Yearly Curriculum Overview
Our residents come from all areas of the United States and the first year class is a mix of categorical, designated and nondesignated interns.
Most call is now home call. Some services have an in-house call that will average q4-q7, depending on the service. There are some day/night shifts for services such as Trauma, Emergency General Surgery and some community rotations. One of the community hospitals has a night float rotation.
Twelve categorical surgical interns are accepted into the residency at the first-year (R-1) level. A typical year includes five months of general surgery, one month of emergency medicine and six months of surgical specialties.
Residents are integral members of the surgical team and are directly responsible for patient care. A typical team consists of the R-1 intern, a junior resident and a chief surgical resident. Interns perform, under direct supervision, those surgical procedures that are commensurate with their skills and training. In addition to direct patient care duties, interns are regular participants in teaching conferences and attending rounds. Residents also participate actively in teaching principles of surgery to medical students.
During the second year (R-2), surgery residents rotate through burn surgery, cardiopulmonary surgery, general surgery, trauma, SICU and pediatric surgery. Much of the year is spent on surgical specialties which provide intense experiences invaluable to the general surgeon, who must be skilled in the care of patients of all ages with complex problems, multisystem diseases, or injuries. During the VAMC general surgery rotation, residents gain considerable expertise in endoscopy including colonoscopy, flexible sigmoidoscopy and gastroesophageal endoscopy. Residents share responsibility for intern and student teaching.
The third year (R-3) is characterized by an increased operative experience in general surgery. Rotations on cardiopulmonary and peripheral vascular surgery are also included. Because of the advanced status of R-3s, they have increased responsibility in the performance of operative care. Residents have more advanced teaching responsibilities at this level.
Research Year (Optional)
The resident's goal for this year is to learn how to design and implement basic or elemental research and to evaluate the medical literature critically. Opportunities for research projects are numerous and are arranged with preceptors in the Department of Surgery. The year is spent in OHSU or VAMC laboratories and other nationally prominent locations. In recent years, residents have spent up to two years working with faculty in facilities such as the National Cancer Institute in Bethesda, Maryland, and Children's Hospital in Pittsburgh, Pennsylvania. It is the goal of research residents to gain experience in designing and performing research projects, analyzing their data, writing papers and presenting their research at local, regional and national meetings. Work during the research year has led to numerous publications by residents in the department.
During the fourth year (R-4), residents have increasing responsibility for providing complex care in general surgery. Residents rotate on general surgery at Kaiser Sunnyside and St. Vincent Hospital; the pediatric surgery, transplantation, and head and neck services at OHSU; and trauma at OHSU or Emanuel Hospital. During the year they gain experience through expanded duties as senior residents in increased operative experience, team leadership and teaching.
The fifth year (R-5) is the "chief year." The program includes 10-12 chief residents in general surgery: three at OHSU, three at the VAMC and one at St. Vincent's Hospital, Good Samaritan Hospital and Kaiser Sunnyside Medical Center. Chief residents are expected to perform a challenging number of surgical cases. During this year, they handle approximately 450 cases. This experience provides an excellent operative record when applying to take the American Board of Surgery Qualifying Examination. While at the VAMC, residents have an opportunity to perform major head and neck surgery as well as peripheral vascular surgery. At OHSU, residents are responsible for care and management of general surgical patients and advanced problems in surgical oncology. Chief residents at Good Samaritan Hospital, Kaiser Sunnyside Medical Center, Emanuel Hospital and St. Vincent Hospital are exposed to the full spectrum of general surgery, including vascular surgery. By the end of the fifth year, typical residents have performed a total of 750 to 1000 surgical cases. More importantly, they are prepared for independent practice and have been exposed to a learning process that will continue throughout their professional lives.
Teaching rounds conferences and meetings
Many conferences are sponsored by the department and the residents' active participation is vigorously encouraged. The weekly Residents Conference covers the range of the basic and clinical science of surgery and its specialties in a systematic fashion over a two-year cycle. A "team" of residents is guided in its presentation by a faculty member. Readings for the week are distributed to all residents before the conference and sessions are designed to be interactive. The sessions provide key information to aid in preparation for the annual in-training examination and, eventually, for the American Board of Surgery Qualifying Examination. The Morbidity and Mortality Conference (M&M) and Surgery Grand Rounds are held weekly for all Department of Surgery faculty and residents at OHSU and the VAMC. St. Vincent, Good Samaritan, Emanuel and Kaiser Sunnyside have their own weekly Morbidity and Mortality Conferences (M&M). Besides the required conferences (M&M, Grand Rounds and Resident Conference), the department faculty are involved in numerous other specialty conferences which residents attend while they are rotating on those services. The following is an example of a typical weekly calendar of events:
- Surgery Tumor Conference, VAMC
- Morbidity and Mortality (M&M), OHSU
- Department Grand Rounds, OHSU
- Resident Conference, OHSU
- Plastic Surgery Grand Rounds, OHSU
- Neurosurgery Grand Rounds, OHSU
- Pathology Conference, GSH
- Tumor Board, GSH
- Teaching Rounds, GSH
- Trauma Conference, OHSU
- Green Surgery Teaching Conference, OHSU
- Breast Conference, OHSU
- Surgery Teaching Conference, VAMC
- Patient Teaching Rounds, VAMC
- Surgery M&M, GSH
- Cardiac Surgery M&M, StV
- Surgery Grand Rounds, StV
- Cardiac Rounds, StV
- Med/Surg GI Conference, OHSU
- Surgery Tumor Conference, OHSU
- Trauma Breakfast, OHSU
- Vascular Surgery Grand Rounds, OHSU