Level 1 Trauma

The Department of Surgery sought Level I Trauma Center designation to enrich our educational program and improve the quality of care of our injured patients in 1988. Using the optimal resources document of the American College of Surgeons, the 911 evaluation unit of the New York City Emergency Medical Service designated Mary Immaculate Hospital a Level I Trauma Center at that time and we continue in that capacity to the present.

The trauma center admits over 500 multiple injured patients annually and provides a rich hands-on experience for residents at all levels.

The trauma service is managed by the director of trauma surgery at Mary Immaculate Hospital and specially qualified trauma attendings in conjunction with the PGY-5 and PGY-4 assigned to Mary Immaculate Hospital. The latter two individuals are responsible for the direction of the trauma service in the absence of the trauma directors. They have independent operating privileges, and may initiate emergency surgery until the attending trauma surgeon arrives.

In order for a resident to be a member of the trauma service or work in the emergency department he/she must successfully complete BCLS, ACLS and ATLS (Advanced Trauma Life Support). These courses are provided at Saint Vincent Catholic Medical Centers during orientation prior to beginning the surgical residency.

Surgical Critical Care

The residents graduating from Saint Vincent Catholic Medical Centers Queens Surgical Program are very well trained in critical care. Starting at the PGY 1 level, daily exposure to critical care is offered to the residents. The chief resident at each hospital division is directly responsible for the care in the Surgical Intensive Care Unit (SICU) and rounds twice daily on all patients. He/she obtains report from the PGY III resident at Mary Immaculate Hospital Division who is assigned to the ICU for a period of five months and the PGY III at St. John's Queens Hospital. The PGY I residents round twice daily in the SICU with the surgical team and follow their own patients in the SICU.

The supervision and teaching is provided by the chief, division of surgical critical care. He is the director of surgery at Mary Immaculate Hospital and possesses a certificate of Added Qualification in Surgical Critical Care. Also, there is a Chief of the Surgical Intensive Care Unit at St. John's Queens Hospital Division.

The PGY III rotating in Mary Immaculate Hospital�s Surgical Intensive Care Unit manages an average of 160 patients over a five-month rotation. The residents spend one month in cardiac surgery and manage the patients in the Cardiac Intensive Care Unit at New York Medical College.

The critical care units at both hospital divisions are shared by surgery and medicine, and they function as distinct entities with a surgical and a medical chief supervising their own house staff. The primary responsibility of the surgical patients is clearly that of the surgical chief resident who exerts her/his judgment in calling medical colleagues for consultation.

Evaluations

The resident's evaluation is an essential part of the teaching process. Three parameters are reviewed by the faculty for each individual resident on a regular basis:

• Cognitive skills
• Technical skills
• Behavior and attitudes

The faculty is composed of Saint Vincent Catholic Medical Centers Queens members and meets twice yearly. There is a Surgical Education Committee composed of teaching staff and PGY V's and IV's which meets monthly and conducts an ongoing review of resident evaluations. The results of the deliberations are reported directly and confidentially to each resident by the chairman of the department and the associate program directors. The objective review of the parameters described (including results of the basic science and in/training examinations) will constitute the basis for promotion into the next level of training.

A "reverse evaluation" process is available to the residents in order to maintain ongoing quality of education in the department of surgery. Confidentiality is assured for both parties.

Hierarchy

The surgical residents are part of a team of which the chief resident is the "captain." All disciplinary matters will be handled by him. If the matter cannot be resolved at the resident level, it will be referred to the director of surgery at that facility. A counseling program is available and residents are encouraged to use it.