Clinical practice 6th year (clerkship)

A.A. 2020/2021
6
Crediti massimi
90
Ore totali
SSD
MED/09 MED/18
Lingua
Inglese
Obiettivi formativi
The clerkship scheduled in the 6th year conclude the practical training started in the 5th year. Students are trained to more advanced surgical and medical skills through attendance in the ward (medical and surgical) and in the operating room and consolidate technical and soft knowledge and skills developed during frontal lectures.
Risultati apprendimento attesi
Students are expected to achieve the following requirements:
- knowing how to perform a complete physical examination and knowing how to identify the pathological pictures
- report the basics of clinical judgment in the evaluation of patients starting from their presenting problems
- manage complex differential diagnoses by the appropriate use of clinical, laboratory, tests and exams findings
- manage the basics of a proper patient's treatment
- For each presenting problem Identify the most appropriate tests to formulate a correct diagnosis and plan the appropriate treatment
- Principles of electrosurgery
- Minimally invasive surgical techniques (laparoscopy)
- Central venous cannulation
- Urinary catheter insertion
- Nasogastric tube insertion
- General anesthesia and orotracheal intubation
- The ultrasound of the abdomen
- Laparoscopic simulator
For each presenting problem:
- Identify the most appropriate tests to formulate a correct diagnosis
- Plan the appropriate treatment
Programma e organizzazione didattica

Edizione unica

The teaching, given the current health situation, will be carried out entirely at a distance.
Prerequisiti
To attend the Clinical Practice course, students must have already passed all the exams of the first and second year (Fundamentals of Basic Sciences, Cells, Molecules and Genes 1 and 2, Human Body, Functions and Mechanisms of Diseases).
Modalità di verifica dell’apprendimento e criteri di valutazione
The Clinical Practice exam is organized as a combination of written, practical and oral examinations. Final formal examination may be preceded by an intermediate evaluation test of General Surgery at the end of the 5th year. Also reviews and discussion on medical literature and/or specific clinical research topics could concur to the evaluation either at intermediate or final stage.
· Written test: it is a multiple choice test, and focuses all the discipline of the 5th and 6th year courses of Clinical Practice, but Internal Medicine. Surgery and Biostatistics. Multiple choices Q&A questionnaire will be used. The questionnaire is prepared on the slides presented at the frontal lessons (uploaded in the University website for student access) and on the official textbooks.
Each question has 4 answers, and each answer can be true or false. The passing threshold is the 75% of all answers, with at least one correct question (all answers in the question) in each module. Once passed, the written test is valid for the next three years. Either the teaching staff and/or the IMS office will inform the students about the results of the written test.
Biostatistics assessment is based on the evaluation of a presentation of the work conducted during the practical activities.
Practical test: it evaluates the practical skills acquired by the students, and consists in a circuit of stations, in which students are examined on a simulated patient. Once passed, the practical test is valid for the next three years.
Oral test: When students pass both the written and the practical tests, they are allowed to take the oral examination of Internal Medicine and General Surgery. The final mark is the average of the two marks obtained in Internal Medicine and in General Surgery, weighted by the number of credits of each discipline.
The exam is deemed to be passed successfully if the final grade is equal to or higher than 18/30. In the event of a full grade (30/30) honors (lode) may be granted with the consent of all the professors.
Registration to the exam through SIFA is mandatory.
Internal medicine
Programma
Comprehensive Training on clinical judgment in the evaluation of patients with complex presenting problem and complex diseases, prescription and interpretation of appropriate use of clinical, laboratory, tests and exams findings

Internal medicine:
Clinical approach to admitted patients: execution of a complete physical examination and recognition of pathological pictures, discussion of possible differential diagnoses and related exams prescription, setting of a therapeutic scheme. Multidisciplinary meeting attendance.
Metodi didattici
Interactive lectures, Clinical cases, Seminars, Discussion on clinical cases. Clerkship attendance and sufficient exposure to practice (i.e. simulation lab, formal patients examination at bedside, training of basic medical-surgical techniques etc.) will be registered, as clinical teaching will be based also on direct participation of the students to different aspects of the hospital life.
Materiale di riferimento
· Harrison's Principles of Internal Medicine, 20th Edition, McGraw Hill, 2018 (also available as ebook in the digital library of the University of Milano http://www.sba.unimi.it/)
· UP To Date - Evidence Based Clinical Decision Support resource
· ACSM's Guidelines for Exercise Testing and Prescription. 2018, 10th ed
· Up to Date-Evidence based clinical decision support resources
General surgery
Programma
Clinical approach to surgical patient:
Operating Room Attendance: Surgical hand scrub, management of sterility during surgery. Assist to surgical incision and principles of hemostasis, wound suture, peripheral venous cannulation.
Physical examination of operated patients: physical examination of the surgical patients, wound care, management of drainage
Metodi didattici
Interactive lectures, Clinical cases, Seminars, Discussion on clinical cases. Clerkship attendance and sufficient exposure to practice (i.e. simulation lab, formal patients examination at bedside, training of basic medical-surgical techniques etc.) will be registered, as clinical teaching will be based also on direct participation of the students to different aspects of the hospital life.
Materiale di riferimento
Significant material and all slides used during frontal lessons and seminars are uploaded in the Ariel platform for student access.
· Sabiston Textbook of Surgery. The Biological Basis of Modern Surgical Practice. 20th Edition Elsevier 2017
Moduli o unità didattiche
General surgery
MED/18 - CHIRURGIA GENERALE - CFU: 3
Clerkship (att.prof.): 45 ore

Internal medicine
MED/09 - MEDICINA INTERNA - CFU: 3
Clerkship (att.prof.): 45 ore

Docente/i
Ricevimento:
Previo appuntamento da concordare via e-mail
ASST Grande Ospedale Metropolitano Niguarda, Blocco Sud
Ricevimento:
su appuntamento +39 02 6444.2291
Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milano
Ricevimento:
Martedì e Giovedì ore 12 previo appuntamento