General Surgery In the Department of Surgery

Core General Surgery Training Program

The first two years of the general surgery training program are specifically designed to provide a one or two year core experience in the principal components of general surgery and the surgical subspecialties. The objective is to provide residents with first-hand experience managing surgical patients in a variety of surgical areas. The intent is to develop skills in surgical diagnosis, pre- and postoperative patient management, and to begin the development of technical skills by first-hand operative experience. Daily activities involve evaluating patients in an ambulatory setting, managing an inpatient bed service, and performing and assisting in the operating room, including ambulatory surgery. These activities are supplemented by didactic lectures, clinical case conferences in all specialty areas, and radiology and pathology conferences.

Thirty-two individuals are selected annually to enter the PGY-1 year in surgery at Stanford. All positions are offered through the National Resident Matching Program. Six individuals are selected to enter the categorical general surgery training program and five are selected for the preliminary track. They are joined by others who have been chosen for training in the surgical specialties at Stanford: four in otolaryngology/head and neck surgery: four in orthopaedics; three in plastic and reconstructive surgery; four in neurosurgery; three in urology, one in vascular surgery, and two in cardiothoracic surgery.

Rotations in the PG 1 year are designed specifically to provide a broad core general surgery experience in preparation for training in general surgery or the surgical specialties. First year training for general surgery categorical residents consists of rotations in general surgery (including surgical oncology, gastrointestinal surgery, minimally invasive surgery, breast surgery, trauma, colorectal surgery), vascular surgery, transplant surgery, thoracic surgery, orthopaedics, neurosurgery and pediatric surgery. Second year training for general surgery categorical residents consists of rotations in general surgery, ICU, cardiac surgery, plastic and burn surgery, and urology. Schedules for PGY 1 and 2 preliminary residents are slightly variable due to the educational requirements of the various surgical subspecialties. Those residents selected by the orthopaedic, otolaryngology, and neurosurgery programs enter their respective programs at the start of their second year of residency. All general surgery, plastic surgery, and urology residents remain in the General Surgery Training Program throughout their second year of residency.

Each first and second year resident functions as an integral member of a team consisting of one or more faculty attending surgeons, senior residents, and one or two medical students. The first year resident has primary responsibility for directing the pre- and post-operative management of patients conducted in the inpatient or outpatient setting under the direct supervision of the senior resident and attending surgeon. These responsibilities include providing the written history and examination of all patients, teaching of medical students assigned to the service, and assisting in the operating room. In this first year, residents usually start performing a variety of minor procedures including biopsies, appendectomies, hernia repair, and emergency room work. The second year resident has similar responsibilities at a higher level to that of the first year resident and is also introduced to experiences in surgical consultation in the emergency room.

The internship year is spent mostly at Stanford while PGY 2 residents spend 60% of their year rotating at the integrated hospitals. Three weeks of vacation is assigned throughout the year. In-house on call responsibilities at Stanford and all affiliated hospitals average every fifth night. Some rotations are home based call and there is a night float rotation at Stanford. Residents are appointed a faculty advisor at the start of their internship year for support with training as well as with making decisions regarding research and career pathways. Residents meet quarterly with their advisor to discuss the program and their progress. Upon completion of the PG 1 year, residents are expected to have been a surgeon on an average of 125 cases appropriate to their level and approximately 375 cases by the end of the two year block.

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