The General Surgery Residency provides broad spectrum exposure to all components of general surgery with a blend of inpatient and outpatient experiences. This experience resembles the practice of general surgeons throughout the United States. Gundersen Health System is a tertiary referral center and designated as a Trauma Center Level II. Residents see both the routine and more unusual cases in surgery in an environment dedicated to graduate medical education and outstanding patient care.
Residents have a unique opportunity to work side-by-side with attending surgeons from day one where they are expected to be in the operating room. Residents enjoy extensive hands-on experiences in surgical specialties during their five years. They gain increasing responsibilities in care of patients before, during and after surgery and, as chief residents, they run a surgical service under the guidance of supervising surgeons.
A typical resident performs more than 1,100 operations during the five-year program, including 350 in the PGY V year. PGY I residents complete approximately 100 surgeries as junior surgeon by the end of the year. Endoscopy experience is ample and residents typically complete greater than 250 endoscopies during their training. All of our graduates complete the Fundamentals of Laparoscopic Surgery and Fundamentals of Endoscopic Surgery curricula and examinations as mandated by the American Board of Surgery.
The program is geared toward surgeons interested in general surgery, with many of our graduates choosing to practice in smaller communities. Historically, two-thirds of our graduates have entered general surgery practice directly from residency. However, every graduate who has chosen to continue training into a surgical sub-specialty has been accepted into fellowships in cardiothoracic, vascular, plastic, endocrine, colorectal, advanced laparoscopic and trauma/critical care surgery. We are focused on developing the complete general surgeon with leadership courses, a formal patient safety and quality curriculum, an ethics lecture series, financial planning series, team based training and focused attention on appropriate areas of improvement throughout training.
Twenty-four percent of our former residents are women, including the first woman in Wisconsin to graduate from a general surgery program. Our graduates have an exceptional record in passing their written and oral boards on the first attempt — 100 and 89 percent compared with a national average of 85 and 83 percent respectively. This reflects our faculty's commitment to teaching and an impressive clinical experience throughout residency.
Our focus is to train surgeons who are excellent clinicians and understand the basic science behind surgical procedures. Our attending staff is available to answer questions, and values the close working relationships with residents and medical students. The teaching atmosphere is nurturing rather than adversarial, a milieu we believe prepares better doctors and enhances superior patient care. We offer lectures, small group discussions and interactive conferences in which attending and resident physicians discuss cases. We have a long standing history of utilizing simulation to adjunct team based and technical skills training. The Cleary Surgical Techniques Training Laboratory originally opened in 1995 and offered routine simulation experiences. In 2012, we opened the Integrated Center for Education and conference center with brand new laparoscopic towers, a mock operating room, mannequin simulators and up to date connectivity to further our dedication to simulation based training. Residents gain opportunities for additional practice in laparoscopy, trauma, surgical stapling, cadaver dissection, robotics, team based activities, communication assessments and other surgical techniques.
Our attending surgeons are interested in clinical research, patient safety collaborations and quality initiatives. Residents are expected to publish two papers in peer-reviewed journals during their residency and make two presentations at regional or national medical meetings. These requirements enhance the residents' ability to access and use medical literature and create a desire to find answers to problems that surgeons experience in practice. The residents are supported with funding to accomplish their presentations and the majority exceed our baseline requirements. To further support this requirement, we provide the assistance of a surgical research associate, a secretary, databases and statistical resources. A departmental library and dedicated computers augment these resources. Residents receive full credit for the work they do and are recognized as author or co-author of these projects.
Additional benefits of the program include supplying residents with personally-fit surgical loupes to assist with the performance of fine procedures, the purchase of a variety of surgical texts and a conference/book allowance each year. In addition, because there are no residents or fellows in surgical subspecialties, such as neurosurgery, cardiac surgery or urology, surgical residents are actively involved in the care of patients in these areas. Rather than serving as observers or third assistants, they have hands-on experience as first assistants or as the operating surgeon.
The General Surgery Residency is a five-year program leading to American Board of Surgery eligibility. The general surgery experience is afforded through fairly equal experience on four teams (Teams A-D) which cover vascular, pediatric, minimally invasive, foregut, hernia, colorectal, hepatobiliary, pancreatic, gastrointestinal, trauma/critical care, breast, and endocrine surgery. Residents also complete rotations in orthopaedic surgery, otolaryngology, emergency medicine, urological surgery, anesthesia, endoscopy, plastic surgery, cardiothoracic surgery, endoscopy, critical care and obstetrics/gynecology.
Second-year and third-year residents receive experience in the care of burn patients and transplant patients on four-week rotations at the University of Wisconsin Hospital in Madison.
There are two months of elective time (one each during the PGY III and PGY IV years). Residents utilize this time for a variety of routine electives (rural surgery, international rotations, research) and some choose to focus on a clinical avenue (endocrine, breast, cardiothoracic, plastics).
We have a Chief Surgery Resident Service which is led by the chief residents for an equal number of months each year. The chiefs are responsible for their own office, operating room and endoscopy schedule, call responsibilities and administrative tasks. All of this is under the appropriate guidance of our attending surgeons – but the continuity is maintained for the chief residents relationship with the patient.