The UT Southwestern General Surgery Residency Program is a five-year program that provides residents with a broad experience in surgery. The program is well rounded with an excellent balance of clinical training, structured education, and research opportunities. The main goal is to prepare the resident for a career in community surgical practice, research, academic surgery, or post-residency fellowship training. There are currently 13 approved categorical positions in the General Surgery Residency Program. Additional preliminary residents train in the program during the first one to three years and matriculate into subspecialties such as neurosurgery, orthopaedic surgery, otorhinolaryngology, oral surgery, plastic surgery and urology.
Rotations during the five years include the general surgery services, trauma services, and surgical specialty services at Parkland Health and Hospital System, The Veterans Affairs North Texas Health Care System, Children's Medical Center Dallas, Zale Lipshy University Hospital, and St. Paul Medical Center.
During the first year of residency, all surgical residents rotate through virtually every division of the department and various specialty departments, including general surgery, trauma surgery, surgical oncology, emergency medicine, neurosurgery, orthopedic surgery, pediatric surgery, plastic surgery, and cardiovascular surgery. Our goal is to expose the trainee to a large number of patients with a vast array of surgical diseases. In the first year, the primary emphasis is on pre- and postoperative care of patients with elective surgical problems.
During the second year of training, there is an increased emphasis on the care of critically ill patients. Rotations during the second year include experience on general surgery, burn surgery, trauma surgery, cardiothoracic surgery, and surgical intensive care. Second-year residents also spend one week with board-certified surgeons in private practice. This special preceptorship gives the resident an intensive experience in the practice of general surgery and has resulted in a larger proportion of graduating residents choosing general surgery as a career.
During the third year, the rotations focus entirely on the general surgery, intensive care, trauma, and vascular services. This is the major operating year for the surgical residents. The third-year resident is in charge of the service throughout the rotation, making the final disposition of patients and performing the majority of the operations under the supervision of the fifth-year resident and faculty surgeon on the service. The structure of the third year is one of the unique features of our surgical training program as the experience gained prepares a resident to receive optimal benefit from the fourth- and fifth-year rotations.
During the fourth year, the rotations focus largely on surgical specialty rotations with major operative experiences in these disciplines: cardiothoracic surgery, gastroenterology, vascular surgery, pediatric surgery, surgical oncology, breast surgery, trauma surgery, and transplant surgery. Each resident also spends four weeks on a special rotation in San Angelo, Texas. This highly popular experience immerses the resident into a more extensive private practice environment with experienced general surgeons. Each resident performs between 60 and 80 major cases during this rotation, including major vascular operations, noncardiac thoracic procedures, and other complex general surgery operations.
During the fifth-year, residents rotate on general surgery and trauma, and services with administrative as well as clinical duties. He or she is an integral part of the surgical team and has significant teaching responsibilities of the junior house staff members and medical students. The fifth-year resident performs the more intricate surgical procedures such as liver resection, advanced laparascopic procedures, and pancreaticoduodenectomies. At the completion of the fifth year, the chief resident has performed approximately 1000 to 1200 major operations and is eligible to sit for the American Board of Surgery Qualifying Examination.
Progression from the PGY-1 to the PGY-5 level involves a graded increase in responsibility at each resident level commensurate with the resident's skills and abilities. Full-time faculty surgeons who have wide interests and well-honed teaching skills cover each of the surgical services.
General Educational Goals and Objectives for GS Residents by PGY Level
Competency-Based Educational Goals and Objectives for Surgery Residents
CONFERENCES
There are numerous scheduled teaching conferences, including weekly teaching rounds on the surgical services, a weekly Chairman's critique conference where patient management is discussed, and surgical grand rounds. One of the more popular conferences, Dr. Robert McClelland's Selected Readings in General Surgery and Current lit, is also held weekly. Finally, each of the surgical services and surgical specialities holds its own teaching conferences, and residents rotating on those services are required to attend conferences given by the faculty and senior residents on those rotations.
RESEARCH/SPECIAL EDUCATION OPPORTUNITIES
All categorical general surgery residents are required to complete scholarly activity on a project of their choosing. Each resident works with a faculty mentor to develop the protocol, conduct the study, and provide the final analysis. The fifth-year resident projects are formally presented at an annual research conference in June. Many of the projects are submitted for publication in a refereed journal at that time.
While formal laboratory research is not required, the categorical general surgery residents are strongly encouraged to take time off from the residency program to conduct investigative work in a laboratory or to participate in some other advanced educational experience. The structured time usually lasts two years, beginning after the third year. Two or three residents each year have opted for this elective program. In addition to direct laboratory experience, other programs have been developed through extramural routes such as the Robert Wood Johnson Foundation Fellowship Program. The goal of this experience is to prepare the resident for an academic career. These residents present their work at national meetings and are published in numerous articles in peer-reviewed journals.
PLACEMENT OF GRADUATES
The UT Southwestern General Surgery Residency Program places a strong emphasis on developing individual careers. Residents are prepared for careers in community surgical practice, research, academic surgery, or post-residency fellowship training. Approximately one-third of our residents enter the private practice of general surgery in areas throughout the country; another third pursue careers in academic surgery; and the final third continue training in post-residency fellowships. Recent graduates have gone on to fellowships in pediatric surgery, vascular surgery, surgical oncology, trauma/critical care surgery, cardiothoracic surgery, transplantation surgery and plastic surgery.