Clinical Experience: Saint Francis Hospital and Medical Center

Saint Francis Hospital and Medical Center is a 600+ bed tertiary care referral center and ACS-verified Level I Trauma Center serving the greater Hartford region. General Surgery residents rotate through the White, Orange, and Red services, gaining broad exposure to trauma, acute care surgery, minimally invasive surgery, colorectal surgery, breast surgery, plastic surgery, thoracic surgery, surgical oncology, endocrine surgery, and critical care. A separate Blue Service is staffed primarily by advanced practice providers.

White Surgery: Acute Care Surgery, Trauma Surgery, and Emergency General Surgery

Team Structure: R5, R4, R3, R2 (Consult), R2, R1, Physician Assistant

The White Service is a high-volume, resident-driven Acute Care Surgery service that provides comprehensive care for trauma and emergency general surgery patients. Faculty practice within the Acute Care Surgery model, covering trauma and emergency surgical consultations throughout the hospital while maintaining elective practices.

Residents benefit from graduated autonomy appropriate to their level of training and participate in daily bedside teaching rounds led by the chief resident and supervised by attending surgeons. The service offers extensive exposure to a wide range of surgical pathology, including:

  • Blunt and penetrating trauma
  • Traumatic brain injury
  • Diverticulitis
  • Pancreatitis
  • Peptic ulcer disease
  • Acute biliary pathology
  • Compartment syndrome
  • Necrotizing soft tissue infections
  • Complex wound management

The R3, R4, and R5 function as team leaders, while the dedicated R2 consult resident manages acute care surgery consultations from the Emergency Department and inpatient services. Consult residents work 12-hour shifts in an alternating day/night float structure, providing concentrated experience in surgical decision-making and operative triage.

Residents also participate in a weekly half-day outpatient clinic. The service is particularly recognized for its strong culture of bedside and operative teaching by faculty committed to surgical education.

Orange Surgery: General Surgery, Minimally Invasive Surgery, Bariatrics, and Colorectal Surgery

Team Structure: MIS Fellow, Colorectal Fellow, R3, R2, R1, Physician Assistant

The Orange Service provides comprehensive experience in general surgery, minimally invasive surgery (MIS), bariatric surgery, and colorectal surgery. Residents work closely with fellows, attendings, and advanced practice providers in both operative and perioperative patient care.

Operative opportunities include open, laparoscopic, and robotic procedures across the service lines.

  • R3 residents take an active role in advanced operative cases, including colorectal, bariatric, and robotic procedures.
  • R2 residents focus primarily on minimally invasive surgery while also gaining exposure to general surgery cases alongside senior residents and fellows.
  • R1 residents develop foundational operative and perioperative management skills.

The service includes a dedicated weekly outpatient clinic, providing continuity of care and exposure to preoperative evaluation and postoperative management. Educational rounds are coordinated by the chief resident, who facilitates communication among the multiple attending surgeons on the service.

Surgical Intensive Care Unit (SICU)

Team Structure: R2, R1 (variable), Physician Assistants

The Surgical ICU rotation provides residents with intensive exposure to the management of critically ill surgical and trauma patients. The SICU is staffed by the same attending surgeons who oversee the Acute Care Surgery Service and operates within a highly collaborative multidisciplinary environment.

This rotation is primarily designed for R2 residents, with sometimes participation by R1 residents. A senior physician assistant is always available to support patient care and resident education.

Key learning experiences include:

  • Hemodynamic resuscitation
  • Sepsis recognition and management
  • Mechanical ventilator management
  • Cardiac arrhythmia evaluation and treatment
  • Multiorgan system support

Residents benefit from extensive bedside teaching provided by experienced physician assistants and faculty intensivists, allowing them to progressively develop confidence in critical care decision-making and procedural skills.

Red Surgery: Breast, Plastics, Thoracic, Surgical Oncology, and Endocrine Surgery

Team Structure: R4, R1, Physician Assistants

The Red Service provides exposure to a broad spectrum of surgical subspecialties, including breast surgery, plastic surgery, thoracic surgery, surgical oncology, and endocrine surgery.

Residents participate in the full continuum of surgical care, including inpatient management, perioperative decision-making, and operative procedures ranging from complex open operations to advanced minimally invasive and robotic techniques.

  • R4 residents are heavily involved in advanced operative cases and serve in a leadership role on the service.
  • R1 residents gain experience in perioperative management, procedural skills, and subspecialty surgical care.
  • The service emphasizes multidisciplinary care and close collaboration with attending surgeons across multiple specialties.

This rotation offers broad exposure to several surgical subspecialties and provides valuable experience in complex surgical care, perioperative management, and multidisciplinary treatment planning.

Blue Surgery: Vascular Surgery and Neurosurgery

The Blue Service is staffed primarily by physician assistants. Vascular surgery patients are also managed by the residents from the Integrated Vascular Surgery Residency Program, while neurosurgical patients are cared for by the dedicated neurosurgical team.

While General Surgery residents do not routinely rotate on this service, its presence contributes to the collaborative multidisciplinary environment at Saint Francis Hospital and Medical Center.

Educational Highlights

  • Training at a 600+ bed tertiary referral center and ACS-verified Level I Trauma Center
  • Broad operative experience across trauma, emergency general surgery, minimally invasive surgery, colorectal surgery, breast surgery, plastic surgery, thoracic surgery, surgical oncology, endocrine surgery, and critical care
  • Strong emphasis on graduated autonomy
  • Daily resident-led teaching rounds
  • Dedicated outpatient clinic experiences
  • High-volume operative exposure with open, laparoscopic, and robotic procedures
  • Faculty, fellows, and advanced practice providers committed to resident education and mentorship

This combination of high clinical volume, operative diversity, structured teaching, and progressive responsibility provides residents with a comprehensive and well-rounded surgical training experience.