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Curriculum – General Surgery

Curriculum – General Surgery

Comprehensive curriculum:

Junior-Level Curriculum
Senior-Level Curriculum
Representative Operative Experience
Six Core Competencies
Surgical Simulation Lab

As a surgical resident, you will share with attending surgeons all responsibilities related to their patients’ pre- and post-operative care. The amount of clinical responsibility is commensurate with your level of training, clinical skills and technical ability. Most residents experience the following:

Dr. Scott Helton (left) with surgical staff and residents work together in the surgical simulation lab.

Junior-level curriculum

As a PGY 1: Participate in a broad range of surgical procedures during rotations in general, orthopedic, plastic and thoracic surgery and learn to care for critically ill patients during an SICU rotation. (See chart for detail on the types of procedures focused on in each principal area of study.) You will also be assigned a mentor faculty member to serve as a resource throughout your residency. Your mentor will help you initiate a research project during the year.

As in each of your five years here, residents receive a book allowance, plus have 24-hour access to a Health Sciences Library committed to meeting the informational, educational and research needs of the hospital community. More than 2,000 books and 400 journals are housed here, along with seven computers available for use. The library has its own home page via any computer within the hospital’s IP range, offering programs such as UpToDate (an evidence-based clinical information resource), MDConsult, PubMed (an online medical computer program that enables residents to engage in literature searches for clinical projects and patient care, as well as write articles with the guidance of attending physicians), Cochrane and the Microsoft Office programs, among others. These services are complemented by the Yale Medical Library.

As a PGY 2: Increased responsibility in patient management and operative procedures. Each resident receives surgical loupes. You’ll gain experience in general and endoscopic surgery, and surgical critical care, and participate in extramural rotations in pediatric surgery and burn management.

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Senior-level curriculum

As a PGY 3: More independence. As a senior resident, you’ll assist and perform complex surgical procedures. You’ll gain experience in general, vascular, and transplant surgery. Those who exceed academic standards may be given the opportunity to perform a one-month elective this year. Prior approval by the program director is required.

Guided by faculty and peers on the Research Council Committee, all Categorical residents are required to have their research project completed by the end of this year, with submission for publication or presentation. Indeed, Saint Raphael residents regularly present at regional meetings of the New England division of the American Cancer Society, New England Surgical Society, the annual meeting of the Connecticut chapter of the American College of Surgeons, the annual Connecticut Trauma Conference, and the annual meeting of the American College of Surgeons.

Recent research papers and presentations include “Ventilatory Requirements Following Esophagectomy: A Comparison Between Open and Minimally Invasive Esophagectomy”, “Outcomes Following Severe Head Injury: An NTDB Based Comparison of Level I and Level II Trauma Centers”, “Short Term Outcome of Laparoscopic Ventral Hernia Repair Using Intraperitoneal Polypropylene Mesh”, “Thoracoscopic Enucleation of Leiomyoma”, “Bile Leak in Open Cholecytectomy is Related to Gangrenous Cholesystitis”, and “Bilateral Video Assisted Thoracoscopic Approach for Pulmonary Vein Isolation in Patients with Isolated Atrial Fibrilation.”

As a PGY 4: An important transitional year. To set the stage for ascension to the chief year, you will oversee the thoracic service and have increased clinical and operative responsibilities. General and thoracic services are the primary focus of this year.

As a PGY 5: Chief resident status, satisfying the requirements for eligibility to the American Board of Surgery. You will lead surgical teams, conduct teaching rounds with junior house staff and perform more than 200 cases. You’re also given the opportunity to select and attend at least one major scientific meeting, with all expenses paid by the surgery department.

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Representative Operative Experience

The following table displays the average number of operative experiences for four chief residents who graduated in 2008.

Operations

Average Number Performed

Minimum Number Required

Skin, Soft Tissue, Breast

38

25

Head and Neck

32

24

Alimentary Tract

158

72

Abdomen

96

65

Liver

10

4

Pancreas

5

3

Vascular

98

44

Endocrine

11

8

Trauma-Operative

12

10

Trauma-Non-Operative

24

20

Thoracic

56

15

Pediatric

30

20

Plastic

10

5

Laparoscopy-Basic

93

60

Endoscopy

108

29

Laparoscopy-Complex

111

25

 

Six core competencies of Accreditation Council 

The curriculum also addresses the Accreditation Council for Graduate Medical Education (ACGME) six core competencies of Patient Care, Medical Knowledge, Practice Based Learning and Improvement, Interpersonal and Communication Skills, Professionalism, and Systems Based Practice. These competencies are embedded in the curriculum and residents must become proficient with them at the level expected of new practitioners. Educational experiences are structured to provide specific knowledge, skills, and attitudes required for residents to demonstrate competence in these areas.

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Recently launched a Surgical Simulation Lab

The program launched a new surgical simulation lab in the summer of 2008.  The lab is outfitted with six Stryker trainers, a flat screen TV connected to ORs for viewing procedures, two CentralLineMan simulators for practicing central lines, four computers, a printer, and numerous laparoscopic and suturing tools and equipment.

The curriculum is structured using the ACS/APDS surgical simulation modules.  In addition, residents are guided through the Fundamentals of Laparoscopic Surgery (FLS) curriculum, which the American College of Surgeons has mandated that starting in 2010 all residents must pass in order to finish their training.

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Page last updated on Nov. 21, 2008