Rotations and Clinical Expertise

First year categorical and preliminary residents (PGY 1) rotate through 4-week rotations in general surgery, trauma, transplant, and vascular surgery. First year residents are exposed to a broad range of surgical disciplines: acute care, surgical oncology, bariatrics, minimally invasive, colorectal, vascular, and transplant. During these rotations, residents are involved in the initial evaluation and treatment of the patient across multiple settings (clinic, floor, and emergency department). Basic surgical skills are taught and experienced during each rotation in the simulation center and level-appropriate cases. First year residents act as mentors, guides, and teachers to medical students across the surgical continuum. Residents participate in daily rounds and attend conferences which are tailored to their level. Emphasis during the first year is on building a solid foundation of clinical and technical skills to ensure that residents are comfortable and capable of managing pre- and post-operative patients. Aligning with our mission of providing compassionate care with a commitment to improving the health of diverse communities, interns participate in a patient-centered communication workshop and a longitudinal social determinants of health course.

Second year categorical and preliminary residents (PGY 2) rotate through rotations in trauma, acute care, and the surgical intensive care unit. The second-year resident gains increasing responsibility and management of critically ill trauma and general surgery patients in the intensive care units. Residents acquire experience with bedside ICU procedures, resuscitation, and operative technique. Second year residents are responsible for daily rounds in the TICU, SICU and BICU, mentoring and teaching interns and students, and communicating with patients and families. Faculty guide and mentor residents through goals of care and end of life discussions with diverse populations creating a framework and foundation for their surgical careers. Second year residents participate in the care of burn patients as part of the trauma rotation. Residents participate in all aspects of care of burn or other patients with skin conditions requiring complex care admitted to the burn unit from the moment of arrival, including any operative intervention, through discharge and to outpatient follow-up.  

Third year residents (PGY 3) continue to gain operative and clinical autonomy in the SICU and on the Blue and Green Surgical Services. In the SICU, the third-year resident is responsible for the care of trauma and surgical ICU patients at night (with in house night trauma/critical care attending and fellow supervision). The SICU provides an opportunity for residents to transition to a leadership role and to demonstrate knowledge and skills acquired during the first two years. As the mid-level resident on the Blue and Green service, they operate extensively in an apprenticeship format with attendings. Cases include endoscopy, pediatrics, breast, thoracic, and outpatient surgeries.

Fourth year residents (PGY 4) are the chief residents on Trauma, Vascular and Blue and Green Services.  Fourth year residents have primary responsibility for all pre- and post-operative care. Under the close supervision of attending faculty, fourth year residents assume greater leadership roles, operative autonomy, and decision making. Residents spend the majority of their time in the operating room with increasingly complex cases and for appropriate level cases, can assume a teaching role and mentoring junior residents.  

The chief resident year of general surgery (PGY 5) provides increasing clinical and technical autonomy and responsibility. Chief residents lead their services, teach/mentor junior residents and medical students, and model communication skills and interactions across diverse populations. Chief residents rotate on Acute Care, Blue and Green and General Surgery Services. Each rotation provides opportunities to work consistently with core faculty, demonstrate clinical and technical competence, and gain experience teaching junior residents during level appropriate cases. By the end of their chief year, residents are expected to be independent and competent surgeons able to provide compassionate care for diverse populations.