Clinical Experience: Saint Francis Hospital and Medical Center

This is an urban 600-plus bed hospital that serves as a tertiary hospital and regional ACS designated level II trauma center. General surgery residents will rotate through the White, Orange and Green services. There is also a red service run by mid-level practitioners.

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

Team: R5, R4, R3, R2, R2, R1, R1, R1: This is a high volume resident and PA run service that involves caring for acute care surgery and trauma surgery patients. The attendings adopt an Acute Care Surgery model where they cover Emergency General Surgery throughout the hospital in addition to trauma. The attendings also have an elective practice. Residents will be afforded autonomy commensurate to their level. Daily bedside teaching rounds take place led by the chief resident and supervised by the service attending. A wide variety of pathology is encountered including blunt and penetrating trauma, traumatic brain injury, diverticulitis, pancreatitis, peptic ulcer disease, acute biliary problems, compartment syndromes, necrotizing soft tissue infections and complex wound care. The R3, R4, and R5 are the team leaders. The R2 on the team is the dedicated consult resident-covering all acute care consults from the ED and the floor. The R2 consult residents work 13 hour shifts in an alternating night float type model. There is an outpatient clinic experience one half day a week. The service is known for bedside and operative teaching by attendings who are motivated surgical educators.

Orange Surgery: General Surgery, MIS, and Surgical Oncology

Team: R5, R2, R1 – This is a resident and PA-run general surgery, MIS, and surgical oncology service. The R5 will be covering advanced surgical oncology cases and sometimes advanced laparoscopic cases. The fellow works exclusively with the MIS cases of two attendings that run the Saint Francis MIS fellowship. The R2 will be mainly focusing on MIS cases but will also operate with the general surgeons on the service, and will participate in teach assist cases with the R5 or MIS fellow. Orange surgery clinic is Thursday morning, weekly. The R5 is responsible for teaching rounds on this service and communicating plans with the various service attendings.

Surgical ICU (R2,R1): The surgical ICU at Saint Francis is staffed with the same attendings who cover the Acute care surgery service and is a PA run service where the residents are afforded the opportunity to learn at their own pace. This is an R2 but sometimes also an R1 level rotation. The R1 is always on call with an R2. There is always a senior PA on call. There is an excellent opportunity to learn resuscitation, sepsis management, ventilator management, cardiac arrhythmia management and the evaluation and management of neurosurgical ICU problems. The PAs have several years of experience and are known for excellent bedside teaching in addition to what the attending of the week does.

Thoracic Surgery/Vascular Surgery (R4): The thoracic surgery R4 will scrub in cases and take care of their service at Hartford Hospital but is part of the Saint Francis chief call pool. Similarly the R4 on Vascular at UConn covers call at Saint Francis. This is a two block experience as an R4.

Green Surgery (Colorectal) (R2)

The colorectal service is managed primary by PAs and a fellow who the R2 will work with directly. The attendings perform standard laparoscopic and robotic colorectal procedures.

Red Surgery (Vascular/Breast/Plastics)

This is a strictly PA-run service.