university of benghazi
faculty of medicine

Department of Surgery
Course specifications: Surgery M.B.Ch.B. fourth and fifth year
Author : 1. Assistant Professor Fathi Hussain, Head of surgery department. 2. Associate Professor Tawfik Abuzalout, Head of quality control committee of surgery department. 3.Assistant Professor Salah Mansor, Member of quality control committee of surgery department. 4. Lecturer Khalid Ali, Member of quality control committee of surgery department

1.  Basic information

·  Course title: General and specialty Surgery

·  Course code: ………

·  Course duration: 72 weeks

·  Department offering the course: Surgery

·  Program on which this course is given: M.B.Ch.B

·  Department offering the program: Surgery

·  Academic year Level: 4th & 5th year of M.B.Ch.B

·  Date of specifications /revision: 2017

·  Date of approval by departmental/faculty council : ……..

·  Teaching language: English

·  Taught hours:

·  Lectures: 158 hours ( 2 hours /week)

·  Tutorial: 48 hours ( 1 hours /week)

·  Practical: 450 hours ( 15 hours/week)

·  Total : 656 hours (18 hours /week)

2.  Overall aim of the course

·  To educate practicing graduates with the knowledge, skills and attitude that enable him/her to understand, diagnose and manage and/or refer common surgical problems in order to provide safe, efficient and cost effective humane patient care at a highly qualified doctor level .

·  To educate practicing graduates with an appropriate background covering the common and/or important surgical emergencies, that will be laid on the primary care of the acute surgical diseases, injured and trauma patients.

·  To enable the development and application of appropriate professional attitude, ethical principles and communication skills.

·  To enable the graduates to be an active participant in community research programs for assessment and problems solving.

3.  Intended learning outcomes (ILOs)

a)  Knowledge and understanding:

On successful completion of the course, the graduate should be able to

a1 Understand the surgical anatomy and surgical physiology of surgically important organs, systems and regions in human body.

a2 Identify the etiology, pathophysiology, clinical features, principles of diagnostic modalities, management plan and complications of common and urgent surgical diseases in adult and children.

a3 Understand the principles and practice of preoperative preparation and postoperative care as, indications and methods for fluid and electrolyte replacement therapy, blood transfusion and pain management.

a4 Define asepsis, disinfection, sterilization and recommend update international gaid use of antibiotics.

a5 Identify the risk factors and clinical features of common malignancies in the country and their management including prevention with highlighting on the concept of screening.

a6 Mention of basic principle of minor surgical procedure.

a7 Identify different types of anesthetic agents, their indications, mode of administration, contraindications and side effects.

a8 Recognize the ethical principles and aspect in surgical practice.

b)  Intellectual skills

b1 Analyze and interpret the results of commonly used laboratory and radiological diagnostic procedures.

b2 Evaluate patients with life threatening conditions

b3 Appraise their current medical practice in order to update and improve it.

b4 Demonstrate Skills in identifying, evaluating and solving clinical problems objectively.

b5 Organize and integrate the results of different clinical, laboratory and radiological tests in order to construct a meaningful diagnosis.

b6 Distinguish disease risk factors to determine strategies for appropriate response.

c)  Professional & practical skills

On successful completion of the course, the graduate should be able to

c1 Obtain an accurate and complete surgical history.

c2 Approach any surgical case with complete

systemic and local clinical examination.

c3 Detect physical signs on local examination.

c4 Diagnose common surgical conditions both acute and

chronic, in adult and children.

c5 Identify the significant clinical signs of common and life

threatening surgical diseases and emergencies.

c6 Recognize the radiological signs of surgical diseases.

c7 Plan various laboratory tests for surgical conditions and

interpret the results

c8 Perform simple bedside testes.

c9 Identify the proper management of hemorrhagic shock, be

able to maintain patent air-way and resuscitate a critically

injured patients.

c10 Monitor patients of head, chest, spinal and abdominal

injuries, both in adults and children.

c11 Identify the principles of pre-operative preparation,

operative and post-operative monitoring.

c12 Treat open wounds including preventive measures against

tetanus and gas gangrene.

c13 Identify of common surgical instruments.

c14 Understand the principles of sterile techniques and infection

control guidelines.

d)  General transferable skills

d1 Display attentive listening and show kindness and patients during patient interview.

d2 Understand and accept different patient backgrounds, values and beliefs.

d3 Explain to patients and their families the management plan including required investigations and their findings, the impact of investigation results on the management, the indications, risks, benefits and alternatives of therapeutic interventions as well as the expected prognosis and follow-up plan.

d4 Obtain informed consent from the patient or their caregiver for the agreed treatment plan.

d5 Ask for senior consultation when needed.

d6 Demonstrate ability to present accurate and focused summaries of patient's illness

d7 Demonstrate constructive team work with other healthcare professionals in order to maximize patient benefits and safety. d8 Write clear and concise medical records including: admission notes, daily progress notes, and physician’ orders, referrals and requests for consultation, discharge summaries and follow up notes.

d9 Identify his/her personal weaknesses through accurate selfassessment and/or assessment by supervisors and colleagues and actively formulate an effective personal development/learning plan to address any gaps in his/her knowledge or skills.

d10 Utilize the resources of biomedical information and effectively use them to update his/her knowledge.

d11 Understand and respect the role of other health care professionals and collaborate with them in effective multidisciplinary teamwork to provide a safe and high quality patient care.

4.  Course contents

hours / weeks / Topic
Total / Others / Clinical / Tutorials / Lectures
212 / 150 / 11 / 51 / General surgery / 1
14 / 6 / 0 / 8 / Vascular surgery / 2
99 / 75 / 6 / 18 / Orthopedic surgery / 3
25 / 15 / 3 / 7 / Plastic and Reconstructive surgery / 4
30 / 15 / 4 / 11 / Thoracic surgery / 5
25 / 15 / 3 / 7 / Neurosurgery / 6
94 / 75 / 6 / 13 / Urogenital surgery / 7
35 / 19 / 5 / 11 / Pediatric surgery / 8
94 / 66 / 6 / 22 / ENT Surgery / 9
28 / 15 / 3 / 10 / Anesthesia / 10
656 / Total

5.  Teaching format

·  Illustrated lectures: Large group plenary lectures in lecture halls to set the scene for a topic, highlight important issues and arouse curiosity in relevant areas for 3 hours per week.

·  Practical/Bedside teaching (small groups): Instructors demonstrate the core practical clinical skills and students practice these skills on patient's under supervision for 3 hours daily.

·  Tutorials (small groups): utilized to teach how to approach certain presenting complaints, interpretations of laboratory tests, radiography for 3 hours weekly.

·  Group discussion: small self-study groups to discuss case scenarios, data interpretations, answering multiple choice questions and searching the literature for relevant answers and discussions for 3 hours per week.

Teaching plan: (الجدول الأسبوعي)

Saturday / Lecture
Time:9:00-10:00 / Lecture
Time:10:00-11:00 / Lecture
Time:11:00-12:00
Sunday / Tutorial
Time:8:30-9:30 / Bedside Teaching
Time:9:30-12:30
Monday / Tutorial
Time:8:30-9:30 / Bedside Teaching
Time:9:30-12:30
Tuesday / Tutorial
Time:8:30-9:30 / Bedside Teaching
Time:9:30-12:30 / Group discussion
Time: 13:00-14:00
Wednesday / Bedside Teaching
Time:9:30-12:30 / Group discussion
Time: 13:00-14:00
Thursday / Bedside Teaching
Time:9:30-12:30 / Group discussion
Time: 13:00-14:00

Lectures` list (قائمة عناوين المحاضرات)

Hours / Subject / No.
51 / General Surgery / 1
2 / Fluid & electrolyte balance and acid base regulation / 1
1 / Acute hemorrhage & blood transfusion / 2
1 / Hemostasis / 3
1 / Intravenous fluid therapy in surgery / 4
2 / Shock / 5
1 / Metabolic response to surgery / 6
4 / Surgical infections antibiotics and / 7
1 / Nutrition in surgery / 8
1 / General post-operative complications / 9
1 / Tumors / 10
1 / Organ transplantation / 11
2 / Wound healing / 12
1 / Major trauma and multiple injured patient / 13
1 / Salivary glands / 14
1 / Neck / 15
2 / Thyroid gland / 16
1 / Parathyroid gland / 18
2 / Abdominal wall and hernias / 19
2 / Breast / 20
2 / Stomach and duodenum / 21
4 / liver / 22
2 / Biliary system / 23
2 / Pancreas / 24
1 / Spleen / 25
2 / Peritoneum, momentum, mesentery and Appendix / 26
2 / Intestinal obstruction / 27
4 / Small and large intestines / 28
2 / Anal canal / 29
1 / Minima invasive surgery / 30
1 / Medical ethics & communication skills / 31
8 / Vascular surgery / 2
4 / Arterial Disorders / 1
2 / Venous Disorders / 2
2 / Lymphatic system / 3
18 / Orthopedic surgery / 3
1 / Introduction to fractures, dislocations and principles of treatment / 1
1 / Fracture complications & their management / 2
1 / Fractures and dislocations around shoulder, and fracture arm / 3
1 / Fractures and dislocations around elbow and forearm / 4
1 / Fractures and dislocations around wrist and hand / 5
1 / Fractures and dislocations around pelvis and hip / 6
1 / Fractures of the femur / 7
1 / Fractures and dislocations around knee / 8
1 / Fractures and dislocations around leg, ankle and foot / 9
1 / Principles of treatment of orthopedic disorders / 10
2 / Bone tumors / 11
1 / Bone and joint infection / 12
1 / Congenital anomalies of bones and joints / 13
1 / Metabolic and generalized bone diseases / 14
1 / Non infective arthritis / 15
1 / Neurological disorders affecting musculoskeletal system / 16
1 / Spinal deformities and low back pain / 17
7 / Plastic and Reconstructive surgery / 4
2 / Burns / 1
1 / Management of Facial Injuries / 2
1 / Reconstructive Surgery / 3
2 / Surgical lesions of the skin / 4
1 / Cleft Lip and Palate / 5
11 / Thoracic surgery / 5
2 / Thoracic trauma / 1
1 / Mediastinum / 2
2 / esophageal diseases / 3
2 / Lung Cancer / 4
1 / Thoracic cage, pleural diseases, spontaneous pneumothorax and bullous disorders / 5
1 / Thoracic infections and parasite infestation / 6
1 / Pleural diseases in general / 7
1 / Surgical aspect of heart diseases (pericardium and great vessels) / 8
7 / Neurosurgery / 6
1 / Head injury / 1
1 / Spinal injury / 2
1 / Hydrocephalus / 3
1 / Brain tumor WHO classification / 4
1 / Spinal tumors classification / 5
1 / Subarachnoid hemorrhage / 6
1 / Developmental anomalies / 7
13 / Urogenital surgery / 7
2 / Urinary tract infections / 1
2 / Injury of genitourinary tract / 2
2 / Benign prostatic hyperplasia / 3
2 / Urolithiasis / 4
1 / Congenital anomalies / 5
2 / Renal tumors / 6
1 / Urothelial tumors / 7
1 / Cancer prostate & testicular tumors / 8
11 / Pediatric surgery / 8
1 / Hernia and hydrocele in children / 1
1 / Undescended Testis / 2
1 / Pyloric stenosis / 3
1 / Acute abdomen in children / 4
1 / Neck swelling in children / 5
1 / Intussusceptions in children / 6
1 / Neo-natal intestinal obstructions / 7
1 / Anorectal anomalies / 8
1 / Congenital mega-colon (Hirschsprung disease) / 9
1 / Neonatal respiratory distress -Surgical causes / 10
1 / Malignant solid tumors in children / 11
22 / ENT surgery / 9
1 / Conditions of external ear (pinna , external canal and meatus) / 1
2 / Conditions of middle ear / 2
3 / Conditions of inner ear / 3
1 / Benign nasal conditions / 4
1 / Epistaxis / 5
1 / Nasal trauma / 6
1 / Tumors of nose and para-nasal sinuses / 7
1 / Lymphoid tissue (tonsils and adenoids) / 8
1 / Abscesses (peritonsillar, parapharyngeal and ,retropharyngeal) / 9
1 / Conditions of larynx / 10
1 / Tumors of larynx, hypopharynx, and oropharynx / 11
1 / Air way problems / 12
1 / Congenital anomalies in otolaryngology / 13
1 / Facial nerve paralysis / 14
1 / Miscellaneous topics / 15
1 / Ear and hearing (Introduction) / 16
1 / Nose and para-nasal sinuses (Introduction) / 17
2 / Oropharynx , hypopharynx , nasopharynx, larynx and trachea-bronchial tree (Introduction) / 18
10 / Anesthesia / 10
1 / Preoperative assessment / 1
1 / Inhalational anaesthetic agents / 2
1 / Intravenous anaesthetic agents / 3
1 / Neuromuscular blockade ( muscle relaxants ) / 4
1 / Laryngoscopy & endotracheal intubation (ETI) / 5
1 / Complications of General Anasthesia / 6
1 / Regional anaesthesia / 7
2 / Shock / 8
1 / Analgesia and pain control / 9

Tutorials` list

hours / Subject / No.
11 / General surgery / 1
1 / Abdominal injuries / 1
1 / Acute abdomen / 2
1 / Management of upper gastrointestinal bleeding / 3
1 / Bleeding per rectum / 4
1 / Multiple injured patient / 5
1 / Management of solitary thyroid nodule / 6
1 / Management of a breast lump / 7
1 / Common surgical instrument &tubes / 8
1 / Common surgical operation / 9
1 / Symptomatology of vascular diseases / 10
1 / Management of diabetic foot / 11
7 / Orthopedic surgery / 2
1 / Disorders of the shoulder / 1
1 / Disorders of the knee / 2
1 / Disorders of the elbow / 3
1 / Disorders of wrist and hand / 4
1 / Disorders of the hip / 5
1 / Disorders of the foot / 6
1 / Types and principles of fractures fixation / 7
3 / Plastic and Reconstructive surgery / 3
1 / Fluid resuscitation in burn patient / 1
1 / Reconstructive procedures / 2
1 / Management of skin ulcer / 3
4 / Thoracic surgery / 4
1 / Management of pneumothorax / 1
1 / Mediastinal mass / 2
1 / Chest radiology / 3
1 / Hydatid cyst lung / 4
3 / Neurosurgery / 5
1 / Nervous system History taking / 1
1 / Nervous and Motor examination / 2
1 / Hydrocephalus / 3
5 / Pediatric surgery / 6
1 / Differential diagnosis of acute abdomen / 1
1 / Surgical causes of constipation in children / 2
1 / Management of neck swelling / 3
1 / Acute scrotal swelling / 4
1 / Hypertrophic pyloric stenosis / 5
6 / ENT / 7
1 / Ear & hearing / 1
1 / Nose & para-nasal sinuses / 2
1 / Oropharynx, hypopharynx, nasopharynx & larynx & tracheabronchial tree / 3
1 / Epistaxis / 4
1 / Otitis media / 5
1 / sinusitis / 6
3 / Anesthesia
1 / Instruments in anesthesia / 1
1 / Invasive vascular access procedures / 2
1 / Pain management / 3
6 / Urology
1 / Introduction to urology / 1
1 / Hematuria / 2
1 / Urinary retention / 3
1 / Scrotal pathology / 4
1 / Urological radiology / 5
1 / Emergency of urology / 6

Practical/Clinical Cases list