Program Coordinator: Dana Sands, MD

Duration: 4 weeks
Availability: Year round
No. of Students: 1

Prerequisite

Completion of all core clerkships. Open to senior medical students.

Objectives

To provide students with clinical and surgical exposure to the diagnosis and treatment of patients with colorectal disorders.

Description

Students actively participate in all outpatient and inpatient activities to ensure a broad, balanced, in-depth, comprehensive experience. Students are expected to stay to the end of surgery on surgery days and round on some weekend days.

Supervision is provided by the five staff surgeons and five clinical residents, who have special interests in familial adenomatous polyposis, Crohn's disease, ulcerative colitis, large bowel cancer and disorders of evacuation.

Emphasis is placed on history taking, physical examination and diagnosis indigenous to this area, including anoscopy, flexible sigmoidoscopy and office procedures. There is an active Anorectal Physiology Lab with studies including manometry, cinedefecography, pelvic floor electromyography and anal ultrasonography. The Department is accredited as part of the NAPRC and holds a weekly MDT conference that students attend.

Students observe colonoscopies, polypectomies, biopsies and surveillance colonoscopies performed by the staff. They make hospital rounds each day with the staff surgeons and colorectal surgery residents. They participate in preoperative evaluation, and are exposed to a wide range of open, laparoscopic and anorectal operative experiences, including stoma creation, ileoanal reservoir surgery, rectal cancer, Crohn’s disease operations and operations for prolapse and incontinence, and a wide array of anorectal operations including hemorrhoidectomies, sphincterotomies, fistulotomies and sphincteroplasties.

The department has a high level of academic productivity to which the student will be exposed. In addition to numerous research protocols, several clinical and research – oriented conferences are held each week. The student will derive significant benefit for participation. There are no “on call” responsibilities. Postoperative care includes daily rounds on the floor and intensive care units, and active participation in patient management. As a tertiary referral center for colorectal disease patients from around the world present for management of many complex and challenging problems; preoperative surgery is a common reason for referral to the department.

The ranges of procedures performed include virtually all new and innovative modalities such as taTME, TAMIS, SNS, complex reoperative abdominal surgery and minimally invasive colorectal surgery including laparoscopy and robotics.

Evaluation

Evaluations will be distributed by the MSE department to the preceptor at the end of the rotation.