Medical Doctor Education Program
Sylabus
Course title                                     Surgery I
Faculty                                             Faculty of Medicine
Level of education      One-cycle educational program, VII semester
Course lecturers        Professor – Archil Aladashvili E-mail: archil.aladashvili@eu.edu.ge
                        Invited lecturer - Irakli Phiphia E-mail : pipia.irakli@eu.edu.ge
Course status           Compulsory
The aim of the course   The course aims to teach students: common surgical diseases and their
                        etiology and pathogenesis and their clinical manifestations and
                        complications. Clinical research methods and surgical treatment strategies
                        and techniques.
ECTS                    5 ECTS credits (1 credit = 25 hours) - 125 hours.
                        Among them:
                         49     hours   Student’s contact hours, including:
                         15     hours   Lecture
                         30     hours   Group work – practical training
                         2      hours   Mid-term
                         2      hours   Final exam
                         76     hour    Student’s independent work
                                s
                        Semester consists of 20 weeks, including:
                        15 - Training weeks, 5 – Session weeks.
                        Training weeks are used for lectures / group works and related activities
                        and practical trainings.
                        Sessions weeks are devoted to the mid-term / final exams.
                        Mid-term exam will be held on the 8th week of the academic semester.
                        The final exam will be held on the 17th - 18th week of the semester.
                        Additional exam is conducted on the 19th - 20th week of the semester and
                        must be held within 10 day period after the final exam date.
Prerequisites           Topographical anatomy and operative surgery
Learning outcomes                            1. Knowledge and understanding:
                                               The student knows / understands:
                        • etiology, pathogenesis, diagnosis methods of deep and systemic levels of
                        common surgical diseases, which will allow the student to realize the
                        pathological process and carry out diagnostics;
                        • surgical treatment methods on deep and systemic levels, that can help the
                        student in determining relevant surgical treatment tactics and methods in
                        accordance with the diagnose.
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                                •
                                          2. The ability to apply knowledge in practice:
                                                       The student is able to:
                             • diagnose and create a treatment plan based on a critical analysis of the
                             history and examination results;
                             • Treatment of injuries and bandaging
                                                    3. Ability to make inference:
                                                       The student is able to:
                                 • Diagnosis and treatment scheme based on the analysis and
                                     examination.
                                                      4. Communication skills:
                                                      The student is able to:
                             • Effective verbal and non-verbal communication with the patient, keeping
                             a writing record of the patient history.
                                                             5. Values
                                                      The student is able to:
                             • Protecting the patient confidentiality and the patient’s interests in
                             accordance with the professional ethics.
The content of learning      See Appendix 1
course
The format of the learning   The      training     process     uses     following       methodology:
course                       Lecture: - provision of the training materials to the students in a
                             systematic and orderly manner; discussion and explanation of any topic or
                             subject at issue. The training course will be held in an interactive lecture
                             format using presentations. Classes are held using demonstration
                             materials (atlases, posters, medicine, exhibits, etc.) and the use of modern
                             computer technology.
                             Practical trainings – students’ individual work on practical types of
                             problems or on themes based on seminars, in accordance with the course
                             program;
                             Students' independent work: time spent for successful completion of the
                             course curriculum, which includes learning the basic and supplementary
                             literature, studying, understanding the daily tasks and homework, and
                             preparation for midterm and final exams.
Teaching and learning        Practical trainings will be evaluated using the following methods:
methods                      • Lecture – explaining new topic and clarifying obscure materials
                             • Interactive Lecture (based on past materials, when explaining new
                             topic involvement of students in a lecture, recalling old materials, and
                             finding solutions to the posed issues)
                             • Discussion – (to develop students' activity and reasoning skills, to
                             develop their own ideas for discussion and help clear up the issue in
                             depth)
                             • Visual aids - slide show, atlases, posters, charts, demo products, power
                             point presentations.
                             • Verbal Method - verbal presentation of the material – talking about the
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                       material on a particular issue, answering the questions;
                       • Demonstration of practical skills - examination of the patient, data
                       registration, scheduling testing methods, interpretation of test results,
                       conducting differential diagnosis, determining the type diagnosis and
                       determine the appropriate treatment plan.
                       • Analysis – based on the specific case prescribing the relevant medicine
                       and determining pharmacokinetics and pharmacodynamics.
                       The student's independent work includes learning the provided materials;
                       understanding and analyzing; if necessary, researching additional
                       materials using computer technology.
Evaluation criteria:                   Components of evaluating student knowledge:
                                            Assessment components:
                                    Assessment sum             100%/max. 100 points
                        Among them:
                        Mid-term evaluations                        Max 60 points
                        Among them:
                        Oral presentation of theoretical material   maximum 30 points
                        Presentation                                maximum 10 points
                        Midterm                                     maximum 20 points
                        Final Exam                                  maximum 40 points
                       1. Oral presentation of the material
                       The student will be evaluated 3 times and can get max. 30 points per
                       semester;
                       2. Presentation – 10 points, once during the semester.
                       Presentation prepared by the student will be evaluated with the
                       following ranking:
                       9-10 points: The answer is complete; The issue is conveyed accurately and
                       comprehensively; Student knows the subject very well, has mastered the
                       basics of literature.
                       • 6-8 points: The answer is complete, but limited; Correct terminology;
                       The issue is presented in a comprehensive manner; There is a fundamental
                       error; Student knows the subject very well; Have mastered the basic
                       literature. • • 5-6 points: The answer is incomplete; The issue is
                       satisfactory;The terminology is insufficient; The student owns the
                       program material, but there are few errors.
                       • 3-5 points: The answer is incomplete; The terminology is incorrect;
                       material is set out in part; The student has sufficiently mastered the
                       literature; Marked a fundamental error.
                       • 1-2 points: The answer is insufficient, the terminology is not used or is
                       not appropriate; The answer is essentially correct. The only relevant issue
                       is set out in the separate fragments.
                       • 0 points: the answer to the question is not relevant or is not given.
                       3.     Mid-term exam:
                       Mid-term exam includes 20 MSQs, each for 1 point.
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                          4. Final exam:
                          The final exam will be in written form. Final exam consists of 40 closed
                          questions , each for 1 point;
Evaluation system         Student's knowledge will be assessed with a 100-point system. The
                          maximum score is 100 points. Prerequisite for receiving credit is obtaining
                          at least 51 points from 100.
                                                   The evaluation system
                               Points                                          Evaluation
                           91%-100%           A       Excellent
                           81%-90%            B       Very good
                           71%-80%            C       Good
                           61%-70%            D       Satisfactory
                           51%-60%            E       Poor/ sufficient
                           41-50%             Fx      Did not pass (In order to pass, the student needs to do
                                                      independently and is given the opportunity to retake
                                                      more time)
                           0-40%                F     Failed( The work that the student has done is not eno
                                                      should retakethe course)
Administrative Notes       On the first lecture of the course, the lecturer is obliged to inform the
                              students on the work requirements of the program and the strategies
                              for the proceeding work.
                           The student must:
                              Carefully study the course syllabus.
                              Comply with the requirements set forth in the syllabus (to comply
                                 with homework, prepare for seminars and practical work, testing,
                                 presentation, etc.).
Required Books               1. Shvartz, Shires, Spencer - PRINCIPLES OF SURGERY 9th
                                  edition, 2010
                             2. Bailey and Love’s – Short practice of Surgery - 2018 27th ed. by
                                  Norman S Williams, Christopher J.K. Bulstrode, and P Ronan
                                  O'Connell
                             3. NMS Surgery-2016
Language of instruction   English
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                                             Appendix 1
                                  The content of learning course
N                         Subject (lectures, group work and practical work sessions)
      (Lecture - 1 hour, practical training - 2 hours)
      .The Thyroid gland
      Learning objectives
      •• To understand the development and anatomy of the
I     thyroid gland
      •• To know the physiology and investigation of thyroid
      function
      •• To be able to select appropriate investigations for
      thyroid swellings
       •• To know when to operate on a thyroid swelling
      •• To describe thyroidectomy
      •• To know the risks and complications of thyroid surgery
      (Lecture - 1 hour, practical training - 2 hours)
      Week 2
      The parathyroid glands
      Learning objectives
      To understand:
      •• The anatomy of the parathyroid glands
      •• The physiology of calcium regulation
      •• The underlying causes of hypercalcaemia and
II    appropriate emergency management
      •• The aetiology, presentation, investigation and
      management of primary hyperparathyroidism and
      associated special cases
      •• The aetiology, presentation, investigation
      and management of secondary and tertiary
      hyperparathyroidism
      •• The aetiology and management of parathyroid
      carcinoma
      (Lecture - 1 hour, practical training - 2 hours)
      Week 3
         The adrenal glands and other abdominal endocrine disorders
      Learning objectives
      To understand:
III   •• The anatomy and function of the adrenal and other
      abdominal endocrine glands
      •• The diagnosis and management of these endocrine
      disorders
      •• The role of surgery in the management of these
      endocrine disorders
IV    (Lecture - 1 hour, practical training - 2 hours)
      Week 4 – lecture - 1 hour
        The Breast
      Learning objectives
      To understand:
      •• Appropriate investigation of breast disease
      •• Breast anomalies and the complexity of benign breast
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           disease
           •• The modern management of breast cancer
          (Lecture - 1 hour, practical training - 2 hours)
          Week 5
          Cardiac surgery
  V        Learning objectives
          To understand:
          •• The important role of surgery in cardiac disease
          •• The role of investigation in planning surgery
          •• The management of coronary heart disease
          (Lecture - 1 hour, practical training - 2 hours)
          Week 6
          Cardiac surgery
  VI       Learning objectives
          •• The role of surgery in valvular heart disease
          •• The special role of surgery in congenital heart disease
          •• The management of aortic vascular and pericardial
           disease
          (Lecture - 1 hour, practical training - 2 hours)
          Week 7
           The Thorax
 VII      Learning objectives
          To understand:
          •• The anatomy and physiology of the thorax
          •• Investigation of chest pathology
          2 hour midterm
Session
                                                     Mid-term exam
 week
                      (preparation material – covered materials from week I including week VII)
          (Lecture - 1 hour, practical training - 2 hours)
          Week 8
          The Thorax
 VIII     Learning objectives
          •• The role of surgery in pleural disease
          •• The assessment of patients requiring lung surgery
          •• Surgical oncology as applied to chest surgery
          (Lecture - 1 hour, practical training - 2 hours)
          Week 9
          Arterial disorders
          Learning objectives
          To understand:
  IX      •• The nature and associated features of occlusive
          peripheral arterial disease
          •• The investigation and treatment options for occlusive
          peripheral arterial disease
          •• The principles of management of the severely ischaemic
          limb
  X       (Lecture - 1 hour, practical training - 2 hours)
          Week 10
          Lymphatic disorders
          Learning objectives
          To understand:
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       •• The main functions of the lymphatic system
       •• The development of the lymphatic system
       •• The various causes of limb swelling
       •• The aetiology, clinical features, investigations and
       treatment of lymphoedema
       (Lecture - 1 hour, practical training - 2 hours)
       Week 11
        Venous disorders
       Learning objectives
       To understand:
XI     •• Venous anatomy and the physiology of venous
       return
       •• The pathophysiology of venous hypertension
       •• The clinical significance and management of superficial
       venous reflux
       •• The management of venous ulceration
       •• Venous thromboembolism
       (Lecture - 1 hour, practical training - 2 hours)
       Week 12
       History and examination of the abdomen
       Learning objectives
       To understand:
       •• The pathway for clinical diagnosis of a patient
       presenting with an abdominal complaint
XII    •• The importance of recognising the organ or system
       responsible for the clinical features
       •• The pathophysiological basis of common abdominal
       symptoms and signs
       To identify:
       •• Leading questions based on the organ or system
       affected and reach the most likely differential diagnosis
       •• The relevant physical signs and come to an appropriate
       clinical diagnosis
       (Lecture - 1 hour, practical training - 2 hours)
       Week 13
       Abdominal wall, hernia and umbilicus
       Learning objectives
XIII   To know and understand:
       •• Basic anatomy of the abdominal wall and its weaknesses
       •• Causes of abdominal hernia
       •• Types of hernia and classifications
       •• Clinical history and examination findings in hernia
       (Lecture - 1 hour, practical training - 2 hours)
       Week 14
       Abdominal wall, hernia and umbilicus
       Learning objectives
XIV
         •• Complications of abdominal hernia
       •• Non-surgical and surgical management of hernia –
       including mesh
       •• Complications of hernia surgery
       •• Other abdominal wall conditions
XV     (Lecture - 1 hour, practical training - 2 hours)
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Week 15
The oesophagus
Learning objectives
To understand:
•• The anatomy and physiology of the oesophagus and
their relationship to disease
•• The clinical features, investigations and treatment of
benign and malignant disease with particular reference
to the common adult disorders