Rotation Structure

The Program provides clinical learning and experience in the pre-operative, operative and post-operative learning and surgical experience for patients with all diseases which fall within the scope of practice of general surgery including:

1. Skin and soft tissue
2. Diseases of the head, neck and endocrine system
3. Diseases of the gastrointestinal tract and other abdominal viscera
4. Diseases of the breast
5. Diseases of the abdominal wall
6. Thoracic surgery and diseases of the vascular system
7. Trauma, emergency surgery, surgical critical care
8. Endoscopy

• The PGY 1 resident must also:
  • Attend (Detroit Medical Center / Wayne State University Medical School) Trauma Symposium
  • Take annual ABSITE In-Service Examination
  • Pass COMLEX 3 / USMLE STEP 3 before a contract will be offered for PGY2 position
  • Participate in mandatory board review and M&M conferences and attend trauma clinic when on trauma rotations
  • Participate in weekly ½ day Outpatient Surgery Clinics
• All seriously or critically ill, as well as recent post-operative patients, will be seen prior to commencing with the daily operating schedule.
• All admissions are to be reviewed and seen by the resident staff. Admission history and physical examinations, admission notes, and orders may be delegated to other house staff, but the resident is responsible for their completeness and appropriateness.
• Patient rounds should be made with the attending surgeon daily.
• The resident should see all patients on the service daily except during a resident's off duty weekend.
• The resident shall conduct a detailed study of the following day's surgeries; including anatomy, surgical technique, potential complications and operative indications. Laboratory data and x-rays for each case should be reviewed.
• The resident shall accompany surgeons during their performance of consultations, or review consultations within 24 hours.

• The PGY 2 resident must also:
  
  • Attend trauma clinic when on trauma rotation
  • Attend SCS (or equivalent) ATLS course
  • Attend (Detroit Medical Center / Wayne State University Medical School) Trauma Symposium
  • Participate in weekly ½ day Outpatient Surgery Clinics
  • Conduct a scholarly project in accordance with the ACGME guidelines.
  • Take annual ABSITE In-Service Examination

• It is expected that all seriously ill or critically ill as well as recent post-operative patients will be seen prior to commencing with the daily operating schedule.
• All admissions are to be reviewed and seen by the resident staff. Admission history and physical examination, admission notes, and orders may be delegated to other house staff, but the resident is responsible for their completeness and appropriateness.
• Patient rounds should be made with the attending surgeon daily, if possible. If not possible, the resident should see all of the patients on the service daily except during the resident's off duty weekends.
• The resident shall conduct a detailed study of the following days' surgeries; including anatomy, surgical technique, potential complications and operative indications. Laboratory data and x-rays for each case should be reviewed.
• The resident shall accompany surgeons during their performance of consultations or review consultations within twenty-four hours.
• The resident shall participate in the education of interns, students, and other trainees.

• The PGY 3 resident must also:
  • Attend (Detroit Medical Center/Wayne State University Medical School) Trauma Symposium
  • Conduct a scholarly project following ACGME guidelines
  • Take annual ABSITE In-Service Examination
  • Attend trauma clinic when on Trauma rotation
  • Complete skill requirements for FLS certification  
  • Participate in weekly ½ day Outpatient Surgery Clinics
• The third-year resident should be capable of increased independent, but supervised care of the surgical patient.
• PGY 1 and 2 responsibilities continue.

• The PGY 4 resident must also:
  • Attend (Detroit Medical Center/Wayne State University Medical School) Trauma Symposium
  • Conduct a scholarly project following ACGME Guidelines
  • Take annual ABSITE In-Service Examination
  • Participate in weekly ½ day Outpatient Surgery Clinics
• The resident having progressed to this point should be able to care independently (although with supervision/observation) for the general surgical patient. The resident, however, should still require guidance in the care of the more complicated cases.
• PGY 1, 2 and 3 responsibilities continue.
• The resident shall complete FES Certification

• The PGY 5 resident must also:
  • Attend (Detroit Medical Center/Wayne State University Medical School) Trauma Symposium
  • Conduct a scholarly project following ACGME guidelines
  • Take annual ABSITE In-Service Examination
  • Participate in weekly ½ day Outpatient Surgery Clinics
• The fifth year resident should be able to assume almost total care of most general surgery patients. It is to be remembered that the attending surgeon remains morally and legally responsible for the patients' total care. The resident's treatment plan should only be followed after discussion with the attending surgeon.