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The General Surgery rotations are based at Einstein Philadelphia and Einstein Montgomery. Each setting has a different patient and case-load mix. Einstein Philadelphia is the 700-bed quarternary referral center within the Einstein system. Northeast Philadelphia provides a diverse and under-privileged patient population. In addition to a busy elective volume, Einstein Philadelphia provides the most exposure to emergency and acute-care surgery. Einstein Montgomery has begun to provide a large case-load of “bread and butter” elective surgery, in addition to vascular, bariatric, and thoracic surgery.
Einstein Elkins Park is a smaller 300-bed acute care hospital in nearby Elkins Park. The bulk of the surgical volume here is elective. It is the principal home of the Bariatric program, but also provides a large volume of non-Bariatric minimally invasive surgery.
The SICU rotation is based at Einstein Philadelphia. 1st and 2nd year residents staff the 18-bed SICU. The typical categorical resident will rotate through the SICU for 4-5 months in the first two years. This prepares them well as they transition to a mid-level resident. This is a demanding rotation, as many of the hospital’s sickest patients are cared for here. Critically ill patients from the general surgical, transplant, trauma, and neurosurgery services are cared for by three critical-care board-certified surgeons.
The Trauma rotation is staffed by a 4th year and 1st year resident. Einstein Philadelphia is a Level-1 Trauma center, one of 5 in Philadelphia. Annually the service has 1500 Level 1 or 2 trauma-activations. The blunt/penetrating ratio is 3:1. The service performs about 100 acute trauma operations per year. On nights and weekends, the trauma service is led by an in-house attending surgeon and the on-call 4th or 5th year resident.
The Vascular/Thoracic rotation is based at Einstein Philadelphia. Because we have no fellows in vascular surgery, all of these cases are staffed by our surgical residents. Our vascular surgeons operate both in the operating room and a state-of-the-art endovascular suite. The service provides a rich case-load of open and endovascular cases. We also have an SVS-certified vascular laboratory for arterial and venous ultrasound studies. We have a busy wound-care center that provides a large number of referrals. We have three thoracic surgeons who are skilled in general, minimally-invasive, and oncologic thoracic surgery.
The Transplant rotation is based at Einstein Philadelphia. 3 full-time transplant surgeons perform liver transplants, kidney transplants, and organ procurements. This rotation is staffed by a 2nd year resident, in addition to one transplant fellow (the only fellow in the department of Surgery).
Our 4th year residents are allowed a month-long elective in the field and institution of their choice.
Typically, our chief-residents graduate with 1000-1200 major cases by the end of their residency.
Training young surgeons involves several components: understanding of surgical anatomy and physiology; mastery of surgical technique; and development of Teaching takes place in the operating room, the clinic, the wards, and the conference. All of our faculty and full-time employed surgeons who have joined Einstein because teaching is part of their core responsibilities. The educational curriculum is largely focused during our weekly Wednesday-morning protected time. This includes Morbidity & Mortality, House-staff meetings, Didactic conference, Grand Rounds, Journal Club, Weekly Teaching Rounds, and the Simulation curriculum. We have the benefit of a state-of-the-art Simulation Center, which includes multiple mannequins, models, a mock-OR suite, and laparoscopic simulators. We conduct animal and cadavers labs several times during the year.
It is expected that most residents will participate in meaningful research. We have multiple avenues for research including robust Trauma, Thoracic, Transplant, and Breast databases. Occasionally, residents are permitted to take years off to pursue extramural research—this requires significant planning in advance.
A General Surgery resident shares her experience and explains how her expectations have been met through her first two years within Einstein Medical Center's Department of Surgery Residency.