The residency training program in general surgery has been carefully planned to provide a balance of clinical, research, didactic, and operative experience under the close supervision of the full-time and voluntary faculty at two institutions: Maimonides Medical Center and Coney Island Hospital.
In the first year, residents are exposed to the fundamentals of clinical surgery, including pre- and post-operative principles and a full didactic course in basic core surgical knowledge. The PGY-1 resident is the patient's primary physician and assumes responsibility for the patient's hospitalization and clinical contact. This is done under the close supervision of the senior resident staff and faculty. The resident scrubs as a second assistant on major operative cases and first-assists on appropriate cases. When the resident has achieved clinical competency for his or her level, the opportunity to perform appropriate procedures under supervision is provided. Six to eight months of this year are spent in general surgery. The balance is given to subspecialties, which include cardio-thoracic, vascular, urology, anesthesia and radiology.
The PGY-2 resident experience differs from the first year in that additional responsibility is given to the resident along with an increased operative load and exposure to even more subspecialties. The PGY-2 resident is a central member of the general surgical team and is increasingly responsible for consultations, emergency admissions and assisting in the supervision of students and PGY-1 residents. The majority of the year is spent in general surgery with the remainder of the year assigned to the Surgical Intensive Care Unit, Vascular Surgery and Trauma services at Maryland Shock Trauma Center.
The PGY-3 curriculum is designed to expand overall operative experience in general surgery and in the surgical subspecialties, as well as exposure to other multi-disciplinary fields that work in collaboration with surgery. At Coney Island Hospital, the resident is a senior member of the general surgical team and functions with increased independence in patient management. Subspecialty rotations include pediatric surgery, transplantation, and cardiothoracic surgery. The cardiothoracic rotation emphasizes thoracic surgery with specialized training in esophagoscopy and bronchoscopy. The resident, however, functions at a senior level and is involved with all aspects of patient care—both thoracic and cardiac patients—in the Cardiothoracic Intensive Care Unit and on the floor. An elective rotation is spent in gastroenterology. Hands-on experience includes endoscopic gastroduodenoscopy, bilary stenting, papilotomies, and colonoscopy.
The fourth post-graduate year provides the resident with the opportunity to run a service and assume complete responsibility for all the activities of that service. The experience ensures intensive exposure to general surgery, trauma and oncologic surgery. Two months are spent at the Maryland Shock Trauma Center. Residents are responsible for patient management decisions and the supervision of all surgical house staff at the institution. The fourth-year resident acts as chief at Coney Island Hospital and is fully responsible for running the surgical service under faculty-attending supervision. The emphasis of the fourth year is operative surgery and mastery of all basic surgery skills.
The final year of the program is designed to complete the resident's training in general surgery, as well as in the important areas of vascular and head and neck surgery. The fifth-year residents attend and manage weekly clinics for their respective services. This structure provides valuable pre- and post-operative exposure to surgical patients under their care, as well as a practical exposure to the management of a surgical practice.
The Mock Oral Exam
A biannual exam for PGY3-5 years replicates the certifying board exam with video and written feedback. We feel having to critically think through complex surgical problems and defend answers in a safe testing environment is a critical component in preparation for successfully passing the certifying board exam