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In compliance with the ACGME minimum program requirements, the General Surgery
Residency Program at Medical College of Georgia requires its residents to obtain competencies
in the 6 areas listed below to the level expected of a new practitioner:
1. Patient Care that is compassionate, appropriate, and effective for the treatment of health
problems and the promotion of health
2. Medical Knowledge about established and evolving biomedical, clinical, and cognate
(e.g. epidemiological and social-behavioral) sciences and the application of this
knowledge to patient care
3. Practice-Based Learning and Improvement that involves investigation and evaluation of
their own patient care, appraisal and assimilation of scientific evidence, and
improvements in patient care
4. Interpersonal and Communication Skills that result in effective information exchange and
teaming with patients, their families, and other health professionals
6. All residents will prepare for and take the annual in-service examination sponsored by the
American Board of General Surgery. Residents scoring lower than 20th percentile will
participate in a weekly remediation group for the purpose of bolstering fund of
knowledge. Residents will prepare for, attend, and actively participate in this meeting.
Competency or Objective: Medical Knowledge
Documentation: In-Service Examination Scores
7. Residents are responsible for all histories and physicals as well as obtaining preoperative
consent under the supervision of the attending surgeon. Attending notes are added to
comply with the laws of Medicare/Medicaid/Tricare. The residents are to write daily
notes and orders, operative notes and orders. A discharge note and complete orders are to
be on the chart on the day of discharge prior to beginning daily duties, such as clinic or
operations. Discharge summaries and consultations are to be sent to referring
physicians. Rounds with faculty responsible for individual in house patients will occur
on a daily basis with the exception of weekends. Residents are to contact the appropriate
faculty member regarding any patient management questions.
Competency or Objective: Patient Care, Professionalism
Documentation: Faculty Evaluations, daily chart review by faculty.
8. For surgical cases in which the resident is the only resident and/or is the primary surgeon,
residents are expected to:
a. Have familiarized themselves with the patient, their history, and their physical
findings.
b. Done the appropriate reading prior to any operation
c. Have all necessary radiographic studies available for easy viewing in the O.R. prior
to the start of the case.
d. Dictate operative reports within 24 hours. If not dictated in 48 hrs, residents will lose
O.R. privileges
e. Write post-operative admission orders or outpatient orders including prescriptions
f. Enter cases into their own personal and the ACGME online case log in a prompt
manner (by the end of the week during which the case was performed).
Competency or Objective: Patient Care, Technical Skills, Institutional Requirements,
Delinquent Dictation Reports from Medical Records
Documentation: Faculty Evaluations, Biannual Resident Case Review
9. All residents are to adhere to the 80 hour work week policy described in the Section of
General Surgery Policy and Procedures portion of this Handbook. If the time limit is
reached, the resident should notify the chief resident and/or supervising faculty member,
sign-out his or her pager, and leave the facility.
Competency or Objective: ACGME/Institutional Regulations, Patient Care
Documentation: Time Logs, Time Log Audit Reports, ACGME surveys.
10. All residents are responsible for monitoring their level of fatigue. If a resident feels as if
their level of fatigue is compromising their ability to provide patient care, the resident
should notify the chief resident and/or supervising faculty member, sign-out his or her
pager, and go to an appropriate call bedroom (or home if near the end of shift and the
resident is not too compromised to drive) and sleep. The resident may return to duty after
a nap if he or she feels sufficiently rested and the shift is not completed or the 80 hour
work week limits have not been reached. If a resident is judged to be too fatigued to
adequately provide patient care by the chief resident and/or supervising faculty, even if
section didactic lectures by hospital legal counsel and VA Ethics Conference, Evaluations
from Faculty, Nursing Staff, Administrative Staff, Peers, Patients
16. During clinic, inpatient rounds, surgical procedures, and conferences, residents are
expected to take part in the teaching of students, interns, and more junior residents
including but not limited to discussions of normal anatomy, physiology and
embryogenesis; elements of surgical history taking; elements and technique of physical
examination; common signs and symptoms, their implications, and components of
appropriate evaluation; patient disease processes and congenital anomalies; rationale,
indications, and risks of surgical procedures and medical interventions; wound care, ,
sterile technique, sharps safety, universal precautions, and perioperative patient care.
Competency or Objective: Medical Knowledge, Interpersonal and Communication
Skills, Professionalism
Documentation: Student and Chief Resident Evaluations
17. Residents are required to participate in academic contributions to the Section of General
Surgery by seeking opportunities for involvement in research such as questioning
existing data through literature reviews, formulating research questions, and discussing
potential research projects with faculty members. Summarizing the history and course of
an interesting patient in the form of a case report is also acceptable. Production of one
publishable paper or poster presentation is required for each academic year. Residents
are required to understand and comply with the institutional Human Assurance
Committee Policies. For projects approved by the involved faculty member, residents can
access data from existing databases maintained by that faculty member or establish and
collect a novel data set from patient chart reviews. After data analysis and interpretation
residents are expected to present their findings via manuscript submission. Submission of
associated abstracts to scientific meetings is also encouraged. Dedicated research time
with which to perform basic science research is available, with one or two residents
routinely seeking this opportunity. Attempts will be made to accommodate all residents
that wish to pursue dedicated research efforts with protected time.
Competency or Objective: Medical Knowledge, Practice-Based Learning
Documentation: Submitted/Accepted Manuscripts and Abstracts
3.
4.
5.
6.
7.
8.
i. Invasive monitoring
j. Ventilatory support
k. Pressor management.
l. Percutaneous line placement, including interpretation of results.
m. Chest tube management.
n. Antibiotic use, including procedural prophylaxis.
Competency or Objective: Medical Knowledge, Patient Care, Technical Skill
Documentation: Faculty Evaluations, Morbidity and Mortality Reports
Experience and skill at preoperative assessment of patient risk factors, determination of
special evaluations that should be performed to optimize patient medical comorbid status
prior to an anesthetic.
Competency or Objective: Medical Knowledge, Patient Care, Technical Skill
Documentation: Faculty Evaluations, Morbidity and Mortality Reports
Knowledge and experience with the prophylactic measures utilized to prevent
complications such as
a. Wound infections
b. Atelectasis
c. Deep venous thrombosis
d. Pulmonary embolus
e. Delirium tremens
f. Bacterial endocarditis.
Competency or Objective: Medical Knowledge, Patient Care
Documentation: Faculty Evaluations, Morbidity and Mortality Reports
Radiological evaluation of acutely ill patients, including, but not limited to:
a. Evaluation of CXR for pneumonia, hemo/pneumothorax, pulmonary edema and
ARDS and other thoracoabdominal pathology.
b. Evaluation of abdominal plain films for bowel obstruction, free air, pneumatosis
intestinalis and other intraabdominal pathology.
c. Evaluation of head and neck CTs for head, face and neck trauma..
d. Evaluation of plain films of the extremities for fractures and soft tissue pathology.
e. Evaluation of extremity vasculature, central vasculature and the breast using
ultrasound.
f. Evaluation of chest and abdominal CT scans.
Competency or Objective: Medical Knowledge, Patient Care
Documentation: Faculty Evaluations
Emergency evaluation of surgical patients including triage, prioritization and appropriate
consultation.
Competency or Objective: Medical Knowledge, Patient Care, Technical Skill
Documentation: Faculty Evaluations
Familiarity with the art of collegiality and interaction between surgeons of various
specialties, and doctors in other fields and specialties who collaborate with us in the total
care of patients
Competency or Objective: Professionalism, Patient Care
Documentation: Faculty Evaluations
Knowledge of general surgical instruments and retractors, electrocautery safety, laser
safety, and precautions for preventing the spread of blood-borne illnesses