Division of General Surgery / Undergraduate

The first two years of your medical career will be among the most exciting of your training! Everything is new and the thrill of learning the skills you will need to be a great and thoughtful physician is challenging and invigorating. There is a vast amount of material to learn from every specialty in the preclerkship curriculum. The goal is to lay the foundation that will ensure you have the basic tools to be a caring and well-rounded physician. 

One of the other tasks of the preclerkship years is to begin to explore which specialties appeal to you the most. Although the undergraduate curriculum is full, there are many opportunities in the Division of General Surgery and the Department of Surgery to do clinical electives, meet with surgeons to get advice about career choices, do summer research projects and interact with residents.

Clinical Electives: Students are paired with a surgeon whose schedule and  clinical interests are in keeping with the students interests. The goal is to choose surgeons who also operate on days when the student’s schedule would allow them to go to the operating room with the surgeon on their O.R. day. This type of elective may be as short as one afternoon or may stretch into many weeks and possibly a meaningful mentorship.

S3D (Student Surgical Skills Development) club: Surgeons are invited to come speak about their careers and lifestyles to medical students who may be interested in surgery. These are organized by medical students, however our division enthusiastically supports this initiative.

Summer Research: Our division is home to some extremely talented and successful researchers in medical education, clinical epidemiology and basic science. There are often summer studentships available and we would be delighted to help match you to a supervisor.

"One Day Matters" (Coming Soon to an Operating Theatre near you):
In June 2010, the Division of General Surgery launched a very successful University wide pilot program to allow first year medical students to catch a glimpse of what happens in the operating rooms. 100 first year students participated across 11 affiliated hospitals. We intend this program called One Day Matters to become part of first year med school life at U of T and it will be embedded in the first year curriculum as part of the Structure and Function block.

We would be delighted to enhance the preclerkship years with time working with one of the surgeons in our division and I would be happy to help facilitate this for you. Please email me or call my office if I can help answer your questions. 

Darlene Fenech, BScH, MSc MD, FRCS(C) 
Colorectal Surgery, Division of General Surgery 
Sunnybrook Health Sciences Centre 
University of Toronto 
darlene.fenech@sunnybrook.ca 

Phone: 416 480 4027 

Welcome to general surgery! The goal of clerkship in general surgery is to provide an overview of the many different types of surgical care we provide to our patients. You will be assigned to a team and it is expected that you will be fully integrated into the daily patient care activities whether it be on rounds, in the clinic or in the O.R. 

You will see a breadth of surgical problems, with exposure to general surgical issues and specialty surgical issues. Your experience will be enhanced by on-call shifts with the other housestaff at which time you will be involved with the care of emergency and critically ill patients. We will get you to see the patients first so that you can take a history and physical and come up with a diagnosis and management plan. This is an excellent opportunity to see patients from their initial presentationthroughout their entire hospital stay. 

You will quickly come to appreciate that surgeons are not mere technicians. Much of the art of surgery lies in the evaluation of the patient's presenting concern within the context of his or her overall physiologic status. The abilities to determine what (if any) operation is appropriate and to anticipate potential problems are as important as operative expertise. A physician-patient relationship must be forged, often in the acute setting, which allows patients to submit to painful procedures to their benefit. Managing the anxiety and pain concomitant with operative intervention is an important part of the care we provide. 

Although the pace and organized chaos may make you feel overwhelmed, rest assured that you are an integral member of the team and the residents will rely on you to help manage busy surgical services.We work as a team and you may not think that you have a role, but you do! On morning rounds you can help by getting the charts ready and organized, reading out the vitals and new developments from the charts; this will help immensely and speed up rounds. Also, this will get you involved with learning about the patients. During the course of the day we may ask you to go and help us arrange tests in radiology or otherwise. This too helps the team function. 

A good habit to get into is to check the bloodwork daily in the afternoon. When you do this write it down on a piece of paper (or use the attached template see below). If you do this before the PGY-1 does it andgive it to them they will love it! This will free them up to do the menial tasks that we would neverdream of asking you to do. 

The most important part of the rotation, however, is being in the OR! You get to see what makes surgery different from every other thing inmedicine. You will learn to tie knots and we will get you involved in the case. 

It is important to take initiative during the rotation and seek out any learning opportunity you wish. Try to read around the cases you see and ask your team questions. Start by reading the Toronto Notes. The other really good book I tell all clerks to get is called "Surgical Recall". It is a yellow andgreen book available at the U of T Bookstore. It is really good and easy to read. Don't buy the Advanced Recall - just buy the basic one. And finally, if you are super keen and know you are going to be asurgeon no matter what, buy Surgical Management and Treament by Lawrence Way (a red paperback book).