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Curriculum & Conferences

Clinical rotations

PGY 1

  • General Surgery (eight months)
  • Anesthesia
  • Emergency Medicine
  • Intensive Care Unit

PGY 2

  • General Surgery (eight months)
  • Burn Surgery at the University of Wisconsin
  • Cardiothoracic Surgery
  • Intensive Care Unit
  • Otolaryngology
  • Urological Surgery

PGY 3 

  • General Surgery (six months)
  • Endoscopy
  • Intensive Care Unit
  • Obstetrics/Gynecology (two months)
  • Transplant Rotation at the University of Wisconsin
  • Elective (Rural Surgery, International Rotation, Research, etc.) (one month)

PGY 4

  • General Surgery
  • Cardiothoracic Surgery
  • Endoscopy
  • Interventional Radiology
  • Elective (Rural Surgery, International Rotation & Research) (one month)

PGY 5

  • General Surgery (eight months)
  • Chief Surgery Resident Service (four months)

Rotation schedule 

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) that cover vascular, pediatric, minimally invasive, foregut, hernia, colorectal, hepatobiliary, pancreatic, gastrointestinal, trauma/critical care, breast and endocrine surgery. Residents complete rotations across the spectrum of general surgery to include anesthesia, emergency medicine, otolaryngology, urological surgery, cardiothoracic surgery, endoscopy, critical care and obstetrics/gynecology.  

Because there are no residents or fellows in surgical subspecialties, such as neurosurgery, intensive care, cardiac surgery or urology, surgical residents are actively involved in the care of patients in these areas. Rather than serving as observers or second assistants, they have hands-on experience as first assistants or as the operating surgeon. Residents also participate in two “away” rotations at the University of Wisconsin Hospital in Madison; PGY 2 residents and PGY 3 residents complete four-week rotations on burn surgery and transplant surgery, respectively. 

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, national rotations with underserved populations, research) and some choose to focus on a clinical avenue (endocrine, breast, cardiothoracic, plastics, orthopedics).

We have a chief surgery resident service that 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. This is an unbelievable environment for chief residents to transition to their ultimate practice.

Elective opportunities

Orthopedic surgery – Residents learn pre/post-operative care of orthopedic patients in the hospital/clinic and assist in surgery. Learning opportunities include working with orthopedic surgeons in the management of fracture cases and non-traumatic conditions involving the musculoskeletal system.

International/underserved rotation – We are dedicated to promoting opportunities for residents to serve diverse populations where surgical needs are robust. Residents have rotated in a variety of international locations, including Cameroon, Kenya, Dominican Republic, Ecuador and Nicaragua with different service organizations. We also have opportunities to work with Indian Health Services in Fairbanks, Alaska.

Rural surgery – Residents work with Gundersen regional surgeons to provide rural surgical care to a broad patient population. Cesarean sections, endoscopies (screening, therapeutic and diagnostic), gynecologic and broad spectrum general surgical procedures are accomplished in rural settings without the typical resources present within our primary site.

Plastic surgery – Residents work with our plastic surgeons to gain experience with a variety of plastic reconstructive and cosmetic surgeries. There is exposure to Moh's surgery as well.

Conferences

Weekly

  • Basic Science Lecture (two-year curriculum)
  • Clinical Science Conference
  • Morbidity/Mortality Conference
  • Breast Cancer Conference
  • Gastrointestinal Tumor Board
  • Vascular Conference

Monthly

  • Anatomic Dissection Lab – Anatomage (virtual cadaver)
  • Journal Club
  • Medical Ethics Conference
  • Trauma Conference
  • Surgical Skills Lab Training (two to four per month)

Other Conferences

In addition to mandatory surgery conferences, surgical residents are encouraged to attend as many of the daily conferences at the medical center involving other specialties as their schedules permit.

Operative Experience

Experiences are wide ranging, but they vary according to the needs of patients at the time each resident is on service. Over the course of five years, a resident typically performs more than 1,100 operative procedures, including 350 major procedures during the fifth year. The following are an average of the major procedures for our graduating residents.

Group Defined Category RRC Minimum Program Average
Skin and Soft Tissue Skin and Soft Tissue 25 74
Breast Mastectomy 5 81
  Axilla 5 23
  Breast Total 40 120
Head and Neck Head and Neck 25 55
Alimentary Tract Esophagus 5 11
  Stomach 15 18
  Small Intestine 25 46
  Large Intestine 40 74
  Appendix 40 83
  Anorectal 20 54
  Alimentary Tract Total 180 287
Abdominal Biliary 85 142
  Hernia 85 144
  Liver 5 6
  Pancreas 5 6
  Abdominal Total 250 438
Vascular Access 10 34
  Anastomosis, Repair, Exposure, or Endarterectomy 10 84
  Vascular Total 50 234
Endocrine Thyroid or Parathyroid 10 26
  Endocrine Total 15 28
Operative Trauma Operative 10 20
Non-Operative Trauma Team Leader Resuscitation 10 19
  Non-Operative Trauma Total 40 71
Thoracic Open Thoracotomy 5 17
  Thoracic Total 20 31
Pediatric Pediatric 20 24
Plastic Plastic 10 18
Surgical Critical Care Surgical Critical Care 40 134
Laparoscopic - Basic Laparoscopic- Basic 100 250
Endoscopy Upper Endoscopy 35 49
  Colonoscopy 50 137
  Endoscopy Total 85 190
Laparoscopic - Complex Laparoscopic - Complex 75 141
Role Totals Total MAJOR 850 1,267
  Total SURGEON CHIEF 200 309
  Total TEACHING ASSISTANT 25 50

Residents are exposed to a wide variety of minimally invasive operations including laparoscopy, endoscopy, robotics and endovascular procedures.

Specialty services

Anesthesiology – Residents work individually with one of the department's anesthesiologists to learn airway management, support of the anesthetized patient, regional anesthesia, respiratory care and care of ICU patients. Challenging cases are discussed at monthly conferences.

Cardiothoracic surgery – Residents work closely with cardiovascular surgeons on diagnostic evaluation of patients, interpreting results and assisting at major operations. Residents gain maximum experience in cardiac surgery, thoracic and thoracoscopic surgery.
Endoscopy – Residents work with the gastroenterologists to learn the indications, complications and techniques of colonoscopy and esophagogastroduodenoscopy, percutaneous endoscopic gastrectomy. The resident is also exposed to endoscopic retrograde cholangiopancreatography and associated techniques.

Obstetrics and gynecology – This busy service has more than 1,500 deliveries a year, offering residents opportunities to work with board-certified obstetricians/gynecologists on a wide range of gynecological experiences.

Urology – Through this service, residents work with board-certified urologists, learn diagnosis and treatment of urological conditions and gain an understanding of how urology works with other specialties.

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