Surgery (Clinical practice)


Clinical Skills:
-To know and correctly apply  surgical language;
-To know main surgical syndromes understanding, its etiopathogenesis and semiology, as well as the fundamentals of its diagnosis and treatment;
-To be able to distinguish clinical situations with elective and urgent surgical indication;
-To know how to plan and perform a methodical and complete clinical examination;
-To know how to select and request the complementary diagnostic tests needed to clarify e ach clinical case;
-To know how to evaluate the nutritional status and surgical risk of a patient;
-To know how to hierarchize data from a clinical history and formulate the diagnostic hypotheses;
-To know how to perform the most common small surgery techniques and know the techniques of anesthesia and asepsis necessary for this purpose.

Social training skills - behaviors and attitudes:
-To know how to respect patients and their families and know their rights and obligations;
-To know the ethical principles inherent in confidentiality and the adequate transmission of          information necessary for the informed consent of surgical procedures;
-Know how to communicate properly and work as a team with colleagues, other health              professionals and their superiors;
-Adopt a proactive attitude towards the development of the personal competencies inherent to the medical profession, especially as regards integrity, responsibility and interest in personal     valuation;
-Recognizing the importance of lifelong medical training.

General characterization





Responsible teacher

Prof. Doutor Rui Maio


Weekly - Available soon

Total - Available soon

Teaching language





-“Current Surgical Diagnosis and Treatment” – G. M Doherty;
-“Surgery Scientific Principles & Practice” – Greenfield´s;
-“Cirurgia, Patologia e Clínica” – Alves Pereira;
-“Textbook of Surgery” – Schwartz;
-“Licenciado Médico em Portugal”;
-“The Tuning Project”;
-“Tomorrow´s Doctors”;
-“Relatório do Projeto Nacional de Avaliação das capacidades dos alunos que concluem os Cursos de Licenciatura em Medicina”;
-“Current Surgical Diagnosis and Treatment” – G.M.Doherty, 12th edition, Lange Medical Books;
-“Cirurgia, Patologia e Clínica”, Alves Pereira – 2ª edição McGraw Hill;
-“Textbook of Surgery” – Schwartz;
-TEAM (Trauma Evaluation And Management) Student Manual, American College of Surgeons.

Teaching method

•  theoretical classes (lectures of an expositive nature, directed at large groups, lasting no more than 50m)

•  theoretical-practical classes (they integrate an expository component and an interactive compo-nent, directed to small groups)

•  Practical classes: clinics (supervised occupational situations and integrated into care work) and non-clinical (aiming at the execution of exercises and procedures in small groups under the supervision of a teacher)

At the end of the surgery internship students should have consolidated previous knowledge and obtained clinical and social skills considered essential for future professional practice.

With regard to clinical competences, students must demonstrate knowledge and know how to correctly evaluate the most common cynical situations, determine the priorities of action and estab-lish the essential measures and procedures for their adequate resolution. They must also have per-formed or observed a number of pre-established procedures that will be registered in a perfor-mance book (log-book).

Regarding social skills, it is essential that students demonstrate that they can communicate correctly with patients and their families, valuing their perspectives, concerns and expectations. It is also essential to demonstrate their ability to communicate and integrate in team with their peers, other health professionals and their superiors, as well as their attitude expressed in the interest and motivation to acquire new knowledge and skills.

Evaluation method

Types of evaluation:
 The evaluation will take into account participation in theoretical sessions, theoretical-practical and practical;

 In the evaluation process, three mandatory meetings are held during the internship between the tutor and the student scheduled according to the availability of both. These meetings should result in a registration in the individual process and validated by the tutor and the student;

 The tutor's assessment is provisional and is given on a scale of 0 to 20 values. For this classification, the following aspects contribute in a weighted way:

 Level of knowledge demonstrated during the internship (NC) (20%);
 Ability to integrate knowledge acquired in clinical practice (HF) (20%);
 Quantity and quality of procedures performed (P) (15%);
 Behaviors and attitudes in clinical practice (CA) (15%);
 Assiduity (A) (15%);
 Activity Report (AR) (15%);

Thus, the Provisional Classification (PC) is calculated using the following formula and presented on a scale of 0 to 20:

PC=(20 NC+20 IC+15 P+15 CA+15 A+15 RA)/100

Subject matter

Theoretical sessions:
-Leadership and teamwork - Eng. Isabel Vaz
-Principles of management in health care - Dr. Artur Vaz
-Role of simulation in pre-graduate teaching - Dr. Francisca Leite
-Clinical risk and performance in surgery - Prof. Dr. Rui Maio
-Communication techniques - Dr. Graça Rosendo
-Managing stress and prevention of burnout - Dr. Pedro Rocha
-Nutrition and surgery - Prof. Dr. Marília Cravo
-Value-based medicine - Professor Doutor Rui Maio
-Trauma Evaluation And Management - Dr. José Luís Ferreira
-ERAS Program – Professor Doutor Rui Maio

Theoretical-practical sessions:
-Behaviors and Attitudes in a Surgery Ward - Nurses Teresa Simões and Teresa Afonso;
-Training, supervision and acquisition of necessary skills for those who practice invasive techniques; Ethical considerations and informed consent - Dr. António Martins Batista;
-Basic principles of infection control; Technique for carrying out sterile procedures - Dr. Carlos    Palos and collaborators;
-Placement of peripheral venous access / venipuncture; Handling of infusion systems and syring-es; Intra-dermal injection, intramuscular injection, intravenous injection, subcutaneous injec-tion; Blood culture harvest; Harvest of arterial blood; Peripheral arterial line placement; Place-ment of central venous catheter (jugular, subclavian, femoral) - Dr. António Messias and collab-orators;
-Local anesthesia; Suture techniques; Abscess drainage; Approach of the patient with ingrown toenail; Approach to subungual hematoma – Professor Doutor Rui Maio and collaborators;
-To algaliarize; Suprapubic puncture - Dr. Rui Sousa and collaborators;
-Nasogastric tube insertion; Paracentesis; Rectal touch; Anuscopy – Prof. Dr. Marília Cravo and   collaborators;
-Tracheal intubation (naso / oro); Difficult airway management; Emergency cricotiroidotomy - Dr. Miguel Ghira and collaborators;
-Thoracic drainage insertion; Thoracocentesis; Pleural biopsy - Dr. Sofia Furtado  and collabora-tors;
-Principle of approach to severe polytrauma - Dr. Pedro Amado;
-Primary approach of the polytraumatized – Dr. Pedro Amado.

Practical Teaching:
-Consultation: Follow-up of the tutor in the external consultation; Accomplishment of clinical     history and objective examination; Discussion of diagnostic hypotheses and therapeutic pro-posals with the tutor; Realization of dressings;
-Admission: Daily observation of patients; Accomplishment of clinical history and clinical journals; Objective examination; Discussion of the diagnosis and therapeutic proposal of each case with the tutor; Realization of dressings;
-Operating room: Individual preparation for participation in surgical procedures; Participation in the surgical acts as 2nd assistant;
-Emergency: Tutoring during a period of 12 hours per week; Accomplishment of clinical history; Objective examination; Discussion of diagnostic and therapeutic proposals with the tutor;          Accomplishment of acts in the small surgery; Disinfection and suturing of wounds; Drainage of  abscesses;
-Service meetings and clinical sessions of the hospital: Participation in the clinical meetings of the General Surgery and Gastroenterology services and in the weekly clinical sessions of the Hospi-tal.

Mini congress
Scientific curiosity and the capacity for self-learning will be stimulated through the performance of a presentation paper at a seminar held at the end of the internship period. These studies should cover a clinical case accompanied during the internship and include a literature review on the presented         pathology.

Trauma Evaluation And Management (TEAM)

The TEAM course is organized by ATLS Portugal and the Portuguese Society of Surgery, according to the educational format proposed by the American College of Surgeons for medical students. Its objec-tives are:
-Describe the fundamental principles of the Initial Approach;
-Identify the correct sequence of priorities for approach;
-Review adequate resuscitation techniques;
-To value the (known) history of the patient;
-Understand the mechanisms of each injury;
-Identify concepts of "teamwork" in the treatment of severe trauma.

The TEAM course integrates a theoretical component and a practical component with four practical stalls: Airway, Shock, Vertebro-medullary Trauma and RX in Trauma. It is held at the beginning of each rotation, and attendance at both the lectures and the practice stands in full is mandatory for the award of the Diploma of the Course. The basic support materials will be made available in Moodle. 


Programs where the course is taught: