Concept of Program

The surgical residency program at Saint Vincent Catholic Medical Centers Queens is designed to train well-rounded general surgeons who will be able to meet the standards of the American Board of Surgery. The residents have the unique opportunity, because of the physical structure of the program, to be extensively exposed to both community and academic surgery.

PGY-1:
During the first year, the resident is responsible for the primary evaluation of all surgical admissions (elective, emergency and trauma patients alike); writing orders on these patients under the supervision of the senior and chief residents as well as under the supervision of the attending staff. When operative procedures are indicated, they discuss these with the senior and chief residents including risks and benefits. When surgery is performed, the first year residents perform the simpler operations with the assistance of the more senior resident or attending. Administrative responsibilities at the PGY-1 level consist of learning the essentials of accurate record keeping, obtaining and documenting a pre-operative informed consent; and other essential tasks in an era of ever-growing quality assurance evaluation.

PGY-2:
The second year residents have increasing responsibilities in general surgery and with the management of critically ill patients. This increasing responsibility occurs at the three stages of patient management. Pre-operatively, their patient assessments are more readily accepted without modification by their supervisors (senior residents and attending surgeons). Their operative experience broadens significantly both in number and complexity of the procedures performed. Post-operatively, they are responsible for the patients' daily needs and are allowed more independence in decision-making. Nonetheless, the PGY-2 residents must confer with the senior residents and staff surgeons prior to making any major change in patient management. On all rotations and services, the PGY-2 residents are supervised by more senior residents and the faculty of the respective services.

PGY-3:
The third year residents reach a different status by virtue of their experience and acquired knowledge. They are administrators on their respective clinical assignments, responsible for data collection of the service and for clinical presentations at the weekly morbidity and mortality conferences, at which time statistics of all the services are presented. These residents are expected to analyze cases in depth, discuss viable therapeutic options, and begin to exercise independent clinical judgment. They are a vital link between the junior and the senior residents for information and teaching. During the first three years of training, the residents progress through more complex procedures. This is regularly monitored and documented on an updated credential sheet. On the general surgery rotations at Mary Immaculate and St. Johns Queens Hospital, PGY-3 residents assist in the supervision of PGY-1 and PGY-2 residents: their own activities are supervised by the PGY-4 and PGY-5 residents, and the teaching faculty and attending staff. While rotating at Mary Immaculate Hospital in surgical intensive care and at New York Medical College, Westchester County Health Care Corporation, in cardio-thoracic surgery, the residents are under the supervision of more senior residents and the surgical attendings.

PGY-4:
During the assignment to the general surgery service, the fourth year resident is responsible for the trauma service under the supervision of the chief resident and the general surgical services.  At this level, the residents are considered mature and skilled surgeons, and are called upon for consultation by the other clinical departments and the emergency department. As appropriate, supervision is provided by the faculty and attending staff.

PGY-5:
The chief resident is responsible for general surgical services at Mary Immaculate and St. Johns Queens Hospitals. Clinical and administrative responsibilities are quite extensive and involve the total management of patients, teaching junior residents, and organizing the conference and call schedule. The chief resident is therefore expected to be a mature and informed surgeon with good psychomotor skills, a teacher, a diplomat, and an administrator, as well as clinical scientist with an open mind. Faculty and attending staff supervision is provided to the chief resident on an as-needed basis.