Hours/week: one hour/week

Objective: To enable the student to achieve the terminal objectives in the final sixth year of surgical course.

• Introduction and history: scope of modern surgery, development milestones of surgery, development of aseptic and anti-septic surgery.
• Wound and repair: definitions, types, classifications, clinical features and management. Scars: definitions, types. Tissue repair: definitions, pathophysiology of wound and factors affect wound healing.
• Wound infections: pathophysiology, host response, local and systemic manifestation, route of infection. Types: abscess, cellulitis, lymphangitis, erysipelas, boil, carbuncles. Definition, clinical features and management for each type.
• Specific infections: tetanus, gas gangrene, anthrax, tuberculosis, syphilis, necrotizing fasciitis, bacteremia and septicemia. Discuss definition, pathophysiology, clinical features, investigations, treatment and prophylaxis.
• Fluid and electrolyte balance: recall fluid body compartment and volume regulation, water and electrolytes balance. Causes, clinical features and management of every electrolyte derangement.
• Acid–base balance: recall basic definitions of PH, acid-base balance and buffering systems, describe clinical effects of acidosis and alkalosis, outline various acid-base disorders and their management, outline concept of anion gap.
• Surgical nutrition and metabolism: recall the essential components of normal nutrition. Indication, types and complications of enteral and parenteral nutrition. Methods of assessment of nutritional status of surgical patients. Outline the concept of nitrogen balance. Review about mediators of metabolic response to trauma and its concept and the factors affect it.
• Shock: classifications and grading of shock. Causes and clinical features of every type of shock, outline management and monitoring procedures and methods of resuscitation.
• Hemorrhage and blood transfusion: list different types of hemorrhage, signs and symptoms of blood loss, assessment and management of degree of acute bleeding. Outline the indication of blood transfusion, various types of blood and blood products and their transfusion complications.
• Tumor: definitions, classification, concept of grading and staging, etiology, pathogenesis and behavior of benign and malignant tumors. List modality of spread of malignant tumors, ways of diagnosis and screening and methods of treatment.
• Ulcers, sinuses and fistulae: definitions, classification, causes of each item, outline the clinical features, diagnosis and line of management.
• Diabetic foot and gangrene: etiology including precipitating factors, pathophysiology, clinical features, classification, investigations and management.
• Hernias: definitions, etiology and predisposing factors, classifications, clinical features, review methods of clinical examinations, differential diagnosis, management, complications of surgery and recurrence; this scenario is applied for every type of hernia.
• Abdominal wall: recall surgical anatomy of abdominal wall, outline the whole aspect of abdominal dehiscence (burst abdomen), review of incisional hernias, outline diseases of umbilicus congenital and acquired, recall synergistic infection of abdominal wall and neoplasm in particular desmoids tumors, also short review about diaphragm and hiatus hernia.

Hours/week: 8 hours/week

Objectives:

• Writing a case sheet includes notes taken from patient and examination of the patient and records the physical signs.
• Long case examination in the ward at the end of their clinical training.
• Encouraging students to take case histories themselves and to the clinical examination and try to correlated and bind clinical facts together by method of exclusion to reach to a diagnosis.
• Stressing on the importance of surface anatomy.
• The first half-an-hour should be left to the students to make their own rounds and prepare cases for discussion.
• Teaching students the method of reaching to a diagnosis, differential diagnosis and some simple investigations and training them on the organized problem solving methods.

The primary teaching methodology of this course is problem-based learning (PBL). In this type of learning experience, students work with paper cases as though they were actual patients, using a method similar to that which they will later use as residents or practicing physicians.

The students make the decisions themselves, formulating differential diagnoses, eliciting relevant items from a history and physical examination, proceeding with a diagnostic work-up, and creating a treatment plan.

PBL is student-centered, with students taking responsibility for their own learning. Content is taught through skills, and context is highly specific to real-world challenges.

The instructor's role is to model problem-solving strategies rather than lecture. Students meet for 1 hour weekly for a total of 12 weeks.