AAFP Core Educational Guidelines
Care of the Surgical Patient: Recommended Core Educational Guidelines for Family Practice Residents
Am Fam Physician. 1999 Sep 1;60(3):1030-1036.
This document has been endorsed by the American Academy of Family Physicians and was developed in cooperation with the Association of Departments of Family Medicine, the Association of Family Practice Residency Directors and the Society of Teachers of Family Medicine.
Surgical care may be defined as the body of knowledge, skills and attitudes necessary to evaluate and manage conditions and disorders requiring operative intervention.
The resident should develop attitudes that encompass the following:
Recognition of the importance of family physician and surgeon collaborating as partners in the evaluation of and decision making for the care of surgical patients.
Awareness of the principles involved in differentiating the causative origin of clinical symptoms resulting in the need for medical versus surgical intervention.
Sensitivity to the patient's and family's concerns and anxieties regarding the potential need for surgical intervention.
Basic principles of surgical diagnosis
Basic surgical anatomy
Wound physiology, care and healing processes
Clinical assessment, including history, physical examination, laboratory evaluation and differential diagnosis of key signs and symptoms of surgical conditions
Invasive versus noninvasive diagnostic tests
Routes of administration
Recognition of surgical emergencies
Ethical and legal considerations
Quality of life
Surgical risk assessment
Patient preparation (bowel, etc.)
Basic principles of asepsis and sterile technique
Use of basic surgical instruments
Suctions and drains
Fever work-up and management
Postoperative observation principles
Office care of common conditions
Lumps and bumps
Approach to the care of common surgical conditions
Carpal tunnel syndrome
Coronary artery disease (obstruction)
Cysts and hematomas
Intervertebral disk herniation
Shared management of common general surgical conditions
Anal fistula, fissure or perianal abscess
Organ donation and transplantation
Surgical risk evaluation
Noninvasive diagnostic procedures
Invasive diagnostic procedures
Central venous access (central venous pressure, Swan-Ganz catheter)
Needle aspiration/biopsy technique
Emergent surgical techniques
Preparation and draping of operative field
First assist at major surgery
Basic use of surgical instruments
Incision and dissection
Estimation of blood loss
Technique selection (ligature, staples, adhesives)
Minor surgical techniques
Incision and drainage of cysts and abscesses
Foreign body removal
Enucleation/excision of external thrombotic hemorrhoid
Rectal polyp removal
The implementation of this curriculum segment should combine a minimum of two months of block rotations and longitudinal learning experiences throughout the 36 months of training. The curricular content should be required and integrated into the conference schedule and into teaching activities in the family practice center. Relevant materials should be prominent in the residency library.
Resourcesshow all references
Wolcott MW, ed. Ferguson's Surgery of the ambulatory patient. 5th ed. Philadelphia: Lippincott, 1974....
Wolcott MW, ed. Ferguson's Surgery of the ambulatory patient. 5th ed. Philadelphia: Lippincott, 1974.
Way LW, ed. Current surgical diagnosis and treatment. 10th ed. Norwalk, Conn.: Appleton & Lange, 1994.Condon RE, Nyhus LM. Manual of surgical therapeutics. 9th ed. Boston: Little, Brown, 1996.
Sabiston DC Jr, Lyerly HK. Textbook of surgery: the biological basis of surgical practice. 15th ed. Philadelphia: Saunders, 1997.
Pfenninger JL, Fowler GC. Procedures for primary care physicians. St. Louis, Mo.: Mosby, 1994.
Copyright © 1999 by the American Academy of Family Physicians.
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