Drexel University

Plastic Surgery Pathway

Curriculum through Class of 2019 only. For students graduating Class of 2020 and beyond, please see new curriculum link.

Introduction

The Plastic Surgery Discipline-Based Pathway will provide a basic experience in Plastic Surgery with additional areas of emphasis in fields related to Plastic Surgery. Required courses will include the Internal Medicine and Neurology courses which are required for graduation. A Plastic Surgery course based at home will be required as well. General Surgery subinternship and a choice of several electives will be offered.

Sites and Personnel

Pathway Director and Site Coordinator:
Drexel University College of Medicine

Paul M. Glat, M.D.
St. Christopher's Hospital for Children
Division of Plastic Surgery
Erie Avenue at Front Street
Philadelphia, PA 19134
Phone: 215-427-5191
Fax: 215-427-5389
e-mail: paul.glat@tenethealth.com

Amit Mitra, M.D.
Hahnemann Center for Plastic and Cosmetic Surgery
231 N. Broad Street, 3rd floor
Philadelphia, PA 19107
Phone: 215-557-7227
Fax: 215-557-7384
e-mail: amitabhamitra@gmail.com

Office Manager:
Betsy Kessel
215-557-7435
Betsy1.Kessel@tenethealth.com

Manager, Surgical Clerkship:
Tricia Grey
Hahnemann University Hospital
245 N. 15th Street
7th Floor, Suite 7604
Philadelphia, PA 19102
Phone: 215-762-2065
Fax: 215-762-3058
e-mail: tag25@drexel.edu

Teaching Sites

The Plastic Surgery Course in the Discipline-Based Pathway will be available for one student per month and will take place at several campuses. The course will be coordinated through the coure director. The sites for clinical participation are the following:

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Goals and Objectives

The primary goal of the Division of Plastic Surgery's Senior Year Discipline-based Pathway is to provide a framework for students to structure their senior year in preparation for a planned residency in Plastic Surgery. Traditionally, Plastic Surgery has been a surgical specialty that is entered after completing training in General Surgery or a Surgical sub-specialty. The current trend is to accept students into a 6 or 7 year direct training program at the end of medical school. The Pathway includes a required course in Plastic Surgery as well as the required courses for graduation at DUCOM. The elective courses are chosen to highlight areas of clinical importance to plastic surgery. Additional elective time can be utilized to obtain training in other fields of medicine. Three electives are similarly available to participate in research or advanced studies.

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Description of Pathway

Click here for summary table of Plastic Surgery Pathway

The Pathway includes 3 required courses and 6 electives. The required courses must be performed at "home" sites while the electives may be chosen at "home" or "away" sites. A research elective must be summarized in an end report.

The required subintership in Medicine and Neurology course are DUCOM graduation requirements and are described in detail elsewhere. The General Surgery required rotation is a strongly recommended course in the Plastic Surgery Pathway. A course description is provided in the Surgery Pathway. The Plastic Surgery course must be taken during one of the first 6 rotation periods. The student must have an opportunity early on in the Pathway to interact directly with the faculty and residents. In that way the student will further appreciate the subsequent electives. The faculty will, furthermore, be in a better advisory position. The Plastic Surgery course description will follow.

The optional elective menu consists of several course options, of which the student must select two.

Anesthesia is a discipline which is closely allied to Plastic Surgery. The student must be exposed to intravenous sedation, regional anesthesia, and general anesthesia. The rotation will provide the student extensive exposure to airway management, complex metabolic issues, and clinical pharmacology.

Dermatology is critical for plastic surgical training. Plastic surgeons treat multiple skin problems including wounds, skin tumors, and skin resurfacing. The student should have exposure to the clinical evaluation of skin lesions, laser treatments, dermatographic surgery and dermatopathology.

Infectious diseases is a medical subspecialty which works closely with Plastic Surgery in treating many complex infections. The student should learn how to evaluate and treat sepsis, acute and chronic infections and understand the medical treatment of serious surgical infection such as fasciitis, mediastinitis, osteomyelitis, visceral abscesses, etc. The student must learn the appropriate use of antibiotics.

Ophthalmology is an elective in which the student should learn how to properly examine the eye and recognize orbital disorders. An understanding of eye anatomy and function as well as the relationship of the orbit to the periorbital tissues is required.

Oral surgery will provide the student with an opportunity to understand occlusal pathology, maxillofacial anatomy, and transoral approaches to the facial skeleton.

Orthopaedics will provide a framework for understanding skeletal and muscular anatomy and function. The student requires exposure to the clinical evaluation and operative treatment of orthopedic trauma, congenital deformities, osteomyelitis, and hand disorders.

Otolaryngology is an important rotation during which the student should learn to do a proper head and neck examination. Head and neck anatomy, congenital deformities of the face and neck and benign and malignant masses of the head and neck are topics which will be thoroughly covered during this rotation.

Surgical Pathology is critical for the development of sound surgical decision making. The student must recognize that pathology is the foundation of many plastic surgical procedures, particularly oncologic and reconstructive surgeries. The student will be exposed to the diverse range of normal and abnormal tissue types on frozen and permanent analysis. The student should learn how to orient a surgical specimen and perform a gross examination. The student will be schooled in the diagnosis of common surgical diseases.

The student will be given 3 free elective rotations. A maximum of 3 elective courses may be chosen from the surgical disciplines. If the student elects to perform a research elective, a 3 month continuous block is required. All research electives must be pre-planned and approved by the Pathway Director.

Required Home Based Plastic Surgery Course

This course is a one month course designed to provide an overview of Plastic Surgery for the students. The course must be taken during one of the first 6 rotation periods. The course will be a well supervised educational experience designed to build upon already acquired cognitive and technical skills. Through the course, a student will be given an appropriate environment for learning technical skills, clinical skills in patient evaluation, the intellectual skills of surgical decision making, and social skills in terms of dealing with patients, family, and staff. The student will fulfill clinical and academic responsibilities as an integral team member of the Plastic Surgery Service. The experience will be both hospital-based and will extend to outpatient offices.

Medical Student Responsibilities

1. The medical student will be assigned patients to be under his/her direct care at HUH. The student will be supervised by a Plastic Surgery Fellow, a surgical resident on rotation in Plastic Surgery, and by the staff of Plastic Surgery Attendings. The workday will begin at approximately 6 a.m. At that time, it is expected that the student will receive sign out rounds from the night call resident.

2. Optimal patient load for students will be five to 10 patients. Plastic Surgery patients do not require intensive care during their hospital stay, as do patients on the Medical or General Surgical Services. The students will see on average one new admission per day and one to two consults per day.

3. A comprehensive history and physical examination, assessment and plan must be performed on all new patients on the day of admission. This history and physical examination will be reviewed by the supervising residents on the Plastic Surgery Service.

4. A comprehensive consultation shall be performed by the resident for consult patients. This will consist of an extensive history and physical examination, assessment and plan. This must be reviewed by an attending plastic surgeon on call before being placed in the patient chart.

5. Daily problem oriented progress notes shall be written on all of their patients. These notes will be reviewed, critiqued and countersigned by a supervising resident or attending physician daily.

6. The medical student will attend one to two outpatient office hours sessions per week. Each of these sessions will be one half day. The student will be directly supervised by the Plastic Surgery Attending during these sessions. They will be given an opportunity to assess new patients referred to the Plastic Surgery Service as well as to evaluate post-operative patients.

7. The students will be expected to participate in surgical activities. They will assist during surgical operations. It is their responsibility to read about these surgeries prior to their appearance in the operating room, in order to derive the maximum benefit from these surgeries as a learning experience.

8. The student will be required to attend conferences held by the Department of Surgery, including Morbidity/Mortality, Grand Rounds, and clinical presentation conferences. Specific Plastic Surgery Conferences will be required when they are developed.

Clinical Campuses

One student will be provided the opportunity to take the Plastic Surgery rotation at a time. The student will have primary clinical responsibilities for patient care at HUH and SCHC. However, they will be expected to participate in surgical activities at all other sites.

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Evaluation

Performance on the wards will be evaluated by the supervising resident and attending physicians using the standard University Clinical Evaluation Form. The student will be evaluated for fund of knowledge, history taking, physical examination, communication skills, data synthesis, case management skills, personal qualities, effectiveness in training assignments, interaction with patients and technical skills. Furthermore, the student's participation in the clinical rotation, conferences and attendance at meetings will be integrated into the summary evaluation. A final evaluation and grade will be developed by the Pathway Director.

Mid-Rotation Student Progress Report
Midway through the clinical rotation, the clinical preceptors (Attending & Resident) will discuss with the student, his/her progress including a recommendation for improvement. The Clinical Pathway Director will be notified by residents and attendings if the performance of the student is found to be marginal or unsatisfactory.

Exit Interview-Student & Clinical Preceptor
1. A Clinical Preceptor will review the student's 4 week progress as a rotator on the Plastic Surgery Service and will complete the senior student clinical evaluation report form including the "Formative & Summative" comments and recommendations.

2. The student will be asked to critique the course and must complete a confidential evaluation form of:
a. the clinical rotation service experience
b. the attending and resident teaching and oversight

3. Preceptor evaluation forms will be forwarded to the Course Director's Office.

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Textbooks and Learning Resources

Grabb & Smith's Essentials of Plastic Surgery and Cohen's Mastery of Plastic Surgery are recommended for the Plastic Surgery rotations, and are available at the Libraries for reference.

The standard textbooks of Medicine are recommended as references including Harrison's, Cecil, Stein, etc. The Washington Manual is recommended as a quick reference while working on clinical wards. The standard textbooks of Surgery are also recommended as references including Greenfield, Schwartz, and Sabiston. The standard textbooks of Plastic Surgery including Grabb & Smith's, Essentials of Plastic Surgery, and Mastery of Plastic Surgery will be available at the Libraries for reference during the Plastic Surgery Rotations.

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Evaluations

The student's performance while on elective course assignments will be evaluated by both the supervising attending physician and resident using the standard University Clinical Evaluation Form. This completed form will be forwarded as soon as possible to the Office of the Division of Plastic Surgery Senior Student Pathway Course Director for assessment and data entry. Students not receiving a grade of satisfactory or higher will be counseled and provided with remediation.

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Revised 10/02/04/17