelioma
(2-3 PM)

19. Weeks 2-5: Clinical rotation.
4 days- fully spent in the hospital.
Thursdays: In the college for tutorials

20. Hospital postings- 4weeks
Surgical units: In-patient, operating room, emergency room & OPD
.Actively participate in history taking, physical examination and discussing differential diagnosis.
Present patient’s case history, physical examination and participate in case discussion with in-charge clinicians.
Expected to master history taking and perform clinical examination on surgical patients as well as participating in patient-care related activities.
Follow up and interpret investigation (blood, imaging) results.
Discuss management plan and attend surgery with the treating team.

21. Hospital postings
Maintain a logbook- document all patients seen, procedures attended/participated (signed by a consultant/ registrar/ tutor.)
Display professional behavior at all time.
Must abide by the hospital rules.
Must strictly adhere to the confidentiality of patients and hospital.
Must follow the dress code.
Carry own pen torch and stethoscope.

22. SKILLS/PROCEDURES- AT HOSPITAL
History & examination of different organ systems
Study of imaging studies
Interpretation of laboratory investigations
Nasogastric tube
Wound drains
Wound care
IV line
PR exam
Prostate examination
Proctoscopy
Suturing
Urinary catheterization (Male & Female)
Colostomy care (if available)

23. Hospital posting & Tutorials, Surg. 2 636 Semester 161
Day
8 AM to 4 PM
SUN
HOSPITAL POSTING
MON
TUE
WED
THU
TUTORIALS at the College

24. Case scenario- Acute abdomen
TUTORIALS on THURSDAYS at ALMAAREFA COLLEGE (Semester 161)
DAY &
DATE
Tutorial AM
BREAK AM
TUORIAL AM
PRAYER PM
TUTORIAL
1 PM- 4 PM
THURSDAY
Case scenario- Acute abdomen
Dr. Akeely
Interpretation of common imaging studies
Prof Alam
Case scenario- Breast lump
Case scenario: Complications of abdominal surgery
Topic: Examples of laparoscopic Surgery procedures
Prof. AlSaigh
Case scenario: A trauma patient
Interpretation of common laboratory investigations
Spot diagnosis
Case scenario: Thyroid & other neck swellings
Prof AlSaigh
Case presentation by students
Prof Alam/Prof AlSaigh

25. Sixth (6th) week- Examinations
MCQ
Case scenario
OSCE
Clinical examination

26. Marks distribution Mid-Block examination- 30 Marks
Case presentation (5) + logbook (5)- 10 Marks
Log book evaluation- attendance, h/e of pts., case presentation, skills attended/participated & tutor signature
End Block examination Marks

27. EXAMINATIONS MID-BLOCK EXAMINATION (1st Jan. 2017)
MCQ : 45 questions Marks
Slide Show- 5 slides Marks (Each slide 2 marks)
History taking Marks (Volunteer/ SP)
2. END BLOCK EXAMINATION (6th week)
MCQ: 30 questions Marks
Case scenarios: 2cases 10 Marks (Case slides & questions)
OSCE: 5 stations Marks ( X-ray, lab results, specimens, instruments, skill procedures)
Clinical examination: 20 marks (Wednesday)- Real patients

30. Thank you!