The General Surgery Residency is a five-year program with three categorical positions per year leading to American Board of Surgery eligibility. We are dedicated to the preparation of surgery residents to be competent and confident to practice general surgery upon graduation from our program. We have amazing support to accomplish this task with dedicated teaching faculty members, research support and high clinical volumes across the spectrum of general surgery. We have a rich history of preparing residents for successful fellowship match at competitive programs when desired, but we are equally proud of our graduates who enter practice immediately after graduation. A few strengths of our program include a dedicated chief surgery resident service with designated office and operating room block time, at-home call for PGY I-V residents, the option of serving underserved populations internationally or nationally and a state-of-the-art simulation lab with a structured curriculum. Additional highlights include a formal robotic curriculum, on-site housing for residents and a commitment to promoting resident resilience.
Finding the right training program was a very important decision for me. I entered residency with a desire to one day practice surgery in global and low-resource settings. I wanted to graduate feeling comfortable performing c-sections and other common, essential procedures not routinely taught in U.S. general surgery residencies. I hoped to train with and under faculty who considered my maturity and integrity as a person, husband and father to be equally (if not more) important than my development as a surgeon or leader. I wanted to work within a resident team that looked out for each other and emphasized relationships and cohesiveness over case volumes and professional ladder climbing. And, ultimately, I aspired to finish residency with the same passions and goals I started it with: to fear God, serve others and steward the gift of surgery wisely and humbly. No training program is perfect, but this one not only trains its residents well and broadly, but does so in a manner that honors these other values. I would choose it again without hesitation or reservations.
Brendon Esquibel, MD
La Crosse, Wis.
General Surgery Residency at Gundersen is a well-rounded and diverse training experience. We are offered exceptional technical and operative training encompassing broad-spectrum general surgery, but this is only a small part of what makes this program so unique. The program fosters resident surgeon development as potential future leaders at a departmental and institutional level, along with imparting us with the mission of providing truly patient-centered care. I consider myself very fortunate to have had the opportunity to train here. After completing five years of surgical training at Gundersen, I feel capable of practicing surgery in nearly any environment. The culture here is very supportive and collaborative, with a strong focus on educating residents. This is a large part of the reason I made the decision to join the department as Trauma staff at the completion of my fellowship.
Nolan Rudder, DO
Critical Care Fellow, Medical College of Wisconsin
We seek to train general surgeons who are outstanding clinicians. Our graduates will have an intense commitment to patient care and lifelong learning. We will assist the development of this expertise by providing our trainees with strong foundations of academic excellence, sound technical skills, clinical research, and an understanding of contemporary issues in surgical practice.
About the Residency
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 routine and more unusual surgical cases 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. Additionally, we afford ATLS instructorship courses and have an established robotic curriculum.
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 (cardiothoracic, colorectal, endocrine, hepatobiliary-pancreatic, advanced laparoscopic, plastic, trauma/critical care and vascular). 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.
Forty 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 of 100 percent pass rate for their written examination and 88% percent pass rate for their oral examination on the first attempt over the past three years. In comparison, the national average is 94 and 81 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 value 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 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, fresh cadaver labs, 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 residents' ability to access and use medical literature and create a desire to find answers to problems that surgeons experience in practice. Residents are supported with funding to accomplish their presentations, and the majority of residents exceed our baseline requirements. To further support this requirement, we provide the assistance of a surgical research associate, 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 fitted 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.
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