Training and Rotations
Anyone contemplating interviewing at Stanford and becoming part of this training program will want to know something about the rotations during their five clinical years of training. We have chosen to divide the residency into two components; the Core General Surgery Residency and the Senior General Surgery Training Program.
At Stanford, the six categorical General Surgery residents are joined by up to five preliminary residents who are entering fields such as Interventional Radiology, Anesthesiology, etc., as well as seven first year Orthopedic residents, three first year Plastic Surgery residents, three Urology residents, four Otolaryngology/Head and Neck residents , two Cardiothoracic residents, and one Vascular resident. Thus, in the first postgraduate year there are a total of 31 interns at Stanford. In the second year of training there are at least 15 residents and occasionally 17 or 18, consisting of the six categorical General Surgery residents, the three Plastic Surgery residents, three Urology residents, two Cardiothoracic residents, 1 Vascular, and occasionally two or three individuals seeking a second year of training before going into a different subspecialty. These residents are considered to be part of the Core General Surgery Residency.
The assignments of residents are driven by a core curriculum and by the special requirements of the Residency Review Committee. A representative sample of rotations follows this brief narrative description. The goal of the Core General Surgery Residency is to provide residents with graduated responsibilities in the primary components of General Surgery. In addition, it will give them an appropriate experience in subspecialties required by the Residency Review Committee. It is extremely important to point out that during these first two years the residents do a large number of operations under the direct supervision of a faculty attending or in some cases, a senior surgical resident. Our interns and second year residents perform as many as 100-200 cases per year during this time.
The Core & Senior General Surgery Training
Junior residents at Stanford perform 100-300 cases per year beginning in the PGY-1 year. When you visit us you will have the opportunity to speak with our residents for details of their individual experiences.
A finishing Chief Resident at Stanford will, on average, have performed more than 1000 operations and will have had an excellent personal experience in all of the primary components of General Surgery.
Training Schedule & ACGME
The Training Program at Stanford is dedicated to developing a call schedule whose goal is consistent with the core curriculum, not with service that makes learning difficult or in some cases impossible. We have committed ourselves to following the ACGME work hour rules.
Where You Rotate
Take a virtual tour through our different rotation locations including the brand new Stanford Hospital, Lucile Packard Children's Hospital, Kaiser Santa Clara, and the VA Palo Alto.
Stanford Health Care
With a state-of-the-art hospital that opened in 2019, patients are referred to Stanford Hospital and Clinics from all around the San Francisco Bay Area, but also come from as far as Nevada, Oregon, Washington, and Southern California. At Stanford, international patients from Asia and Europe are also occasionally soon The Stanford medical campus has both a Comprehensive Cancer Center, Women’s Cancer Center, and is a Level I Trauma Hospital.
Santa Clara Valley Medical Center
Santa Clara Valley Medical Center is one of four adult level one trauma centers and one of three pediatric level one trauma centers in Northern California (in addition to Stanford Hospital). It operates the only federally-designated spinal cord injury center in Northern California along with the only traumatic brain injury center for the treatment and rehabilitation of patients. It operates one of four burn centers in Northern California, and it is the only trauma center in California to co-locate all five of these services on one campus. Residents receive a large experience in trauma management, ICU, and burn management.
Kaiser Santa Clara Medical Center
The Kaiser Permanente Santa Clara Medical Center serves more than 400,000 members in the Santa Clara service area.
Residents in their third clinical year rotate at SHC ValleyCare in Pleasanton. While this is primarily an endoscopy rotation residents also gain operative experience with colorectal, endocrine, breast, acute care, thoracic, and vascular. A 45-minute drive from Palo Alto, this is a reverse commute and transportation is compensated. There is no call or rounding while on this rotation.
Endoscopy Rotation with Intermountain Health
Starting in May 2019, Stanford’s General Surgery Residency Program included a new elective surgical endoscopy rotation with Intermountain Healthcare (IMH). The 3- to 4-week rotation is offered to General Surgery Residents in the third postgraduate year of clinical training.
“This training rotation allows Stanford residents to gain the endoscopy skills they need in an integrated healthcare delivery system and bring what they learn back to Stanford and to their future practice,” said Dr. Mark Ott, chief medical director at IMH.
IMH has a full-time, surgery-run endoscopy service, meaning the residents will have the opportunity to see patients from the beginning to the end of their treatment.
Global Health Rotation with OBGYN
The Departments of Surgery and Obstetrics and Gynecology (ObGyn) have combined resources to create a new elective rotation designed to give general surgeons the tools they need to provide life-saving obstetric and gynecologic surgical care in low-resource settings, both abroad and in the US.
The Global Surgery/OBGYN elective is directed by Dr. Rachel Seay, a Clinical Associate Professor in the Department of ObGyn. The curriculum includes both simulation as well as time in clinic and the OR. The elective is open to all general surgery residents in their third clinical year.
Choose two: Transplant, Surgical Oncology, Thoracic, Breast Surgery, …or Africa?
“I want [the residents] to see medicine practiced in a very different environment and construct than they are used to, to compare and contrast two distinct healthcare delivery systems and to see the strengths and weaknesses in both,” said Wren, who supervises the international rotation on the local side.
International rotations in a resource-constrained environment offer a rich opportunity for personal and professional growth. During their third clinical year, Stanford General Surgery residents may choose to rotate at the University of Zimbabwe during one of their two elective rotations.
Residents participating in this rotation are supervised on site by Professor Godfrey Muguti, FRCS, University of Zimbabwe, and at Stanford by International Rotation Director Dr. Sherry Wren.
About the University of Zimbabwe
Zimbabwe is a low-income country emerging from an economically challenged decade where the basic medical education structure of the country was severely impacted. The University of Zimbabwe is the only medical school in the country and offers certified training programs in general surgery, orthopedics, and pediatric surgery. The hospital is the trauma center and tertiary referral center for the entire country. There are 13 surgical faculty with the academic and program leadership being led by Professor Godfrey Muguti, FRCS.
Description of the Clinical Experience:
● Type of center: governmental tertiary referral university health care system
● Hospital is the referral hospital for all complex surgical care in Zimbabwe and has general, neurosurgery, urology, ENT, and orthopedics services. Surgeons perform all of the endoscopy in the hospital.
● Hospital has 12 operating rooms daily.
● Trained anesthesia physicians are present in the OR for all cases, basic radiology services of plain x-ray are routinely available. Advanced imaging such as CT or US is occasionally available. Basic laboratory services are available.
● Residents will attend clinic with the general surgery team in the hospital.
● Residents will enter cases via the web-based case log system.
● Residents will serve as educators for the medical students on service and the more junior residents in basic surgical skills such as suturing and knot tying.
There is a full range of conferences that take place at Stanford and the affiliated hospitals. These include Surgical Grand Rounds, the weekly Morbidity and Mortality conferences, Breast Cancer and Gastrointestinal Tumor Boards, Basic Science and Attending Service rounds.