SURGERY RESIDENCY PROGRAM
Weekly Education Curriculum
Our residency curriculum is based on the precept that a firm foundation in the principles of preoperative and postoperative care of patients is as essential as technical operating skills. Residents are provided thorough experience in the diagnosis and operative management of a large number of patients with disorders which comprise the entire field of general surgery. Clinical and academic teaching and research is emphasized. All residents are fully prepared to sit and pass the American Board of Surgery examination upon completion of the program. This preparation starts on the first day of entering the program and steadily progresses throughout the five years of training.
PG-I During the first year (PGY-I), emphasis is placed on the development of basic surgical skills and pre- and post- operative care. Services covered are general surgery and surgical sub-specialties, including thoracic surgery, vascular surgery, pediatric surgery, orthopedics, urology, neurosurgery, ENT, and plastic surgery, both wards and clinics. Interns are under the direction and teaching of the senior residents and the attending staff.
PG-II The second-year resident (PGY-II) is responsible for overall supervision of the inpatient service to which they are assigned. The residents are expected to see all patients on admission, to elicit a history and perform a physical examination. The residents make daily rounds on their service and discuss the patients with both the attending surgeons and the senior residents. They assume a graduated responsibility for the therapeutic and diagnostic procedures in the hospital, under the direction of the senior resident and attending staff.
The residents assist at operations and carry out procedures, under supervision, which are commensurate with their level of training and experience; assist on other cases from their service; and attend the surgical clinics. The surgical residents are expected to understand surgical anatomy, pathology, operative techniques and procedures, and the use of instruments related to specific surgical procedures so that they may concentrate on developing the basic surgical skills which give a firm foundation for sound surgical practice.
PG-III The third-year resident (PGY-III) has increasing responsibilities. He/She provides supervision to the junior house staff in the pre- and post- operative management of patients and in the surgical outpatient department. In addition, he/she performs the less complex surgical procedures, acquiring the dexterity needed for a career in surgery. Operative responsibility is determined by the resident's training and ability. During this time, he/she rotates through the San Joaquin General Hospital, the University of California, Davis, Medical Center, and St. Joseph's Medical Center.
PG-IV In the fourth year, the resident has increasing responsibility in the clinics and on the ward. In this year, he/she performs surgical procedures of greater magnitude. He/She provides senior resident responsibility in general surgery, pediatric and thoracic surgery at the San Joaquin General Hospital, St. Joseph's Medical Center, and the University of California, Davis, Medical Center. The fourth year surgery resident functions as Acting Chief Resident in Surgery at St. Joseph's Medical Center for a period of four to six months. During the last quarter of the year, a gradual transition toward responsibility of the Chief Resident is made. Teaching remains a major component of the program.
PG-V The Chief Resident (PGY-V) spends 8 months at San Joaquin General Hospital and 4 months at St. Joseph’s Medical Center on the surgical service. During this time, he/she has complete responsibility for the management and supervision of all services. He/She schedules operations and notifies the attending staff of their assignments. He/She directs treatment and maintains discipline over all surgical interns and residents. He/She conducts daily rounds, which are attended by the surgical interns and residents. The Chief Resident assists in assigning journals and topics to the residents and interns for Journal Club. He/She is responsible for maintaining minutes of this meeting as well as the Surgical Staff meetings. The Chief Surgical Resident organizes and conducts the weekly surgical conferences and panel discussions. He/She collects monthly statistics of operative procedures, complications, deaths and autopsies. With consultation, under the guidance of the Chief of Surgery, the Director of Surgical Education and attending faculty, he/she is responsible for the supervision of all major and minor surgical procedures.
During the fifth year, he/she will perform approximately 300 to 500 major surgical procedures and will supervise many additional procedures. During the total five-year program, a finishing resident will have performed between 1,000 and 1,400 surgical procedures. These surgical procedures are done under the direct supervision of the attending staff. In the last months of the residency, the Chief Surgical Resident is given more individual discretion in the care of his/her patients.
Important adjuncts to the surgical training which the residents and interns receive are the teaching conferences. Seminars and panel discussions are held throughout the year. All of the medical disciplines hold weekly departmental conferences, seminars and bedside rounds.
The driving philosophy of the San Joaquin General Hospital Surgical Residency program is that broad experience in operative surgery is essential for the properly trained surgeon. Therefore, each resident in this program will obtain substantial operative experience, not only at San Joaquin General Hospital (SJGH) but also at St. Joseph’s Medical Center of Stockton (SJMC), and the University of California, Davis Medical Center (Sacramento) (UCD). During the assigned clinical years, approximately 70% of the total time is spent at the San Joaquin General Hospital, 20% at St. Joseph’s Medical Center, 10% at University of California, Davis Medical Center. These three hospitals provide our surgical residents with generous clinical experience in general surgery including vascular, gastrointestinal, colon and rectal, endocrine, thoracic, pediatric, trauma, transplant, and endoscopy. Additionally, there is excellent exposure to surgical sub-specialty services.