General Surgery Residency

Goal: The resident will achieve a detailed knowledge of the pathophysiology of blunt and penetrating trauma and develop the skills necessary to treat the trauma patient. 

Objectives: The resident should be able to…

1. Describe the mechanisms of injury of blunt and penetrating trauma. 

2. Become familiar with the steps of the primary, secondary, and tertiary surveys. 

3. Discuss the diagnosis and treatment of thoracic injuries, including: 

a. Flail chest

b. Aortic Injury

c. Plus the diagnoses and treatments discussed on PGY 1-3.

4. Discuss the diagnosis and treatment of abdominal injuries, including: 

a. Pancreatic injury

b. Renal and bladder injury

5. Discuss the diagnosis and treatment of orthopedic injuries 

6. Study and memorize the steps in the diagnosis and treatment of hemorrhagic shock. 

7. Understand the pathophysiology of coagulopathy and interpret the different coagulation tests, including Thromboelastography. 

8. Review the indications for and complications of blood product transfusions.

Goal: The resident will provide patient care that is compassionate, appropriate, and effective care in the initial evaluation and management of the trauma patient. 

Objectives: The resident should be able to…

1. Perform primary, secondary, and tertiary survey of trauma patient. 

2. Promptly designate roles and tasks to the other members of the trauma team during the initial evaluation of trauma patient. 

3. Perform a complete neurological evaluation of trauma patient. 

4. Accurately assign GCS score. 

5. Maintain ATLS certification.  

6. Participate with graduated independence in the emergency treatment of rib fractures and flail chest, cardiac tamponade, pulmonary contusions, hemothorax, pneumothorax, and airway obstruction. 

7. Independently perform the following procedures: 

a. Chest tube placement 

b. Diagnostic peritoneal lavage 

c. Focused Assessment with Sonography for Trauma (FAST) exam

8. Independently perform emergent procedures, including: 

a. ER Thoracotomy

b. Pericardiocentesis 

c. Pericardial window  

9. Achieve mastery of technique and skills in the operative treatment of thoracic and abdominal trauma. 

1. Continually re-evaluates personal performance and patient outcomes and seeks to improve practice.  

2. Recognizes the importance of lifelong learning in surgical practice.

3. Continuous supervision of junior residents carrying out patient care responsibilities.

4. Serves as an educator of medical students and junior residents. 

5. Participates in local, regional, and national activities, optional conferences, and/or self-assessment programs. 

6. Demonstrates use of a system or process for keeping up with changes in literature and initiates assignments for other learners. 

7. Leads surgical skills experiences for students and residents and participates in the development of new curriculum. 

1. Provides an example of effective communication and strong interpersonal skills to junior residents and medical students on the trauma team. 

2. Confidently discuss and explain traumatic injuries, diagnoses and prognoses to patients and their families as well as possible treatment options, including the risks and benefits of each. 

3. Assumes overall leadership of a health care team responsible for his or her patients, while at the same time seeking and valuing input from other team members. 

4. Demonstrates willingness and ability to educate junior residents and medical students on the trauma service. 

5. Competently manages the trauma service. 

6. Serves as a role model and consultant for junior residents.

7. Communicates details of patient progress to the appropriate attending.  

8. Negotiates and manages conflict among care providers. 

Goal: The resident will demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value. 

Objectives: The resident should be able to: 

1. Coordinates and directs all aspects of care of the trauma patient, including the initial evaluation, acute management, and long-term rehabilitation.

2. Demonstrate an awareness of and responsiveness to the larger context and systems of health care and the ability to effectively call on system resources to provide care that is of optimal value. 

3. Recognizes the surgeon’s role within the larger context of a healthcare system as well as the roles of other healthcare professionals in the overall management of patients. 

4. Oversees and assists junior residents in directing the rehabilitation plan and timely discharge/placement of the trauma patient. 

5. Coordinate the total care of the trauma patient through established relationships with other healthcare professionals, such as: 

a. Social workers

b. Nurse practitioners

c. Physician assistants

d. Dieticians/Nutritionists

e. Physical therapists

f. Occupational therapists. 

6. Advocates cost-effective medicine. Limits the use of unnecessary diagnostic tests/studies and educates junior residents and medical students in this practice. 

7. Manifests proficiency in the rational use of surgical literature and evidence-based medicine in the management of the trauma patient. 

8. Possesses knowledge and understanding of risk-benefit analysis and applies this to daily decision-making in current practice. 

1. Consistently demonstrates integrity in all aspects of care and professional relationships. 

2. Demonstrates personal and professional responsibility. Positively influences others by assertively modeling professional behavior.  

3. Demonstrates leadership skills and interpersonal skills necessary for independent practice as a specialist in surgery. 

4. Accepts responsibility for errors in patient care and can initiate corrective action. 

5. Serves as a role model for ethical behavior and consistently places the interests of patients ahead of self-interests when appropriate. 

6. Understand the concepts of autonomy, beneficence, non-maleficence, justice and respect for life. 

7. Maintain patient confidentiality.