One of the main reasons for surgery students to travel to a developing country is because of the surgical elective. Developing countries are faced with many challenges in the delivery of optimal health care. These challenges include poor accessibility to health care due to distances to health facilities, limited resources in the healthcare institutions and inadequate staffing
Surgery elective participants often find themselves carrying out difficult and critical procedures and managing conditions that they would otherwise encounter after several years of practice in their home countries under supervision of our well known mentors within these facilities. With this diversified surgical elective experience, we are not only confident participants will be more confident with hands on surgical procedures but also hope to raise in you greater questions about global health equity.
Students get the benefit to learn in a low resource settings, viewing a broader scope of surgical conditions and at different pathological stages with greater reliance on history taking and physical examination skills and sociocultural aspects of management provision which add infinite value to one's expertise.
We offer you this experiential advantage in an optimal setting involving safe and supervised hands on experience. We emphasize on aiding the conceptualization and understanding of diverse surgical principles and the practice of various surgical skills.
It is an opportunity to get significant hands on experience in both minor and major surgery as well as more specialized surgical areas depending on the student's interest and the type of elective placement.
This offers students a supporting role in patient care including pre-operative evaluation, operative intervention and post-operative care and management. While under supervision, the student may be involved in pre-operative decision making such as patient assessment and counselling, obtaining informed consent, pre-operative medication e.g. thrombophylaxis, prophylactic antibiotics, blood transfusions, anxiolytics and glyceamic control. Preoperative imaging, radiographic and sonographic interpretation is also an essential part of our program.
The surgery elective student will also assist intra-operatively in major theatre surgical conditions that require general anaesthesia like:
Thyroidectomy, pancreatectomy, splenectomys and cholangietectomy, skin grafts and flaps, hernia repairs are also common.
The student will also get minor theatre time and assist in procedures under local anaesthetic like:
Postoperative participatory care will include fluid and electrolyte management in burns and stoma care. Surgical patient analgesia and pain management. Heamatology and pathology lab interpretations, imaging and nutrition. Reviewing of abdominal drains and management of donor/recipient sites in grafts. In addition to the above, our general surgery experience will expose students to other procedures or enhance skills such as history taking and physical examination. Participation in conferences, case based learning and rounds will be expected.
Opportunity to participate in diagnosis and active treatment of patients, including case application, manipulation of simple fractures, closed and open reduction, management of orthopeadic implants like external and internal fixation. Knail insertion, k-wire insertion and plate & screws are all common occurrences. The student will also get to participate in POP application, attend surgery and post-op management.
Participate in burn related critical care, fluid and electrolyte resuscitation, review of heamatologic indices. Management of surgical wounds and surgical procedures related to burn care like: skin harvesting and grafting, escharotomys, counselling, reconstructive surgery. Exposure will include care of both major and minor burns patients. Critically injured techniques will be invasive critical care, Swan-Ganz catheter insertion and monitoring amongst others.
Trauma & Emergency Surgery:
Students get an opportunity to involve in dealing with acute trauma patients. They learn how to effectively manage patients during the resuscitative and evaluation phases of care. Application of the ATLS protocols, management of multiple trauma and shock management. They will handle emergency intervention such as chest intubations, tracheostomy and fluid management of shock. Participants will follow patients through treatment and their rehabilitation from acute trauma and help monitor some patients. They will also take responsibility in attending to and develop appropriate treatment and rehabilitation plans for these patients. The students will work under the direct supervision of the attending and will be expected to attend any conferences and case based learning held.
Surgical Critical Care:
This offers students the opportunity to get involved in managing critically ill surgical patients in both the intensive care units and high dependency unit. This will be done both preoperatively and postoperatively. Students learn how to use invasive monitoring and support systems. They also get an opportunity to perform procedures such as insertion of arterial lines, central lines and intubations, perform history taking, physical examination, daily notes and orders, evaluation and treatment planning. Students will work under surgery department resident and attending and are expected to attend any bedside teachings and conferences.
Students get surgical experience focusing on the care of patients with malignant and benign disorders, both inpatient and in the surgical outpatient clinic. Their experience will span preoperative, operative and postoperative management and continued care. Oral and Maxillofacial Surgery: Students participate in the surgical management of oral and head and neck pathology e.g cystic hygromas, thyroid carcinomas, cleft palate & lips and the correction of congenital and traumatic deformities like Le fort fractures and orbital blow-out fractures. Acute trauma care is a major component. The student will have some responsibility for inpatient care. Students will have the opportunity to perform or assist in minor procedures in the clinic as well as the emergency room and operating room under supervision.
Rural Surgery: For participants interested in our Migori, Kenya placements
Provide students with diverse and challenging aspects of the practice of rural surgery by participating in clinics as well as outpatient and inpatient surgical cases. Students will participate in evaluating patients presenting with emergency conditions and to perform or assist with invasive monitoring and treatment procedures.
The student will be an integral part of the surgical team and participate in evaluating and managing pre and post-operative pediatric surgical conditions including neonatal intussuception, tracheo-esophageal fistulas, posterior urethral valves, spina bifida, umbilical hernias, trauma and will assist in operative care. Related opportunities to learn the essentials of pediatric enteral and parenteral nutritional support, invasive and non-invasive monitoring procedures and techniques, respiratory support techniques and a variety of pediatric vascular access procedures are available depending on placement facility. The surgery elective is targeted at medical students, residency doctors and students pursuing surgery as a specialty and is a fulfilling way to pursuing an away elective or just to volunteer their skills to underserved communities while experiencing healthcare in a different setting.
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