Green OR Schedule


1	Week of: 11/12-11/16
2
3	Service:				Hepatobiliary					Skin/Soft Tissue/Breast
4	Residents:				Skavdahl/Gleaton					***
5	Vacations:				None					***
6	Attending on call:				***
7
8	MONDAY	Attending	OR	Time	Case	Coverage	Attending	OR	Time	Case	Coverage
9			Dana	07:00	Resident conference				700	Plastic and Hand (all day)
10			Clinic	AM	Mac Clinic every other week	APP
11	APPs: Amy
12					HOSPITAL HOLIDAY
13
14
15
16
17
18
19
20
21	TUESDAY
22			Clinic	AM	Fitzgerald Clinic	APP/David
23
24		Mac	OR 8	0730	Redo Parathryoidectomy	APP
25	APPs: Amy, Laura	Mac	OR 8	0940	PTHectomy	APP
26		Mac	OR 8	1140	R thyroid lobectomy	APP
27		Mac	OR 8	1400	Total Thyroidectomy	David
28		Mac	OR 8	1620	Radical Neck Dissection	David
29
30	WEDNESDAY
31				700	Liver tumor board			MMC	630	Melanoma tumor board - 1x/month
32			Clinic	All day	Mac Clinic	APP
33	APPs: Laura, Amy, Heather
34		Fitz	OR 11	740	Open Liver Resection	David
35		Fitz	OR 11	1120	Dx lap + mediport	Astrid
36		Fitz	OR 11	1320	Dx lap + mediport	Astrid
37		Fitz	OR 11	1520	Wide excision of back sarcoma	David
38
39	THURSDAY
40					7:00 - 10:00 Thursday Morning didactics; M&M; Grand Rounds
41
42	APPs: Laura, Amy, Kim
43		Mac	MR	930	R arm skin lesion excision	APP or UC
44		Mac	OR 19	1000	Liver resection -seg 5	David
45		Mac	OR 19	1300	R thyroid lobectomy	David
46
47
48
49
50
51	FRIDAY
52			Clinic	AM	Fitzgerald Clinic	APP & Astrid
53			Clinic	12-1	Inidcations meeting	Resident	Dsjardin	Clinic	0800-1600	Clinic	Zach/Justin
54	APPs: Laura, Liz, Kim
55		Mac	OR 14	0720	Parathyroid	David
56		Mac	OR 14	0900	Total Thyroid	David
57		Mac	OR 14	1200	Whipple	David
58
59
60
61
62
63	SATURDAY/SUNDAY
64
65	Attending on call:
66	Saturday / Sunday APP:
67	Green Resident Days:
68	Green Resident Night:


1	Week of: 11/5-11/9
2
3	Service:				Hepatobiliary					Skin/Soft Tissue/Breast
4	Residents:				Skavdahl/Gleaton					***
5	Vacations:				None					***
6	Attending on call:				***
7
8	MONDAY	Attending	OR	Time	Case	Coverage	Attending	OR	Time	Case	Coverage
9			Dana	07:00	Resident conference				700	Plastic and Hand (all day)
10			Clinic	AM	Mac Clinic every other week	APP
11	APPs:						Desjardin	10	0720-1640	4 cases	Zach/Justin in PM
12		Fitz	OR12	0800	STSG to right flank	David		5	1230	Mediport	Zach/Justin in PM
13		Fitz	OR 12	0940	HIPEC	David
14		Fitz	OR 12	1410	R buttocks merkel cell exc + SLNBx	David	Teller	Clinic	0720-1200	Clinic	Justin
15		Fitz	OR 12	1600	Right vastus lateralis muscle biopsy	David
16
17		Mac	OR 15	1530	neck I&D + dressing change	Astrid
18
19
20
21	TUESDAY
22			Clinic	AM	Fitzgerald Clinic	APP/David
23
24		Mac	OR 8	0730	Lap chole	Astrid	Teller	2	0740-1120	Mastectomy x 2	Justin
25	APPs:	Mac	OR 8	0940	Parathyroidectomy	Astrid
26		Mac	OR 8	1110	Total thyroidectomy	Astrid	Desjardin	Clinic	0830-1400	Clinic	Zach
27		Mac	OR 8	1330	Lap left adrenalectomy	David
28		Mac	OR 8	1600	Exc L axillary node	David
29
30	WEDNESDAY
31				700	Liver tumor board			MMC	630	Melanoma tumor board - 1x/month
32			Clinic	All day	Mac Clinic	APP
33	APPs:						Desjardin	4	0740-1400	4 x cases	Zach/Justin
34		Fitz	OR 11	740	Lap left liver resection	David
35		Fitz	OR 11	1120	Resection of left thigh lipoma	David
36		Fitz	OR 11	1320	total gastrectomy with EJ reconstruction	David
37		Fitz	MR	1300	Basal cell excision	UC
38
39	THURSDAY
40					7:00 - 10:00 Thursday Morning didactics; M&M; Grand Rounds
41
42	APPs:
43		Mac	MR	930	melanoma exc back	APP or UC	Desjardin	Clinic	1000-1700	Clinic	Zach/Justin
44		Mac	OR 19	1030	Total thyroid	APP
45
46
47
48
49
50
51	FRIDAY
52			Clinic	AM	Fitzgerald Clinic	APP & David
53			Clinic	12-1	Inidcations meeting	Resident	Dsjardin	Clinic	0800-1600	Clinic	Zach/Justin
54	APPs:
55					Mac is slacking off!
56
57
58
59
60
61
62
63	SATURDAY/SUNDAY
64
65	Attending on call:
66	Saturday / Sunday APP:
67	Green Resident Days:
68	Green Resident Night:


1	Week of: 10/29-11/2
2
3	Service:				Hepatobiliary					Skin/Soft Tissue/Breast
4	Residents:				Skavdahl/Gleaton					***
5	Vacations:				None					***
6	Attending on call:				***
7
8	MONDAY	Attending	OR	Time	Case	Coverage	Attending	OR	Time	Case	Coverage
9			Dana	07:00	Resident conference				700	Plastic and Hand (all day)
10			Clinic	AM	Mac Clinic every other week	APP
11	APPs:						Desjardin	SSC		x2	Justin
12		Fitz	OR 15	0740	WLE SCC R back	David
13		Fitz	OR 15	0940	Lap liver resection	David	Teller	Clinic	830-1100		Sheila
14		Fitz	OR 15	1210	Distal panc and spleen	David
15		Fitz	OR 15	1610	Mediport insertion + Dx lap	David	Desjardin	Clinic	1300-1530		Justin/Sheila
16
17		Mac	OR 8	0730	PTHectomy	APP
18		Mac	OR 8	1130	R thyroidectomy	APP
19		Mac	OR 8	1350	L thyroidectomy	Astrid
20		Mac	OR 8	1610	R thyroidectomy	Astrid
21	TUESDAY
22			Clinic	AM	Fitzgerald Clinic	APP/Astrid
23							Teller	SSC	0740-1430	4 cases	Sheila
24		Mac	OR 8	0730	Lap left adrenalectomy	David
25	APPs:	Mac	OR 8	0940	Parathyroidectomy	David
26		Mac	OR 8	1140	Lap abdominal node biopsy	David	Desjardin	Clinic	0830-1530		Justin
27		Mac	OR 8	1400	Parathyroidectomy	David
28
29
30	WEDNESDAY
31				700	Liver tumor board			MMC	630	Melanoma tumor board - 1x/month
32			Clinic	All day	Mac Clinic	APP/Astrid in am
33	APPs:						Desjardin	SSC	740	Lumpectomy	Justin
34		Fitz	OR 11	1150	Bile Duct Resection; radical chole, poss Whipple	David		Bram	1300	Lumpectom	Justin
35		Fitz	OR 11	1610	WLE L forearm melanoma + SLNBx	David
36							Teller	Clinic	0800-1600	Clinic	Sheila
37	THURSDAY
38					7:00 - 10:00 Thursday Morning didactics; M&M; Grand Rounds
39
40	APPs:
41
42		Mac	OR 19	1000	Total thyroid	APP	Teller	Bram	0830	Mastectomy	Uncovered
43		Mac	OR 19	1220	Para	APP
44		Mac	OR 19	1450	Para	APP	Teller	clinic	1330-1630		Justin
45
46		Mac	MR	1205	Exc Neck Mass	Astrid	Desjardin	clinic	1400-1600		Sheila
47
48
49	FRIDAY
50			Clinic	AM	Fitzgerald Clinic	APP & David
51			Clinic	12-1	Inidcations meeting	Resident	Desjardin	SSC	0740	B Mastectomy	Sheila/Justin
52	APPs:
53		Mac	OR 14	0720	Para	Astrid		Clinic	1300-1530		Sheila/Justin
54		Mac	OR 14	0900	Lap chole	Astrid
55		Mac	OR 14	1030	Para	Astrid
56		Mac	OR 14	1300	R thyroidectomy	David
57		Mac	OR 14	1520	Lap adrenalectomy	David
58
59
60
61	SATURDAY/SUNDAY
62
63	Attending on call:
64	Saturday / Sunday APP:
65	Green Resident Days:
66	Green Resident Night:


1	Week of: 10/22-10/26
2
3	Service:				Hepatobiliary					Skin/Soft Tissue/Breast
4	Residents:				Skavdahl/Gleaton					***
5	Vacations:				None					***
6	Attending on call:				***
7
8	MONDAY	Attending	OR	Time	Case	Coverage	Attending	OR	Time	Case	Coverage
9			Dana	07:00	Resident conference				700	Plastic and Hand (all day)
10			Clinic	AM	Mac Clinic every other week	APP/David
11	APPs: Amy, Wendy				David @ ACS Congress all day
12		Fitz	OR 15	0740	Right hepatectomy	Astrid
13		Fitz	OR 15	1150	Hepatico-J for choledochal cyst	Astrid
14		Fitz	OR 15	1650	Lap right colectomy	Astrid
15
16		Mac	OR 8	1030	Parathryoid	APP
17		Mac	OR 8	1300	Total thyroid	APP
18		Mac	OR 8	1530	Total thyroid	APP
19	TUESDAY
20			Clinic	AM	Fitzgerald Clinic	APP/David
21									700	Plastic and Hand (until 1130)
22		Mac	OR 8	0730	Parathyroidectomy	Astrid	Breast Clinic		AM	Chao
23	APPs: Laura, Liz	Mac	OR 8	0910	Parathyroidectomy	Astrid	Breast Clinic		AM	Rutstein
24		Mac	OR 8	1140	Lap gastric resection for GIST	David		SSC	1200	Breast Tumor Board
25		Mac	OR 8	1410	Left thyroidectomy	David
26		Mac	OR 8	1630	Mediport	David
27							Breast Clinic		PM	Chao
28
29
30
31	WEDNESDAY
32				700	Liver tumor board			MMC	630	Melanoma tumor board - 1x/month
33			Clinic	All day	Mac Clinic	APP/Astrid in am
34	APPs: Laura, Elise
35		Fitz	OR 11	1150	Total Gastrectomy with RY reconstruction	David
36		Fitz	OR 11	1610	R axillary LN excisional biopsy	David
37
38
39
40
41
42
43	THURSDAY
44					7:00 - 10:00 Thursday Morning didactics; M&M; Grand Rounds
45							Breast Clinic		AM	Chao
46	APPs: Amy, Laura, Jenn, Kim	fitz	SSC	830	Rsxn lipomas	UC	Breast Clinic		PM	Chao
47
48		Mac	OR 11	830	Redo Para	APP
49		Mac	OR 11	1040	Total thyroid	David
50		Mac	OR 11	1300	Total thyroid	David
51		Mac	OR 11	1520	R thyroid lobectomy	David
52
53
54
55	FRIDAY
56			Clinic	AM	Fitzgerald Clinic	APP & David
57			Clinic	12-1	Inidcations meeting	Resident
58	APPs: Amy, Kim
59		Mac	OR 14	0720	PTHectomy	Astrid
60		Mac	OR 14	0900	Left arm melanoma excision	Astrid
61		Mac	OR 14	0900	Redo PTHectomy	Astrid
62		Mac	OR 14	1130	Total thyroidectomy	Astrid
63		Mac	OR 14	1350	Lap left adrenalectomy	David
64
65
66
67	SATURDAY/SUNDAY
68
69	Attending on call:
70	Saturday / Sunday APP:
71	Green Resident Days:
72	Green Resident Night:


1	Week of: 10/15-10/19
2
3	Service:				Hepatobiliary					Skin/Soft Tissue/Breast
4	Residents:				Skavdahl/Vernamonti					***
5	Vacations:				None					***
6	Attending on call:				***
7
8	MONDAY	Attending	OR	Time	Case	Coverage	Attending	OR	Time	Case	Coverage
9			Dana	07:00	Resident conference				700	Plastic and Hand (all day)
10			Clinic	AM	Mac Clinic every other week	APP/David
11	APPs:
12	Laura	Fitz	OR 15	0740	WLE of posterior calf sarcoma	Jack
13		Fitz	OR 15	0850	Exc/Bx of posterior neck lymph node	Jack
14
15		Mac	OR 8	1300	PTHectomy	David
16		Mac	OR 8	1500	Lap small bowel resection	David
17
18
19	TUESDAY
20			Clinic	AM	Fitzgerald Clinic	APP/David
21									700	Plastic and Hand (until 1130)
22		Mac	OR 8	0730	Parathyroidectomy	APP	Breast Clinic		AM	Chao
23	APPs:	Mac	OR 8	0940	Parathyroidectomy	APP	Breast Clinic		AM	Rutstein
24	Kim	Mac	OR 8	1210	R lobectomy	David		SSC	1200	Breast Tumor Board
25	Liz	Mac	OR 8	1430	Total thyroidectomy	David
26
27							Breast Clinic		PM	Chao
28
29
30
31	WEDNESDAY
32				700	Liver tumor board			MMC	630	Melanoma tumor board - 1x/month
33			Clinic	All day	Mac Clinic	APP
34	APPs:
35	Laura	Fitz	OR 11	740	VIHR	David
36	Amy	Fitz	OR 11	950	Mediport, ? dx lap	David
37	Lisa	Fitz	MR	1300	WLE L arm melanoma	David
38
39
40
41
42
43	THURSDAY
44					7:00 - 10:00 Thursday Morning didactics; M&M; Grand Rounds
45							Breast Clinic		AM	Chao
46	APPs:	Mac	OR 19	1000	Whipple	David	Breast Clinic		PM	Chao
47
48	Amy
49	Kim
50	Donna
51
52
53
54
55	FRIDAY
56			Clinic	AM	Fitzgerald Clinic	APP or resident
57			Clinic	12-1	Inidcations meeting	Resident
58	APPs:
59		Mac	OR 14	0720	PTHectomy	APP	Teller	SSC 10	0740	B/l mastectomy, R SLNBx	David
60	Amy	Mac	OR 14	0930	Left thyroid lobectomy	APP	Teller	SSC 10	1130	L lumpectomy + SLNBx	David
61	Kim	Mac	OR 14	1150	PTHectomy	Jack	Teller	SSC 10	1350	R breast exc biopsy	David
62	Donna	Mac	OR 14	1350	PTHectomy	Jack	Teller	SSC 10	1510	R breast exc biopsy	David
63		Mac	OR 14	1550	Left thyroid lobectomy	Jack
64
65
66
67	SATURDAY/SUNDAY
68
69	Attending on call:
70	Saturday / Sunday APP:
71	Green Resident Days:
72	Green Resident Night:


1	Week of: 10/8-10/12
2
3	Service:				Hepatibiliary					Skin/Soft Tissue/Breast
4	Residents:				***					***
5	Vacations:				***					***
6	Attending on call:				***
7
8	MONDAY	Attending	OR	Time	Case	Coverage	Attending	OR	Time	Case	Coverage
9			Dana	07:00	Resident conference				700	Plastic and Hand (all day)
10			Clinic	AM	Mac Clinic every other week	APP
11	APPs:
12		Mac	OR8	0730	Laparascopic Mesenteric biopsy
13		Mac	OR8	0840	Parathyroidectomy	Laura
14		Mac	OR8	1110	Left thyroidectomy	Laura
15		Mac	OR8	1330	Left neck node dissection	David
16		Mac	OR8	1530	Exc Merkel Cell Carcinoma	David
17
18		Fitz	OR15	0740	Distal panc/spleen	David
19		Fitz	OR15	1120	Lap chole	David
20		Fitz	OR15	1350	Mediport	Jack
21
22
23	TUESDAY
24			Clinic	AM	Fitzgerald Clinic
25									700	Plastic and Hand (until 1130)
26		Mac	OR8	0730	R thyroid lobectomy	APP	Breast Clinic		AM	Chao
27	APPs:	Mac	OR8	0940	L thyroid lobectomy	APP	Breast Clinic		AM	Rutstein
28		Mac	OR8	1200	PTHectomy	Skavdahl		SSC	1200	Breast Tumor Board
29		Mac	OR8	1400	Total Thyroid	Skavdahl
30		Mac	OR8	1620	Total Thyroid	Skavdahl
31							Breast Clinic		PM	Chao
32
33
34
35	WEDNESDAY
36				700	Liver tumor board			MMC	630	Melanoma tumor board - 1x/month
37			Clinic	All day	Mac Clinic	APP
38	APPs:
39		Fitz	OR 11	740	Whipple	Skavdahl	Teller	SSC1	740	L lumpectomy, SLNBx
40		Fitz	OR 11	1200	Mediport	Jack	Teller	SSC1	1000	Bilateral simple mastectomy; L SLNBx
41		Fitz	MR	1300	Left axilla exc biopsy	APP	Teller	SSC4	1310	Mammo guided L breast biopsy
42		Fitz	MR	1355	Left calf mass excision	APP	Teller	SSC4	1430	Left excisional breast bx
43		Fitz	OR 11	1445	Mediport placement/dx lap	Jack
44		Fitz	OR 11	1645	R knee wide local excision	Jack
45
46
47	THURSDAY
48					7:00 - 10:00 Thursday Morning didactics; M&M; Grand Rounds
49							Breast Clinic		AM	Chao
50	APPs:	Mac	OR 19	1000	PTHectomy	APP	Breast Clinic		PM	Chao
51		Mac	OR 19	1200	Total thyroid	APP
52		Mac	OR 19	1420	total thyroid	Jack
53
54		Fitz	SSC9	1030	Removal of L SCV mediport	UC
55		Fitz	SSC9	1120	WLE basal cell: R shoulder	UC
56		Fitz	SSC9	1210	Exc basal cell carcinoma: left shoulder, left shoulder, left nose	UC
57		Fitz	OR 11	1445	Right colectomy	Skavdahl
58
59	FRIDAY
60			Clinic	AM	Fitzgerald Clinic	APP or resident
61			Clinic	12-1	Inidcations meeting	Resident
62	APPs:
63		Mac	OR 14	0720	PTHectomy	Jack	Teller	SSC 4	0740	Bilateral simple mastectomy
64		Mac	OR 14	0900	R thyroidectomy, PTHectomy	Skavdahl	Teller	SSC 4	1130	Exc R breast biopsy
65		Mac	OR 14	1100	R neck dissection	Skavdahl	Teller	SSC 4	1250	Left breast lumpectomy
66		Mac	OR 14	1330	PTHectomy	Skavdahl
67
68
69
70
71	SATURDAY/SUNDAY
72
73	Attending on call:
74	Saturday / Sunday APP:
75	Green Resident Days:
76	Green Resident Night:


1	Week of: 10/1 - 10/5
2
3	Service:				Hepatibiliary					Skin/Soft Tissue/Breast
4	Residents:				Skavdahl/Vernamonti					***
5	Vacations:									***
6	Attending on call:
7
8	MONDAY	Attending	OR	Time	Case	Coverage	Attending	OR	Time	Case	Coverage
9			Dana	07:00	Resident conference				700	Plastic and Hand (all day)
10			Clinic	AM	Mac Clinic every other week	APP
11	APPs:
12	Laura	Fitz	OR 16		Left buttocks I&D	Skavdahl
13		Fitz	OR 15		R neck melanoma exc + SLNB	Skavdahl
14		Fitz	OR 15		mediport	Skavdahl
15		Fitz	OR 15		R trunk melanoma + SLNB	Skavdahl
16
17		Mac	OR 8		PTHectomy	Jack
18		Mac	OR 8		lobectomy vs total thyroid	Jack
19	TUESDAY
20			Clinic	AM	Fitzgerald Clinic
21									700	Plastic and Hand (until 1130)
22		Mac	OR 8	0730	PTHectomy	David	Breast Clinic		AM	Chao
23	APPs:	Mac	OR 8	0910	Total Thyroidectomy	David	Breast Clinic		AM	Rutstein
24	Laura	Mac	OR 8	1130	Right thyroidectomy	David		SSC	1200	Breast Tumor Board
25	Wendy	Mac	OR 8	1350	Left thyroidectomy	Jack
26		Mac	OR 8	1610	Mediport	Jack
27							Breast Clinic		PM	Chao
28
29
30
31	WEDNESDAY
32				700	Liver tumor board			MMC	630	Melanoma tumor board - 1x/month
33			Clinic	All day	Mac Clinic	APP
34	APPs:
35	Laura	Fitz	OR 11	740	LAR	Skavdahl
36	Lisa	Fitz	OR 11	1150	L thigh melanoma + SLNB	Skavdahl
37	Julie	Fitz	MR	1320	Ex R leg mass	UC
38		Fitz	OR 11	1350	R thigh exc + SLNB + neck lesion bx	Skavdahl
39		Fitz	OR 11	1535	Groin lymphoma exc	Skavdahl
40
41
42
43	THURSDAY
44					7:00 - 10:00 Thursday Morning didactics; M&M; Grand Rounds
45							Breast Clinic		AM	Chao
46	APPs						Breast Clinic		PM	Chao
47	Laura
48	Amy
49	Elise
50
51
52
53
54
55
56
57	FRIDAY
58			Clinic	AM	Fitzgerald Clinic	APP or resident
59			Clinic	12-1	Inidcations meeting	Resident
60	APPs:
61	Laura
62	Liz
63
64
65
66
67
68
69	SATURDAY/SUNDAY
70
71	Attending on call:
72	Saturday / Sunday APP:
73	Green Resident Days:
74	Green Resident Night:


1	Block	Dates	Resident Vacation	APP Vacation	Other Events (melnick etc)
2	1	July 2-8	-
3		July 9-15	-
4	2	July 16-22	-
5		July 23-29	-
6	3	July 30 - Aug 5	-
7		Aug 6-12	-
8	4	Aug 13-19	-
9		Aug 20-26	-
10	5	Aug 27 - Sept 2	-
11		Sept 3-9	-
12	6	Sept 10-16	-
13		Sept 17-23	-
14	7	Sept 24-30	only one resident (Molly)
15		Oct 1-7	only one resident (Molly)
16	8	Oct 8-14	-
17		Oct 15-21	-
18	9	Oct 22-28	-
19		Oct 29 - Nov 4	-
20	10	Nov 5-11	-
21		Nov 12-18	-
22	11	Nov 19-25	-
23		Nov 26 - Dec 2	-
24	12	Dec 3-9	Molly Douglas (chief)
25		Dec10-16	-
26	13	Dec 17-23	Alex Dowli ("intern")
27		Dec 24-30	Michele Siciliano (chief)
28	14	Dec 31 - Jan 6	-
29		Jan 7-13	-
30	15	Jan 14-20	-
31		Jan 21-27	-
32	16	Jan 28 - Feb 3	-
33		Feb 4-10	-
34	17	Feb 11-17	-
35		Feb 18-24	William Devan (intern)
36	18	Feb 25 - March 3	-
37		March 4-10	-
38	19	March 11-17	-
39		March 18-24	-
40	20	March 25-31	-
41		April 1-7	-
42	21	April 8-14	Jamie Tung (chief)
43		April 15-21	-
44	22	April 22-28	-
45		April 29 - May 5	-
46	23	May 6-12	Joe Mack ("intern")
47		May 13-19	-
48	24	May 20-26	-
49		May 27 - June 2	-
50	25	June 3-9	-
51		June 10-16	-
52	26	June 17-23	Chia Murphy ("intern")
53		June 24-30	-


1
2	Cases	Plan to cover all of the breast & melanoma cases, plus occasional other skin lesion cases.	If there are multilpe cases going at once, check in with Green chief to determine who can provide additional coverage. All attendings are independent and do not need cases covered, but want to know if they will be without a resident.
3
4	Rounds	Round on any inpatients you have in the hospital. It is usually not many.	Do round on all overnight breast patient's in scarborough or bramhall Anybody that Plastics operates on, Plastics becomes primary. They will handle all dispo stuff.
5
6	Clinic	Location	Scarborough breast center - right-most entrance as you face the building. Go in, take first big right, then double doors to the waiting room are on your left. Go to the right of the desk then straight back.
7		Overview	The breast center is a very well-organized operation, staffed almost exclusively by women. Appointments for benign conditions and surgical follow-ups look pretty much like you would expect. However, appointments for cancer diagnoses are a bit different - the patient will be roomed with their faimily members in one of the 4 "Consult Rooms" - these have carpet and soft chairs, and a separate exam area in the back. Patient's with new cancer gnereally see a slew of people - one of the APPs initially, a surgeon (often at a later visit), their APP again, and Cindy the breast cancer navigator who gives the patient a tote bag (this is called "toteing" the patient) full of resouce pamphlets and funny-shaped pillow. (Breast cancer is very well funded.)	The center has mammography and ultrasound in the same suite. Medical oncology is in an adjacent suite. Everyone works pretty closely together.
8		Where to sit	If you go straight back from the desk and turn right and go past the photocopiers, there is a small room with 2 computers labeled "Provider Dictation." The room has no permanent inhabitants - Dr. Rutstein will sit there when the are in clinic - and it is usually fair game to put your bag in there and use one of the computers as a home base.
9		Charting	The clinic is on Epic for records. There is a new patient info sheet, either completed at the visit, or sometimes prior and in "media" tab. This is very helpful for history, risk factors, etc. when doing notest. There are dot phrases for Dr. Teller/Desjardin, just ask which they want you to use. Rutstein still usually dictates all her H&P's, but was ok with resident's writing follow-up visit notes.	Beware, there is (as of July 2015) currently no way to designate a co-signer on outpatient notes. You have to tell the attending you wrote the note, and then they can add their addendum. Yes, it's stupid. They're "working on it."	After the note, you have to asign a level of service to the encounter and put follow-up requirments in the "wrap up" screen. Talk to the attending before signing the encounter.
10
11		People in Clinic	APP's are starting to cross cover everyone but have some Drs they work with more
12		Lynn Ried -	APP that works with Dr. Rutstein, and Dr. Teller/Desjardin as well - SHE IS THE PERSON TO TALK TO if you are going to a Rutstein clinic. When Rutsteins sees new patients, Lynn has generally seen them all first and dictated a full H&P at a prior appointment and ordered all the appropriate studies and work-up - by the time they see Rut there is basically a plan already made and they "meet with the surgeon" as more of a fomrality. Check in with Lynn about the day before clinic starts; she can direct you who is good to see.	Currently, the APPs don't feel they are equipped to have residents shadow or work with them for their clinic days. This may change
13		Karen Gronberg	APP that works with Dr.Desjardin and Teller. Also does the full work-up before patients meet with their surgeons. Also a great reasource; maybe a bit less itnerested in teaching than Lynn.
14		Dr. Liz Pietras	One of the breast radiologists. Willing to discuss imaging wity you and allow you to watch biopsies
15		Mary Tard & Alicia ...	MA's at the fron desk - check patients in and if you let them know who you are going to see, will give you the chart and let you know when they are in a room
16		Andrea	Is some form of radiology coordinator. Her office is to the left past the breakroom. Check in with her if you want to arrange shadowing the mammo or ultrasound techs or watching biopsies (it seems good to attach yourself to a tech for biopsies, so you get to see the process of positioning prior to the radiologist coming in).
17
18	Breast tumor board	Where/when	Thursday at 12:00-1:00 in the conference room off the little "library" area which is on the right as you come in the buidling and head towards the breast center. Just ask one of the attendings to show you on your first clinic day. It's very close.	However, this is subject to frequent change. Update this sheet if time or location of breast conference changes!
19		Who	Attended by surgery including APPs, med onc, radiology, pathology, social work, genetics. Having all these people at the table is part of requiremnets for accreditation as a breast center.
20		What	There are several types of questions generally trying to be answered by the group at tumor board - For a new cancer diagnosis, does the pt need surgery or medical therapy first? - If surgery is done, does pathology etc indicate need for any MORE surgery, or do they go on to med onc? (ie "path review") - Given receptor status and risk profile including age, does a patient need chemo or just endocrine therapy, or both? - For patients with incompelte work-up, is any special imaging needed, like MRI? - How agggressive should we really be with this octegenarian? (or nonagenarian?) - Is the patient a candidate for genetic testing based on family history? Of course there are more, but those are the common ones
21		Expectations	You are expected to attend tumor board. You are expected to present a few patient's per week. KEY: You won't be on the email chain, so talk to Cindy on Monday or Tuesday and she can give you the schedule with full names - make a copy so you can figure out who to present. Dr. Desjardin volunteered to send my the tumor board sheet by email, I just had to remind her. Talk with Lynn and Karen about who you will present, and they will let you do the talking. If the surgical attending is actually going to conference (hopefully this will happen more in future) you should talk to the attending too.	When presenting patients, the appropriate format is: "This is a 46 y/o woman with right infiltrating ductal carcinoma, clinical stage IIB (T2N1), ER-/PR-/H+, s/p neoadjuvang chemo (AC x4, Taxol x12), now s/p right RSL lumpectomy/ALND on 12/31/2013 needing a post-op path review." Adjust the content as necessary.
22
23	Specifics by Case	Lumpectomy	Unless this is for a palpble mass, most will be an RSL (radio-seed localized) lumpecotmy - patients have a radioactive I-99 seed placed up to 5 days before OR and you find it using the radiation probe in the OR. Take note of the in-vivo and ex-vivo counts (in-vivo should be higher than ex-vivo).	Almost all will go home the same day.	Can't use suction in the wound with the seed due to fear of loosing seed (apparently this creates havoc) - so only dab until seed confirmed in specimen by xray.
24		Mastectomy	Without reconstruction	Routinely stay overnight. Will have received pre-op teaching including some info about drains. See in AM and discharge; usually attending will want to see them too before they go home.
25			With reconstruction	Routinely stay overnight. PLASTICS will handle all their d/c stuff including instructions and scripts. They get extensive pre-op teaching. They get antibiotics until the drains come out.
26		Breast sentinel node biopsies	Radiology tech will come in Pre-op and inject technetium-99 in 4 areas around nipple. They carry special little box. Dr. Rutstein routinely uses methylene blue injected while patient asleep under nipple. Dr. Teller/Desjardin, only if no radio tracer signal is present in the axilla.	Use probe and blue color to locate sentinel nodes. After first (usually highest) count node is removed, remove any additional nodes with counts >=10% of highest count - up to 3 nodes.
27		Melanoma with sentinel node biopsies	Especially for turnk melanomas, need to have sentinel lymph node localized before operation. Will be booked for appt with radioloy ~2 hrs before surgery and get techentium-99 injected at melanoma site and then imaged -- nodal basin will light up and rads will mark the skin overlying the hot node	May drain to more than one basin (ie bilateral axilla) Also inject blue dye in OR once pt asleep.	Same rules as breast for finding and removing nodes.
28		Scarborough Cases	FYI if they stay overnight - 1st call is the attending
29
30	Spedifics by attending
31		Dressings	All attendings use mastasol/steris/tega
32		Dr. Desjardin	does the running sub q monocryl with knots, the other two are without knots.
33			She does her mastectomies with tumesence and sharply, and routinely takes extra margins from lumpectomy sites
34		Dr. Teller/Rutstein	Do their cases in similar techniques. Mast/lump with cautery, selective margin takers.
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1
2	2015 American Thyroid Assocaition Guidlines:	https://www.thyroidcancercanada.org/userfiles/files/ATA_Guidelines_Thyroid_Nodules_2016.pdf	AKA, everything you ever watned to know about thyroid nodules
3
4	Mac Clinic:	Arrival:
5		Where to sit:
6		People to know:
7		Lunch?	No break. Do bring food and munch as you go.
8		Outpatient Epic:	Notes:
9			Plan section:
10			Wrap up:
11
12
13	OR	Positioning for thyroid cases	Supine, both arms tucked, shoulder roll, head on a shay	You should set up the nerve monitor by placing the electrodes (green above, white below) over the upper sternum and plugging everyting into the color-codes spots on the little connector box
14
15		Thyroidectomy operative steps (MacGillivary):	Incision using knife (not bovie) to get all the way through dermis	Open platysma with bovie, make flaps under plattysma up to thyroid cartilage and down to sternal notch (avoid the EJ veins)	Open mildine cervical fascia, use bovie to get the straps off the thyroid	Kitner time. Peel soft tissues away from thyroid. Usually middle thyroid vein first then go to upper pole. Tie AND clip and harmonic most upper pole vessls	Work around the middle and lower pole, detaching from trachea when easy to do so	On underside of thyroid, will have to find nerve and use stimulator to ensure preservation of nerve
16			Once thyroid out and parathyroids look ok:	Fibrillar in space	Close midline fascia with 3-0 vicryl	4-0 vicryl w knots to close platysma, then do more local	close skin with 4-0 monocryl, no knots, and dermabond
17
18
19
20		Espohagectomy	4x ports, supraumbilical 12 port
21		Post-op esophagctomy


1	Week of: ***
2
3	Service:				Hepatibiliary					Skin/Soft Tissue/Breast
4	Residents:				***					***
5	Vacations:				***					***
6	Attending on call:				***
7
8	MONDAY	Attending	OR	Time	Case	Coverage	Attending	OR	Time	Case	Coverage
9			Dana	07:00	Resident conference				700	Plastic and Hand (all day)
10			Clinic	AM	Mac Clinic every other week	APP
11	APPs:
12
13
14
15
16
17
18
19	TUESDAY
20			Clinic	AM	Fitzgerald Clinic
21									700	Plastic and Hand (until 1130)
22							Breast Clinic		AM	Chao
23	APPs:						Breast Clinic		AM	Rutstein
24								SSC	1200	Breast Tumor Board
25
26
27							Breast Clinic		PM	Chao
28
29
30
31	WEDNESDAY
32				700	Liver tumor board			MMC	630	Melanoma tumor board - 1x/month
33			Clinic	All day	Mac Clinic	APP
34	APPs:
35
36
37
38
39
40
41
42
43	THURSDAY
44					7:00 - 10:00 Thursday Morning didactics; M&M; Grand Rounds
45							Breast Clinic		AM	Chao
46	APPs:						Breast Clinic		PM	Chao
47
48
49
50
51
52
53
54
55	FRIDAY
56			Clinic	AM	Fitzgerald Clinic	APP or resident
57			Clinic	12-1	Inidcations meeting	Resident
58	APPs:
59
60
61
62
63
64
65
66
67	SATURDAY/SUNDAY
68
69	Attending on call:
70	Saturday / Sunday APP:
71	Green Resident Days:
72	Green Resident Night:


1			Residents on-service	Resident vacations	APP vacations	Other events/anticipated coverage gaps

2	Block 1	July 1-9	Misercola, Heidt	-	Jamie
3		July 10-17	Misercola, Heidt	-	Jamie
4	Block 2	July 18-30	Misercola, Heidt	-		July 20 - Britt out for Boards
5		July 23-30	Misercola, Heidt	-	Chris
6	Block 3	July 31-Aug 6	Misercola, MacDowell	-	Chris
7		Aug 7-13	Misercola, MacDowell	-
8	Block 4	Aug 14-20	Misercola, MacDowell	-	Angela	Premium per diem offered
9		Aug 21-27	Misercola, MacDowell	-		Lobster bake Aug 25
10	Block 5	Aug 28 - Sept 3	Misercola, Gleaton	-
11		Sept 4-10	Misercola, Gleaton	-
12	Block 6	Sept 11-17	Misercola, Gleaton	-
13		Sept 18-24	Misercola, Gleaton	-		Britt out for ATLS instructor course
14	Block 7	Sept 25 - Oct 1	Douglas	-
15		Oct 2-8	Douglas	-
16	Block 8	Oct 9-15	Douglas, Zhang	-
17		Oct 16-22	Douglas, Zhang	-
18	Block 9	Oct 23-29	Douglas, Vernamonit	-
19		Oct 30 - Nov 5	Douglas, Vernamonit	-
20	Block 10	Nov 6-12	Douglas, Vernamonit	-
21		Nov 13-19	Douglas, Vernamonit	-
22	Block 11	Nov 20-26	Douglas, Meader	-
23		Nov 27 - Dec 3	Douglas, Meader	-
24	Block 12	Dec 4-10	Douglas, Meader, Moccia	Douglas
25		Dec 11-17	Douglas, Meader, Moccia	-
26	Block 13	Dec 18-24	Siciliano, Dowli	Dowli
27		Dec 25-31	Siciliano, Dowli	Siciliano
28	Block 14	Jan 1-7	Siciliano, Dowli	-
29		Jan 8-14	Siciliano, Dowli	-
30	Block 15	Jan 15-21	Siciliano, Murphy	-
31		Jan 22-28	Siciliano, Murphy	-
32	Block 16	Jan 29 - Feb 4	Siciliano, Murphy	-
33		Feb 5-11	Siciliano, Murphy	-
34	Block 17	Feb 12-18	Siciliano, Devan	-
35		Feb 19-25	Siciliano, Devan	Devan
36	Block 18	Feb 26 - March 4	Siciliano, Devan	-
37		March 5-11	Siciliano, Devan	-
38	Block 19	March 12-18	Lipinska, Dowli	-
39		March 19-25	Lipinska, Dowli	-
40	Block 20	March 26 - April 1	Lipinska, Dowli	-
41		April 2-8	Lipinska, Dowli	-
42	Block 21	April 9-15	Tung, Bernal	Tung
43		April 16-22	Tung, Bernal	-
44	Block 22	April 23-29	Tung, Bernal	-
45		April 30 - May 6	Tung, Bernal	-
46	Block 23	May 7-13	Wilkes, Mack	Mack
47		May 14-20	Wilkes, Mack	-
48	Block 24	May 21-27	Wilkes, Mack	-
49		May 28 - June 3	Wilkes, Mack	-
50	Block 25	June 4-10	Ackerman, Pletch	-
51		June 11-17	Ackerman, Pletch	-
52	Block 26	June 18-24	Ackerman, Murphy	Murphy
53		June 25 - July 1	Ackerman, Murphy	-