Clinical Sites: Saint Francis Hospital

White Surgery (Acute Care/Emergency)
This is an exciting and busy service that offers the resident an abundance of experience in trauma and emergency surgery. The resident at each level will be challenged.

Team: General Surgery R5, R4, R3, R2, R1, Family Medicine R1, PAs, APRNs.

Daytime Responsibilities: Senior residents are responsible for supervision and direction of the team, as well as doing senior level surgeries and seeing all consults. The R2 and R3 are responsible for carrying the consult pager and evaluating consults. Junior residents are responsible for orders, contacting consults, labs, responding to floor pages from nurses, performing bedside procedures (removal/insertion of NGT tubes/JP drains/Chest tubes), as well as discharging patients from the hospital. There is one overnight intern each week. The mid-level and chief residents will take call every 3-4 nights.

OR Cases: Elective gallbladders, colectomies, hernias, breast biopsies; emergency appendectomy, gallbladders, incarcerated hernias, other emergency perforated viscous and elective cases booked from clinic.

Clinic: 1 half day a week in the Gengras building.

Green Surgery (General, MIS, Colorectal, Surgical Oncology)
This is a private service that offers experience in laparoscopic, surgical oncology, general and colorectal surgery. There is a wide variety of operative experience for the R3 and R1.

Team: R3, R1, Physician assistants (2-3).

The R3 is given much leadership responsibility in conducting rounds. R1’s help with the daily work of the service including: discharges, checking AM labs and replacing electrolytes, ordering and following-up on various tests and studies discussed at sign-out, first response to problem patients on the floor and maintaining “the list”.
The mid-level practitioners function to assist the residents in their daily work. Some have extensive experience and can function at an R3 level and can assist in seeing consults and/or direct communication with attendings as well. There is a weekly clinic expectation of one half day each week.

Red Surgery (Vascular)
Team: R5, R4, R2, R1

Service Chief responsibilities (R5): daily walk rounds with interns on all floor patients, attending communications, ensuring junior residents work hours and clinic attendance, updating and maintaining M&M lists, presentation of M&M’s.
The R4 is mainly responsible for afternoon rounds and may round on the ICU patients and/or higher level acuity outlier patients. Also responsible for M&M presentations. The R2 and R1 will manage appropriate floor work and have the opportunity to double scrub on vascular cases. Weekly clinic experience is available to each resident during faculty office hours.

Cases: Vascular access, amputation, revascularization

Call schedule: Q4 for the R2, 4, and 5. One intern is on call for one week of each month.

Thoracic Surgery
This service the R1 and R2 the opportunity for a thoracic surgery experience. Management of frequent thoracic disease processes, chest tubes on floor patients, consults, and experience in thoracic surgeries (open and laparoscopic) are offered to the resident on this rotation.

Surgical ICU
The SICU team manages care for any critically ill patient admitted to the general surgery service or any of the surgical subspecialties (pre- or post-op). Objectives during the rotation are to become familiar with ventilation support, sepsis management and peri-operative care of the critically ill surgical patient. The SICU is a closed unit.

The Surgical ICU (SICU) team is comprised of experienced critical care PAs, and 2-3 junior level residents from various subspecialties (surgery, OB/GYN, ED). Attendings change weekly.

Conferences: Wednesday: 7:00 a.m. M&M. Please utilize the PAs for adlib lectures about nutrition or vent management.
You will be responsible for triaging/admitting patients, placing lines and making critical care plans, including communicating with attendings. You are also supported by the chief resident on-call. The on-call resident is responsible for all pre-rounding and notes for the day.

Call schedule: approx. q3 (10-11 calls per month)

Procedures: Opportunities for a-line, central line (with sonosite), swan ganz, EGD, PEG and percutaneous tracheostomy.