Undergraduate Medical Education | Department of Surgery

In addition to residency programs and fellowships, the Department offers required and elective courses and research opportunities for medical students.

Surgery Clinical Experience Director Mackenzie Cook, M.D., and Associate Surgery Clinical Experience Director Enjae Jung, M.D., are committed to the training and development of surgeons early in their education. They are actively engaged in teaching and providing opportunities for medical students interested in surgery.

Related: Undergraduate Medical Education program objectives and competencies | Explore the M.D. Program curriculum

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First and Second Year Students

First and Second Year Students (MS1, MS2) are introduced to surgery through workshops, research and courses. There is also the opportunity to join the Surgical Interest Group (SIG).

Electives

1 credit

Introduction to Surgery I introduces students to a surgical career and explores a range of surgical career options and lifestyles. An understanding of suturing, knot tying, and other basic surgical skills is acquired, as well as a familiarity with essential surgical instruments.

Hands-on experience enables students to become comfortable in the operating room while utilizing proper etiquette. Interaction with OHSU surgeons provides opportunity for mentoring.

Students will attend two Surgical Skills Lab sessions, attend at least one SIG Student/Faculty Interactive session, attend a minimum of four hours in the operating rooms, and mentor other students through volunteering for a minimum of two hours.

Volunteer work includes mentoring high school students who are interested in a surgery career during an OHSU skills lab or helping to teach suturing to premedical or other medical students. Fulfilling the elective requirements and submitting the Introduction to Surgery I Form is required to complete this course.

1 credit

Introduction to Surgery II expands upon Introduction to Surgery I. A basic proficiency of the technical skills taught in Introduction to Surgery I is required.

This course requires further attendance of surgical conferences and specialty talks. Students enrolled will be responsible for teaching 705B students in lab workshops. Students will also gain further experience by participating in operations during this period.

Two hours of volunteer work are required, which includes mentoring high school students who are interested in a surgery career during an OHSU skills lab or helping to teach suturing to premedical or other medical students. Participating in the skills lab beyond the initial two hour requirement can fulfill the volunteer requirement. Fulfilling the elective requirements and submitting the Introduction to Surgery II Form is required to complete this course.

1-4 credits

Students participate in self-arranged surgery research. At the completion of the rotation a 2-4 page summary of the research performed will be submitted.

Summaries should include a background of the selected research focus and the purpose of the research, as well as a description of the actual research experience. This description should include the methods of the research project and which specific information was obtained.

The summary should also describe methods used for statistical analysis. Using preliminary data to write an abstract is encouraged.

Students should also include a plan for eventual submission and presentation of their work.

Surgery Research Elective Instructions

The Surgery Research elective is an opportunity for you to participate in a research project that you may have interest in. In order to receive credit, there are some things we will need from you to process your paperwork.

Approval of rotation

  • Obtain a request form from the Dean’s office and get the appropriate signatures.
  • Once you have signed and your preceptor has signed, you will need to turn it on to the surgery Medical Student Coordinator along with a brief summary and your preceptor’s name, phone number, and email address. Your summary should include what the expected outcome you are looking for and what the project will include.
  • The Medical Student Coordinator will submit it to the Clerkship Director for approval.
  • The Medical Student Coordinator will send it to the Dean’s office for approval.
  • The Medical Student Coordinator will contact you to let you know your request has been accepted, needs more information, or not approved.
  • Once approved and signed by all parties, the Medical Student Coordinator will send you a copy of your completed signed form.

Completion of rotation

You will need to submit a 2-4 page report to include the following topics and information:

  • Attending's name and contact information.
  • Hours worked.
  • Background of the process you are studying and the question you are trying to answer.
  • Description of your actual research experience.
    • Were charts reviewed?
    • Were patients enrolled?
    • What information did you examine?
    • Did you undertake a statistical analysis?
    • Which methods were utilized?
  • If you have preliminary data, you should try to write an abstract.
  • Submit a plan for eventual submission and presentation of your work.

Third Year Students

Third year students are occupied mainly by clinical clerkships. The Department of Surgery offers on- and off-campus rotations. Offsite locations include Oregon destinations such as Bend, Eugene, Grants Pass, Salem, and the Portland metro area. There are several on-campus rotation options at OHSU and the adjacent VA Portland Healthcare System. Regardless of location, each site offers one-on-one preceptoring, operative experience, and participation in inpatient and outpatient settings.

All third year students are required to complete a five week course in clinical surgery. This course is designed to help the student understand the fundamentals of etiology, diagnosis and treatment of the diseases commonly requiring surgical care. Students will improve their ability to question and examine patients and to construct an appropriate symptom list and plan of action.

In addition to clinical work, students will participate in research and learn to utilize current surgical literature.

This five week course also covers the basics of preoperative decision making, operative conduct, and postoperative care through participation in the day-to-day activities of a surgical service, which prepares students for a senior clerkship during which they will be an integral part of a clinical service without special didactic sessions or other interruptions.

Students will participate in the following ways:

  • Patient evaluation and management
  • Patient workups/presentations
  • Teaching sessions
  • Teaching rounds
  • Student-led seminar
  • Taking call

The sites for the rotation include the following locations:

Electives

3 credits

This course introduces students to the treatment of adult cardiac and thoracic surgery, which includes valvular and coronary heart disease, aortic surgery, surgery for arrhythmia, heart transplantation, lung resection, esophageal surgery, and mediastinal procedures.

Students work with house staff and faculty and are responsible for patient workups, assisting in operations, and postoperative care in the ICU and on wards.

Students rotate one week in cardiac service and the second week in thoracic service. There will be opportunity to scrub in on heart surgery cases and experience both didactic and one-on-one teaching with faculty. Preliminary reading in cardiac and thoracic surgery is recommended.

3 credits

Students will participate with faculty and residents to gain experience in preoperative, operative, and postoperative care of pediatric patients with general surgical diseases.

During this two week rotation, students will have the opportunity to scrub in to cases and participate in didactic teaching sessions. Students may have the opportunity to rotate at either OHSU or Legacy Emanuel Hospital in Portland.

3 credits

Students will participate with the University or VAMC vascular surgery service, which includes operating room experience, as well as inpatient and outpatient work.

During this two week rotation, students will gain familiarity with the workups of common vascular disease processes. Students will be able to participate in didactic teaching sessions during the rotation.

3 credits

Students will spend 5-10 hours per week in discussion/didactic sessions with faculty in addition to 20-30 hours per week of clinical responsibilities.

Students will be expected to take overnight call on a schedule determined by faculty availability. Student responsibilities include patient workups, participation in operations, and postoperative care rounds with surgical, wound care, nutritional, and multidisciplinary teams.

Didactics and discussions will focus on topics and literature relevant to surgical nutrition.

While performing clinical duties, special emphasis will be placed on care of patients with special nutritional needs. At the completion of the rotation, students will be able to design and implement a plan for nutrition management for a patient throughout the course of their surgical procedure.

3 credits

Students participate in self-arranged surgery research. At the completion of the rotation a 2-4 page summary of the research performed will be submitted.

Summaries should include a background of the selected research topic and the purpose of the research, as well as a description of the actual research experience. This includes the research methods and results sections.

The summary should also describe methods used for statistical analysis. Use of preliminary data to write an abstract is encouraged. Students should also include a plan for eventual submission and presentation of their work.

Surgery Research Elective Instructions

The Surgery Research elective is an opportunity for you to participate in a research project that you may have interest in. In order to receive credit, there are some things we will need from you to process your paperwork.

Approval of rotation

  • Obtain a request form from the Dean’s office and get the appropriate signatures.
  • Once you have signed and your preceptor has signed, you will need to turn it on to the surgery Medical Student Coordinator along with a brief summary and your preceptor’s name, phone number, and email address. Your summary should include what the expected outcome you are looking for and what the project will include.
  • The Medical Student Coordinator will submit it to the Clerkship Director for approval.
  • The Medical Student Coordinator will send it to the Dean’s office for approval.
  • The Medical Student Coordinator will contact you to let you know your request has been accepted, needs more information, or not approved.
  • Once approved and signed by all parties, the Medical Student Coordinator will send you a copy of your completed signed form.

Completion of rotation

You will need to submit a 2-4 page report to include the following topics and information:

  • Attending's name and contact information.
  • Hours worked.
  • Background of the process you are studying and the question you are trying to answer.
  • Description of your actual research experience.
    • Were charts reviewed?
    • Were patients enrolled?
    • What information did you examine?
    • Did you undertake a statistical analysis?
    • Which methods were utilized?
  • If you have preliminary data, you should try to write an abstract.
  • Submit a plan for eventual submission and presentation of your work.

Fourth Year Students

Fourth Year Medical Students (MS4) continue their education by choosing to complete either a general surgery or specialty rotation. There are several specialty rotations to choose from on-campus as well as off-site.

Fourth year students are required to complete a fourth year surgery elective. The Department of Surgery also offers courses fulfilling the sub-internship and ICU requirements. A variety of rotations are available at OHSU and at off-campus sites. Please see the course descriptions below for further information.

Rotation sites include the following locations:

MS4 electives instructions

The Surgery-Away, Surgery-Community, Surgery-Preceptorship, and Surgery Research electives require additional steps.

Surgery electives are an opportunity for you to participate in a research project or participate at a community site or elective we do not offer. In order to receive credit, there are some things we will need from you to process your paperwork.

Approval of rotation

  • Obtain a request form from the Dean’s office and get the appropriate signatures.
  • Once you have signed and your preceptor has signed, you will need to turn it on to the surgery Medical Student Coordinator along with a brief summary (use the Teaching Plan as a guide):
    • Preceptor/Community Elective: Your summary should say what you will be doing and how it will fulfill your surgery requirements.
    • Research Elective: Your summary should include what the expected outcome you are looking for and what the project will include.
  • The Medical Student Coordinator will submit it to the Clerkship Director for approval.
  • The Medical Student Coordinator will send it to the Dean’s office for approval.
  • The Medical Student Coordinator will contact you to let you know your request has been accepted, needs more information, or not approved.

Completion of rotation

Preceptor/Community Elective

You will need to submit a 1-2 page report along with your skills card. Your report should include the following topics and information:

  • Preceptor/Attendings name and contact information
  • Hours worked
  • Patient Care
  • History and Physicals you did
  • Presentations OR Time
  • Call
Research Elective

You will need to submit a 2-4 page report to include the following topics and information:

  • Attending’s name and contact information.
  • Hours worked.
  • Background of the process you are studying and the question you are trying to answer.
  • Description of your actual research experience.
    • Were charts reviewed?
    • Were patients enrolled?
    • What information did you examine?
    • Did you undertake a statistical analysis?
    • Which methods were utilized?
  • If you have preliminary data, you should try to write an abstract.
  • Submit a plan for eventual submission and presentation of your work.

Electives

6 credits

This course is designed to educate students regarding the surgical management of liver and kidney transplantation as well as hepatobiliary surgery.

Exposure to transplant patients encourages appreciation of the process of abdominal organ transplantation from the patient perspective. Interactions with experts in the field allow students to expand their clinical knowledge in kidney disease, liver disease and transplant surgery.

Students participate in rounds, clinic, selection committee meetings and tumor board conferences, as well as assist with surgical procedures. Students may have the option of participating in local organ procurement procedures as they occur.

6 credits

The burns/general surgery rotation includes general surgery, acute burn care (including ICU and step-down care), reconstructive burn care, and a variety of complex wound management cases, such as necrotizing soft tissue infections, open abdomen/fistulas, purpura fulminanas, truncal pressure and ulcers. In addition, there are plastic admissions to our house staff service.

3-6 credits

The cardiothoracic surgery course provides intimate exposure to all aspects of adult cardiac and thoracic surgery, including valvular and coronary heart disease, aortic surgery, surgery for arrhythmia, heart transplantation, lung resection, esophageal surgery and mediastinal procedures.

Students work with house staff and faculty and are responsible for patient workups with the opportunity to scrub in on heart surgery cases and experience both didactic and one-on-one teaching with faculty.

6 credits

The majority of time is spent in general surgery with the opportunity to rotate through other surgical specialties, including ENT, urology, gynecology and/or orthopedics.

Students will have exposure to a rural general surgery practice and identify the differences between a rural surgery practice and a tertiary referral center, as well as learn to identify critical points in spectrum of rural general surgical procedures.

Students will continue to expand their skills at evaluating, diagnosing and treating surgical patients, including experience with minor office procedures.

6 credits

Students will be fully participating members on a Foregut and Minimally Invasive Surgery team. They will perform preoperative and postoperative care, evaluate patients in the emergency room and in outpatient clinics, and assist in surgery.

6 credits

Students will be fully participating members on a Colorectal and Bariatric Surgery team. They will perform preoperative and postoperative care, evaluate patients in the emergency room and in outpatient clinics, and assist in surgery.

6 credits

Students will be fully participating members on a General Surgery team. They will perform preoperative and postoperative care, evaluate patients in the emergency room and in outpatient clinics, and assist in surgery.

3-6 credits

Students will participate with faculty and house staff at a level comparable to that of an intern in the preoperative, operative and postoperative care of pediatric patients with general surgical disease.

3-6 credits

Students are exposed to an extraordinary variety of congenital and acquired defects in both children and adults.

Cranio-facial anomalies, maxillofacial trauma, microsurgery and unusual surgical problems are seen daily. Cosmetic surgery and reconstructive surgery of the hand, head, neck, torso, and lower extremities are common procedures.

Students will have the opportunity to evaluate patients and actively participate in the operating room, clinics and wards. They will interact directly with attendings, residents and patients.

6 credits

Students will learn to recognize signs of healing and infection. They will diagnose and treat conditions such as cleft lip and palate. Sewing skills are also acquired.

6 credits

Students will work with five attending physicians on the Veterans Administration Medical Center plastic surgery service.

Responsibilities include attending clinic, participating in the operating room, and rounding.

There is ample opportunity to see patients with supervision and to work closely with the attending staff as a first assistant in the operating room.

6 credits

Medical students are responsible for making their own arrangements for an away rotation. Approval forms must be submitted to the Education and Student Affairs office for review and approval prior to leaving for the rotation. See instructions above.

6 credits

A clinical preceptorship in general surgery is offered with a specific community surgeon. 

Students are responsible for making their own arrangements.

Students participate in the evaluation of patients during office visits, perform pre- and postoperative care, as well as assist in surgery. To enroll in this course, see instructions above.

3-6 credits

Clinical experience is offered in any of the surgical specialties at OHSU or the VAMC. Students participate in supervised care of surgical patients in hospital and outpatient settings. Key principles are learned in the care of surgical patients pre- and postoperatively. To enroll in this course, see instructions above.

4-12 credits

Students participate in surgery research (arrangement made by student). At the completion of the rotation they should turn in a summary of the research performed (2-4 pages).

This should include a section on the background of the process they are studying and the question they are trying to answer. Next they should include a description of their actual research experience. This should include the methods of research project and which specific information was obtained.

The summary should also describe methods used for statistical analysis. Using preliminary data to write an abstract is encouraged.

Students should also include a plan for eventual submission and presentation of their work. To participate in this elective, see instructions above.

6 credits

Students participate in the management of complex, critically ill general surgery, vascular and transplant patients. This is a highly educational experience that combines opportunities for patient management with excellent bedside and didactic teaching. OHSU is a quaternary care center for the state of Oregon, which serves to enhance this opportunity.

6 credits

Students participate in patient care in the surgical intensive care unit and learn principles for managing severely ill, injured, and postoperative patients.

3 credits

Students spend 5-10 hours per week in discussion/didactic sessions with faculty in addition to 20-30 hours per week of clinical responsibilities.

Students will be expected to take overnight call on a schedule determined by faculty availability.

Student responsibilities include patient workups, participation in operations, and postoperative care rounds with surgical, would care, nutritional and multidisciplinary teams. Didactics and discussions will focus on topics and literature relevant to surgical nutrition.

While performing clinical duties, special emphasis will be placed on care of patients with special nutritional needs. At the completion of the rotation, students will be able to design and implement a plan for nutrition management for a patient throughout the course of their surgical condition.

6 credits

Students gain experience in clinical oncology through participation in radiotherapy and chemotherapy clinics, tumor clinic and tumor board, surgery conferences, and inpatient rounds.

3 credits

The course teaches the basic technical and patient management skills expected of any surgical intern using a hands-on approach and case-based scenarios.

It includes deliberate practice sessions of all the listed technical skills with concurrent and summary feedback provided by residents and faculty.

Emphasis is placed on preparing students to manage common problems encountered while treating ward patients. Students are asked to independently assess and form a plan of action of patient care prior to conferring with the supervising resident and then undergo mock pages as the primary contact for all non-immediate life threatening occurrences. This course is offered once per year.

6 credits

Students participate in the care of critically injured patients at Legacy Emanuel Medical Center, which is one of two  Level 1 Trauma Centers in Oregon. Students make daily rounds with trauma surgeons, fellows, residents and physician assistants.

6 credits

Students participate in the care of critically injured patients at OHSU, which is one of two Level 1 Trauma Centers in Oregon. Students make daily rounds with trauma surgeons, fellows, residents and physician assistants.

This is an excellent educational experience includes multiple planned conferences to include Trauma Conference, Morbidity and Mortality Conference, and a didactic lecture series. Students have the opportunity to present a case they have managed at one of the Trauma Conferences.

3-6 credits

Students function as sub-interns on the University or VAMC vascular surgery service, which includes experience in the operating room, inpatient and outpatient work. Students gain experience treating vascular surgery patients and disease.

Visiting Students

The Department of Surgery looks forward to receiving visiting students from all over the country each year. We generally accept students for summer, fall and the beginning of winter as we have room to schedule. OHSU utilizes the AAMC Visiting Student Learning Opportunities (VSLO) portal to receive visiting M.D. and D.O. student applications. 

VSLO opens March 27, 2023 and the Department of Surgery will begin accepting students April 19, 2023. Please refer to the OHSU School of Medicine Visiting Students site for additional information and requirements. Applicants must first be accepted through the School of Medicine Dean’s office and then by the Department of Surgery.

You may apply for up to 2 rotations with the possibility of one or both occurring during the off-months (late fall/early winter).

In addition to the School of Medicine requirements, the Department of Surgery requires the following items to be loaded in VSLO prior to acceptance:

  • Letter of Recommendation from a surgeon you have worked with in the past
  • Letter of Intent (indicating your desired rotation and reason for applying)
  • Letter of Good Standing

You may be asked for additional information during the application process as well as completion of required modules if accepted. 

We offer the following General Surgery rotations to our Visiting Students:

  • Blue/General Surgery – Hepatopancreaticobiliary
  • Gold/General Surgery – Oncology
  • Green/General Surgery – Colorectal and General Surgery
  • Red/General Surgery – Esophagus
  • Trauma/Surgical ICU
  • Cardiothoracic Surgery
  • Pediatric Surgery
  • Plastic Surgery
  • Vascular Surgery
  • Surgery Research (requires prior arrangements)

If you are interested in applying for one of our Integrated Residency Programs (Plastic or Vascular Surgery), you will need apply under the Integrated Plastic or Vascular Surgery rotation.  If you apply under General Surgery, you will not be considered for the integrated program.

Plastic Surgery (Integrated Program)

  • Plastic Surgery

Vascular Surgery (Integrated Program)

  • Vascular Surgery

Please keep in mind that acceptance for a visiting rotation is not a guarantee that you will be invited to interview for a position in our general surgery or plastic surgery residency programs.

If you are an accepted visiting student who finds themselves unable to fulfill their assigned rotation, please notify the Department of Surgery Medical Student Coordinator in writing as soon as possible. This will allow rotation opportunities to be offered to additional candidates.

Diversity Visiting Student Scholarship

The OHSU Department of Surgery Diversity, Equity and Inclusion Council is pleased to announce a new Diversity Visiting Student Surgery Scholarship opportunity. We are looking for highly qualified URM students who will spend 1 month at OHSU as a surgical Sub-Intern. Scholarship recipients will be supported with a $3,000 stipend to be used towards the VSLO application fee, transportation, housing and/or incidental expenses.

Eligible rotations for the Diversity Visiting Student Surgery Scholarship:

  • Blue/General Surgery – Hepatopancreaticobiliary
  • Gold/General Surgery – Oncology
  • Green/General Surgery – Colorectal and General Surgery
  • Red/General Surgery – Esophagus

Read more about the DEI Visiting Student Surgery Scholarship and how to apply.

If you have any further questions regarding visiting student applications or our program, please email our Medical Student Coordinator.

Simulation for Medical Students

The medical student simulation programs are designed to increase clinical proficiency in both technical and non-technical skills. The simulation events facilitate linking patient symptoms, exam findings and management plans to students' knowledge of anatomy, pathophysiology and pharmacology. Simulations range from e-chart management, invasive procedural training on manikins and tabletop simulators to interactions with standardized patients.

Topics include:

  • Suturing
  • Scrubbing, gowning and gloving
  • Knot-tying
  • Laproscopic equipment

Learn more about simulation at OHSU

Vascular Surgery Away Rotation Opportunity

The OHSU Division of Vascular and Endovascular Surgery is excited to offer a 4 week away rotation for fourth year medical students interested in an integrated vascular residency. OHSU is the only quaternary referral center for the state of Oregon and treats the full breadth of vascular disease. Visiting students will have exposure to clinic-based procedures, vascular lab, operating and hybrid room operations, and endovascular suite procedures. Students will also function as an integral part of the inpatient care team and be expected to participate in patient care and educational conference.  

Portland and the Pacific Northwest also offer a variety of outdoor and cultural activities. Hiking, water activities and the city center are within minutes of campus. Application requirements and available dates can be found at https://www.ohsu.edu/school-of-medicine/md-program/visiting-students. We look forward to reviewing your applications and answering any questions.   

Surgery Clinical Experience Director

Mackenzie Cook, M.D.

Mackenzie Cook, M.D., joined the OHSU Division of Trauma, Critical Care and Acute Care Surgery in 2017. Originally from Pittsburgh, Dr. Cook grew up in Connecticut before obtaining his bachelor's degree at Cornell University and medical degree at Duke University. He completed his general surgery residency at OHSU and Surgical Critical Care fellowship at the Harborview Medical Center in Seattle, Wash.

While a resident, Dr. Cook was honored with teaching awards from the OHSU medical students as well as the general surgery residency. He was recognized by the American College of Surgeons as one of the top 10 resident educators in the nation. His wife, Crystal Weis, M.D., is an emergency medicine doctor in the Legacy Health system in Portland. When not at work, the Cooks enjoy taking their three young children and two older dogs on outdoor adventures.

Associate Surgery Clinical Experience Director

Vahagn Nikolian

Dr. Vahagn Nikolian is a board-certified General Surgeon with advanced training and expertise in abdominal wall reconstruction. He is a member of a talented team of surgeons at OHSU where he uses his experience and research to help advance the treatment of patients with hernias and abdominal wall defects.

Dr. Nikolian was raised in Southern California, where he attended medical school and graduated with honors from the University of Southern California. He completed his surgical residency at the University of Michigan. He completed his complex abdominal wall reconstruction fellowship at Columbia University Medical Center in New York City, where he mastered techniques in minimally invasive and robotic hernia repair and abdominal wall reconstruction. 

His research and commentaries have been published in several prominent journals such as the Journal of the American Medical Association and Annals of Surgery. His research at OHSU involves utilizing technology to improve patient care. Specifically, he directs his efforts towards improving access to digital health and improving outcomes in hernia surgery using minimally invasive and robotic surgical technology. To date, he has over 60 peer-reviewed publications and book chapters focused on general surgery, resident education, and digital health. He has received numerous national awards as well as funding from the National Institutes of Health and other surgical societies.

Dr. Nikolian is passionate about integrating technology to improve the academic and educational environment. From video based assessments, to telementoring, to telecoaching, he integrates advanced approaches to education for both peer-support as well as student and resident education.

Surgery Experience Student Coordinator

Marci Jo Ashby, Surgery Experience Student Coordinator

Marci Jo Ashby was born in Portland, Oregon. As the daughter of an Air Force officer, she lived in various states throughout her life. During her time in Central California she attended Modesto College where she earned her certification in Medical Assisting. Marci Jo also has a certification in Phlebotomy and Leadership Training and is currently working on her Business Degree. She is always looking for ways to improve her skills and learn new things. Currently, Marci Jo serves on two executive boards and is a member of several committees. She also maintains an active role in her church. In her free time, Marci Jo enjoys spending time with her new husband, two adult sons, new family, reading, singing, acting, going to the beach, taking trips and hanging out with friends. She loves working with students and finding creative ways to help them through their rotations.