Physicians
Residency
Surgery
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The
Educational Program in Surgery at Physicians Medical
Center Carraway (PMCC) combines the strengths of an
academic medical center with the practical advantages
of a community hospital. The surgical resident reaps
the rewards of an intense surgical experience, weighted
toward early operative skill development and guided
by close faculty level supervision. This philosophy
permeates the residency program and leads to close interactions
among residents as well as between residents and faculty.
The early emphasis on operative skill development is
carried forward in the context of an intellectual continuum,
beginning with the preoperative assessment of the patient
and following through to the patient's postoperative
and convalescent care. Believing the dictum that a resident
learns more by managing the patient upon whom he/she
operates, pre and postoperative care are emphasized
early in the educational program. Each resident develops
keen awareness and expertise in recognition of preoperative
risk factors and care of postoperative complications.
Responsibility in the operating room requires preparation
and dexterity, and the level of operative complexity
depends on the individual. The program is non-pyramidal;
it is the intention to finish all who are accepted and
strive to achieve excellence.
Goal
The
Educational Program in Surgery has one purpose: to prepare
the resident to become a superior clinical surgeon.
The means to attain this goal are multifaceted. Success
is customarily measured by performance on the qualifying
and certifying examinations of the American Board of
Surgery, but emphasis is also placed on the humanistic
side of surgery and the intangible concept of surgical
judgment. The descriptions of the Educational Program
in Surgery which follow serve to underscore the breadth
of exposure the surgical resident has to the technical,
didactic and scholarly aspects of surgery.
Graded
Responsibility
The initial years of the surgical residency emphasize
preoperative and postoperative care and mastery of operative
skills, in order to prepare for a career in general
surgery or a surgical specialty. Developing empathy
for surgical patients and their families and determining
operative risk and benefit are stressed. Each resident
receives extensive operative experience as first assistant
and by performing, under supervision, a variety of surgical
procedures commensurate with his or her level of ability.
During
the first two years, the resident gains experience in
the broad field of general surgery, as well as vascular
surgery, emergency medicine, plastic surgery, neurosurgery
and anesthesia. Additional elective rotations are available
in orthopedics, urology, and otolaryngology.
Off-site
rotations include transplantation and pediatric surgery.
Nonetheless, the resident is fortunate to spend most
of his/her residency at PMCC under the watchful eye
of full time surgical faculty.
Those
continuing in the general surgery program receive progressive
responsibility leading to the opportunity to independently
manage complex surgical problems and prioritize care
of the critically ill. The resident is challenged at
all times to make and justify decisions which affect
the patient's care and outcome. Junior residents participate
in overall care of patients suffering from both acute
and chronic surgical illness. Endoscopic experience
in the GI clinic vastly exceeds the minimum required
caseload. The fourth year is a concentrated clinical
year and includes experience as Senior Resident on the
trauma service at DCH Medical Center, one of Alabama's
busiest emergency facilities, as well as continued exposure
to vascular and general surgery. The fifth and final
year is spent as Chief Resident on the two general surgical
services and on the vascular service.
Conferences
The conference schedule is an active one, which balances
the need for didactic education with the demands of
a busy clinical schedule. Resident attendance is expected
at the following weekly sessions:
>
Multidisciplinary Resident Conference
> Basic Science Conference
> Mortality & Morbidity Conference
> Surgical Textbook review
The Multidisciplinary Resident Conference addresses
curriculum issues common to residents in all disciplines,
and, in rotation, a Cancer Conference that includes
all specialties which deal with the diagnosis and treatment
of malignancies. The surgical resident learns from discussions
by both surgical and non-surgical faculty. The Basic
Science Conference is resident-led, and presentations
originate from a defined list of topics covering the
entire spectrum of basic science as it relates to surgical
care. The Mortality & Morbidity Conference involves
presentations by the operating surgical resident who
describes events leading to a complication or death;
discussion is led by surgical faculty. This conference
is the backbone of the teaching program and follows
the supposition that it is best to learn from adverse
experience of others.
Additional
learning experiences include Textbook Review and Journal
Club. The textbook review program provides each resident
with one of the authoritative surgical textbooks, which
is purchased by the Program, and assigns chapter readings
each week. A weekly written quiz is given to confirm
resident reading. A prize is awarded each year for the
best scores on the textbook review. This emphasis on
core surgical knowledge is complemented by a monthly
Journal Club which has its emphasis on the surgical
literature. Journal Club is an educational experience
and also an opportunity to interact socially with colleagues.
Articles are assigned from contemporary literature and
presented over dinner at local restaurants. Faculty
members provide insightful comments.
Meetings
and Vacations
To further the educational value of the residency years,
each resident in the senior program is provided a stipend
to attend a scientific surgical conference. The meeting
may be selected by the resident, subject to the approval
of the program director. In addition, residents are
encouraged to submit abstracts for presentation and,
if accepted, their meeting expenses are covered by the
program.
Total
vacation time approaches three weeks, with two weeks
traditional vacation and an additional week allocated
during the Holiday Season.
Research
Residents who participate in meritorious research gain
greatly in knowledge, clinical insight and self-confidence.
Although program emphasis is on clinical surgery, each
resident is expected to engage in a meaningful research
activity. Presentations are encouraged at the annual
Physicians Education and Research Day, a forum which
provides an opportunity to showcase research activities
at PMCC and offers awards for best papers. Residents
are encouraged to participate with faculty in pursuing
clinical studies. Presentations and publications in
collaboration with faculty constitute the mainstay of
scholarly activity within the program, and both basic
science and clinical research are available.
Surgeons
as Physicians First
Through curriculum innovation and new approaches
to learning, the program strengthens the role of the
surgeon as a compassionate and caring physician. Enhancement
of communication skills, participation in hospital performance
improvement programs, and an emphasis on the role of
colleagues and cost sensitive patient care are stressed
throughout the program. Upon completion of the program,
the resident will be qualified to take his/her place
among other practitioners and interact in a collegial
and effective manner.
Evaluation
Residents are evaluated at the completion of each clinical
rotation. These evaluations are available for review
by the resident and are discussed periodically by faculty
at meetings of the Surgery Program Advisory Committee.
The resident is expected to prepare for and take the
American Board of Surgery In-Training Examination(ABSITE).
Semi-annual meetings occur between the individual resident
and the Program Director, in order to review resident
performance and provide constructive recommendations.
Such meetings may occur more frequently if remediation
is necessary. It is the intent of the program to finish
all residents who are accepted into categorical positions,
provided the resident's performance warrants such support.
The faculty is also annually evaluated by residents,
and these evaluations are reviewed with individual faculty
members by the program director in order to stimulate
teaching excellence among faculty.
Faculty
A residency program is only as good as its faculty and
the quality of the residents it attracts. Physicians
is fortunate in having an excellent geographically based
full time teaching staff dedicated to the surgical residency
program. Each faculty member is skilled in general surgery
and complements his general surgery expertise with an
area of special interest. Current areas of special interest
include vascular surgery, non-cardiac thoracic surgery,
minimally invasive surgery, trauma/surgical critical
care, complicated wound management, bariatric surgery,
colon and rectal surgery, breast disease management,
and endocrine surgery. In addition, surgical specialists
are geographically full time in urology, neurosurgery,
orthopedic surgery, plastic surgery, otolaryngology,
ophthalmology, cardiac surgery and anesthesia. Since
there are no specialty residents, experience in the
surgical specialties is more meaningful and the operative
experience is excellent.
Defined
Category Report
Resident
Recruitment
Physicians
Medical Center Carraway participates in the National
Resident Matching Program (NRMP). The surgical residency
is five years in duration, and three PG-1 categorical
positions are offered. It is expected that these three
individuals will continue through the five years of
the program. Additional positions are offered to resident
applicants who want one or two years of surgical training
prior to entering a related field. The Educational Program
in Surgery welcomes inquiries from qualified applicants.
Physicians
Medical
Center Carraway
Surgical Residency Program
1600 Carraway Boulevard
Birmingham, Alabama 35234
(205) 502-6230
gsres@pmcc.net
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