The rotation consists of a six-week clinical experience as a junior
member of the surgical team, combined with didactic instruction
including problem-based learning, case presentations, and a series of
lectures delivered at Jefferson Medical College. The clinical rotation
is an opportunity to experience the gamut of common general surgical
problems as well as the range of surgical procedures. The rotation
includes exposure to transplant surgery, vascular surgery, and
The third-year student splits his or her six-week rotation on two
separate services consisting of three to five attending physicians, a
chief resident, and three other junior residents. Students are expected
to perform patient evaluations, write appropriate orders, and follow
their patients through surgery and postoperative management. Clinical
evaluation skills, introduction to and practice of technical surgical
skills including suturing and minor procedures, and the understanding of
anatomy are stressed.
Patient evaluation and problem-based learning and conferences are held
on a weekly basis throughout the six weeks. A didactic lecture series is
held at Jefferson Medical College, usually on Saturday mornings.
Attending physicians from Lankenau and Bryn Mawr Hospitals proctor the
patient evaluation and problem-based learning conferences. In addition,
various multi-specialty conferences are held throughout the course of
the rotation, including Oncology, Radiology, and GI conferences. The
didactic experience should provide a broad exposure to all surgical
problems as well as improve clinical evaluation skills.
Average Patient Load
Third-year medical students will evaluate patients in the emergency
room, preoperative patients, and hospital admissions. The number of
primary patient evaluations varies with the ability of the student but
ranges between four and ten per week. Students usually follow three to
five patients on their teams. Both junior and senior residents review
the patient evaluation and provide feedback, as well as assist in
writing orders. The student is responsible for follow-up evaluations and
progress notes on his or her patients during their stay in the hospital.
Teaching rounds are performed by the residents as well as the attending
The third-year student is not assigned to any one physician as a
preceptor, but has access to junior and senior residents in each
service, as well as the attending staff. Experience is gained both on
the wards and in the operating room. Students are considered part of the
team and receive the same attention in terms of education as the
Due to the nature of a surgical rotation, duty hours vary considerably.
Since the surgical experience involves not only time on the wards
evaluating patients, but also a significant amount of time in the
operating room, exact start and finish times cannot be guaranteed. Sign
in rounds each morning for each team occur at 7:00 a.m. and patients are
usually seen prior to this time. Sign out rounds in the evening usually
occur at approximately 5:00 p.m., but on many days OR cases and
emergencies may delay the time for sign out. Third-year students are not
expected to come to the hospital on Saturdays or Sundays unless they are
on call. However, the lecture series at Jefferson Medical College
usually involves Saturday morning lectures.
Night call for a third-year student will occur no more often than every
third night. During the call, the third-year student is expected to see
consults in the ER, admissions to the hospital, and emergency cases in
the OR. This experience generally requires a third-year student to
remain in the hospital overnight. Overnight sleeping quarters are
Number of Students on Rotation
There are usually three to five third-year medical students at Lankenau
Medical Center during each six-week block. There may also be fourth-year
students on rotation during any of these six-week time slots.
Student Expectations or Learning Objectives
Description of a Typical Day
A typical day for a third-year clerk in surgery begins at approximately
6:00 a.m. Following round on his or her patients, sign in with the team
occurs at approximately 7:00 a.m. All patients on the team are discussed
at that time. Conferences are held on Tuesday and Thursday mornings
following sign in and include patient management conferences. Rounds
then occur with the attending staff. Students assigned to cases in the
OR should be present 15 minutes prior to the procedure. Operations occur
Monday through Friday beginning at 7:30 a.m. Following attending rounds,
students will either be in the OR, evaluating new patients, performing
procedures on the ward, or revisiting patients on the service.
Educational conferences are scheduled on Tuesdays and Thursdays at noon,
as well as other afternoon conferences. Sign out rounds with each team
usually occur at approximately 5:00 p.m. However, there may be many
reasons for staying later than 5:00. There are many opportunities for
learning throughout the day and the student that is enthusiastic,
inquisitive, aggressive, and independent will take away what he or she
needs to learn from the surgical rotation.
Please contact the Department of Surgery at 484-476-2169 with your
inquiries about the clerkship.
Connect with MLH
Graduate Medical Education
Main Line Health
100 Lancaster Avenue
Wynnewood, PA 19096
For more information, call 1.866.CALL.MLH.