General Surgery Presentations

[Melanie Wendelberger]

Thegoal of the General Surgery Residency is to provide the highest level of training to develop leaders in the practice of clinical and academic surgery. The program provides the opportunity for residents to learn in-depth the fundamentals of basic science as they are applied to clinical surgery, while also learning the surgical skills necessary to undertake the most complex and demanding surgical conditions.

The program provides outstanding experience in the preoperative, operative and postoperative care of patients in all areas that constitute the essential components of general surgery as specified by the ACGME and Surgical Review.

The fully accredited program is approved to graduate five chief residents in general surgery per year. The first two years of the program are designed to provide a core experience in the principal components of general surgery and the surgical subspecialities. After the second year, many residents choose to pursue two years of additional training in areas such as basic science research, surgical education or health care delivery and outcomes research. Laboratory experience of two years is encouraged and available to those who wish to pursue an academic career. The third through fifth years of training are to provide an in-depth experience in trauma, acute care surgery, surgical oncology, endocrine surgery, minimally invasive surgery, vascular surgery, colon and rectal surgery and pediatric surgery.

The entire process provides a broad-based and well-balanced experience in surgery that allows graduates to be well-qualified to pursue advanced training in various fellowships as well as subsequent career paths in either academic or private-practice settings.

The Simulation Center is a Level I American College of Surgeons (ACS) Accredited Education Institute as well as a Fundamentals of Laparoscopic Surgery (FLS) and Fundamental of Endoscopic Surgery (FES) approved test site.

Three weeks of vacation are assigned throughout the year. In-house on-call responsibilities average every fourth to fifth night. There is a night-float rotation covering the core surgical disciplines.

Penn State Health is a multi-hospital health system serving patients and communities across 29 counties of Pennsylvania. Its mission is to improve health through patient care, research, education and community outreach.

In December 2017, the system partnered with Highmark Health to facilitate creation of a value-based, community care network in the region. The shared goal of Highmark and Penn State Health is to ensure patients in the community are within:

Wellness, including emotional, spiritual, social and physical health, is a crucial component to training and to becoming a professional, compassionate and resilient physician. Self-care is a skill which must be continually practiced and reinforced. Penn State College of Medicine and Penn State Health are committed to addressing wellness among residents and fellows, with multiple resources readily available.

The vision at Penn State College of Medicine and Penn State Health is to equip learners with the knowledge, skills and attitudes they will need to provide culturally excellent health care and research for an increasingly diverse U.S. population. The Office for Culturally Responsive Health Care Education was formed to help meet that goal.

In addition, the institution does not tolerate discrimination, biases, microaggression, harassment or learner mistreatment of any kind, and any concerns are immediately addressed by the Office for a Respectful Learning Environment.

The General Surgery Residency is structured to provide residents with graduated responsibilities in the primary components of general surgery over five years of training. Each year is constructed to build on the experiences of the preceding level.

The core curriculum in general surgery is designed to provide residents with a strong knowledge base in the fundamentals of diagnosis and treatment of surgical diseases. The overall schedule is structured on SCORE (Surgical Council on Resident Education) and is on a two-year cycle. The curriculum is highly integrated with didactic sessions, case-based learning lectures, surgical techniques and skills sessions. Skills based learning occurs in both dry and wet lab settings. ABSITE preparation is supplemented with a subscription to TrueLearn.

Three hours of protected time every Thursday morning are devoted to education. Each Thursday morning generally consists of a one-hour lecture on a SCORE-based topic. The subsequent two hours may then be spent in case-based learning, small group seminars and simulation skills sessions.

The first and second years of the General Surgery Residency are designed to provide the individual with the experience necessary to develop a foundation in the core components of general surgery and the surgery subspecialties.

The first-year resident has primary responsibility for directing the pre-and postoperative care of patients in the inpatient and outpatient settings under the direct supervision of a senior resident and attending surgeon. These responsibilities include history and physical examinations, daily management of inpatient service and participation in approved-level surgical presentations.

In the third through fifth years, the focus transitions to increasing operative skills and service leadership. Protected time on Thursday mornings includes mock oral examinations, descriptions of more complex operations and pathologies, and teaching junior residents.

UPMC Pinnacle Community Osteopathic is located off Union Deposit Road in suburban Harrisburg, Pa., approximately 20 minutes from Hershey. The Osteopathic campus includes an acute-care hospital, medical sciences pavilion, cancer center, outpatient center and multiple physician practices and specialty offices.

Morbidity and Mortality Conference occurs at 7 a.m. Thursdays. Residents are responsible for presenting cases that are chosen for their educational and management learning points. The assigned resident is expected to develop a PowerPoint presentation and to review it with the responsible attending prior to the conference.

Residents have also participated in laboratories outside of the department, both within Penn State College of Medicine and other institutions, including the National Institutes of Health, returning after their career-development years to resume clinical training in Hershey.

The possibility of pursuing an advanced degree in a number of areas within the Penn State system exists during the two years of career development between the second and third clinical years. Degrees available include:

The mission of the Penn State Health Global Surgery Program is accomplished through the mission objectives. In addition to the research objective, the program also seeks to provide training and mentorship in global surgery for staff, residents, fellows and medical students. The purpose of the training is to develop future leaders in global surgery that will have the skills to continue working abroad, as well as at home, to increase health and prosperity around the globe. The assets available at Penn State Health Milton S. Hershey Medical Center provide a world-class foundation in humanitarian health care, medical health systems and global medical ethics.

The award, given monthly by the Office for a Respectful Learning Environment, accepts nominations from College of Medicine students who are invited to submit narratives about faculty members, residents, fellows, nurses or any other educators who challenge them and provide an exceptional learning experience. See more about the award here.

The intent of the event is to provide an opportunity for residents and fellows to showcase their research accomplishments to their peers in other clinical departments, as well as their colleagues in the basic sciences.

This Standardized Toolbox of Education for Pediatric Surgery (STEPS) is a resource for faculty and senior residents to use for teaching medical students and junior residents. The APSA Education Committee has designed these presentations and we invite you to explore and use these resources. Each module is created to be utilized as a disease based presentation ideally suited for small group interactive learning. The modules are formatted to a standard template that ends with questions to complete the discussion. These modules were not created to be stand alone self-study tools. The topics chosen are those we believe to be the core knowledge required for pediatric surgery for medical students and junior residents in general surgery.

The general surgery residency is a five-year program encompassing all aspects of general surgery as well as the surgical specialties, with an optional year of basic research available. The general surgical subspecialties include endocrine surgery, gastrointestinal surgery, surgical oncology, vascular surgery, advanced laparoscopic surgery, surgical ICU, and trauma surgery. Residents can also be assigned to other surgical services including orthopaedic surgery and urology. Six categorical residency positions are offered each year and we also offer 14 preliminary internship positions annually.

PGY1: Assignments during this year are for one-month blocks,providing exposure to general and specialty services in the four affiliatedhospitals: ART, VA, Main and the MUSC Shawn Jenkins Children's Hospital. Theresident will rotate through general surgery and the surgical specialtiesincluding anesthesia, cardiothoracic surgery, transplant, vascular surgery,orthopedic surgery, pediatric surgery, plastic surgery, and urology. Emphasisis directed to the fundamentals of both preoperative and postoperative surgicalcare and to learning fundamental technical skills.

PGY2: Assignments in this year are for one to two monthperiods, focusing on pediatric surgery, trauma/acute care, cardiothoracic ICU,vascular surgery, breast/endocrine surgery, transplant surgery, night ART, andSTICU.

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