Curriculum
SURGICAL
INTERN (PGY-I)
During the
first year (PGY-I), emphasis is placed on the development of basic surgical
skills and pre- and postoperative care. Services covered are general
surgery and the surgical sub-specialties, including thoracic surgery, vascular
surgery, pediatric surgery, orthopedics, urology, neurosurgery, ENT, and
plastic surgery, both wards and clinics. Interns are under the direction
and teaching of the senior residents and the attending staff.
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SECOND-YEAR
RESIDENT (PGY-II)
The second-year
resident (PGY-II) is responsible for overall supervision of the inpatient
service to which they are assigned. The residents are expected to
see all patients on admission, to elicit a history and perform the physical
examination. The residents make daily rounds on their service and
discuss the patients with both the attending surgeons and the senior residents.
They assume a graduated responsibility for the therapeutic and diagnostic
procedures in the hospital, under the direction of the senior resident
and attending staff.
The residents
assist at operations and carry out procedures, under supervision, which
are commensurate with their level of training and experience; assist on
other cases from their service; and attend the surgical clinics.
The surgical residents are expected to understand surgical anatomy, pathology,
operative techniques and procedures, and the use of instruments related
to specific surgical procedures so that they may concentrate on developing
the basic surgical skills which give a firm foundation for sound surgical
practice.
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THIRD-YEAR
RESIDENT (PGY-III)
The third-year
resident (PGY-III) has increasing responsibilities. He/She provides
supervision to the junior house staff in the pre- and postoperative management
of patients and in the surgical outpatient department. In addition,
he/she performs the less complex surgical procedures, acquiring the dexterity
needed for a career in surgery. Operative responsibility is determined
by the resident's training and ability. During this time, he/she
rotates through the San Joaquin General Hospital, the University
of California, Davis, Medical Center and St. Joseph's Medical Center.
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FOURTH-YEAR
RESIDENT (PGY-IV)
In the fourth
year, the resident has increasing responsibility in the clinics and on
the ward. In this year, he/she performs surgical procedures of greater
magnitude. He/She provides senior resident responsibility in general
surgery, pediatric and thoracic surgery at the San Joaquin General Hospital,
St. Joseph's Medical Center, and the University of California, Davis, Medical
Center. The fourth year surgery resident functions as Acting Chief
Resident in Surgery at St. Joseph's Medical Center for a period of four
to six months. During the last quarter of the year, a gradual transition
toward responsibility of the Chief Resident is made. Teaching remains a
major component of the program.
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FIFTH-YEAR
RESIDENT (PGY-V) CHIEF RESIDENT
The Chief
Resident (PGY-V) spends his/her entire last 12 months at the San Joaquin
General Hospital on the surgical services. During this time, he/she
has complete responsibility for the management and the supervision of all
services. He/She schedules operations and notifies the attending
staff of their assignments. He/She directs treatment and maintains
discipline over all surgical interns and residents. He/She
conducts daily rounds, which are attended by the surgical interns and residents.
The Chief Resident assists in assigning journals and topics to the residents
and interns for the Journal Club. He/She is responsible for maintaining
minutes of this meeting as well as the Surgical Staff meetings. The
Chief Surgical Resident organizes and conducts the weekly surgical conferences
and panel discussions. He/She collects monthly statistics of operative
procedures, complications, deaths and autopsies. With consultation,
under the guidance of the Chief of Surgery, the Director of Surgical Education
and attending faculty, he/she is responsible for the supervision of all
major and minor surgical procedures.
During the
fifth year, he/she will perform approximately 300 to 500 major surgical
procedures and will supervise many additional procedures. During
the total five-year program, a finishing resident will have performed between
1,000 and 1,400 surgical procedures. These surgical procedures are
done under the direct supervision of the attending staff. In the
last months of the residency, the Chief Surgical Resident is given more
individual discretion in the care of his/her patients.
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EMERGENCY
DEPARTMENT
San Joaquin
General Hospital is the major emergency center of the San Joaquin County.
All PGY-I house staff rotate through this service. A proper mix of
responsibility and supervision makes this an extremely valuable rotation.
A full-time director supervises the training program. The Emergency Department
is the focus for the County Paramedic Training Program and serves as the
Primary Base Station Hospital for this effort.
The Emergency
Department sees over 3,000 patients monthly and 50,000 annually
in all disease categories.
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OUTPATIENT
CLINICS
Over 160,000
patient visits are made each year. Clinics are held regularly in
all major and sub-specialty services. House staff rotate through
these clinics on a regular basis.
Hospital outpatient
clinics include: Anesthesiology, Pulmonary, Endocrinology, Rheumatology,
Hematology/Oncology, Gastroenterology, Nephrology, Neurology, Cardiology,
General Surgery, Vascular Surgery, Orthopedic Surgery, Plastic Surgery,
ENT, Urology, Ophthalmology, and PM&R.
Additionally, there are clinics for
Audiology, Pain, and Addiction.
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INTENSIVE
CARE UNITS
The Intensive
Care and Coronary Care Units are jointly supervised by a full-time Director.
Each house officer follows his/her own patients in the Intensive Care Units.
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SURGICAL
RESIDENCY TEACHING PROGRAM
The Surgical
Department has specialty services in General Surgery, Thoracic Surgery,
Vascular Surgery, Neurosurgery, Urology, Orthopedics, Plastic Surgery,
Otorhinolaryngology and Ophthalmology. Residents have increasing
responsibility as they rotate through each service. They participate
actively in the teaching of interns and residents below their level on
the respective services.
The surgical
residents and interns are also assigned to each of the surgical clinics,
and the assigned surgical resident supervises the conduct of the clinics.
Attending staff surgeons are assigned to the respective clinics for teaching
and consultation. As in private practice, surgical clinics are popular
with the house staff because it is from these clinics that majority of
patients are admitted to the hospital for elective surgical care.
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