SEGO Overview Booklet:
Outline of Module in Surgery, Emergency
Medicine, Gastroenterology and Oncology

For 4th Year Medical Students
University of Otago, Christchurch
2021

Outline of Course
Welcome to the SEGO module.
This module is an 8 week immersion in a surgical team, integrated with 4 weeks of Gastroenterology
and 4 weeks of Oncology. Half of you will start on Gastroenterology and the other half wil  start on
Oncology. After four weeks you wil  swap and do the other. Emergency Medicine continues through
the whole eight weeks. The course is taught by tutors from Surgery, Emergency Medicine,
Gastroenterology, and Oncology. In addition, there is a tutorial programme throughout the eight
weeks. The workload is summarised in the fol owing table.
Department
Clinical Work
Formal Teaching (held on
Fridays)
Attached to surgery team.
Outpatients clinics, elective surgery,
Surgery
9-10 tutorials and one Core Skills
acute surgery, endoscopy,
training session (abdo exam)
pathology/x-ray sessions, consultant
ward rounds etc.
Emergency
Medicine
4 x 4 hour sessions
6-7 tutorials and one Core Skills
training session (resus scenario)
Gastroenterology  4 x ½ day clinics
3 tutorials
Oncology
4 x ½ day clinics
3 tutorials
Attendance and Conflicting Opportunities
•  The Core Skills session, Friday tutorials, OSCE, and vertical module teaching are compulsory.
•  The scheduled gastroenterology and oncology clinical sessions take precedence over
anything else scheduled at that time.
•  The rest of the time you should attend al  scheduled clinical learning opportunities – some
will clash, in which case it is up to you to decide where you should be, based on the need to
get an appropriate sampling of experiences over the module and your perception of where
you will get the most benefit. (Where you are unable to sort this out yourself, or where
there are other difficulties getting to appropriate activities, you should discuss this with your
supervising consultants or alternatively with Mr Chris Wakeman or Ms Tamara Glyn.)
•  If there is a period with nothing scheduled on your timetable, you can stil  be with your
surgical team experiencing the routine management of surgical inpatients or you can use the
time to complete assignments or study.
Team Activities
You are expected to become deeply involved in the activities of your surgical team – more details
can be found in the Surgery Booklet. You should become familiar with your patients and their
management, and devote time to reading about the topics listed in the Objectives section of this
handbook, and about the problems your patients have.
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Assessments
Assessment in this module is categorised into three main areas: clinical work, submitted work, and
the OSCE. Each area contains several assessment elements as listed below.
Clinical work
Consultant feedback: Consultant Feedback Form.
Submitted work
Surgery case histories, emergency medicine shift logs, surgery log book, gastroenterology case
history, gastroenterology endoscopy observation log, oncology case history, oncology log book.
OSCE
Four exam stations: general surgery (abdominal examination); emergency medicine;
gastroenterology (history taking); oncology.
Each student will receive a level of achievement (Potential Distinction, Pass, Conditional Pass,
Incomplete or Fail) for each element. Each element will have its own criteria for the different levels
of achievement. An overall achievement level for the eight week module will be based on
achievement in the three main areas of clinical work, submitted work, and OSCE marks.
To be awarded a Potential Distinction (PD) for the module as a whole, a student would normal y
have achieved approximately half of the elements as PD, with PDs in each of the three areas of
activity (clinical assessments, formal submitted assessments, and OSCE assessments).
Deadlines
It is important that work is submitted on time so that formative feedback can be given to you during
the run (regarding the case histories, for example) and grades can be promptly returned to you at
the end of the run. However, it is understood that sometimes circumstances wil  get in the way and
an extension to the submission deadline is needed. If you need an extension, please contact the
administrator prior to the deadline and explain your reasons. They may discuss it with the relevant
teacher before granting an extension. The granting of an extension cannot be guaranteed.
Most of the submitted assignments are based on work staggered throughout the eight weeks of the
run. Circumstances intervening late in the eight weeks (for example, sickness), preventing you
completing a lot of ‘last minute’ work that should have been accumulating earlier in the run wil  not
necessarily be worthy of an extension.
If you don’t have an extension and hand work in late, the consequences wil  be:
1.  The first time this occurs, the work wil  be excluded from the possibility of achieving a
Potential Distinction grade and the marker has the option to refuse to mark it at al , in which
case it will receive a Fail grade.
2.  If it occurs a second time, the student will receive a Conditional Pass for the entire SEGO run.
The attached ‘condition’ required for the awarding of terms at the end of the year wil  be
that there are no further problems with handing work in late.
3.  If it occurs a third time, the student will receive a Fail grade for the entire SEGO run.

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Finally
Patients wil  judge you initial y by your appearance – it is important that you dress appropriately and
in a respectful way. A tidy, semi-formal style of dress is required. Introduce yourself clearly to
patients and their relatives, explaining who you are and why you are there.
This run can be challenging as there are many opportunities and these sometimes conflict. However,
remember that you are primarily based with a surgical team and that team is your ‘home’.
Communicate with people who may expect you to be somewhere, when you need to be elsewhere.
If there are problems with clashes which cannot be negotiated with the staff involved, please
arrange a time to see Mr Chris Wakeman, Ms Tamara Glyn, or Associate Professor Tim Eglinton.
Similarly, any other problems related to this run can be discussed with Mr Chris Wakeman. We hope
that you find all the senior staff to be approachable and helpful.
Although the run can be busy and confusing (particularly if it is your first in a very busy acute
hospital), if you approach it with good sense, enthusiasm and respect for the demands of the staff
and the needs of the patients, then you will find it interesting, educational, and enjoyable.
The principal aim of the module should be to steadily build competence at the ‘clinical task’ (history,
examination, differential diagnosis, investigations and plan), understand how the surgical team
works, and to begin to develop a sound knowledge base in relation to the patients you encounter.
The specific objectives and assessment methods are detailed below.
Staff Contacts
If you are having problems during the module, please contact one of us below. Don’t leave it until
the end of the run.
•  Jen Van Dijk, Administrator, Academic Department of Surgery. Ph 021 279 0185. Email
[email address]

•  Mr Chris Wakeman, Overal  SEGO Convenor and Surgery Convenor, Academic Department
of Surgery. Ph 364 3630. Email [email address]
•  Ms Tamara Glyn, Surgery Co-Convenor, Academic Department of Surgery. Ph 364 3630.
Email [email address]

•  Associate Professor Tim Eglinton, Head of Academic Department of Surgery. Ph 364 3610.
Email [email address]
•  Professor Michael Ardagh, Emergency Medicine Convenor, Emergency Department, Ph
80278. Email [email address]
•  Associate Professor Catherine Stedman, Gastroenterology Convenor, Gastroenterology
Department. Ph 80922. Email [email address]
•  Professor Bridget Robinson, Oncology Convenor, Oncology Department. Email:
[email address]
•  Dr Matthew Strother, Oncology Co-Convenor, Oncology Department. Email:
[email address]

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Learning Objectives, Assessments and Criteria for a Pass
Summary of Objectives
Knowledge
•  General Surgery
•  Emergency Medicine
•  Gastroenterology
•  Oncology
Clinical skills
•  History taking
•  Examination (with emphasis on abdominal examination)
•  Investigation interpretation (radiology)
•  Obtaining informed consent
•  Obtaining venous blood
•  Rectal examination
•  Emergency Medicine core skills
•  Evidence-based practice skills
Professional attitudes, behaviour and ethics
Summary of Assessments
Submit all assessments on Moodle by 10 pm on the day due (see Moodle for dates), except for the
Surgical Log Book which you must hand in at the end of run OSCE).
1.  Surgical Case Histories (2). The first is due by Friday of week 3 of the module; the second by
Friday of week 6.
2.  Surgical Log Book (use Pocket Organiser). Due by Friday in week 8 of the module. Hand in to
the SEGO Administrator at the OSCE, held at the SIM Centre. It wil  be marked and returned
to you for you to use for future reference.
3.  Emergency Medicine Shift Logs (see Emergency Medicine Manual). Submit by Thursday in
week 8 of the module. They wil  be marked for you to use as a future reference.
4.  Gastroenterology Case History. Submit by Wednesday of the fourth week on
Gastroenterology.
5.  Gastroenterology Endoscopy Clinic Observations Log. Submit by Wednesday of the fourth
week on Gastroenterology.
6.  Oncology Case History (1). Submit by Wednesday of the fourth week on Oncology. It wil  be
marked promptly.
7.  Oncology Outpatient Log (6 cases). Submit by Wednesday of the fourth week on Oncology. It
wil  be marked promptly.
8.  Terms requirements: the following are required for terms, but are not graded (see Surgery
Booklet for details):
•  Colorectal Pathology Meeting Presentation
•  Pathology Labs Sample Analysis
•  Completion of the General Surgery Manual Self-Assessment Quizzes by Friday in
week 8 of the module
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9.  Satisfactory attendance and performance in al  aspects of the run, as documented by your
surgical supervisors (your surgical consultants on the 8 week attachment) and by your
various tutors in tutorials, lectures and outpatient clinics.
10. Satisfactory performance in the OSCE examination during week 8 of the run.
NOTE: Progression to the OSCE examination may be denied if any of 1. to 8. above have not been
satisfactorily completed.
Detailed Objectives, Assessments and Pass Criteria
A.  Knowledge
1.  Gain a sound knowledge of how the surgical team works, who is involved, and how they
facilitate getting the patient through their surgical journey.
2.  Gain a sound knowledge of common surgical conditions and their management
Conditions include:
•  abdominal pain
•  acute appendicitis
•  gallstones, cholecystitis and biliary tract disorders
•  acute and chronic pancreatitis
•  bowel obstruction
•  gastrointestinal tract haemorrhage (haematemesis, melaena, rectal bleeding)
•  abdominal and inguinal swelling or mass
•  breast lumps
•  thyroid disease
•  common post operative complications
3.  Gain a sound knowledge of important gastroenterological problems and their management
Conditions include:
•  dyspepsia, peptic ulceration and gastroesophageal reflux disease
•  altered bowel habit including constipation and diarrhoea
•  inflammatory bowel disease
•  jaundice and abnormal liver function tests
•  hepatitis
•  chronic liver disease
•  anorexia, nausea and vomiting
•  malabsorption, loss of weight
•  loss/gain of weight
•  iron deficiency anaemia
4.  Gain a sound knowledge of common oncology conditions and principles of their management
Conditions include:
•  colorectal cancer
•  breast cancer
•  lung cancer
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•  lymphoma
•  germ cell tumours
•  common oncological emergencies
•  approach to oncology patients (assessed through Oncology Focused Case History and
Outpatient Log)
5.  Gain a sound knowledge of important problems and principles in emergency medicine
These include:
•  approach to the unwell patient
•  abnormalities of airway and breathing
•  poisoning and drug overdose
•  altered state of consciousness
•  multiple trauma
•  extremity injury
•  pain management
•  wound care
•  the undifferentiated patient
•  triage
•  the place of the emergency department in the health system
Assessment Instruments
OSCE examination, Surgery Log Book review, Emergency Medicine Shift Log review,
Gastroenterology Case History, Gastroenterology Endoscopy Clinic Observations Log, Oncology Case
History, Oncology Outpatient Log, Supervisors’ and Tutors’ assessments.
Pass criteria
•  Satisfactory attendance and participation in tutorials, seminars and ward work
•  Satisfactory participation in Emergency Department shifts
•  Satisfactory completion of submitted course work as outlined in Summary on page 5
•  Satisfactory performance in the OSCE
B.  Clinical skills
1.  Demonstrate competent history taking
Assessment Instruments
a.  Surgical case histories
•  Two from surgical patients on which the student has performed a history and physical
Pass criteria
To gain a mark of at least pass on any one case history a student must include the following:
•  Presenting complaint and symptoms accurately described
•  Appropriate past history, family and social history
•  Details of a complete and accurate clinical examination
•  Concise summary and complete problem list with differential diagnoses
•  List of relevant investigations
•  Complete and comprehensive management plan appropriate to the individual patient
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•  Results of investigations and patient progress notes
•  Overall well sequenced, clear, and concise
•  A short discussion of an interesting aspect of the case with references
The template used for marking case histories can be found on Moodle in the 4th Year SEGO module
under the Objectives and Assessments tab. Example case write ups are also available on Moodle.
Please do not record the patient’s name or other identifiable features (such as their NHI number).
Simply record ‘60 year old male’ or similar.
A student will receive at least a pass mark for the module case history section if they have been
asked to resubmit no more than:
•  one case history, and the resubmission is of an acceptable standard;
•  two case histories, and after review by convenor, at least one of which is determined to be
of acceptable standard.
A student will receive a conditional pass on the module case history section if they:
•  are asked to resubmit two case histories, and
•  after review by convenor, two are of unacceptable standard.
Students should make sure that all submitted work is their own. Plagiarism is a form of dishonest
practice. Plagiarism is defined as copying or paraphrasing another’s work, whether intentionally or
otherwise, and presenting it as one’s own (approved: University Council, December 2004). In practice
this means plagiarism includes any attempt in any piece of submitted work (e.g. an assignment or
test) to present as one’s own work the work of another (whether of another student or a published
authority). Any student found responsible for plagiarism in any piece of work submitted for
assessment shall be subject to the University’s dishonest practice regulations which may result in
various penalties, including forfeiture of marks for the piece of work submitted, a zero grade for the
paper, or in extreme cases exclusion from the University.
b.  OSCE history taking station
Pass criteria
•  The history of the presenting complaint was taken accurately
•  Inquiry regarding other relevant symptoms, past history, social or family history was
undertaken
•  An accurate diagnosis or differential diagnosis was discussed
•  Appropriate use of open and closed questions was used
•  The student communicated effectively and used language that the patient could understand
2.  Demonstrate competent examination of the abdomen
Assessment instrument
•  OSCE examination station
Pass criteria
•  A systematic and complete examination was performed
•  Physical signs were identified and described
•  The signs were interpreted accurately
•  Appropriate introduction was made
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•  The student treated the patient with consideration
•  Instructions to the patient were clearly expressed
3.  Analyse and interpret radiological images
Assessment instrument
•  OSCE – radiology may be included in a number of stations
Pass criteria
•  Correctly identifies the imaging modality used
•  Accurately describes the abnormalities present
•  Provides an appropriate interpretation of the abnormalities including the most likely
cause(s)
•  Clearly describes the pathophysiological basis to the radiographic appearances
4.  Take a venous blood sample under supervision
Assessment instrument
•  Supervisor (resident medical officer)
Pass criteria
•  Prepares the necessary equipment
•  Explains the procedure to the patient and obtains consent
•  Successfully completes the procedure including specimen labelling and needle disposal
•  Understands the risks and management of needle stick injuries
5.  Perform the fol owing Emergency Medicine core skills
Perform the following skills in the clinical skills vertical module, the Core Skills session, or the
tutorials (and then observe, and possibly do in the clinical environment):
•  Bag and mask ventilation
•  IV cannula insertion
•  Wound suturing
•  Demonstrate the examination of distal function of structures which might be injured after a
wrist or forearm laceration
•  Estimate the Glasgow Coma Score (GCS) using a GCS chart
Assessment Instrument
•  Some of these skills might appear in the OSCE
Pass criteria
•  Successful y completes the skil , if required, during the OSCE examination
C.  Professional attitudes
1.  Participates in team activities
Assessment Instrument
•  Consultant feedback via feedback form
Pass criteria
•  Satisfactory participation as determined by the consultants

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Formal Teaching Sessions
Core Tutorials
These are aimed to give you a structural framework around which to base your learning. It is
important that you attend the core tutorials.
The teaching timetable for the core tutorials held on Fridays can be found in your handouts or on
Moodle. In summary:
•  From 1130 to 1230, Gastroenterology and Oncology tutorials run simultaneously for those
attached to Gastro and Onc.
o  Gastroenterology tutorials: meet by the lifts at the entrance to Ward B5 in Waipapa.
o  Oncology tutorials: Oncology Tutorial Room, Oncology Learning Centre, Ground
Floor Oncology Department.
•  From 1330 to 1630, the whole group (Surg/Gastro and Surg/Onc students) come together
for tutorials held in Room 706, 7th Floor, University of Otago, Christchurch (UOC) main
building.
Core Skills
Core Skills sessions on Abdominal Examination and Basic Resuscitation will be held in the University
Simulation Centre, Level 1, 72 Oxford Terrace, usual y on the first Friday morning of the attachment.
This is also noted on the core tutorials handout and on Moodle.
Course Readings
Course readings and recommended textbooks are listed on Moodle under the Course Information
tab; click on ‘eReserve’.
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Document Outline