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Clinical Experience/Electives
The General Surgery rotations are currently based at Einstein Medical Center Philadelphia (EMCP), Einstein Medical Center Montgomery and New Jersey Jefferson. Each setting has a different patient and case-load mix. Learn more about our clinical sites.
The SICU rotation is based at Einstein Medical Center 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 Vascular rotation for the general surgery residents is based at Einstein Medical Center Philadelphia. In their first three years, general surgery residents rotate with the vascular residents and all the cases are staffed by the 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 many referrals.
The Surgical Oncology rotation is based at Einstein Medical Center Philadelphia, and includes Breast, Hepatobiliary, and Thoracic Surgical Oncology. This rotation includes exposure to medical oncology and oncologic radiology, as well as multi-disciplinary tumor conferences. All categorical residents also spend two months at Fox Chase Cancer Center in Philadelphia, PA.
The Transplant rotation is based at Einstein Medical Center Philadelphia. Four full-time transplant surgeons perform liver transplants, kidney transplants, and organ procurements. This rotation is staffed by a two residents resident. Residents get valuable operative exposure to organ procurements, kidney transplantation, and vascular access. They also get clinical exposure to the management of complicated hepatic and renal transplant patients.
PGY 1-4 residents rotate on the Acute Care Surgery service. EMCP is a Level 1 Trauma center that receives critically injured patients directly through the Emergency Department (ED), as well as referred from outside medical institutions. The trauma program conforms to the Pennsylvania Trauma Foundation guidelines with regard to standards and reporting. All faculty and residents are ATLS-certified. The trauma residents respond immediately to all trauma activations. The trauma attending directly supervises all trauma activations. There is a daily multi-disciplinary meeting on trauma patients that includes the resident house staff, attending surgeons, nursing, social services, care management, administration and risk management. This session allows for development of treatment plans, didactic multidisciplinary teaching, exposure of residents to multidisciplinary components of comprehensive care and utilization of hospital-based resources. There is a bi-weekly trauma conference that includes case reviews and teaching from outside experts in their respective fields. There is also a bi-weekly multidisciplinary performance-improvement trauma meeting that comprises attendings, nurses, and the trauma program staff. The PGY 4 resident attends this meeting.
Night Float is a rotation limited to PGY 1-2 residents. It is based at EMCP. Night float residents cover the Surgical Oncology, White, Blue, Transplant, Trauma, and Elkins Park services. Supervision is provided by senior residents (PGY 3-5), an in-house general surgeon, and other surgical faculty (available by phone). The Night Float rotation will provide experience in pre-operative, operative, and post-operative care of surgical inpatients. This is also a rotation with significant exposure to trauma and transplant. Night Float residents are expected to attend Wednesday morning conference, in accordance with ACGME duty-hour regulations.
Our 4th year residents are allowed a month-long elective in the field and institution of their choice.
Typically, our chief residents graduate with 1200 major cases by the end of their residency. This puts them consistently above the 65th percentile nationwide in terms of cases. In the last academic year, our chief residents were above the 90th percentile.
New Jersey Jefferson. Our second- and fourth-year residents spend three months each at our sister institution covering their busy general surgery and vascular services. New Jersey Washington Township and New Jersey Stratford have become one of the highest volume surgical sites for our residents. They share coverage of the hospitals with Jefferson Residents and a robust group of Physician Assistants.
Resident Responsibilities
Training young surgeons involves several components: understanding of surgical anatomy and physiology; mastery of surgical technique; and development of critical decision-making and leadership skills. All of our faculty are 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, Didactic conferences (SCORE-based and textbook-based), Visiting Professorships, a Critical Care teaching series, Vascular teaching series, and Breast teaching series, monthly off-campus journal clubs, along with the Simulation curriculum.
We have the benefit of a state-of-the-art Simulation Center, which includes multiple mannequins, models, a mock-OR suite, animal facilities, and laparoscopic simulators. We conduct animal and cadavers labs several times during the year. All residents receive ATLS training, along with ASSET and ATOM training. All chief residents participate in the Philadelphia ACS Chapter-sponsored mock oral examinations.
Although Einstein is an independent program (we do not have an on-site medical school), we are a strongly academic program. Therefore, it is expected that all residents will participate in meaningful research. We have multiple avenues for research including robust Trauma, Thoracic, Transplant, and Breast databases. Our residents present every year at multiple meetings and produce 10-20 manuscripts per year. We encourage some of our residents (those who wish to) to take years off to pursue extramural research. Recently, residents have conducted their research years at Jefferson Medical College, Fox Chase Cancer Center, and the Children’s Hospital of LA. Residents typically present or participate annually at the Southeast Surgical Congress, the Association for Academic Surgery, the Society for Clinical Vascular Surgery, SAGES, and the American College of Surgeons.
Preliminary Residents
We have 5 Preliminary Residents per year available to designated and non-designated candidates. These are all PGY-1. This track is quite competitive, as we have had great success placing qualified, accomplished and non-designated preliminary residents into categorical positions both here and at other institutions. Preliminary and categorical residents have almost identical rotations schedules.