GENERAL SURGERY RESIDENCY PROGRAM

Extensive goals and objectives for each of the competency domains have been developed for each PGY level for each rotation. These goals and objectives are provided to each resident at the beginning of each rotation. The broad goals of each assignment are described below.

The clinical material on the general surgery service is based on the busy referral practices that the attending staff maintains in colorectal surgery, hepatobiliary surgery, surgical oncology, and endocrine surgery. Broad-based exposure to general surgical care is provided by the on call responsibilities and general surgery portion of the practices.

This rotation is intended to instruct residents in the fundamentals of surgical care in the content areas described above. At the conclusion of this rotation residents should be able to accurately evaluate and provide postoperative care for patients with common general surgical problems such as the acute abdomen, colon cancer, biliary colic, and thyroid nodules. Technical skills gained during this rotation should enable the resident to perform minor surgical procedures such as inguinal hernia repair, hemorrhoidectomy, and appendectomy with guidance. Residents also learn effective presentation skills, clinical problem-solving, and the culture of professionalism in surgery. Involvement in the care of more complex cases provides a foundation for upper level rotations.

Residents gain independence in managing common surgical problems and more experience with complex problems such as hepatocellular carcinoma, pheochromocytoma, and rectal cancer. The operative experience is focused on more complex operations such as colectomy, thyroidectomy, and laparoscopic cholecystectomy. Residents refine preoperative decision-making skills and learn to identify and manage surgical complications. Residents gain maturity through instruction of medical students and junior residents, M&M presentations, and increased leadership responsibilities.

This rotation is intended to prepare the resident for independent practice in general surgery. Under the auspices of appropriate supervision, residents independently manage complex general surgical problems by providing comprehensive surgical care. Surgical skills are refined by performing complex operations such as laparoscopic adrenalectomy, the Whipple procedure, and rectal cancer resection. Leadership skills are refined through the independent responsibility of managing patients, residents, students, and mid-level providers on the service as well as M&M conference.

This rotation provides focused instruction by two fellowship-trained, board-certified vascular surgeons whose practice is limited to vascular surgery.

This rotation is intended to instruct residents in the fundamentals of vascular surgical care. At the conclusion of this rotation residents should be able to accurately evaluate and provide postoperative care for patients with common vascular surgical problems such as rest pain, acute limb ischemia, and abdominal aortic aneurysm. Technical skills gained during this rotation should enable the resident to perform minor surgical procedures such as porta-cath insertion and amputation with guidance. Residents also learn effective presentation skills, clinical problem-solving, and the culture of professionalism in surgery. Involvement in the care of more complex cases provides a foundation for upper level rotations.

Residents gain independence in managing common vascular surgical problems and more experience with complex problems such as cerebrovascular disease, subclavian steal syndrome, and ruptured abdominal aortic aneurysm. The operative experience is focused on more complex operations such as carotid endarterectomy, AV fistula, and femoro-popliteal bypass. Residents refine preoperative decision-making skills and learn to identify and manage surgical complications. Residents gain maturity through instruction of medical students and junior residents, M&M presentations, and increased leadership responsibilities.

This rotation is intended to prepare the resident for the independent practice of vascular surgery as part of general surgical practice. Experience with more complex issues in vascular surgery are intended to provide greater depth of understanding, refinement of technical skills, and to provide instruction in evolving techniques such as endovascular aneurysm repair. Under the auspices of appropriate supervision, residents independently manage complex vascular surgical problems by providing comprehensive surgical care. Leadership skills are refined through the independent responsibility of managing patients, residents, students, and mid-level providers on the service.

The attending staff on this rotation is comprised of three fellowship-trained and board-certified trauma/critical care surgeons. All trauma patients are admitted to this service. Two of the surgeons also maintain busy practices in general surgery and breast surgery, respectively.

This rotation is intended to instruct residents in the fundamentals of surgical care for the injured patient and the general surgical patient. A focused experience in breast surgery is provided as well. At the conclusion of this rotation, residents should be able to accurately evaluate the injured patient using ATLS protocols, facilitate their care, and implement discharge plans. In addition, they should be able to evaluate and provide postoperative care for patients with common general surgical problems such as the acute abdomen, colon cancer, biliary colic, and breast masses. Technical skills gained during this rotation should enable the resident to perform minor surgical procedures such as central line placement, inguinal hernia repair, breast biopsy, and appendectomy with guidance. Residents also learn effective presentation skills, clinical problem-solving, and the culture of professionalism in surgery. Involvement in the care of critically injured patients provides a foundation for upper level rotations.

This rotation is intended to prepare the resident for the independent practice of general surgery with a special emphasis on the care of the injured patient. Under the auspices of appropriate supervision, the chief resident independently leads all trauma resuscitations, develops and implements plans for diagnosis and treatment, and determines treatment priorities in multisystem injury. The resident also provides comprehensive care of patients with general surgical problems, especially those with breast disease. Leadership skills are refined through the independent responsibility of managing patients with multisystem injury and Trauma M&M Conference. Residents should be able to perform the vast majority of procedures on the service with minimal guidance.

The goal of this rotation is to provide residents with exposure to the surgical approaches to anatomic areas that are encountered in general surgical practice but are most often cared for by subspecialists in our institution. These areas include ENT, urology, thoracic surgery, gynecology, and plastic surgery.

This rotation is intended to instruct residents in the fundamentals of surgical care in the content areas described above. By assisting in surgery, the resident will become knowledgeable about the anatomy and surgical exposure of these areas and will be able to perform minor procedures such as tracheostomy and complex skin closure with guidance. The resident will become familiar with the postoperative management of patients in the surgical subspecialties. Residents also learn effective presentation skills, clinical problem-solving, and the culture of professionalism in surgery.

This rotation is intended to instruct residents in the surgical approaches to the head and neck, genitourinary tract, chest, and complex soft tissue defects. Residents should able to perform complex procedures such as radical neck dissection, pulmonary resection, and laparoscopic nephrectomy with guidance. The resident should be independent in basic postoperative care of subspecialty patients and gain experience with more complex postoperative management principles.

The rotation at Corning Hospital is intended to instruct third- and fourth-year residents in the management of general surgical problems in a small, rural, community hospital setting. Corning Hospital is a 99-bed acute care hospital located in Corning, NY with a population of 10,842. Residents work primarily with two general surgeons that are partners in a regional office of the Guthrie Clinic. The operative experience is focused on operations such as colectomy, thyroidectomy, and laparoscopic cholecystectomy. Residents participate in longitudinal patient care and gain an understanding of rural healthcare issues such as the effects of socioeconomic status and rural culture on healthcare, access to care, limited hospital services and resources, transfer needs, limited community resources, and healthcare workforce shortages.

This rotation is intended to develop the knowledge base and clinical skills necessary to independently manage critically ill surgical patients.

This PGY-2 rotation is intended to familiarize the resident with the evaluation and management of common pediatric surgical problems. At the conclusion of the rotation the resident should be able to perform pediatric hernia repair and appendectomy independently. The clinical experience should solidify their knowledge of pediatric surgery topics. They should gain an understanding of and facility with the psychosocial, socioeconomic, and cultural aspects of pediatric surgical care.

This PGY-2 rotation is intended to familiarize the resident with the perioperative management of transplant patients. Residents gain an understanding of the indications, treatment options, and complications of kidney, pancreas, and liver transplantation. The resident should understand the clinical implications of transplant immunology.

This PGY-2 rotation is intended to instruct the resident in the principles of wound healing and management of the burn patient. Residents should become proficient at skin grafting.

This PGY-3 rotation is intended to provide practical instruction in research methodology by allowing dedicated time to complete a research project. Although the study does not need to be completed by the end of the rotation, it is expected that each resident will present at least one research paper at an external meeting during their residency.

This rotation is intended to develop independent skills at diagnostic and therapeutic endoscopy. At the conclusion of the rotation, residents should be independent in the performance of colonoscopy with biopsy, esophagogastroduodenoscopy, percutaneous endoscopic gastrostomy. Stereotactic breast biopsy training is also included in this rotation.