The OHSU Department of Surgery was one of the first institutions in the country to offer the American College of Surgeons Mastery in General Surgery Program: an opportunity to transition directly from residency to independent surgical practice.
The Mastery Program supports the transition to independent practice in general surgery through:
- Building autonomy, decision-making, and clinical skills
- Developing experience in practice management, leadership, and quality improvement
- Learning the business of medicine
- Launching your career in general surgery
Read below for our program highlights and description.
OHSU Program Description
OHSU’s Mastery of General Surgery experience includes complimentary experiences at a rural critical access hospital and a busy community hospital in an urban setting. The Junior Associate will share call with the faculty members at the training sites and meet referring physicians. Direct supervision will progress to independent practice early in each rotation, once the Junior Associate’s technical skills and medical decision making are assessed. Junior Associates have assigned backup coverage throughout the year to provide a clear support structure. Regular assessments will evaluate the Junior Associate’s progress and review goals for the remainder of the rotation.
The Junior Associate will work in two Oregon hospitals: Adventist Health Portland, and Columbia Memorial Hospital in Astoria, OR. Upon arrival at the training site, the Junior Associate will undergo a baseline evaluation of a minimum of five supervised general surgical operations. The intake assessment will be used to identify the level of performance of the Junior Associate and to identify learning objectives for the program.
To begin, the Junior Associate will share call and procedures with the Mastery in General Surgery Program faculty members. Supervision will then progress to indirect supervision in clinic, on call, and in the operating room based on the assessment of Senior Faculty at each training site. Duties include taking General Surgery call for the Emergency Department, seeing patients in the ambulatory setting, performing operations and endoscopic procedures, rounding daily on inpatients, and taking consultations from the hospital. In addition to basic general surgical procedures, gastrointestinal endoscopy will be a major feature of the Junior Associate’s curriculum at the rural training site, with regularly scheduled endoscopy clinics. The Junior Associate is expected to confer with the Mastery in General Surgery Program Senior Faculty regarding management decisions as needed.
The Junior Associate’s performance will be formally assessed at the end of the first month and subsequently at quarterly intervals. The Junior Associate will be assessed in the following domains: Technical Skills, Interactions with Patients, Interactions with Surgeon Colleagues, Interactions with the Greater Medical Community, and Self-Care. An action plan will be created that will be reviewed at the next quarterly evaluation.
A semiannual review will be scheduled to include the Junior Associate, the Senior Associate from the training site, and the Mastery in General Surgery Program Director to assess performance based on the goals and objectives that were established at the intake assessment and quarterly evaluations. This will also be an opportunity to refine goals and objectives predicated on the performance and recognized needs to date.
The Junior Associate will learn about practice management issues including billing, collections, medical liability, contract negotiations, quality improvement, and patient safety initiatives from the primary faculty as well as from the practice manager of the surgical group. The practice group will hold a regularly scheduled morbidity and mortality conference at which all deaths and complications are discussed using a root cause analysis format.