Goals and Objectives of the Residency Program
GOALS OF THE UAMS SURGERY RESIDENCY
PROGRAM
1. To provide a program of training which will prepare physicians for
certification by the American Board of Surgery for practice in the specialty
of Surgery, and as a prerequisite for further training in other surgical
specialties or subspecialties.
2. To provide designated preliminary training for physicians who are
accepted into residency training programs requiring or accepting one or more
years of prerequisite surgical experience.
3. To provide undesignated preliminary training for one to two years for
selected physicians who wish to complete residency training in a surgical
specialty but who have not yet been accepted into a surgical training
program.
EDUCATIONAL
OBJECTIVES OF THE UAMS SURGERY RESIDENCY
The pursuit of
a surgical education is both physically and intellectually challenging.
Rarely is one’s performance flawless, but we expect our residents to make
both an honest effort and good progress towards attainment of all
educational objectives.
We insist that the following
critical requirements be met by all members of our professional community,
regardless of level of training. These requirements are so crucial that the
inability to meet any one of them may be cause for dismissal from our
program. These critical requirements are:
1. Residents must act with complete honesty and integrity in the
treatment of patients and in research.
2. Residents must act in accordance with the responsibilities inherent
in the surgeon-patient relationship.
3. Residents must interact in a professional manner with physicians,
students, nurses and other members of the health care team.
ACGME GENERAL COMPETENCIES
The Accreditation Council
for Graduate Medical Education (ACGME) has identified the following six
general competencies that describe the general outcomes expected in the
conduct of Graduate Medical Education. Specific expectations of the
Residency Review Committee for Surgery are listed in parenthesis following
each General Competency description. By completion of training, residents
must become competent in these six areas at the level expected of an
entry-level surgical practitioner.
1.
Patient Care that is compassionate, appropriate, and effective for
the treatment of health problems and the promotion of health.
(Surgical residents
must: demonstrate manual dexterity appropriate for their training level and be able to develop and execute patient care plans)
2.
Medical Knowledge about established and evolving biomedical,
clinical, and cognate (e.g. epidemiological and social-behavioral) sciences
and the application of this knowledge to patient care.
(Surgical residents are
expected to: critically evaluate and demonstrate knowledge of pertinent scientific information)
3.
Practice-Based Learning and Improvement that involves
investigation and evaluation of their own patient care, appraisal and
assimilation of scientific evidence, and improvements in patient care.
(Surgical residents are
expected to: critique personal practice outcomes and demonstrate a recognition of the importance of lifelong
learning in surgical practice)
4.
Interpersonal and Communication Skills that result in effective
information exchange and teaming with patients, their families, and other
health professionals.
(Surgical residents are
expected to: communicate effectively with other health care professionals, counsel and educate patients and families, and
effectively document practice activities)
5.
Professionalism, as manifested through a commitment to carrying
out professional responsibilities, adherence to ethical principles,
and sensitivity to a diverse patient population.
(Surgical residents are
expected to: maintain high standards of ethical behavior, demonstrate a commitment to continuity of patient care, and
demonstrate sensitivity to age, gender and culture of patients and other health care
professionals)
6. Systems-Based Practice as manifested by actions that
demonstrate an awareness of and response to the larger context and system of
health care and effectively call on system resources to provide optimal care.
(Surgical residents are
expected to: practice high quality, cost effective patient care; demonstrate knowledge of risk-benefit analysis; and demonstrate
an understanding of the role of different specialists and other health care
professionals in overall patient management)
The following general educational objectives
amplify the expectations of the ACGME General Competencies and apply to
residents at all levels. These objectives characterize the general
requirements for successful completion of our residency program. A
continuum of achievement in accomplishing these goals throughout residency
training will serve as one marker of satisfactory progress.
1. The ability to evaluate surgical patients, including recognition of
medical or surgical emergencies which threaten life or limb and require
initiation of emergency medical or surgical care.
2. The ability to develop, defend and carry out a rational plan of care
for surgical patients.
3. The ability to understand and participate in surgical education and
research. All residents are expected to develop proficiency in use of
surgical literature. Categorical residents who enter the program in July,
2000 and after are expected to complete one project that is accepted for
publication in a peer-reviewed journal or presented at a major surgical
meeting prior to completion of residency training.
4. Demonstration of a humane and considerate approach to patients and
family members.
5. Proficiency in written and oral communication in bedside care, case
presentations, the medical record and manuscripts.
6. Satisfactory and timely completion of medical record
responsibilities.
The following yearly educational objectives characterize our specific
expectations for the professional maturation of our residents. Promotion
(or program completion in the case of PGY-5 residents) will generally be
dependent on satisfactory achievement of these objectives.
PGY-1 residents are
expected to accomplish and maintain the following objectives:
1. Establish basic proficiency in the evaluation of patients under
routine and emergency circumstances (recognizes surgical emergencies,
performs a history and physical examination, orders appropriate basic
ancillary studies, effectively communicates findings to other physicians.
2. Establish basic proficiency in providing pre-operative and
post-operative care (writes appropriate pre-op and post-op orders for floor
patients, handles nursing calls appropriately, manages most routine
postoperative care with minimal intervention by supervisors).
3. Develop a working knowledge of common problems in general surgery,
vascular surgery, cardiothoracic surgery, surgical oncology and pediatric
surgery (achieves acceptable grade on rotation evaluation).
4. Establish a working knowledge and familiarity with common procedures
of the surgical specialties (achieves acceptable grade on rotation
evaluation).
5. Acquire basic operative skills necessary to perform less complex
surgical procedures, such as hernia repair, central line procedures and
minor outpatient surgery. (assessed by direct observation by faculty or
senior residents)
6. Develop a working knowledge of and familiarity with the management of
common problems in plastic and reconstructive surgery (achieve specific
goals & objectives on this service, assessment of technical skills by direct
observation).
7. Develop personal values and interpersonal skills appropriate for the
surgical resident (is available at required times, gives patient care needs
highest priority, complies with department and university policy, is not
subject of excessive or substantial complaints from patients, families or
other members of the health care team).
PGY-2 residents are
expected to accomplish and maintain the following objectives:
1. Develop enhanced proficiency in the provision of pre-operative and
post-operative care (manages pre-operative and post-operative care of
complex patients with minimal intervention by supervisors).
2. Establish a knowledge based and skill proficiency for the management
of the critically ill surgical patient and the burned patient (achieves
acceptable grade on rotation evaluation, can place endotracheal tube, S-G
catheters, arterial lines, and perform escharotomy).
3. Develop organizational and teaching skills necessary for basic
management of a surgical service (attends efficiently to organizational
duties of service such as organizing rounds and teaching sessions,
participates in organized teaching activities for medical students under
faculty supervision).
4. Acquire proficiency in surgical endoscopy (successfully performs
colonoscopy, EGD, anoscopy, bronchoscopy).
5. Develop a working knowledge of and familiarity with the management of
common problems in thoracic surgery (achieve specific goals & objectives on
this service, performs uncomplicated general thoracic surgical procedures).
6. Increased skill in operative technique required for procedures of
increasing surgical complexity, such as skin grafting, more complex hernia
repairs and complex soft-tissue surgery (is able to perform these operations
with minimal assistance).
PGY-3 residents are
expected to accomplish and maintain the following objectives:
1. Continues to develop technical skills necessary for the performance
of more complex surgical procedures in general, vascular and minimally
invasive surgery (performs laparoscopic cholecystectomy, small bowel
resection, uncomplicated aneurysm repair and other procedures of similar
complexity).
2. Establish a knowledge base, judgment and interpersonal skills
necessary to function as a surgical consultant (successfully manages simple
consults with minimal help).
3. Develop enhanced skills in the management of a surgical service
(manages service administrative duties assigned by chief resident or
faculty).
4. Develop knowledge and skills necessary for function as the trauma
team leader for adult patients (successfully directs trauma resuscitations
with faculty supervision and review).
5. Proficiency in the rational use of surgical literature and
evidence-based medicine (defends discussions and recommendation with
scientific evidence).
PGY-4 residents are
expected to accomplish and maintain the following objectives:
1. Continue to develop knowledge and skills necessary for the complete
management of common problems in general surgery, pediatric surgery,
thoracic surgery and surgical oncology (manages most common problems in
these specialties with minimal assistance).
2. Develop knowledge and skills necessary for function as the trauma
team leader for pediatric patients (successfully directs trauma
resuscitations with faculty supervision and review).
3. Demonstrates satisfactory performance as a teacher of junior
residents and medical students (receives acceptable feedback from students
and peers).
4. Demonstrates interpersonal skills and conduct required for
surgical practice in the private practice setting. (receives individual
feedback and acceptable rotation evaluation from private surgery faculty).
PGY-5 residents are
expected to accomplish and maintain the following objectives:
1. Develop knowledge and skills necessary to assume complete
responsibility for the management of the surgical patient, including mastery
of the fundamental components of surgery as defined by the American Board of
Surgery (achieves acceptable score on written and oral examinations and
receives acceptable rotation evaluations).
2. Proficiency in management of complex problems in general surgery,
vascular surgery, surgical oncology and trauma (treats complex problems in
the discipline with minimal help).
3. Demonstrates personal and professional responsibility, leadership
skills and interpersonal skills necessary for independent practice as a
specialist in surgery (successfully manages the chief resident services).
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