Clinical Experience: The Hospital of Central Connecticut

Introduction

The surgery rotation at The Hospital of Central Connecticut (THOCC) provides residents with the opportunity to practice in an engaging, supportive, and well-balanced community hospital environment. The rotation offers a broad spectrum of surgical pathology and a diverse operative experience in a setting that combines a more measured pace with strong clinical and educational opportunities.

Residents care for a wide breadth of surgical patients and gain operative exposure ranging from straightforward ambulatory procedures to complex cases in surgical oncology, colorectal, thoracic, vascular, and acute care surgery. The rotation is designed to progressively increase resident autonomy while maintaining close attending supervision and an emphasis on education.

Team Structure

PGY4, PGY2, PGY2, PGY1(s), Designated APP

Team Member Roles

Each member of the team has a distinct yet collaborative role, with responsibilities designed to promote progressive autonomy, operative experience, and leadership development.

R4
The R4 serves as the senior resident and runs the service under direct attending supervision. The R4 leads daily bedside rounds, providing junior residents with opportunities to present their patients, develop assessment and management plans, and participate in clinical decision-making. Afternoon rounds are expected to have a strong educational focus and are led by the R4.

One of the major highlights of the rotation is the R4’s priority for operative case selection. The R4 has first pick of appropriate index-level cases, providing valuable operative experience and excellent preparation for the transition to chief resident year.

R3
The R3 has the opportunity to take chief call, providing increased autonomy and an opportunity for continued growth in clinical decision-making and leadership. Chief call also facilitates close one-on-one interaction with attending surgeons, allowing the resident to gain valuable insight into different surgical practices, approaches, and decision-making styles. When the R4 is unavailable, the R3 assumes responsibility for leading the team.

R2
The R2 serves as the primary consult resident on call days and provides direct supervision and guidance to the intern. On non-call days, the R2’s operative experience focuses on bread-and-butter general surgery cases in the Ambulatory Surgery Unit, as well as basic laparoscopic and acute care surgery cases in the Main Operating Room.

R1(s)
The R1 works closely with the Red Team APP to manage the day-to-day needs of the service. Responsibilities include patient discharges, reviewing morning laboratory results, ordering and following up on studies discussed during sign-out, responding to nursing calls, and maintaining the daily patient list.

The intern’s operative experience is primarily based in the Ambulatory Surgery Unit, with an emphasis on skin and soft-tissue procedures and basic general surgery cases.

Red Team APP
The Red Team APP provides continuity and support for the daily management of the service. Responsibilities include facilitating discharges, ordering and following up on diagnostic studies, responding to nursing calls, participating in daily progression rounds, and assisting with overall service coordination.

Surgical Subspecialties

Residents have exposure to a broad range of surgical specialties, including:

  • Acute Care Surgery
  • Breast Surgery
  • Colorectal Surgery
  • Endocrine Surgery
  • General Surgery
  • Hand Surgery
  • Minimally Invasive and Robotic Surgery
  • Plastic Surgery
  • Surgical Oncology
  • Thoracic Surgery
  • Trauma Surgery
  • Vascular Surgery

Clinic

Residents participate in a weekly General Surgery Clinic on Wednesday afternoons, with direct attending supervision from an Acute Care Surgeon. The clinic provides experience in preoperative evaluation, postoperative follow-up, longitudinal patient care, and clinical decision-making in the outpatient setting.

Call

The resident team takes call three days per week: Monday, Friday, and Sunday. The call team consists of a senior and junior resident and is responsible for the care of in-house surgical patients, surgical consultations from the Emergency Department and medical floors, line placement, bedside procedures, and operative cases.

Designated APP coverage is available for trauma, providing additional support for the resident team and facilitating timely management of trauma patients.