MD HANDBOOK

Orthopedics, traumatology
and surgical emergencies

Faculty of Medicine and Health

Sciences
An-Najah National University



About this report Contents

The MD Clinical Handbook is created to oversee and guide medical

students during their clinical rotations. It is the responsibility of each Medical Tests before starting clinical training 

clinical group to keep the MD clinical handbook tidy, completely filled,

Dress Code for Clinical Students 
and up to date. The MD clinical handbook contains instructions about
clinical rotations, timetables, and rotation maps for each clinical Attendance and Absence Instructions 
course. The MD handbook structure and design is created by
An-Najah National University (ANU) and will be updated regularly to Course Description and Objectives 

meet ANU goals and objectives.

Intended Learning Outcomes (ILO’s) 

Rotation Maps 

Assessment Methods 

Contact Faculty Members 

Medical Tests before starting clinical training
Medicine Department students who are training at An-Najah National
University Hospital must take the following vaccinations and tests
before starting the clinical training:
 Td/Tdap, MMR, Hepatitis B vaccines.
 In case the student did not have had Chickenpox, s/he must do
Titer and take the vaccination if needed.
 A chest X-ray with a report showing that the student is
tuberculosis-free.
 Hepatitis B surface antibody (anti-HBs) test.
 HCV antibody and HIV antibody tests.
 Flu vaccination between October and January.
Dress Code for Clinical Students
In order to maintain a professional appearance for medical students
during clinical practice, the Medicine Department imposed standards
and guidelines for dress and appearance. All medical students in clinical
phase should adhere to the dress standards, as disciplinary action will
be taken if violated.
The following are some guidelines to be followed during clinical practice
whether in hospitals or other health facilities such as outpatient clinics
and primary healthcare clinics.
Guidelines on Students Appearance
Generally, clothes should be conservative and should not outrage
public decency.
Students need to wear white coats at all times, in hospitals, clinics
or primary healthcare centers.
 The white coat length must reach the knee.
 The clothes (including the white coat) must be neat, clean and not
wrinkled.
 Students should wear their identification badges that show their
name, code, and university logo, ideally placed on the white coat, at all
times in clinical settings.
 Students must remove Personal Protective Equipment (PPE) before
leaving the Operating Room following the Infection Control
Department instructions
 Avoid wearing excessive make-up, perfumes, or jewelry.
 The clothes must be in good repair (should not be ripped or
frayed).
Blue jeans and ripped or frayed cloths are not acceptable.
 Shorts are not allowed.
 Cloths with screen-printing on any side are not allowed.
 Shoes must be clean, in good repair and fully enclosed. High
heels, sandals and open-toe shoes are not allowed, as it is better to
wear comfortable footwear to reduce fatigue.
 For female students: Hair must be neat at all times. Long hair
should be tied back or covered when working in clinical areas.
 For male students: Beards must be neat and trimmed at all times
 Nails should be short, clean and neatly trimmed, and nail polish is
not allowed.
 Chewing gum is not acceptable at all times during clinical
practice.
 Male students should not have long or spiky hair.
 Tattoos are not allowed on uncovered areas of the body.
 Sunglasses are not allowed inside the Hospital
 Necklace and accessories that include religious, sectarian or
partisan logos are not allowed.
 Female students are allowed to wear earrings in each ear,
provided that they are not larger than the earlobe size when dealing
with patients directly, and must not be larger than ٣ cm in other
clinical settings.
 Headphones and ear buds are not allowed during training.
 Students need to make sure to take off their white coats when
they are outside the hospital.
 Students are expected to possess a stethoscope, tape measure,
and a penlight.
 Smoking is prohibited except in smoking areas.
Please note that not adhering to these standards gives the supervising
physician the right to expel the student from clinical training for that day
(absent, without excuse)
Attendance and Absence Instructions
First: Clinical training starts daily at ٨:٠٠ am, all students should be present at
the morning meeting hall of their department. If the teaching physician is late,
they should attend the morning meeting and start clinical practice, even if the
physician is still absent. Attending the morning meeting is obligatory, and not
attending means an absence without excuse and will be dealt with according to
the Medical Department regulations.
Second: If the student is absent without an excuse accepted by the Medical
Department, it will be dealt with according to the Medical Department
regulations
Third: Excused Absences:
Students are not allowed to exceed more than ٪١٠ absence of the actual
training days from the course duration, after the approval of the Department's
teaching and research assistants who coordinate with the course teacher.
As for sick leaves, students should provide a medical certificate, which the
University physician must approve. Medical certificates will not be taken into
consideration if not approved by the University physician.
Fourth: Students are not allowed to leave before the end of working hours at
pm, on the pretext of scientific research purposes
Fifth: No gathering is allowed in the hallways
Sixth: Students can only communicate with staff members and research and
teaching assistants via email. They are not allowed to communicate with them
through social media or phone calls, especially during off-hours.

Seventh: The email is the only official mean of communication between
staff members and students; therefore, students will receive the faculty’s
decisions and announcements via email, thus should check their emails
constantly.
Eighth: Guidelines on student dress code will be distributed among
students, titled: “Doctors in Training” which students should adhere to, as
disciplinary action will be taken if violated.
Ninth: The Medical Department represented by its director, and teaching
and research assistant staff is the student reference regarding attendance
and absence.
Tenth: If the teaching physician is absent, students should directly contact
the teaching and research assistants or will be considered absent without
excuse.
Course Description and Objectives
Orthopedics: This is a four-week clinical rotation for fifth-year medical
students during which the students will be introduced to general orthopedic
disorders. Students at the end of the course are expected to have covered all
aspects regarding assessing fractures, general management and complications
of fractures, evaluation, and assessment of orthopedic disorders affecting bone
and joints are also covered. Students are trained to obtain relevant history and
to perform a physical examination of patients with common musculoskeletal
disorders. General management of common orthopedic problems is also
covered. Throughout the course, students will be involved in the daily morning
report, clinical rounds, outpatient clinics, interactive seminars, and observation
of surgeries in the operating room.
Traumatology and Surgical Emergencies: This three-week course allows
students to play an active role in the ongoing care of ED patients. Students are
responsible for the initial evaluation of patients and early identification of
high-risk patients. They obtain a thorough history, perform a focused physical
exam, formulate a differential diagnosis and suggest a diagnostic workup and
treatment plan. Students acquire important procedural skills by being exposed
to and encouraged to participate in the supervised performance of a wide
variety of procedures in the ED. 
This course also introduces the knowledge and skills required to evaluate and
stabilize the trauma patient. This is accomplished through instruction and
hands-on sessions focusing on rapid assessment and emergency care
interventions in the emergency department. In addition, this course
emphasizes the students’ ability for critical decision-making for trauma
patients, the importance of team working, and the rapid assessment and
evaluation of traumatic cases, including the maintenance of life support and
hemodynamic stability. Students are also introduced to the principles of
Disaster Medicine.
Neurosurgery: This course aims to introduce the students to general
neurosurgical disorders. Students have the opportunity to evaluate patients
with conditions that require neurosurgical intervention and learn about the
emergencies in this field what they are, how to spot them, and differentiate
between them, and how to manage them. This course consists of experiences
in inpatient care (history taking and physical examination), group discussions,
and reviewing common findings in images like CT and MRI that pertain to this
field.
Intended Learning Outcomes (ILO’s)
Orthopedics
 Understand pathophysiology, clinical presentation, and management
of major Orthopedic disorders.
 Be able to conduct full histories and physical examinations in a
professional ethical manner in common orthopedic disorders.
 Propose a suitable management plan, including the selection of
laboratory and radiologic tests, interpretation of their results, and
implementation of interventions, to diagnose and treat common
orthopedic disorders.
 
Traumatology and Surgical Emergencies
 Understand clinical presentation and management of common
emergency cases.
 Be able to conduct histories and physical examinations in a
professional ethical manner in the emergency department.
 Propose a suitable management plan, including the selection of
laboratory and radiologic tests like x-ray, interpretation of their results
to give the proper treatment to ER patients.
Neurosurgery
 Understand pathophysiology, clinical presentation, and management
of major neurosurgical disorders.
 Be able to conduct histories and physical examinations in a
professional ethical manner to neurosurgical patients.
 Propose a suitable management plan, including the selection of
laboratory and radiologic tests, interpretation of their results, and
implementation of interventions, to diagnose and treat common
neurosurgical conditions
All the courses must meet the following ILOs: -
 Communicate with other colleagues and work effectively in groups,
and be able to give a summary about the patient clinical condition.
 Appraise the medical literature and electronic resources for validity,
applicability, limitations, and standard of care for the provision of care
to individual patients and populations. Use evidence-based strategies to
teach colleagues, patients and the community-at-large about patient
care in multiple clinical settings.
 Discuss the elements of health care systems that lead to health
outcome disparities. Describe the ways in which cultures and belief
systems impact responses to health and illness. Use appropriate
healthcare resources for the optimization of patient care in a
cost-effective manner.
 Demonstrate the ability to apply ethical principles in
decision-making.
 Demonstrate ability to carry out a minor research-based project.
Rotation Maps Open Fractures

Orthopedics Osteomyelitis

DDH
Instructor's
 Plan SCFE
Signature 
Clubfoot
Introduction to Orthopedics (Trauma , Basic, Orthopedics)
Pediatric Supracondylar Fracture
Anatomy of the skeletal system
Osteoarthritis
X - ray joint and other part of skeletal system
Osteonecrosis
Orthopedic history and physical examination

 Shoulder examination and tests

Hip examination and tests

Traumatology and Surgical Emergencies
Knee examination and tests
Instructor's
hand wrist examination (CTS, trigger)  Plan
Signature
Elbow examination (tennis and golf)
Learn how to conduct a rapid primary survey, resuscitate the patient
Upper limb trauma
if necessary and conduct a secondary survey.
Shoulder dislocation 
Learn and understand the presentation and proper management of
Humeral shaft fracture
head & spinal cord trauma patients.
Distal humerus fracture
Learn and understand the presentation and proper management of
 Forearm (Shaft, Monteggia and Galeazzi fractures)
Abdominal trauma patients.
Distal radius fracture (Smith, Colle’s, Barton and Chauffeur's 
Learn and understand the presentation and proper management of
fractures)
Genitourinary Tract Injuries.
Scaphoid fracture
Metacarpals and phalanges (General) Learn and understand the presentation and proper management of

Chest trauma patients.

Pelvic Fracture
 Learn and understand the presentation and proper management of
Femur Neck Fracture
Orthopedic Injuries.
Intertrochanteric & Subtrochanteric Fractures
Learn proper wound management.
Shaft & Distal Femur Fracture

Patellar Fracture

Tibial Fracture

Ankle Sprain (Low, High)

Ankle Fracture
 
Neurosurgery
Management
Instructor's
  
 Plan
Signature  Indications for surgery

Review of basic Neuroanatomy + Head Trauma

Hydrocephalus + Pseudotumor cerebri
- Neuroanatomy:
- Hydrocephalus:
 Revision of certain basic relevant neuroanatomic and
 Define hydrocephalus
neurophysiologic concepts.
   Explain its pathophysiology & different etiologies
- Head Trauma:
 Illustrate its radiological features
 Define different types of head injury.
 Discuss the types of neurosurgical management.
 Understand the pathophysiology of head injury
- Pseudotumor cerebri
 
 Recognize the investigation tools in head injury
 Define it

Head Trauma (complementary)  Discuss its possible pathophysiology.

 Recognize it s underlying risk factors and associated

 Define the indications to scan a patient with head injury
medical conditions.
 Recognize the management of different types of head
   Illustrate its radiological features on imaging
injury, including the indications for surgery.
 Explain the importance of lumbar puncture
 Understand primary and secondary surveys in head injury.
 Discuss its management
 Explain the different possible complications of head injury.
End of rotation
Spontaneous Subarachnoid Hemorrhage (sSAH) + Spine

Degenerative diseases Feedback session

 
Evaluation
- sSAH:
Summative assessment (OSCE exam)
 Know the possible underlying causes of sSAH

 Risk factors of cerebral aneurysms.

 Grading of sSAH
 
 Presentation

 Investigations

Management of sSAH and ruptured intracranial aneurysms.

- Spine Degenerative Diseases:

 History taking and physical examination.

Role of imaging in the diagnosis

 
Timetables
Neurosurgery
Orthopedics
Time Topic Time Topic

Morning reports Morning report & clinical round with bedside teaching (history taking,



 

With resident lecture physical examination, etc…)


 
 Clinical rounds 
 
Break

 
    
  Clinic (or Theatre). Direct clinical cases discussion, virtual cases
Break

 
simulation.

Regular case - based discussion  

  
Break
Formative assessment (Mini -


 
    (physical cases, virtual cases,
CCX)

 simulation) Clinic (or Theatre). Direct clinical cases discussion, virtual cases
Once per ٢ weeks 
 

-  times per week simulation.


 
 Bedside teaching (taking history, physical examination, etc..) 
 
Closing round (Briefing, general discussion)


 
 Closing round (Briefing, General discussion)

Traumatology and Surgical Emergencies

Time Topic
Assessment Methods


 Clinical rounds with the supervising doctor in the ER

 
  
Break

  Formative Assessment (Mini-CEX).
 Summative Assessment:
Regular case - based discussion
Formative assessment (Mini -
 Short Answer Questions
 
   (physical cases, virtual cases,  Final Exam
CCX)

 simulation)  In-Training Evaluation
Once per ٢ weeks
-times per week


 
Bedside teaching (taking history, physical examination, etc..)

 
 Contact Faculty Members

The Deanship and the Council of Medicine Department

Name Position Email/phone

Dr. Khalil Issa Dean of Faculty of Medicine and Health k.issa@najah.edu

Sciences

Director of Medicine Department and

Dr. Hasan Fitian hasan.fitian@najah.edu
Head of IRB Committee
husam.salameh@najah.edu /
Dr. Husam Salameh Head of Internal Medicine Division


adalbah@najah.edu /
Dr. Ahmad Dalbah Head of General Surgery Division


maysa.alawneh@najah.edu /
Dr. Maysaa Alawneh Head of Pediatrics Division


Dr. Abdallateef Head of Obstetrics and Gynecology

dr.abueseed@yahoo.com
Daraghmeh Division

Dr. Mohammad Head of Surgical Subspecialties Division

m.mazouz@najah.edu /
Ma'zoz 
Head of Familyand community Medicine lubna_saudi@najah.edu /
Dr. Lubna AlSaudi Division 
Head of Selected Medical Specialties wafiq.othman@najah.edu /
Dr. Wafiq Othman
Division 

Dr. Rayyan Al Ali Director of Forensic Medicine Institute

Dr.Rasha Khayyat Scientific Research Unit Head rasha.khayyat@najah.edu

Nour Al - Qadi Medicine Department Secretary medicine.dep@najah.edu

Deanship of the Faculty of Medicine and

Deanship Secretary medicine@najah.edu
Health Sciences Secretary