Clinical – Surgical Rotation & Roles
I. Observation Role (0)
A. The O role is defined as a student who has not met the FS or SS criteria. The student is observing a case in either the sterile or nonsterile role. Observation cases cannot be applied toward the required 120-case count but must be documented.
II. Case requirements – A student must complete a minimum of 120 cases as delineated below:
A. General surgery
1. A student must complete a minimum of 30 cases in General Surgery.
a. 20 of these cases must be performed in the FS role.
b. The remaining 10 cases may be performed in either the FS or SS role.
B. Specialty surgery.
1. A student must complete a minimum of 90 cases in various surgical specialties, excluding General Surgery.
a. A minimum of 60 cases must be performed in the FS role and distributed amongst a minimum of four surgical specialties.
i. A minimum of ten cases in four different specialties must be completed in the FS role (40 cases total)
ii. The additional 20 cases in the FS role may be distributed amongst any one surgical specialty or multiple surgical specialties.
b. The remaining 30 cases may be performed in any surgical specialty in either the FS or SS role.
2. Surgical specialties (excluding General Surgery)
a. Cardiothoracic
b. Genitourinary
c. Neurologic
d. Obstetric and gynecologic
e. Orthopedic
f. Otorhinolaryngologic
g. Ophthalmologic
h. Oral Maxillofacial
i. Peripheral vascular
j. Plastics and reconstructive
k. Procurement and transplant
2 Programs should contact their accrediting agencies for additional clarification.
www.arcstsa.org
III. Counting cases
A. Cases may be counted according to surgical specialty2 as defined in the core curriculum.
1. One pathology is counted as one procedure.
Example: A patient requires a breast biopsy followed by a mastectomy. It is one pathology, breast cancer, and the specialty is general surgery; therefore, it is counted and documented as one procedure and one case.
2. Counting more than one case on the same patient.
Example: A trauma patient requires a splenectomy and repair of a LeFort I fracture. Two cases can be counted and documented since the splenectomy is a general surgery, and the LeFort I repair is an oral-maxillofacial surgical specialty.
Example: A procedure that requires different setups and includes different specialties may be counted as separate cases. A mastectomy procedure (general surgery) followed by immediate reconstruction or augmentation (plastics and reconstruction) is counted as a separate case.
3. Diagnostic vs. operative endoscopy cases
a. An endoscopy, classified as a semi-critical procedure, is considered a diagnostic case.
b. An endoscopy, classified as a critical procedure, is considered an operative case.
c. Diagnostic and operative cases will be counted according to specialty.
d. Diagnostic cases are counted in the SS role up to a total of ten of the required 120 cases.
Example: A cystoscopy is a diagnostic procedure. If an adjunct procedure is performed, it is considered operative; therefore, a cystoscopy with ureteral stent placement is an operative procedure.
B. Vaginal delivery cases are counted in the SS role of the OB/GYN specialty, up to a total of five of the required 120.
IV. Documentation2*
A. Case performed
B. Role performed
C. Performance evaluations
D. Verification by the program director
*The surgical technology program is required to verify through the surgical rotation documentation the students’ progression in the scrub role in surgical procedures of increased complexity as he/she moves towards entry-level graduate competency.