What you will do:

This is an inpatient and outpatient rural general surgery experience during which you will be under the supervision of a  board-certified general surgeon. In the 1990s, over 25% of rural general surgeons in the U.S. were international medical graduates. Today, IMGs continue to play an important role in providing surgical care to rural populations.

According to the American College of Surgeons, there are 15 general surgery residency programs that have a special focus or track related to rural surgery:

Rural General Surgery Residency Programs

Residency Training in Rural Surgery

Rural Surgery Training Programs in the United States: A Review of the Literature

Rotators will spend most of their time in the operating room scrubbed in with the surgeon or the surgeon's colleagues. On Tuesday and Thursday mornings, the cases will be focused on general surgery and will include breast surgery (biopsy, mastectomy, lumpectomy), cholecystectomy, appendectomy, hernia repair, excision of larger masses, and other procedures. On Mondays and Wednesdays, there will be opportunities to scrub into orthopedic cases (total shoulder, hip, knee replacement; knee/shoulder arthroscopy, fractures). Friday mornings will be spent in the OR performing endoscopies.

When you are not in the operating room, you will be in the outpatient clinic. At times, you will be able to observe procedures in the office, including biopsies and excisions. Patients will also be seen for initial consultations and follow-up visits. Of note, many patients will be seen for wound care.

The attending recommends that students read about the next day's cases to make the most of the learning opportunity in the operating room. Per the attending, a useful resource is Surgical Recall.

During your experience, you will learn the following U.S. medical practices under the preceptor’s supervision:

• Taking patient histories.

• Performing physical exams under the physician's supervision.

• Presenting patients.

• Spending time in the operating room (per hospital policy, rotators are permitted to scrub in).

• Have opportunities to research the literature to answer clinical questions at the point of care.

• Spending time with other healthcare professionals to understand their roles and responsibilities.

The activities above will mostly take place in the outpatient setting. As a result of hospital policies, inpatient activities will be more observational.