Each year three individuals will be chosen for the Categorical General Surgery Training Program. The three individuals in the General Surgery Categorical track are expected to become future outstanding community practitioners and leaders in surgery. We will strive to provide our residents with a customized and individualized graduated surgical development experience over a five year period providing the resident the opportunity to meet ACGME milestones and respecting the goals and prior experiences of the individual resident. Our model includes apprenticeship with experienced private faculty surgeons and a team-based arrangement guided by an attending faculty surgeon.

Upon completion of the chief resident (PGY-5) year training, our graduates will be eligible to take the American Board of Surgery written and oral examinations and they should be good candidates for advanced clinical training in any of the surgical subspecialties.

Clinical Postgraduate Years 1 and 2

The first two clinical years in our training program will be focused on the development of foundational skills and experiences in the broad spectrum of general and vascular surgery, trauma, critical care, anesthesia, and the initial two levels of the endoscopy curriculum. Rotations in the PGY-2 year include a focus on developing more advanced technical skills in general surgery, surgical consultation, and management of the critically ill and injured. These rotations are designed to assure that each resident obtains the American Board of Surgery required minimum of invasive procedures and operations in the first two consecutive residency years (200 cases in defined categories, including endoscopy and E-codes, and 50 other cases such as I&D procedures, central venous access, arterial lines, tube thoracostomy, and other minor procedures). ATLS training and certification will take place early in the internship.

Clinical Postgraduate Years 3 to 5

During the third clinical year residents receive further training in general, endocrine, colorectal, oncologic, transplant, and pediatric surgery, and in acute care, critical care, and trauma. The FLS (Fundamentals of Laparoscopic Surgery) course and certification must be completed by the end of the PGY3 year. During the fourth clinical year, residents will receive further training and increased responsibility in general, hepatobiliary, oncologic, vascular, and trauma surgery, allowing the resident to spend special focus on areas of their developing specialty surgical interests. Completion of the Flexible Endoscopy Curriculum for General Surgery Residents should also be well on towards completion by the end of the PGY4 year (obtaining procedural numbers and obtaining certification in FES {Fundamentals of Endoscopic Surgery} must be completed prior to graduation rotations include additional training in trauma surgery, complex hepato-pancreatico-biliary surgery, surgical oncology and complex laparoscopic surgery.

Operative Experience

Our expectation is that our categorical general surgery residents will perform approximately 900-1000 operations at the end of five clinical years. This experience is planned to be outstanding in the complexity of the procedures performed, especially in gastrointestinal, biliary, pancreatic, breast, endocrine, and vascular surgery. Moreover, operative experience in trauma and surgical critical care is expected to be excellent based on the volume of cases now admitted to our Level II Trauma Center at Regional Medical Center Bayonet Point. The endoscopic experience is also expected to be outstanding based on the procedures presently being performed by our surgeons and the partnerships for resident teaching being developed with our gastroenterologists.

Teaching

The teaching of residents in our new Division of Surgical Education in the Department of Graduate Medical Education at Hospital Corporation of America-West Florida Division is of highest priority. Teaching will consist of extensive interaction with faculty, staff, and available surgical teaching resources on the wards, in the operating room, in the skills center, and in problem-based learning sessions in the hospital conference rooms and at the GME facility. In addition, a number of quality improvement conferences, didactic lectures, grand rounds, and visiting professor conferences designed to supplement the clinical experience will be held regularly.

The Program Director and members of the faculty will conduct weekly teaching rounds in the hospital that focus on discussion of interesting cases, case management, evidence-based medicine, and helping residents to feel comfortable with the problems they’re managing. There will be “Education Thursday” each week consisting of a Quality Improvement Conference starting at 7:00 a.m. followed by either Subject Oriented Conference or Surgical Grand Rounds featuring presentations or moderated sessions by faculty members and invited leaders in surgery from throughout the country. Residents will be expected to make presentations periodically on assigned subjects as part of this Grand Rounds series. Following these formal conferences the SCORE Reading Review Conference will take place led by the Program Director or a member of the Surgery Teaching Faculty. We utilize the Surgical Council on Resident Education Curriculum Outline for General Surgery (www.surgicalcore.org) , a list of topics to be covered in a five-year general surgery residency training program. A special reading curriculum will be developed for the fourth and fifth year residents who would have completed three years of the S.C.O.R.E. reading program. Trauma and Morbidity and Mortality conferences will take place during rotations on the Trauma Service at Regional Medical Center Bayonet Point (RMCBP).

A multitude of small-group conferences led by senior departmental staff members will be held each week for residents at all levels. The Program Director and a member of the Department of Pathology will review surgical specimens with the residents weekly or biweekly to help correlate and better understand intra-operative findings. Additionally, residents will participate in the monthly Tumor Board Conference where cancer cases are presented, discussed by a multi-disciplinary oncology faculty, and treatment recommendations delineated. Residents will frequently present their cases.

A monthly Journal Club will take place 9-10 months out of the academic year for the purpose of teaching systematic finding, appraising, and using surgical literature and research findings as a basis for clinical decision-making.

Assessment

The American Board of Surgery In-Service Training Examination is required and will be administered to each resident annually. A 30th percentile minimum examination score is expected each year.

Research

Longitudinal clinical research throughout the length of the program, done independently or in conjunction with the faculty, is required and at least one project each year will be expected. These projects can include quality improvement topics.