This Colon and Rectal Surgery Residency program is one year in duration. Nine months are spent at the sponsoring institution, St Joseph Mercy Hospital in Ann Arbor, MI, on the Colon and Rectal Surgery service. The resident will rotate for three months month at the University of Michigan to include one month at the Michigan Bowel Control Center (Pelvic Floor Disorder Clinic). This Colon and Rectal Surgery program provides the resident with a deep and broad academic and clinical training environment.
At St Joseph Mercy Hospital, the resident will work with 4 busy Colon and Rectal surgeons with large clinical inpatient and outpatient volumes. The resident will have the opportunity to see and thoroughly evaluate patients before surgery in the on-campus office of these surgeons. Here, the resident will see patients with faculty and Enterostomal Nursing, and will actively participate in preoperative planning. The resident will be an integral part of the Enhanced Recovery (Fast Track) Patient Safety and Quality Initiative, a program that begins with comprehensive pre-admission patient education of expectations and milestones. The resident will have the opportunity to closely follow postoperative patients, thereby ensuring continuity of care. With progressive autonomy, the resident will increasingly lead the discussion with patients to include options, risks, and benefits in preparation for independent practice. Patients will evaluate this experience. Opportunities are plentiful for those residents interested in learning about the intricacies of a surgery office, including preparation for evaluating employment options. In addition, the resident will see colorectal cancer patients in the Multidisciplinary GI Cancer Clinic on Tuesday immediately following the Multidisciplinary GI Cancer Conference. The resident will have space with a desk and computer and will, in many ways, be treated as a member of the faculty in preparation for independence.
The resident will make daily rounds on the dedicated Colon and Rectal Surgery service with a team composed of General Surgery residents and medical students. The Colon and Rectal Surgery resident leads the bedside discussion for those patients that he/she evaluates in consultation in the office, operating room, emergency room, or Patient Care Units. The Chief General Surgery resident leads the bedside discussion for the other patients on the service with the Colon and Rectal Surgery resident serving as a guide, resource, junior attending, and valuable member of the team. The entire inpatient service is discussed immediately after rounds at the Discharge Planning Meeting. This meeting is held in a conference room on the Patient Care Unit and is attended by faculty, Colon and Rectal Surgery resident, General Surgery residents, Nutrition, Case Manager, Social Worker, Home Care Nurse, Enterostomal Nursing, Clinical Nurse Leader, and others. Enhanced Recovery concepts are detailed at this meeting with special attention to discharge needs.
The resident will have the opportunity to see Emergency Department and inpatient consultations during the day and when on call in the evening. All daytime Colon and Rectal Surgery consults are paged to the Colon and Rectal Surgery resident through WebXChange. Faculty are available to staff consultations 24 hours a day.
The Colon and Rectal Surgery resident will take call 2 days a week and 2 weekends a month during the nine months at St Joseph Mercy Hospital. At night and on weekends, the Emergency Department General Surgery resident will call the Colon and Rectal Surgery resident first when that resident is on call. The Colon and Rectal Surgery resident will call the appropriate Colon and Rectal Surgery faculty through WebXChange or via mobile phone. Decision-making for Emergency Department and Patient Care Unit consults will be based on the Colon and Rectal Surgery Supervision Policy, the document of which is reviewed with the Program Director. The Colon and Rectal Surgery resident will faithfully log patient encounters appropriately on the ACGME Log Case System website on a daily basis and this is monitored on a weekly basis by the Program Director. Duty hour regulations are strictly adhered to, monitored 24/7, and evaluated monthly at the Surgery Education Committee Meeting.
The program at the sponsoring institution includes an extensive on-campus outpatient anorectal surgery experience. Here, the resident will participate in operations for a broad and comprehensive spectrum of anorectal disease to include hemorrhoids, fissures, fistulas (fistulotomy, advancement flaps, LIFT procedures, plug procedures), pilonidal disease, and condyloma. This is detailed in the document entitled Competency Based Assignment Goals and Objectives.
The resident will be well trained in interventional colonoscopy, flexible and rigid sigmoidoscopy and anoscopy. At least one half day a week is devoted to the Endoscopy Suite. Some of the endoscopy experience in gained in the office outpatient setting.
The operative experience in this residency program is broad and comprehensive. The resident will participate in open, laparoscopic, and robotic surgery for colon and rectal cancer, diverticulitis, lower gastrointestinal hemorrhage, chronic constipation, inflammatory bowel disease, rectal prolapse, retrorectal neoplasms, carcinoid and other neoplasms, and many other colorectal diseases. The Program Director assigns cases on a daily basis, ensuring that operative needs are met with the Competency Based Assignment and Objectives document as a guide. This program is somewhat unique because of the robotic experience. The Program Director has been assigned by the Association of Program Directors for Colon and Rectal Surgery to develop a standardized robotic curriculum for residency training that will be submitted for approval by the American Society of Colon and Rectal Surgeons. The Program Director is faculty for the national Mentor-Fellow Robotic Training Course. The Colon and Rectal Surgery resident attends this 2-day course designed to allow the faculty and resident to safely perform dual console cases upon return to their institution. As a result of this, some of our residents are prepared to start a Colon and Rectal Surgery Robotics program upon completion of the residency year. Operative skills for open, laparoscopic, and robotic surgery are mentored and evaluated with formative feedback over the course of the year. ACGME Case Logs for operative cases, endoscopic cases, Disease Management outpatient patient encounters, inpatient and Emergency Department consults are maintained on a daily basis and monitored by the Program Director on a weekly basis. The resident receives progressive autonomy so that upon completion of the residency, the resident is more than capable of independently caring for and operating on patients with diseases of the colon, rectum, and anus.
This program is very committed to resident education. The Program Director (Dr Cleary) was Assistant Program Director for the General Surgery residency for 7 years. One of the Colon and Rectal Surgery Faculty (Dr Eggenberger) is currently the Program Director for the General Surgery residency. This unique collaboration is dedicated to comprehensive education of the resident with regard to diseases of the colon, rectum, and anus, and ensures that the General Surgery resident and Colon and Rectal Surgery resident both benefit from this collaborative opportunity.
The resident education program is characterized by the Comprehensive Written Curriculum that covers all defined components of colon and rectal surgery. The Plan-Do-Study-Act program, which includes structured text reading, literature assimilation and appraisal, video analysis and simulator modules, NSQIP and MSQC database analysis, Death and Complications presentations, and a Grand Rounds presentation, is specifically designed to address Medical Knowledge, Patient Care, and Practice-Based Learning and Improvement.
a) ASCRS text
This text, sponsored by the American Society of Colon and Rectal Surgeons, is the text referenced for questions on the CARSITE and Qualifying Board Examinations. For this reason, we have chosen to use this text and the resident is provided this text on arrival.
b) CREST Curriculum
This is an online module of all relevant diseases of the colon, rectum, and anus. The Program Director is the author of the Anal Fissure module. It is analogous to the SCORE curriculum for General Surgery and will soon be widely available.
c) Evidence-Based Reviews in Surgery
The resident will participate in all 6 modules starting in October and jointly sponsored by the American College of Surgeons and Canadian Association of General Surgeons. The resident will participate in a list-serve discussion that is followed by clinical and methodological expert reviews, and then a post-test. This program is an excellent opportunity to critically appraise literature and incorporate what is meaningful and appropriate into practice. It also is an excellent Maintenance of Certification option.
d) Video Analysis
The Program Director actively records many operative procedures. These videos are edited and available for resident education. Many are state-of-the-art robotic colorectal surgery videos used at national meetings to include the Mentor-Fellow Robot Instruction Course. We are constantly monitoring other video available online including the American College of Surgeons Video Library.
Tuesday morning is devoted to education and attendance is mandatory for residents and staff. Education and Evaluation of the Colon and Rectal Surgery resident in this program is based on the 6 Core Competencies. The Colon and Rectal Surgery Preoperative Conference, Discharge Planning Rounds, Ethical issues in Clinical Surgery, LIFE curriculum for sleep deprivation, fatigue, and professionalism, Root Cause Analysis and Ann Arbor Patient Safety Meetings, and Patient Safety Checklist are designed to address Interpersonal Skills, Professionalism, and Systems-Based Practice. Evaluation of the resident is 360 degrees to include Attending Staff, Nurses, General Surgery residents, Self, and Patients, and is based on Core Competencies. The resident will review CARSEP cover to cover and be prepared to take the annual CARSITE examination in November, and will participate in the annual multi-institutional (4 Michigan residency programs) Mock Oral Exam that is held at our institution. The resident is expected to follow and adhere to all SJMHS GME policies and procedures.
Attendance is documented at, and the resident will evaluate most meetings to include all didactic seminars. When available, we plan to implement the E-form developed by the APDCRS to document resident attendance and participation in educational conferences, academic activities, scientific meetings, and teaching methods.
1) Grand Rounds
This conference occurs twice a month. The resident will have the opportunity to listen to, gain knowledge from, and meet visiting professors and guest speakers. The resident will assimilate and appraise literature and conduct one Grand Rounds presentation during the spring.
2) Death and Complications Conference
The resident will have the opportunity to present cases and participate in discussion of cases relevant to diseases of the colon, rectum, and anus. This is designed to increase knowledge base and develop the ability to assimilate and appraise literature in a critical manner with attention to methodology, and to formulate alternate ideas, which may impact positive changes in practice. The resident is required to complete a practice-based improvement log regarding the case. It is reviewed with the resident by the Program Director. The practice-based improvement log form is filed permanently in the resident’s portfolio. This form includes Patient Data, Effect of Complication on Patient’s Outcome, Which Factors Led To The Complication (unfamiliar surroundings, inappropriate help/support, patient condition, high pressure environment, disease process, etc.), Operating Room Environment, and Non-Operating Room System Factors. These activities help the resident identify knowledge gaps and, along with the Plan-Do-Study-Act learning tool, are designed to promote habits of life-long learning and improvement through personal programs of structured textbook and literature reading and professional activities. The resident is expected to use knowledge gained to educate patients and their families, other health professionals, residents and students.
3) Colon and Rectal Surgery Preoperative Conference
This weekly Monday morning conference is characterized by a discussion of upcoming cases with attention to preoperative, operative, and postoperative teaching points, and with reference to critical appraisal of pertinent literature. It is an opportunity to discuss preoperative evaluation and planning of upcoming surgery patients, potential cultural, socioeconomic, and other special patient needs, as well as perioperative and postoperative expectations, potential complications and how to manage those complications.
4) Colon and Rectal Surgery Didactic Seminars
These weekly Didactic and Core Subject Conferences are designed to cover all relevant topics in Colon and Rectal Surgery. They are based on the ASCRS text and the Program Director provides many other journal-based references. The conference varies in format. Many are short Power Point presentations by the Colon and Rectal Surgery resident based on the ASCRS text. This format allows comprehensive understanding of the topic at hand, while at the same time providing an opportunity for the resident to develop public speaking skills. Others are led by faculty and also attended by the General Surgery residents. This format is a comprehensive examination of topics related to diseases of the colon, rectum, and anus are discussed with reference to and critical appraisal of pertinent literature. This latter format typically occurs on Monday afternoon.
5) Colon and Rectal Surgery Journal Club
This monthly conference is an opportunity to critically evaluate, present, and discuss pertinent literature, with emphasis on Diseases of the Colon and Rectum and the ACS-CAGS Evidence-Based Reviews in Surgery. It is held on Tuesday morning and well attended. Emphasis is often placed on literature related to Pathology, and GI Pathologists are invited, thereby providing a multidisciplinary focus. Using methodology as a guide, the resident is asked to critically appraise the relevant articles. Reviews of each article by experts are also provided when available. Application of this knowledge to patient care will be central to the ensuing discussion. The goal is for the resident to deepen their knowledge about the relevant topic and to learn critical appraisal skills to be utilized when evaluating other articles in the future, thereby facilitating the decision as to what literature should be incorporated into practice and applied to patient care. This process exposes each resident to the skills required to locate, use, appraise, assimilate and apply evidenced based information to their clinical practice
6) Multidisciplinary Cancer Conference
This weekly conference is attended by Pathology, Radiation Oncology, Interventional Radiology, Medical Oncology, Gastroenterology, Oncology Nurse Navigators, Geneticist, and Colon and Rectal Surgery. The resident has the opportunity to present cases and participate in the multidisciplinary discussion of cancers of the colon, rectum, and anus. Pathologic histologic material and imaging studies are analyzed for each patient presented at this conference. Following this one-hour conference, patients discussed in this conference are seen in the Multidisciplinary Cancer clinic by all relevant disciplines. Adjuvant therapies and operative intervention are discussed at length, planned, and implemented at this time. Patients are also considered for regional and national study participation at this time.
7) Multidisciplinary GI Conference
This conference occurs every other month and is attended by Gastroenterology, Radiology, Pathology, Emergency Medicine, and Colon and Rectal Surgery faculty and residents. The resident will have the opportunity to present cases and participate in the multidisciplinary discussion of benign diseases of the colon, rectum, and anus. Emphasis is on the multidisciplinary management of Inflammatory Bowel Disease and innovative colonoscopic interventions.
8) Multidisciplinary GI Oncology Workgroup
This workgroup meets monthly to discuss current and potential studies related to GI Oncology. In addition, the future of Oncology at our institution is evaluated and discussed with attention to innovation. This meeting led to establishing state-of-the-art programs to include CyberKnife radiation for select inoperable tumors and robotic surgery for colorectal cancer. The National Cancer Institute (NCI) considers SJMHS a model Community Clinical Oncology Program (CCOP) and has funded our program since 1994. St. Joseph Mercy Health System, Ann Arbor, is the lead institution in the Michigan Cancer Research Consortium, one of 50 programs nationwide. SJMH is one of the top ten accruing CCOPs in the country, conducting hundreds of CCOP and pharmaceutical trials with 600 to 700 patients enrolled per year. Nationally, we partner with the Mayo Clinic through the Alliance. The resident will learn about planning and reviewing available national study protocols, as well as reviewing current and planning future technologies. This workgroup led to development of the Multidisciplinary GI Cancer Clinic.
9) Faculty Colon and Rectal Surgery Meeting
Faculty, the Office Manager, and Enterostomal Nursing attend this monthly meeting. At this time, the business of the Colon and Rectal Surgery is discussed, issues addressed, and future plans made. Agenda items include new innovations, Enhanced Recovery, research, website updates, and other business-related topics. The Fellowship is a standing item on the agenda. The resident is invited to attend parts of this meeting in preparation for independence upon completion of the program.
10) Research Meeting
See below. This weekly Monday morning meeting is attended by the Director of Research (Michael Franz MD), the Surgical Quality Coordinator (James VandeWarker, BSN), pertinent faculty, research coordinators, and surgery residents involved in Research. All active research projects are discussed, evaluated, and mentored. Potential new topics are discussed. It is at this meeting that the Colon and Rectal Surgery resident will present a research idea. Relevant literature and methodology are discussed. Formal applications to the Research Committee for funding and the hospital IRB are discussed. This group mentors the resident weekly from conception of the research idea to IRB presentation, to implementation of the project, to presentation at regional and national meetings, and to submission for publication.
11) Enhanced Recovery Meetings
Enhanced recovery initiatives are programs of collective standardized evidence-based preoperative, intraoperative, and postoperative bundled, team-based interventions requiring close collaboration between surgeons, anesthesiologists, nurses, dieticians, and home care specialists. They were first implemented in clinical practice and described by Kehlet in 1997 and have also been referred to as enhanced recovery after surgery programs (to emphasize the quality of patient recovery rather than the speed of discharge), fast-track surgery, and standardized care pathways. Many of these evidence-based interventions are believed to attenuate the neurohormonal stress response to surgery, limiting physiologic stress and thereby diminishing complications and organ dysfunction, and enabling more rapid recovery. Enhanced recovery initiatives are rooted in evidence-based literature to improve patient management and outcomes, thereby reducing hospital length of stay and postoperative complications.
An Enhanced Recovery Initiative was implemented at St Joseph Mercy Hospital Ann Arbor on February 14, 2012, after a year of monthly meetings in preparation. Nutrition, Anesthesia, Colon and Rectal Surgery, and other disciplines reviewed literature and proposed evidence-based best practices. There are 17 parts to the initiative that emphasize patient participation in their own recovery, pre-admission education of expectations and milestones, carbohydrate loading, pain management algorithms that wean narcotics, early feeding, and early mobilization. Average hospital length of stay has been decreased to less than 4 days without an increase in readmissions, and 14 have been discharged on postoperative day 1 after robotic colectomies, none of whom required readmission.
The Colon and Rectal Surgery resident actively participates in daily Enhanced Recovery patient care and quickly becomes knowledgeable in Enhanced Recovery details. The resident attends the monthly Enhanced Recovery meetings and participates in the dynamic discussion and Patient Safety and Quality-centered proposals for change in the Initiative.
12) Discharge Planning Meeting
This meeting was developed originally as an extension of the Enhanced Recovery Initiative that went live on February 14, 2012. Enhanced Recovery is a dynamic initiative with monthly meetings designed to improve patient safety and quality outcomes. Discharge planning begins with preadmission education for elective surgical patients. It was determined during Enhanced Recovery meetings that there was room for improvement in the discharge process, from pre-admission education, to discharge instructions during the hospital stay, to Home Care after discharge and managing the outpatient care process. This meeting is held every morning immediately after morning rounds and is attended by Colon and Rectal Surgery faculty, the Colon and Rectal Surgery resident, General Surgery residents, the Patient Care Unit Clinical Nurse Leader, Enterostomal Nursing Staff, the Nutritionist, the Social Worker, the Case Manager, and Home Care Nursing. Every patient on the Colon and Rectal Surgery service is discussed with emphasis on discharge needs, including those in the intensive care unit days to weeks from discharge.
13) Colon and Rectal Surgery Robotic Committee.
St Joseph Mercy Hospital, Ann Arbor, has a robust multidisciplinary Robotic Surgery program composed of Cardiac, Thoracic, Gynecology, Gynecology-Oncology, Urology, General Surgery, Colon and Rectal Surgery, and ENT. The resident will be a member of this committee devoted to monitoring and dynamic evaluation of the robotics program, resident robotic training, collaborative interactions with Nursing, and research efforts.
14) CARSEP/CARSITE Review
The Program Director and faculty will review CARSEP with the resident from cover to cover in preparation for the November CARSITE exam on a weekly basis. Emphasis is placed on the ASCRS text as reference. Many of the questions lend themselves to on-the-spot didactic discussion. Upon receipt of CARSITE results, the Program Director formally reviews knowledge gaps related to this exam. This program makes every effort to assist the resident in preparation for Qualifying and Certifying examinations.
13) Multidisciplinary Mock Oral Examination
This program conceived, implemented, and hosted the first annual multi-institutional Michigan Mock Oral Examination on May 6, 2012. All 4 Michigan Residency programs (William Beaumont, Spectrum in Grand Rapids, Henry Ford Hospital Detroit, and St Joseph Mercy Hospital Ann Arbor) met at our institution. All Colon and Rectal Surgery residents for all programs were invited to participate, including those that finished the year before. Two faculty from each institution participated. The format has been utilized with success by our General Surgery program and closely mimics the formal Certifying Examination. Formative feedback from residents and faculty were received after the exam. The consensus was that it was very valuable and we have therefore continued this Mock Oral exam on an annual basis. The Program Director formally reviews knowledge gaps with the resident related to this exam.
14) Ethics Conference.
The resident will participate in this conference, which is based on the American College of Surgeons “Ethical Issues in Clinical Surgery” text and occurs every other month.
15) Research Advisory Committee Meeting.
The resident will be a member of this committee and attend this monthly meeting which reviews all research projects, publications, local oral presentations, and national oral presentations. The annual spring St Joseph Mercy Hospital Research Forum is also planned at this meeting. The resident will present meritorious work at this annual research forum as well as at the Michigan Chapter of the American College of Surgeons, and the American Society of Colon and Rectal Surgeons Annual Meeting.
16) Surgery Education Committee Meeting.
The resident will be a member of this committee which covers a monthly agenda devoted to surgical residency issues including preparation for exams and research forums, analysis of RRC related issues, and monthly tabulation of resident duty hours.
17) Graduate Medical Education Meeting
The resident will be a member of this committee and attend some of the monthly meetings.
18) Quarterly Clinical Care Collaborative Practice Team.
The resident will be a member of the Gastrointestinal and Nutrition CCCPT which meets quarterly to discuss and advance issues related to Gastrointestinal Disease and Nutrition. This meeting generated the Lower Gastrointestinal Bleeding Algorithm and is investigating an Inflammatory Bowel Disease Multidisciplinary Clinic.
The resident will spend a total of 3 months at the University of Michigan this academic year. One month is devoted to a comprehensive Pelvic Floor Disorder learning experience and the other two are centered on complicated colorectal cases. Here, the resident will gain valuable experience in complicated colorectal cases including ileo-anal J pouches for Ulcerative Colitis and Familial Polyposis, and benefit from the complexity of cases received by this institution from hospitals statewide. The Colon and Rectal Surgery resident will lead the Colon and Rectal Surgery service at the University of Michigan. This service includes a PGY-3 and 2-3 PGY-1 and PGY-2. As there is no General Surgery Chief resident on this service, call for the Colon and Rectal Surgery resident is shared with the PGY-3 resident and the General Surgery Chief resident on the Surgical Oncology service. Call is taken at home and consists of problems for patients on the service. A separate surgery service is assigned to Emergency Room and inpatient consults. The program Director for this rotation is Karin Hardiman, MD.
This rotation is a comprehensive one-month learning opportunity conducted at the University of Michigan Bowel Control Program (MBCP) under the supervision of multidisciplinary faculty at the University of Michigan. This multidisciplinary effort is dedicated to the treatment of patients with defecation and pelvic floor disorders. The multidisciplinary team includes Urogynecologists, Gastroenterologists, Colorectal Surgeons, Physical Therapists, Physical Medicine and Rehabilitation physicians, Radiologists, Clinical Care Coordinators, and GI Physiology Laboratory Nursing staff. The MBCP team mission is to improve quality of life in a currently underserved population through:
During this month, the Colon and Rectal Surgery Resident will meet competency-based goals and objectives in the clinical and physiologic evaluation of, and treatment of patients with defecation and pelvic floor disorders, including constipation, dysmotility, anismus, and other forms of pelvic outlet obstruction; fecal incontinence; and rectal and pelvic prolapse, rectocele, and solitary rectal ulcer syndrome.
The resident will demonstrate a high level of skill and dexterity in the performance of essential procedures and in the interpretation of clinical and laboratory study results to include anorectal manometry, anorectal ultrasound and pelvic magnetic resonance imaging (MRI), electromyography, pudendal nerve motor terminal latency testing, defecography, and transit time studies.
This program is multidisciplinary and much of the strength of the program is in the cordial working relationships we have established over decades with Anesthesiology, Gastroenterology, Pathology, Interventional Radiology, Medical Oncology, and Radiation Oncology. We have established a close bond motivated by collegiality and passion for education with the University of Michigan. We are also an integral part of the Multidisciplinary GI Oncology Work Group and actively participate in the weekly Multidisciplinary Cancer Clinic at this institution. The resident has an opportunity to see colon and rectal cancer patients in this clinic, work directly with Gastroenterologists, Radiation Oncologists, Medical Oncologists, Geneticist, and other related disciplines, and will soon utilize teleconferencing with other institutions seeking our advice. The resident will experience Interpersonal Skills and Systems-Based Practice learning from an Oncology Nurse Navigator and Oncology Patient Financial Advisor helping patients find mechanisms to cope with financial hardships.
The resident will actively participate in several Patient Safety and Quality projects including:
The resident receives formative feedback on a regular basis. Some of the tools used to evaluate the resident include Direct Observation, Global Assessment, Structured Case Discussion, Review of Patient Outcomes, Record/Chart Review, CARSEP Review, CARSITE Review, Mock Oral Exam, the Practice-Based Improvement Log, and the Technical Skills and Performance Evaluation.
Global 360-degree evaluations include those from:
The resident will evaluate the faculty and the program at 6 months and again upon completion of the program.
The resident will attend the following meetings:
The resident is provided unique research opportunities. Senior Colon and Rectal Surgery faculty, the Surgery Quality Coordinator (James Vanderwarker, BSN), and research coordinators are intimately involved in all projects and meet weekly, mentoring the resident every step along the way from the conception of the research idea, to formulating best methodology, to submitting Research Committee and IRB proposals, to preparation for presentation at regional and national meetings, to submission for publication. The hospital has a comprehensive IRB and an infrastructure that encourages and supports scholarly activity. The resident will meet regularly with a statistician and have the opportunity for real-time education in statistics and methodology. This Research Department has been prolific in the publication of new literature. The Colon and Rectal Surgery resident will have the opportunity to present meritorious work at a local research forum sponsored by St Joseph Mercy Hospital. In addition, the resident will present at other local and national meetings, to include the annual spring American Society of Colon and Rectal Surgeons Meeting, and will be required to write a manuscript for publication. The resident is allotted a half day per week to work on scholarly activity.
The resident will be responsible for rounding on his/her patients on a daily basis, strictly adhering to and logging duty hours, strictly maintaining case and patient logs (Professionalism Core Competency), committing to the Core Competency-Based education curriculum as described above, attending conferences, teaching General Surgery residents and students, attending clinic, and providing call at stated intervals. The resident will meet with the Program Director on a regular basis to ensure all these goals are met and to ensure any deficiencies are addressed promptly. The resident will learn and promote interpersonal skills and professionalism.
Upon completion of the program, the resident will be well prepared to apply the highest standards of patient care in any academic setting across the country. The resident will be well versed in the management of all relevant diseases of the colon, rectum, and anus. We expect that patients will be genuinely fond of the resident and feel so strongly about the quality of resident care rendered that they would recommend family and friends. Our resident will be well trained in the critical appraisal of current literature and aspire to contribute on a lifelong basis. Upon completion of training, we expect our resident to be an effective and collegial provider in any community or academic practice in the country.