The curriculum of the General Surgery Residency Program at New York Hospital Queens is structured to increase a resident's responsibility as he or she moves through the program. Our curriculum is competency—based and inclusive of all required disciplines, in compliance with the RRC. Each post-graduate year is structured to build on the skills developed in previous years of training. PGY-1 through PGY-5 residents are on in-house call an average of five to seven nights per month. The call schedule is created in accordance with the ACGME and New York State Department of Health 80-hour work week regulations, by which all residents are expected to abide.
Each PGY-1 resident completes rotations on each of the three general surgery services, the trauma service, the surgical intensive care unit, emergency room, and the vascular service. The resident is introduced to the basic elements of surgical patient care. Instruction includes conducting a comprehensive history and physical examination; evaluating the patient's problem and establishing a plan; ordering appropriate laboratory tests, radiological tests and medications; preoperative and operative care at the PGY-1 level; postoperative care; and patient care in the inpatient facility. All PGY-1 residents are expected to complete the American College of Surgeons Fundamentals of Surgery Curriculum™.
PGY-1 residents attend daily rounds directed by the service's chief resident, attend faculty attending rounds and participate in several teaching conferences throughout each month. Conferences may include board review conference, basic science conference, M&M/ QI conference, tumor board, mock orals and visiting professor grand rounds, as well as a laparoscopic skills lab.
The general surgery services encompass emergency care/acute surgery, gastrointestinal surgery and minimal access surgery, breast, colorectal, endocrine, urology and plastic surgery. PGY-1 residents master simple laparoscopic procedures ; learn about gross interpretation of various GI radiographs in discussions with the attending surgeon; and demonstrate the ability to examine, diagnose and develop care and treatment plans for patients with GI and anorectal diseases. The residents participate in basic and advanced open and laparoscopic general surgical procedures.
Exposure to operative and non-operative trauma management is included in the first post-graduate year. PGY-1 residents participate in surgical procedures performed in the emergency department or at the bedside and participate in the resuscitation of injured patients. Extensive clinical experience is gained in trauma patient evaluation, pre- and post-injury care, and critical care in the trauma ICU. Each PGY-1 resident completes a critical care rotation. PGY-1 residents also rotate through the Emergency Room.
Each resident is evaluated monthly by the service's chief resident and by attending physicians assigned to the service.
Post-graduate year two also includes rotations on the general surgery services, as well as thoracic surgery and the surgical ICU. Rotations, including transplant surgery, pediatric surgery and burn are also included in PGY-2 experience. The general surgery services concentrate in the same areas listed previously. The PGY-2 resident also functions as the surgical resident in the Emergency Room.
The PGY-2 house officer assumes the role of intermediate resident on each of the general surgery teams. The PGY-2 surgical resident on the trauma/critical care service learns: initial resuscitation of the acutely injured patient, indications for mechanical ventilation, basic pulmonary physiological concepts related to ventilation, cardiovascular physiology, details of head and spine injury, principles of nutritional support, cause, prevention and management of ARDS and MOSF, and performance of many procedures in the ICU.
The third post-graduate year consists of rotation on the general surgery services, the trauma/ critical care service, and the vascular service. The general surgery services concentrate in the same areas listed previously. Surgical residents are given increasing responsibility in patient care and operative experience and oversee and teach junior residents and medical students. Specialized skills are developed in the care of the emergency surgical (non-trauma) patient. PGY-3 residents manage and operate on patients with GI and anorectal disease, breast procedures; care for patients who have melanoma, breast and colon cancers; and assist with operations on patients with other cancers as well as a wide scope of general surgical diseases.
A rotation on GI/Endoscopy is also included in PGY-3 experience.
During the PGY-4 year, each resident rotates through the general surgery services, the trauma/ critical care service, and the vascular service. A one-month elective clinical rotation is encouraged for all PGY-4 residents. Each resident is responsible for setting up the elective.
The PGY-5 year includes 11 months of general surgery as the chief resident on one of the general surgery services. During the chief resident year, the resident takes full responsibility for the surgical service. This includes teaching and supervising junior residents and medical students. During this year, chief residents gain extensive experience in complex surgical cases. Each chief resident assumes administrative responsibilities during the course of their chief year.