Introduction

The surgery rotation at THOCC gives residents the opportunity to function in a more even-paced and relaxed, yet stimulating environment. During this rotation, the residents care for a wide breath of surgical patients in a teaching community hospital setting. There is a robust and diverse operative experience for all residents, ranging from simple ambulatory surgery cases to complex surgical oncology, colorectal, thoracic, and vascular cases.

Team Structure

Residents – R4, R3, R2, R1(s), and designated APP

Team Member Roles

Each member of the team has a distinct but synchronous role:

• The R4 runs the service under direct attending supervision. The R4 leads daily bedside rounds, allowing the opportunity for the junior residents to present their patients and formulate plans. Afternoon rounds are expected to have an educational focus, led by the R4. Having first pick on operative cases is one of the major highlights of this rotation; the R4 has the priority to operate on index level cases, which is an excellent preparation for chief year.
• R3 has the opportunity of preceptorship with one of the private surgeons. Typically, the R3 rounds with the resident team in the morning, then follows the preceptor to the operating room or the private office. This is a great opportunity to develop a one-on-one relationship with the attending, and allows the resident to gain tremendous insight as to their overall practice and be more thoroughly exposed to the continuum of care across in-patient and out-patient settings. In the absence of the chief, R3 assumes the role of the team leader.
• R2 functions as the primary consult resident on call days and provides direct supervision and guidance to the intern. On off call days, the operative experience of the R2 is focused on bread-and-butter general surgery cases in the Ambulatory Surgery Unit, as well as basic laparoscopic acute care surgery cases in the Main Operating Room.
• R1(s) works in collaboration with the Red Team APP to maintain the daily work of the service: discharges, checking AM labs, ordering and following-up on various tests and studies discussed during sign-out, responding to nurse calls on the floor, and maintaining “the list”. The operative experience of the intern is primarily at the Ambulatory Surgery Unit focusing on skin and soft tissue as well as basic general surgical cases.
• The Red Team APP is responsible to maintain the daily work of the service: discharges, ordering and following-up on various tests and studies discussed during sign-out, responding to nurse calls on the floor, and participating in daily progression rounds.

Surgical Subspecialties

Acute Care, Breast, Colorectal, Endocrine, General, Hand, Minimally Invasive and Robotic, Plastics, Surgical Oncology, Thoracic, Trauma, and Vascular Surgery.

Clinic

Weekly General Surgery Clinic on Wednesday afternoons, with direct supervision of an Acute Care Surgeon.

Call

The resident team takes call three days a week on Monday, Thursday, and Saturday. The call team is composed of a senior and a junior resident, and is responsible for all in-house surgical patients, line insertions, bedside procedures, operative cases, and surgical consults in the ED or the medical floors.