1. Introduction to Surgery 2 (SURG 636) Semester 171
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- history taking.
Perform and demonstrate- clinical examination.
Demonstrate skills to- interpret clinical signs.
Record & produce- full & summarized history & clinical examinations.
Demonstrate knowledge 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.
Getting involved with surgical emergencies & critically ill patients.
Skill to choose from- spectrum of surgical care ( operative vs non-operative).
Demonstrate self-learning & use of different teaching aids
Demonstrate dedication, concern, confidentiality of information.
Demonstrate professional manners.

6. COURSE DESCRIPTION Surgery 2 (SURG 636) Six (6) weeks.
1st Rotation (R1)- Sun 17th Sept- Mon 23rd Oct 2017
2nd rotation (R2)- Tue 24th Oct- Mon 27th Nov 2017
3rd rotation (R3)- Tue 28th Nov - Mon 01st Jan 2018

7. Course plan Final examination Lectures & Tutorials -Sunday & Monday
Hospital posting- Tuesday- Thursday
3rd week SUNDAY- Mid-Block examination
Case presentation ( last Tutorial day)
Final examination

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

9. Tutorial topics for students
1. Intervention radiology procedures in general surgery Indications & patient preparation
2. How to prepare patients for general surgery procedures
3. Post-operative (recovery room & ward) management.

10. 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

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

12. General Surgery Upper GI hemorrhage. Lower GI hemorrhage
Small bowel obstruction
Large bowel obstruction and colostomies
Obstructive jaundice
Bariatric surgery- surgical management of obesity
Minimally invasive surgery

13. 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.

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

15. Paediatric 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

16. Vascular surgery 1. Arterial diseases- Acute &Chronic- 2 lectures
Venous diseases & lymphatic diseases

17. Plastic surgery
Management of burn
Skin and subcutaneous tumours

18. Neurosurgery Management of head injury
Intracranial tumours and infections

19. Lecture Timetable- Group 1, Group 2 & Group 3
ALMAAREFA COLLEGE
Teaching program: SURG 2 (636) Semester 171
Lecture Timetable- Group 1, Group 2 & Group 3
Day AM AM
Break
9.40 -
10 AM
Prayer PM
1-2 PM
2-3 PM
1st Week
SUNDAY
R1: R R
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
R1: R R
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
2nd week
R1: R R
General presentation, assessment & 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
R1: R R
Diseases of lower urinary tract
Diseases of external genitalia
Surgical mgt. of morbid obesity in adults
Anaesthesia & pain management(G3)
Dr. Bilal
Common neonatal emergencies
Pediatric emergencies
3rd week
R1: R R
Management of Burn
Dr. Shareef
Management of skin & subcutaneous tumours, skin grafts
Obstructive jaundice
Introduction to minimally invasive surgery
Prof AlSaigh
Large bowel obstruction
Bronchogenic carcinoma, other lung tumours, metastatic carcinoma & mesothelioma
Dr. Waseem Hajjar
R1: R R
Case scenario- Breast lump
Case scenario: Thyroid & other neck swellings
Interpretation of common imaging studies

20. 4th Week
SUNDAY
R1: R R
Intervention radiology procedures in general surgery Indications & patient preparation
Presentation by students (Gr 1)
Case scenario: A trauma patient
Prof Alam
How to prepare patients for general surgery procedures
Presentation by students (Gr 2)
MONDAY
R1: R R
Case scenario: Complications of abdominal surgery
Examples of laparoscopic surgery procedures.
Prof. AlSaigh
Post-operative (recovery room & ward) management.
Presentation by students (Gr 3)
5th Week
R1: R R
Case scenario- Acute abdomen
Dr. Akeely
Spot diagnosis
Interpretation of common laboratory investigations
R1: R R
Prof. Alam
Case presentation by students
Prof Alam / Prof AlSaigh
Prof Alam / Prof AlSaigh

21. Hospital postings
3 days- fully spent in the hospital. (Tuesday-Thursday)

22. Hospital postings
Surgical units: In-patient, operating room, emergency room & OPD
.Actively participate in history taking, physical examination and discussing differential diagnosis.
Present 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 & attend surgery with the treating team.

23. 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.

24. 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)

25. Examinations Final exams: Mid block exam: 45-MCQ s 30- MCQs
Case scenario
Slide show
OSCE
Clinical examination (2 short cases)

26. Marks distribution Mid-Block examination- 15 Marks
Case presentation (5) + logbook (5)- 10 Marks
Log book evaluation- attendance, h/e of pts., case presentation, skills attended/participated & tutor signature
Final examination Marks

27. MID-BLOCK EXAMINATIONS
R1 – Sunday 1st October 2017
R2 - Sunday 12th November 2017
R3 - Sunday 17th December 2017
Exam components:
MCQ : 45 questions Marks

28. FINAL EXAMINATIONS R1- Sun 22 Oct & Mon 23 Oct 2017
R2 Sun 26 Nov & Mon 27 Nov 2017
R3 – Sun 31 Dec & Mon 01 Jan 2018
Examination components:
MCQ: questions Marks
2. Slide Show: 5 slides Marks (Each slide 2 marks)
3. Case scenarios: (2cases) Marks (Case slides/scenario & questions)
4. OSCE: (5 stations) Marks
(X-ray, lab results, specimens, instruments, clinical pictures, history taking, clinical examination)
5. Clinical examination: 20 marks on real patients in hospital

31. BLUEPRINT FOR MCQs MCQs- 45 Mid-block exam MCQs- 30 End-block exam 1-2
Lecture Topics
MCQs- 45
Mid-block exam
MCQs- 30
End-block exam
Anaesthesia and pain management
1-2
Sterilization, aseptic technique and operation room (Sutures, diathermy, drains, laparoscopic surgery)
2-3
3. Day surgery
4. Principles of transplantation surgery
5. Upper GI hemorrhage
3-5
6. Lower GI hemorrhage
7. Small bowel obstruction
8. Large bowel obstruction and colostomies
9. Obstructive jaundice
10. Surgical management of morbid obesity in adults
11. General presentation, assessment &investigations of urinary tract diseases.
3-4
12. Diseases of upper urinary tract (kidney & ureter)
13. Diseases of lower urinary tract (bladder, prostate, urethra)
14. Diseases of external genitalia: Circumcision, Congenital abnormalities of the penis, undescended testis (cryptorchidism), Torsion of the testis, Epididymo-orchitis, hydrocele, Varicocoele.
15. Diseases of oesophagus
16. Mediastinum, and pleuro-pulmonary infections
17. Presentation and management of: Bronchogenic carcinoma, other lung tumours including metastatic carcinoma, mesothelioma.
1-3
18. Management of head injury
19. Intracranial tumours and infections
20. Management of burn
21. Skin and subcutaneous tumours,
22. Common neonatal emergencies: Hirschsprung’s disease, Esophageal atresia, Imperforated anus, intestinal atresia,
23. Pediatric emergencies: Acute appendicitis, intussusception, Meckel’s diverticulum, Foreign bodies, perianal sepsis
24. Hernias, abdominal wall defects, undescended testis, childhood obesity
25. Chronic arterial diseases
26. Acute arterial ischemia
27. Venous disease and lymphedema
28. Tutorial topics
4-6
29. Minimally Invasive Surgery
BLUEPRINT FOR MCQs

34. Thank you!