General Surgery Residency Education

• Active participation of residents across the continuum of patient care.
• Graded responsibility and autonomy for patient care based upon the resident’s knowledge and experience.
• Proper supervision and mentoring by multiple board certified faculty.
• The curriculum integrates programs of self-study, general surgery and surgical specialties conferences.
• Case-based learning modules, including the SCORE curriculum sponsor by the American Board of Surgery.
• Robotics and surgical skills laboratories.
• Foster a culture of inquiry, excellence, altruism, professionalism and integrity that is aligned with the core values of our healthcare system.

• There is a 20% dedicated outpatient care.
• Residents are expected to follow horizontally one (1) patient/year.
• Allows residents the opportunity of outpatient care and experience a “group practice” model and helps them better understand all aspects of patient care.

It is the mission of the Memorial Healthcare System Wellness Committee to promote the health and well-being of our residents through education and initiatives that:

• Seeks to define well-being as it contributes to personal and professional growth
• Increases awareness of factors and resources contributing to well-being
• Inspires and empowers individuals to take responsibility for their own health
• Supports a sense of community
• Offers dedicated fitness wellness centers accessible to all residents
• Allows residents to utilize four days a year to tend to personal and medical needs

PGY1

During the first year residents rotate through all three hospitals. Responsibilities include evaluating and planning for treatment of patients, attending rounds, outpatient clinics, and conferences, assisting in the operating room, and participating as a member of the educational staff for medical students during their surgical clerkships. While junior house officers acquire significant responsibility, close supervision and backup by more senior house officers and faculty is provided. Residents are trained to assume daily primary care responsibility for patients on their service and to perform the mandated interventions. The goal during the first year is to train the novice surgeon to understand the principles of pre- and post-operative care. Residents should gain valuable operating room experience both as an assistant and an operating surgeon working under close senior supervision. Some rotations are home-call based; others may be in-house every third or every fourth night. Rotations in general, acute care surgery, and pediatric surgery comprise eight to nine months of the experience. The remaining rotations provide exposure to minimally invasive surgery and robotic surgery.

PGY2

During the second year, rotations include general surgery, transplant surgery, thoracic surgery, cardio surgery, breast surgery, endocrine surgery, critical care and trauma. On the General Surgery services the operating experience broadens to include opening and closing laparotomy wounds, repairing more complicated hernias, some trauma, less complicated biliary procedures. An increasing amount of clinical independence is expected and achieved. Residents must become ATLS certified.

PGY3

During the third year the resident assumes greater decision-making responsibility through consultations. Rotations include minimally invasive surgery, colorectal surgery, surgical oncology, surgical endoscopy and vascular surgery. Also, there is a two month elective rotation that will help residents to identify potential areas for surgery fellowships.

PGY4

The fourth year continues the gradual assumption of increased leadership, decision making, and responsibility. Fourth year residents are the senior residents on the pediatric, transplant and elective general surgery rotations. Additional rotations where they serve as senior residents include thoracic and endocrine surgery.

PGY5

The Chief Residency year of the General Surgery program provides increasing senior-level responsibility in patient-care decision making, teaching, and education, and promotes the mature judgment essential for surgical practice. The chief resident is required to prepare and present at conferences and is responsible for the teaching and training of more junior house officers and students on his or her service. The chief resident is involved with major elective procedures emphasizing complex gastroenterological, oncologic, trauma and peripheral vascular surgery. The chief resident is responsible for the management of all the patients on his or her service. Requests for surgical consultation from other clinical departments are channeled through the chief resident.

The final year of the General Surgery experience completes a progressively graded comprehensive training program of increasing responsibility as required by the American Board of Surgery. Chief Residents participate in administrative roles within the department and attend departmental Graduate Medical Education meetings, coordinate call schedules, and work closely with the office of Graduate Medical Education.

In-Service Training Examination

Each year all Department of Surgery residents participate in the In-Service Training Examination sponsored by the American Board of Surgery (ABSITE). This test is given nationally by all departments of surgery to evaluate each individual resident’s progress. These examinations assess the resident’s surgical fund of knowledge and are a reasonably good predictor of performance in the American Board of Surgery qualifying examination.

Evaluations

The performance of each resident in the Department of Surgery is regularly evaluated by faculty members on their respective rotations. Faculty evaluation records are forwarded to the Surgical Education office at the end of each rotation. Attention is placed to ensure that residents are meeting the Milestones of surgical education as expected by the ACGME. Residents are expected to maintain the standards of the Department. The residents are also asked to evaluate each of their rotations and the faculty.

Mock Oral Examination

Each year the faculty members of the Department of Surgery administer a practice oral examination to the senior residents to prepare them for their certification examination. Our expectation is that our graduates will demonstrate a high level of proficiency in both the qualifying and certifying examinations.

Workshops

• Evidence-Based Medicine workshop
• Understanding Healthcare
• Multiple web-based simulation workshops
• ATLS/ACLS
• Pre-ABSITE Boot Camp

Didactics

All residents attend protected, dedicated education time every Tuesday from 7 am to 11 am, including: Curriculum Conference, Morbidity and Mortality Conference, Grand Rounds, Journal Club and simulation lab. The majority of surgical services also have weekly education conferences. All residents have access to SCORE and resources of the Health Sciences Library, as well as a yearly educational stipend.