Division of Surgical Education
UNIQUE ASPECTS OF THE GENERAL SURGERY TRAINING PROGRAM
Protected Block Curriculum
Each resident participates in the Protected Block Curriculum based on their program year, during which time residents develop camaraderie through peer learning, support and mentoring. The curriculum is competency-based and presented and facilitated by faculty and staff using multiple educational tools including didactic lectures, peer-reviewed articles, skill sessions, hands-on workshops, and case-based discussions. For the PGY 1 and 2 years, residents are relieved of all clinical duties during the curriculum in order to prepare for and fully participate in curriculum activities. Over a five year period, the Protected Block Curriculum represents nearly 1,000 hours of concentrated learning.
As an Intern (first year resident/PGY I), there are six blocks of protected time beginning with Orientation in late June. Each session is between three and four days in length. Other sessions occur in September, November, February, April and May. The PGY I Curriculum is led by Dr. Philip Redlich and Dr. Rebecca Anderson.
For PGY 2 (post graduate year 2) residents, curriculum sessions begin in July. Each session is focused around a theme which changes for each of the curriculum weeks. The PGY2 Curriculum includes: Critical Care in July, Colon and GI cancers in August, Vascular Surgery in October, Breast Disease in January, Diverticular Disease in March, and Trauma in June. These core competences are taught under the direction of Dr. Travis Webb.
The PGY 3-5 Curriculum for upper level residents participate in curriculum as a group. Topics are presented every month (except during summer) from 9:15am to 12:15pm. The topics in this curriculum are presented over a three year cycle and consists of both clinical science and basic science portions. These sessions are facilitated by faculty in an oral boards format. Animal operative labs are featured in this curriculum. Dr. Kellie Brown and Dr. Alysandra Lal lead the curriculum.
Residents are free of clinical duties for PGY 1 and 2 curriculums starting at 12:00pm, one and a half days prior to the start of the curriculum week (Example: Saturday at noon for a Monday start). This 1.5 day prep-time allows the residents to adequately prepare for the 3-4 days of learning.
The faculty’s role in curriculum is to teach sessions or facilitate skills workshops during a designated time block. A longitudinal laparoscopy curriculum is being developed based upon the SAGES Fundamentals of Laparoscopic Surgery.
Resident Research Project
In 2007, Dr. Walker, with support from the Division of Education, initiated a scholarly research project to be completed by general surgery residents. The project is expected to result in an article of publication quality and be presented at Grand Rounds in the Chief Resident year. Karen Brasel, MD, MPH was appointed Director of Resident Research and oversees the program. This educational initiative was put into place to insure that all residents participate in scholarly activity, improve patient care, satisfy scientific and intellectual curiosity, advance knowledge and enhance critical thinking. Each resident will finish a project prior to graduation with the goal of presenting and/or publishing their research internally and externally of the Medical College of Wisconsin.
Surgical Learning & Instructional Portfolio (SLIP)
All categorical general surgery, preliminary, and integrated plastic surgery residents are responsible for developing a Surgical Learning and Instructional Portfolio (SLIP) during their rotations in the surgical training program. Every resident is required to submit 12 cases per academic year. This case is to be chosen by the resident and completed according to the template. Information on the template includes: case history, diagnostic studies, differential diagnosis, ICD9 Code, management options, treatment used, and two peer reviewed journal articles that support their learning. Residents access online searches linked to electronic journals, professional data bases and other resources available through the Medical College of Wisconsin library system to support their decisions. All SLIPs are reviewed by a faculty member who provides timely feedback with resources and additional perspectives to consider in decision-making. The feedback is two-way and continues until both the resident and the faculty person agree upon all impacting factors, with the resident possibly providing additional evidence to clarify a position in regard to the case presented in the SLIP.
Mock ABSITE Exam
All general surgery, preliminary, and integrated plastic surgery residents participate in a Mock ABSITE Exam approximately five weeks before the American Board of Surgery required examination. Exams are scored and residents are ranked amongst their peers. A Mock ABSITE review session occurs 10 days after the exam. During this faculty run educational session, each exam question is discussed allowing residents to correctly understand the reasoning behind the answer.
Mock Oral Boards
PGY 3 through PGY 5 residents participate in Mock Oral Boards each June. This exercise presents itself as a representation of the American Board of Surgery Certifying Exam. Each resident has three, one-on-one sessions with 1-2 faculty members during which time they are asked patient-centered questions. Residents are graded on their ability to articulate correct responses, think on their feet and communicate in a professional manner, all in preparation for the certifying examination.
Chief Resident Travel
Each PGY V resident is provided through an endowment the opportunity to attend one major conference of choice for up to seven days during the chief year. This conference must provide an educational learning environment that allows a resident to broaden their knowledge base in clinical or basic science.
Family Conference OSCE (Objective Structured Clinical Examination)
The family conference OSCE for all residents was developed in 2007 with the help of a grant from the University of Minnesota received by Travis Webb, MD, and will continue with support from the residency program. The learning goals of the exam include: (1) to create a longitudinal set of skills in professionalism and leadership through family conferences; and (2) to develop interpersonal and communication skills that are needed in adverse situations with patients and families. PGY 2 residents will perform the OSCE in order to continue to develop the needed skills by the end of the PGY 2 year.
The first of its kind at our institution, residents are required to engage in this simulation exam (role play) with two standardized cases. In a safe setting, residents practice delivering “bad news” to families and receive feedback on interpersonal and communication skills from both medical faculty and standardized patients. One case requires residents to counsel family members about end-of-life decisions and gain consensus about a relative’s care. The second case requires residents to explain an iatrogenic complication that occurred and gain family support for a revised treatment plan.
This exam was originally developed for the SICU Fellowship Program at the University of Minnesota in 2004-05. It was significantly revised, piloted, and re-tested in 2006. Our faculty have collaborated with the University of Minnesota and others including: Hennepin County Medical Center, the Mayo Clinic in Rochester, Minnesota; and the University of Arizona in an effort to further develop and improve this communication and professionalism OSCE.
Annual Family Events
We believe that your family is important and spending time with them is a necessary part of your life. We provide for several annual events which are Department or resident driven. These include a Resident Welcome Picnic each July, the Thanksgiving Dinner in November, and a Resident Holiday Party in December.