Page 10 - HPB Handbook - May 30 2022 (Flipbook) v2

Page 10 of 22

The fellow will cover rounding duties on the weekend when the senior residents are not on call. The schedule is not
consistent so requires some proactivity to plan ahead of time.
The fellow is also responsible for covering the ward round with the junior when the seniors are at their mandatory teaching
session Thursday a.m.

The Fellow is responsible for presenting the HPB Quality of Care rounds on Friday a.m. They are assigned to the HPB staff
OR but in the event they are unable to make it due to other reasons, they need to arrange cover by another fellow and notify
the staff of the change. They are expected to go to Tuesday Hepatoma and GI Oncology Rounds, (see page 14), as well as
th
Radiation Oncology clinics (Dr. L. Dawson – 09:00 – PMH 4 floor) and Medical Oncology clinics (TBD pending clinic
th
schedules - PMH 4 floor).

Orientation and Midterm Feedback
All residents will meet with at least one staff member for an orientation and a midterm assessment. Orientation will take
place in the first few days of residents’ rotation and is necessary for a better understanding of the HPB protocols and
procedures.

Residents spend varying amounts of time on our unit, so if you have not met with a staff member midway through your
rotation please let one of us know. This is a necessary and valuable meeting and will provide the resident with constructive
feedback of what she or he is doing well and not so well. It is not intended in any way to be destructive and should be
considered a valuable critique by the resident.

Importantly, this will also be a time when the resident can provide feedback on what is and what is not working on the unit
and will allow us to effect change, if necessary, before your term is finished. Residents are encouraged to consider what their
objectives are in terms of what they want to get out of their limited time on our service. We encourage you to talk to us about
this early so that we can help you meet those objectives. Every resident will come to us with different levels of experience,
different expectations, and different objectives. Please share yours with us. We ARE interested. We will discuss the progress
of your objectives at your midterm assessment.

ROUNDS

HPB MANDATORY CLINICAL ROUNDS

In general, residents are expected to attend all rounds as outlined in the general surgery manual. More specifically, HPB
residents must make all efforts to attend the following rounds of relevance to HPB surgical oncology and the patients.

Ward Rounds
Morning ward rounds should commence at the time that is necessary to cover all patients. All the patients on the ward and
ICU, as well as referrals from other wards are seen and reviewed, and their management plans are discussed. It is important
that the Junior Resident has all the relevant results of blood tests and imaging, so that decisions can be made. This may
necessitate arriving to work earlier, so that results can be collated. It is the responsibility of the Senior Resident to lead the
rounds and the responsibility of the Fellow to oversee the Senior.

On this round the day’s tasks are set out – this may include contacting the on-call staff to provide them with test results etc.,
or to seek an answer to a specific question that may have arisen.

The on-call staff will come to the ward at least once every day (including weekends) to see all HPB patients. They will
contact the house staff to round at a suitable time. It is expected that the residents will know the case histories of all the
patients in detail, including the results of investigations, the opinions given by consultants, and the overall treatment plan.

Bullet Rounds
Monday through Thursday at 08:00 each day in room 312, a HPB resident is required to meet nursing and all allied health
staff for bullet rounds (for approx. 30 mins). You will discuss concerns and plans for all HPB patients, with specific attention
to factors related to safe discharge. These rounds are mandatory and it is expected that one member team attend. The senior