Page 11 - HPB Handbook - May 30 2022 (Flipbook) v2

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resident will decide either on a weekly or a daily basis which resident should attend. This should fluctuate depending on OR
attendance. It has been the history in this unit that discharges are poorly planned and bullet rounds have therefore been
instituted by the staff to correct this issue.

Friday Sign-over Rounds
The 5 staff surgeons will cover all inpatients on a 1 in 5 weekly schedule, beginning after the ward round each Friday, at
TGH 9ES. The entire team will meet at 08:30 sharp to do a complete round with all residents and 5 staff surgeons. The
senior resident is expected to provide a brief, but detailed and accurate summary of each patient to ensure safe and thorough
sign-over to the on-call staff surgeon for the upcoming 7 days of inpatient care. The senior resident needs to have the ‘big
picture’ management of each patient at their fingertips. As the junior resident gains experience on the unit, the senior resident
should delegate the task of presenting patients to the junior resident. Presenting patients and answering questions from the
staff on the ward round is a good way of finding out whether you really know the patient and is an invaluable learning
experience. It is the senior’s job to ensure that junior staff is given this opportunity. Friday sign-over rounds will begin at
07:30 in the summer when there are no Friday morning Tri-Hospital or University Rounds.

Weekend Rounds
These morning rounds are necessary to cover all patients during the weekend. Patients on the ward and ICU, as well as
referrals from other wards are seen and reviewed, and their management plans are discussed. Support staff is limited on the
weekends, so requests should be prioritized. The Junior Residents have to review all the relevant results of blood tests and
imaging, so that decisions can be made. The Fellows will oversee the Junior Residents as Senior Residents are usually off-
site.

ADDITIONAL ROUNDS

Monday
Quality Care Rounds: 16:30 hrs. 025/026 Gr Eaton Wing TGH

Tuesday
th
Hepatoma Rounds: 16:00 hrs. Auditorium – 6 Floor
th
GI Oncology Rounds : 17:00 hrs. Auditorium – 6 Floor

Wednesday
GI/Gen Surgery Rounds: 17:00 hrs. Mt Sinai 14 Floor Classroom
th

Thursday
th
McCain Pancreas MCCs : 12:30 – 13:30 hrs 3-976 PMCC – 4 Floor
Medical Imaging Conference Room

Friday
Tri-hospital /University rounds 7:30 – 8:30 hrs Locations vary
Fellows’ Research Rounds 10:00 - 11:00 hrs 11PMB 196
Fellows’ Professor Rounds 11:00 - 12:00 hrs 11PMB 196

HPB Resident Teaching: Thursday 16:00 –17:00, 10EN-205, TGH
This is a weekly teaching seminar for residents and medical students with the objective of increasing practical clinical
knowledge and reviewing current literature in HPB/surgical oncology. Brief presentations on two or three different themes
within a given topic are made by residents/medical students, followed by a discussion moderated by fellows and an HPB
faculty member. Through the presentations and subsequent discussion, learners will improve clinical knowledge and
decision-making and gain insight into how HPB surgeons make decisions in specific clinical scenarios.

CLINICS
It is expected that each clinic be attended by at least one Resident (Junior or Senior) and the Fellow. There should be little
exception to this. This is a crucial part of training in surgery and should not be overlooked.

Tuesday (all day) Reichman - 4th Floor GI clinic – PMCC
Tuesday (p.m.) Shwaartz – 10th Floor TGH