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Curriculum

 Didactic ¦ Clinical ¦  Faculty ¦  Duty Hours ¦  Benefits

Goals and Objectives of the 
General Surgery Program 
In addition to the overall goals and objectives of the program, which follow; each PGY level has specific goals and objectives pertinent to the curriculum and development of the surgical resident.

Goals:

  • Educate physicians who will be dedicated to providing skilled and knowledgeable surgical care to patients and who will be responsible, ethical, compassionate professionals;
  •  provide surgical education that emphasizes graded authority and increasing responsibility as experience is gained in the operative and nonoperative evaluation and treatment of disease;
  • foster an environment that enables residents to become competent in the six core competencies at the level expected of a surgical practitioner;
  • foster an educational environment that enables residents to achieve certification by the American Board of Surgery (ABS);
  • motivate resident commitment for professional growth through a lifelong process of self-education.

Objectives:
  • Learn the concepts and practice of general surgery
  • Increase knowledge of the diagnosis and treatment of disease in the essential components of general surgery (abdo-men and its contents; the alimentary tract; skin, soft tissue, and breast; endocrine surgery; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and non-operative trauma; and the vascular system)
  • Acquire an understanding of the principles in preoperative, operative, and postoperative care
  • Participate in the management of patients with common problems (burn management, plastic surgery, thoracic and cardiac surgery, transplant surgery, and urology) 
  • Provide opportunities to manage patients who may or may not require surgical intervention and to acquire skill in nonoperative management 
  • Provide learning experience in critical thinking, design of experiments, evaluation of data, and advances in
  •  Encourage participation in research activities

Didactic Curriculum
The educational program includes the fundamentals of basic science as applied to clinical surgery, including: applied surgical anatomy and surgical pathology; the elements of wound healing; homeostasis, shock and circulatory physiology; hematologic disorders; immunobiology and transplantation; oncology; surgical endocrinology; surgical nutrition, fluid and electrolyte balance; and the metabolic response to injury, including burns. Our didactic curriculum includes: ABSITE reviews, anatomy, animal, and skills/simulation labs, general surgery case presentations, GME core curriculum lectures, senior and junior mock orals, mortality/morbidity and tumor conferences, nutrition symposium, surgical and critical care rounds, and research/journal club conferences. . All conferences are designed with specific goals and objectives.

Attendance at scheduled conferences is mandatory unless the resident is on personal time off (PTO), approved meeting time off, or has an excused absence.  Late arrival at conferences is indicative of noncompliance with program guidelines and is unprofessional behavior.  Surgical residents will dress professionally for all conferences (shirt and tie for male residents, professional dress for female residents, clean lab coat. All Educational Conferences will be scheduled during Thursday morning protected time 0700-1200. 

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Clinical Curriculum
Surgery rotations are designed to provide residents with a balanced experience in the essential components of general surgery. The essential components include abdomen and its contents; the alimentary tract; skin, soft tissue, and breast; endocrine surgery; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and nonop-erative trauma (burn experience that includes patient management may be counted toward non-operative trauma); and the vascular system. Knowledge of burn physiology and initial burn management is required. A formal transplant rotation is required. Endoscopic experience is included in all postgraduate years and residents are given graded responsibility according to their level of expertise. At the completion of their residency, each resident will have met the requirements to be certified for hospital privileges in upper and lower endoscopy. Endoscopic procedures included are choledochoscopy, bronchoscopy, laryngoscopy, ERCP, and peritoneoscopy.

The clinical curriculum is designed to be sequential, comprehensive, and organized from basic to complex.  Clinical assignments are structured to ensure that graded levels of responsibilities, continuity in patient care, a balance between education and service, and progressive clinical experiences are achieved for each resident. The 60-month clinical program is organized as follows:

Essential Components (55.5 months):
General Surgery – 37.5 months
Surgical Critical Care – 5 months
GS Trauma/Night Float – 6 months
Pediatrics – 2 months
Burns – 1 month
Peripheral vascular – 4 months

Other: (4.5 months)
Anesthesia – 0.5 months
Cardiothoracic surgery – 1 month
Plastic Surgery – 1 month
Urology – 1 month
Transplant – 1 month
 

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Teaching Faculty by Surgical Rotations
Each rotation will have teaching faculty who are primarily responsible for this rotation.  Each resident is required to attend at least one half day a week in an office or clinic setting (except for Surgical Critical Care and Night Float rota-tions).  The residents on the General Surgery White and Blue teams will be assigned clinic/office days while residents on all other rotations are responsible for setting up with the primary teaching faculty for that rotation the clinic/office assignments.  The resident’s interaction and experience during the rotation will not be limited only to the primary teaching faculty but having designated primary teaching faculty will improve communication between residents and teaching faculty and maintain more consistent educational experience for the resident on each rotation.

The rotations are:  General Surgery: white team, blue team, and trauma; General Surgery at St. Joseph Health Center; General Surgery at St. Elizabeth Boardman Health Center; peripheral vascular, surgical critical care, pediatric sur-gery/burns; transplant surgery, cardiothoracic surgery, plastic surgery, urology, and anesthesia.

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Duty Hours
80-hour workweek – residents may not work more than 80 hours a week averaged over continuous 4-week pe-riod. Duty hours are monitored and are compliant with ACGME requirements.
24-hour on duty limit – continuous on-site duty, including in-house call, must not exceed 24 consecutive hours.  Residents may remain on duty for up to 6 additional hours to participate in didactic activities, transfer care of patients, conduct outpatient clinics, and maintain continuity of medical and surgical care.
Adequate rest between duty periods – A 10-hour time period must be provided between all daily duty periods and after in-house call to ensure adequate time for rest and personal activities.
One day in seven off duty – residents must be provided with 1 day in 7 free from all educational and clinical responsibilities, averaged over a 4-week period, inclusive of call.  One day is defined as one continuous 24-hour period free from all clinical, educational, and administrative duties.
No more frequent call than every 3 nights – in-house call must occur no more frequently than every third night, averaged over a 4-week period.

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Personal Time Off (PTO) and Meetings
General Surgery Residents are entitled to PTO, meeting days, examination days, and interview days as follows:

PGY 2-5

15 PTO days that should be taken as 3 one-week blocks
3 PTO days that can be taken together or individually
5 Meeting Days (including up to 1 travel day before and after the meeting)


PGY 1
15 PTO days that should be taken as 3 one-week blocks
5 Meeting Days (including up to 1 travel day before and after the meeting)

In addition (at the discretion of the Program Director)
Interview days for Senior Residents as deemed necessary
2 days (Friday and Saturday) for ATLS as scheduled
2 days for Board Exams (as necessary in all years)
½ day for ACLS Recertification

Each resident is allowed up to 5 days a year to attend one educational meeting per year, subject to the approval of the Program Director.  If a resident does not use the allotted meeting days, the days cannot be transferred to the next academic year.  Attendance is mandatory at (minimum) one regional, national, or international meeting during the 5-year residency.  Residents are also provided funds to attend educational meetings, based on the PGY year:

Other Amenities
Meals
: Each resident receives a monthly food allowance for meals while on duty.
Lab Coats:  Two new white lab coats are assigned to each resident; laundering is the resident's responsibility 
Parking:  Parking in the medical staff parking lot is free, is secured and covered, with direct access to the hospital.
Fitness:  A new up-to-date fitness center is free of charge and is located adjacent to the hospital.
Lounges:  A resident lounge is provided for resident use 24/7 and is equipped with TV, computers, microwaves, refrigerator. A surgical lounge is available next to the surgical education offices and is equipped with computers and a skills lab trainer.  The chief's administrative office is located next door for the chief residents.

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