在三级中心的培训为见习学生提供了轮换各种外科专业的机会，这是其他方式无法获得的。在我们的机构，学生在 9 周内轮流学习普通外科课程，其余 3 周提供选修课。因此，学生对核心普通外科病例的经验可能有限，这些病例必须在见习结束时完成才能证明其能力。为了标准化临床培训，学生必须在手术室或通过 Wise-MD 模块记录 11 个核心普外科病例。当学生在手术轮转期间没有机会看到某些病例时，可以使用 Wise-MD 代替参与手术室。该研究的目的是确定与 Wise-MD 相比，三年级医学生在手术室经历核心普通外科病例的比例，从而深入了解改善外科见习的方法。见习学生记录手术病例是否通过 Wise-MD 完成MD或有手术室经验。对 2018 年 1 月至 2022 年 9 月期间完成外科见习的学生提交的表格进行了分析。对于每个核心手术病例（肛门直肠炎、阑尾炎、肠梗阻、乳腺癌、胆囊炎、结肠癌、憩室炎、腹股沟疝气、肺癌、皮肤癌和创伤），学生根据他们报告的经验进行分层。计算了 Wise-MD 与手术室病例的比例。2018 年 1 月至 2022 年 9 月，共有 411 名学生提交了完整的病例日志。在所有手术病例中，60%是学生在手术室经历的。手术室经历比例最高的手术病例包括阑尾炎（78%）、胆囊炎（85%）、腹股沟疝（79%）和外伤（76%）。手术室经验比例最低的手术病例包括肺癌（34%）和皮肤癌（44%）。尽管实施了普通手术封锁，但约40%的学生没有经历过大多数“面包和黄油”手术病例。书记官应注意外科团队中医学生的分配，因为这可能会影响观察的病例。此外，外科选修课的机会可能会影响普通外科手术的暴露。由爱思唯尔公司出版。

Training at a tertiary center offers clerkship students the opportunity to rotate through a wide range of surgical specialties that may not be otherwise available. At our institution, students rotate through general surgery for 3 out of 9 weeks, with the remainder offering electives. As a result, students may have limited experience with core general surgery cases which are necessary to complete by the end of the clerkship to demonstrate competency. In efforts to standardize clinical training, students must log 11 core general surgery cases either in the operating room or modules via Wise-MD. Wise-MD is used in place of participating in the operating room when students do not have the opportunity to see certain cases during their surgical rotation. The purpose of the study is to ascertain what proportion of third year medical students experience core general surgery cases in the operating room versus Wise-MD, providing insight into ways to improve the surgical clerkship.Clerkship students recorded whether surgical cases are completed via Wise-MD or experienced in the operating room. Forms submitted by students who completed surgical clerkship between January 2018 to September 2022 were analyzed. For each core surgical case (anorectal, appendicitis, bowel obstruction, breast cancer, cholecystitis, colon cancer, diverticulitis, inguinal hernia, lung cancer, skin cancer, and trauma) students were stratified based on their reported experience. The proportion of Wise-MD versus operating room cases was calculated.Between January 2018 and September 2022 a total of 411 students submitted completed case logs. Among all surgical cases, 60% were experienced by students in the operating room. The surgical cases with the highest proportion of operating room experience included appendicitis (78%), cholecystitis (85%), inguinal hernia (79%), and trauma (76%). The surgical cases with the lowest proportion of operating room experience included lung cancer (34%) and skin cancer (44%).Despite enforcing a general surgery block, about 40% of students are not experiencing most "bread and butter" surgical cases. Clerkship directors should be mindful about the distribution of medical students among surgical teams as this may affect which cases are observed. Moreover, the opportunity for surgical electives may influence general surgery exposure.Published by Elsevier Inc.