Department of Surgery
The five-year Residency Program in General Surgery
at the Nassau University Medical Center (NUMC)
fulfills the training requirements for certification
by the American Board of Surgery. It provides
a graded experience, with increasing responsibility
both in performance of surgical procedures and
in the pre-and postoperative management of surgical
patients.
The Department offers three Categorical and eleven
Preliminary Surgical PGY-1 positions in a comprehensive
teaching program designed to prepare the candidate
for further training in General Surgery or a related
specialty.
There are ten full-time surgeons in the Department,
which is headed by a full-time Chairman and a
Vice Chairman. The remainder of the staff includes
geographic full-time, part time and voluntary
Attendings, all of whom are Board Certified. In
addition to General Surgery, the Department includes
active specialty services in Trauma Surgery, Surgical
Critical Care, Surgical Endoscopy, Otorhinolaryngology,
Oncology, Neurosurgery, Vascular Surgery, Thoracic
Surgery, Bariatric Surgery, Colorectal Surgery,
Pediatric Surgery, Head and Neck Surgery, and
Hand and Plastic Surgery. The services are conducted
by full-time Attendings certified in their respective
specialties. All divisions and specialty sections
conduct separate outpatient clinics.
The Resident Teaching Faculty is selected to insure
positive orientation towards the Department's
training goals. No distinction is made between
private and service patients. Residents work under
close supervision with all types of clinical material
to permit progressive development of surgical
maturity, and are given total responsibility for
the care of private patients of the Faculty, commensurate
with the individual Resident's skill and experience.
Moreover, because Nassau University Medical Center
is a Level I Trauma Center in the New York Emergency
Medical Services System, Residents gain extensive
experience in the management of major trauma to
round out their training and fulfill the certification
requirements in general and specialty surgery.
First Postgraduate Year - During
the initial year of the program, Residents spend
approximately five months on a General Surgical
Service and two months on the Red (Trauma) Service.
While assigned to the Trauma Service, they also
participate in the management of patients with
Neurosurgical Trauma and Burns. There is a two
month assignment to the Surgical Intensive Care
Unit, a one month rotation to the Department of
Emergency Medicine and one to three months with
Anesthesiology and surgical specialties. In the
Intensive Care Unit, the Resident is responsible
for formulating and carrying out the care plan,
including learning the manual and technical skills
of critical care, under senior surgical supervision.
First-year Residents are responsible for the care
of all private and service patients under the
supervision of the full-time, part-time and visiting
staff of the Department's Resident Teaching Faculty.
Bedside teaching activities and conferences are
specifically organized for first-year Residents
and student clerks rotating through the service.
House Officers also participate in the management
of patients in the Outpatient Department, under
supervision, including discovery, formulation
of treatment plans and follow-up care for patients
after discharge. There also is opportunity to
evaluate and follow private patients in the offices
of the geographic full-time Faculty.
During a two-year cycle, the formal, didactic
educational program reviews the complete sphere
of surgical knowledge.
Second Postgraduate Year - During
the second year, Residents spend a third of their
time on specialty rotations, with one month each
on the remaining surgical specialties of Gynecology,
Neurosurgery, Urology and Orthopedic Surgery.
The rotation to Gynecology is designed to give
the Resident familiarity with routine gynecologic
diagnostic techniques, including laparoscopy,
culdocentesis, and dilatation and curettage. Residents
assist at major gynecologic procedures and perform
routine procedures under supervision. All other
specialty rotations involve similar experience
in the principles and actual operative techniques
of each respective discipline.
Four additional months are spent at our integrated
affiliate, South Nassau Communities Hospital (SNCH)
which has a full range of General, Thoracic, Vascular,
and Specialty Surgery. The remainder of the year
is spent on ICU and Trauma rotations at NUMC.
Third Postgraduate Year - During
the third year, the Resident spends one month
on rotation in the Cardiovascular-Thoracic service
at Long Island Jewish Hospital (LIJH). There is
also a one-month rotation at State University
of NY Health Sciences Center at Brooklyn (HSCAB)
during which Residents are trained in the principles
of Immunology and Organ Transplantation. The remaining
eight months are spent on the General Surgical
Services at NUMC or SNCH with each Resident assuming
an increased measure of responsibility for direct
patient care commensurate with demonstrated capabilities
and expertise.
Fourth Postgraduate Year - The
exposure to clinical surgery is intensified in
the final two years of training. Residents are
assigned to the General Surgical Service at NUMC
for the entire fourth year. During this time,
four months are spent as functional Chief Resident
on the Red (Emergency Trauma) Service, where Residents
assume complete responsibility for the management
of all torso and multiple system trauma and independently,
under guidance, decide on treatment plans and
operate on all patients admitted to that Service.
On the elective Surgical Services, Residents at
this level are responsible for supervision of
preoperative workups and the preparation of patients
for operation. Under the guidance of experienced
Attendings, there is opportunity to exercise independent
judgment and to acquire the skills required to
serve as Chief Resident. As part of their teaching
responsibility, Senior Residents actively participate
in the educational programs for third-year medical
students from State University of New York Health
Science Center at Stony Brook (SUNY HSCSB) and
New York College of Osteopathic Medicine (NYCOM),
who serve clerkships in the Department.
Fifth Postgraduate Year - The
Chief Resident is in charge of all patients on
his/her service, both private and service and,
with the advice of the Resident Teaching Faculty,
independently decides on treatment plans and operates
on all patients or assigns less complex problems
to junior Residents for operation. Chief Residents
are responsible for, and supervise the care of
all of the patients on their respective services
and they conduct the weekly Outpatient Care Clinics
from their Service where postoperative patients
are followed up and preoperative patients are
worked up and scheduled for operation. They also
may see private patients first in the offices
of the geographic full-time Faculty, where they
establish the diagnoses and institute treatment
plans. Chief Residents admit these private patients
to the hospital, with the concurrence of the faculty
and operate as the primary member of the operative
team, applying the experience, judgment and technical
skills attained in their previous years of training.
During this final year which is devoted entirely
to clinical surgery, the Resident performs major
abdominal, vascular, head and neck, thoracic,
and pediatric procedures. He/she is responsible
for conducting bedside rounds and for supervision
of the junior Residents in the Operating Room,
as well as for responding to requests for consultation
from other services and directing and participating
in the medical student teaching program. In addition,
the Department sends each Chief Resident to one
national surgical meeting and encourages all house
officers to attend local surgical meetings.
Basic Research Experience - The
Department includes a PhD Research Scientist on
its Faculty in charge of the Surgical Research
Laboratory. He encourages all Residents to participate
in basic and clinical research and will facilitate
research projects that the Resident is interested
in pursuing. All Categorical Residents may be
able to spend one year doing basic research either
at NUMC or with the approval of the Program Chairman,
at a research facility of their choice. This research
usually is accomplished between the second and
third postgraduate clinical years.
Patient Care - The Department
of Surgery is responsible for 50 clinical beds
for patients on the Residency Teaching Services.
These numbers are flexible and may be increased
as the need arises. There is a 12-suite operating
area where more than 8000 general surgical procedures
are performed annually. In the same period, the
hospital's active Emergency Department handles
more than 85,000 patient visits.
The 12-bed Surgical Intensive Care Unit for critically
ill patients is under the direction of Surgical
Intensivists who are board-certified in Critical
Care, ably assisted by a dedicated cadre of skilled
critical care nurses. An extensive array of pharmacologic,
endoscopic and manometric interventions are carried
out here by the house staff under close supervision.
With Laboratory, Radiology and Anesthesia support
services providing daily bedside rounding, this
rotation provides a unique opportunity to acquire
understanding of clinical surgical pathophysiology
and the interplay of the various critical care
fields.
Patient care responsibilities are shared by Osteopathic
Interns and Podiatric Residents not included in
the Residency Program. The presence of this additional
staff reduces the service responsibility.
House Staff Education - Full-time
and sessional members of the Resident Teaching
Faculty are actively engaged in house staff education
at the operating table, through didactic sessions
and at the bedside. Weekly conferences conducted
by various divisions of the Department are organized
around case material of current interest. Emphasis
is on Resident presentation and prepared discussions
by Attending staff. Rounding on both private and
service patients is formally done weekly with
the full-time Attending staff and the Surgeons
assigned to each service.
Regularly scheduled conferences include weekly
Mortality, Morbidity, Indication & Education,
Grand Rounds, Neoplastic Disease Rounds (Tumor
board), Surgical Topic Review Conference, Basic
Science Lectures, Journal Club, Multidisciplinary
Trauma conference, and formal lectures devoted
to in-depth review of specific surgical problems.
Guest speakers of national prominence are invited
twice monthly to speak on topics of current interest
in basic science or clinical practice.
While the Department maintains a close liaison
with the Endoscopy Service of the Division of
Gastroenterology, which performs a complete range
of fiberoptic and rigid endoscopic procedures,
Surgical Residents are trained in endoscopy under
the supervision of Surgical Endoscopists, learning
the manual skills of flexible laryngoscopy, bronchoscopy,
upper and lower gastrointestinal diagnostic and
therapeutic endoscopy, including colonoscopy.
The latest thoracoscopic and laparoscopic operative
procedures are learned and practiced by the Surgical
Residents. Exposure to the full spectrum of gastrointestinal
disorders is provided to Resident staff through
frequent informal meetings and a weekly joint
conference.
The Department conducts special programs for Preliminary
House Officers interested in other specialties
that require at least one year of General Surgical
Residency. Such a training program is structured
to emphasize a particular field of interest through
special assignments in the operating room, management
of patients with problems in that subspecialty,
and attendance at conferences in that division.
Facilities
Surgical Research - Experimental activities of
the Department are centered in a completely equipped
and adequately staffed surgical research laboratory,
which has facilities for handling over 60 dogs
and numerous small animals. Categorical Residents
are required to spend time in Surgical Research
as part of their training during the Residency
Program.
Non-Invasive Vascular Laboratory - Non-invasive
techniques for diagnosis and evaluation of peripheral
vascular disease are performed in the Department's
Non-Invasive Vascular Laboratory. This facility
is supervised by the Chief of the Vascular Surgical
Service, assisted by a full-time coordinator trained
in the sophisticated instrumentation required
for identification and assessment of arterial
and venous lesions. Doppler, Ultrasound, Real
Time B Mode Scanning, Plethysmographic and impedance
equipment are available to provide accurate data
regarding site and extent of vascular derangements.
Residents assigned to the Vascular Service gain
proficiency in applying non-invasive methodology
to aid patient selection for vascular reconstructive
surgery and to evaluate hemodynamic results.
Tumor Registry -The Hospital has a fully staffed,
well-organized computerized Tumor Registry for
data input, follow-up retrieval and analysis of
cancer cases. Individuals with special interest
in neoplastic diseases will find this the key
to a balanced, comprehensive cancer program.
Trauma Registry-The Department has established
a computerized registry for all major trauma
patients seen at the Nassau University Medical
Center. This will permit easy evaluation of
the efficiency of our management of these patients
and aid in the preparation of clinical papers.
Department of Surgery
Telephone: (516) 572-6703
|
