VCU Department of Surgery | About the Department

The Division of Surgical Oncology is responsible for one of the general surgical services at the VCU Medical Center, including participating in the clinical activities of the general surgical service at the Hunter Holmes McGuire Veterans Administration Medical Center (MVAMC).

The Divison plays a key role in the clinical, basic research, and clinical research activities of the Massey Cancer Center, one of 60 NCI-designated cancer centers in the country. The clinical faculty supervises and participates in all general oncologic surgery and provides undergraduate and postgraduate training in General Surgery.

Virtually all of the surgical care of patients with cancer that falls within the realm of general surgery is provided on the Surgical Oncology Service. In addition, this service provides general surgical care for patients with other cancers. Clinical trials research and patient care activities of inpatients and outpatients are an integral part of the service's training.

The Division of Surgical Oncology at VCU's MCV Hospitals has an inpatient census that is generally in the range of 10 to 20 patients. In 2002, there were more than 450 patients admitted to the inpatient service and there were approximately 1,250 operations carried out by this service at VCU's MCV Hospitals (including ambulatory surgical procedures). These included head and neck cancer operations, gastrointestinal operations, breast surgery, soft tissue sarcoma resections, major liver resections, hepatic tumor ablations and a number of other oncologic procedures.

In 2002, more than 894 new patients were referred to the Breast Health Center, the multidisciplinary breast clinic and over 247 new patients were referred to the GI Tumor Center. The usual assignment of housestaff to this service includes one fifth-year surgical resident (Chief), one fourth-year general surgical resident (SAR), two or three first-year surgical house officers and, on occasion, an oral surgery house officer. In addition, there is one post-residency surgical oncology fellow who functions as a junior faculty member. Our service operates three separate operating rooms at VCU's MCV Hospitals (two in the Main OR and one in Ambulatory Surgery) and one at the MVAMC each Monday, Wednesday and Friday. The fellow and the Chief Resident are usually responsible for different surgical cases in separate OR’s and each supervises his/her own "sub-service" patients. Therefore, the participation of the fellow does not reduce or dilute the operative experience of the general surgery house officers. The Chief Resident at the MVAMC is assisted in the operating room by one of our faculty members.

All of the outpatient activities of the Division of Surgical Oncology are conducted in the John Dalton Oncology Clinic and include specific sessions for general surgical oncology patients (mostly GI cancers and sarcomas), a busy breast clinic, a head and neck cancer clinic, and a surgical adjuvant therapy clinic. Through the John Dalton Oncology Clinic and the Massey Cancer Center, the Division of Surgical Oncology is the primary surgical service for the multidisciplinary clinics for patients with breast cancer and GI cancers.

Surgical house officers participate in the outpatient clinics in addition to their training on the inpatient service. This outpatient experience occurs on Tuesdays and Thursdays, giving the residents an opportunity to participate in the diagnostic and pre-operative evaluations as well as long-term follow-up of patients with cancer. At the MVAMC, the Surgical Oncology Clinic is held from 1:00 p.m. to 3:00 p.m. on Wednesdays.

RESIDENCY PROGRAM
The overall goal of the general surgery resident on the Surgical Oncology Service is to learn the basic principles of preoperative and postoperative surgical care as well as to develop basic operative skills. The level of responsibility and performance ranges from basic patient care decisions and performance of relatively minor operative procedures (e.g., breast biopsies, insertion of venous access devices, melanoma excisions) under supervision for PGY-1 trainees, to overall patient responsibility for the entire surgical service and the performance of complex and demanding oncologic operative procedures ( e.g., major liver resections, total gastrectomies and pancreaticoduodenoctomies) during the Chief Resident’s rotation.

In addition to performing intermediate level procedures, (e.g., mastectomies, radical node dissections, colectomies), the fourth-year resident also carries the primary responsibility for evaluating patients for whom consults have been requested by other services. This ranges from newly diagnosed neoplasms to venous access for patients with leukemias and lymphomas to management of acute general surgical problems in patients with any form of cancer. Graduated responsibility during the course of the five-year training in general surgery routinely results in an effective practicing surgeon, who is both technically and intellectually competent to deal with most cancers.

FELLOWSHIPS
The Surgical Oncology Training Program at VCU's Medical Center is a three-year fellowship with one year spent on clinical rotations and two years spent doing Oncology related research. LEARN MORE