MINISTRY OF HEALTH OF THE REPUBLIC OF BELARUS Educational establishment

B E L A R U S I A N S T A T E M E :>ICAL U N I V E R S I T Y

CLINICAL INPATIENT PRACTICE (SURGERY)

Work Experience Practical Training

Curriculum for the Speciality:l-79 01 01 «General Medicine»

2019

APPI Firstл

Reg/ oroz

COMPILERS: Sinilo S.B., PhD, Associate Professor Kondratenko G.G. DMedSc, Professor Tratsyak S J. DMedSc, Professor Ignatovich I.N., DMedSc, Professor Vasilevich A.P., PhD, Associate Professor Zhura A.V., PhD, Associate Professor Kozlov V.G., PhD, Associate Professor

RECOMMENDED FOR APPROVAL:

By the 1st and 2nd departments of Surgery of Belarusian State Medical University (protocol №16 15.04.2019);

By the methodological committee of the Surgical Sciences of Belarusian State Medical University (protocol №6 17.04.2019).

EXPLANATORY NOTE The clinical inpatient practice curriculum for the speciality 1-79 01 01

«General Medicine» was compiled in accordance with the educational standard of the first stage of higher education of the Republic of Belarus by Decree №150 of 28.11.2017 "About the Amendments and Additions to Certain Decrees of the Ministry of Education of the Republic of Belarus" and the standard educational plan.

The organization and procedure of the clinical practical training are determined by the Decree of the Council of Ministers of the Republic of Belarus of June, 03, 2010, No.860 «About the approval of the regulations of the practical training of students, cadets, trainees» (as amended by the Decree of Council of Ministers of August, 04, 2011 No. 1049, of December, 09, 2011 No.1663, of September, 11, 2012 No.844, of May, 8th, 2013 No.356, of August 22nd, 2013 No.736) and Regulation «About the practical training of students of educational institution Belarusian State Medical University» of January, 29, 2014 No.l 18.

The aim of the clinical practical training is to strengthen the acquired knowledge and to obtain practical skills, which are the matter of physician's professional activity.

The objectives of the clinical practical training are: - to get acquainted with the structure of a health care facility and management of

medical stuff work; - the formation and development of the basis of social and personal competences of

students by acquiring skills in interpersonal communication with medical staff and patients;

- the formation of a basis of students' professional competences by acquiring skills in practical application of knowledge of surgical diseases. A student undergoes clinical practical training in Surgery as a physician's assistant

in healthcare institutions. During the clinical practical training the students submit all the working

regulations of a healthcare institution. The students are admitted to practical training after being instmcted in safety measures at a workplace.

On completing the practical training students should know: - the role and goals of a physician while providing the competent and

specialized medical assistance to the population; - the basis of sanitary and epidemiological regimens of healthcare institution

and fulfill all the requirements in surgical and admission departments, ICU, operating rooms.

- the rules of making medical records in a hospital; - the clinical manifestations, classification, main signs, additional diagnostic

studies, first aid, management and treatment of common surgical diseases; - the clinical protocols of the Ministry of Health of the Republic of Belarus

of medical help to emergency patients; - the management (diagnostics and treatment) of the all urgent surgical

diseases; the sequence of care and features of the examination of patients with a combined trauma;

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- the procedure for assisting with mass admission of patients to the emergency department;

- the principles of deontology and medical etic; - the basics of working disability expertise; - rules and norms of labor protection and fire safety, should be able: - to identify the main and additional complaints of patients, to collect history, analyze and present the data in the medical card of the inpatient; - to perform an objective examination of the patient, identify and interpret the identified pathology;

to confirm the preliminary diagnosis, determine the further plan of laboratory and instrumental examination to clarify the clinical diagnosis;

to interpret the results of laboratory tests of blood, urine and other biological media correctly, as well as the data from instrumental examination (radiological, ultrasound, endoscopic, etc.);

to carry out differential diagnostics of surgical diseases and to formulate a clinical diagnosis;

to determine the severity of the patient's condition, the likely prognosis and tactics of treatment; - to prescribe and justify etiologic, pathogenic therapy;

to fill in correctly the basic medical documentation of admission department, surgical hospital (under the supervision of a surgeon);

to justify the tactics of treatment of patients with acute surgical pathology, defining the indications for emergency and elective surgery;

to organize and provide first medical aid for bleeding, bums and frostbite, for electrical injuries, fractures, dislocations, injuries, for burns of the esophagus, with uncomplicated chest injuries, etc.; - to fill in observation diaries, to write out epicrises of surgical patients;

to fill in protocols for erythrocyte mass transfusion, plasma, plasma replacement solutions;

to assist in the puncture and drainage of the pleural and abdominal cavities, laparocentesis and diagnostic laparoscopy, in the puncture of the joints and the introduction of the Blackmore probe, should master:; - the general clinical techniques and methods of examination of a surgical

patient; - the me thods of primary surgical treatment of wounds; - the technique of applying and removing skin seams; - the rules of ligation of clean and purulent wounds; - the principles of local anesthesia according to A.Y.Vishnevsky; - the technique of closed heart massage and artificial respiration; - the rules for opening abscesses and phlegmons of soft tissues, whitlow,

treatment of bedsores; - the technique of staging of the gastric probe and gastric lavage;

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- the methods of catheterization of the bladder and the rules of care of the catheter;

- the rules of the digital examination of the rectum and its examination with the help of a rectal speculum, reposition of the dropped out hemorrhoids and the rectum;

- the rules of the care of tampons and drains of the abdominal cavity, soft tissues and equipment, and the timing of their removal;

- the technique of staging various enemas (siphon, cleansing, medical, etc.); - the rules of imposing an occlusive dressing with open pneumothorax; - the technique of puncture of the peripheral vein and the implementation of

venesection; assistance techniques for emergency and planned operations as the 1st and 2nd assistant;

- the rules of imposing skeletal traction for fractures, reduction of dislocations and reposition of bone fractures;

- plaster casting technique.

Total number of hours given to the clinical practice in Surgery is 162 academic hours for 3 weeks at the end of the 10th semester in health care institutions, which are the bases of the practice of the educational institution "Belarusian State Medical University" for a period of five years. There are 108 hours of classroom work, including three evening shifts from 16.00 to 21.00, and 54 hours of student independent work.

Current assessment is carried out in accordance with speciality curriculum in the form of differentiated credit (11 semester).

The current assessment is carried out according to the diary presented by the student, the report on the; implementation of the curriculum of clinical inpatient practice in surgery, and the written testimonial from the practice supervisor of health care institution.

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CONTENT OF THE PROGRAM OF MEDICAL CLINICAL MANUFACTURING PRACTICE

1. State, industry and local regulatory framework 1. About approval of the clinical protocol for emergency medical help to the

adult population and declaring certain structural elements non-valid of Decree of the Ministry of Health of the Republic of Belarus of June 13, 2006 No. 484: Order of the Ministry of Health of the Republic of Belarus of September 30, 2010 No. 1030.

2. About approval of clinical protocols and treatment of patients (adults) with acute surgical diseases: decree of the Ministry of Health of the Republic of Belarus of June 01,2017 №46.

3. About establishment of the republican formulary of medicinal products and recognition as non-valid of the Resolution of the Ministry of Health of the Republic of Belarus of July 01, 2016 No. 80: Resolution of the Ministry of Health of June 26, 2017 No. 67

4. About measures to reduce the antibacterial resistance of microorganisms: Decree of the Ministry of Health of the Republic of Belarus of November 29, 2015 No. 1301.

5. About aipproval of clinical protocols "Emergency medical help for patients with anaphylaxis", "Diagnosis and treatment of systemic toxicity in the application of local anesthetics": Resolution of the Ministry of Health of the Republic of Belarus of June 01, 2017 No. 50.

6. About approval of the Instruction of the procedure for issuing and processing disability certificates and certificates of temporary disability: Resolution of the Ministry of Health, Ministry of Labor and Social Protection of January 4, 2017 No. 1/1.

7. About Amendments to the Resolution No. 65 of the Ministry of Health of the Republic of Belarus of July 16, 2007: Resolution No. 65 of the Ministry of Health of the Republic of Belarus of August 13, 2018 No. 50.

8. About approval of sanitary norms and rules "Sanitary-epidemiological requirements for organizations providing medical care and carrying out sanitary and anti-epidemiological measures for the prevention of infectious diseases in these organizations", declaring some of the decrees of the Ministry of Health of the Republic of Belarus non-valid: Resolution of the Ministry of Health of July 05, 2017 No.73.

9. About approval of Sanitary standards and regulations "Requirements for the organization and carrying-out of sanitary and anti-epidemic measures for prevention the occurrence and spread of viral hepatitis and invalidation of the Resolution of the Ministry of Health of the Republic of Belarus of November 14, 2011 No. 112: Resolution of the Ministry of Health of the Republic of Belarus of February 06, 2013 №11.

10. About the revision of departmental regulations governing issues on the problem of HIV / AIDS: Decree No. 351 of the Ministry of Health of the Republic of Belarus of December 16, 1998 № 351.

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About aipproval of the instruction on the procedure for the organization of blood transfusion in the preparation, processing, storage, sale of blood and its components in the territory of the Republic of Belarus: Resolution of the Ministry of Health of the Republic of Belarus of May 19, 2011 No. 38.

2. Equipment and equipment of the hospital department Safe working conditions, fire safety rules. Medical instruments and materials.

Medical equipment. Rules of asepsis and antiseptics, methods of processing and protecting the

hands of medical personnel, sanitary and anti-epidemic regime.

3. Professional techniques Students undergo clinical practical training in surgery in the surgical

departments: surgical, urological, neurosurgical, trauma, vascular, combined injuries. Students, who practice in district hospitals can participate with the surgeon at the clinic, assist the patient at home and ambulance.

In the hospital, the student studies the structure and organization of the surgical department. The student works as an assistant physician, supervises 4 to 6 patients, participates daily in rounds of the attending phy sician and the department manager, fills in medical records (case histories, writes diaries, draws up discharge certificates), performs diagnostic and therapeutic procedures. The student independently collects anamnesis from admitted patients, fills out a medical card of an inpatient patient, determines the plan of examination and treatment, gets acquainted with the methods and results of examination of patients in the diagnostic departments of the hospital: endoscopic, X-ray (including CT), MR1, laboratory; departments of radioisotope and ultrasound research methods. In a dressing room, a student, under the guidance of a doctor, makes dressings, removes stitches, removes drains, imposes plaster bandages, etc. If possible, participates in all operations of the surgical department as an assistant. Performs some surgical procedures with the permission and under the supervision of the head of the department. It provides first aid for life-threatening conditions and emergency surgical diseases. The student has to be present at the morning reports, with autopsy and clinical and pathological conferences. In addition, students take part in hospital professional meetings, carry out sanitary enlightenment and educational work.

During the passage of the clinical practice of medical practice in surgery, the student must conduct 3 duties from 16 to 21 hours as an assistant surgeon on duty of the receiving department (emergency room) of hospital.

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APPROXIATE THEMES AND FORMS OF SANITARY EDUCATIONAL WORK

Subjects of conversation: 1. Pancreatitis - medical and social problem. 2. Actual problems of surgery (peptic ulcer, gallstone disease, acute and chronic pancreatitis, abdominal wall hernias, varicose veins, diabetic foot, etc.). 3. The importance of early patients' activity in the postoperative period. 4. Maintain a healthy lifestyle. 5. Food hygiene. 6. Rational nutrition in diabetes. 7. The effect of smoking on the occurrence and complications in obliterating vascular diseases of the lower extremities, diseases of the chest organs, etc. 8. The role of alcohol in the occurrence of domestic and industrial injuries. 9. Alcohol and di seases of the gastrointestinal tract. 10. Healthy lifestyle is the key to health.

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INFORMATIONAL AND METHODICAL PART

CALENDAR, THEMATIC PLAN OF THE MEDICAL CLINICAL PRACTICE IN SURGERY

Name of works Number of days (classroom hours / self-work)

1. Work in the surgical departments (emergency, planned, purulent surgery, thoracic, urological, neurosurgical, etc.). Curation of 4-6 patients. Filling in medical records.

15 (90/0)

1.1 .Participation in the morning conferences 15 (0,5/0)

1.2. Examination of surgical patients in the intensive care unit. 15 (15/0)

1.3. Work in the operating room. 14 (14/0) 1.4. Work in the treatment room (determination of blood group, pro bes before blood products transfusion, placement of peripheral catheters, etc.)

6 (6/0)

1.5. Work in dressing rooms, including in purulent department. 14 (14/0)

1.6. Work in the endoscopy room (to be present when performing upper endoscopy, colonoscopy, bronchoscopy with the evaluation of the findings).

6 (6/0)

1.7. Work in ultrasound rooms with evaluation of the findings. 14 (14/0)

1.8. Work in the room of computed tomography (reading the data together with the doctor).

5 (5/0)

1.9. Work in the MRI room (reading the findings with the doctor) 3 (3/0)

1.10.Work in the X-ray room (reading radiographs with a doctor). 5(5/0)

1.11 . Work in the admission department 5 (5/0) 1.12. Participation in the work of the 1 (0,5/0)

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WCC

1.13 . Work in operating rooms for angiography, during stenting of vessels. Evaluation of the received angiography together with the doctor.

2 (2/0)

2.. Emergency surgery shifts 3 (18/0) 3. Conducting health education 9 (0/18) 4, Records? practice diary, practice summary report 9(0/18) 5. The task of the discipline "Public Health and Healthcare" 9(0/18)

Total: 15 (108/54) Notes: 1. The calendar thematic plan can be changed by the head of the clinical base

practice, depending on the presence in the structure of the clinical base of special examination methods (CT, MRI, medical equipment for interventional x-ray surgery);

2. Points 1.1.-1.13. relate to the main work in the surgical departments and are performed during medical practice.

METHODICAL INSTRUCTIONS FOR HEADS OF PRACTICE AND STUDENTS

The educational and methodological guidance of medical clinical practice of students on surgery and taking tests are carried out by the 1st and 2nd departments of surgical diseases. Heads of these departments are responsible for the quality and effectiveness of the practices.

In medical institutions of public health, general management of students' practical experience is conducted by the deputy chief physician of surgery or by a medical unit, and directly by the head of the surgical department and the attending physician (according to the order of the chief physician of the institution). The direct supeivisor assures with his signature in his diary the student's practical training and the nature of the work he did.

The teachers of the 1st and 2nd Department of Surgical Disorders appointed by order of the Rector of the University for the current academic year of the students' clinical practical training are responsible for the quality of its implementation:

- exercise control over the organization and conduct the practice; - monitor the implementation of the program of clinical practical training; -provide students with practical organizational methodological assistance; - check the diaries and reports on the implementation of the practical training

program by the students. The head of the practice from the health care institution, which is the base of

the practice, is also responsible for the quality of the clinical work practice: - instructs students in safety engineering and labor protection;

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- identifies and eliminates promptly the deficiencies in the course of the practice, and, if necessary, reports them to the management of the educational institution "Belarusian State Medical University" and the public health institution;

- controls student discipline; -informs the dean of the student's practice debts; - creates the necessary conditions for students to complete the practice

program; -at the end of the practice, gives the description of the work of each student,

which is signed by the head of the practice, the head physician and sealed by the health care institution (Appendix No. 4);

OBLIGATIONS OF THE STUDENT DURING THE PRACTICAL TRAINING

During the internship the student must: 1. familiarize with the program of medical clinical practical training on the

website of the university; 2. comply with the internal regulations of the health care institution; 3. comply with the principles of deontology; 4. perform an internship program. 5. comply with the rules and regulations of health and safety, fire safety and

industrial hygiene. During the internship, the student must keep a "Diary of medical clinical work

practice" and a report on the credit standards of the program of practice. 1. The diary is a document that records the implementation of the program of

medical clinical practical training, which details all the manipulations performed during the working day.

The student records the main points of his familiarization and practical activities daily at various departments of the health care institution, indicating the procedures, diagnostic tests or other manipulations he performed, and those which he carried out independently or under the guidance of health professionals.

2. The report on the test standards of the program of practice is compiled at the end of medical clinical practical training. It should contain a list of medical manipulations at which the student was present; a list of medical manipulations (with an indication of their number) that the student performed independently under the guidance of a doctor. It is necessary to give a step-by-step description of all the actions of one of the medical manipulations, which the student carried out independently most often during the practice.

At the end of the clinical internship, the diary and the student's report (Appendices 1,2,3) are signed by the supervisor of the internship, by the head of healthcare institution and sealed by the health care institution.

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EXAMINATION QUESTIONS FOR DIFFERENTIATED CREDIT ON CLINICAL INPATIENT PRACTICE IN SURGERY

1. Classification, clinical manifestations and diagnosis of acute appendicitis. 2. Clinical and laboratory syndromes, specific symptoms in acute

appendicitis. 3. Classification, clinical manifestations and diagnosis of acute cholecystitis. 4. Clinical and laboratory syndromes, specific symptoms in acute

cholecystitis. 5. Diagnostic and treatment algorithm for acute cholecystitis. 6. Classification, clinical manifestations and diagnosis of acute pancreatitis. 7. Clinical and laboratory syndromes, specific symptoms in acute pancreatitis. 8. Determination of acute pancreatitis severity. 9. Etiopathogenic treatment of acute destructive pancreatitis, indications for

surgery. 10. Special methods of investigation (ultrasound, CT, endoscopic, etc.),

specific findings and complications in necrotizing pancreatitis. 11. Management of patients with acute calculous cholecystitis, indications for

emergency surgery, postponed and elective surgery. 12. Management of patients with acute destructive pancreatitis, indications for

emergency surgery, postponed and elective surgery. 13. Classification, clinical manifestations and diagnosis of intestinal

obstruction. 14. Clinical and laboratory syndromes, specific symptoms of intestinal

obstruction. 15. Describe the necessity and technique of the diagnostic-and-treatment

complex for acute intestinal obstruction. 16. Radiological and specific clinical symptoms of intestinal obstruction. 17. Management (algorithm of examination and treatment) of intestinal

obstruction. 18. The basic principles of preoperative preparation and postoperative care in

patients with intestinal obstruction. 19. Classification, clinical manifestations and diagnosis of duodenal and gastric

ulcer perforation. 20. Sealed perforation of gastric and duodenal ulcer. Features of the disease

course and diagnosis. 21. Features of clinical picture and diagnosis of duodenal and gastric ulcer

perforation according to the stage of peritonitis. 22. Clinical and laboratory syndromes, specific symptoms of duodenal and

gastric ulcer perforation. 23. Management (algorithm of examination and treatment) of patients with

duodenal and gastric ulcer perforation. 24. Basic principles of preoperative preparation and postoperative care in

patients with duodenal and gastric ulcer perforation. 25. Complications of abdominal hernia. Local signs of hernia strangulation.

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26. Clinical picture and diagnosis of strangulated abdominal hernia. 27. Basic principles and stages of operations for non-complicated and

strangulated hernia. 28. Criteria for assessing the viability of the strangulated intestinal loop and

measures for its "revitalization". 29. Strangulated abdominal hernia. Types of the elastic compression. 30. False incarceration of hernia, false reduction, spontaneous reduction of

strangulated hernia. Surgical tactics in these conditions. 31. Hemorrhagic shock, stages and scheme of medical help. 32. Traumatic shock, stages and scheme of medical help. 33. The stages of medical help and features of examination of the patients with

multi-trauma. 34. The sequence of medical help in mass admission of patients to the

admission department. 35. Principles of deontology: keeping the medical confidentiality, rules of

relationships with medical staff, the patient arid his relatives. 36. Features of clinical course of acute appendicitis in elderly, pregnant women

and children. 37. Complications of acute appendicitis before and during surgery. Clinical

manifestations, diagnosis, treatment. 38. Postoperative complications of acute appendicitis. Clinical manifestations,

diagnosis, treatment. 39. Appendiceal mass. Etiology and pathogenesis, clinical manifestations,

diagnosis, treatment. 40. Functional intestinal obstruction. Etiology and pathogenesis, clinical

manifestations, diagnosis, treatment. 41. Intraoperative bile ducts exploration. 42. Complications of the gallstone disease. Clinical manifestations, diagnosis,

treatment. 43. Mechanical intestinal obstruction. Features of clinical manifestations,

diagnosis, and treatment. 44. Functional intestinal obstruction. Etiology and pathogenesis, clinical

manifestations, diagnosis, treatment. 45. The choice of surgical procedure for perforated gastric and duodenal ulcer. 46. Peritonitis. Etiology and pathogenesis, classification, clinical

manifestations, diagnosis. 47. Modern principles of treatment of peritonitis. 48. Modem principles of detoxification therapy for peritonitis. 49. Complex treatment of peritonitis. 50. Diagnostic algorithm for cholestasis. 51. Rules of primary surgical treatment of wounds. 52. Technique of applying and removing sutures. 53. Rules of dressing clean and purulent wounds. 54. A.V.Vishnevsky principles of local anesthesia

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55. Technique of close heart massage and artificial lung ventilation. 56. Types of anesthesia and rules of drainage for whitlow. 57. Rules of treatment of pressure ulcers (necrosis). 58. Techniques of urinary bladder catheterization and rules of care for the

catheter. 59. Indications and technique of gastric probe insertion and lavage. 60. Rules of soft tissue abscess and phlegmon drainage. 61. Rules of digital rectal examination. 62. Rules of rectum, examination with rectal retractors. 63. Rules of relapsed rectum reduction. 64. Indications and technique of siphon enema. 65. Indications for peritoneal cavity drainage and rules of care for the drainage

tubes. Terms of tube removal. 66. Indications for peritoneal cavity pads packing and rules of care for them.

Terms of removal. 67. First aid for frostbites. 68. Indications and technique of cleansing enema. 69. Indicati ons, rules, and technique of plaster cast, applying. 70. The main duties of 2nd assistant in urgent and emergent surgery. 71. Indicati ons and technique of pleural puncture. 72. Rules of filling in protocols for red blood cells transfusions. 73. Rules of filling in protocols for fresh frozen plasma transfusions. 74. Rules of filling in protocols for plasma extender transfusions. 75. Rules of occlusive dressing applying for open pneumothorax. 76. Indications and technique of venesection and puncture of arteries. 77. Technique of laparocentesis for ascites. 78. First aid for esophageal burns. 79. Indications and teclmique of Sengstaken-Blakemore balloon tamponade. 80. First aid for soft tissue burns. 81. Stages of treatment for extremity joints dislocations. 82. Rules of bone fractures reposition. 83. Rules of tourniq uet applying for bleeding arrest. 84. General clinical techniques and methods of surgical patient investigation. 85. Indications and techniques of joint puncture. 86. Rules of immobilization for transportation in trauma of extremities. 87. Methods of treatment of extremity fractures. 88. Rules of immobilization for transportation in vertebral and pelvic trauma. 89. Rules of immobilization for transportation in hip fracture. 90. Features of filling in epicrisis of surgical patients. 91. Detection of blood group according to ABO system. 92. Methods of arterial bleeding control. 93. FLules of blood individual compatibility test of donor and recipient. 94. Rules of blood Rh compatibility test of donor and recipient. 95. Technique of blood biological compatibility test of donor and recipient.

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96. Indications for RBC transfusion. 97. Side effects in RBC transfusion. 98. Indications and technique of fresh frozen plasma transfusion. 99. Visual assessment of preparedness to transfusion of red blood cells pack. 100. Duties of physician, who performs transfusion of RBC and other blood

components.

LIST OF PRACTICAL SKILLS, GAINED DURING THE CLINICAL PRACTICE IN SURGERY

1. Inspection and filling medical history for an emergency patient 2. Filling the medical history of a planned patient 3. Making observation diaries for an emergency patient 4. Filling a case history of a planned patient 5. Registration of the red blood cell transfusion protocol 6. Registration of plasma transfusion protocol 7. Registration of discharge epicrisis 8. Registration of discharge epicrisis documents for cancer patients 9. Registration of the protocol of surgical intervention 10. Making indications for surgical intervention 11 „ Primary surgical treatment of wounds 12. Drainage of abscesses and phlegmon of soft tissues 13. Drainage of whitlow 14. Local anesthesia 15. Dressing clean wounds and removing sutures 16. Removal of drains 17. Dressing of purulent wounds 18. Dressing of bedsores 19. Blood group detection 20. Red blood cell transfusion 21. Transfusion of plasma and other blood products. 22. Puncture of the veins, catheterization of peripheral superficial veins, venesection. 23. Puncture of joints and bursal sacs, the injection of drugs. 24. Gastric probe setting and gastric lavage 25. Performing siphon enema 26. Setting the Blackmore probe 27. Performing pleural puncture 28. Drainage of the pleural cavity 29. Puncture of the abdominal cavity with ascites 30. Participation in the laparocentesis and diagnostic laparoscopy 31. Bladder catheterization 32. Digital rectal examination, rectal examination with rectal retractors 33. Reduction of the rectal prolapse 34. Participation as 1st assistant in emergency and planned operations

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35. Participation as a 2nd assistant in emergency and planned operations 36. Skeletal traction for fractures 37. Reduction of joints dislocations

LITERATURE

1. Жура, А. В. Заболевания желчного пузыря и протоков = Diseases of the Gallbladder and Bile Ducts: учеб.-метод, пособие на английском языке / А. В. Жура, А. В. Большое. - Минск: БГМУ, 2015. - 40 с. 2. Жура, А. В. Закрытая травма живота = Closed Abdomen Trauma: учеб.-метод. пособие на английском языке / А. В. Ж:ура, В. Г. Козлов. - Минск: БГМУ, 2015. - 4 0 с. 3. Жура, А. В. Острый панкреатит :=: Acute Pancreatitis: учеб.-метод, пособие на английском языке / А. В. Жура. - Минск: БГМУ, 2015. - 32 с. 4. Жура, А.В. Грыжи = Hernias: учеб.-метод, пособие / А.В. Жура, А.В. Большов. - Минск: БГМУ, 2017. - 32 с. 5. Жура, А.В. Заболевания аорты = Diseases of the aorta : учеб.-метод. Пособие / А.В. Жура, В.Я. Хрыщанович. - Минск: БГМУ, 2016. - 28 с. 6. Жура, А.В. Заболевания артерий = Diseases of the arteries: учеб.-метод. Пособие / А.В. Жура, С.И. Третьяк, А.В. Романович. - Минск: БГМУ, 2016.-40 с. 7. Жура, А.В. Острый и хронический аппендицит = Acute and chronic appendicitis: учеб.-метод. пособие / А.В. Жура, С.И. Третьяк. - Минск: БГМУ, 2017.-26 с. 8. Завада Н.В. Неотложная хирургия органов брюшной полости (стандарты диагностики и лечения). / Мн.: БелМАПО, 2005.117с. 9. Игнатович, И.Н. Контрольные вопросы по хирургическим болезням = Examinational questions in surgical diseases: методические рекомендации / И.Н. Игнатович, С,В. Якубовский, А.В. Жура. - Минск: БГМУ, 2018. - 76 с. 10. Третьяк, С.И. Схема учебной истории болезни по хирургическим болезням = Scheme of educational case history in surgical diseases: метод. Рекомендации / С.И. Третьяк, А.В. Жура. - Минск: БГМУ, 2017. - 7 с. 11. Clinical Surgery. Authors: Alfred Cuschieri, Pierce A. Grace, Ara Darzi, Neil R. Borley, David I. Rowley 12. Common Surgical Diseases, Second Edition. Authors: Jonathan A. Myers, Keith W. Millikan, Theodore J. Saclarid.es, Jonathan A. Myers, Keith W. Millikan, Theodore J. Saclarides. 13. Essential Practice in Surgery: Basic Science and Clinical Evidence. Author: Jeffrey A. Norton. 14. Essentials of General Surgery, Authors: Peter F. Lawrence MD, Richard M. Bell MD, Merril T. Dayton MD, James C. Hebert MD FACS, 608P.

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15. Schwartz's Principles of Surgery, Ninth Edition, Authors: F. Brunicardi, Dana Andersen), Timothy Billiar, David Dunn, John Hunter, Jeffrey Matthews, Raphael E. Pollock, 1888P. 16. Surgery: tests for the 4th year students of the Faculty for Foreign Students: тесты для студентов 4 курса фак. иностр. учащихся (курс обучения на англ. яз.) / Н. И. Батвинков [и др.]. Гродно: ГрГМУ, 2012. 3350 с.

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Appendix 1. Form of the Diary First Page

MINISTRY OF HEALTH OF REPUBLIC OF BELARUS

Educational Institution «BELARUSIAN STATE MEDICAL UNIVERSITY»

Health Care Institution (NAME OF HEALTH CARE INSTITUTION)

APPROVED Director of the Health Care Institution

(signature, name, surname)

20 STAMP HERE

D I A R Y

Clinical Inpatient Practice in Surgery

(name, surname)

Faculty Course Academic Group №

Training at ( Name of Health Care Institution, Name of the Department)

Student Supervisor from Healthcare institution _____

(name, surname, signature)

Lecturer of В SMU (name, surname, signature)

20

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Appendix 2. Approximate Form of the Diary

Date Forms and Types of Work Total

Only the work performed by the student are to be shown, indicating the degree of participation (observed, assisted, performed independently). It is desirable, that a student will make his own assessment of the full working day, and analysis of the current result of practical training compared with credit standards.

Student's signature (daily) Date, signature of the supervisor (weekly), personal

medical stamp of the Head of the department

Notes: 1. The diary should be handwritten. Entries are done in an accurate neat,

legible handwriting. Corrections, additions after sighting of records by the head of practice are not allowed.

2. Registration of the: report;,, characteristics is carried out on paper A4 format using MS Word-2003 (or later) and is carried out in accordance with the requirements of the state standard STB 6-38-2004 for details, text, document design and data in tables.

3. The signature of the supervisor in the practice diary, the practice report and the student's testimonial is certified in the prescribed manner.

4. Diaries, reports, testimonials, and other documents are stored in accordance with the nomenclature of affairs of the departments of BSMXJ responsible for the organization of production practices.

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Appendix 3. Form of the Practice Report

APPROVED Head of the Health Care Institution

(Signature, Name, Surname)

20 STAMP HERE

Student (Name, Surname )

of Clinical Inpatient Practice Report at

(Name of health institution, Department)

During the period from « » 20 to « » 20_

Student ( signature)

Supervisor from healthcare institution

( signature)

21

Appendix 3.1. Form of the Practice Report Curriculum standards: for clinical inpatient practice in surgery, specialty:

1-79 OIL 01 General Medicine

Practical skill Required by the standard

Studied by literature Observed

1st or 2nd

assistant Performed on his own

Number of daily observed patients. 4-6 Shifts at the admission department. 3 Examination of emergency patients and filling in a case history. 15 Filling in a case history for scheduled hospitalization. 10 Emergency patients' diaries. 10 Maintaining of not urgent patients' cards. 15 Protocols for RBC transfusions. 3 Protocols for Fresh Frozen Plasma transfusions. 3 Documentation on case history final report. 10 Documentation on case history final report for oncological patients. 5 Filling in protocol of surgical procedure. 5 Filling in indications for surgery. 3 Primary surgical treatment of wounds. 10 Surgical draining of soft tissue abscesses. 5 Surgical draining of whitlow. 3 Local anesthesia. 10 Wound dressings and removal of sutures. 25 Removal of draining tubes. 6 Infected wound dressing. 25

22

P r a c t i c a l sk i l l Required by the standard

Studied by literature Observed 1st or 2nd

assistant Performed on his own

Bedsore dressing. 5 i !

Detection of blood group. 20 RBC transfusions. 3 Plasma and other blood components transfusions. 5 Puncture of veins, catheterization of peripheral superficial veins, venesection. 15 Puncture of joints and joint capsules, injection of drugs. 5 Gastric tube placement and lavage. 5 Siphon enema. 3 S engstaken-B lakemore balloon tamponade. 2 Pleural puncture. 5 Pleural drainage. 2 Puncture of the abdominal cavity for ascites. 3 Participation in laparocentesis and diagnostic laparoscopy. 3 Urinary bladder catheterization. 5 Digital rectal examination, examination of the rectum with rectal retractors. 5 Reduction of rectum prolapse. 3 Participation as 1st assistant in urgent and elective surgery. 5 Participation as 2st assistant in urgent and elective surgery. 10 Formation of skeletal traction for bone fractures. 2 Reposition of extremity joints dislocations. 2 Reposition of bone 2

23

P r a c t i c a l skill Required by the standard

Studied by literature Observed

1st or 2nd

assistant Performed on his own

fractures. j ; Applying of plaster cast. 3 Participation in patient's examination by X-Ray. 3 Participation in patient's examination by endoscopy. 3 Participation in patient's examination by CT, MRI, and US examination. 5 Acquaintance with doctor-laboratory assistant work (in laboratory). 3 TOTAL

24

Appendix 4. Testimonial approximate form

T E S T I M O N I A L

Student (name, surname )

(Student's Name Surname) passed the clinical inpatient practice in surgery on the basis of (Name of Healthcare institution) in the department from 00.00.20 to 00.00.20 . The testimonial should reflect the student-trainee ability to acquire professional skills as a doctor, indicate the presence and the development of personal qualities necessary for the medical profession, give an overall evaluation of the results of the curriculum and the achieved level of practical training, characterize the relationship with the staff, the knowledge and the implementation of the rules of medical ethics and deontology. In the conclusion suggestions for the university about student's permission to practical training attestation, recommendations how to improve the quality of theoretical training at the university should be given.

Student supervisor from Healthcare institution

(signature, name, surname) 20

I have been acquainted with the testimonial:

(date) (student's signature) (student's name, surname)

Note: The testimonial should be on one page.

25

(COMPILERS/AUTHORS:

Associate Professor of the 2st Surgical Disease Department of Educational Institution "Belarusian State Medical University", PhD

Head of the 1 st Surgical Disease Department of Educational Institution "Belarusian State Medical University", DMedSc, Professor Head of the 2st Surgical Disease Department of Educational Institution "Belarusian State Medical University", Corresponding member of the National Academy of Sciences of Belarus, DMedSc, Professor Professor of the 1 st Surgical Disease Department of Educational Institution "Belarusian State Medical University", DMedSc Associate Professor of the 1 st S urgical Disease Department of Educational Institution "Belarusian State Medical University", PhD Associate Professor of the 2st S urgical Disease Department of Educational Institution "Belarusian State Medical University", PhD Associate Professor of the 2st Surgical Disease Department of Educational Institution "Belarusian State Medical University", PhD

Sinilo S.B.

Kondratenko G.G.

Tratsyak S. I.

Ignatovich I.N.

Yasilevich A.P.

А / К

Zhura A.V.

/>

Kozlov V.G.

Curriculum content, composition and accompanying documents comply with established requirements.

Dean of the Medical Faculty of International Students

/3. A T 20 Уf

Head of the Practical Training of Educational Institution "Belarusian State: Medical University1

Methodologist of Educational Institution "Belarusian State medical University"

20__

Head of the Foreign Languages Department /3 PS 20У^

Ishutin O.S.

Zilinskaya L.I.

Romanovskaya O.R.

Petrova M.N.

26

Information about the authors Family name, name, patronymic

SINILO SOFIA BRONISLAVOVNA

Position, scientific degree, title Associate Professor of the 2nd Surgical Disease Department of Educational Institution "Belarusian State Medical University", PhD

© work +375 17 2878638

E-mail: Surg2@bsmu.by Name KONDRATENKO GENNADIJ GEORGIEVICH Position, scientific degree, title Head of the 1st Surgical Disease Department of Educational

Institution "Belarusian State Medical University", DMedSc, Professor

© work (017) 3400454 E-mail: Surgl@bsmu.by Name TRATSYAK STANISLAU IVANOVICH Position, scientific degree, title Head of the 2st Surgical Disease Department of Educational

Institution "Belarusian State Medical University", Corresponding member of the National Academy of Sciences of Belarus, DMedSc, Professor

© work (017)2870024 E-mail: Surg2@bsmu.by Name IGNATOVICH IGOR NIKOLAEVICH Position, scientific degree, title Professor of the 1st Surgical Disease Department of

Educational Institution "Belarusian State Medical University", DMedSc

© work +375 17 340 02 52 E-mail: Ini67@inbox.ru Name VASILEVICIL ALEXANDR PAVLOVICH Position, scientific degree, title Associate Professor of the 1st Surgical Disease Department of

Educational Institution "Belarusian State Medical University", PhD

© work +375 17 2870024

E-mail: Surgl@bsmu.by

Name ZHURA ALEXANDR VLADIMIROVICH Position, scientific degree, title Associate Professor of the 2nd Surgical Disease Department of

Educational Institution "Belarusian State Medical University", PhD

© work +375 17 3987929 E-mail: ZhuraAV@bsmu.by Family name, name, patronymic

KOZLOV VYACHESLAV GENN AD' EVICH

Position, scientific degree, title Associate Professor of the 2nd Surgical Disease Department of Educational Institution "Belarusian State Medical University", PhD

© work +375 17 3987929

E-mail: Surg2@bsmu.by