Transplant Surgery

Competency Objectives

Patient Care

1. Perform a history and physical, and initiate appropriate preoperative preparation of renal transplant patients with special attention to elements relevant to immunodeficiency (faculty evaluations, 360 evaluations, oral exams)
2. Understand and arrange appropriate postoperative followup for patients who have undergone operations addressing the above pathology (faculty evaluations, 360 evaluations, oral exams)
3. Participate in the preoperative workup of hospitalized  patients prior to transplantation, with special attention to issues relevant to immundeficiency  (faculty evaluations, 360 evaluations, oral exams)
4. Formulate an appropriate initial immunosuppressive protocol for patients after renal
5. transplant. Make modifications to that protocol based on the patients clinical course. (faculty evaluations, 360 evaluations, oral exams)
6. Respond to common medical problems of  renal transplant patients (faculty evaluations, 360 evaluations, oral exams)
7. Participate in the postoperative care of renal transplant outpatients at least ½ day per week(faculty evaluations, 360 evaluations, oral exams)
8. Aspirational- Participate in one multiorgan recovery as a surgeon junior (faculty evaluations, 360 evaluations, op log)
9. With assistance from attending, complete an uncomplicated renal transplant as the
10. surgeon. This involves: incision, exposure of external iliac vessels, performing at least half of both venous and arterial anastomosis, and half of ureteral anastomisis followed by closure (faculty evaluations, op log)
11. With assistance from an attending, complete an uncomplicated transplant nephrectomy, this includes incision, exposure, control of the hilum and closure. (faculty evaluation, op log)

Medical Knowledge

1. Progress thru units 1-4 in the Canvas Curriculum (posttests, ABSITES)

Practice Based Learning

1. Contribute to the Surgical Adverse Event Database any patient adverse event that you were directly involved in. (review of complication database)
2. Present on Transplant Surgery Teaching rounds (faculty evaluation)
3. Complete Canvas post test and address any deficiencies (wrong answers) (Canvas test results)
4. Describe the Scientific Registry of Transplant Recipients and demonstrate how to access it. (faculty evaluation)

Interpersonal and Communication

1. Interact with Transplant Surgery NP , with communication as often as needed for patient care (faculty evaluations, 360 evaluations)
2. Maintain communication with attendings. (faculty evaluations, 360 evaluations)
3. Communicate plans of care thru problem based charting in Epic  and interpersonal interactions with staff (faculty evaluations, 360 evaluations)
4. Obtain surgical consent in patients (faculty evaluations, 360 evaluations)
5. Participate in keeping patients informed as to daily plans and any changes to daily plans (faculty evaluations, 360 evaluations)

Professionalism

1. Adhere to Department of Surgery Code of Conduct at all times (faculty evaluations, 360 evaluations)
2. Maintain a neat and professional appearance (faculty evaluations)
3. Complete all documentation requirements including history and physicals, procedure notes, daily notes duty hours and discharge summaries in a timely and legible fashion. (faculty evaluations, 360 evaluations, direct program director oversight)
4. Demonstrate respect compassion and integrity for all patients on the service; a responsiveness to the needs of patients and society that supersedes self-interest; accountability to patients, society and the profession; and a commitment to excellence (faculty evaluations, 360 evaluations)
5. Demonstrate a commitment to ethical principles pertaining to provision or withholding of clinical care, confidentiality of patient information, informed consent, and business practices. (faculty evaluations, 360 evaluations)
6. Demonstrate sensitivity and responsiveness to patients’ culture, age, gender, and disabilities(faculty evaluations, 360 evaluations)
7. Demonstrate an understanding of the importance of maintaining donor/recipient confidentiality (faculty evaluations, 360 evaluations)
8. Record Duty hours and pay attention to personal signs of fatigue

Systems Based Practice

1. Take responsibility for making sure appropriate consultative services and home support services along with all team members are arranged for Transplant service patients (faculty evaluations, 360 evaluations
2. Take responsibility for medication reconciliation along with all team members on general surgical patients (faculty evaluations, 360 evaluations)
3. Demonstrate an ability to assist patients in dealing with systems issues(faculty evaluations, 360 evaluations)
4. Attend and participate in Transplant Candidate Review and Transplant QAPI (faculty evaluations, 360 evaluations)
5. Spend at least ½ day with the staff of the immunology laboratory (faculty evaluation)

Schedule