UW Department of Surgery Residency Applicants Information

The General Surgery Residency Program at the University of Washington Affiliated Hospitals provides integrated training in all areas of general surgery through an intensive five-year clinical, didactic and investigative program. The program is dedicated to the education of diverse individuals who will become excellent clinicians and many of whom will assume leadership positions in academic medicine.

Like most university-based surgical programs, the University of Washington program provides a rigorous, comprehensive experience that is designed to produce the highest caliber surgeon. It is intellectually as well as physically challenging, with high expectations and standards for its trainees. At the same time it fosters a sense of camaraderie and accomplishment emanating from the collective talent and dedication of the entire department, bolstered by the inspiring environs of the Pacific Northwest.

The University of Washington bears a special responsibility for undergraduate medical education as the sole medical school in the WWAMI area. For our residency program, however, we train graduates of all medical schools based strictly on their qualifications.

Chronology of the Residency Program

First Year

The R-1 is assigned to general surgery for five to six months and to the emergency trauma center at Harborview for one or two months. Experience in the burn center and in cardiothoracic, pediatric, orthopedic, urologic, and neurologic surgery completes the year. When on general surgery, the R-1 serves on a team with medical students and three or four senior surgical residents. Responsibility focuses on initial evaluation and on pre- and post-operative care. The R-1 assists in operations on his/her patients and performs appropriate operative procedures. View a copy of the 2009-10 R1 rotation schedule (44k PDF).

Second Year

The R-2 concentrates on the fundamentals of critical care, with primary responsibility in the ICU's and in the Harborview Emergency Trauma Center. Rotations on various other services, such as transplantation, surgical oncology, surgcial consult service, and cardiac surgery broaden this experience. The R-2 performs operative procedures appropriate to that level of training. View a copy of the 2009-10 R2 rotation schedule (42k PDF).

Third Year

The R-3 spends the year in general surgery at the VA and University of Washington Medical Center where advanced laparoscopy and bariatric surgery is the focus. A rotation as a senior fellow in medical gastroenterology augments the R-3's knowledge and expertise in upper and lower GI endoscopy. On the trauma surgery services the R-3 has their first experience with primary responsibility for leading a team under the direction of a chief resident. This leadership role is reinforced on the burns/plastic service, transplant and pediatric surgery where the R-3 is the senior resident. A community hospital rotation at the Everett Clinic/Providence-Everett Hospital completes the year. The R-3 performs major operations under close supervision. This early acquisition of technical ability permits a shift of emphasis in later years to the refinement of diagnostic sense, clinical and operative judgment, teaching and investigative skills. View a copy of the 2009-10 R3 rotation schedule (39k PDF).

Fourth Year

With the operative experience and surgical maturity gained during the R-3 year, the R-4 fine tunes their knowledge and technical skills on both general surgery and subspecialty services. Rotations on general surgery, advanced GI and hepatobiliary surgery, surgical oncology and advanced laparoscopic surgery at UWMC, and vascular and thoracic surgery at the VA and HMC provide meaningful and rewarding clinical experiences. View a copy of the 2009-10 R4 rotation schedule (35k PDF).

Fifth Year

The chief resident year provides major responsibility in patient care, teaching, and administrative areas. S/he performs the most complex operative procedures, supervises the other residents when appropriate, and assumes responsibility for the operative and supportive care of all surgical patients. Chief residents enjoy a significant amount of decision-making latitude in the context of constant attending staff supervision. As leaders in the program, they also participate extensively in teaching students and residents, clinical investigations, and in departmental and service administrative matters. View a copy of the 2009-10 R5 rotation schedule (39k PDF).

^ TOP

Non-Clinical Training

ISIS Simulation Photo The UW Department of Surgery focuses on the development of the total surgeon in the three areas of intellect, skills and humanity.

All residents are required to complete one academic project for graduation with a UW faculty mentor. This was instituted so that all residents have the benefit of compiling, analyzing, synthesizing and presenting scientific data even when laboratory research time is not done. We also strongly believe that review of surgical outcomes and problem-based learning and improvement should be an ongoing pursuit that is woven into the fabric of a surgical career for residents and faculty. For this reason, we have incorporated review of our NSQIP and SCOAP data into our weekly M&M conference. Residents are also exposed to formal workshops designed to improve their teaching skills and provide a foundation in principles of adult education in a clinical setting. Excellence in teaching is an important expectation for both faculty and residents alike.

The Department is fortunate to have a number of faculty nationally renowned in the areas of surgical simulation, skills acquisition and robotics. We have a formal technical skills curriculum for our residents at all levels that include both open and laparoscopic operative techniques. This curriculum has been in place for over 15 years and encompasses the full range of topics from the ACS/APDS Surgical Skills Curriculum for Residents. Team training in our simulated OR began in 2008 and our simulated ICU and trauma bay open in 2009. Residents are assigned to faculty-directed technical skills labs designed to introduce operative techniques with both animate and inanimate models and surgical simulators. These labs occur at each year of training and are designed to be level-specific. Technical skills training is provided in ISIS (Institute for Simulation and Interprofessional Studies). This is a multi-disciplinary simulation center containing both high-tech and low-tech simulations to learn technical skills. Our technical skills curriculum has been in place for over 15 years

The program provides formal training seminars in Practice Management and the related business aspects of medicine as well as a Leadership curriculum. The six ACGME competencies have provided a clear framework for instruction in other areas of medicine such as palliative care, ethics and professionalism.

^ TOP

Residency Advisory Council

Surgery residents are intimately involved as representatives at the department, university and national level. Residents meet once per month with the chairman and the program director informally following Grand Rounds. The surgery department's Residency Advisory Council is composed of an elected member from each resident year. This council advises the Chairman and the Residency Program Directors on issues of concern and interest to residents. They meet regularly with the Program Directors to furnish counsel on matters related to the residency program. This furnishes a central mechanism for resident participation in the structure of their program.

Residents also serve on the department's Resident Education Committee where residents have input into issues ranging from the conduct of didactic teaching conferences and the educational content of the training program. Residents also serve on the Dean's Housestaff and Fellow Advisory Committees as well as on national bodies including the AAMC and the American College of Surgeons sections for residents.

^ TOP

Didactic and Clinical Teaching Activities

In addition to the usual bedside, clinic, and operating room teaching activities, a more formal approach is taken on two levels: department-wide and hospital-based.

Departmental Grand Rounds is held once per month at the University hospital. Department teaching conferences are concentrated in a four hour weekly block of time on Wednesday mornings known as the Surgical Science Series. This weekly conference is held at a central location and continental breakfast is served. The Surgical Science Series is an interactive conference headed by a faculty member expert in that area. The conference is divided into 2 sessions. The junior resident sessions focus on building a foundation in basic general surgical principles. The senior resident sessions focus on classical reviews of the surgical literature and evidence-based approaches to specific topics. Each session encompasses surgical DVD reviews of operative tips and ends with a mock oral board-type question. Wednesday morning is a time to enjoy the company of fellow residents and faculty from around the system, to catch up on the latest advances and help foster the camaraderie and fellowship that makes residency a positive experience.

In addition to department-wide conferences, each of the teaching hospitals has a weekly M & M review plus individual conferences based on the clinical emphasis of its services. These include Medical-Surgical GI, Pathology, Chest, Trauma, Vascular Surgery, Medical-Surgical Cardiac, Oncology, and a twice-weekly Intensive Care Unit Conference to name only a few.

Conference activities are supplemented by selected reference materials furnished by the department for residents' personal use. Fully equipped libraries and study areas are available to the residents at each training site.

^ TOP

Computer Technology

The University of Washington's nationally renowned program in healthcare informatics and proximity to cutting-edge computer companies such as Microsoft Corporation are evident in its adoption and creation of the latest technology for patient care. Our use of industry-leader Electronic Medical Record Systems is coupled with powerful UW-developed systems, such as UWCores (Computerized Resident Sign-out). UWCores is a Web-based rounding and sign-out system developed for residents that quickly and easily provides real-time data at the bedside. In addition, these systems provide computerized laboratory results, vital sign data, transcribed documents and even radiology images (via PACS) on physicians' internet-connected home computers as well.

Call rooms and all resident offices are equipped with fast Ethernet PC systems for quick access to patient care information. All of these machines are equipped with the most recent suite of word processing, presentation design and spreadsheet software. Our department maintains a set of the latest laptop PC and LCD projector systems for resident presentations. In addition, the UW Health Sciences Library provides free full-text access to a vast collection of electronic journals and access to the most popular Internet clinical resources, such as MEDLINE, Up-To-Date and MD Consult. Our resident intranet site condenses into a handy reference all of the learning objectives, clinical policies and resident survival tips, and makes them available online anytime. And finally, our institution now subscribes to the MedHub residency management system for on-line work hours entry, evaluations, scheduling and a host of other portal-based options.

^ TOP

Operative Experience

Our graduates finish with about 1000 major cases done as surgeon, with 254 done in the Chief year. Greater than 95% of all cases done in the system are done with the resident acting as primary surgeon. Residents do the range of basic general surgery cases, but also receive in-depth experience in cases typical of a tertiary referral center such as: liver resections, major pancreatic and esophageal resections, thoraco-abdominal resections for retroperitoneal sarcomas, thoracic, open and endovascular cases, endocrine cases (including a large number of thyroid and parathyroids), state-of-the-art training in breast disease and other areas of surgical oncology, colorectal and advanced GI surgery. Our residents spend about 25% of their residency time at Harborview Medical Center where they are trained in some of the best trauma and critical care in the world. Experience in Thoracic, Pediatric, Plastic Surgery (non principal components) and the other specialty areas round out the program. We take advantage of the varied strengths of our teaching hospitals to provide complete training for General Surgery and specialty residents with no areas of deficit. A major strength to our five hospital system rests in the focused experiences provided at each hospital.

^ TOP

Benefits

Vacation Policy
All residents are allowed three weeks (15 working days) annual leave. Vacations are taken during, or are coordinated with, the EVATS rotation. Exceptions are June 15 - July 15.

Fitness Facility
All residents are eligible for membership to the Intramural Activities Building (IMA). This facility is host to many indoor and outdoor activities including: studios for aerobic exercise and martial arts, archery, basketball, handball/racquetball courts, squash courts (International an North American), swimming pool, thirteen tennis courts (six night lighted), volleyball, ultimate frisbee, and a fitness center with over 300 pieces of free weights, cardio and single station weight machines. Memberships may be purchased on a single use, quarterly or annual basis.

updated 8/09