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Rotations on the following services with defined goals and objectives ensure the resident an understanding of the principles and personal clinical experience: non-cardiac Thoracic Surgery (one month SJMH, PGY-V years), Pediatric Surgery (one month, University of Michigan Health System, PGY-IV year), experience on the Trauma Service (SJMH, PGY-I through V years), and experience on the Critical Care Service (SJMH, PGY-I through III years), Plastic Surgery (one month, SJMH, PGY-II year), Transplant Surgery (one month, University of Michigan Health System, PGY-II year). The resident has responsibility for the total care of these surgical patients by direct participation in preoperative evaluation, intraoperative care and decision-making, and postoperative management. These functions are performed under the direct supervision of attending faculty members.

For Gynecology, Neurological, and Orthopedic Surgery experience, which do not include separate rotations, the resident is exposed to the principles of these specialties through basic and clinical science lectures, textbook reading and presentations at Death & Complication and Trauma Audit Conferences, as well as involvement in the clinical management of these patients. Gynecologic experience is obtained through evaluation and management of females with abdominal pain in the emergency room and with gynecologic malignancies requiring bowel and major viscera resections. SJMH is a large, busy Level-II Trauma Center with a predominance of blunt trauma. All patients with multiple injuries requiring admission to the hospital are initially admitted onto the Critical Care Service where they are managed by the general surgery residents under the supervision of the attending general surgeon. Patients with multiple injuries frequently require both Neurological and Orthopedic Surgery, evaluation, and care. Patients remain on the Critical Care Service for varying lengths of time, and there is frequent interaction with both neurosurgery and orthopedic surgery staff and residents where these problems are discussed and appropriately addressed.

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