Resident Education

Resident Education

 UVA Med Ctr 2013

UVA Surgery Resident Education

  

The General Surgery Program at the University of Virginia offers a unique commitment to the residents through a rigorous clinical experience, dedicated research and a structured curriculum striving to create the future leaders in academic surgery.  During the five-years of the clinical program, residents gain knowledge of the pre-operative and post-operative patient care with a strong focus on critical care, develop surgical technical skills and most importantly, acquire pre-, intra-, and post-operative decision making skills. 

Additionally, all residents spend at least one month of dedicated and protected research time and most residents spend one to three years in the NIH-funded clinical or basic science research laboratories combining academic excellence with clinical expertise. 

We have a strong tradition of education.  Faculty are dedicated to resident education at a departmental and individual level.  Residents are dedicated to the education of other residents and of students.  It is a culture and an expectation that residents in our program seek opportunities to educate.  Evidence supporting this include that many UVa students cite this as a reason to seek entrance to our residency and the plethora of teaching awards won by our residents.  A grossly disproportionate percentage of teaching awards available in our institution are won by the Department of Surgery.

 

Resident Education per Year

Surgical Rotations

PGY-1 

During their intern year, general surgery residents will be exposed to the majority of surgical specialties.  They will complete 4 week rotations in the following: Blue surgery (colorectal), Orange surgery (laparoscopy, upper GI, bariatric), Gold surgery (surgical oncology, endocrine), Green surgery (hepatobiliary), Plastic surgery, Cardiothoracic or Vascular surgery, Transplant surgery, Surgical critical care, Surgical Nutrition & Endoscopy, Pediatric surgery and Night float.  Most of their time is spent learning pre-operative and post-operative patient management and acquiring basic surgical skills in the operating room or in the surgical skills laboratory.    The incoming intern class consists of approximately 17 residents, 5 of whom are in the categorical general surgery program. 

PGY-2

Greater responsibility, autonomy and a higher level of surgical skills are acquired during the second year.  Residents focus extensively on the management of critically ill patients, participate in basic laparoscopic cases, but also learn more advance techniques of vascular surgery as they rotate through transplant & vascular access service, Trauma and Cardiovascular/Thoracic intensive care unit, Endoscopy and Vascular surgery.  During the second year, residents have the opportunity to care for the veterans as they spend several months at the Veterans' Hospital in Salem Virginia.  Second year residents also start to function as the general surgery consult resident in close coordination with a chief resident.

Following completion of the second year, residents are encouraged to pursue basic science or clinical research. 

PGY-3

An in-depth look at the surgical education with a specific focus on patient evaluation and operating occurs during the third year of residency.  Four to five months are typically spent on general surgery services, one to two months on Surgical oncology, Thoracic surgery and Acute Care Surgery.    In addition, the third year residents act as the first line surgical consultant. 

PGY-4 

During the fourth year residents spend much more time functioning as the chief of service.  Residents rotate on Pediatric Surgery, Vascular, Trauma and Red (endocrine) surgery.   One block is spent at Augusta Medical Center, a busy community hospital, in Fishersville, VA.

PGY-5

By the fifth year, our residents emerge as skilled surgeons performing complex cases and perfecting their surgical techniques and clinical decision making skills.  The Chief general surgery rotations include Blue surgery (colorectal), Orange surgery (laparoscopy, upper GI, bariatric),Green surgery (hepatobiliary), and a rotation at the Salem Veterans Hospital.  As Chiefs, they assume great responsibilities for patient care and education, mentoring and management of their teams.  Chiefs also finalize their plans for fellowship or practice following completion of their general surgery residency training. 

Operative Experience

The Surgery Residents at UVA finish with a multitude of cases and a vast experience in very complex ones, more than satisfying the requirements set forth by the American Board of Surgery.  The following are the average case totals for the graduated chief class of 2009.  

 

Defined Categories

RRC Requirements

UVA Average

National Average+

UVA/Natl Percentile

 

 

 

 

 

Skin Soft Tissue/Breast

25

49.5

43

*

Head and Neck

24

62

25

*

Alimentary Tract

72

193

142

*

Abdominal

65

147

138

*

Liver

4

23

8.8

*

Pancreas

3

15

10.5

*

Vascular

44

103

91

*

Endocrine

8

38

30

*

Trauma Operative

10

17

24

*

Trauma non-Operative

25

130

43

*

Thoracic

15

56

35

*

Pediatric

20

60

44

*

Plastic

5

13

13

*

Laparoscopic-basic

60

121

130

*

Endoscopy

85

115

76

*

Laparoscopic-complex

60

124

58

*

Total major

750

1034

910

*

Total chief

150

232

234

*

Total Teaching Assist

0

61

30

*

* Data Unavailable

+The national averages are from the chief class finishing in 2008 and will be updated when this data is available.  The percentiles likewise will be added.

Conferences 

Patient care offers ample opportunities for learning; however, structured surgical training through daily or weekly conferences and readings are an equally important part of the UVA's educational plan. 

Morning Report is a daily conference during which residents sign-out patients and present the most valuable teaching points from the previous 24 hours.  A short teaching presentation is given daily during this conference.

Teaching Conference marks the beginning of Wednesday's educational block.  Residents and medical students are required to read a chapter per week set forth by the two-year American College of Surgeons' curriculum.  They participate in weekly topic discussions and lectures.  The chiefs and senior residents are responsible for preparing these conferences and an attending with expertise on the topic mentors each session.

Mortality and Morbidity conference allows for discussion of all deaths and complications in an open forum on weekly basis. 

Grand Rounds introduces a variety of pertinent surgical, economic and social topics to residents in a lecture format.  We are grateful to have the opportunity to meet and learn from some of the most accomplished surgeons in the world. 

Mock Orals test the knowledge and prepares our residents for the board examinations.  PGY4 and 5 residents are assessed and trained to pass the oral examinations several times a year.

Other conferences

A multitude of conferences specific to the rotations are attended on weekly basis.  Please see the attached link for full details.   Click here to view the typical weekly conference schedule.

Research 

There is a strong tradition of research among the residents at the University of Virginia.  All residents are required to participate in at least one month of dedicated research time.  Some residents may elect to spend a single month during the third clinical year.  Most residents spend one to three years working in a basic or clinical science laboratory.  Some even seize the opportunity to receive a Masters in Public Health or Clinical Sciences during this time.   

In order to enable this research experience to be productive, the Department of Surgery has developed a policy regarding resident research.  This policy also highlights some of the departmental and institutional resources designed to facilitate this research experience.

Resident research can only thrive with appropriate mentorship.  The faculty of the University of Virginia Department of Surgery are committed to research in their own careers as well as to helping residents develop as surgeon-scientists.  

Categorical residents are required to submit a research proposal in the winter and present their topic during Resident Research Day in April as a poster or an oral presentation.  Pre-existing work is acceptable, but novel research created for research day also is encouraged.  This frequently also results in this work being presented and published in other forums including presentations at local, regional, or national meetings and publication in peer reviewed journals. 

Submission of research primarily for presentation at professional society meetings also is encouraged.  When a resident working with a surgery faculty mentor succeeds in getting an abstract accepted for presentation at a meeting, the resident is given the opportunity to travel to that meeting, present the work, and expenses related to this are covered.

Laparoscopic Skills Laboratory

Fundamental surgical skills including laparoscopy are learned in a skills laboratory located within the operating room suite.  Monthly skills are mastered by the residents and tested by the attendings or chiefs for proficiency.  In addition, residents have the opportunity to travel to national meetings and further improve their laparoscopic techniques. 

LapLab.jpg 

Leave

At UVA you work hard, but we also give you time to rest.  Interns and PGY-2 residents each get a calendar month of vacation.  PGY-3 and above, each get three 9 day vacation blocks.  You are granted time away to present at meetings which is separate from your vacation time.  In addition, Chief residents are granted a week of conference leave where they are not required to present.  During the Christmas/New Year period residents are each given 5 to 6 days off.  Similarly on or around Thanksgiving each resident is given 2 days off.