VCU Department of Surgery

Surgery Grand Rounds are held each Thursday morning from 7:00 – 8:00 am and are part of the Thursday Morning Didactic Teaching Conferences. (Appendix A - Grand Rounds Schedule 2006 - 2007).

The Grand Rounds lectures consist of presentations on clinical topics stressing evolving surgical techniques, new management principles of surgical patients, rare and/or complex cases and current and ongoing research endeavors related to surgery. Visiting Professors give about 20% of the lectures and about 40% of the Grand Rounds Conferences are given by members of the VCU faculty or other Departments at VCUHS. PGY-4 and PGY-5 residents are required to present interesting cases and/or debates. The residents are responsible for providing a review of supporting literature from opposing opinions.

The GME office hosts a Grand Rounds Conference monthly relevant to the Six Core Competencies as outlined by the ACGME. In addition to the regularly scheduled Grand Rounds September through June, the department has the Resident Educational Summer Series (Appendix B – Resident Educational Summer Series 2007) July through August. The topics covered include Shock/Trauma, Fluids and Electrolytes, Hemostasis, Coagulation, Transfusions, Sleep Deprivation, Fatigue and Effects on Performance, Impaired Physicians, Professionalism, Medical Malpractice, Financial Planning, Chart Documentation Pitfalls, and Overview of Coding and Billing. These presentations are given by faculty, hospital and administrative staff, each presenting from their areas of expertise. Attendance is required for the residents. The Thursday morning didactic conference is teleconferenced to the VAMC for faculty, residents and students.

Each year the Department of Surgery hosts Research Day. Dr. Thomas Miller, Vice Chair for Research invites a nationally recognized researcher to present at Grand Rounds (on Thursday) and to judge the residents research work in a special conference on Wednesday afternoon. All surgery residents who have conducted or are currently conducting research are required to present for Research Day. (Appendix C – Research Day 2007 Program)

OBJECTIVES:
Residents will attend 75% or greater of the Grand Rounds Teaching Conferences.

PGY 4 and 5 residents will present Interesting Cases and participate in debates examining options in treatment and care of surgical patients and building communication and presentation skills.

Residents will practice presentations for research and publications accepted for national and regional meetings, incorporating critiques from faculty and peers.

Basic Science Conference

The Basic Science conference, also a component of the Thursday Didactic Conference, offers presentations of core specialty knowledge, including teaching in evidence based medicine and is presented in a two-three year cycle.

Residents are assigned topics and are expected to prepare presentations, with handouts, covering the basic and clinical science fundamentals to surgery in general collaborating with their faculty mentor in preparing for their presentation. Following the presentations by the Residents, the faculty mentors present the clinical aspects relating to the topics and pose questions to the residents in many formats, including case presentations and surgical jeopardy. The basic science curriculum is designed to provide level specific lectures for the PGY1, PGY-2, and Lab residents. The senior level conference provides a more advanced lecture series for the PGY 3, 4 and 5 residents.

The primary textbook for the junior residents is The Surgical Review: An Integrated Basic and Clinical Science Study Guide by Kreisel et. al., The Essential Practice of Surgery by Li, et. al. The seniors use Current Surgical Therapy byCameron. They review material in the above mentioned textbooks as well as others and current literature available on the assigned topics. Residents are expected to be prepared to actively discuss and interact during the question and answer session. Intermittent quizzes are administered.

In addition to the Basic Science lectures, Skills Sessions are intermittently scheduled throughout the year, junior level residents participate in the more basic level Skills Sessions including knot tying and suturing and the senior participate in the more advanced level Skills Session including advanced laparoscopic skills and vascular anastomosis.

The Department of Surgery has partnered with the VCU Anatomy Department to offer cadaver dissection two to three times per year. All residents have access to Vesalius which is an internet based educational tool for anatomy and surgical technique.

VCU received a $2 million federal grant to train health professionals in geriatric care. The grant focuses on improving the training of health professionals on issues such as cognition and dementia, nutrition and obesity prevention and treatment, end-of-life care, mental health and the prevention of dependence brought on through falls. The General Surgery residents receive extensive training and lectures in geriatric medicine. Dr. Peter Boling, Professor of Medicine and Geriatrics has developed a curriculum specifically addressing the geriatric surgical patient.

Residents apply knowledge to clinical decisions through Q & A sessions with faculty mentors.

Residents are administered intermittent quizzes based on lectures and reading materials.

PGY 1’s, 2’s and lab residents are administered mock orals once a year to assess their clinical decision making and application of basic science to pre-op and post-op care and the core components of general surgery, as well as the sub-specialties. PGY 3’s, 4’s and 5’s are administered mock orals once a year to assess their knowledge base and clinical decision making in the care of the surgical patient.

All categorical residents and the designated preliminary residents for plastic surgery are required to take the In-service exam administered through the American Board of Surgery.

ASSESSMENT:
Program Director reviews conference attendance of residents at least quarterly and disciplinary action can be taken for residents whose attendance falls below 75%.

Intermittent quizzes are graded and reviewed by the Program Director. The results are discussed in meetings with the Program Director and mentors.

Surgical skills development is critiqued by supervising fellows and/or faculty members in Skills Sessions.

Journal Club is held monthly on Thursdays during the Thursday Morning Didactic Conferences. Evidence based Reviews in Surgery (EBRS) is the program used for articles being reviewed for Journal Club. EBRS is an on-line journal review program available through the Division of Education of the American College of surgeons, http://www.facs.org/education/ebrs.html

The form below is to aid in the evaluation of the article(s) in order to provide a critical assessment.