Upon completion of this placement, the Physician Associate student will be able to obtain the appropriate database (history, physical exam, and laboratory and x-ray studies) relative to the surgical patient. The student will be knowledgeable of factors which predispose the surgical patient to complications either during or following surgery. The student will demonstrate understanding of the preoperative and postoperative management of the surgical patient as well develop appropriate skills and techniques to assist in surgery.
It is important to remember that the primary purpose of this experience is to prepare Physician Associate students to deal professionally and confidentially with general surgical health issues they may encounter in a variety of healthcare settings. The focus is therefore on common and important general surgical problems and their management.
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The Physician Associate student will be able to obtain a comprehensive history from a patient, relative, or other informed source, sufficient to diagnose and participate in the treatment of common and important surgical problems.
The student will be able to perform appropriate physical examinations, distinguish normal from abnormal physical findings, and comprehensively record examination findings in a logical and systematic way.
The student will utilise laboratory and diagnostic studies appropriately to support or modify tentative diagnostic impressions, recognise and diagnose surgical emergencies, and determine whether a patient is a good surgical candidate based on their presentation and co-existing medical conditions.
The student should be aware of and able to propose pharmacological therapy, demonstrating understanding of the indications, contraindications, major side-effects/adverse reactions and correct dosing schedules for medications, commonly used in surgical settings.
The student will analyse information obtained from the history, physical examination, diagnostic tests, and procedures to formulate a problem list, develop a comprehensive, prioritised differential diagnosis list, and utilise all available clinical data to accurately recognise and diagnose common surgical conditions in the adult patient.
During their surgical placement, the Physician Associate student will be able to:
- Develop skills and techniques related to surgery
- Participate in preoperative and postoperative management of surgical patients
- Participate in surgical procedures for diseases that the student would likely encounter in primary care
- Employ correct scrub, gown and glove technique in the operating room
The student will be able to assess patient presentations in alignment with the GMC’s PA Registration Assessment (PARA) content map, and propose appropriate management plans. Within surgery, Physician Associate students are expected to be able to assess and manage the following presentations:
· Abdominal distension/mass
· Abdominal pain
· Anal pain
· Breast lump
· Change in bowel habit
· Dysphagia
· Haematuria
· Jaundice (dark urine, pale stools)
· Lumps in the groin
· Nipple discharge
· Painful, cold limb
· Per rectum bleeding
· Rectal prolapse
· Wound discharge
· Weight loss
PA students should also demonstrate the ability to recognise and propose management of the following conditions:
· Aortic aneurysm/dissection
· Appendicitis
· Benign breast disease (abscess, infection, cysts)
· Biliary disease
· Bowel ischaemia
· Bowel obstruction
· Breast malignancy
· Diverticulitis
· Gastrointestinal malignancy
· Hernia
· Intussusception
· Major haemorrhage
· Pancreatitis
· Peri-anal disease
· Peritonitis